Bonnerpearce4320

Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a kind of very rare idiopathic disease. The most common feature is the excessive accumulation of Langerhans cells in lymph nodes, but it may also occur in other areas and lead to related organ damage. We report a case of a 60-year-old man with Rosai-Dorfman disease, which led to dyspnea. Surgery is the best treatment to relieve the patient's dyspnea in a short time. Rosai-Dorfman disease has trend to self-healing, but in the case of special location, surgery should be selected. Some similar mass recurred in the operative area and bilateral nasal cavity in half a year after operation. Now we reviewed the relevant literatures and summarized the experience of diagnosis and treatment in Rosai-Dorfman disease.An 18-year-old man presented with a slow-growing, painful mass on the nasal dorsum that first appeared 4 years earlier. Clinical examination revealed a 5 cm×6 cm, claret-coloured, firm, nonmobile mass on the dorsum of the nose with superficial ulceration and purulent discharge. After several operations, radiotherapy and chemotherapy, no nasal recurrence was found, but recurrence of metastatic masses in the neck. Histopathologic examination showed that the neoplasms were solid nests with adenoid and squamous differentiation. Immunohistochemical result showed that EMA（－）, CEA（－）, p16（+）, p53（+）, Ki-67 progressive heighten. The disease is rare, and clinical manifestations are nonspecific. Diagnosis depends on histopathological examination. Ki-67 can be used as a reference index to judge the degree of EPC malignancy. Expanded early excision should be performed. Patient with cervical metastasis had a poor prognosis. Radiotherapy and chemotherapy were ineffective.Small cell neuroendocrine carcinoma（SCNC） of larynx is very rare. Primary small cell neuroendocrine carcinomas constitute less than 0.5% of all laryngeal cancers. Tumor can occur in any laryngeal subsite, while the supraglottis is the most common. Patients usually complaint with hoarseness and neck mass. The diagnosis of this kind of carcinomas relies strictly on histopathological examination and immunohistochemical testing. The prognosis of laryngeal SCNC is generally poor. Here, we report a case of a 55-year-old-male patient who presented with a poorly differentiated SCNC of the supraglottic larynx and neck mass.ObjectiveTo investigate the feasibility of endoscopic nasolacrimal decompression for chronic dacryocystitis. Method22 patients with chronic dacryocystitis hospitalized at Longgang ENT hospital were participated in this study. An injection of 30% iohexol was administered to conduct lacrimal sac angiography. The injection was stopped when the agent reflux from the lacrimal duct, and a computed tomography（CT） scan of the lacrimal duct was performed immediately. Sinuses Trachea Isoftware was used to reconstruct a three-dimensional（3D） view of the lacrimal passage and its surrounding structures. The software was used to simulate the "cutting" of the lacrimal sac and nasolacrimal duct; the lacrimal sac and nasal lacrimal duct were removed after 1/2-3/4 circumferences to decompress the passage and expose the membranous nasolacrimal duct. CT scans were performed on ten adult frozen cadaveric heads, and the nasolacrimal duct decompression operation was simulated. Then, the bone of the nasolacrimal duct was removed, membranous nasolacrimal duct was exposed, and the capsular nasolacrimal duct was dilated. Result①The lacrimal angiography study revealed that lacrimal duct obstruction occurred in the nasolacrimal duct segment, accounting for 72.7%（16/22） of the study cases. ② The anatomical examination showed that the outer sidewall of the nasolacrimal duct was composed of the tear groove of the maxilla, and the inner wall was composed of the descending process of the lacrimal bone. ③ In cadaveric heads, decompression of the osseous nasolacrimal duct was performed, exposing the membranous nasolacrimal duct. ④ A balloon catheter could dilate the membranous nasolacrimal duct and allow the lacrimal passage to be flushed. ConclusionEndoscopic nasolacrimal decompression preserves the integrity of the lacrimal duct, allows drainage of the lacrimal duct, and avoids obstruction of the lacrimal duct by preventing lacrimal granulation.ObjectiveTo analysis the clinical and histopathological features, and the effect of surgical treatment and adjuvant therapy for the survival in patients of head and neck mucosal melanoma（HNMM）. MethodA retrospective analysis was conducted on the clinical data of 46 patients with HNMM, and the factors related to survival were analyzed. Kaplan-Meier analysis was used for survival analysis. Log-rank test was used for univariate analysis, and COX proportional hazard model was used for multivariate analysis. ResultThe 3 and 5 year cumulative survival rates of 46 patients with HNMM were 47.5% and 34.1%, respectively, and the median survival time was 36 months. Univariate analysis revealed that the factors affecting survival rates in patients with HNMM included tumor staging, surgical margins, postoperative targeted therapy, distant metastasis and local recurrence（P less then 0.05）. Multiple factor COX regression analysis showed that distant metastasis, tumor staging, surgical margins were independent risk factors for survival rates in patients with HNMM, and postoperative targeted therapy was the protective factor. ConclusionHNMM is of high malignancy and low survival rate. selleck chemicals Early diagnosis and complete surgical resection are the primary methods to improve the survival, and postoperative targeted therapy may be an intervention to improve the survival.ObjectiveTo observe the efficacy and safety of high dose dexamethasone injection in the tympanic cavity in the patients with sudden and severe deafness who failed conventional treatment. MethodA total of 43 patients with unilateral sudden and severe deafness were recruited in this study. All patients were not cured with conventional comprehensive treatment in the department of otology. They were divided into two groups 21cases were treated with high dose dexamethasone injection into the tympanic cavity by ventilation tube （dexamethasone group）, while routine treatment was continued in 22 cases （conventional control group）. Each patient underwent a hearing test before treatment, the hearing thresholds of 6 frequencies （0.25, 0.5, 1.0, 2.0, 4.0, 8.0 kHz） were recorded. After one week of treatment, the above-mentioned six frequencies were re-recorded. A decrease of the pure tone threshold average （PTA） more than 15 dB was set for effective. ResultAfter 1 week treatment, comparison of the PTA value before and after treatment in dexamethasone group（t=11.