Humans ; Nasal Cavity ; injuries ; Paranasal Sinuses ; Pharynx ; injuries ; Wounds, Penetrating ; diagnosis ; therapy

OBJECTIVETo investigate the clinicopathological features and prognosis of patients with the malignant transformation of sinonasal inverted papilloma.

METHODSThirty-two consecutive cases encountered between January 1991 and January 2008 were retrospectively reviewed. Survival rates and prognostic factors were calculated with SPSS 17.0 software using the Kaplan-Meier method and multivariate Cox model survival analysis.

RESULTSThe malignancy accounted for 8.99% of all types of sinonasal inverted papilloma. There were 25 males and 7 females, the median age was 56.5 years. The sites of tumor included 22 cases in nasal cavity and ethmoid sinuses, 10 cases in maxillary sinuses. The tumors included 21 high grade tumors, 8 intermediate grade tumors and 3 low grade tumors. Thirty-two patients were staged as T1(3/32), T2(10/32), T3(16/32), T4(3/32). According to the percentage of the malignant cell in the entire tumor tissue, 5 patients were in grade I, 5 patients were in grade II, 8 patients were in grade III, 14 patients were in grade IV. There were 3 distant metastasis in 32 patients; 19 patients underwent surgery plus postoperative radiotherapy, 10 underwent surgery alone and 3 underwent radiotherapy alone. The 5-year overall survival were 72.5%, and the median overall survival time was 62.2 months. Kaplan-Meier univariate survival analysis indicated that the clinical stages and treatment modalities were prognostic factors, and multivariate Cox model survival analysis confirmed that the clinical stages and treatment modalities were independent factors for overall survival (HR were 4.211 and 0.312, all P < 0.05).

CONCLUSIONSThe morbidity of sinonasal inverted papilloma-associated malignancy is low, the clinical features were not specificity. The clinical stages and treatment modalities may affect the prognosis. Surgery plus postoperative radiotherapy are main treatment means.

Aged ; Carcinoma, Squamous Cell ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Papilloma, Inverted ; pathology ; therapy ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Retrospective Studies ; Survival Rate

Administration, Oral ; Anticoagulants ; adverse effects ; Aspirin ; adverse effects ; Epistaxis ; chemically induced ; Humans

China ; Congresses as Topic ; Humans ; Otolaryngology

OBJECTIVETo analyze the correlation between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with mild cognitive impairment (MCI).

METHODSFifty patients with MCI were compared with fifty controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). SPSS 13.0 software was used to analyze the data.

RESULTST&T olfactory testing revealed that MCI patients had higher scores than controls (t = 3.142, P < 0.05). Both men and women with MCI were affected by the same extent of olfactory loss(t = 0.973, P > 0.05). Both men and women as controls were affected by the same extent of olfactory loss (t = 1.092, P > 0.05).OB volume of left side in MCI patients was (36.35 ± 4.09) mm(3), right side was (36.57 ± 4.13) mm(3), average OB volume was (36.47 ± 4.12) mm3; OB volume of left side in controls was (46.65 ± 6.23) mm(3), right side was (46.83 ± 6.27) mm(3), average OB volume was (46.71 ± 6.25)mm(3); OB volumes were lower in MCI patients as compared with controls (t value was 3.113, 3.145 and 3.132, all P < 0.01).OS depth study revealed no statistical different between MCI patients and controls (t value was 0.876,0.952 and 0.904, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in MCI patients and controls (r value was -0.643, -0.541, both P < 0.05); was no correlated with depth of OS (r value was -0.167 and -0.183, both P > 0.05). Olfactory discriminate threshold was negatively correlated with cognitive impairment degree in MCI patients (r value was -0.427, -0.418 and -0.399, all P < 0.05), average OB volume was positively correlated with cognitive impairment degree in MCI patients (r value was 0.364, 0.383 and 0.379, all P < 0.05).

CONCLUSIONSThe OB volumes are lower in MCI patients as compared with controls, the depth of OS show no significant changes in MCI patients. The OB volume is correlated with olfactory function, the depth of OS is not correlated with olfactory function. Cognitive impairment degree in MCI patients is accordance with olfactory function lower degree. The olfactory loss may be a earlier period and objective diagnosis indicator for MCI patients.

Cognition Disorders ; Cognitive Dysfunction ; complications ; epidemiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Olfaction Disorders ; complications ; epidemiology ; Olfactory Bulb ; Organ Size ; Smell

OBJECTIVETo analyze the correlation between olfactory bulb (OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with idiopathic Parkinson's disease (IPD).

METHODSOne hundred patients with IPD between January 2011 to December 2013 in Tianjin Huanhu Hospotal were compared with one hundred controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with Magnetic resonance imaging (MRI). One hundred IPD patients were investigated and estimated H-Y degrees, UPDRS, MMSE, MoCA. SPSS 13.0 software was used to analyze the data.

RESULTST&T olfactory testing revealed that IPD patients (3.0 ± 0.3) had higher scores than controls (1.3 ± 0.2, t = 2.537, P < 0.01). Both men and women with IPD were affected by the same extent of olfactory loss (t = 0.893, P > 0.05). Both men and women as controls were affected by the same extent of olfactory loss(t = 1.184, P > 0.05). OB volume of left side in IPD patients was (34.25 ± 5.14) mm(3), right side was (35.79 ± 5.28)mm(3), average OB volume was (35.28 ± 5.21) mm(3); OB volume of left side in controls was (47.38 ± 6.47) mm(3), right side was (47.75 ± 6.51) mm(3), average OB volume was (47.53 ± 6.49) mm(3); OB volume were lower in IPD patients as compared to controls (t value were 2.876, 2.747, 2.798, all P < 0.01). OS depth study revealed no statistical difference between IPD patients and controls (t value were 0.914, 0.987, 0.951, all P > 0.05). Olfactory discriminate threshold was negatively correlated with average OB volume in IPD patients and controls (r value were -0.537,-0.526, both P < 0.05); was no correlated with average depth of OS (r value were -0.142, -0.157, both P > 0.05). There was relation between the average OB volume and UPDRS III, UPDRS, the degree of H-Y in IPD patients (r value were 0.312, -0.419, -0.358, all P < 0.05). However the average OB volume was not related to the course of disease (r = -0.089, P > 0.05).

CONCLUSIONSThe OB volume is lower in IPD patients as compared to controls, the depth of OS have no significant changes in IPD patients; The OB volume is correlated with olfactory function, the depth of OS is not correlated with olfactory function; Olfactory function lower degree is accordance with serious degree in IPD patients, is not accordance with the course of disease.

Female ; Humans ; Magnetic Resonance Imaging ; Male ; Olfaction Disorders ; epidemiology ; Olfactory Bulb ; Parkinson Disease ; epidemiology ; Smell

OBJECTIVETo analyze the correlation between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with olfactory dysfunction after upper respiratory tract infection.

METHODSOne hundred patients with olfactory dysfunction after upper respiratory tract infection (patient group) were compared with one hundred normal controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). T&T testing and MRI were performed again after a year in patient group and the results were compared. SPSS 13.0 software was used to analyze the data.

RESULTST&T olfactory testing revealed that the patient group had higher scores than controls (t = 4.014, P < 0.05). Both men and women in patient group were affected by the same extent of olfactory loss (t value was 0.892, P > 0.05). Both men and women in control group were affected by the same extent of olfactory loss (t value was 1.011, P > 0.05). OB volume of left side in patient group was (38.14 ± 4.31) mm³, right side was (38.72 ± 4.22) mm³, average OB volume was (38.47 ± 4.27) mm³; OB volume of left side in controls was (51.65 ± 6.30) mm³, right side was (51.98 ± 6.34) mm³, average OB volume was (51.81 ± 6.32) mm³; OB volume was lower in patient group as compared with controls (t value were 4.233, 4.267 and 4.249, all P < 0.01). OS depth study revealed no statistical difference between patient group and control group (t value were 0.901, 0.948 and 0.927, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in patient group and control group (r value were -0.598, -0.512, both P < 0.05) Olfactory discriminate threshold was not correlated with the depth of OS (r value were -0.152, -0.174, both P > 0.05). Olfactory discriminate threshold and OB volume were not correlated with the persistent time of the dysosmia in patient group (r value were -0.121, 0.139, both P > 0.05). Among 100 olfactory dysfunction patients after upper respiratory tract infection, when followed-up, 24 showed increased in OB volume and olfactory function after a year, but no statistical difference was found with the first time (t value were 0.894, 0.914, 0.942 and 0.931, all P > 0.05). The other 76 patients showed no significant changes of OB volume and olfactory function.

CONCLUSIONSThe OB volume was lower in patient group as compared with normal controls, the depth of OS showed no significant changes in patient group. The OB volume was correlated with olfactory function, the depth of OS was not correlated with olfactory function; Olfactory function had not correlated with the persistent time of the dysosmia in patient group.

Female ; Humans ; Magnetic Resonance Imaging ; Male ; Olfaction Disorders ; diagnosis ; Olfactory Bulb ; pathology ; Prefrontal Cortex ; pathology ; Respiratory Tract Infections ; physiopathology

OBJECTIVETo summarize the clinical characteristics and treatment of patients with malignant nasal mucosa melanoma, and explore the factors influencing the prognosis of malignant nasal mucosa melanoma.

METHODSTo retrospectively analyze the clinical data of 29 patients with malignant nasal mucosa melanoma in Tianjin Huanhu hospital, department of otorhinolaryngology head and neck surgery between October, 1999 and June, 2013. Eighteen of them were male, other eleven were female, the median age was 61.5 years. The patients were staged according to the American Joint Committee on Cancer (AJCC) staging system, eight cases were in T1, ten cases were in T2, six cases were in T3, five cases were in T4. Among the 29 cases, twenty-two patients received surgical treatment, twenty-eight patients accepted radiotherapy, seventeen patients had the chemotherapy. The Kaplan-Meier method was used to analyze the prognosis impacts of gender, age, disease location, clinical staging, treatment, and histopathological features and so on.

RESULTSIn this series, the overall 3 year survival rate was 48.3% and 5 year survival rate was 27.6%. There were 4 factors effecting the 5 year survival rate : the location of tumor, T stage, surgical treatment and black pigmentation (P value was 0.008, 0.012, 0.021 and 0.027). But, gender, age, chemotherapy and other factors had no effect on overall survival rate.

CONCLUSIONSAJCC staging system can effectively predict the prognosis of patients. The prognosis of patients with pathogenic site in nasal septum is better than the others. The surgical treatment is the preferred method of treatment. Histological features such as tumor melanin pigmentation affect the prognosis of the patients.

Factor Analysis, Statistical ; Female ; Humans ; Male ; Melanoma ; diagnosis ; Nasal Mucosa ; Nose Neoplasms ; diagnosis ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess.

METHODSEighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded.

RESULTSAll patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach.

CONCLUSIONSTranssphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.

Abscess ; surgery ; Adolescent ; Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Pituitary Diseases ; surgery ; Retrospective Studies ; Sphenoid Sinus ; surgery ; Young Adult

OBJECTIVETo analyze the clinical and imaging characteristics of patients with cystic lesions in sella region and to describe the experience of endoscopic transsphenoidal surgery.

METHODSFourty-six cases of cystic lesions in sella region confirmed by surgery and pathology between June 2003 and September 2013 were retrospectively analysed. The clinical features, imaging, surgical technique and postoperative recurrence in 46 cases were presented.

RESULTSAll lesions were resected through transsphenoidal endoscopic endonasal approach. Followed up lasted from 6 months to 6 years. Postoperatively, headache was recovered in 26 cases and wasn't recovered in 8 cases, visual was improved in 12 cases and wasn't improved in 2 cases, hypopituitarism was relieved in 18 cases and wasn't relieved in 15 cases, polyuria was disappeared in 8 cases and wasn't disappeared in 4 cases. Seven cases recurred, including 4 cases of craniopharyngioma, 2 cases of pituitary abscess, 1 case of cystic adenoma. There were no death and serious complication. The small age of onset, visual acuity and visual field symptoms, tumor in suprasellar, third ventricle compression was easy to occur in craniopharyngioma; cystic tumor, cavernous sinus invasion, the solid part homogeneous enhancement could be seen in cystic adenoma; Rathke cyst showed simple cystic, lighter clinical symptoms and a short course. Prone to diabetes insipidus, low multiple hormone level and the lesions of annular enhancement was more common in pituitary abscess.

CONCLUSIONSThe clinical features and imaging of cystic lesions in sella region feature overlap each other, but there are certain specificity. Transsphenoidal endoscopic endonasal approach for the surgery of cystic lesions in sella is effective and safe.

Abscess ; complications ; Adenoma ; complications ; Craniopharyngioma ; complications ; Cysts ; surgery ; Endoscopy ; methods ; Headache ; complications ; Humans ; Hypopituitarism ; complications ; Neoplasm Recurrence, Local ; Nose ; Pituitary Diseases ; surgery ; Pituitary Neoplasms ; complications ; Retrospective Studies ; Sella Turcica ; pathology