Microendoscopic endonasal approach in treating diseases of nasal cavity, paranasal sinuses, and adjacent structures--a preliminary communication.

Since the beginning of 1997 the authors has introduced routinely in their practice a method of combined nasal endoscopy and microrhinoscopy in the diagnosis and minimally invasive surgery of diseases of nasal cavity, paranasal sinuses, and adjacent structures. The results of the method applied in 25 patients (19 males and 6 females) aging from 2 months to 77 years with doubtful initial diagnosis are analysed. In 17 of the patients the initial diagnosis was confirmed, in 5 the diagnosis was revised, and in 3 no pathology of the nasal cavity and paranasal sinuses was found. In 13 patients minimally invasive surgery was successfully performed using this modern method. The results obtained are compared to the related literature data.     

鼻内镜术后鼻腔冲洗健康教育干预效果评价

目的探讨改进鼻内镜术后患者行鼻腔冲洗健康教育的方法,对健康教育干预效果进行评价。方法选取2013年10—12月北京同仁医院耳鼻咽喉头颈外科鼻内镜鼻窦术后行鼻腔冲洗的患者100例,随机分成对照组50例和观察组50例。对照组采用传统口头讲解健康教育方式,观察组采用发放鼻腔冲洗关键词健康指导单并口头讲解。评价2组患者的健康教育知识知晓率,并调查患者出院8周内行鼻腔冲洗依从性。结果 100例患者鼻腔冲洗调查问卷中观察组知识知晓率94%,对照组知识知晓率80%,观察组患者健康教育知识的知晓状况得分明显高于对照组。在鼻腔冲洗顺序（对照组74%,观察组94%）、温度（对照组80%,观察组96%）、压力（对照组70%,观察组88%）等指标的知晓率上差异有统计学意义（t=2.01,P=0.01）。出院8周随访患者鼻腔冲洗依从性,随访到观察组46人,93.48%按医嘱坚持冲洗;对照组43人,72.09%按医嘱坚持冲洗,观察组依从性显著高于对照组,差异有统计学意义（χ^2=7.253,P=0.007）。结论实施关键词式的健康教育能有效提高鼻内镜术后患者对鼻腔冲洗知识的掌握及出院后患者鼻腔冲洗的依从性,有利于优质护理有效落实,提高护理质量。     

Malignant melanomas of the nasal cavity after occupational exposure to formaldehyde.

Formaldehyde is a well known nasal carcinogen in rodents, but so far there has been no convincing evidence that workers occupationally exposed to formaldehyde have an increased risk of nasal cancer. In this study three cases of malignant melanoma of the nasal mucosa in persons occupationally exposed to formaldehyde for a long time are presented. The occurrence of such a rare tumour in patients with significant exposure to a known carcinogen warrants further investigation.     

Adenocarcinoma of the nasal cavity and sinuses in England and Wales

Acheson, E. D., Cowdell, R. H., and Rang, Elizabeth (1972).Brit. J. industr. Med.,29, 21-30. Adenocarcinoma of the nasal cavity and sinuses in England and Wales. A survey of nasal adenocarcinoma in England and Wales (excluding the Oxford region) is described. Where possible, occupational details were obtained and the histological material on the basis of which the diagnosis had been made was reassessed. A total of 107 patients with adenocarcinoma (80 men and 27 women) and 110 matched control cases of nasal cancer of other histological types (85 men and 25 women) were accepted for analysis. The material was classified according to occupation and the distribution compared with that of the population of England and Wales in 1961. Thirty-four of the adenocarcinoma patients (including one woman) and nine patients in the control group had at some stage of their career worked with wood—the majority in the furniture industry. In addition to providing abundant further evidence of the association between nasal adenocarcinoma and work in the furniture industry the evidence suggests that a smaller but nevertheless material risk of developing other histological types of nasal cancer may exist for workers in the industry. It is probable that certain woodworkers outside the furniture industry are also at risk although the risk is almost certainly very much less than in the furniture industry. An excess of nasal cancer patients who had been leather workers (usually in the boot and shoe making and repairing industries) was also found.     

鼻腔恶性肿瘤临床分期的探讨

目的探索适合临床医生应用的鼻腔恶性肿瘤临床分期。方法对122例鼻腔恶性肿瘤病人的资料,使用Cox模型筛选有统计学意义的分期因素,运用聚类分析进行预分类,生存分析用Lifetable和KaplanMeier。结果Cox模型筛选的影响分期因素有筛窦、眼眶、颅底、病理类型、肿瘤控制5个因素,用聚类法得分类树状图,结合临床经验,产生鼻腔恶性肿瘤新的临床分期。新临床分期各期对比有统计学意义,各期病例人数构成合理。122例病人5年生存率为52.71%,8年生存率为43.37%。结论应用Cox模型和聚类分析法确定鼻腔恶性肿瘤新的临床分期,有助于指导临床医生选择治疗方案。     

Cancer of the nasal cavity and paranasal sinuses in poultry breeders. An unsuspected occupation at risk

BACKGROUND: Wood dust exposure is strongly associated with the induction of cancer of the nasal cavity and paranasal sinuses (NSC), mainly among furniture production workers. Only limited information is available on wood dust exposure in other industrial sectors, including agriculture. NSC's are defined as "high occupational aetiology fraction" neoplasms, and are therefore indicated as sentinel tumours in occupational medicine. OBJECTIVES: The report concerns two cases of NSC that occurred in two poultry breeders and the investigations performed in order to define their occupational exposure. METHODS AND RESULTS: Epidemiological surveillance of NSC within the framework of routine activity of the Cancer Registry of the Province of Brescia (one million inhabitants) identified the two cases. Initially the first NSC case was considered as "probably exposed to formaldehyde" during shed tile disinfecting operations. After discovery of a similar case and further investigation in the sector formaldehyde exposure was found to be at a very low level. However, the observation that hard and soft wood dust was present, followed by dust monitoring, revealed a high level of exposure. The 23 personal and area air samples, performed in a turkey breeding shed, gave concentrations of between 1.3 and 2.3 mg/mc during low dust exposure jobs and concentrations of between 4 and 43.2 mg/mc during litter replacement (100% exceeded the ACGH TLV limit of 1 mg/cm and 25% were even above the legal limits (5 mg/mc according to Italian D.Lgs. 66/2000)). Since breeders are not aware of this type of risk and the use ofpersonal protection is not scrupulous, the local health and safety unit has started an information campaign for the entire work category as regards the necessity of controlling this cancer risk. The two cases of NSC described here were reported to the National Labour Insurance Institute (INAIL) for compensation. CONCLUSION: NSC epidemiological surveillance performed through a population registry proved to be of great use in the identification of cases among employees in similar sectors, and thus the identification of previously unknown wood dust exposures with consequent implementation of preventive measures.     

鼻内镜下鼻腔扩容术对鼻腔通气改善的疗效分析

探讨鼻内镜下鼻腔扩容术对鼻腔通气改善的疗效分析。方法：回顾性分析165例鼻中隔偏曲及慢性肥厚性鼻炎患者,全部行鼻内镜下鼻腔扩容术,如在鼻中隔三线减张成形术、中鼻甲内移固定术、双侧中鼻道鼻窦对称开放术及下鼻甲外移固定术等,针对不同病例行个性化手术。结果：术后随访3~12个月,165例中,治愈117例,好转44例,总有效率97.6%,无并发症发生。结论：鼻内镜下鼻腔扩容术效果满意,安全可靠,最大限度地保留了鼻中隔,中、下鼻甲正常组织结构,具有创伤小,并发症少等优点,对改善鼻腔通气起到了明显效果,并将手术提升到微创水平。     

PVA海绵通气管在鼻腔术后应用效果评价

目的确定PVA海绵通气管在鼻腔术后应用价值。方法对2013年1月至2013年10月鼻内窥镜下鼻腔手术术后90例鼻腔填塞物对患者引发的鼻腔胀痛、头痛、口腔呼吸、睡眠情况、恐惧感等不良反应进行分析,通过3种鼻腔填塞物对比,采用术后鼻腔填塞物对患者的影响分值评定标准,统计、对比3种填塞物分值,评价PVA海绵通气管在鼻腔术后应用价值。结果通过对比统计分值可以看出PVA海绵通气管是油纱条术后鼻腔填塞痛苦及负面影响的54%,是3组中分值最小,能够确定PVA海绵通气管在减轻鼻腔填塞物对患者的损害,降低对患者的负面影响及痛苦感受上最具临床应用价值。结论PVA海绵通气管在鼻腔术后应用价值较其他鼻腔填塞物更具优势,值得临床推广。     

A case-referent study of cancer of the nasal cavity and sinuses in Hong Kong

A case-referent study of cancer of the nasal cavity and sinuses (NCS) was conducted in Hong Kong where textile and garment manufacturing are major industries. The study population included 225 nasal cavity and sinus cancer cases (NCS), 224 nasopharyngeal cancer (NPC) referents, and 226 all other malignancies (AOM) referents, diagnosed at the Institute of Radiology and Oncology from 1974 through 1981. A strikingly close similarity in occupational distribution between NPC referents and NCS cases was found. Compared to AOM referents, statistically significantly elevated odds ratios of association with nasal cavity and sinuses cancer were found among textile workers (OR, 2.93), fishermen (OR, 3.38), farmers (OR, 1.94) and construction workers (OR, 1.91) particularly for textile workers and fishermen with more than 15 years of employment (textile workers, OR 7.39), (fishermen, OR 3.72). Among textile workers, somewhat more elevated risks were found among weavers (OR, 4.72) after controlling for employment years. Slightly but not statistically significant elevated relative risks of NCS were also associated with those who smoked (OR 1.40) and those who were locally born in Hong Kong (OR 1.53). The known risk of nasopharyngeal cancer among fishermen and those originating from the southern Chinese province of Guangdong was also evident. These findings confirm an association of nasal cavity and sinuses cancer with textile work which has been previously suggested by other studies and provide new leads for further research on the environmental aetiology of cancer of the nasal cavity, sinuses and nasopharynx.     

Effect of potassium bichromate on mucous membranes of the nasal cavity and paranasal sinuses in animal experiments

Common white rats were used in the study of potassium bichromate (PB) influence and paranasal sinuses mucosae. Single 2-10 PB endonasal introductions were performed on hemostatic collagenic sponge and on paraffin. PB revealed ability in significant causing chronic atrophic rhinosinusitis , and demonstrated weak carcinogenic properties through the induction of some nasal tumours after a prolonged contact of the nasal mucosa with the substance.