Objective: To discuss the misdiagnosis of pyriform sinus fistula and to better understand this kind of illness. Methods: The analysis was based on twenty-eight patients with congenital pyriform sinus fistula aged from 11 months to 14 years, with the median age of 5 years, and who were surgically treated from January 2013 to January 2017 in Kunming Children′s Hospital.Twenty patients were misdiagnosed in other hospital.After the routine examination of neck ultrasound and enhanced CT, internal fistula was found by self-retaining laryngoscope, traced by methylene blue, and excised by high ligation. Results: Twenty patients were misdiagnosed.The misdiagnosis time ranged from 6 months to 3 years.Under self-retaining laryngoscope, piriform fossa fistula were found in all patients.Nineteen fistula were found in the left and 1 in the right.The fistula in patients was unilateral.Seven cases were misdiagnosed as suppurative lymphadensitis, undergone abscess incisional drainage many times.Three cases were misdiagnosed as thyroglossal duct cyst and performed excision of thyroglossal duct cyst.One case was treated by extended Sistruck operation again because the doctor considered that excision of middle segment of hyoid bone was not enough and the fistula was not ligated completely.One case was misdiagnosed as second branchial cleft fistula on the right side of the neck.Nine cases were misdiagnosed as hyroid-associated diseases including 2 cases suppurative thyroiditis, 2 cases subacute thyroiditis and 5 cases thyroid neoplasms.Among them, 2 cases underwent partial thyroidectomy.All the patients were treated with high ligation of fistula under general anesthesia.The operation was smooth, and no hoarseness, bucking and pharyngeal fistula occurred after the operation.Postoperative follow-up time ranged from 12 months to 4 years and the median follow-up was 18 months without recurrence.The diagnosis was confirmed pathologically. Conclusions Pyriform sinus fistula in children was uncommon and easily misdiagnosed in clinic.The majority of physician including some otolaryngologists were lack of understanding of the disease.It should be regarded as one of the important differential diagnosis of neck mass in children.Children with recurrent left neck infection and/or abscess should be highly suspected.Self-retaining laryngoscopic examination can make a definite diagnosis and high ligation of the fistula through the external neck approach can achieve good therapeutic effect.

Objective To study the causes and theoretical basis for good bone healing ability of magnetic Porous Ca3 (PO4) 2 ( MPTCP). Methods Seven MPTCP specimens with size of 2 cm × 1 cm × 0.5 cm were placed in the material physical system for detecting 42 times and the mean detection value was used to measure the MPTCP curve. The attachment 16451B of impedance spectrometer HP RLC was employed to measure dielectric spectroscopy and dielectric spectroscopy of MPTCP. Four-wire method was used to measure the impedance of MPTCP. Results The magnetic intensity changed rapidly when magnetic field was in a range of-10,000-10,000 Oe. The peak of dielectric spectroscopy and impedance of magnetic bioceramics was in the range of 103-104 Hz. When the external electromagnetic wave of frequency was ≤ 1 000 Hz, electrical impedance of MPTCP was large;while when the electromagnetic wave frequency was≥1 000 Hz, the impedance was relatively small and stable. Conclusion The environmental magnetic fields may change the magnetic and electric behavior of MPTCP and promote the biological healing, which may be the cause for the good bone healing ability of MPTCP.

OBJECTIVE: Evaluation of different repair mechanism and influencing factors for Prognosis of tympanic membrane perforations. METHOD: One hundred and twelve female patients of tympanic membrane perforations were randomly divided into two groups: control group (natural repair group) and treatment group (gelatin sponge patch bonded repair group). The perforation healing were dynamically observed in two groups by endoscope. RESULT: The result show that low, medium and high perforations healing rates were 100.00%, 90.48%, 93.33%. The healing time of low, medium and high was (9.0 +/- 2.8) d, (13.0 +/- 2.6) d, (22.0 +/- 4.7) d, the epithelial layer reverse growth in 5 cases. The result show that low, medium and high perforations healing rates were 91.67%, 95.24%, 84.62%. The healing time of low, medium and high was (11.0 +/- 3.7) d, (24.0 +/- 3.8) d, (36.0 +/- 2.1) d, 2 cases were undergone surgeries. CONCLUSION There are differences in repair mechanism between natural repair and patch bonded repair patch bonded repair can promote granulation hyperplasia, it can help recovering and lessening the patient's conductive hearing loss and occasional tinnitus. granulation hyperplasia and the healing time is closely related. The epithelial layer reverse growth may affect the healing of tympanic membrane perforation.
Adult ; Female ; Humans ; Middle Aged ; Tympanic Membrane Perforation ; etiology ; therapy ; Wound Healing ; Young Adult

Objective To discuss endoscopic surgical treatment and its effect of intranasal contact point headaches.Methods Twe(n)ty-five patients with intranasal contact point headaches were treated by endoscopic rhinoplasty of nasal cavity,including middle turbinoplasty,functional resection of ostiomeatal complex,endoscopic submucous septoplasty.Achieved organic combination of the above surgery methods according to the different results of the CT scan and endoscope,the surgical procedure waft designed individually.Results All patients were followed up for 9 to 12 months.Recovery was 21 cases(84.00%),efficacy was 3 cases(12.00%),inefficacy was 1 case(4.00%),the rate of fully recovered without serious complication was 96.00%(24/25).Conclusions Intranagal contact point headaches is a sort of the nasal headaches as a result of multi abnormality of nasal cavity structure.Endoscopic rhinoplagty is an effective treatment by means of reconstructing the balance of bilateral nasal cavity and improving its function.

Objective:To study the influence of endoscopic sinus surgery(ESS)on nasal airway resistance(NAR) of intranasal contact point headaches.Method:The NAR and nasalairflow sensation were measured with anterior rhinomanometry in 20 patients(40sides) before and after the ESS.Result:A telephone follow-up six months after operation,16(85%)cases were cured,3(15%)were improved and 1(5%)had no response and the effective rate was 95%. NAR decreased significantly after the operation. The change ratesin NAR before and after the decongestion were there was a significant difference(P<0.05).Conclusion:The improvement of nasal functions by ESS is due to thealteration of the anatomic structure of the nasal cavity and the amelioration of mucosal edema. The rhinomanometry can be used as a useful clinical tool in determining nasal patency.

Objective:To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. Method: Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry,routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxietas-athy-mia private measuring scale, coefficient of variation of the R-R(CVR-R), bioavailable testosterone detection(Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallied sequential multi-therapy for every patient according to the cause of disease. Result:The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychictrauma,32 endocrine system disease,106 upper gastrointestinol disease, circulatory disease,9 circulatory disease,3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility,and the efficiency rate was 96.23%. Conclusion:Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short term recurrence and unsatisfactory curative effect.

OBJECTIVE: To study the influence of endoscopic sinus surgery (ESS) on nasal airway resistance (NAR) of intranasal contact point headaches. METHOD: The NAR and nasal airflow sensation were measured with anterior rhinomanometry in 20 patients (40 sides) before and after the ESS. RESULT: A telephone follow-up six months after operation, 16 (85%) cases were cured, 3 (15%) were improved and 1 (5%) had no response and the effective rate was 95%. NAR decreased significantly after the operation. The change rates in NAR before and after the decongestion were (-0.34+/-0.23), (-0.75+/-0.21) and (-0.68+/-0.20), (-0.74+/-0.16) kPa x s/L, respectively, and there was a significant difference (P<0.05). CONCLUSION The improvement of nasal functions by ESS is due to the alteration of the anatomic structure of the nasal cavity and the amelioration of mucosal edema. The rhinomanometry can be used as a useful clinical tool in determining nasal patency.
Adult ; Airway Resistance ; Endoscopy ; Female ; Follow-Up Studies ; Headache ; pathology ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology

OBJECTIVE: To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. METHOD: Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry, routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxieties-athymic private measuring scale, coefficient of variation of the R-R (CVR-R), bioavailable testosterone detection (Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallized sequential multi-therapy for every patient according to the cause of disease. RESULT: The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychic trauma, 32 endocrine system disease, 106 upper gastrointestinal disease, circulatory disease, 9 circulatory disease, 3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility, and the efficiency rate was 96.23%. CONCLUSION Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short-term recurrence and unsatisfactory curative effect.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Paresthesia ; diagnosis ; etiology ; therapy ; Pharyngeal Diseases ; diagnosis ; etiology ; therapy ; Pharynx ; pathology ; Young Adult

OBJECTIVE: To investigate the epidemic features and risk factors of voice diseases of 5758 business dealers. METHOD: Questionnaire survey was conducted among 5785 business dealers of four markets in Yiwu city by random cluster sampling from March to July, 2006. They were also examined by indirect laryngoscopy. The incidence of voice disease was calculated and the risk factors were evaluated in four markets. RESULT: The incidence of voice disease was 39.3%, 18.8%, 28.4% and 58.1% in garment market, crafts market, stock market, and vegetable market, respectively. The average incidence was 30.4% in four markets. The difference of incidence among four markets was statistically significant (P < 0.01). The difference of incidence between female and male was statistically significant in any market. Chronic laryngitis and polyp of vocal cord were found to be the major pathological manifestations in men, while Chronic laryngitis and vocal nodules were found to be the major pathological manifestations in women. In addition, laryngeal carcinoma was confirmed in 8 cases. Market noise, pollution, unhealthy habits of business trade and excessive voice were the high risk factors. The female and the business dealers aged from 30 to 50 were the high risk people. CONCLUSION Varied relevant measures should be taken to prevent and control voice disease in different subgroups of population. People should be examined thoroughly as soon as they got voice problem. Improvement of market environment and timely intervention may reduce the prevalence rate of voice disease.
Adolescent ; Adult ; Aged ; China ; Female ; Humans ; Incidence ; Laryngeal Diseases ; epidemiology ; etiology ; Male ; Middle Aged ; Noise, Occupational ; statistics & numerical data ; Prevalence ; Risk Factors ; Smoking ; Surveys and Questionnaires ; Voice Disorders ; epidemiology ; etiology ; Young Adult

Objective Analysis the concomitance symptom and region of refractoriness paraesthesia pharynges.Methods Investigated 219 misdiagnosed pharyngeal paraesthesia patients with their history,routine examination,24 hours pH value determined of esophagus,esophago-barium visualization,anxietas-athymia private measuring scale,erectexperiment,coefficient of variation of the R-R(CVR-R) and man climacteric syndrome 10 questionnaire.according to the cause of disease we adopted Sequence therapy and individualized combined treatment for every patient.Results In the cases of219,169 were cured,29 were effective,with total effective rate of 90.41 %.21(9.59%) cases were not cured.Eighty three(37.90 %) of them with the type of a mental scar had a 89.16%(74/83).Among 42(19.18 %) cases of climacteric syndrome and menst rual disordertype,41 cases were cured with a 97.62 % effective rate.Eleven(5.02 %) cases of the type of functionaldisturbance of independence nerve were whole cured.Ninteen(8.68 %) of them with the type of reflux esophagitis had 89.47 %(17) effective rate.Sixty four(29.22%) cases of the type of Laryngopharyngeal reflux had 85.94%(55) effective rate.There were 94 menstrual disorder,73 sleep disorders,29 dreaminess,32 hypodynamia,71 heart disorders,11 chest distress,63 digestive tract symptom with heartburn、stomac discomfort etc.73 were breastbone of midline cervix and position permanent ;91 were not constant and migrationed.Conclusions There were obvious relation between the following symptom and the spot ofparaesthesia pharynges and their causa morbi,To clinical diagnosis the causa morbi of paraesthesia pharynges and treatment have the extremely important guiding sense for carefull inquirying the following symptom and spot of paraesthesia pharynges.