目的:通过MSCT分析慢性鼻窦炎患者钩突上附着点(Superior attachment of uncinate process,SAUP)的解剖变异及其引流路径改变,并探讨其对额窦炎引流的影响。方法:收集拟行鼻内镜手术并行MSCT扫描的鼻窦炎患者111例222侧。通过MSCT观察确...目的:通过MSCT分析慢性鼻窦炎患者钩突上附着点(Superior attachment of uncinate process,SAUP)的解剖变异及其引流路径改变,并探讨其对额窦炎引流的影响。方法:收集拟行鼻内镜手术并行MSCT扫描的鼻窦炎患者111例222侧。通过MSCT观察确定SAUP各型的发生率,及其与钩突内、外引流的相关性;比较内、外引流组发生额窦炎的差异。结果:222侧SAUP分型中,最常见的分别是Ⅰ型(55%)、Ⅳ型(19.8%)、Ⅴ型(12.6%)。在额窦炎的评估方面,88侧(39.6%)有额窦炎,钩突内引流中57侧(46.7%)有额窦炎,外引流中31侧(31.0%)有额窦炎。慢性鼻窦炎患者中,与外引流相比,额窦炎更常见于SAUP的内引流中(46.7% vs 31.0%,P<0.05)。结论:鼻内镜术前需明确SAUP的解剖变异,SAUP分型所致额窦流出道的位置改变影响额窦炎的发生。慢性鼻窦炎患者中,当额窦引流的区域在内侧时,明显比外侧引流更容易发生额窦炎。展开更多
The laser damage resistances of four crystals(CaF_(2),MgF_(2),Al_(2)O_(3),and SiO_(2))and fused silica(JGS1)irradiated at 355nm(8 ns,300-on-1)are reported.The laser-induced damage threshold is measured using a tripled...The laser damage resistances of four crystals(CaF_(2),MgF_(2),Al_(2)O_(3),and SiO_(2))and fused silica(JGS1)irradiated at 355nm(8 ns,300-on-1)are reported.The laser-induced damage threshold is measured using a tripled Nd:YAG laser system.The results obtained from the pure crystals are in accordance with their specific optical,mechanical,and thermal properties.An empirical law based on the Franz–Keldysh effect can interpret the experimental results.展开更多
Background Traditional techniques used for harvesting the pectoralis major myocutaneous （PMMC） flap have accompanying disadvantages,such as the necessity for an upper chest skin incision,the bulkiness of myocutaneou...Background Traditional techniques used for harvesting the pectoralis major myocutaneous （PMMC） flap have accompanying disadvantages,such as the necessity for an upper chest skin incision,the bulkiness of myocutaneous tissue at the pedicle of the flap,and the risk of total or partial necrosis of flap tissue.The aim of this study was to develop a safe and fast method for preparing PMMC island flaps using preoperative ultrasonography for vessel detection.Methods Forty-one PMMC island flaps were used for one-stage reconstruction of head and neck defects,including 21 cases in the treatment group and 20 cases in the control group.In the treatment group,ultrasonography was used to mark out the course of the thoracic branches of the thoracoacromial artery and the lower end of this artery perforating from the fascia into the muscles,as well as the largest perforating branch of the fourth or fifth internal mammary artery entering the PMMC flap.A line,from the lower end of the thoracic branch to the largest perforating branch of the fourth or fifth internal mammary artery,was drawn to determine the axis of the PMMC flap.In the control group,PMMC island flaps were designed according to conventional methods without using ultrasonography.Results According to the ultrasonic marks,the distance from lower end of thoracic branch to the midpoint of the margin of the inferior clavicular was （5.1±1.2） cm.The time from designing to transferring the island flap was significantly shorter in the treatment group （（51.0±10.5） minutes） compared with the control group （（78.0±13.9） minutes,P 〈0.01）.The rate of partial necrosis was 4.7% （1/21） in the treatment group and 35.0% （7/20） in the control group.There was one case of flap failure in the control group due to vascular injury during vascular pedicle dissection.Conclusion Preoperative vessel detection by ultrasonography facilitates easy and safe harvesting of the true PMMC island flap.展开更多
Background Sinonasal malignancy with orbital invasion is rare. The objective of the current study was to evaluate the clinical and pathological features, treatment outcomes and survival rates for these malignancies. ...Background Sinonasal malignancy with orbital invasion is rare. The objective of the current study was to evaluate the clinical and pathological features, treatment outcomes and survival rates for these malignancies. Methods Ninety-three patients who were treated between 1997 and 2007 were retrospectively reviewed. Age, life style, symptoms, location of lesions, previous occurrences, histological subtypes, and treatment modalities were analyzed. Results Ninety-three patients were evaluated, including 51 men and 42 women： the gender ratio was 1.2 men to 1.0 women. The median age was 40.5 years old. The nasal cavity （34.4%）, the maxillary sinus （29.0%） and the ethmoid sinus （19.4%） were the most common primary malignant tumor sites. Almost half of the patients, 44.1% had squamous cell carcinoma, 13.9% had neuroectodermal carcinoma, 11.7% had rhabdomyosarcoma, 9% had adenocarcinoma and salivary gland-type carcinoma, and 11% had other malignancy. The majority of patients presented with T3/T4 （99%）, N0 （93.1%）, M0 （98%） disease. The distant metastasis rate was 20.9%. The overall survival and disease-free survival rates were 68.1% and 40.9% at three years, respectively. When the overall survival rate was computed according to the epicenter of the original malignant tumor, patients with nasal cavity malignancy and maxillary sinus had the best survival, and patients with ethmoid sinus malignancy had the worse survival （P=0.03）. According to their pathology classification, patients with rhabdomyosarcoma had worse overall survival than those with squamous cell carcinoma, or neuroendocrine carcinoma （P 〈0.001）. Squamous cell carcinoma and rhabdomyosarcoma invaded the orbit more often and malignancy of the nasal cavity invaded the orbit more than malignancy of the nasal sinus. Conclusions For nasal orbital tumors early diagnosis is crucial. Orbital exenteration and postoperative rehabilitation should be carefully considered. The current data suggest that surgical resection with postoperative radiation therapy may offer durable local control.展开更多
文摘目的:通过MSCT分析慢性鼻窦炎患者钩突上附着点(Superior attachment of uncinate process,SAUP)的解剖变异及其引流路径改变,并探讨其对额窦炎引流的影响。方法:收集拟行鼻内镜手术并行MSCT扫描的鼻窦炎患者111例222侧。通过MSCT观察确定SAUP各型的发生率,及其与钩突内、外引流的相关性;比较内、外引流组发生额窦炎的差异。结果:222侧SAUP分型中,最常见的分别是Ⅰ型(55%)、Ⅳ型(19.8%)、Ⅴ型(12.6%)。在额窦炎的评估方面,88侧(39.6%)有额窦炎,钩突内引流中57侧(46.7%)有额窦炎,外引流中31侧(31.0%)有额窦炎。慢性鼻窦炎患者中,与外引流相比,额窦炎更常见于SAUP的内引流中(46.7% vs 31.0%,P<0.05)。结论:鼻内镜术前需明确SAUP的解剖变异,SAUP分型所致额窦流出道的位置改变影响额窦炎的发生。慢性鼻窦炎患者中,当额窦引流的区域在内侧时,明显比外侧引流更容易发生额窦炎。
基金Supported by the National Natural Science Foundation of China under Grant No 11104293.
文摘The laser damage resistances of four crystals(CaF_(2),MgF_(2),Al_(2)O_(3),and SiO_(2))and fused silica(JGS1)irradiated at 355nm(8 ns,300-on-1)are reported.The laser-induced damage threshold is measured using a tripled Nd:YAG laser system.The results obtained from the pure crystals are in accordance with their specific optical,mechanical,and thermal properties.An empirical law based on the Franz–Keldysh effect can interpret the experimental results.
文摘Background Traditional techniques used for harvesting the pectoralis major myocutaneous （PMMC） flap have accompanying disadvantages,such as the necessity for an upper chest skin incision,the bulkiness of myocutaneous tissue at the pedicle of the flap,and the risk of total or partial necrosis of flap tissue.The aim of this study was to develop a safe and fast method for preparing PMMC island flaps using preoperative ultrasonography for vessel detection.Methods Forty-one PMMC island flaps were used for one-stage reconstruction of head and neck defects,including 21 cases in the treatment group and 20 cases in the control group.In the treatment group,ultrasonography was used to mark out the course of the thoracic branches of the thoracoacromial artery and the lower end of this artery perforating from the fascia into the muscles,as well as the largest perforating branch of the fourth or fifth internal mammary artery entering the PMMC flap.A line,from the lower end of the thoracic branch to the largest perforating branch of the fourth or fifth internal mammary artery,was drawn to determine the axis of the PMMC flap.In the control group,PMMC island flaps were designed according to conventional methods without using ultrasonography.Results According to the ultrasonic marks,the distance from lower end of thoracic branch to the midpoint of the margin of the inferior clavicular was （5.1±1.2） cm.The time from designing to transferring the island flap was significantly shorter in the treatment group （（51.0±10.5） minutes） compared with the control group （（78.0±13.9） minutes,P 〈0.01）.The rate of partial necrosis was 4.7% （1/21） in the treatment group and 35.0% （7/20） in the control group.There was one case of flap failure in the control group due to vascular injury during vascular pedicle dissection.Conclusion Preoperative vessel detection by ultrasonography facilitates easy and safe harvesting of the true PMMC island flap.
基金This study was supported by the grants from the Health System High Level Health Technical Personnel Training Plan of Beijing city （2009-3-31） and the National Natural Science Foundation of China （No. 81070769）.
文摘Background Sinonasal malignancy with orbital invasion is rare. The objective of the current study was to evaluate the clinical and pathological features, treatment outcomes and survival rates for these malignancies. Methods Ninety-three patients who were treated between 1997 and 2007 were retrospectively reviewed. Age, life style, symptoms, location of lesions, previous occurrences, histological subtypes, and treatment modalities were analyzed. Results Ninety-three patients were evaluated, including 51 men and 42 women： the gender ratio was 1.2 men to 1.0 women. The median age was 40.5 years old. The nasal cavity （34.4%）, the maxillary sinus （29.0%） and the ethmoid sinus （19.4%） were the most common primary malignant tumor sites. Almost half of the patients, 44.1% had squamous cell carcinoma, 13.9% had neuroectodermal carcinoma, 11.7% had rhabdomyosarcoma, 9% had adenocarcinoma and salivary gland-type carcinoma, and 11% had other malignancy. The majority of patients presented with T3/T4 （99%）, N0 （93.1%）, M0 （98%） disease. The distant metastasis rate was 20.9%. The overall survival and disease-free survival rates were 68.1% and 40.9% at three years, respectively. When the overall survival rate was computed according to the epicenter of the original malignant tumor, patients with nasal cavity malignancy and maxillary sinus had the best survival, and patients with ethmoid sinus malignancy had the worse survival （P=0.03）. According to their pathology classification, patients with rhabdomyosarcoma had worse overall survival than those with squamous cell carcinoma, or neuroendocrine carcinoma （P 〈0.001）. Squamous cell carcinoma and rhabdomyosarcoma invaded the orbit more often and malignancy of the nasal cavity invaded the orbit more than malignancy of the nasal sinus. Conclusions For nasal orbital tumors early diagnosis is crucial. Orbital exenteration and postoperative rehabilitation should be carefully considered. The current data suggest that surgical resection with postoperative radiation therapy may offer durable local control.
