角膜基质层注射治疗真菌性角膜炎

目的 观察角膜基质层注射氟康唑注射液治疗真菌性角膜炎的临床效果。方法 将诊断为真菌性角膜炎的70眼随机分为对照组和实验组,每组35眼。对照组：碘酊烧灼角膜溃疡后用重组牛碱性成纤维细胞生长因子眼胶及氟康唑眼膏包眼。实验组：角膜基质层注射氟康唑注射液于角膜溃疡后用重组牛碱性成纤维细胞生长因子眼胶及氟康唑眼膏包眼。观察和对比碘酊烧灼和角膜基质层注射氟康唑注射液治疗真菌性角膜炎的临床可行性。结果 实验组所有溃疡愈合,病程缩短,效果优于对照组(P(<0.05)。两组治疗前后视力平均值差异有统计学意义(P<0.05)。结论 角膜基质层注射氟康唑注射液治疗真菌性角膜炎可以明显提高治愈率,是一种高效、安全的治疗方法。     

Craniofacial growth in children with nasal septum deviation: A cephalometric comparative study

Objective

Nasal-breathing impairment has been described as a possible determinant of maxillofacial development in children with adenoids/tonsils hypertrophy. However little is known about the possible influence of nasal septum deviation on craniofacial growth in childhood. We conducted a multicenter cephalometric study to compare skeletal and dental features in children with chronic nasal-breathing obstruction secondary to nasal septum deviation and nose-breathing controls.

Methods

Ninety-eight children (59M, 39F; mean age 8.8 years; age range 7-12 years) with obligate mouth-breathing secondary to nasal septum deviation (group 1) and 98 age- and sex-matched nasal-breathing controls (group 2) were evaluated. Nasal-breathing function was assessed in all patients with clinical history, ENT instrumental examination and anterior active rhinomanometry. Cephalometric parameters were recorded in all subjects.

Results

Patients of group 1 showed a statistically significant increase of upper anterior facial height (N-palatal plane) and total anterior facial height (N-Me) with regards to group 2. The angular relationships of the sella-nasion, palatal, and occlusal planes to the mandibular plane were greater in group 1 in comparison to controls. The gonial angle (Ar-Go-Me), palatal height and overjet were significantly higher in the mouth-breathing group. A significantly retrognatic position of the maxilla and mandible was recorded in group 1 in comparison to group 2. Most mouth-breathing children showed class II malocclusion, while the majority of control subjects presented normal occlusion. The prevalence of cross-bite was higher in group 1 with respect to controls (p = 0.02).

Conclusion

Children with obligate mouth-breathing due to nasal septum deviations show facial and dental anomalies in comparison to nose-breathing controls. Possible physiologic explanations of our findings are reported.     

Nasal responsiveness to methacholine stimulation in allergic rhinitis patients

Summary We examined the nasal responsiveness to topical methacholine application in allergic rhinitis and non-allergic chronic rhinitis patients, and in control subjects. Methacholine responsiveness was significantly higher in allergic rhinitis patients than in non-allergic patients and control subjects. In perennial rhinitis, methacholine responsiveness correlated with the severity of daily nasal symptoms and those provoked by specific allergen challenge tests. Among nasal symptoms, hyper-rhinorrhoea was found to be closely related to methacholine responsiveness. As a result of these findings, the possibility of cholinergic hyper-reactivity in allergic rhinitis patients is discussed.     

经鼻内镜鼻窦手术360例临床分析

目的 探讨经鼻内镜鼻窦手术治疗慢性鼻窦炎、鼻息肉的远期疗效。方法 对1996-2000年360例（663侧）完成随访的鼻内镜手术进行临床分析。术后随访6个月-2年。结果 治愈率为73.15%，其中I型治愈率为92.53%，Ⅱ型治愈率为67.92%，Ⅲ型治愈率为44.44%，3型治愈率呈递减趋势。结论 鼻内镜手术是治疗慢性鼻窦炎和鼻息肉的有效方法，手术疗效与其临床分型密切相关。术中恰当处理中鼻甲、鼻中隔偏曲及术后的综合治疗，对鼻内镜鼻窦手术远期疗效具有重要的意义。     

慢性鼻窦炎鼻息肉鼻内镜术后的康复治疗

目的:分析鼻息肉、慢性鼻窦炎经鼻内镜手术后影响疗效的因素,并探讨其预防措施。 方法:对因鼻息肉、慢性鼻窦炎接受鼻内镜手术、随访3年以上的226例患者从职业、个人生活习 惯、术后是否坚持系统的康复治疗及持续时间、临床转归等方面进行回顾性分析。结果:从事接触 刺激性物质或粉尘的职业(化工、纺织、建筑、装饰、锅炉和厨师等)、具有不良生活习惯(喜食辛辣 食物、嗜烟酒)、术后(尤其是出院后)根本不曾或不能坚持进行系统康复治疗(包括局部用药、全 身用药、鼻腔冲洗、定期鼻内镜下清理术腔等)的患者与不具有前述"特质"的患者鼻息肉、鼻窦炎 复发的可能性明显居高、复发时间亦明显提前;具备前述"特质"类别愈多,复发愈快、愈剧。其中 尤以系统康复治疗对术后转归影响最显著。结论:术后定期、足够疗程的系统康复治疗是提高鼻 息肉、慢性鼻窦炎经鼻内镜手术疗效的有力措施,良好的职业保护和戒除不良生活习惯能有效地 预防和减缓鼻息肉、慢性鼻窦炎经鼻内镜手术后的复发。     

白细胞介素-12在变应性鼻炎鼻粘膜中的表达

目的 :探讨白细胞介素 12 (IL 12 )在变应性鼻炎鼻粘膜中的表达。方法 :以卵清蛋白为变应原建立豚鼠变应性鼻炎模型 (模型组 )。取该模型和健康豚鼠鼻粘膜行常规HE染色 (对照组 ) ,并采用逆转录 聚合酶链反应 (RT PCR)检测方法 ,对两组动物鼻粘膜组织中IL 12mRNA表达水平进行相对定量比较。结果 :IL 12mR NA在两组鼻粘膜中均有表达 ,模型组的表达水平为 0 .6 6 7± 0 .10 4显著低于正常对照组 0 .84 7± 0 .0 71(P <0 .0 1)。结论 :在变应性鼻炎鼻粘膜组织中IL 12的表达下降 ,提示应用IL 12替代疗法治疗变应性鼻炎的可能性。     

The 'butterfly' graft in functional secondary rhinoplasty

OBJECTIVE: To describe a surgical technique (the conchal cartilage "butterfly" graft) which, when used in properly selected patients, has been found to be a dependable method for alleviation of postrhinoplasty internal nasal valve dysfunction. STUDY DESIGN: Retrospective chart review. METHODS: Analysis of consecutive patients with weakness and/or collapse of the upper lateral cartilages following rhinoplasty. Seventy-two patients (37 women and 35 men, age range 17-76 y) had severe nasal obstruction and were found to have indications for this procedure. All patients had undergone at least one rhinoplastic procedure. All patients were followed for a minimum of 2 years after surgery. RESULTS: All 72 patients experienced significant subjective improvement in relative nasal obstruction. Two patients (3%) reported less than total resolution of their difficulty breathing through their nose; the remaining 70 patients (97%) reported complete resolution of their nasal airway problems. No patients reported their postoperative nasal obstruction as the same or worse than their preoperative baseline. Sixty-two patients (86%) reported improvement in the appearance of their nose, 8 patients (11%) felt that their appearance was unchanged, and 2 patients (3%) felt that the appearance of their nose was made worse by the procedure. CONCLUSIONS: Patients presenting with nasal obstruction after rhinoplasty are frequently found to have collapse and/or weakening of their upper lateral cartilages with resulting nasal valve dysfunction. The conchal cartilage "butterfly" graft is a technique which, when properly performed during revision rhinoplasty, yields predictable functional and cosmetic results with minimal morbidity.     

症状、CT和鼻声反射在慢性鼻窦炎组织重构诊断中的意义

目的探讨鼻塞症状、CT扫描Lund-Mackay评分和鼻声反射测量鼻黏膜充血指数与慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)组织重构程度之间的相关性,探讨三者在CRS组织重构诊断中的意义。方法选取CRS患者43例,应用视觉模拟评分(visual analogous scale,VAS)系统评价鼻塞症状;Lund- Mackay平分系统评价鼻窦CT扫描结果;鼻声反射测量获取鼻黏膜充血指数;钩突黏膜组织标本行鼻黏膜纤维化程度评分。应用统计学方法对其相关性进行分析。结果鼻塞症状严重程度与鼻黏膜纤维化程度之间无明显相关性(r=-0.046,P=0.77);CT评分与黏膜组织纤维化评分之间无相关性(r=0.132,P=0.40);鼻黏膜纤维化程度与鼻黏膜充血指数之间呈负相关(r=-0.348, P=0.022)。结论鼻黏膜充血指数能够反映病变黏膜的组织重构程度,辅助症状与CT检查指导CRS治疗策略。