1.Clinical study of endoscopic surgery for recurrent nasopharyngeal carcinoma.
Yin HE ; Hai YIN ; Jiasen WU ; Wen ZHENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):771-777
Objective:To compare the clinical effects and complications of surgery + chemotherapy and radiotherapy + chemotherapy in patients with nasopharyngeal carcinoma recurrence, so as to compare the safety and efficacy of two different therapeutic methods. Methods:A retrospective analysis was performed on 40 patients with recurrent nasopharyngeal carcinoma after radiotherapy and chemotherapy admitted to our hospital from January 2016 to June 2020. Among them, 26 patients were treated with surgery. The recurrent tumor was removed under nasal endoscope, and the frozen resection margin was negative during the operation. Chemotherapy was continued for stage Ⅲ and Ⅳ patients from 3 to 5 weeks after surgery. Fourteen patients received secondary radiotherapy and chemotherapy. Postoperative complications and survival rate were observed. Results:There were 14 patients in the secondary chemoradiotherapy group(control group) and 26 patients in the nasal endoscopic surgery group(observation group). Among the 26 patients, 19 patients underwent nasal septal mucosal repair, 5 patients underwent temporal muscle flap repair, 2 patients underwent submental flap repair, 2 patients had nasal septal mucosal flap necrosis and cerebrospinal fluid leakage, and the temporal muscle flap was used for secondary repair in the second stage operation, and 8 patients needed cervical lymph node dissection. The patients recovered well after surgery, and the patients in stage Ⅲ and Ⅳ were treated with chemotherapy after 3 weeks to 5 weeks according to the patient's wound condition. There were significant differences in the incidence of complications and 1-, 2-, and 3-year survival rates between the two groups(P<0.05). Conclusion:Patients with recurrent nasopharyngeal carcinoma can be treated by nasal endoscopic surgery to remove the tumor, and the use of pedicled nasal septal mucosal flap or temporal muscle flap for skull base reconstruction, The operation can effectively prevent major complications such as internal carotid artery rupture and hemorrhage, and improve the survival rate and quality of life of patients. It provides a safe and effective treatment for patients with recurrent nasopharyngeal carcinoma.
Humans
;
Plastic Surgery Procedures
;
Nasopharyngeal Carcinoma/surgery*
;
Retrospective Studies
;
Quality of Life
;
Skull Base/surgery*
;
Nose Diseases/pathology*
;
Nasopharyngeal Neoplasms/pathology*
2.Surgical treatment of vidianneurectomy and selective vidianneurectomy in 60 cases of refractory allergic rhinitis.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(7):705-709
Objective: To explore the effect of vidian neurectomy and selective vidian neurectomy in the treatment of moderate and severe persistent allergic rhinitis (AR). Methods: A total of 60 patients with moderate-to-severe persistent AR treated in Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine from June 2018 to June 2020 were selected, including 28 males and 32 females. A total of 40 cases in the observation group were subjected to vidianneurectomy, while, 20 cases in the control group underwent selective vidianneurectomy. Patients in the two groups were followed up at 6 months, 1 year, and 2 years, respectively, and evaluated according to AR diagnostic and efficacy assessment criteria. Four symptoms of sneezing, clear runny nose, nasal congestion, and nasal itching were scored as efficacy indices before and at 6 months, 1 year, and 2 years after surgery. The regression of the lower turbinate swelling after surgery was assessed by nasal endoscopy or sinus CT. Postoperative tear secretion was followed up in both groups, and patients with dry eyes were counted in combination with ocular symptoms. SPSS 19.0 software was used to statistically analyze the data before and after the surgery and between the two groups. Results: The preoperative, 6-month, 1-year, and 2-year postoperative inferior turbinate signs were (2.73±0.45), (1.20±0.41), (1.25±0.49) and (1.30±0.56) points in the observation group and (2.75±0.44), (1.45±0.69), (1.75±0.72) and (1.90±0.85) points in the control group, respectively, with a statistically significant difference in the between-subjects effect test between the two groups (F=8.28, P<0.05), indicating a more durable surgical effect in the observation group. The total effective rate at 2 years after surgery was 95.0% (38/40) in the observation group and 50% (10/20) in the control group. The difference between the two groups by Fisher's exact test was statistically significant. No dry eye patient was found in either group at a 1.5-year postoperative follow-up. Conclusion: Both vidianneurectomy and selective vidianneurectomy have good recent treatment effects, vidianneurectomy has better long-term curative effects than selective vidianneurectomy.
Male
;
Female
;
Humans
;
Treatment Outcome
;
Rhinitis, Allergic/surgery*
;
Turbinates/surgery*
;
Denervation
;
Nose Diseases
6.Upper airway cough syndrome in 103 children.
Fan GAO ; Qing-Long GU ; Zi-Dong JIANG
Chinese Medical Journal 2019;132(6):653-658
BACKGROUND:
In China, upper airway cough syndrome (UACS) is only less frequent than cough-variant asthma and accounts for 24.71% of chronic cough. This study aimed to determine the pathogenetic constituents and factors affecting UACS in children of different age groups, and to identify clinical clues for diagnosing UACS and a method for curative effect evaluation.
METHODS:
A total of 103 children with UACS whose chief complaint was chronic cough were studied from January to November 2013 at Children's Hospital, Capital Institute of Pediatrics. According to their age, children with UACS were divided into 3 groups: nursing children, pre-school children, and school-age children. We analyzed the differences in pathogenetic constituents and factors affecting UACS in children. The effect of UACS treatment was evaluated by the visual analog scale (VAS) and an objective examination. Chi-squared test and analysis of variance were performed with the SPSS 19.0 statistical software.
RESULTS:
There was a high incidence of UACS in school-age children. Rhinitis with adenoid hypertrophy was the main cause of 103 suspected UACS cases. Adenoidal hypertrophy was the major cause of UACS in the pre-school children group, while rhinitis was the major reason in the nursing children and school-age children groups. Among the 103 children, there were 45 allergen-positive children, with no significant difference among different age groups. VAS scores in the different disease groups after treatment were lower than those before treatment (all P < 0.01). VAS scores in different disease groups showed significant differences, except for 12 vs. 24 weeks after treatment (P = 0.023). Different age groups had different secondary complaints.
CONCLUSIONS
There are different pathogeneses in different UACS age groups. Clinical treatment efficacy of children with UACS can be evaluated by the VAS combined with an objective examination. We recommend that the course of treatment should be 12 weeks.
Adolescent
;
Asthma
;
epidemiology
;
Chi-Square Distribution
;
Child
;
Child, Preschool
;
China
;
epidemiology
;
Chronic Disease
;
epidemiology
;
Cough
;
epidemiology
;
Female
;
Humans
;
Incidence
;
Male
;
Nose Diseases
;
epidemiology
;
Rhinitis
;
epidemiology
;
Rhinitis, Allergic
;
epidemiology
7.Tricho-rhino-phalangeal syndrome due to a novel frameshift variation of the TRPS1 gene.
Ning LIU ; Ying BAI ; Yin FENG ; Xiangdong KONG
Chinese Journal of Medical Genetics 2019;36(10):993-995
OBJECTIVE:
To explore the genetic etiology of a pedigree affected with tricho-rhino-phalangeal syndrome.
METHODS:
Next-generation sequencing (NGS) using a gene panel for hereditary osteopathies was carried out for the proband. Suspected mutation was validated in the proband and her parents by Sanger sequencing.
RESULTS:
A heterozygous frameshift variation c.1995dupA (p.Gly666Argfs*20) of the TRPS1 gene was detected in the proband but not in her parents.
CONCLUSION
The novel c.1995dupA (p.Gly666Argfs*20) mutation of the TRPS1 gene probably underlies the disease in the proband.
DNA-Binding Proteins
;
genetics
;
Female
;
Fingers
;
abnormalities
;
Frameshift Mutation
;
Hair Diseases
;
genetics
;
Humans
;
Langer-Giedion Syndrome
;
genetics
;
Nose
;
abnormalities
;
Pedigree
;
Transcription Factors
;
genetics
8.The Effects of Air Pollutants on the Prevalence of Common Ear, Nose, and Throat Diseases in South Korea: A National Population-Based Study
Mina PARK ; Ji Sung LEE ; Moo Kyun PARK
Clinical and Experimental Otorhinolaryngology 2019;12(3):294-300
OBJECTIVES: The effects of air pollutants on upper airway disease development have been seldom studied. In this study, we evaluated the effects of air pollution on the prevalence of ENT diseases. METHODS: We identified cases of ENT disease occurring in 2009, as recorded by the Korea National Health and Nutrition Examination Survey, and explored their associations with the levels of five air pollutants: sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), carbon monoxide (CO), and particulate matter (PM₁₀ particles; particulates ≤10 μm in aerodynamic diameter). Subjects diagnosed with at least one of the five studied ENT diseases were included in analysis, but those aged under 19 years were excluded. Linear associations between ENT disease frequency and pollutant levels were evaluated by calculating Spearman correlations. After adjusting for age, gender, and geographic region, multivariate logistic regression was used to obtain odds ratios (OR) with 95% confidence intervals (CI). RESULTS: A total of 7,399 subjects with ENT diseases were identified. A linear association was evident between PM₁₀ concentration and the frequency of septal deviation (Spearman coefficient, 0.507; P=0.045). After adjustment, the PM₁₀ level was associated with high odds ratios for chronic rhinosinusitis (1.22; 95% CI, 1.02 to 1.46) and septal deviation (1.43; 95% CI, 1.22 to 1.67). Both of these conditions were more prevalent in males. CONCLUSION: We found that increased ambient concentrations of PM₁₀ particles were clearly associated with increased the risk of chronic rhinosinusitis and septal deviation; the exposure-response relationship was definitive.
Air Pollutants
;
Air Pollution
;
Carbon Monoxide
;
Ear
;
Health Impact Assessment
;
Humans
;
Korea
;
Logistic Models
;
Male
;
Nitrogen Dioxide
;
Nose
;
Nutrition Surveys
;
Odds Ratio
;
Otorhinolaryngologic Diseases
;
Ozone
;
Particulate Matter
;
Pharynx
;
Prevalence
;
Respiratory Tract Infections
;
Sulfur Dioxide
9.Saddle Nose Deformity as a Result of an Aseptic Nasal Abscess Accompanied by Ulcerative Colitis and Pyoderma Gangrenosum.
Journal of Rhinology 2018;25(1):55-58
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that causes granulomatous inflammation in the mucous membrane of the intestinal tract, especially in the colon. Additionally, UC can be accompanied by extraintestinal manifestation (EIM). EIM of UC includes cutaneous lesions such as pyoderma gangrenosum, and rarely, systemically occurring aseptic abscesses (AA) have been reported in a few cases. Nasal involvement of UC as an extraintestinal manifestation of IBD is rare, and few reports of nasal mucosa and septal cartilage involvement have been documented in the literature. However, aseptic nasal abscess involving septal cartilage associated with UC and pyoderma gangrenosum resulting in saddle nose deformity have not been reported. The author presents a case of a 52 year-old woman with UC and pyoderma gangrenosum and an aseptic abscess in the nasal septal cartilage resulting in saddle nose deformity, which was corrected by augmentation rhinoplasty.
Abscess*
;
Cartilage
;
Colitis, Ulcerative*
;
Colon
;
Congenital Abnormalities*
;
Female
;
Humans
;
Inflammation
;
Inflammatory Bowel Diseases
;
Mucous Membrane
;
Nasal Mucosa
;
Nose*
;
Pyoderma Gangrenosum*
;
Pyoderma*
;
Rhinoplasty
;
Ulcer*
10.Restoration of an Upper Lip Affected by Necrotizing Ulcerative Stomatitis Using Bilateral Cheek Advancement with a Crescentic Perialar Excision.
Yu Gil PARK ; Sang Hun KIM ; Eun Soo PARK
Archives of Aesthetic Plastic Surgery 2018;24(2):87-90
Necrotizing ulcerative stomatitis (NUS) refers to ulceration of the oral mucosa that precedes rapid orofacial soft- and hard-tissue destruction. NUS on the upper lip is considered a reconstructive challenge because of the functional importance and complex multidimensional structure of the facial units that are involved, and is most commonly found in developing countries. Therefore, few studies have been conducted on NUS. Moreover, reconstruction options vary from local regional flaps to free-tissue transfers. We report a very interesting case in which we performed regional flap surgery using bilateral cheek advancement in a patient with NUS. A 75-year-old woman with a history of diabetes mellitus and hypertension, but no other immunological diseases, presented with skin necrosis on the upper lip. At presentation, necrotic tissue covered the upper lip and philtrum, but it had not invaded the nose or lower lip. After debridement of the necrotic tissue, approximately 70% of the upper lip was missing. We therefore designed a bilateral cheek advancement and rotation flap, in which the flap was sutured in 3 layers. There was no need to perform additional procedures, as the flap healed well and showed no other complications or recurrence. The patient exhibited good voluntary muscle control and oral competence while eating and drinking, and she was also very satisfied with the cosmetic results. Thus, regional flap surgery using a simple advancement flap may result in good recovery of both functional and aesthetic units in patients with NUS.
Aged
;
Cheek*
;
Debridement
;
Developing Countries
;
Diabetes Mellitus
;
Drinking
;
Eating
;
Female
;
Gingivitis, Necrotizing Ulcerative*
;
Humans
;
Hypertension
;
Immune System Diseases
;
Lip*
;
Mental Competency
;
Mouth Mucosa
;
Muscle, Skeletal
;
Necrosis
;
Noma
;
Nose
;
Reconstructive Surgical Procedures
;
Recurrence
;
Skin
;
Surgical Flaps
;
Ulcer*

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