44 obstructive sleepapnea-hypopnea syndrome ( OSAHS) patients were Supplemented by an controlla-ble appliance in their intervene treatments. The data of polysomnography ( PSG) , Epworth sleepiness scale( ESS) and quality of life-Quebec sleep questionnaire( QSQ) before and 3 treatment period months after oral appliance were recorded. Correlations between subjective and objective measure before treated with OA and subsequently investi-gate treatment mechanism of oral appliance( OA) . Correlations indexes between before and after 3 treatment with an controllable appliance, and evaluation had statistically significance ( P <0. 05 ) . Absolute correlations between PSG indexes and subjective measures before oral appliance ranged from 0. 321 ~0. 433 , and 3 treatment period months after oral appliance ranged from 0. 306~0. 437 . Both PSG indexes and quality of life improved significantly after oral appliance(P<0. 05).

OBJECTIVE To discuss t he diagnosis and surgical methods of the Madelung's disease. METHODS Detailed clinical data of 6 patients with Madelung's disease who was received surgical treatment in our department from January 2011 to November 2015 were reviewed. RESULTS All patients were male, aged from 35 to 65 years. The 6 patients had excessive subcutaneous fat deposit predominantly around the neck. One of the 6 patients had excessive fat deposit in larynx. All patients had history of heavy drinking. Two patients had the complication of cardiac disease, pulmonary disease and cerebral disease. One patient had the complication of glucose intolerance. Five patients were associated with sleep apnea syndrome. One patient came to hospital with dyspnea in emergency. All patients had received surgical treatment and abstinence from alcohol, 4 patients had the total neck lipectomy and tracheotomy. One patient had the total neck lipectomy with no tracheotomy. One patient had received emergency surgery-partial neck lipectomy and tracheotomy because the patient came to hospital with dyspnea in emergency. This case was referred to respiratory department without a second surgery for his severe complications and high surgical risk. This case discharged with tracheal tube. No obvious recurrence was seen during a follow-up of 15 days to 48 months. The pathological results were nonencapsulated fat. CONCLUSION Madelung's disease is a kind of benign disease arised from lipodystrophy which characterized by massive accumulation of nonencapsulated subcutaneous fat mainly located symmetrically in the fascial space of neck and shoulder. Most patients had heavy drinking history, chronic alcoholism may be a major risk factor. It may be associated with some complications. Total neck lipectomy has good effect. The aim of the operation is to improve outline appearance and function of the neck, which is good for patient's quality of life.

OBJECTIVE To study the anatomicallandmarks of the accessory nerve (AN) , the great auricular nerve (GAN)and the transverse nerve of neck (TN) in neck level Ⅱ-Ⅳ and provide a reliable surgical basis for treatment of functional neck dissection in neck level Ⅱ-Ⅳ. METHODS The courses of the AN, GAN and TN were studied in 42 patients (56 sides) who underwent lateral neck dissection. Meanwhile, the correlations among the three nerves above and their surrounding structures were observed. RESULTS After emerging from the inferior border of the posterior belly of digastric muscle, the AN descends obliquely downward and backward before the transverse process along with the sternocleidomastoid branch of occipital artery to the upper part of the deep surface of the sternomastoid muscle. The distance from the mastoid process to the point where AN enters the sternocleidomastoid muscle is (4.93?0.75) cm. The point where AN emerges from sternocleidomastoid muscle (point A) located above the point where the GAN exits the sternocleidomastoid muscle (point B). The distance between the two points is (1.04?0.59) cm while the distance from point A to the middle point of clavicle (point C) is (8.09?0.65) cm. The GAN leaves the cervical plexus at the posterior border of the sternocleidomastoid muscle and run anteriorly between the lateral surface of this muscle and the deep surface of platysma. It is (6.37?0.73) cm long from point B to point D where the GAN send out posterior aurem branches, auricular lobule branches and anterior auricular branches. The distance from point B to point C is (7.67?1.00) cm. Most of GANand external jugular vein run nearly in parallel and the distance between them is (1.02?0.61) cm. The point where the TN emerges from the posterior border of the sternocleidomastoid muscle is below point B. Then the TN which is below the external jugular vein runs almost horizontally over the surface of the sternocleidomastoid muscle to sector branches in the lateral neck and part of its branches are distributed in the lateral neck after going across the anterior jugular vein. The point where the TN gives off branches is multivariate. There is no significant difference between the data get from left and right neck (P

Retrospective analysis of two cases of advanced carcinoma of the middle ear. Two patients underwent operation and radiotherapy. A case developed extensive necrosis in ear and neck, which finally led to lethal hemorrhage. Multiple relapse with cranial fossa invasion and extensive necrosis was found in the other case.
Aged ; Ear Neoplasms ; pathology ; radiotherapy ; surgery ; Ear, Middle ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local ; Retrospective Studies

Deglutition Disorders ; surgery ; Dyspnea ; surgery ; Humans ; Spondylosis

Adult ; Bronchi ; pathology ; Diagnostic Errors ; Foreign Bodies ; Humans ; Trachea ; pathology

OBJECTIVE To investigate the incidence of the cricopharyngeal bar in Chinese patients with dysphagia. METHODS One hundred and forty-six patients with dysphagia undertook a barium swallow radiological examination. Three patients with cricopharyngeal bar were further examined with esophagoscopy. RESULTS The incidence of cricopharyngeal bar was 14.4 %(21 out of 146). There is no significant difference between age groups, e.g. 14.3 % in elderly group and 13.8 % in adult group. CONCLUSION Some patients with dysphagia is associated with the appearance of the cricopharyngeal bar.

OBJECTIVE To study the causes of recurrence and treatment methods in patients with recurrent sinonasal melanoma. METHODS From 1993 to 2003, a retrospective analysis of consecutive 11 cases with recurrent sinonasal melanoma was conducted. RESULTS Four out of the 11 cases with recurrent sinonasal melanoma were caused by misdiagnosis, while the other 7 cases recurred after operation with pathological diagnosis. Among the 7 cases, 5 were found recurrences after operation alone, and the other 2 after the operation and radiation therapy. The recurrence lesions located in nasal and paranasal sinus in 7 cases, in orbit, skull base, soft and hard palate in 1 case, in parotid gland and skin in 1 case. In face, orbit and extended skull base in 1 case. Cervical lymph node recurrence developed in 1 patient. The time of first relapse was 10 months after therapy. The 1-, 2-and 3-year survival rates after reoperation were 72.7 %, 18.2 % and 9.1 % respectively. CONCLUSION The reasonable treatment and decrease the misdignosis are the main measures to improve the cure rate of recurrent sinonasal melanoma.

OBJECTIVE: To investigate the clinical features, imaging characteristics, pathological types, the misdiagnosis causes and the early diagnosis method of malignant lymphoma in nasal cavity and paranasal sinuses. METHOD: Clinicopathological data of 34 patients with malignant lymphoma in nasal cavity and paranasal sinuses were retrospectively analyzed. RESULT: Most of patients were middle aged man, the incidence of malignant lymphoma of nasal cavity and paranasal sinuses accounted for 21.7% of nasal malignant tumor over the same period, nasal malignant lymphoma incidence rate was higher than the sinus malignant lymphoma (76.5% VS. 17.6%). The main symptoms were presented as snuffle, epistaxis, purulent nasal discharge, fever and so on. Nasal neoplasm, nasal mucosa hyperemia, erosion, necrosis are the main signs of the disease. CT features were summarized as the lesions located in the anterior-middle area in nasal cavity, homogeneous in density, soft tissue swelling in some cases and less bone destruction. The majority pathological type of nasal malignant lymphoma was NK/T cell lymphoma, but the common pathological type of paranasal sinus malignant lymphoma was B-cell lymphoma. The misdiagnosis rate of malignant lymphoma in nasal cavity and paranasal sinus was 21.2%. CONCLUSION Malignant lymphoma in nasal cavity and paranasal sinuses without specific clinical characteristics, but has some certain CT characteristics. Combined with the clinical, imaging and pathological features, can improve the cognition and diagnosis of the disease.
Diagnostic Errors ; Epistaxis ; Humans ; Lymphoma ; diagnosis ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Necrosis ; Paranasal Sinus Neoplasms ; diagnosis ; Paranasal Sinuses ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: Through the use of the categories of auditory performance (CAP-II), the speech, spatial and qualities of hearing scale-parents' version (SSQ-P), children using hearing implants quality of life (CuHI-QoL) in patients with prelingual hearing impairment to compare the rehabilitation effect between preoperative and postoperative auditory performance, speech behavior and quality of life and at the same time to figure out dose rehabilitation effect connected to age. METHOD: Mainly used classification method to compare the audotory performance, speech behavior and quality of life of 50 patients before and after 2.5 years after the implantation. At the same time these 50 patients are divided on the basis of the age received the surgery, A group received the surgery before 6(1.0-5.9) years old and group B received the therapy after this age (6.0-10.9). Their auditory performance, speech behavior and quality of life were all evaluated. RESULT: There were statistical difference between two kinds of classification method of CAP-II. In the study of SSQ-P and CuHI-QoL, there was no statistical difference in well-being and happiness before and 3 years after the implant, also there was no statistical difference in parental stress between two age groups. In addition to the above two, the rest all have statistical significance. CONCLUSION After the implant, postoperative auditory performance, speech behavior and quality of life all had improved and the smaller the age, the better the performance.
Age Factors ; Child ; Cochlear Implantation ; Cochlear Implants ; Deafness ; therapy ; Hearing ; Hearing Tests ; Humans ; Quality of Life ; Speech