The Study on Prognosis in Patients with Adenoid Cystic Carcinoma of the External Auditory Canal.

BACKGROUND: Adenoid cystic carcinoma of the external auditory canal is a rare primary malignancy, and surgery is the primary management strategy. This study aims to optimize management strategies and improve prognosis of adenoid cystic carcinoma of the external auditory canal. METHODS: Seventeen patients with adenoid cystic carcinoma of external auditory canal who had been admitted to a single institution from January 2008 to March 2019 were recruited and retrospectively reviewed. Among patients with T1 tumors, 2 underwent local external auditory canal resection, 1 received lateral temporal bone resection+superficial parotidectomy. Among patients with T2 tumors, all 5 patients underwent lateral temporal bone resection+superficial parotidectomy. Among patients with T3 tumors, 3 underwent subtotal temporal bone resection+superficial parotidectomy, 2 underwent subtotal temporal bone resection+superficial parotidectomy+radiotherapy, and 1 underwent extended temporal bone resection+superficial parotidectomy+radiotherapy. Among patients with T4 tumors, 2 underwent subtotal temporal bone resection+superficial parotidectomy and 1 underwent extended temporal bone resection+total parotidectomy+radiotherapy. RESULTS: The common manifestations included otalgia (82.4%), hearing loss (23.5%), external auditory canal mass (23.5%), otorrhea (17.6%), and aural fullness (5.9%). In the study, 5/17 (29.4%) patients had been misdiagnosed preoperatively, 5/17 (29.4%) patients revealed local recurrence, and 3/17 patients (17.6%) were identified with distant metastasis postoperatively. The 3- and 5-year overall survival rates were 88.2% and 82.3%, respectively. There was no significant difference in overall survival (P=.746) and disease-free survival (P=.933) between patients receiving different surgical approaches. Three out of 17 patients (17.6%) died of T2, T3, and T4 diseases, respectively. CONCLUSION: Otalgia is the most common manifestation of adenoid cystic carcinoma of the external auditory canal, and misdiagnosis is frequently encountered. Surgery is the preferred therapy, and local resection is associated with relapse, lateral temporal bone resection is strongly recommended in patients with early-stage tumor. Regular follow-up should be routinely conducted postoperatively to early identify local recurrence.

[The treatment of trigeminal neuralgia by resecting maxillary nerve and infraorbital nerve under the endoscopy at the pterygopalatofossa through approach to the maxillary sinus].

OBJECTIVE: This paper presents a method for treating maxillary neuralgia, the second division of trigeminal nerve. METHOD: One hundred and thirty six cases with 136 trigeminal neuralgia were treated from 2004 to 2011. All patients were treated with endoscopic surgery at the pterygopalatofossa through approach to the maxillary sinus for resecting maxillary nerve and infraorbital nerve. RESULT: One hundred and eighteen patients were relieved after operation and no recurrence of neuralgia was occurred after 2 to 8 years of follow-up. CONCLUSION: This method had the advantages of avoiding to operate craniotomy with no complications, which was performed easily with valid efficacy.

Expression of VEGF-C/VEGFR-3 in human laryngeal squamous cell carcinomas and its significance for lymphatic metastasis.

OBJECTIVES: Expression of vascular endothelial growth factor C (VEGF-C)and vascular endothelial growth factor receptor-3 (VEGFR-3) in laryngeal squamous carcinoma and its relationship to lymph node metastasis were investigated. METHODS: VEGF-C and VEGFR-3 gene expression in 30 cases of normal laryngeal mucosa tissue (NLM), primary laryngeal carcinoma cell carcinomas (PLC) and cervical lymph nodes (CLN) was examined by reverse transcription polymerase chain reaction (RT-PCR). Protein levels of VEGF-C expression were determined by immunohistochemical staining in 60 cases of PLC. RESULTS: Expression of VEGF-C and VEGFR-3 different among NLM, PLC and CLN in the same patient. In PLC, expression was significantly higher in lymph node positive group than in the lymph node negative group and associated with histological grade of differentiation; Expression of VEGF-C and VEGFR-3 was not linked with age, sex, site or T stage. CONCLUSIONS: A close correlation was found between VEGF-C/VEGFR-3 expression and lymph node metastasis in PLC, suggesting a role in metastasis of laryngeal carcinomas.