3.The outcome of transnasal endoscopic total maxillectomy in the treatment of sinonasal adenoid cystic carcinoma.
Quan LIU ; Yuting LAI ; Jingyi YANG ; Huankang ZHANG ; Xicai SUN ; Yurong GU ; Houyong LI ; Hongmeng YU ; Dehui WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):243-251
Objective:To assess the prognosis of sinonasal adenoid cystic carcinoma with hard palatine invasion treated by transnasal endoscopic total maxillectomy. Methods:Clinical data of twenty-six patients with sinonasal adenoid cystic carcinoma invading hard palatine treated by transnasal endoscopic total maxillectomy between May 2014 and December 2020 was analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Cox regression was used to investigate the prognosis factors. Masticatory function after maxillectomy has also been assessed using the questionnaire of patients' satisfaction about masticatory function. Results:Margins in 8 patients(30%) were positive. The median time of follow-up was 38 months(6 to 85 months). Twenty-five patients recurred. Four patients died of distant metastasis. The 5-year overall survival rate and relapse-free survival rate was 79.5% and 89.1%, respectively. Independent predictors of outcome on multivariate analysis were positive margin(P=0.018), recurrence(P=0.006) and distant metastasis(P=0.04). Conclusion:Transnasal endoscopic total maxillectomy could be performed for the treatment of the sinonasal adenoid cystic carcinoma with hard palatine invasion. Positive margin, local recurrence and distant metastasis were important predictors for patients' prognosis.
Humans
;
Carcinoma, Adenoid Cystic/pathology*
;
Paranasal Sinus Neoplasms/pathology*
;
Retrospective Studies
;
Neoplasm Recurrence, Local/pathology*
;
Prognosis
4.Treatment and prognosis analysis of perineural invasion on sinonasal adenoid cystic carcinoma.
Ze Kun WANG ; Jiang Hu ZHANG ; Xue Song CHEN ; Qing Feng LIU ; Jing Bo WANG ; Run Yu WU ; Ye ZHANG ; Kai WANG ; Yuan QU ; Xiao Dong HUANG ; Jian Ping XIAO ; Li GAO ; Guo Zhen XU ; Jun Lin YI ; Jing Wei LUO
Chinese Journal of Oncology 2022;44(2):185-191
Objective: To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. Methods: The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition. Follow-up visits were conducted to obtain information of treatment failure and survival outcome. The Log rank test was used for univariate analysis of prognostic factors, and Cox regression model was used for multivariate prognostic analysis. Results: The maxillary sinus (n=59) was the most common primary site, followed by the nasal cavity (n=38). There were 93 patients with stage Ⅲ-Ⅳ. The treatment modalities included surgery alone (n=14), radiotherapy alone (n=13), preoperative radiotherapy plus surgery (n=10), and surgery plus postoperative radiotherapy (n=68). The median follow-up time was 91.8 months, the 5-year local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 72.6%, 73.0%, 52.9% and 78.0%, respectively. There were 33 patients (31.4%) with PNI-positive. The 5-year DMFS, PFS, and OS rates of PNI-positive group were 53.7%, 29.4% and 56.5%, respectively, which were significantly inferior to those of PNI-negative group (80.8%, 63.0% and 86.8%, respectively, P<0.05), while there was no significant difference in the 5-year LC rate between both groups (64.5% vs 76.5%, P=0.273). The multivariate Cox regression analysis showed PNI was one of the poor prognostic factors of DMFS (HR=3.514, 95%CI: 1.557-7.932), PFS (HR=2.562, 95%CI: 1.349-4.866) and OS (HR=2.605, 95%CI: 1.169-5.806). Among patients with PNI-positive, the 5-year LC, PFS and OS rates of patients received surgery combined with radiotherapy were 84.9%, 41.3% and 72.7%, respectively, which were significantly higher than 23.3%, 10.0% and 26.7% of patients receiving surgery or radiotherapy alone (P<0.05). Conclusion: The presence of PNI increases the risk of distant metastasis in patients with sinonasal ACC. Compared with patients with PNI-negative, the prognosis of patients with PNI-positive is relatively poor, and surgery combined with radiotherapy for PNI-positive sinonasal ACC results in good clinical outcomes.
Carcinoma, Adenoid Cystic/pathology*
;
Humans
;
Paranasal Sinus Neoplasms/therapy*
;
Prognosis
;
Proportional Hazards Models
;
Retrospective Studies
6.Radiologic Features of Nuclear Protein of the Testis Midline Carcinoma of the Nasal Cavity and Paranasal Sinuses:Report of One Case.
Xue-Ying HE ; Zhao-Hui LIU ; Qian ZHANG
Acta Academiae Medicinae Sinicae 2020;42(2):279-282
Nuclear protein of the testis midline carcinoma (NMC) is a rare malignant tumor that is mostly located in the upper trachea,mediastinal midline,and paravertebral midline,and few literature has described the imaging features of NMC in the nasal cavity and paranasal sinuses. In this article we summarize the clinical,radiologic,and pathologic data of one case of pathologically confirmed NMC in the nasal cavity and paranasal sinus by focusing on its CT and magnetic resonance imaging features.
Humans
;
Magnetic Resonance Imaging
;
Nasal Cavity
;
pathology
;
Nose Neoplasms
;
diagnostic imaging
;
Nuclear Proteins
;
Paranasal Sinus Neoplasms
;
diagnostic imaging
;
Paranasal Sinuses
;
pathology
;
Tomography, X-Ray Computed
9.Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus.
Qingjia GU ; Jiangang FAN ; Jingxian LI ; Debing LI ; Libing ZHAO ; Gang HE ; Linhong SONG ; Shenqing WANG ; Shuihong ZHOU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(19):1739-1742
OBJECTIVE:
To investigate the clinical features, therapeutic methods and therapeutic efficacy of imflammatory myofibroblastic tumor(IMT)of the nasal cavity and paranasal sinuses.
METHOD:
Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy.
RESULT:
All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor.
CONCLUSION
IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treatment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operation. Due to high recurrence rate, long-term follow up is necessary after operation.
Adolescent
;
Adult
;
Aged
;
Female
;
Humans
;
Immunohistochemistry
;
Male
;
Middle Aged
;
Nasal Cavity
;
pathology
;
Neoplasm Recurrence, Local
;
Neoplasms, Muscle Tissue
;
pathology
;
radiotherapy
;
surgery
;
Paranasal Sinus Neoplasms
;
pathology
;
radiotherapy
;
surgery
;
Paranasal Sinuses
;
pathology
;
Retrospective Studies
;
Young Adult
10.Clinical study on efficacy of nasal surgical expansion as a basic operation in treatment of patients with OSAHS.
Peilin HUI ; Yuping XIE ; Wei MA ; Lijun ZHAO ; Jinfeng WANG ; Xiaoquan WEI ; Liya ZHOU ; Chao XU ; Gang ZHAO ; Yiping HOU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(21):1860-1863
OBJECTIVE:
To observe the clinical effect of nasal surgical expansion as basical surgical treatment of patients with OSAHS.
METHOD:
A total of 320 patients with OSAHS were retrospectively analyzed. The patient was diagnosed by PSG. The electronic nasopharyngolarygnoscope exam airway CT, and MRI were applied to determining the nasal plane block. According to the concrete reasons, the nasal endoscopic nasal septum corrective surgery and open surgery were carried out, respectively. Nasal sinus neoplasm resection of off shoring, inferior turbinate fracture surgery or inferior turbinate back-end 1/3 line expansion and low temperature plasma ablation of nasal surgery, respectively. Pittsburgh sleep quality index (PSQI), snore outcome survey (SOS), epworth sleepiness score (ESS), the lowest arterial oxygen saturation (LSaO2) and AHI, time and ratio of slow wave sleep (SWS) stage and rapid eye movement (REM) stage were applied to comparing the curative effect between pre-operation and post-operation periods.
RESULT:
Snoring, sleep apnea, subjective mental symptoms of all patients with OSAHS were improved after operation; PSQI, SOS and ESS score were improved compared to pretreatment (P < 0.05); according to the 2009 OSAHS diagnosis and curative effect evaluation standard, 38 cases cured, 189 cases had obvious effect, 93 cases effective, and the total effective rate was 100%; there was statistical difference between the pre-operative period and 6 months post-operative in PSQI, SOS and ESS, LSaO2, AHI and proportion of REM (P < 0.05); sleep structure was improved, time and proportion of SWS were increased after the operation (P < 0.05).
CONCLUSION
Solving the problem of nasal airway obstruction is the first step in surgical treatment of patients with OSAHS.
Endoscopy
;
Humans
;
Nasal Obstruction
;
Nasal Septum
;
surgery
;
Nasal Surgical Procedures
;
Oximetry
;
Paranasal Sinus Neoplasms
;
surgery
;
Paranasal Sinuses
;
pathology
;
Reconstructive Surgical Procedures
;
Retrospective Studies
;
Sleep Apnea, Obstructive
;
surgery
;
Sleep Stages
;
Sleep, REM
;
Snoring
;
Turbinates
;
surgery

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