The clinical data of 3 cases of Ramsay-Hunt syndrome concurrent with ipsilateral vocal cord paralysis were retrospectively analyzed, and the relevant literatures were also reviewed. Ramsay-Hunt syndrome is a kind of disease characterized by heavy ear pain, herpes zoster oticus and inner ear neurologic symptoms, which can also affect the vocal cords and give rise to vocal cords paralysis. Ramsay-Hunt syndrome can cause multiple in flammation of cranial nerves. The viral infection can also involve the 3rd and 10th cranial nerves. It mainly damage the facial nerve, followed by the involvement of vestibulocochlear nerve. The vagus nerve damage is rare, so the relevant clinical reports are less. It is important to take the objective data as well as subjective symptoms of the patients into consideration to make a definite diagnosis, so that we can treat it as soon as possible to achieve better curative effect.
Adult ; Aged ; Female ; Herpes Zoster Oticus ; complications ; Humans ; Male ; Middle Aged ; Vocal Cord Paralysis ; complications

Objective To investigate the clinical efficacy of endoscopic surgery for extensive osteoradionecrosis (ORN) of skull base in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.Methods Seventeen patients diagnosed as ORN of skull base after radiotherapy for NPC and underwent endoscopic surgery were retrospectively studied with their clinic data.Results Based on the CT and endoscopic examination,all patients had large skull base defects with bone defects averaged 7.02 cm2 (range,3.60-14.19 cm2).Excepting for curetting the sequestra,endoscopic surgery was also used to repair the wound or to protect the internal carotid artery with flap in 12 patients.No bone reconstructions were conducted in all patients with the bone defects of skull base.CT examinations were taken after endoscopic surgery when required.The postoperative follow-up ranged from 8 months to 6 years (average,14 months).Aside from 1 patient with delayed cerebrospinal fluid (CSF),others had no related complications.Conclusions The patients with extensive ORN can be treated with endoscopic surgery to curette the necrotic bone of skull base,and endoscopic reconstruction provides an alternative technique.It may not be necessary to reconstruct the bone defects at skull base,however,the exposed important structures of skull base,such as internal carotid artery,need to repair with soft tissue such as flap.

ObjectiveTo investigate the clinical application value of pancreaticoduodenectomy with the assistance of robotic operation system for pancreatic head cancer.MethodsClinical data of 38 patients with pancreatic head cancer undergoing pancreaticoduodenectomy using Da Vinci Si robotic system in Shanghai Ruijin Hospital from May 2010 to April 2014 were analyzed retrospectively. There were 25 males and 13 females with the mean age of (59±10) years old. The informed consents of all patients were obtained and the ethical committee approval was received. Three robotic exclusive Trocars, 1 camera Trocar and 1 assistant Trocar were inserted using 5-port approach and the robotic arms were inserted. Pancreaticoduodenectomy was performed under the assistance of robotic system. The perioperative situation including operation time, intraoperative blood loss, operation, postoperative complication and survive were observed.ResultsAll the operations of 38 cases were finished successfully with radical (R0) resection rate 97% (37/38), R1 resection rate 3% (1/38) and the median operation time 413(210-520)min, intraoperative blood loss 320(50-1 100)ml, lymphnode clearance number 15(2-24), postoperative hospital stay 20(7-36)d. The incidence of postoperative complication was 42% (16/38) including pancreatic ifstula (n=8), biliary ifstula (n=2), postoperative infection (n=6). The postoperative survival time was 25(3-42) months and disease-free survival time was 14(5-28) months.ConclusionPancreaticoduodenectomy with the assistance of robotic operation system is safe and feasible for resecting pancreatic head cancer.