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*

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

OBJECTIVETo study whether the dose of controlling antihypertensive drug is reduced by transcutaneous electrical acupoint stimulation (TEAS) and the anesthetics, as well as the control of blood pressure (BP) and heart rate (HR) in endoscopic endonasal surgery with general anesthesia.

METHODSSixty patients for selective endoscopic endonasal surgery with general anesthetics and controlling antihypertension involved were selected and randomized into a TEAS group, a sham-TEAS group, 30 cases in each one. The electric pads were attached to bilateral Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6) and Quchi (LI 11), stimulated with Hans-200 apparatus, 3 to 5 mA, 2 Hz/100 Hz in the TEAS group based on the patients' response to comfort. No electric stimulation was applied to the sham-TEAS group. The general anesthesia started after 30 min intervention and lasted till the end of surgery. The BP and HR were observed and recorded at the end of monitoring in operation room, 10 min after tranquilization (T0), 30 min after intervention (Tj, after induction~of general anestiesa (T2), 30 min after surgery start (T3), 60 min after surgery start (T4) and 30 min after extubation (T5). The doses of vecuronium bromide, propofol and nitroglycerin were recorded statistically in surgery, as well as the operative bleeding volume, the operative time, the resuscitation time and the visual analogue scale (VAS) score after resuscitation.

RESULTSCompared with that at T0, the mean arterial pressure (MAP) at T2, T3, T4 and T5 in the TEAS group and at T3 and T4 in the sham-TEAS group was all reduced, indicating the significant difference (all P < 0.01). MAP at T2 and T5 in the TEAS group was lower than that in the sham-TEAS group (both P < 0.01). Compared, with that at T5, except at T2 in the TEAS group (P<0. 05), HR was not different significantly at the rest time points (all P > 0.05). HR was different at T2 to Ts in the sham-TEAS group statistically (all P < 0.01). The doses of vecuronium bromide, propofol and nitroglycerin, the operative bleeding volume, the operative time, the resuscitation time and VAS after resuscitation were not different significantly between the two groups (all P > 0.05).

CONCLUSIONThe general anesthesia with TEAS and anesthetics involved for controlling antihypertension contributes to the control of BP and HR in the patients in endoscopic endonasal surgery. The impacts are not obvious on the doses of antihypertensive drug, the general anesthetics, the operative bleeding volume, the time of resuscitation and the postoperative analgesia.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Anesthetics, General ; administration & dosage ; Blood Pressure ; Electric Stimulation ; Endoscopy ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Nose Diseases ; physiopathology ; surgery ; Young Adult

To analyze six cases concerning clinical features, the treatment process and curative effect of Rhinolith. The six patients had unilateral nasal obstruction, three of them were accompanied with purulent nasal discharge, two had blood with them, one patient had repeated hemorrhage of nasal cavity and two patients had developed headache. By using endoscopic, four irregular stones which are yellow, gray and brown were found in the middle and back end. Because of the severe nasal septum deviation and inferior turbinate polypoid, the stone could not be seen clearly but could be touched by aspirator. In sinus CT examination of 6 cases, it showed incomplete irregular shapes and had high density unilateral nasal cavity in the posterior segment. 4 patients had nasal deviation, 3 patients had ipsilateral sinusitis. 4 patients removed their stone by using endoscopy, 2 patients took the stone away after correction of nasal septum. Pathologic diagnosis: rhinolith. Two patients also had exogenous foreign matters which were considered as pseudo nasal stones.
Back ; Calculi ; Endoscopy ; Headache ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Nose Diseases ; pathology ; surgery ; Paranasal Sinuses ; Sinusitis ; Turbinates

We present an extremely rare case of pleomorphic adenoma of the nasal septum in a 24-year old woman who went to consultation because of right nasal neoplasm. The radiologic discoveries by computerized tomography showed a tumor in the right nasal septum. Incisional biopsy was done, with a histopathological report of pleomorphic adenoma. Later, nasal endoscopy was used to remove the neoplasm and histology revealed pleomorphic adenoma of the nasal septum.
Adenoma, Pleomorphic ; diagnostic imaging ; surgery ; Catheter Ablation ; methods ; Cryotherapy ; methods ; Endoscopy ; Female ; Humans ; Nasal Septum ; diagnostic imaging ; surgery ; Nose Neoplasms ; diagnostic imaging ; surgery ; Rare Diseases ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To observe the effect of hypothermia plasma radiofrequency ablation to the adhesion of nasal cavity after radiotherapy of nasopharyngeal carcinoma. METHOD: The subjective score combined with nasal ventilation function test were used to reflect the degree of patients with nasal adhesion. RESULT: There is a significant improvement in subjective feeling after treatment. Nasal cavity volume began to increase and nasal expiratory resistance decrease obviously 3M later. CONCLUSION Hypothermia plasma radiofrequency ablation technology can improve the nasal cavity adhesion in patients with nasopharyngeal carcinoma after radiotherapy, and also the patients quality of life.
Carcinoma ; Catheter Ablation ; methods ; Female ; Humans ; Hypothermia, Induced ; Male ; Nasal Cavity ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Nose ; Nose Diseases ; surgery ; Quality of Life ; Tissue Adhesions ; surgery

OBJECTIVE: To evaluate the efficacy of the endoscopic maxillary sinus surgery by lateral wall fenestration of the inferior nasal meatus (EMSLWF). METHOD: Based on traditional Messerklinger sinus surgery, we treat the 17 cases with maxillary sinus disorder by lateral wall fenestration of the inferior nasal meatus, removing the polyp, hemangioma, inverting papilloma, invasive sinus aspergillosis etc, trans aperture maxillary and intranasal window. RESULT: The maxillary sinuses of the 17 cases are clean. Mucosa are well recovered and drained of the mid dle and inferior nasal meatus. We did not find the nasal mucosa pathological changes like the fluid-filled blisters or edema etc. The intranasal windows are closed in only 2 cases (4.25%) after about 2 months. The maxillary sinuses of all cases are still clean with no recurrence of primary diseases. CONCLUSION The EMSLWF is well suitable for dealing with the maxillary sinus diseases. Meanwhile, before the function of the nasal mucociliary transportation system recovered in the perioperative period, the gravity drainage affection should be kept by the intranasal win dow in the inferior nasal meatus. The EMSLWF is worthy of more attention in clinic.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged ; Nasal Cavity ; surgery ; Nasolacrimal Duct ; surgery ; Nose ; surgery ; Paranasal Sinus Diseases ; surgery ; Young Adult

OBJECTIVE: To investigate the efficacy of nasal mucosa contact point headache with the treatment of endoscopic sinus surgery. METHOD: Clinical data of 75 cases with nasal mucosa contact point headache treated in our department from Jan 2008 to Nov 2011 were retrospectively analyzed. These patients were performed with endoscopic sinus surgery. RESULT: All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred. CONCLUSION Nasal mucosa contact point headache and primary headache had different clinical features and different treatment. Misdiagnosis were easily made if not being carefully analyzed. Three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications. Therefore, it is necessary to strengthen the awareness of this disease. Nasal structure abnormality is the main reason of nasal mucosa contact point headache. The implementation of individualized nasal endoscopic sinus surgery can achieve satisfactory curative effect.
Adult ; Endoscopy ; Female ; Headache ; diagnosis ; diagnostic imaging ; etiology ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; Nose Diseases ; complications ; diagnosis ; surgery ; Ultrasonography ; Young Adult

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Child ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytosis, Sinus ; diagnostic imaging ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Nose Diseases ; diagnostic imaging ; metabolism ; pathology ; surgery ; Nose Neoplasms ; metabolism ; pathology ; Plasmacytoma ; metabolism ; pathology ; Recurrence ; Rhinoscleroma ; metabolism ; pathology ; S100 Proteins ; metabolism ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the clinicopathologic features and differential diagnosis of extranodal Rosai-Dorfman disease (RDD) of the upper respiratory tract.

METHODSThe clinical, pathologic and immunohistochemical features of 10 cases of RDD were evaluated.

RESULTSAmong the 10 cases studied, there were 3 males and 7 females. The age of patients ranged from 20 to 61 years old (mean 38 years). The lesion arose in the nasal cavity (7 cases), nasopharynx (2 cases) or hard palate to trachea (1 case). Most of the patients presented with nasal obstruction, rhinorrhagia or tumor mass in the nasal/nasopharyngeal regions. CT scan often showed the presence of soft tissue lesion without bone destruction. Histologically, extranodal RDD was characterized by light-staining bands alternating with dark-staining bands. The light-staining bands were formed by aggregates of large round or polygonal histiocytes with emperipoiesis. The dark-staining bands were formed by abundant lymphoplasmacytic infiltrates. Immunohistochemical study showed that the histiocytes strongly expressed S-100 protein and partially expressed CD68. Six patients had no recurrence after surgical resection.

CONCLUSIONSExtranodal RDD of the upper respiratory tract is a rare disorder of histiocytic proliferation, which usually involves the nasal cavity and paranasal sinuses. RDD can easily mimic rhinoscleroma, mainly due to the overlapping morphologic appearance. Immunohistochemical study is helpful in the differential diagnosis.

Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytic Sarcoma ; metabolism ; pathology ; Histiocytosis, Langerhans-Cell ; metabolism ; pathology ; Histiocytosis, Sinus ; diagnostic imaging ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Nasopharyngeal Diseases ; diagnostic imaging ; metabolism ; pathology ; surgery ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; Nose Diseases ; diagnostic imaging ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Tomography, X-Ray Computed ; Young Adult