The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma(NPC) is still a tough problem in clinical practice.An early and accurate diagnosis is important for subsequent...The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma(NPC) is still a tough problem in clinical practice.An early and accurate diagnosis is important for subsequent management.We prospectively evaluated the diagnostic value of plasma Epstein-Barr virus(EBV) DNA in detecting postradiation nasopharyngeal skull base lesions in NPC patients.From July 2006 to September 2010,90 patients with postradiation NPC(34 women and 56 men;median age:42 years) met the selection criteria and were recruited in this study.All postradiation nasopharyngeal skull base lesions were found in the latest magnetic resonance imaging(MRI) examinations before endoscopic surgery,and the nasopharyngeal cavity was normal under flexible nasopharyngoscopy.Plasma EBV DNA detection was performed within 2 weeks before endoscopic surgery.A total of 90 endoscopic operations were successfully performed without any postoperative complications.Recurrences confirmed by postoperative pathology were found in 30 patients.The specificity,positive and negative predictive values of plasma EBV DNA detection were better than those of MRI.In addition,combining plasma EBV DNA detection with MRI improved the specificity and positive predictive values of MRI.Plasma EBV DNA detection followed by MRI would help to diagnose recurrence whereas MRI was unable.These results indicate that plasma EBV DNA is an effective and feasible biomarker for detecting postradiation nasopharyngeal skull base lesions in NPC patients.展开更多
Objectives:The Da Vinci robotic surgical system was used for head and neck surgery.This study aimed to investigate the feasibility,safety,and effect of postauricular approach on the resection of lateral neck cysts.Met...Objectives:The Da Vinci robotic surgical system was used for head and neck surgery.This study aimed to investigate the feasibility,safety,and effect of postauricular approach on the resection of lateral neck cysts.Methods:Eleven patients with lateral neck cysts were enrolled in this retrospective study and accepted robot-assisted surgery via a postauricular approach.Data on volume of cervical cysts,length of incision,bleeding volume,mean operating time,and hospitalization time were analyzed.The postoperative esthetic satisfaction of patients was investigated.Results:In this case series,the average length of the incision was 6.67 cm.Bleeding volumes ranged from 10 to 20mL.Average operation time was 55min.Four patients developed postauricular numbness after the operation,and all recovered over 3 months.No other serious adverse events occurred after the operation.Postoperative cosmetic outcomes were satisfactory.During the follow-up median period of 38.2 months,there was no evidence of recurrence or long-term complications.Conclusion:Robot-assisted resection for lateral neck cysts via a postauricular approach is feasible and safe and yields excellent cosmetic outcomes.展开更多
Objectives:Traditional resection of second branchial cleft fistulas(SBCFs)involves a transcervical incision in the neck,which leaves a prominent scar;therefore,endoscope-assisted excision of SBCFs through the anterior...Objectives:Traditional resection of second branchial cleft fistulas(SBCFs)involves a transcervical incision in the neck,which leaves a prominent scar;therefore,endoscope-assisted excision of SBCFs through the anterior chest approach has been proposed.To introduce endoscope-assisted excision of SBCFs via the anterior chest approach and to evaluate its feasibility,validity,safety,and clinical results.Methods:This was a study of four patients with SBCFs who underwent surgical resection with the assistance of endoscopy via the anterior chest approach between May 2012 and May 2018.Results:All procedures were successfully performed with endoscope-assisted surgery via the anterior chest approach.The volume of blood loss ranged from 5 to 10 mL(median 6 ml).The operating time ranged from 45 to 67 min(median 50 min).No patients presented evidence of long-term complications or recurrence during the median follow-up period of 72-144 months(median 99 months).All patients were satisfied with the cosmetic outcomes.Conclusions:Endoscope-assisted resection of SBCFs via the anterior chest approach is feasible,effective,and safe and has better esthetic effects.Therefore,SBCF surgery via the anterior chest approach could be a novel and superior treatment option for patients with SBCFs.展开更多
文摘The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma(NPC) is still a tough problem in clinical practice.An early and accurate diagnosis is important for subsequent management.We prospectively evaluated the diagnostic value of plasma Epstein-Barr virus(EBV) DNA in detecting postradiation nasopharyngeal skull base lesions in NPC patients.From July 2006 to September 2010,90 patients with postradiation NPC(34 women and 56 men;median age:42 years) met the selection criteria and were recruited in this study.All postradiation nasopharyngeal skull base lesions were found in the latest magnetic resonance imaging(MRI) examinations before endoscopic surgery,and the nasopharyngeal cavity was normal under flexible nasopharyngoscopy.Plasma EBV DNA detection was performed within 2 weeks before endoscopic surgery.A total of 90 endoscopic operations were successfully performed without any postoperative complications.Recurrences confirmed by postoperative pathology were found in 30 patients.The specificity,positive and negative predictive values of plasma EBV DNA detection were better than those of MRI.In addition,combining plasma EBV DNA detection with MRI improved the specificity and positive predictive values of MRI.Plasma EBV DNA detection followed by MRI would help to diagnose recurrence whereas MRI was unable.These results indicate that plasma EBV DNA is an effective and feasible biomarker for detecting postradiation nasopharyngeal skull base lesions in NPC patients.
基金supported by Grant(2013)163 from the Key Laboratory of Malignant Tumor MolecularMechanism and Translational Medicine of the Guangzhou Bureau of Science and Information TechnologyGrant KLB09001 from the Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of the Guangdong Higher Education Institutes.
文摘Objectives:The Da Vinci robotic surgical system was used for head and neck surgery.This study aimed to investigate the feasibility,safety,and effect of postauricular approach on the resection of lateral neck cysts.Methods:Eleven patients with lateral neck cysts were enrolled in this retrospective study and accepted robot-assisted surgery via a postauricular approach.Data on volume of cervical cysts,length of incision,bleeding volume,mean operating time,and hospitalization time were analyzed.The postoperative esthetic satisfaction of patients was investigated.Results:In this case series,the average length of the incision was 6.67 cm.Bleeding volumes ranged from 10 to 20mL.Average operation time was 55min.Four patients developed postauricular numbness after the operation,and all recovered over 3 months.No other serious adverse events occurred after the operation.Postoperative cosmetic outcomes were satisfactory.During the follow-up median period of 38.2 months,there was no evidence of recurrence or long-term complications.Conclusion:Robot-assisted resection for lateral neck cysts via a postauricular approach is feasible and safe and yields excellent cosmetic outcomes.
文摘Objectives:Traditional resection of second branchial cleft fistulas(SBCFs)involves a transcervical incision in the neck,which leaves a prominent scar;therefore,endoscope-assisted excision of SBCFs through the anterior chest approach has been proposed.To introduce endoscope-assisted excision of SBCFs via the anterior chest approach and to evaluate its feasibility,validity,safety,and clinical results.Methods:This was a study of four patients with SBCFs who underwent surgical resection with the assistance of endoscopy via the anterior chest approach between May 2012 and May 2018.Results:All procedures were successfully performed with endoscope-assisted surgery via the anterior chest approach.The volume of blood loss ranged from 5 to 10 mL(median 6 ml).The operating time ranged from 45 to 67 min(median 50 min).No patients presented evidence of long-term complications or recurrence during the median follow-up period of 72-144 months(median 99 months).All patients were satisfied with the cosmetic outcomes.Conclusions:Endoscope-assisted resection of SBCFs via the anterior chest approach is feasible,effective,and safe and has better esthetic effects.Therefore,SBCF surgery via the anterior chest approach could be a novel and superior treatment option for patients with SBCFs.
