Anatomical study and clinical outcomes of endoscopic transoral surgery for benign salivary gland tumors in the parapharyngeal space.

The existing literature provides little insight into the efficacy of transoral endoscopy in exposing benign tumors originating from salivary glands in the parapharyngeal space at the parotid gland base and resecting part of the deep lobe with a safe margin. This study aims to investigate the efficacy of the endoscopic transoral approach for the visualization and resection of such tumors. Through transoral endoscopic cadaveric dissections and surgical procedures, we examined the anatomical structures of the parapharyngeal space and the deep lobe of the parotid gland, identifying key anatomical landmarks. We conducted a retrospective analysis of 19 patients with benign salivary gland-derived tumors in the parapharyngeal space who underwent transoral endoscopic resection. Intraoperative visualization of the tumor pedicle and the deep lobe of the parotid gland was successfully achieved in all cases, allowing for resection with safe margins. During a median follow-up period of 54.0 months, imaging revealed no signs of recurrence. Endoscopic transoral approach provides effective visualization of the deep lobe of the parotid gland and the medial portion of the parotid bed from the parapharyngeal space. Benign tumors of salivary gland-derived in this area can be well exposed and safely resected with adequate margins.

Exploring the evolution of ecosystem health and sustainable zoning: A perspective based on the contributions of climate change and human activities.

Maintaining ecosystem health (EH) in watersheds is crucial for building a national pattern of ecological security. However, a comprehensive diagnosis of watershed EH and an exploration of its driving mechanisms are still lacking. This study proposed an EH assessment model from a vitality-organization-resilience-service-environment (VORSE) perspective. Taking the Yellow River Basin of Shaanxi Province (YRBS), China, as a research object, the spatiotemporal evolution trend of EH from 2000 to 2020 was quantified. At the same time, we also quantified the respective contributions of climate change (CC) and human activities (HA) to the EH dynamics based on residual analysis. The results showed that EH in the YRBS increased by 11.80 % from 2000 to 2020, and the spatial distribution of the EH was higher in the southern region than in the northern part. At the pixel scale, areas with improving trends accounted for 90.57 % of the YRBS, while 9.43 % deteriorated, with the improving areas mainly in northern Shaanxi and the deteriorating areas in the Guanzhong region. The correlation between the EH and precipitation was primarily positive, while the correlation between the EH and temperature was mainly negative. The residual analysis showed that the contribution rate of CC to EH changes was 78.54 %, while that of HA was 21.46 %, indicating that CC was the dominant driver of EH changes in the YRBS. Specifically, 82.64 % of the improvement in EH was attributed to CC and 17.36 % to HA. Conversely, 65.30 % of the deterioration in EH was attributed to CC and 34.70 % to HA. Furthermore, CC, HA, and CC&HA dominated EH changes in 26.85 %, 3.77 %, and 69.38 % of the YRBS area, respectively. In addition, the Hurst exponent analysis identified six types of future EH development scenarios, each requiring different restoration strategies. This study provides valuable insights for future EH diagnosis, EH restoration efforts, and the formulation of sustainable development goals in other watersheds.

[Clinical analysis of 12 cases of solitary fibrous tumors in nasal cavity, sinuses and skull base].

Objective:To summarize and analyze the clinical manifestations, diagnosis and management and prognostic features of solitary fibrous tumor（SFT） in nasal cavity, sinus and skull base. Methods:The clinical data of 12 patients with STF from nasal cavity, sinus and cranial base admitted to the Affiliated Hospital of Qingdao University from April 2014 to January 2022 were retrospectively analyzed, including 4 patients admitted to the department of Otolaryngology head and neck surgery and 8 patients admitted to the department of skull base surgery The clinical characteristics, diagnosis, management and prognosis were analyzed. Results:Twelve patients were included in this research, including 7 males and 5 females. All patients received surgical treatment, and 4 patients also received postoperative adjuvant chemoradiotherapy. After follow-up for 12-60 months, 4 patients with adjuvant radiotherapy and chemotherapy had a good prognosis, and among 8 patients who did not receive radiotherapy and chemotherapy, 6 patients had good prognosis and 2 patients showed relapse. Four patients with a history of recurrence of SFT after surgery were admitted to our hospital for surgical treatment, in which 1 patient had relapse after surgery, and none had metastasis. Nasal cavity and sinus to skull base SFT is rare. The most effective treatment for this disease is surgical resection, and postoperative adjuvant chemoradiation and long-term follow-up can achieve a better prognosis. En bloc resection is the key to treatment success.

Diagnostic significance of peripheral blood indices for eosinophilic chronic rhinosinusitis in Chinese adults.

OBJECTIVE: Eosinophilic chronic rhinosinusitis (eCRS) is a refractory subtype of CRS. This study aimed to compare the differences in clinical features and peripheral blood indices between eCRS and non-eCRS Chinese patients and identify the predictive factors for eCRS. METHODS: In this study, a total of 1352 patients with CRS were enrolled and divided into eCRS and non-eCRS groups based on the degree of eosinophilic infiltration in histopathology, and their demographic and clinical characteristics, as well as peripheral blood indices, were compared. Logistic regression analysis was used to identify the factors associated with eCRS, and the optimal cut-off values of predictors were determined using subject working curves. RESULTS: As compared to those in the non-eCRS group patients, the proportion of males, age, proportion of smokers, peripheral blood eosinophil count, and erythrocyte count were significantly higher, while the peripheral blood neutrophil count, platelet count, neutrophil/lymphocyte count ratio (NLR), platelet/lymphocyte count ratio (PLR), and neutrophil × platelet/lymphocyte count ratio (SII index) were significantly lower in the eCRS group patients. Logistic regression analysis showed that age, peripheral blood neutrophil count, eosinophil count, and platelet count were independent predictors of eCRS, and eosinophil count > 2.05 × 108/L could be used as a diagnostic marker for eCRS with a sensitivity and specificity of 87.1% and 78.3%, respectively. CONCLUSIONS: There were significant differences in the clinical features of eCRS and non-eCRS patients. Peripheral blood eosinophil count could early and more accurately predict eCRS.

Association of Complication Rates and Intensive Care Unit Use With Sinonasal and Skull Base Malignancies: A Propensity Score Matching Analysis.

Background: Patients with sinonasal and skull base malignancies experience many types of complications after surgery. The intensive care unit (ICU) provides a high level of care for these patients; however, the effect of ICU care on complication rates remains unclear. Methods: Between November 2014 and November 2022, we retrospectively analyzed 151 patients with sinonasal and skull base malignancies. Fifty-six of these patients were admitted to the ICU and 95 were admitted to the non-ICU after surgery. Propensity score matching (PSM) was performed to balance baseline characteristics. The complication rates of the ICU and non-ICU groups were compared. Results: Before PSM, the complication rate was 28.5%. Patients admitted to the ICU had a higher incidence of medical complications (P = .032). Orbital injury (n = 9) and diplopia or visual changes (n = 9) were the most common surgical complications, whereas respiratory tract infections (n = 7) were the most common medical complications. After PSM, the incidences of surgical, medical, and all complications in the ICU and non-ICU groups were 23.8% and 19.0% (P = .791), 16.7% and 9.5% (P = .520), and 38.1% and 26.2% (P = .350), respectively. Conclusions: This preliminary study revealed that ICU admission did not reduce the complication rate of patients with sinonasal and skull base malignancies. Further studies are required to validate these findings and clarify the potential role of the ICU.