Objective To observe the anatomical constant sign of the parapharyngeal space operation via endoscopy-assisted transoral approach,and provide evidence for the treatment of the lesions of the pharyngeal space and improve the success rate of the operation. Methods CT multi plane reconstruction and three dimensional reconstruction were performed on 10 fresh dead bodies who were acquired from January 2015 to September 2015,the structure of the lateral pharyngeal space was observed,and the parapharyngeal space operation was performed via endoscopy-assisted transoral approach.Results The CT images showed that dispharynx of very low density extended posterior-lateral into the pharyngeal recess,lateral pharyngeal space located in the lateral pharyngeal recess,a low density triangular shadow with a nar-row of the front and width in the back,wing within muscles,wing outside muscles,masseter and temporal muscle located in the lateral pharyn-geal side clearance,which showed a medium density shadow,styloid process located in the front shadow of pharynx side clearance,the back of the internal carotid artery of pharynx side clearance,which showed medium density shadow.The blood vessels in the pharyngeal space and the nerve development was not clear.Stem styloid located in the temporal bone of the skull base drum subordinates,with length of (24.98 ± 2.01)mm,the internal structures of parapharyngeal space located in styloid process and around the surface of the deep muscular,the outside of styloid process had external carotid artery,facial nerve and mastoid.Inside of the base of styloid process had jugular vein foramen and hypo-glossal canal outside hole,the front inner side had carotid canal outside hole,the foramen spinosum,and oval foramen,the rear with stem hole.The distance between left and right side of root of styloid process to adjacent structures was compared,and the difference had no statisti-cal significance(P >0.05).In addition to the root of the styloid process to stylomastoid foramen.The difference of root of styloid process of males to adjacent structure was greater than that of the females,the difference had statistical significance(P <0.05).Conclusion Endo-scopic-assisted transoral approach to the parapharyngeal space operation hasthe styloid process as the marks of anatomy,the distance of styloid process to adjacent anatomical structures is as the reference,which helps to find and identify the parapharyngeal space of peripheral nerve, blood vessel,etc.

Objective:To summarize endoscopic management of cerebrospinal rhinorrhea and position-determining means.Method:Fifteen cases of cerebrospinal rhinorrhea treated by endoscopic approach at our institution were analyzed retrospectively.Aetiology included accidental trauma (10), surgical trauma (4), idiopathic (1). All patients presented with CSF rhinorrhea.Six cases were operated after failure of conservative treatment. Two cases after failure of neurosurgical repair were referred to our department. The largest defect was as big as 2.5 cm×1.5 cm. All patients were scanned by computed tomography and magnetic resonance imaging and confirmed by biochemistry test.Ten patients received high resolution spiral computed tomography bonding ventriculography.Result:We performed intranasal endoscopic repair in all 15 patients. All repairs were successful at the first attempt with a mean follow up of 20 months. One patient had light headache postoperatively and relieved with conservative treatment. All defects of skull base detected by computed tomography and ventriculography were confirmed in the operation.Conclusion:Intranasal endoscopic repair of cerebrospinal rhinorrhea can be an effective method. High resolution spiral computed tomography scan combined with ventriculography is a precise position-determining means. With the advancement of instrument and operative skill,the scope of endoscopic repair will further extend.

Objective To explore the diagnosis and treatment of gastrointestinal stromal tumors(GISTs).Methods Clinical and pathological data of the 32 GISTs cases treated over the recent 5 years in our hospital were reviewed retrospectively.Results Stomach was the most frequent site for GISTs.Abdominal pain was the most common symptom.Before operation,81.3%(26/32) of the cases were misdiagnosed.All of the cases underwent surgical resection.10 recurrent GIST patients received a second resection,and 8 patients(underwant) three or more resections.Follow-up was made from six months to 5 years,and 8 patients died.Conclusions The diagnosis of GISTs is difficult and mainly depends on histopathology and(immunohistochemistry).Surgical resection is the principal treatment of GISTs.Reoperation is effective for the treatment of recurrent cases.

OBJECTIVE To evaluate the roles of p15,p27 gene protein and expression in nasopharyngeal carcinoma(NPC).METHODS The EnVision immunohistochemical method was used to detect the expression of p15,p27 gene protein in nasopharyngeal carcinoma tissues of 43 NPC cases and non-tumor nasopharyngeal tissues of 21 cases.RESULTS ① The positive expression rates of p15,p27 gene protein were 65%,68% in NPC respectively.There were significant differences between NPC and non-tumor group(P0.05).③The positive expression of p15 gene protein was correlated to the positive expression of p27 gene protein(P

OBJECTIVETo study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma.

METHODSA retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved. All had 55-75 Gy radiotherapy according to their need.

RESULTSA total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05).

CONCLUSIONOnly a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.

Adolescent ; Adult ; Aged ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; physiopathology ; surgery ; Hypopharynx ; surgery ; Larynx ; physiopathology ; Male ; Middle Aged ; Survival Rate

OBJECTIVE: To observe the effect on children with unilateral hearing loss (UHL). METHOD: One hundred and one children with unilateral hearing loss were included in this study from October 2008 to December 2009 in Shenzhen Children's Hospital, 95 of them were investigated on speech recognition abilities, learning abilities et al by telephone interviews. RESULT: The intelligence quotient (IQ) including full-scale intelligence quotient, verbal intelligence quotient and performance intelligence quotient were significantly lower in the severe and profound unilateral hearing loss group when compared with school children with bilateral normal hearing (P < 0.05). The IQ of moderate to severe hearing loss and bilateral normal hearing was not significantly different (P > 0.05). CONCLUSION IQ, speech recognition abilities and learning abilities were affected during unilateral hearing loss children, but proper, early intervention can compensate the deleterious effects of UHL.
Adolescent ; Child ; Child, Preschool ; Early Intervention (Education) ; Female ; Hearing Loss, Unilateral ; Humans ; Infant ; Intelligence ; Male ; Retrospective Studies ; Speech

OBJECTIVE: To summarize endoscopic management of cerebrospinal rhinorrhea and position-determining means. METHOD: Fifteen cases of cerebrospinal rhinorrhea treated by endoscopic approach at our institution were analyzed retrospectively. Aetiology included accidental trauma (10), surgical trauma (4), idiopathic (1). All patients presented with CSF rhinorrhea. Six cases were operated after failure of conservative treatment. Two cases after failure of neurosurgical repair were referred to our department. The largest defect was as big as 2.5 cm x 1.5 cm. All patients were scanned by computed tomography and magnetic resonance imaging and confirmed by biochemistry test. Ten patients received high resolution spiral computed tomography bonding ventriculography. RESULT: We performed intranasal endoscopic repair in all 15 patients. All repairs were successful at the first attempt with a mean follow up of 20 months. One patient had light headache postoperatively and relieved with conservative treatment. All defects of skull base detected by computed tomography and ventriculography were confirmed in the operation. CONCLUSION Intranasal endoscopic repair of cerebrospinal rhinorrhea can be an effective method. High resolution spiral computed tomography scan combined with ventriculography is a precise position-determining means. With the advancement of instrument and operative skill, the scope of endoscopic repair will further extend.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; diagnostic imaging ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Retrospective Studies ; Tomography, Spiral Computed ; Young Adult

Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ.Methods From July 2011 to July 2016,28 adults with odontoid fracture of Anderson-D'Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery,Hospital of 89 Army Group of Chinese PLA.Of them,15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group).All the patients were male,aged from 31 to 59 years (average,42.7 years).The 2 groups were compared in terms of incision length,operation time,intraoperative bleeding,intraoperative fluoroscopic frequency and hospital stay.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible (P ＞ 0.05).All the patients were followed up for 12 to 45 months (average,22.1 months).The internal fixation was in good place and clinical union achieved in all the 28 patients.The incision length (2.2 ± 0.1 cm),operation time (45.0 ± 3.1 min),intraoperative bleeding (29.0 ± 2.3 mL) and intraoperative fluoroscopic frequency (15.5 ± 1.9 times) for the guider group were all significantly less than those (2.9 ±0.7 cm,61.6±3.8 min,51.6±3.9 mL and 21.7±3.2 times,respectively) for the open group (P ＜0.05),but there was no significant difference between the 2 groups in hospital stay (6.5 ± 0.5 d versus 6.5 ± 0.6 d) (P ＞ 0.05).Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ,compared with open anterior ondontoid screw fixation,the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision,shorter operation time,less blood loss and a lower fluoroscopic frequency.