Objective To study the effects of the numbers of the canalith repositioning procedure on the treatment of benign paroxysmal positional vertigo(BPPV).Methods A clinical study was conducted on 68 BPPV patients using randomized controlled methods.The canalith repositioning procedure was performed on 34 patients in the treatment group only a day for 3 consecutive days,whereas it was performed on 34 patients in the control group once only,patients in both groups took betahistine mesylate tablets and flunarizine hydrochloride on the basis of ma-nipulative reduction.After one week and three months,the efficacy was evaluated,and the recovery situation was observed.ResuIts After 1 week of treatment,the cure rate was 82.4% in the treatment group,and 58.8% in the control group.The difference was statistically significant (P<0.05).After 3 months,the cure rate was 91.2% in the treatment group,and 85.3% in the control group,showing no significant difference (P>0.05 ).ConcIusion Based on the classifications of BPPV ,several times of manipulative reduction combined with drug treatment can im-prove short-term cure rates of BPPV and shorten healing time.

OBJECTIVE: To observe the expression of HPA, bFGF and VEGF in nasopharyngeal angiofibroma, and then explore its significance of inducing angiogenesis in the tumor's expansibility growth. METHOD: The expression of heparanase, bFGF, VEGF and CD105 were examined in 30 (I - II period 9 cases, III - IV period 21 cases) samples from nasopharyngeal angiofibroma and 20 inferior turbinate tissues by immunohistochemical staining technique. The microvascular density (MVD) were measured by the immunohistostaining of CD105. The MVD was analyzed with the clinical stage. RESULT: The positive rates of the HPA, bFGF and VEGF expression in JNA tissues were significantly higher than that in inferior turbinate group (P < 0.05). The positive rates of HPA, bFGF and VEGF expression in III - IV period were obviously higher than that in I - II period (P < 0.05). The expression of bFGF and VEGF in JNA tissues was respectively positive correlated with the HPA (r = by 0.499, 0.582, P < 0.05); In JNA tissues, the mean MVD in both HPA and bFGF positive group was higher than each one single positive group or both negative express group (P < 0.05). And the mean MVD in both HPA and VEGF positive group was higher than each one single positive group or both negative express group (P < 0.05). CONCLUSION HPA can induce angiogenesis to promote tumor growth by releasing bFGF and VEGF. Targeting the HPA can be a new direction in JNA adjuvant treatment.
Adolescent ; Adult ; Angiofibroma ; blood supply ; pathology ; Angiogenesis Inducing Agents ; Child ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Glucuronidase ; metabolism ; Humans ; Male ; Nasopharyngeal Neoplasms ; blood supply ; pathology ; Neovascularization, Pathologic ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

OBJECTIVE: To our knowledge, study of the intraoperative profuse bleeding of pterygoid venous plexus (PVP) in large nasopharyngeal angiofibroma resection has not yet been reported. Attention should be paid to this topic in clinical practice. METHOD: From 1981 to 2009, 44 cases of JNAs were treated in our hospital. Twenty-six of 44 cases were large nasopharyngeal angiofibromas according to the Fisch classification system(Fisch type III 16, type IV 10). The amount of intraoperative blood loss in these 26 cases varied from 200 ml to 5200 ml. Factors influencing intraoperative bleeding of 26 large nasopharyngeal angiofibroma resections were analyzed retrospectively. The intra-operative observations and imaging data of three typical cases were hereby studied. RESULT: After embolization of the tumor-supplying branches of the external carotid artery(ECA), both the intraoperative observations and imaging data demonstrated that the pterygoid venous plexus (PVP) played a crucial role in intraoperative hemorrhage. CONCLUSION PVP in the infratemporal fossa communicates with craniofacial veins. There is no valve between these veins. Once PVP is seriously damaged, venous blood of all craniofacial veins will flow out profusely. In the first operation, the intact PVP in the fatty pad generally can be identified and separated from the tumor by delicate surgical managements. If an unsuccessful operation due to serious hemorrhage had been done previously, then scar tissue might tightly adhere with PVP, tumor and the pterygoid muscles, and separation of the tumor from PVP without bleeding is more difficult. Appropriate surgical approach and correct hemostatic procedure of every bleeding point should be done carefully under direct vision. Using finger or instrument for quick blind dissection should be prohibited.
Adolescent ; Angiofibroma ; pathology ; surgery ; Blood Loss, Surgical ; Hemorrhage ; prevention & control ; Humans ; Male ; Nasopharyngeal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Veins ; surgery ; Young Adult