[Clinical evaluation of the styloid process by plain radiographs and three-dimensional computed tomography].

OBJECTIVE: To investigate the relation between radiological and clinical diagnosis for Eagle's syndrome and to evaluate the value of plain radiograph (PR) and three-dimensional CT reconstructional image (3-DCT) of styloid process (SP). METHOD: The length of the 144 SPs from the PR was recorded and the palpation of the SP in tonsillar fossa was carried out in 113 patients with suspective Eagles syndrome. Twenty-three of 113 patients also underwent 3-DCT, so that the length and angulation of the 30 SPs were measured. RESULT: Seventy-eight of 113 patients (31 men and 47 women) were diagnosed as having Eagles syndrome. The age ranged from 32 to 68 years (average age: Forty-two years). A good agreement between the PR and the palpation was determinated, Kappa coefficient was 0.58. The difference value of the length of 30 SPs between the PR and the 3-DCT was (1.59 +/- 1.32) mm, and there were statistically significant difference of the length (t = 6.64, P < 0.01) on the length of SP between the PR and the 3-DCT. Positive correlation between the PR and the 3-DCT was found to be statistically significant (r = 0.982 4 +/- 95% confidence interval: 0.9631, 0.9917). The mean of medial angle of SPs was (25.60 +/- 2.56) degrees in patients with positive palpation and (15.42 +/- 2.79) degrees in those with negative palpation, respectively (P < 0.01) and the mean of anterior angle of SPs was (16.86 +/- 4.83) degrees in patients with positive palpation and (12.71 +/- 3.39) degrees in those with negative palpation, respectively (P < 0.01). The abnormal medial and anterior angles of unilateral SP without more than 30mm long was also objectively diagnostic of SPS in 8 patients with positive palpation. Four patients, whose elongated SP is too tenuous to be palpated preoperatively, underwent intraoral styloidectomy because of the fact that 3-DCT showed the tip of SPs medial and anterior deflexion. CONCLUSION: Despite magnifying image, the PR of SP is enough to diagnose Eagle's syndrome for the majority of cases. 3-DCT allows precise measurement of the length and the angulation of SPs, it is the best for the complementary purpose to the PR and to the selection of surgical approach in some cases.

[Morphologic quantitative analysis of nucleus in laryngeal squamous cell carcinoma with Automatic Image Cytometry].

OBJECTIVE: Analyze morphological character of nucleus in laryngeal squamous cell carcinoma with Automatic Image Cytometry, discuss the relation between morphological parameters and tumor clinic. METHOD: We discussed morphological character of nucleus from 83 cytology specimens which included 21 laryngeal squamous cell carcinomas and 20 benign diseases with Automatic Image Cytometry. RESULT: Nucleus from laryngeal squamous cell carcinomas had bigger nuclear area nuclear radius, nuclear perimeter and more DNA content per nuclear area than from laryngeal benign diseases, furthermore, these parameters showed distinct difference in different anatomic positions and different pathologic types. We concluded that nuclear areas of nucleus in S phase from laryngeal squamous cell carcinomas are more than 77 microm, Second Order Regression Equation(Y =aX2+bX+c) described scattered diagrams between mean nuclear radius and nuclear area of laryngeal cytology specimens with different larynx pathology and different cell phase in cell cycle. The more the value of coefficient "c"(c>1.82) and the less the value of coefficient "b" (b< 0.045), the more the probability of malignant tumor diagnosis. CONCLUSION: Morphologic quantitative analysis parameters, such as nuclear area, mean nuclear radius, nuclear perimeter and DNA content per nuclear area, are suitable for diagnosing laryngeal squamous cell carcinomas. They could offer valuable morphologic quantitative criterion in assisting cytology diagnose and evaluating tumor clinical characters when these parameters associated with nuclear area of nucleus in S-phase and the coefficients of Second Order Regression Equation.

[A comparison of the closed reduction of arytenoid dislocation under indirect and direct laryngoscope].

OBJECTIVE: To assess the curative effects of the dislocation of cricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized to the closed reduction of the displaced arytenoid under local anesthesia. METHOD: 23 patients who underwent the reduction for dislocated arytenoid by IL or DL from Jan 1991 to Jun 2001 have been reviewed, the records were made as follows: The duration of the laryngeal injury; The number of times for the reduction; The side-effective following the treatment; The period of complete return of normal voice. The relation between the duration of the laryngeal lesion and the period of the voice rehabilitation has been studied. RESULT: 13 patients and 10 patients were respectively arranged to perform the reduction by IL and DL. Except that a comparison on the times of the reduction is significantly different, the difference between IL group and DL group in the course and the period of voice rehabilitation, as well as sore throat after the manipulation are not significant. The patients' voice recovery is positively relative to their course, regardless of IL or DL, group. CONCLUSION: The recovery of normal voice is obviously affected by the duration of arytenoid dislocation. The reduction by IL is as successful as by DL in the treatment of arytenoid dislocation. It is very suitable for the patient having his injury for a longer time to receive the reduction by DL.

[The diagnosis of ectopic thyroid].

OBJECTIVE: To explore the diagnosis method of ectopic thyroid. METHOD: 11 cases with ectopic thyroid were analyzed. RESULT: 11 cases were diagnosed by 99mTc scan, 7 cases were complicated by hypothyroidism, 3 cases were diagnosed by ultrasonography and autopsy else. CONCLUSION: 99mTc scan is the best method and the biopsy is an accurate method to diagnose ectopic thyroid.

[The peri-operative cure of patients suffered allergic purpura before tonsillectomy].

OBJECTIVE: To explore the peri-operative cure of patients suffered allergic purpura before tonsillectomy. METHOD: To review the perioperative cure of 7 cases operated on tonsillectomy in retrospect. RESULT: 7 cases didn't bleed during peri-operation and were discharged from hospital after recovery. CONCLUSION: The operation was arranged in allergic purpura catabasis and the acute inflammation controlled. The patients should avoid to contact all kinds of doubtful predisposition and were administered antihistamin, anti-inflammatory agent, drugs decreasing capillary permeability during peri-operation.

[Expression of extracellular matrix glycoprotein tenascin in the laryngeal cancer].

OBJECTIVE: Tenascin (TN) is an extracellular matrix glycoprotein upregulated in some pathological processes. In the study, we investigated its expression in the laryngeal epithelial lesions and explored the relation of TN with the laryngeal tumor. METHOD: Expression of TN were examined by immunohistochemistry SP method in sections of laryngeal lesions from 4 leukoplakia, 8 papilloma, 7 in situ carcinoma and 39 invasive squamous cell cancer patients. An automatic image analyzer was used to analyze the staining results. RESULT: No expression, of TN was found in the extracellular matrix of papilloma or leukoplakia. Only a weak stain was found at their epithelialstromal interface in seldom sections. There was a weak extracellular matrix stain of TN in all situ carcinoma and the stain difference between in situ cancer and papilloma or leukoplakia was significant (P < 0.001). There was a much stronger extracellular matrix stain in invasive cancer than that in situ cancer (P < 0.01). The differences of TN expression among different T stage and histological grade of invasive cancer were insignificant (P > 0.05). But there was a significantly stronger TN stain in the cases with lymph node metastasis than those without lymph node metastasis (P < 0.01). CONCLUSION: TN expression may be involved in the oncogenesis and metastasis of laryngeal squamous cell cancer. It was implicated that the risk of pre cancerous lesions progress to cancer.

[DNA quantitative analysis of head and neck tumor].

OBJECTIVE: This research discussed the diagnostic value of cellular quantitative analysis in head and neck tumor. METHOD: We analysis quantitative parameters of 23 malignant tumors and 20 benign diseases with automated DNA image cytometry, they are the DNA Index (DI), S-phase Fraction (SPF), Proliferation Index (PI) and 5c Exceeding (5c Ex). RESULT: The masculine rate of cellular quantitative analysis and conventional method are 76.92% and 50.00%. The value of SPF, PI and 5c Ex are 14.05%, 19.59% and 1.59% in malignant tumor, respectively. The parameters of SPF and PI showed distinct difference in the area of malignant tumor than the 1 cm sideward area of tumor and the edge of tumor. CONCLUSION: Automatic DNA image cytometry has higher masculine rate of malignant tumor than conventional method in early detection of tumor. The cellular quantitative parameters, such as SPF, PI and 5c Ex, are able to guide clinical work, specially in diagnosing of head and neck tumor, estimating biological character of malignant tumor and evaluating the area of excision.