以睡眠打鼾憋气为首发症状的扁桃体淋巴瘤1例

淋巴瘤是免疫系统恶性肿瘤,病理分型可分为霍奇金淋巴瘤和非霍奇金淋巴瘤(non-Hodgkin lymphoma, NHL).NHL是一类起源于淋巴细胞不同分化阶段的异源性恶性肿瘤,可发生于全身任何部位的淋巴结和淋巴组织,扁桃体是原发于口咽部淋巴瘤的最常见部位,因早期无特异性表现,临床上易误诊及漏诊.我科2016年10月收治1例以睡眠打鼾、憋气为主要症状的扁桃体NHL,现报道如下.     

以声音嘶哑为首发症状的鼻咽癌1例

1 临床资料 患者,男,42岁,因声音嘶哑40天于2006-07-04入院.入院前40天无明显诱因出现声音嘶哑伴有咽痛、吞咽困难、饮水呛咳并有左侧头痛、左耳鸣.无咳嗽、咳痰,无呼吸困难,无鼻堵、鼻出血及回吸涕中带血,无视物模糊、复视和斜视,无嗅觉及味觉异常.     

以岩尖综合征为首发症状的鼻咽癌1例

患者，女，25岁。因“右颞部疼痛，视物模糊，右侧面部麻木”1个月于2002年5月16日入院。该患者入院前1个月感冒后出现右侧颞部阵发性疼痛，为跳痛，伴右眼视物模糊，右侧面部麻木，曾在当地予以止痛剂、青霉素和灯盏花素等治疗，头痛加重，持续时间延长。脑电图示轻度异常，头颅MRI未见异常。近3个月来患者有口干、脓涕、右     

以咽痛为首发症状的鼻咽淋巴瘤1例

1 临床资料 患者,男,47岁,主诉为咽痛9个月,头痛1个月,加重半个月,于2006-06-11入院.     

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。     

以持续性耳闷为首发症状的原发性鼻咽结核1例并文献复习

目的：探讨原发性鼻咽结核的临床特点及诊疗方法。方法：报道在我院就诊的1例以持续性耳闷胀感为首发症状的原发性鼻咽结核病例,并对相关文献进行回顾。结果：患者经鼻咽部活检、组织病理学检查,提示结核性肉芽肿伴干酪样坏死,抗酸检测阳性。经抗结核治疗后,患者症状消失,鼻咽部形态基本正常。结论：对于伴有耳部症状的鼻咽部新生物的患者,原发性鼻咽结核应作为鉴别诊断之一,须通过鼻咽部活检组织病理学检测加以明确诊断,以免延误病情。     

打鼾相关流行病学现状及其影响因素调查研究——以徐州地区为例

目的 以徐州地区为例,了解人群重度打鼾及睡眠呼吸暂停低通气综合征(SAHS)流行病学现状及危险因素。方法 应用随机抽样的方法,以调查问卷方式进行入户调查。筛查出有SAHS指征的对象进行多导睡眠监测,确诊SAHS阳性。采用EpiData3.0软件建立数据库,使用双录入核查比对的方式在Epidata3.0下录入。并应用SPSS 13.0软件分析数据。结果 实际获得有效问卷1 223份(有效率94.1%)。调查显示徐州地区3级及以上打鼾患病率为14.0%,SAHS阳性的患病率为6.2%。3级及以上打鼾的危险因素有性别、饮酒、高血压、体质量指数(BMI)、鼻咽部疾病、家族史等。结论 徐州地区重度打鼾及SAHS的患病率较其他地区低。可以通过控制饮酒、控制血压、保持正常体质量指数、防治鼻咽部疾病等方法减少3级及以上打鼾的发病概率。     

以痛性眼肌麻痹为首发症状的鼻咽癌4例分析

目的:研究以痛性眼肌麻痹为首发症状的鼻咽癌临床特点及误诊原因.方法:回顾分析4例鼻咽癌患者首发临床症状.结果:痛性眼肌麻痹可以是鼻咽癌的首发症状,可有第Ⅲ,Ⅳ,Ⅴ,Ⅵ对颅神经损害.结论:神经系统症状可以是促使鼻咽癌患者就诊的原发症状,应及时进行鼻咽部颁标准检查,CT, MRT检查有助于确诊.     

以外耳道内疼痛为首发症状的狂犬病1例

患者,男,42岁。因双耳内疼痛3d于2006年3月21日就诊。诉双耳内疼痛,呈阵发性,针刺样,以右耳为著,伴耳鸣,不伴听力下降。查体：神志清,双外耳道内有少许耵聍潴留,清除后见外耳道充血肿胀,鼓膜标志清,乳突区无压痛。纯音测听示右耳平均听阈15dBHL,左耳20dBHL;声导抗测试双鼓室曲线图呈A型;听性脑干反应测听（ABR）示、波Ⅰ至波Ⅶ的潜伏期、振幅、波间期均在正常范围;     

以耳流脓为首发症状的鼻咽癌1例

患者,女性,44岁.左耳持续流脓3个月伴左侧头痛半月.起病后曾在多家医院就诊,均以"左化脓性中耳炎"使用多种抗生素及0.3%氧氟沙星滴耳液滴耳治疗2个多月,疗效不佳,于2004年11月10日来本院耳鼻咽喉科就诊.患者无鼻塞、血性涕,无回吸性涕中带血,无耳鸣,无耳道流血性分泌物,无复视.     

A right-sided fourth branchial cleft cyst: a case report

Branchial anomalies are a consequence of abnormal development of the branchial apparatus during embryogenesis. Here, a pediatric case with a right-sided fourth branchial cyst that was discovered on fetal ultrasound scanning (US) is presented. The embryological basis for the occurrence of this cyst and definitive surgical management are discussed.     

Second branchial cyst in the parapharyngealspace: a case report

Objective

We report the clinical findings and management of a large retro- and parapharyngeal branchial cyst in a 54-year-old man whose only complaint was a 12-month history of snoring.

Method

Case report and a review of the world literature concerning parapharyngeal cysts are presented.

Results

On computed tomography (CT) images, a well-marginated cystic mass was observed in the left retro- and parapharyngeal spaces, with displacement of the left internal and common carotid arteries. The cyst contained thick, sterile, yellowish pus, without malignant cells. We performed a transoral resection without any surgical complications. No recurrence was observed 2 years later.

Conclusion

Parapharyngeal branchial cysts are rare and often paucisymptomatic. The transoral approach can provide good exposure allowing complete resection without significant post-operative complications or cervical scarring.     

Second branchial cleft cyst causing internal jugular vein thrombosis — A case report

The branchial cleft cyst also known as lateral cervical cyst is usually present in the lateral part of neck deep to sternocleidomastoid muscle at the junction of its upper third and lower two thirds. Branchial cysts are known for repeated infection with sudden increase in size and pain and for its recurrence. Thrombosis of major vessels of neck secondary to recurrent infection and inflammation of branchial cyst is extremely rare. Here we present the first case of internal jugular vein thrombosis; a rare complication seen with branchial cyst in a 54-year-old male. The patient was treated initially with antibiotics followed by excision of cyst and ligation of internal jugular vein without any complication. Key Message Thrombosis of internal jugular vein secondary to recurrent infection and inflammation of branchial cyst is extremely rare. Here we present the first case of internal jugular vein thrombosis in a 54-year-old male. The patient was treated initially with antibiotics followed by excision of cyst and ligation of internal jugular vein without any complication.     

First branchial cleft anomaly: a report of case

A rare case of first branchial cleft anomaly in a 21-year-old female is described. A fistulous tract was located near the angle of the mandible and anterior to the sternocleidmastoid muscle, extending upwards under the facial nerve and opening into the external auditory canal. The tract was completely removed and the facial nerve was preserved. Histopathologic examination revealed that the tract was composed of keratinizing squamous cell epithelium with adnexal structures and cartilage.     

腮裂囊肿鳞状细胞癌变一例

患者男,65岁.2005年2月,患者发现右颈部肿块,逐渐增大,经抗生素治疗无效,于2005年4月收入院治疗.查体:肿物位于右胸锁乳突肌前缘上1/3深面,大小约2.0 cm ×2.0 cm,中等硬度,边界清楚,与周围无粘连,活动度好,无压痛.     

Fourth branchial cleft cyst with no identifiable tract: case report and treatment approach

We describe a rare case of a fourth branchial cleft cyst that had no identifiable tract. The patient was a 23-year-old man who presented with recurring neck abscesses. After six similar episodes, computed tomography finally demonstrated that the most recent abscess had extended into the thyroid gland, a finding that led to the correct diagnosis. Extensive surgical extirpation of the cyst with an adjacent neck dissection was performed, and the patient remained symptom-free at 25 months of follow-up. The occurrence of a fourth branchial cleft cyst with no clear tract presents a surgical dilemma, as complete dissection cannot be guaranteed. Consequently, such patients are predisposed to recurrence. We propose that definitive management of a fourth branchial cleft cyst with no identifiable tract focus on eliminating the likely embryologically based path of bacterial seeding. This includes a hemithyroidectomy in conjunction with a selective neck dissection to cover all areas where a fourth branchial tract may lie within the neck.