Objective To observe the clinical effects and postoperative recurrence of endoscopic natural opening in the middle nasal meatus-maxillary sinus and prelacrimal recess approach in treating antrochoanal polyp(ACP).Methods Clinical data of 64 patients with ACP from March 2019 to March 2023 were analyzed retrospectively.According to different surgical approaches,the patients were divided into control group(n=32,endoscopic natural opening in the middle nasal meatus-maxillary sinus)and study group(n=32,endoscopic prelacrimal recess approach).Clinical efficacy,surgical indicators,preoperative and postoperative Lund-Mackay nasal endoscopy scores and sinus CT scores were compared between the two groups.Complications and recurrence that occurred within 5 months after surgery were recorded.Results The total clinical effective rate in the study group was 93.75%,higher than that in the control group 75.00%,the difference was statistically significant(P<0.05).Intraoperative blood loss of the study group less than that of control group,hospital stay of the study group shorter than that of the control group,the differences were statistically significant(P<0.05).Three months after surgery,Lund-Mackay nasal endoscopy scores and Lund-Mackay CT scores of both groups decreased,and the study group was lower than those of the control group,the differences were statistically significant(P<0.05).The recurrence rate in the study group was 3.13%,lower than that in the control group 18.75%,the difference was statistically significant(P<0.05),but there was no significant difference in the total incidence of postoperative complications between the groups(P>0.05).Conclusion Endoscopic prelacrimal recess approach is effective in the treatment of ACP.It can clean up the lesions,with little intraoperative blood loss and short hospital stay.Compared with endoscopic natural opening in the middle nasal meatus-maxillary sinus,the recurrence rate after endoscopic prelacrimal recess approach is lower.

Objective:To explore the clinical effects of two kinds of nasal bone reductors used for shortened and displaced overlapping external nasal fracture reduction under nasal endoscopy and the impact on ventilation function. Methods:From January 2020 to February 2022, 82 patients with shortened and displaced overlapping external nasal fractures diagnosed and treated in the Department of Otolaryngology, the Second People's Hospital of Hefei were collected as the study subjects. The patients were divided into control group（41 cases） and observation group（41 cases） by random number table method. Both groups underwent closed reduction under nasal endoscopy. The control group was treated with traditional straight nasal bone reductor, and the observation group was treated with gun-shaped hook type nasal bone reductor. The success rate of reduction, follow-up rate, clinical effect, and complications were compared between the two groups. The visual analogue scale（VAS） was used to evaluate the aesthetic effect and functional recovery. Rhinomanometry and acoustic rhinometry were used to evaluate nasal ventilation function. Results:The success rate of one-time reduction in the observation group was significantly higher than that in the control group, and the nasal reduction adaptation time was shorter than that in the control group（P<0.05）. There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups. The success rate of one-time reduction in observation group was significantly higher than that in the control group, and the adaptation time for nasal reduction in observation group was shorter than that in the control group（P<0.05）. There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups in six months after surgery. the total clinical effective rate in observation group was higher than that in the control group（94.87% vs 76.32%, P<0.05）. After surgery, the scores of nasal aesthetics, nasal congestion and olfactory function in both groups were significantly lower compared with the preoperative scores. All the scores in the observed group were lower than that in the control group（P<0.05）. After surgery, there were significant increases in the minimum cross-sectional area of nasal cavity, volume of nasal cavity and total nasal expiratory volume in both groups. Above indicators in observation group were significantly greater than that in control group. The nasal exhalation and inhalation resistance was significantly lower than that before operation, and the resistance in observation group was significantly lower than that in control group（P<0.05）. The total incidence of complications was lower than that in observation group（P<0.05）. Conclusion:The application of gun-shaped hook-type nasal bone reductor in patients with shortened and displaced overlapping external nasal fractures has better success rate of one-time reduction, adaptation time of nasal reduction and treatment outcome. Moreover, it has more advantages in aesthetic effect of nasal appearance, nasal ventilation function and reduction of complications.
Humans ; Nasal Bone/injuries* ; Male ; Female ; Endoscopy/methods* ; Adult ; Treatment Outcome ; Nose/surgery* ; Middle Aged

OBJECTIVE: To investigate the character of upper airway and to offer the reference for clinical treatment through observing the upper airway caliber and its corresponding pharyngeal wall of OSAHS patients by magnetic resonance imaging (MRI). METHOD: The upper airway of 33 obstructive sleep apnea hypopnea syndrome (OSAHS) patients diagnosed by PSG were analyzed and compared by MRI. The cross-sectional area of the upper airway and thickness of lateral parapharyngeal wall were calculated. The cross-sectional area of the upper airway and thickness of lateral and posterior pharyngeal wall were also measured in 20 nonsnoring age-matched normal subjects selected as the control group. RESULT: The cross-sectional areas of upper airway of OSAHS patients were smaller than that of the control. The Thickness of posterior pharyngeal wall and lateral pharyngeal wall of the retropalatal region, retroglossal region and epiglottal region were thicker in patients group than that of the control. The thickness and length of the palate in patients group were larger than that of the control. The cross-sectional areas of retropalatal region of OSAHS patients had negative correlation with apnea hypopnea index (AHI). There was also negative correlation between the retroglossal region cross-sectional area and the neck circumference. CONCLUSION Measurement of upper airway with MRI could observe the change of pharynx cross-sectional area and had reference value in guiding the clinical diagnosis and treatment.
Adult ; Case-Control Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Palate ; pathology ; Palate, Soft ; pathology ; Pharynx ; pathology ; Respiratory System ; pathology ; Sleep Apnea, Obstructive ; pathology

OBJECTIVE: To describe consultation practice patterns of an otolaryngology chief resident in China. METHOD: The pattern and frequency of patient encounters during the Xijing Hospital of the Fourth Military Medical University otolaryngology residency program for one chief resident were retrospectively analyzed. RESULT: A total of 1062 new inpatients were consulted during a 10-month period of otolaryngology residency, including emergency consultation for 467 cases (43.97%) and routine consultation for 595 cases (56.03%). The chief resident consulted an average of 28 new patients perweek. The most common diagnosis for an emergency consultation was epistaxis (279 cases, 59.72% of emergency consultation), characterized by disturbances of blood coagulation, hypertension, renal failure or liver failure, iatrogenic factors. The second cause was laryngeal obstruction and tracheotomy (113 cases, 24.19% of emergency consultation). There were 43 cases with foreign body in bronchus . For routine consultation on general internal medicine, chronic rhinitis and sinusitis (169 cases) was the most common disorder, followed by chronic pharyngitis, acute or chronic tonsillitis. For consultation on surgery, most cases were concerned about preoperative evaluations (67 cases) of the chronic otolaryngological disorders. CONCLUSION Consultation is an inimitable clinical practice and a challenge to otolaryngology residents. The chief residents should be prepared for the consultation practice. Accumulation of related data from consultation is necessary and helpful for chief residents.
Humans ; Otolaryngology ; Otorhinolaryngologic Diseases ; diagnosis ; therapy ; Physicians ; Referral and Consultation ; statistics & numerical data ; Retrospective Studies ; Workforce