OBJECTIVETo investigate the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.METHODSPatients with postviral olfactory dysfunction were recruited in this study. All patients underwent T&T olfactory testing, sinonasal computer tomgraphy scanning, as well as magnetic resonance scanning of the olfactory pathway. Nebulizing glucocorticoid (pulmicort repulse) was inhaled once daily at the starting dose of 2 mg tapered to 1 mg after two weeks combined with olfactory training for 4 weeks. T&T olfactory testing were repeated after 4-week treatment.RESULTS Twenty four patients received teatment, with a mean age of 54 years old(range 37 to 81 years old), a mean olfactory dysfunction course of 2.20 months(range, 0.25-9 months). Of whom, 21 were anosmia, 3 were hyposmia. After teatment, complete recovery were achieved in 4 patients(16.7%), obvious improvement in 9 (37.5%), improvement in 5 (20.8%), no improvement in 6 (25.0%). No side effect and untoward effect were found.CONCLUSIONThe primmary outcomes suggest the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.

Objective To study the feasibility and rehabilitation outcomes of one -stage cochlear implantation (CI) in profound deaf children with secretory otitis media (SOM ) .Methods A total of 11 profound deaf children with soal receired one -soage unilateral cochlear implantation with a follow -up period from 13~60 months .In-flamed mucosa in the mastoid as well as exudates were removed radical1y at the time of implantation for adequate drainage of the middle ear .After the sugery ,the patients were followed up and the hearing and rehabilitating out-comes were eveluated .Results All 11 patients were successfully operated with 8 cases in the right ear and 3 cases in the left ear .Among them ,7 cases were nucleus 24 CA ,1 case losa clarion AB 90 K ,2 cases were medel combi 40+and 1 case was pulsar .All patients were successfully operated .No infectious complications occurred .No recurrence of secretory otitis media was observed .After initial stimulation and post regular fitting ,the status of the implant-able devices were all stable .All the implantees had satisfied hearing and entered normal kindergartens or schools . Conclusion Profound deaf pediatric patients with SOM are not an absolute contraindication for CI .With sufticient pre-operation preparontion ,proper trentment and nursing .Cochlear implantation should be condnote as early as possible better rehabilitation performance .

Glucocorticoids ; therapeutic use ; Humans ; Olfaction Disorders ; drug therapy ; Smell

OBJECTIVETo explore the application of immediate recurrent laryngeal nerve reconstruction in the treatment of thyroid cancer invading the recurrent laryngeal nerve.

METHODSTen patients with thyroid cancer invading unilateral recurrent laryngeal nerve underwent radical surgery and immediate recurrent laryngeal nerve reconstruction. The reconstructive surgical approach included recurrent laryngeal nerve decompression surgery, end-to-end anastomosis of the recurrent laryngeal nerve, anastomosis of ansa cervicalis nerve to the recurrent laryngeal nerve, and nerve-muscle pedicle (NMP) technique. Among the ten patients, one underwent nerve decompression, one underwent end-to-end anastomosis of the recurrent laryngeal nerve, seven had anastomosis of ansa cervicalis to recurrent laryngeal nerve, and one case had anastomosis of ansa cervicalis to recurrent laryngeal nerve combined with nerve-muscle pedicle (NMP) technique. The effect of surgery was evaluated by videolaryngoscopy, maximum phonation time (MPT), phonation efficiency index (PEI) and voice assessment. T-test was used in the statistical analysis.

RESULTSAll of the 10 patients had no complications including tumor recurrence and hypoparathyroidism after the surgery. Their hoarseness symptoms were improved, and the patients returned to normal or near-normal voice. Postoperative videolaryngoscopy showed that paralyzed vocal cord returned to normal muscle tone and volume, and the vocal cord vibration and mucosal wave were symmetric and the patients got good glottal closure. The pre- and post-operative maximum phone times of the patients were (4.52 ± 0.89) s and (11.91 ± 1.87) s, respectively (P < 0.01). The pre- and post-operative phonation efficiency indices were (1.37 ± 0.43) s/L and (4.02 ± 1.33) s/L, respectively (P < 0.05).

CONCLUSIONSIn patients with thyroid cancer invading unilateral recurrent laryngeal nerve, immediate recurrent laryngeal nerve reconstruction following radical surgery of thyroid cancer can effectively achieve recovery in phonation function and improve the quality of life of the patients.

Anastomosis, Surgical ; Humans ; Neoplasm Recurrence, Local ; surgery ; Neurosurgical Procedures ; Phonation ; Postoperative Complications ; Quality of Life ; Reconstructive Surgical Procedures ; Recurrent Laryngeal Nerve ; pathology ; surgery ; Thyroid Neoplasms ; surgery ; Vocal Cord Paralysis ; Vocal Cords

OBJECTIVE: In-depth understanding of endoscopic anatomy of the skull base is the cornerstone of the development of endoscopic endonasal skull base surgery. The purpose of this study is to explore the anatomical landmarks of the clivus for endoscopic endonasal skull base surgery. METHOD: Eight silicon-injected adult cadaveric heads (16 sides) were dissected performing endoscopic endonasal approach. The clivus and adjacent structures were exposed; and their anatomy shown in detail. High-quality pictures were produced. RESULT: The clivus was subdivided into the upper, the middle and the lower clivus. Extracranial soft tissue landmarks and bony landmarks were presented. Intradural landmarks of the upper clivus were the interpeduncular cistern, posterior cerebral artery, posterior communicating artery, superior cerebellar artery, cranial nerve III and cerebral peduncle; intradural landmarks of the middle clivus were the prepontine cistern, basilar artery, cranial nerve VI and pons; intradural landmarks of lower clivus were premedullary cistern, vertebral artery, cranial nerve XI and medulla oblongata. Surgical routes to the clivus were the upper clivus approach, middle clivus approach, lower clivus approach and panclival approach. CONCLUSION An understanding of the complex anatomy of the clivus is paramount for surgically dealing with the disease involved clivus and adjacent region.
Adult ; Cadaver ; Cranial Fossa, Posterior ; anatomy & histology ; surgery ; Endoscopy ; Humans ; Nose ; Skull Base

OBJECTIVE: To evaluate the etiology and management of delayed epistaxis after endoscopic surgery. METHOD: To retrospectively analyze the clinical data of 11 cases for epistaxis after nasal endoscopic surgery. To compare their precipitating factors, their surgical approach, time and site of bleeding and management in order to find the intrinsic rules. RESULT: The precipitating factors, bleeding sites and treatments varied among patients. CONCLUSION Delayed epistaxis after endoscopic surgery can not be neglected. There may be some precipitating factors. The surgical approach may be related to the bleeding site. It is better to treat the epistaxis using the endoscope to explore the bleeding site and to give corresponding intervention.
Adult ; Endoscopy ; adverse effects ; Epistaxis ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Young Adult

OBJECTIVE: To describe a modified lateral pharyngoplasty with partial transsection of levator veli palatine muscle in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and report the primary outcomes. METHOD: Retrospective review was performed in sixty patients with OSAHS. All the patients underwent modified surgical procedures, including partial transsection of levator veli palatine muscle and high soft palatoplasty. RESULT: The patients with a reduction of the AHI at least 50% were 6 (6/60, 10%). The patients with a reduction of the AHI at least 50% and a postoperative AHI < 20 were 44 (44/60, 73.3%). The patients with a postoperative AHI < 5 were 10 (10/60, 16.7%). Postoperative complications were postoperative bleeding in two cases (3.3%) and short-term velopharyngeal insufficiency in 10 cases (16.7%). CONCLUSION Lateral pharyngoplasty with partial transsection of levator veli palatine muscle provides a safe and effective procedure for selected OSAHS patients with oropharyngeal collapse as the main site.
Adult ; Apnea ; surgery ; Female ; Humans ; Male ; Middle Aged ; Oral Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome

OBJECTIVEThe aim of this study was to analyze the clinical characters, diagnosis and treatment of primary neoplasms in the parapharyngeal regions.

METHODSA total of 115 cases of primary neoplasms in the parapharyngeal regions were included in this study.

RESULTSDisorders of swallowing, breath or speaking were the common symptoms of neoplasms in parapharyngeal regions. The majority of neoplasms parapharyngeal regions were benign. 46 cases were from the deep lobe of the parotid, and 42 cases were neurogenic. CT or MRI provides useful information such as their sizes, shapes and extents. The relationship between the tumor and vessel was shown using super-selective angiography. All the tumors were resected completely by extra-oral approach through the posteroinferior incision of the mandible. The follow-up was carried out from 1 to 10 years, and the data indicated that 2 patients died, 18 cases were lost, and others had no recurrence.

CONCLUSIONCT and/or MRI are essentially useful for diagnosis and presurgical planning. Super-selective angiography can be used if the lesions involved carotid artery. Posteroinferior incision of the mandible is a simple, effective and safe approach for excision of neoplasms parapharyngeal regions.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; surgery ; Parotid Neoplasms ; diagnosis ; pathology ; surgery ; Pharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo study and evaluate the clinical effects of combined preoperative chemotherapy and their relations with multi drug resistance (MDR).

METHODS102 cases with oral squamous cell carcinoma(OSCC) were included in the study (63 males and 39 females, aged 22 to 67 years). Among the subjects there were 57 cases with cancer of tongue and 45 cases with cancer of buccal mucosa. 27 cases in the group were classified as stage II, 55 as stage III and 20 cases as stage IV according to TNM standard. All cases accepted PYM + 5-Fu + DDP combined chemotherapy pre-operatively. The total given dose was PYM 48 mg, 5-Fu 7.5 g and DDP 300 mg. After the chemotherapy, radical surgery were performed within 2 weeks. The diagnosis of all cases were proved as OSCC by biopsy.

RESULTSTotal effective rate of the combined chemotherapy was 82.4%. All of the cases were followed up and their 3 years' survival rate was 67.6%.

CONCLUSIONThe combined chemotherapy of PYM + 5-Fu + DDP is effective in using as one of comprehensive treatment for OSCC.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; administration & dosage ; analogs & derivatives ; Carcinoma, Squamous Cell ; therapy ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Female ; Fluorouracil ; administration & dosage ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; therapy ; Tongue Neoplasms ; therapy ; Treatment Outcome

OBJECTIVEThe purpose of this study was to observe the roentgenographic characters of distraction osteogenesis (DO) correction of cleft palate (CP), to study the expression of BMP proportional to fixation period time intervals, and to explore the new bone formation mechanism in Cleft Palate bone shelf.

METHODS12 cats were used to establish the CP animal model surgically, and then were assigned randomly to (1) Experimental group (12 cats): CP defects were DO repaired at the rate and rhythm of 0.4 mm x 2/day. Specimen retrieval at 2, 4, 6, 8, 12 weeks after completion of distraction, roentgenography and Anti-BMP immunohistochemistry studies were performed; (2) Experimental control group (2 cats): CP defects without any treatment procedures, and (3) Empty control group of 2 cats.

RESULTSAnti-BMP immunohistochemistry study showed positive DAB dye in early 2 weeks and most extensively positive expression of BMP in 4 to 6 weeks. The expression of BMP wore off gradually through 8 to 12 weeks. The roentgenography showed that the newly mineralized bone was developed from the cut bone edges bilaterally to the central transparent zone, and the newly formed bone bridged the defect area completely at the end of the study. The CP bone defect was reconstructed and the distraction gap was filled with de nove osteogenesis. No new bone formation was observed in experimental control group.

CONCLUSIONThe process of new bone formation in the distraction area is dynamic. Being stimulated primarily, the process was kept highly active till quiescence phase finally. The X-ray examination shows that there is distinctively low roentgenopeque. Nevertheless, roentgenography is so far a very effective and convenient method to evaluate and monitor the DO correction efficiency.

Animals ; Bone Morphogenetic Proteins ; biosynthesis ; metabolism ; Bone Regeneration ; Cats ; Cleft Palate ; diagnostic imaging ; metabolism ; surgery ; Osteogenesis ; Osteogenesis, Distraction ; Palate, Hard ; diagnostic imaging ; metabolism ; surgery ; Radiography ; X-Ray Film