鼻腔鼻窦恶性淋巴瘤17例临床分析

鼻腔鼻窦恶性淋巴瘤是主要发生在亚洲和拉丁美洲的一种恶性淋巴瘤，其临床表现缺乏特异性，容易误诊。为了提高对本病的认识，现将1998年1月～2002年12月收治的17例鼻腔鼻窦恶性淋巴瘤患者临床资料总结如下。     

鼻内窥镜在鼻腔鼻窦恶性肿瘤诊断和治疗中的价值

目的探讨鼻内窥镜手术诊断和治疗鼻腔鼻窦恶性肿瘤的价值。方法鼻腔鼻窦恶性肿瘤43例,分别采取鼻内镜下肿瘤切除术、鼻内窥镜辅助下经上颌窦肿瘤切除术以及鼻内窥镜辅助下鼻侧切鼻腔鼻窦恶性肿瘤切除术等。结果 76.7%（33/43）的病例是在鼻内镜下直接取得病理,23.3%（10/43）病例是在鼻内镜辅助下柯陆氏入路进入上颌窦取得病理确诊。能够在鼻内窥镜下将鼻腔鼻窦肿瘤切除的占34.9%（15/43）,在鼻内窥镜下取病理后进一步放疗或化疗的占20.9%（9/43）,在鼻内窥镜辅助下经上颌窦将肿瘤切除的占11.6%（5/43）,在鼻内窥镜辅助下经鼻侧将肿瘤切术的占20.9%（9/43）,在鼻内窥镜下取病理后进一步上颌骨切除术的占11.6%（5/43）。结论鼻内窥镜手术对于明确鼻腔鼻窦恶性肿瘤的诊断,缓解症状、提高患者生存质量具有重要价值,并为其治疗提供了新的术式。     

鼻腔-鼻窦恶性肿瘤的治疗进展

<正>鼻腔-鼻窦恶性肿瘤的发病率相对较低,大约占全部头颈部恶性肿瘤的5%,在所有恶性肿瘤中≤1%~(〔1〕)。这类肿瘤具有多病理类型,发病时往往表现为局部晚期,局部控制失败后常伴有高复发率,导致预后不良。鼻腔-鼻窦恶性肿瘤以上皮来源为主,其中鳞状细胞癌、微小涎腺肿瘤及未分化癌是最常见的肿瘤类型,而非上皮源性的病理类型包括鼻腔神经胶质瘤和恶性黑色素瘤等~(〔2〕)。上颌窦和鼻腔是最易发病部位,其次是筛窦、蝶窦和额窦~(〔3,4〕),因鼻腔-鼻窦恶性肿瘤常毗邻重要组织     

鼻腔及鼻窦出血性息肉135例临床分析

鼻腔及鼻窦出血性息肉１３５例临床分析山东省立医院（２５００２１）王秀云山东省耳鼻喉研究所骆兆平１９６３～１９９０年，我们收治１３５例鼻腔及鼻窦出血性息肉。其中男５９例，女７６例；年龄为１１～８２岁，＜３０岁者７２例（５３．３３％）。病程１周至９年，１...     

鼻腔鼻窦恶性淋巴瘤1例报告

患者男,41岁.因鼻腔疼痛伴右侧头痛、溢泪、流脓涕1个月,于2007年4月3日入院.入院前30 a曾出现右侧鼻腔干燥,当时在外院诊断为鼻硬结症,未行特殊治疗.     

诺通与肾上腺素在鼻腔、鼻窦手术中应用的比较

目的探讨诺通与肾上腺素在鼻腔、鼻窦手术中的应用价值。方法分别观察诺通组、肾上腺素组患者在鼻腔、鼻内窥镜手术中5分钟、10分钟、30分钟时血压、心率的变化,观察出现反跳性鼻腔黏膜充血肿胀的时间和例数,计算出血量并记录。结果诺通组手术前后,30例患者的血压、心率变化差异无显著性,1例局麻患者出现了不良的心血管反应。肾上腺素组手术前后,30例患者的血压、心率变化差异无显著性,3例局麻患者出现了不良的心血管反应。诺通组无1例出现反跳性鼻腔黏膜充血肿胀,肾上腺素组有6例出现轻微的反跳性鼻腔黏膜充血肿胀,诺通组平均出血量300mL,肾上腺素组平均出血量280ml,(P>0.05)。结论我们认为鼻腔、鼻窦手术中,在鼻腔黏膜收缩,血压、心率的改变及出血量方面,诺通组肾上腺素组无明显差异。且使用诺通与肾上腺素相比较,术中间监测血压,心率变化幅度更小,且无鼻腔黏膜反射性充血肿胀。故诺通作为鼻腔、鼻窦手术的减充血剂是更安全、有效的。     

鼻腔及鼻窦恶性肿瘤的治疗体会（附95例报告）

鼻腔、鼻窦恶性肿瘤是耳鼻喉科常见肿瘤之一。1977～1994年,我院收治的鼻腔及鼻窦恶性肿瘤中资料较完整者计95例,现报告如下,并就其治疗中的几个问题进行讨论。     

鼻腔鼻窦恶性淋巴瘤误诊1例报告

患者男，51岁。因右侧鼻腔疼痛，于2007年3月25日入院。患者于入院前30a出现右侧鼻腔干燥，当时在外院诊断为鼻硬结症，未行特殊治疗。平素鼻腔有流脓涕史，鼻涕干痂掏之易出血，偶可闻及臭味。入院前1个月无明显诱因出现右侧鼻腔疼痛，伴右侧头痛、溢泪、流脓涕，无明显鼻塞、嗅觉减退、视力下降，曾在当地医院抗炎治疗，症状无改善。入院后查体：右侧鼻旁及右侧下睑软组织轻微肿胀，右眼视力无下降，眼球活动正常。右侧鼻腔见较多脓性分泌物，鼻腔外侧壁黏膜破坏，质脆，触之易出血，下鼻甲黏膜部分脱落，鼻甲骨外露，     

鼻窦镜下手术清除鼻腔、鼻窦良性病变104例报告

2002～2004年,我们对104例鼻部疾病患者在鼻窦镜下行手术治疗,效果满意。现报告如下。     

Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review

Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis of nasal EMP, and to provide a systematic review of the patients we treated and the published literature. A 45-year-old female patient who presented with epistaxis with nasal obstruction was recommended for magnetic resonance imaging to assess the nature of the lesion. On magnetic resonance imaging, abnormal signal shadow can be seen in the right nasal cavity. Diffusion weighted imaging showed signal of the lesion was significantly limited, presenting high signal, with a low apparent dispersion coefficient, and the lesion was significantly enhanced on contrast-enhanced scan. Combined with the clinical manifestations of the patient, who was initially considered to have a hemangioma. She underwent endoscopic nasal surgery under general anesthesia to remove the mass, and the final pathology confirmed it was EMP. However, the final pathology confirmed EMP. Five months later, the patient came to our hospital for follow-up and underwent fluorine-18-fluorodeoxyglucose/positron emission tomography/computed tomography scan, which showed no recurrence of the lesion and no transformation of multiple myeloma. The nasal EMP imaging findings were mostly soft tissue masses with uniform density or signal, which were significantly enhanced by enhancement scan, high signal on diffusion weighted imaging and low signal on apparent dispersion coefficient. Immunohistochemical staining for CD38, CD138, and CD79a was positive in most of the cases evaluated, while CD20 and CD10 were negative. The absence of dilated features, infiltrative features and the presence of significant contrast enhancement may be relatively specific imaging findings of nasal EMP. The prognosis of nasal EMP is good, and recurrence, metastasis, and transformation into multiple myeloma are rare. Because the lesions are sensitive to radiotherapy, surgical resection combined with radiotherapy is a more effective treatment.     

水蛭寄生鼻腔2例报道

水蛭是一种寄生虫 ,属环节动物 ,身体长形稍扁 ,尾端有吸盘 ,雌雄同体。生活在池沼或水田中 ,以吸食人畜血液为生。我院接诊了 2例鼻腔水蛭病人 ,临床较为少见 ,现报道如下。例 1:患者 ,男 ,35岁 ,农民 ,浙江省缙云县人 ,因左鼻出血 1周 ,伴鼻内异物感。曾在当地诊治 ,具体用药不详 ,无好转 ,于2 0 0 0年 8月 17日来我院就诊 (门诊号 0 0 4 9)。检查见 :左鼻腔大量血性物 ,用吸引器吸净后 ,发现中鼻道有一黑红色异物 ,有鲜血从其周围流出 ,用枪状镊挟之会伸缩 ,且取出困难 ,遂用止血钳挟住用力拽出 ,为一带吸盘的蠕虫 ,予 1%呋麻液棉片覆盖 …     

Bacterial flora of the nasal cavity in laryngectomized patients

Summary In laryngectomized patients, the nose does not function. The absence of a physiological airflow stimulus leads to clinical, cytologic and histologic changes of the nasal mucosa. The aim of this study was to identify the nasal cavity bacterial flora in these patients and to determine whether or not it undergoes changes with time. In a group of 25 patients, the nasal mucosa swabs were taken before, and 8 days and 1 month after the surgery. In a group of 15 patients, the nasal mucosa swabs were taken 1 to 2 years postoperatively.

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Bakterielle Flora in den Nasenhöhlen bei Patienten nach Laryngektomie

Zusammenfassung Nach der Laryngektomie ist die Nase der Patienten außer Funktion. Das Ausbleiben von physiologischen Reizen der Luftströmung führt zu klinischen, zytologischen und histologischen Veränderungen der Nasenschleimhaut. Das Ziel der Untersuchung war die Bestimmung der bakteriologischen Flora der Nasenhöhle bei diesen Patienten, wie auch der Veränderungen, die mit der Zeit entstanden sind. In der Gruppe von 25 Patienten wurden Nasenschleimhaut-Abstriche sowohl vor dem operativen Eingriff als auch 8 Tage beziehungsweise einen Monat nach dem operativen Eingriff gemacht. Bei 15 Patienten wurden Nasenschleimhautabstriche auch 1 und 2 Jahre nach dem operativen Eingriff entnommen.

     

Surgical management of pulmonary cavity associated with fungus ball

Surgery for pulmonary cavity associated with fungus ball is challenged by chronic lung disease. The purpose of this report was to review patient data, operative procedures and results of surgery. This was a retrospective study. Twenty patients were operated on between January 1997 and December 2002. Fourteen (70%) patients were male and the mean age was 46.30 +/- 13.10 years (range, 24 to 76 years). The most common underlying pulmonary disorder was tuberculosis (70%). Ninety five percent of the patients had a history of hemoptysis, and 35% presented with massive hemoptysis. Lobectomy was performed in 11 (55%) patients and 6 (30%) patients were operated on by cavernostomy with transposition of muscle flap technique. There was no operative mortality and 8 complications (3 prolonged airleaks, 2 wound infections, 1 postoperative bleeding, 1 seroma and 1 empyema). It was also found that emergency surgery and cavernostomy with transposition of muscle flap compromised the postoperative course. Surgery is very effective in controlling and preventing hemoptysis in patients who have pulmonary cavity associated with fungus ball. Elective surgery and formal pulmonary resection may be the proper option for low risk patients. Cavernostomy with transposition of muscle flap may be suitable for patients who have poor pulmonary reserve.     

Selective induction of nasal cavity tumors in rats by diallylnitrosamine

Summary Weekly intragastric administration of 20, 40, and 80 mg/kg body weight diallylnitrosamine to BD IX rats selectively induced nasal and paranasal cavity tumors with incidences of 30%, 85%, and 65% in females and of 0%, 75%, and 80% in males, respectively. All tumors were carcinomas of the olfactory region, and 95% were invasive. Only a few papillomas in the anterior region were found simultaneously with the carcinomas.Abbreviations DAN diallylnitrosamine - NPN nasal and paranasal cavity     

鼻腔部异位蛲虫感染21例临床分析

成人和儿童均可感染蛲虫 ,儿童发病率较高 ,我国 5～ 9岁儿童感染率为 2 9.799% [1 ] 。多数患者无明显症状 ,仅夜间雌虫移行至肛门周围排卵时引起会阴部瘙痒导致烦躁不安、夜惊、失眠及遗尿等[2 ] 。蛲虫也可引起女性生殖道、尿道及盆腔等异位感染 ,但鼻腔部异位感染少见。自 1986年作者查到第 1例鼻腔部异位感染者 ,开始注意本病 ,至 2 0 0 0年共搜集 2 1例 ,报告如下。1　材料和方法1.1　一般资料病例均为门诊患者 ,男性 9例 ,女性 12例。年龄 2～ 9岁 ,平均 6岁。双侧鼻腔感染 8例 ,左侧鼻腔感染 7例 ,右侧6例。病史 1～ 18月 ,平均 3月…