原发于咽旁隙孤立性边缘区B细胞淋巴瘤1例

患者，49岁。因咽部异物感2个月，以“右颈部新生物”于2012年4月11日入院。自述2个月前无明显诱因出现咽部异物感，偶伴咽痛，无发热、咳嗽及呼吸吞咽困难，行抗炎治疗未见明显好转。     

侵犯咽部的神经纤维瘤病1例

神经纤维瘤病（von－Recklinghausen病）是一种常染色体显性遗传病，主要表现为皮肤和神经的多发性神经纤维瘤和皮肤色素斑，以咽部症状就诊的少见。现就我院收治1例报告如下。患者女，35岁。因咽培、咽部异物感半年，右扁桃体肿大1个月，以右扁桃体肿物收入院。患者于半年前自觉咽堵、咽部异物感，未予重视。于1个月前发现有扁桃体长出一肿物，逐渐增大，且出现呼吸、吞咽功能障碍，说话含糊不清及闭塞性界音。追问病史，患者于5年前出现全身皮下散在给节性肿块，无疼痛，曾在当地医院多次切除皮肤肿块，但均未行病理检查，患者家族中无类…     

原发性喉软组织血管肉瘤1例

患者，男，66岁。出现咽部异物感半个月，进食时明显，因咽部异物感日益加重就诊。发病以来无咽痛及吞咽困难，无咳嗽咯血，无声音嘶哑及胸闷气急。门诊动态喉镜检查示：左喉前庭新生物。为求进一步治疗于2007年7月11日收入我院。患者既往无手术及放疗病史。嗜烟，平均15支/d。     

异位甲状腺

1临床资料 患者,女,36岁,以咽部异物感3个月,呼气困难半个月为主诉入院。患者3个月前无明显诱因出现咽部异物感等不适,未在意。半个月前开始出现平卧时憋气、呼吸不畅,坐位时呼吸困难可缓解,伴说话含物音及吞咽疼痛,无声嘶。就诊后,可见舌根半球形肿块,表面光滑,以舌根肿块收入院。     

舌根肿瘤

患者,女,53岁,因咽异物感1个月入院。患者1个月前无明显诱因出现咽部左侧异物感,言语口齿清晰,无咽痛,无口腔异味,无痰中带血,无吞咽困难。曾于外院口腔科及耳鼻咽喉头颈外科就诊,口腔与咽喉部未见明显异常,诊为“咽喉炎”并给予对症药物治疗。治疗后无改菩,于我院就诊,舌根左侧可触及质硬肿块,以“舌根肿瘤”收入院。     

以咽异物感为表现的食管型颈椎病1例

1病例报告患者,男,38岁,因咽部异物感半年就诊。半年前无明显诱因出现咽部异物感,在当地医院诊断为慢性咽炎,给予药物(用药不详)、微波治疗后未见好转。鼻内镜、胃镜检查考虑为鼻后滴漏综合征、反流性食管炎,给予鼻窦炎口服液、鼻炎康、奥美拉唑、果胶铋及吗丁啉等药物治疗后仍不见好     

喉癌术后突发消化道应激性溃疡大出血致死一例

患者男，69岁。因下咽异物感、疼痛，伴声嘶1个月于2003年12月1日就诊。患者1个月前无明显诱因出现咽部异物感，以“咽炎”治疗数日，自觉加重。出现下咽部疼痛，声嘶。患者平常身体素质好，无任何疾病记载。纤维喉镜检查发现患者左侧会厌谷近甲杓区处肿胀明显，表面较粗糙；喉前庭及室带、喉室和声带均无明显肿胀，声带活动好。1％丁卡因表面麻醉下取局部组织活检。术后10min，     

左杓状软骨后缘血管瘤1例

<正>患者,女,60岁,因咽部异常感伴左咽部梗塞感1个月,于2013年5月2日来我院就诊。1个月前,无明显诱因出现左咽部异物感,偶有痰中带血,无反酸、呕血、呼吸困难等症状,未予重视,今上述症状加重,并出现吞咽困难来我院门诊就诊,查体示口腔及会厌谷、声门区未见新生物,行纤维喉镜示咽喉部黏膜稍充血,双     

以声嘶为首要症状的食管癌误诊1例

患者，男，51岁。因声嘶、咳嗽、伴咽部不适5个月于2003年5月13日到我院就诊。患者5个月前出现声嘶、阵发性刺激性咳嗽，咯少许白色泡沫痰，伴咽部不适，咽轻度异物感(与吞咽无关)；但无吞咽困难、胸痛咯血、恶心呕吐、畏寒发热等。曾在多家医院耳鼻咽喉科、呼吸内科、神经内科就诊。肺部X线片示“肺纹理稍多”。间接喉镜检查见“右侧声带不活动”。     

咽侧进路切除咽部巨大脊索瘤1例

咽侧进路切除咽部巨大脊索瘤１例张云高１陆书昌２范静平２咽部巨大脊索瘤临床罕见，我科最近收治１例，采用咽侧进路，１次性完整切除，报告如下。患者，男，３２岁，江苏宜兴人，因体检时发现咽部肿块半月来我院就诊。并无明显咽痛、异物感及进食梗阻感。体检：咽后壁...     

以耳部症状首发、合并鼻咽占位的肉芽肿性多血管炎1例并文献复习

目的 探讨1例临床少见的以耳部症状首发、合并鼻咽部占位的肉芽肿性多血管炎(GPA)的临床特征、实验室检查、病理表现及诊疗过程。方法 回顾性分析患者的病例资料,总结病例特点并回顾国内外GPA相关文献。结果 患者以中耳炎、迷路炎症状为首发表现,合并鼻咽部占位,病程中逐渐出现面瘫,三叉神经刺激症状加重。多次留取耳及鼻咽部活检示急慢性炎症细胞浸润。升级抗生素,同时为避免中耳炎侵犯岩骨及颅内行乳突开放术。中耳局部炎症改善后其耳痛、面瘫等仍不缓解,但激素治疗有效,遂进一步完善自免病相关检查并再次行鼻咽部活检,最终确诊为GPA,予激素及免疫抑制剂治疗得以控制症状。术后3个月暂无显著肺部及肾脏受累表现。结论 临床上发现不典型的中耳炎或常规治疗反复不愈,且逐渐进展出现内耳、颅神经侵犯表现如眩晕发作、面神经麻痹等,同时激素治疗有效,且合并鼻咽部占位、鼻窦炎影像学表现,或累及其他器官如肺、肾脏时,均应考虑到GPA的可能。当反复留取病理活检未能取得特异性确诊依据时,动态监测抗中性粒细胞胞浆抗体、红细胞沉降率、尿潜血、胸部CT、血肌酐等也具有重要的提示意义。     

Decreased miRNA-320e correlates with allergy in children with otitis media with effusion

ObjectiveOtitis media with effusion (OME) is a common childhood disease and the main cause of conductive hearing loss in this age group. Many factors predispose to OME but allergy is still widely disputed. The answer may lay in the molecular mechanisms of ear exudate formation and the recent studies showed miRNAs might take part in it. MiRNAs are also potent regulators of allergic response. As miRNAs are present in the middle ear, we hypothesized their expression differs between allergic and non-allergic patients and reflects the difference in pathomechanism of effusion formation between these two groups.Materials and methodsThis study aimed to establish the expression of 5 different miRNAs (miR-223-3p, miR-451a, miR-16-5p, miR-320e, miR-25-3p) in ear exudates in children diagnosed with OME. The allergy group consisted of 18 patients whereas the non-allergic group had 36 patients. MicroRNA was isolated from the middle ear fluid collected during myringotomy and transcribed into cDNA. MiRNA expression was measured with TaqMan™ MicroRNA Assays and analyzed with DataAssist software. The comparative CT method was used for calculating the relative quantification of gene expression based on the endogenous control gene expression (U6 snRNA-001973).ResultsMiR-320e expression was significantly decreased in allergic children with OME. Other studied miRNAs also showed reduced expression in allergic children, but the decrease was not significant.ConclusionsMiRNA expression differs between children with and without allergy in the course of OME, but further studies are needed to explain the exact role of miR-320e and its target genes in OME pathology in allergic patients.     

Experience with vertical partial laryngectomy with special reference to laryngeal reconstruction with cervical fascia

In this paper we report our experience of vertical partial laryngectomy using the superficial cervical fascia; we describe the technique and present the functional and oncological results of this method of treatment. A total of 42 patients with squamous cell carcinoma of the true vocal folds, in stage T(1) (n = 28) or T(2) (n = 14), were treated in our department using vertical partial laryngectomy during the decade 1987-1997. Nine patients had post-operative radiotherapy. The shortest follow-up time was three years. There were six recurrences in all, four in the larynx and two in the neck. All four of the laryngeal recurrences were treated with total laryngectomy and are doing well. Both the patients with neck metastases, who were treated with neck dissection, died. Permanent tracheotomy was necessary in one patient. There were no problems with aspiration. The recurrence rate was 14 per cent, the three-year survival index was 95.2 per cent and the three-year larynx preservation index was 90 per cent. According to our experience, vertical partial laryngectomy, using the method we describe, has a good functional and oncological result for stage T(1) and T(2) tumours.     

Cytokines in children with otitis media with effusion

We assayed 38 middle ear effusions from 23 children aged 4–13 years (mean 7) undergoing tympanostomy tube placements. All fluid was assayed for tumor necrosis factor (TNF) α, interleukin (IL) 1β, IL-8, and IL-10. Cytokine concentrations were measured by means of an enzyme-linked immunosorbent assay. Detectable levels of IL-1β, IL-8, and IL-10 were found in all of the effusions. TNF-α was detected in 18 of the middle ear effusions (47.4%). The mean concentration of TNF-α, IL-1β, IL-8, and IL-10 was, respectively, 0.423 ± 1.39, 30.58 ± 68.7, 7001.9 ± 6743, and 56 ± 58.7 pg/ml. There was a strong, statistically significant correlation between the concentrations of TNF-α and IL-1β (r = 0.87, P = 0.001) and between IL-1β and IL-8 (r = 0.53, P = 0.001). There was no correlation between the concentrations of IL-10 and other cytokines examined or between tympanic membrane pathology and the concentrations of TNF-α, IL-1β, IL-8, or IL-10. The presence of IL-10 in middle ear effusions may be one of the causes of a lack of clinical features of acute inflammation and may lead to a chronic inflammatory state. Received: 25 August 1999 / Accepted: 5 January 2000     

Polymyositis with dysphagia treated with endoscopic balloon dilatation

Polymyositis is characterized by non-specific inflammatory disease associated with an autoimmune disorder involving muscles of the limbs and neck. We report a case of an 80-year-old man who was referred to our clinic with a chief complaint of dysphagia and muscle weakness in all four limbs. The patient was diagnosed with polymyositis based on pathological findings, muscle weakness, electromyogram findings, and an elevated creatine phosphokinase level. The patient was also positive for HLA-DR3. Intravenous predonine administration was initiated, but dysphagia was not improved. We considered a cricopharyngeal myotomy, but this could not be performed because of heart failure. Endoscopic balloon dilation was performed and dysphagia improved on the same day. Therefore, we suggest that this method is a safe and effective approach for polymyositis with dysphagia.     

Otoacoustic emissions in children with otitis media with effusion

OBJECTIVES: Otoacoustic emissions (OAE) are transmitted from the cochlea to the ear canal via the middle ear and the transmission properties of the middle ear directly influence OAE characteristics. The purpose of this study was to establish the mechanisms of changes occurred in middle ear by tympanometric, audiometric and OAE examination. METHODS: Audiometric and tympanometric examination were performed and otoacoustic emissions were recorded from 22 normal ears and 52 ears with middle ear effusions and repeated 3 months later. RESULTS: Results of the air conduction in study group were significantly different from the control group and we found significant recovery in 3 months. When we analysed the DPOAE evaluation results in our study, some of the DPOAE parameters were found to be different between the control and the study group at low frequencies. Changes in the amplitude, especially at low frequencies, were statistically significant after 3 months. CONCLUSION: The results of this study revealed that measurement of otoacoustic emissions, especially distortion product otoacoustic emissions, is helpful in evaluating the condition of middle ear during the treatment.