Zheng Y

Surgical treatment of osteoradionecrosis of the temporal bone in patients with nasopharyngeal carcinoma.

OBJECTIVE To investigate methods of treating diffuse osteoradionecrosis of the temporal bone in cases of nasopharyngeal carcinoma, following radiotherapy. STUDY DESIGN Retrospective. METHODS Fourteen post-irradiation nasopharyngeal carcinoma patients (n = 14 ears) with diffuse osteoradionecrosis received surgical treatment from March 1994 to May 2005. The patients underwent radical mastoidectomy (five ears), extensive radical mastoidectomy (one ear), or radical mastoidectomy and obliteration with local vascularised fascia flaps (eight ears). RESULTS Six ears fully recovered; two ears were still infectious but sequestrum had not re-formed; five ears (50 per cent) still had repeated suppuration and did not epithelialise; and one ear had local re-formation of sequestrum requiring periodic dressing changes. CONCLUSION Diffuse osteoradionecrosis of the temporal bone following radiotherapy for nasopharyngeal carcinoma is difficult to treat surgically. The main objective of surgery is to facilitate drainage and to prevent complications. Radical mastoidectomy and obliteration with local vascularised flaps is an effective method.

Endoscope-assisted partial-superficial parotidectomy through two small skin incisions.

Conclusion. Endoscope-assisted partial-superficial parotidectomy is a feasible method for treatment of benign parotid superficial lobe tumors located at the anterior or the inferior of the auricular lobule. The main advantage of this procedure is that the small operative scar resulted in improved cosmetic results. Objectives. This study evaluated the feasibility of endoscope-assisted partial parotidectomy through two small skin incisions. Patients and methods. Thirty cases with benign parotid superficial lobe tumors with a diameter < 30 mm located at the anterior or the inferior of the auricular lobule underwent endoscope-assisted partial-superficial parotidectomy via retrograde approach through two small skin incisions. Results. All 30 operations were successfully performed endoscopically. All the patients were satisfied with the cosmetic results. Only three patients had transient facial paresis and recovered in 1–2 months. The endoscopic surgery lasted for 106.48±12.62 min. There was no tumor recurrence during the follow-up after 26–50 months.

Intralesional bleomycin A5 injection for the treatment of nasal polyps through inducing apoptosis

Abstract Conclusion: An intralesional bleomycin A5 (BLE) injection might be used as an alternative therapy for eosinophilic-type nasal polyps (NPs). BLE-induced apoptosis might play an important role in shrinkage of NPs. Objectives: The aim of this study is to determine the effect and explore the possible role of apoptosis in shrinkage of NPs. Methods: Twenty-nine patients with eosinophilic-type NPs experienced repeated local injection of BLE. The recurrence rate of this group was obtained. The mechanism of BLE treatment was investigated through an in vitro experiment. Nasal polyp tissues were treated with BLE. The apoptotic activity was detected by the presence of DNA smear and test of terminal deoxynucleotidyl transferase dUTP nick end labeling. The caspase-8 and PARP were examined through immunohistochemistry and Western blotting. Results: After several local injections of BLE, the nasal polyp tissues decreased and then disappeared. During follow-up of 3 years the recurrence rate of this group was significantly lower than another one treated with operation plus medicine treatment. Apoptosis in BLE-treated tissue was prominently detected in the infiltrating inflammatory cells. The expression of PARP and casp-8 were increased in BLE-treated nasal polyp tissue compared with PBS-treated tissue.

Malformation of the external ear and facial paralysis caused by megatemperature hydro-aluminum.

We present a case of right lateral auricle contracture malformation, auricular canal atresia, and complete facial paralysis (House-Brackmann grade VI) caused by a megatemperature hydro-aluminum injury at work. The diastrophic auricle and auricular canal atresia were reshaped. The complete facial paralysis was reanimated to House-Brackmann grade III after surgical hypoglossal–facial end-to-end anastomosis. These outcomes indicate that hypoglossal–facial end-to-end anastomosis is an effective surgical option for successful reanimation of complete facial paralysis.