OBJECTIVE

To report a case of lacrimal gland adenoid cystic carcinoma in a 37-year-old female managed with globe-sparing surgery and adjuvant radiotherapy.

This is a case report.

This report details a 37-year-old Filipino female who presented with a 4-month history of right eye pain and non-axial proptosis. Computed tomography (CT) scan showed a right heterogenous extraconal mass with orbital roof remodeling. Lateral orbitotomy with excision biopsy was performed. Final histopathologic diagnosis of adenoid cystic carcinoma of the lacrimal gland was made based on the classic morphology and distinct arrangement of the neoplastic cells. Systemic surveillance revealed absence of metastases. Patient completed adjuvant radiotherapy four months post-operatively. Vision was preserved at 20/20 without signs of tumor recurrence five months post-operatively.

Adenoid cystic carcinoma is an aggressive lacrimal gland malignancy; hence, meticulous examination and high index of suspicion cannot be over-emphasized. Globe-sparing surgery with adjuvant radiotherapy could significantly preserve quality of life.

OBJECTIVES: This study aims to compare the effects of two orthodontic treatment modalities for skeletal class Ⅲ malocclusion on specific changes in airway volume, morphology, palatal angle, mandibular rotation, and bone displacement. Results provide scientific evidence for the selection of orthodontic treatment plans and reduce the risk of developing obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Thirty-six patients diagnosed with skeletal class Ⅲ malocclusion at the Department of Orthodontics, the Affiliated Stomatological Hospital of Nanjing Medical University from September 2018 to December 2023 were divided into two groups: orthodontic-orthognathic treatment group (18 patients) and camouflage orthodontic treatment group (18 patients). Changes in airway volume, cross-sectional area, palatal angle, mandibular, and tongue positions were observed through pre- and post-operative cone beam computed tomography and 3D cephalometric measurements. RESULTS: In the camouflage orthodontic treatment group, nasopharyngeal volume and oropharyngeal volume statistically increased after treatment (P<0.05). In the orthodontic-orthognathic treatment group, changes in nasopharyngeal volume, nasopharyngeal airway, distance from posterior tongue to pharyngeal wall, palatal angle, mandibular rotation, and hyoid bone displacement were statistically significant after surgery (P<0.05). In the comparison between the two groups after treatment, changes in the distance from posterior tongue to pharyngeal wall, palatal angle, and distance from hyoid bone to sella turcica point were statistically significant (P<0.05). CONCLUSIONS Patients in the orthodontic-orthognathic treatment group showed significantly greater changes in oropharyngeal cross-sectional area, palate angle, and tongue position compared with patients in the camouflage orthodontic treatment group. As individuals susceptible to OSAHS often exhibit mandibular retrusion and decreased minimum airway cross-sectional area, special attention should be paid to airway morphology changes when adopting orthodontic-orthognathic treatment to avoid adverse consequences.
Humans ; Hyoid Bone/diagnostic imaging* ; Malocclusion, Angle Class III/therapy* ; Male ; Female ; Cone-Beam Computed Tomography ; Cephalometry ; Orthodontics, Corrective/methods* ; Adult ; Mandible ; Pharynx/diagnostic imaging* ; Sleep Apnea, Obstructive/etiology* ; Orthognathic Surgical Procedures

OBJECTIVE

To report a case of Mucosa-Associated Lymphoid Tissue (MALT) lymphoma of the nasopharynx in a young woman, and its clinical presentation, laboratory findings and management.

Design: Case Report Report

Setting: Tertiary Government Training Hospital

Patient: One

A 21-year-old woman with a four-month history of right lateral neck mass managed as a case of clinically diagnosed pulmonary tuberculosis consulted us. Nasal endoscopy showed an erythematous, non-ulcerating exophytic mass in the nasopharynx. Histopathologic, immunohistochemical and PET-CT imaging studies confirmed MALT. She completed seven sessions of chemotherapy and is currently in complete remission.

MALT lymphoma of the nasopharynx is rare and may mimic other head and neck tumors both clinically and histologically. A high index of suspicion, thorough examination of Waldeyer’s ring, and confirmatory immunohistochemistry are essential for timely and accurate diagnosis of this uncommon but treatable malignancy.

OBJECTIVE: To observe the clinical efficacy of deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture for adenoid hypertrophy (AH) in children. METHODS: Seventy-two children with AH were randomly divided into an observation group (36 cases, 5 cases dropped out, 1 case was eliminated) and a control group (36 cases, 4 cases dropped out, 2 cases were eliminated). The observation group received deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture. The needle depth of Xiaguan (ST7) was 20-30 mm. Electroacupuncture was applied at Xiaguan (ST7), Yingxiang (LI20), Yintang (GV24⁺), Baihui (GV20), with continuous wave, in frequency of 2 Hz. Warm acupuncture was applied at Zusanli (ST36). The treatment was performed 30 min each time, once a week for 12 weeks. The control group was treated with mometasone furoate aqueous nasal spray, one spray per nostril each time, once a day for 12 weeks. The symptom score, adenoid-to-nasopharynx ratio (A/N), and 18-item health-related quality-of-life survey for children with obstructive sleep apnea (OSA-18) score were observed before and after treatment in the two groups, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the total scores of symptom, A/N, and OSA-18 scores were decreased compared with those before treatment in both groups (P<0.01), the above indexes in the observation group were lower than those in the control group (P<0.01, P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was higher than 83.3% (25/30) in the control group (P<0.05). CONCLUSION Deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture could effectively improve symptoms, reduce adenoid volume, and improve the quality of life in children with AH.
Humans ; Male ; Female ; Acupuncture Points ; Electroacupuncture ; Acupuncture Therapy ; Child ; Child, Preschool ; Hypertrophy/therapy* ; Adenoids/pathology* ; Treatment Outcome ; Combined Modality Therapy

OBJECTIVE: To observe the clinical efficacy of auricular electroacupuncture for post-stroke dysphagia in the pharyngeal phase. METHODS: Eighty-two patients with post-stroke dysphagia in the pharyngeal phase were randomized into an auricular electroacupuncture group (41 cases) and a swallowing electrical stimulation group (41 cases, 1 case dropped out). In the auricular electroacupuncture group, electroacupuncture was applied at auricular points, i.e. Xin (CO₁₅) and Yanhou (TG₃), using disperse-dense wave, in frequency of 2 Hz/10 Hz, 30 min a time. In the swallowing electrical stimulation group, swallowing electrical stimulation was delivered for 30 min a time. Both groups were treated once daily for 4 weeks. The functional oral intake scale (FOIS) grade, as well as the hyolaryngeal complex displacement, the pharyngeal constriction rate (PCR) and the pharyngeal delay time (PDT) under video fluoroscopic study of swallowing (VFSS) were observed before and after treatment, and the clinical efficacy was evaluated in the two groups. RESULTS: Compared before treatment, the FOIS grade was improved (P<0.01), the forward and upward displacement amplitude of hyoid bone and thyroid cartilage was increased (P<0.05), and the PCR and PDT were decreased (P<0.05) after treatment in the two groups. After treatment, compared with the swallowing electrical stimulation group, the FOIS grade was superior (P<0.01), the upward displacement amplitude of hyoid bone and thyroid cartilage was larger (P<0.05) and the PCR and PDT were lower (P<0.05) in the auricular electroacupuncture group. The total effective rate was 85.4% (35/41) in the auricular electroacupuncture group, which was higher than 62.5% (25/40) in the swallowing electrical stimulation group (P<0.05). CONCLUSION Auricular electroacupuncture can effectively trigger pharyngeal initiation and improve post-stroke dysphagia in the pharyngeal phase.
Humans ; Electroacupuncture ; Male ; Deglutition Disorders/etiology* ; Female ; Middle Aged ; Aged ; Stroke/physiopathology* ; Pharynx/physiopathology* ; Acupuncture, Ear ; Acupuncture Points ; Deglutition ; Treatment Outcome ; Adult

Objective:To explore the hypothesis of "pathogen storage pool" by analyzing the local microbial community of adenoids. Methods:Under the guidance of a 70° nasal endoscope, sterile swabs were used to collect secretions from the adenoid crypts of the subjects. The samples were sent to the laboratory for DNA extraction and standard bacterial 16S full-length sequencing analysis. Results:At the species level, the top three microbial communities in adenoid crypts were Bacillus subtilis（18.78%）, Fusobacterium pyogenes（11.42%）, and Streptococcus pneumoniae（9.38%）. Conclusion:The local microbial community of adenoids exhibits a high degree of diversity, including microbial communities from the oral cavity and gastrointestinal tract. Our research results support the hypothesis that adenoids act as a " pathogen reservoir".
Humans ; Adenoids/microbiology* ; RNA, Ribosomal, 16S/genetics* ; Microbiota/genetics* ; Streptococcus pneumoniae/isolation & purification* ; Bacillus subtilis/genetics* ; DNA, Bacterial/analysis*

Objective:To explore the diagnosis and minimal invasive treatment of neonatal pyriform sinus fistula. Methods:A retrospective analysis was conducted on the clinical data of newborns diagnosed with pyriform sinus fistula in the Children's Hospital, Zhejiang University School of Medicine from January 2016 to December 2023, including the diagnostic process and treatment methods. Results:There were 8 children, 2 males and 6 females, with 7 cases on the left side and 1 case on the right side. Six cases revealed a lump in the fetal neck during prenatal examination, and two cases were found to have a neck mass after birth. All cases presented with varying degrees of respiratory disorders. After admission, all patients underwent neck ultrasound and contrast-enhanced CT examination. Neck ultrasound showed cystic masses, with 3 of the cysts accompanied by septa, and an air-fluid level was observed in the cysts in 6 cases from contrast-enhanced CT. All patients underwent ultrasound-guided neck mass puncture and/or tube placement combined with endoscopic electrocauterization. The cystic fluid was found to be yellow and thin, with no signs of infection. The surgical operations were uneventful, and the follow-up time ranged from 12 to 72 months postoperatively. There were no complications such as hoarseness, and no recurrence cases were reported. Conclusion:Neonatal pyriform sinus fistula is often characterized by a large cystic mass in the neck combined with respiratory depression. The presence of an air-fluid level in the cyst from contrast-enhanced CT can be considered an important basis for early diagnosis of pyriform sinus fistula. Ultrasound-guided puncture combined with endoscopic electrocauterization is minimally invasive and safe, making it a suitable minimal invasive treatment for neonatal pyriform sinus fistula.
Humans ; Female ; Male ; Pyriform Sinus/surgery* ; Retrospective Studies ; Infant, Newborn ; Cautery/methods* ; Endoscopy ; Fistula/surgery* ; Punctures ; Tomography, X-Ray Computed

Objective:To discuss the clinical efficacy of low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess for the treatment of congenital pyriform sinus fistula （CPSF） in the acute inflammatory period of children. Methods:Clinical data of 30 patients with CPSF in the acute inflammatory period who received low-temperature radiofrequency ablation assisted by endoscopy under laryngoscope, combined with resection and drainage of cervical abscess, from January 2018 to December 2023 were reviewed. After the operation, patients were followed up closely at different stages. All patients underwent color Doppler ultrasound and electronic laryngoscopy, and the results were analyzed. Results:All 30 children successfully completed the surgery without pharyngeal fistula, dysphagia, perifistula, or distal fistula infection, and the incision in the neck healed well. The follow-up survey ranged from 6 months to 2 years, and no recurrences were observed. Conclusion:Low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess is a promising method for treating CPSF in the acute inflammatory period. It is less traumatic, simple, safe, has a significant curative effect, and a low recurrence rate. This approach can be used as a supplementary operation for CPSF in children and provides a new way for clinical treatment.
Humans ; Pyriform Sinus/abnormalities* ; Abscess/surgery* ; Drainage ; Fistula/congenital* ; Female ; Male ; Child ; Radiofrequency Ablation ; Treatment Outcome ; Postoperative Period ; Endoscopy ; Laryngoscopy ; Inflammation ; Child, Preschool

The patient, a 10-year-old and 4-month-old boy, was admitted to the hospital "with a history of 19 days since tonsil surgery and 11 days of recurrent hematemesis". 19 days ago, bilateral endoscopic tonsil + adenoid plasma melting and bilateral tonsil fossa inferior pole suture were performed in the outer hospital, and recurrent hematemesis occurred 11 days ago, accompanied by transient fatigue and abdominal pain, diagnosis: ①Hematemesis to be investigated: postoperative tonsil bleeding? Upper gastrointestinal bleeding?②Acute moderate hemorrhagic anemia. On the first and third days of admission, the child had two sudden episodes of massive hematemesis, both of which were more than 1 000 mL, with pale lips, fatigue, and hemorrhagic shock. Bleeding was rapid and can terminate spontaneously, and emergency physical examination does not reveal a clear point of bleeding. Bilateral inferior pole sutures in the tonsillar fossa are in place. There were no obvious abnormalities in the emergency digestive endoscopy, no obvious bleeding points were detected in the tonsils and adenoids surgical area, and no obvious abnormalities were found in the neck CT angiography（CTA）. Emergency DSA-guided percutaneous selective external carotid artery intervention was performed, during which about 5 mm contrast agent overflowed at the origin of the facial artery, and a coil was implanted. The child had no active bleeding after the operation, and his life was as usual at 2 months of follow-up.
Humans ; Male ; Child ; Tonsillectomy/adverse effects* ; Postoperative Hemorrhage/therapy* ; Palatine Tonsil/surgery* ; Recurrence

Pleomorphic adenoma arising from the torus tubarius of the nasopharynx is an extremely rare entity with limited epidemiological data and unclear etiological mechanisms. Its pathogenesis may be related to the eustachian tube salivary glands. Here we report an elderly female patient with a long history of snoring, hypernasal speech and epistaxis. Following comprehensive diagnostic evaluation, the patient underwent tumor resection under nasal endoscopy. There were no postoperative complications, the symptoms were significantly improved, and there was no obvious recurrence during the follow-up. We summarized the experience of diagnosis and treatment of giant pleomorphic adenoma of the tubal torus. The main treatment for tubal torus pleomorphic adenoma is complete surgical resection, with a good prognosis and a low recurrence rate.
Humans ; Female ; Adenoma, Pleomorphic/surgery* ; Aged ; Nasopharynx/pathology*