BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardi...BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.展开更多
BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need...BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.展开更多
BACKGROUND Gallstones are frequently observed in patients with cholecystitis,but the migration of free gallstones into the abdominal wall leading to chronic sinus formation is exceedingly rare.CASE SUMMARY We report a...BACKGROUND Gallstones are frequently observed in patients with cholecystitis,but the migration of free gallstones into the abdominal wall leading to chronic sinus formation is exceedingly rare.CASE SUMMARY We report a case of a 72-year-old woman who experienced recurring fever and abdominal pain following laparoscopic cholecystectomy for acute cholecystitis,during which gallbladder rupture was noted.Despite initial conservative management and temporary T-tube placement,the patient developed a chronic sinus in the abdominal wall 9.5 years later,characterized by an area of thickened soft tissue with ulceration and purulent discharge.Surgical exploration revealed the presence of a migrated gallstone at the base of the sinus tract,necessitating careful surgical removal and postoperative wound care.CONCLUSION This case highlights the potential long-term complications of retained free gallstones and the importance of thorough surgical retrieval.展开更多
Background:Tongyang Huoxue Decoction(TYHX)can modulate calcium homeostasis andmitochondrial quality management to safeguard sinus node function.Nonetheless,theprecise chemical process remains unclear.This study aimed ...Background:Tongyang Huoxue Decoction(TYHX)can modulate calcium homeostasis andmitochondrial quality management to safeguard sinus node function.Nonetheless,theprecise chemical process remains unclear.This study aimed to verify the upstreamregulatory influence of SERCA2a on the enhancement of calcium homeostasis andmitochondrial unfolded protein response(mtUPR)in sinus node cells(SANCs)by TYHX,while elucidating the protective mechanism of TYHX on SNC activity.Methods:In vitromodels of sh/ad-SERCA2a and si-β-tubulin were established,and TYHX was employed tointervene in each cell group.Various approaches were employed to detect functionsincluding mitochondrial membrane potential,mitochondrial respiration,oxidative stress,mitochondrial biosynthesis,and mitochondrial autophagy and UPR.In vivo confirmationthat TYHX suppresses apoptosis and inflammatory injury.Results:I/R injury led todiminished SANCs activity,compromised mitochondrial membrane potential,reducedmitochondrial respiratory function,and heightened oxidative stress.This further impededmitochondrial production,destabilized the proteome structure,triggered the mtUPR,andinhibited mitochondrial autophagy,thereby upsetting the dynamic equilibrium of themitochondrial quality control network.Furthermore,I/R injury intensified intracellularcalcium excess and worsened oxidative stress damage.Conversely,TYHX interventionmitigated intracellular calcium overload,augmented mitochondrial antioxidant capacity,stimulated mitochondrial autophagy,and decreased the mtUPR.Sh-SERCA2a counteractedthe regulatory influences of TYHX on calcium homeostasis,mitochondrial biogenesis,mtUPR,mitochondrial autophagy,and apoptosis.Conversely,ad-SERCA2a exerted minimalinfluence on the efficacy of TYHX.SERCA2a is a major target protein for TYHX todemonstrate its efficacy.When tubulin expression was minimal,there was no statisticallysignificant difference in the expression levels of mitochondrial autophagy,mitochondrialbiosynthesis,calcium homeostasis regulation,and mtUPR between the sh-SERCA2a andad-SERCA2a groups.This indicates that the normal expression of tubulin is essential forSERCA2a to enhance the efficiency of TYHX.Tubulin may serve as an upstream regulatorymolecule of SERCA2a.In vivo tests confirmed that TYHX may suppress apoptosis andmitigate cellular inflammatory damage.Conclusion:TYHX preserved intracellular calciumequilibrium,mitigated mitochondrial oxidative stress,sustained mitochondrial stability,enhanced mitochondrial biosynthesis,suppressed the mtUPR,facilitated mitochondrialautophagy,and inhibited apoptosis viaβ-tubulin-SERCA2a,thereby safeguarding sinus nodefunctionality from I/R injury.展开更多
Sinus of Valsalva aneurysm(SoVA)is a rare cardiac defect that may be congenital or acquired.It is characterized by abnormal dilatation of the aortic root due to a weakened elastic lamina at the junction of the annulus...Sinus of Valsalva aneurysm(SoVA)is a rare cardiac defect that may be congenital or acquired.It is characterized by abnormal dilatation of the aortic root due to a weakened elastic lamina at the junction of the annulus fibrosus and the aortic media.SoVAs are present in approximately 0.09%of the general population and comprise up to 3.5%of all congenital cardiac defects.It is usually found inci-dentally on cardiac imaging,with a higher incidence observed in the Western populations and a male-to-female ratio of 4:1.A transthoracic two-dimensional echocardiogram is the initial diagnostic test of choice,which may reveal the characteristic“windsock deformity”that clinches the diagnosis.Other imaging modalities,such as transesophageal echocardiography and cardiac computed tomography angiography,help provide more extensive details of the aneurysm and its adjacent structures.Management options for ruptured and unruptured SoVA include surgical repair or transcatheter closure,which serves as a game-changing development in treatment.This article aims to provide background information on the epidemiology,pathophysiology,diagnosis,and recent advan-cements over the past decade in the management of SoVAs.展开更多
BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)are widely used in gallbladder and biliary tract diseases.During these procedures,vessels or tissues are commonly ligated ...BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)are widely used in gallbladder and biliary tract diseases.During these procedures,vessels or tissues are commonly ligated using clips.However,postoperative migration of clips to the common bile duct(CBD)or Ttube sinus tract is an overlooked complication of laparoscopic biliary surgery.Previously,most reported cases of postoperative clip migration involved metal clips,with only a few cases involving Hem-o-lok clips and review of the literature.CASE SUMMARY This report describes two cases in which Hem-o-lok clips migrated into the CBD and the T-tube sinus tract following laparoscopic surgery.Case 1 is a 68-year-old female admitted due to abdominal discomfort,and two Hem-o-lok clips were found to have migrated into the CBD 17 months after LC and LCBDE with T-tube drainage,and were removed using a stone extraction balloon.The patient was discharged smoothly after recovery.Case 2 is a 74-year-old male who underwent LC and LCBDE with T-tube drainage and laparoscopic biliary tract basket stone extraction.Nine weeks postoperatively,following T-tube removal,a Hem-o-lok clip was found in the sinus tract,and was extracted from the T-tube sinus tract.The patient recovered smoothly postoperatively.This study also reviews the literature from 2013 to July 2024 on using Hem-o-lok clips in LC and/or LCBDE treatment of gallbladder and biliary diseases and the postoperative migration of these clips into the CBD,T-tube sinus tract,or duodenum.CONCLUSION In patients with a history of LC and/or LCBDE,clip migration should be considered as a differential diagnosis.展开更多
Persistent left superior vena cava(PLSVC)is a rare congenital anomaly that may complicate cardiac procedures when associated with a dilated coronary sinus(CS)and conduction disturbances.We report the case of a 27-year...Persistent left superior vena cava(PLSVC)is a rare congenital anomaly that may complicate cardiac procedures when associated with a dilated coronary sinus(CS)and conduction disturbances.We report the case of a 27-year-old male with Wilson’s disease who presented with complete heart block.Echocardiography showed biatrial enlargement and severe CS dilation,while contrast-enhanced computed tomography(CT)confirmed PLSVC draining into the CS without a bridging vein.Anatomical constraints prevented cardiac resynchronization therapy,and dual-chamber pacemaker implantation proved technically challenging due to lead placement difficulties.This case highlights the importance of thorough preoperative assessment and individualized pacing strategies in patients with PLSVC,in order to anticipate anatomical challenges and optimize outcomes.展开更多
Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion...Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. CDST is commonly associated with other pathologies such as myelomeningocele, split cord malformation, tethered cord and inclusion tumors. The authors report a case of a 2-year-old girl discharging lumbosacral CDST. The preoperative MRI showed the dermal sinus tract with 2 intradural lesions from L1 to L3. The tract was surgically excised followed by complete excision of the cyst and lipoma. The dermal sinus tract was attached to the medullary cone and was cut there, allowing “en bloc” removal of the dermal sinus tract. There were two distinct types of tumor. One cystic is located posterior to the medullary cone and the other is located laterally to the medullary cone, whose appearance suggests a lipoma. Both tumors were removed completely. The dura was closed in a tight manner. The pathological examination confirmed the lipoma and Dermoid Cyst. In the postoperative course, the child had a motor deficit in the lower limbs, which recovered completely after 3 months of physiotherapy.展开更多
BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr...BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr virus infection.AIM To explore the anxiety and depression status of patients with NK/T-cell NHL in the nasal cavities and paranasal sinuses and analyzes the relevant influencing factors.METHODS A retrospective analysis was performed,which included 30 patients with primary nasal NK/T-cell NHL treated in Shaanxi Provincial People’s Hospital from January 2017 to January 2023.An additional 50 healthy volunteers were selected as the control group.Both groups were assessed using the self-rating anxiety scale(SAS)and Self-rating(SDS).SDS and SAS scores of patients with NHL at different disease stages were analyzed,and they were further grouped into negative emotion(NE)(n=19)and non-NE(n=11)groups based on their depression and anxiety.Factors affecting the occurrence of NEs in patients with NHL were analyzed using univariate and multivariate logistic regression models.RESULTS Patients with NHL exhibited higher SDS and SAS scores than healthy controls.Moreover,patients with NHL at stages III and IV had higher SDS and SAS scores than those in stage I.Among the 30 patients,there were 13 patients with depression(43.3%),16 patients with anxiety(53.3%),and 10 patients with both anxiety and depression(33.3%).Univariate analysis identified a higher proportion of people in the NE group with stage III-IV NHL,an educational level≤high school,and a monthly household income<5000 yuan compared with the non-NE group.Multiple logistic regression analysis further revealed that stage III-IV was a risk factor for NEs in patients with NHL.CONCLUSION The stage of NK/T-cell NHL in nasal cavities and paranasal sinuses is closely related to patient anxiety and depression.The higher the staging,the greater the incidence of anxiety and depression.展开更多
Sinus venosus defects include two varieties,superior and inferior sinus venosus defects.The superior sinus venosus defect is characterized by abnormal communication between two closely related venoatrial structures:1)...Sinus venosus defects include two varieties,superior and inferior sinus venosus defects.The superior sinus venosus defect is characterized by abnormal communication between two closely related venoatrial structures:1)the normally positioned superior vena cava-right atrium complex and 2)the right pulmonary vein-left atrium complex that is displaced leftward,forward and upward.Inferior sinus venosus defects primarily involve the inferior vena cava-right atrial junction while the right pulmonary vein-left atrial junction can also be affected.Because of the rarity and wide variation of the defects,the morphological characterization of sinus venosus defects is inconsistent among investigators and often inaccurate.Modern imaging technologies with high spatial and temporal resolutions have allowed accurate and detailed assessment of the pathological anatomy in larger numbers of cases.In this pictorial essay,we revisit the established and controversial features of the sinus venous defects using twodimensional(2D)and three-dimensional(3D)images obtained by magnetic resonance(MR)or computed tomography(CT)with brief discussion on imaging and treatment strategies.展开更多
The ultrastructure of the X organ sinus gland complex in sexually immature Chinese mitten crab Eriocheir sinensis was examined under the electron microscope. The sinus gland (SG) is composed primarily of nerve te...The ultrastructure of the X organ sinus gland complex in sexually immature Chinese mitten crab Eriocheir sinensis was examined under the electron microscope. The sinus gland (SG) is composed primarily of nerve terminals and glial cells. The terminal contains a great number of membrane bound granules, mitochondria, rough endoplasmic reticulum and electron lucent vesicles. The profiles of the terminals are sometimes exhibited finger like projections. The X organ (XO) locates at the ventral surface of the medulla terminalis ganglion in the eyestalk, oppositing to SG. According to the features of granule size, shape, electron density and cytoplasm, 6 types of terminals in SG and 7 types of neurosecretory (NS) cells in XO were identified. The release process by exocytosis of the granules in SG was observed and a tentative comparison was made for the granules between different types of terminals and NS cells. It seemed that they had a good correspondence since no change in electron density and just a slight increase of sizes was shown.展开更多
Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this pros...Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CT<sub>MD</sub>). CT<sub>3mm</sub> was reconstructed from CT<sub>MD</sub> data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CT<sub>MD</sub> and CT<sub>3mm</sub> (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT<sub>3mm</sub> scans. The intra-observer reproducibility of CT<sub>3mm</sub> scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT<sub>3mm</sub> in comparison to CT<sub>MD</sub> was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.展开更多
The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vesse...The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.展开更多
<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacen...<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.展开更多
AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive...AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive patients (11 females and 4 males; mean age 40.93 years; age range 13-63 years) with cavernous sinus hemangiomas (CSH) who underwent examination between November 2008 and May 2016 were included for the analysis. MRI, clinical and surgical findings of each patient was retrospectively reviewed. DWI were also analysed and mean-apparent diffusion coefficient (ADC) value was calculated. Eleven patients underwent surgical removal of the lesion and 2 patients had biopsy only. Diagnosis of CSH was confirmed histologically in 13 patients. RESULTSEleven patients (73%) presented with headaches and 10 (66%) had cranial nerve involvement. Extra cavernous sinus extension was noted in 14 (94%). Surgery was performed in 13 (87%) and post-operative radiation was given to 4 (28%) patients. Thirteen patients remained asymptomatic on follow up. Three conspicuous imaging features were highly suggestive of the diagnosis: Lack of diffusion restriction (100%), homogeneous hyperintensity on T2 weighted image sequences (93.3%) and intense post-contrast enhancement (100%). The mean ADC was 1.82 × 10<sup>-3</sup> ± 0.2186 cm<sup>2</sup>/s. CONCLUSIONT1-weighted hypointensity with homogeneous hyperintensity on T2-weighted sequences, intense enhancement and absence of hemosiderin within the lesion on GRE sequence favour the diagnosis. Facilitated diffusion on DWI differentiates CSH from other solid cavernous sinus lesions and significantly improves the diagnostic accuracy, a critical factor for planning surgery.展开更多
OBJECTIVE: To investigate the effectiveness and safety of Zhu-yuan decoction(ZYD) in patients after functional endoscopic sinus surgery(FESS).METHODS: A total of 85 patients were randomized into two groups: 44 were tr...OBJECTIVE: To investigate the effectiveness and safety of Zhu-yuan decoction(ZYD) in patients after functional endoscopic sinus surgery(FESS).METHODS: A total of 85 patients were randomized into two groups: 44 were treated with intranasal corticosteroids(INC), and 41 were given Chinese herbal medicine(CHM). Patients with chronic rhinosinusitis(CRS) who underwent FESS were prospectively enrolled in the study. Before surgery, they were evaluated by visual analog scale(VAS), nasal endoscopy, computed tomography(CT), and routine blood test. After surgery, they were randomized to take ZYD or INC for 12 weeks and revaluated by VAS; nasal endoscopy at 4, 8, and 12 weeks;and CT at 12 weeks after surgery.RESULTS: In the both groups, VAS and endoscopyscores decreased significantly at 4, 8, and 12 weeks,and CT scores after treatment declined at 12 weeks compared with baseline scores. No significant differences were observed with regard to postoperative VAS, endoscopy, or CT scores between groups.ZYD, combined with surgery, can reduce VAS, nasal endoscopy, and CT scores and has the same efficacy and safety profile as INC in post-FESS management.No fatalities or major adverse events occurred in either group.CONCLUSION: Our findings suggest that ZYD has similar effects and safety profiles in patients after FESS compared with INC.展开更多
Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observatio...Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS.Discharged patients were followed up to 72 weeks for all-cause recurrence events.Baseline SES was established based on occupation,education level,and family income of the patients 1 year before the operation.Kaplan–Meier method was used to calculate the recovery rate after ESS,and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.Results Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES;24-week overall recovery rate was 90.4%[95%confidence interval(CI):89.6%–91.2%]in patients of middle SES,13.5%(95%CI:12.8%–14.2%)in patients of low SES,and 31.7%(95%CI:30.7%–32.7%)in patients of high SES(both log-rank P<0.001).After adjustment for covariates,hazard ratios(HRs)were7.69(95%CI:6.17–9.71,Ptrend<0.001)for all-cause recurrence for low SES versus middle SES,and 6.19(95%CI:4.78–7.93,Ptrend<0.001)for middle SES versus high SES.Conclusion Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.展开更多
Objective To provide a new approach for the treatment of tumor in Meckel’s cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave approach. Methods Fifteen ad...Objective To provide a new approach for the treatment of tumor in Meckel’s cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave approach. Methods Fifteen adult cadaver heads （30 sides） were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. Results The approach was divided into 3 steps： entering the maxillary sinus, the later pterygopalatine fossa and the final Meckel’s cave. Safe access to Meckel’s cave could be achieved by tracing the vidian neurovascular bundles and dissecting the quadrangular space （QS）. The distances from the nasal columella to the apertura maxillaries, the sphenopalatine foramen, and the anterior foramen of the pterygoid canal were （44.08±2.61） mm, （64.83±2.42） mm, and （70.43±2.94） mm, respectively. The angles between the horizontal plate of the palatine bone and the link from nasal columella to apertura maxillaries, between the horizontal plate of the palatine bone and the link from nasal columella to sphenopalatine foramen were （38.10±2.46）° and （26.15±2.26）°, respectively. Conclusion The endoscopic approach of transnasal maxillary sinus-pterygopalatine fossa-Meckel’s cave （ENMPA） is a safe and direct way to access Meckel＇s cave, and could be employed for the treatment of tumor in Meckel’s cave.展开更多
Signifcant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. ...Signifcant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been esta-blished. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pul-monary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.展开更多
The aim of the study was to analyze the histologic and ultrastructural changes after maxillary sinus augmentation with simultaneous implant placement using engineered bone graft material.In this study,calcium phosphat...The aim of the study was to analyze the histologic and ultrastructural changes after maxillary sinus augmentation with simultaneous implant placement using engineered bone graft material.In this study,calcium phosphate cement(CPC)scaffolds combined with goat bone marrow stromal cells(BMSCs)were used to fill goat sinus floor space after maxillary sinus floor elevation with simultaneous implant placement comparing with those not filled any grafted materials and used as controls.After a healing period of 3 months,the goat maxillary sinus membrane was examined using light microscopy and scanning electronic microscopy.The results showed that the connective tissue thickness and the epithelium thickness of mucosa were not statistically significant difference between two groups.The tissue engineered bone complex might be an ideal graft for the sinus floor elevation and have no influence on the sinus membrane under the histological and ultrastructural observation.展开更多
文摘BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.
文摘BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.
文摘BACKGROUND Gallstones are frequently observed in patients with cholecystitis,but the migration of free gallstones into the abdominal wall leading to chronic sinus formation is exceedingly rare.CASE SUMMARY We report a case of a 72-year-old woman who experienced recurring fever and abdominal pain following laparoscopic cholecystectomy for acute cholecystitis,during which gallbladder rupture was noted.Despite initial conservative management and temporary T-tube placement,the patient developed a chronic sinus in the abdominal wall 9.5 years later,characterized by an area of thickened soft tissue with ulceration and purulent discharge.Surgical exploration revealed the presence of a migrated gallstone at the base of the sinus tract,necessitating careful surgical removal and postoperative wound care.CONCLUSION This case highlights the potential long-term complications of retained free gallstones and the importance of thorough surgical retrieval.
基金supported by Academic inheritance and communication project of China Academyof Chinese Medical Sciences(CI2022E012XB)High Level Chinese Medical Hospital Promotion Project(HLCMHPP2023053)Beijing Traditional Chinese Medicine Inheritance“New 3+3”Project Zhi-Ming Liu’s(Ru-Xiu Liu)Inheritance Workstation(2023-SZ-G-02).
文摘Background:Tongyang Huoxue Decoction(TYHX)can modulate calcium homeostasis andmitochondrial quality management to safeguard sinus node function.Nonetheless,theprecise chemical process remains unclear.This study aimed to verify the upstreamregulatory influence of SERCA2a on the enhancement of calcium homeostasis andmitochondrial unfolded protein response(mtUPR)in sinus node cells(SANCs)by TYHX,while elucidating the protective mechanism of TYHX on SNC activity.Methods:In vitromodels of sh/ad-SERCA2a and si-β-tubulin were established,and TYHX was employed tointervene in each cell group.Various approaches were employed to detect functionsincluding mitochondrial membrane potential,mitochondrial respiration,oxidative stress,mitochondrial biosynthesis,and mitochondrial autophagy and UPR.In vivo confirmationthat TYHX suppresses apoptosis and inflammatory injury.Results:I/R injury led todiminished SANCs activity,compromised mitochondrial membrane potential,reducedmitochondrial respiratory function,and heightened oxidative stress.This further impededmitochondrial production,destabilized the proteome structure,triggered the mtUPR,andinhibited mitochondrial autophagy,thereby upsetting the dynamic equilibrium of themitochondrial quality control network.Furthermore,I/R injury intensified intracellularcalcium excess and worsened oxidative stress damage.Conversely,TYHX interventionmitigated intracellular calcium overload,augmented mitochondrial antioxidant capacity,stimulated mitochondrial autophagy,and decreased the mtUPR.Sh-SERCA2a counteractedthe regulatory influences of TYHX on calcium homeostasis,mitochondrial biogenesis,mtUPR,mitochondrial autophagy,and apoptosis.Conversely,ad-SERCA2a exerted minimalinfluence on the efficacy of TYHX.SERCA2a is a major target protein for TYHX todemonstrate its efficacy.When tubulin expression was minimal,there was no statisticallysignificant difference in the expression levels of mitochondrial autophagy,mitochondrialbiosynthesis,calcium homeostasis regulation,and mtUPR between the sh-SERCA2a andad-SERCA2a groups.This indicates that the normal expression of tubulin is essential forSERCA2a to enhance the efficiency of TYHX.Tubulin may serve as an upstream regulatorymolecule of SERCA2a.In vivo tests confirmed that TYHX may suppress apoptosis andmitigate cellular inflammatory damage.Conclusion:TYHX preserved intracellular calciumequilibrium,mitigated mitochondrial oxidative stress,sustained mitochondrial stability,enhanced mitochondrial biosynthesis,suppressed the mtUPR,facilitated mitochondrialautophagy,and inhibited apoptosis viaβ-tubulin-SERCA2a,thereby safeguarding sinus nodefunctionality from I/R injury.
文摘Sinus of Valsalva aneurysm(SoVA)is a rare cardiac defect that may be congenital or acquired.It is characterized by abnormal dilatation of the aortic root due to a weakened elastic lamina at the junction of the annulus fibrosus and the aortic media.SoVAs are present in approximately 0.09%of the general population and comprise up to 3.5%of all congenital cardiac defects.It is usually found inci-dentally on cardiac imaging,with a higher incidence observed in the Western populations and a male-to-female ratio of 4:1.A transthoracic two-dimensional echocardiogram is the initial diagnostic test of choice,which may reveal the characteristic“windsock deformity”that clinches the diagnosis.Other imaging modalities,such as transesophageal echocardiography and cardiac computed tomography angiography,help provide more extensive details of the aneurysm and its adjacent structures.Management options for ruptured and unruptured SoVA include surgical repair or transcatheter closure,which serves as a game-changing development in treatment.This article aims to provide background information on the epidemiology,pathophysiology,diagnosis,and recent advan-cements over the past decade in the management of SoVAs.
基金Supported by Shenzhen Science and Technology Program Project,No.JCYJ20220530145006013.
文摘BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)are widely used in gallbladder and biliary tract diseases.During these procedures,vessels or tissues are commonly ligated using clips.However,postoperative migration of clips to the common bile duct(CBD)or Ttube sinus tract is an overlooked complication of laparoscopic biliary surgery.Previously,most reported cases of postoperative clip migration involved metal clips,with only a few cases involving Hem-o-lok clips and review of the literature.CASE SUMMARY This report describes two cases in which Hem-o-lok clips migrated into the CBD and the T-tube sinus tract following laparoscopic surgery.Case 1 is a 68-year-old female admitted due to abdominal discomfort,and two Hem-o-lok clips were found to have migrated into the CBD 17 months after LC and LCBDE with T-tube drainage,and were removed using a stone extraction balloon.The patient was discharged smoothly after recovery.Case 2 is a 74-year-old male who underwent LC and LCBDE with T-tube drainage and laparoscopic biliary tract basket stone extraction.Nine weeks postoperatively,following T-tube removal,a Hem-o-lok clip was found in the sinus tract,and was extracted from the T-tube sinus tract.The patient recovered smoothly postoperatively.This study also reviews the literature from 2013 to July 2024 on using Hem-o-lok clips in LC and/or LCBDE treatment of gallbladder and biliary diseases and the postoperative migration of these clips into the CBD,T-tube sinus tract,or duodenum.CONCLUSION In patients with a history of LC and/or LCBDE,clip migration should be considered as a differential diagnosis.
文摘Persistent left superior vena cava(PLSVC)is a rare congenital anomaly that may complicate cardiac procedures when associated with a dilated coronary sinus(CS)and conduction disturbances.We report the case of a 27-year-old male with Wilson’s disease who presented with complete heart block.Echocardiography showed biatrial enlargement and severe CS dilation,while contrast-enhanced computed tomography(CT)confirmed PLSVC draining into the CS without a bridging vein.Anatomical constraints prevented cardiac resynchronization therapy,and dual-chamber pacemaker implantation proved technically challenging due to lead placement difficulties.This case highlights the importance of thorough preoperative assessment and individualized pacing strategies in patients with PLSVC,in order to anticipate anatomical challenges and optimize outcomes.
文摘Congenital dermal sinus tract (CDST) is a rare entity of spinal dysraphism with an incidence of 1 in 2500 live births. The presumed etiology relates to a focal failure of disjunction resulting in a persistent adhesion between the neural and cutaneous ectoderm. CDST is commonly associated with other pathologies such as myelomeningocele, split cord malformation, tethered cord and inclusion tumors. The authors report a case of a 2-year-old girl discharging lumbosacral CDST. The preoperative MRI showed the dermal sinus tract with 2 intradural lesions from L1 to L3. The tract was surgically excised followed by complete excision of the cyst and lipoma. The dermal sinus tract was attached to the medullary cone and was cut there, allowing “en bloc” removal of the dermal sinus tract. There were two distinct types of tumor. One cystic is located posterior to the medullary cone and the other is located laterally to the medullary cone, whose appearance suggests a lipoma. Both tumors were removed completely. The dura was closed in a tight manner. The pathological examination confirmed the lipoma and Dermoid Cyst. In the postoperative course, the child had a motor deficit in the lower limbs, which recovered completely after 3 months of physiotherapy.
文摘BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr virus infection.AIM To explore the anxiety and depression status of patients with NK/T-cell NHL in the nasal cavities and paranasal sinuses and analyzes the relevant influencing factors.METHODS A retrospective analysis was performed,which included 30 patients with primary nasal NK/T-cell NHL treated in Shaanxi Provincial People’s Hospital from January 2017 to January 2023.An additional 50 healthy volunteers were selected as the control group.Both groups were assessed using the self-rating anxiety scale(SAS)and Self-rating(SDS).SDS and SAS scores of patients with NHL at different disease stages were analyzed,and they were further grouped into negative emotion(NE)(n=19)and non-NE(n=11)groups based on their depression and anxiety.Factors affecting the occurrence of NEs in patients with NHL were analyzed using univariate and multivariate logistic regression models.RESULTS Patients with NHL exhibited higher SDS and SAS scores than healthy controls.Moreover,patients with NHL at stages III and IV had higher SDS and SAS scores than those in stage I.Among the 30 patients,there were 13 patients with depression(43.3%),16 patients with anxiety(53.3%),and 10 patients with both anxiety and depression(33.3%).Univariate analysis identified a higher proportion of people in the NE group with stage III-IV NHL,an educational level≤high school,and a monthly household income<5000 yuan compared with the non-NE group.Multiple logistic regression analysis further revealed that stage III-IV was a risk factor for NEs in patients with NHL.CONCLUSION The stage of NK/T-cell NHL in nasal cavities and paranasal sinuses is closely related to patient anxiety and depression.The higher the staging,the greater the incidence of anxiety and depression.
文摘Sinus venosus defects include two varieties,superior and inferior sinus venosus defects.The superior sinus venosus defect is characterized by abnormal communication between two closely related venoatrial structures:1)the normally positioned superior vena cava-right atrium complex and 2)the right pulmonary vein-left atrium complex that is displaced leftward,forward and upward.Inferior sinus venosus defects primarily involve the inferior vena cava-right atrial junction while the right pulmonary vein-left atrial junction can also be affected.Because of the rarity and wide variation of the defects,the morphological characterization of sinus venosus defects is inconsistent among investigators and often inaccurate.Modern imaging technologies with high spatial and temporal resolutions have allowed accurate and detailed assessment of the pathological anatomy in larger numbers of cases.In this pictorial essay,we revisit the established and controversial features of the sinus venous defects using twodimensional(2D)and three-dimensional(3D)images obtained by magnetic resonance(MR)or computed tomography(CT)with brief discussion on imaging and treatment strategies.
文摘The ultrastructure of the X organ sinus gland complex in sexually immature Chinese mitten crab Eriocheir sinensis was examined under the electron microscope. The sinus gland (SG) is composed primarily of nerve terminals and glial cells. The terminal contains a great number of membrane bound granules, mitochondria, rough endoplasmic reticulum and electron lucent vesicles. The profiles of the terminals are sometimes exhibited finger like projections. The X organ (XO) locates at the ventral surface of the medulla terminalis ganglion in the eyestalk, oppositing to SG. According to the features of granule size, shape, electron density and cytoplasm, 6 types of terminals in SG and 7 types of neurosecretory (NS) cells in XO were identified. The release process by exocytosis of the granules in SG was observed and a tentative comparison was made for the granules between different types of terminals and NS cells. It seemed that they had a good correspondence since no change in electron density and just a slight increase of sizes was shown.
文摘Background: After the failure of medical treatment, the surgery of chronic rhinosinusitis (CRS) is planned according to endoscopic and paranasal sinus computed tomography (CT) findings. Objective: The aim of this prospective study was to evaluate whether this study method might be eligible in studies aiming at radiation dose reduction. Sinus CT scans were chosen as a model because of the high variation of the radiological anatomy of surgically important sinonasal structures. We hypothesized that 3 mm-slice-thick reconstruction CT had poor reproducibility. Methods: 59 CRS patients underwent routine multi-detector sinus CT (CT<sub>MD</sub>). CT<sub>3mm</sub> was reconstructed from CT<sub>MD</sub> data-sets. Lund-Mackay (LM) scores and 43 other structural parameters were analyzed blinded. Agreement was studied between CT<sub>MD</sub> and CT<sub>3mm</sub> (intra-observer reproducibility), and between three observers (inter-observer reproducibility) by using Cohen’s kappa. Results: The inter-observer agreement was moderate (kappa 0.4 - 0.6, p < 0.01) in the majority of structures of CT<sub>3mm</sub> scans. The intra-observer reproducibility of CT<sub>3mm</sub> scans was very good in most structures, however, it was poor in important structures such as frontal and spheno-ethmoid recess, lamina papyracae, and location of optic nerve or anterior ethmoidal artery. The grade of surgeon’s confidence of CT<sub>3mm</sub> in comparison to CT<sub>MD</sub> was lower (kappa 0.2 - 0.4, P < 0.05). Conclusion: This methodology might have some use in studies aiming at radiation dose reduction. As was expected, 3 mm-slice-thick reconstruction CT had poor reproducibility and surgeon’s confidence. More recent methods such as cone beam computed tomography scans have nowadays more relevant dose reduction potential.
文摘The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.
文摘<strong>Introduction:</strong> Paranasal sinuses mucoceles are benign, epithelial lined, mucus filled lesions, causing destruction of the adjacent sinus walls, and with further gradual extension to adjacent structures, serious morbidities and mortalities may occur. <strong>Objective:</strong> To emphasize on the efficacy of endonasal endoscopic marsupialization in the treatment of paranasal sinus mucoceles. <strong>Method:</strong> Retrospective descriptive study on paranasal sinus mucocele cases operated on endoscopically by the author (AAM), in the 10-year-period from to 2009-2019. <strong>Result:</strong> Total of 23 cases were included, 16 were males and 7 females, age ranging between 14 - 76 years, with a mean age of 45 years Location of mucoceles varied between: Frontal 7 cases (30%), Fronto-ethmoidal 6 cases (26%), Isolated Ethmoidal accounted for 3 cases (13%), sphenoidal 4 cases (17%), maxillary were 3 cases (13%) all of the 23 cases underwent endonasal endoscopic complete marsupialization, none of them required combination with external approach in-spite of different locations and complications, with no recurrence in a mean follow up period of 2.4 years. <strong>Conclusion:</strong> Endonasal endoscopic approach is a safe, efficient approach in the treatment of most paranasal sinus mucocele case in their different presentations and locations.
文摘AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive patients (11 females and 4 males; mean age 40.93 years; age range 13-63 years) with cavernous sinus hemangiomas (CSH) who underwent examination between November 2008 and May 2016 were included for the analysis. MRI, clinical and surgical findings of each patient was retrospectively reviewed. DWI were also analysed and mean-apparent diffusion coefficient (ADC) value was calculated. Eleven patients underwent surgical removal of the lesion and 2 patients had biopsy only. Diagnosis of CSH was confirmed histologically in 13 patients. RESULTSEleven patients (73%) presented with headaches and 10 (66%) had cranial nerve involvement. Extra cavernous sinus extension was noted in 14 (94%). Surgery was performed in 13 (87%) and post-operative radiation was given to 4 (28%) patients. Thirteen patients remained asymptomatic on follow up. Three conspicuous imaging features were highly suggestive of the diagnosis: Lack of diffusion restriction (100%), homogeneous hyperintensity on T2 weighted image sequences (93.3%) and intense post-contrast enhancement (100%). The mean ADC was 1.82 × 10<sup>-3</sup> ± 0.2186 cm<sup>2</sup>/s. CONCLUSIONT1-weighted hypointensity with homogeneous hyperintensity on T2-weighted sequences, intense enhancement and absence of hemosiderin within the lesion on GRE sequence favour the diagnosis. Facilitated diffusion on DWI differentiates CSH from other solid cavernous sinus lesions and significantly improves the diagnostic accuracy, a critical factor for planning surgery.
基金Supported by the 3-year Major Support Project for Traditional Chinese Medicine Cause of Shanghai for the Treatment of Chronic Nasosinusitis(No.ZYSNXD-CC-ZDYJ026)
文摘OBJECTIVE: To investigate the effectiveness and safety of Zhu-yuan decoction(ZYD) in patients after functional endoscopic sinus surgery(FESS).METHODS: A total of 85 patients were randomized into two groups: 44 were treated with intranasal corticosteroids(INC), and 41 were given Chinese herbal medicine(CHM). Patients with chronic rhinosinusitis(CRS) who underwent FESS were prospectively enrolled in the study. Before surgery, they were evaluated by visual analog scale(VAS), nasal endoscopy, computed tomography(CT), and routine blood test. After surgery, they were randomized to take ZYD or INC for 12 weeks and revaluated by VAS; nasal endoscopy at 4, 8, and 12 weeks;and CT at 12 weeks after surgery.RESULTS: In the both groups, VAS and endoscopyscores decreased significantly at 4, 8, and 12 weeks,and CT scores after treatment declined at 12 weeks compared with baseline scores. No significant differences were observed with regard to postoperative VAS, endoscopy, or CT scores between groups.ZYD, combined with surgery, can reduce VAS, nasal endoscopy, and CT scores and has the same efficacy and safety profile as INC in post-FESS management.No fatalities or major adverse events occurred in either group.CONCLUSION: Our findings suggest that ZYD has similar effects and safety profiles in patients after FESS compared with INC.
文摘Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS.Discharged patients were followed up to 72 weeks for all-cause recurrence events.Baseline SES was established based on occupation,education level,and family income of the patients 1 year before the operation.Kaplan–Meier method was used to calculate the recovery rate after ESS,and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.Results Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES;24-week overall recovery rate was 90.4%[95%confidence interval(CI):89.6%–91.2%]in patients of middle SES,13.5%(95%CI:12.8%–14.2%)in patients of low SES,and 31.7%(95%CI:30.7%–32.7%)in patients of high SES(both log-rank P<0.001).After adjustment for covariates,hazard ratios(HRs)were7.69(95%CI:6.17–9.71,Ptrend<0.001)for all-cause recurrence for low SES versus middle SES,and 6.19(95%CI:4.78–7.93,Ptrend<0.001)for middle SES versus high SES.Conclusion Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.
基金supported by the National key Technology R & D Program during the Eleventh Five-Year Plan Period of China (No. 2006BAI01A12)
文摘Objective To provide a new approach for the treatment of tumor in Meckel’s cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave approach. Methods Fifteen adult cadaver heads （30 sides） were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. Results The approach was divided into 3 steps： entering the maxillary sinus, the later pterygopalatine fossa and the final Meckel’s cave. Safe access to Meckel’s cave could be achieved by tracing the vidian neurovascular bundles and dissecting the quadrangular space （QS）. The distances from the nasal columella to the apertura maxillaries, the sphenopalatine foramen, and the anterior foramen of the pterygoid canal were （44.08±2.61） mm, （64.83±2.42） mm, and （70.43±2.94） mm, respectively. The angles between the horizontal plate of the palatine bone and the link from nasal columella to apertura maxillaries, between the horizontal plate of the palatine bone and the link from nasal columella to sphenopalatine foramen were （38.10±2.46）° and （26.15±2.26）°, respectively. Conclusion The endoscopic approach of transnasal maxillary sinus-pterygopalatine fossa-Meckel’s cave （ENMPA） is a safe and direct way to access Meckel＇s cave, and could be employed for the treatment of tumor in Meckel’s cave.
基金Supported by JSPS KAKENHI(Grants-in-Aid for Scientific Research),No.25462642
文摘Signifcant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been esta-blished. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pul-monary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.
基金the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality (Nos.09JC1411700 and S30206)the Natural Science Foundation of Shanghai Jiaotong University School of Medicine(No.09XJ21030)
文摘The aim of the study was to analyze the histologic and ultrastructural changes after maxillary sinus augmentation with simultaneous implant placement using engineered bone graft material.In this study,calcium phosphate cement(CPC)scaffolds combined with goat bone marrow stromal cells(BMSCs)were used to fill goat sinus floor space after maxillary sinus floor elevation with simultaneous implant placement comparing with those not filled any grafted materials and used as controls.After a healing period of 3 months,the goat maxillary sinus membrane was examined using light microscopy and scanning electronic microscopy.The results showed that the connective tissue thickness and the epithelium thickness of mucosa were not statistically significant difference between two groups.The tissue engineered bone complex might be an ideal graft for the sinus floor elevation and have no influence on the sinus membrane under the histological and ultrastructural observation.
