Search

Objective: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit., Method: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up., Result: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed., Conclusion: Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.

Objective: To discuss the complication of common anatomic variant of the middle turbinate-concha bullosa., Method: We present a 35 years old man with inner canthus proptosis and orbital pain who was diagnosed to be a pyocele originated from concha bullosa by CT and operation., Result: Concha bullosa can develop to a pyocele. Direct extension of the mass from the nose into the orbit may occur. Good therapeutic effect was obtained by endoscopic operation., Conclusion: Concha bullosa can result in obstruction of middle meatus and lead to sinusitis. Polyps or mucocele may also occur to Concha bullosa itself. Pyocele of concha bullosa can develop to such a massive extent that it leads to orbital complication. Endoscopic operation is best treatment to this disease.

Objective: Studying the method to treat the sinus mucoceles invaded in orbit with marsupialization under nasal endoscope, and determing the long-term efficacy of the endoscopic surgical treatment., Method: Twenty-four patients underwent endoscopic wide marsupialization of the mucocele cavity. The postoperative cleaning were carried out according to ESS routine, the focus on preventing obstruction of sinus ostia and middle meatal adhesions., Result: Follow-up ranged from 1 to 5 years. There is no case of recurrence and orbital complications., Conclusion: Endoscopic approach with marsupialization to the treatment of sinus mucoceles invaded in orbit is associated with no rate of recurrence and no complication, and it is a reliable therapeutic measures. The aim of postoperative cleaning is at preventing obstruction of sinus ostia and middle meatal adhesions. Long time follow-up is needed.

Objective: The purpose of this article was to observe the effect of by microwave thermocoagulation on oral benign tumor and to provide theoretical basis for clinic treatment of oral benign tumor., Methods: 165 patients with oral benign tumor were included. There were 83 patients with oral bursa cyst, 42 patients with hemangioma, 19 patients with papilloma, 14 patients with fibrous hyperplasia and 7 patients with epulis. All the patients were treated by WB-100 microwave thermocoagulation., Results: 144 patients were effective after the first treatment and 21 patients were effective after the second treatments. No side effect and reoccurrence were found after 3 years., Conclusion: Microwave thermocoagulation is an effective and safe method in clinic treatment of oral benign tumor.

Objective: To discuss the feasibility and superiority of lateral thyrotomy approach on the paraglottic space operation., Method: Five case mucocele of larynx located at paraglottic space were resected the cyst completely by a U-shaped lateral thyrotomy approach. One cases of laryngeal trauma foreign body in paraglottic space was taken out by approach through vertical split of the thyroid lamina., Result: Three cases mucocele of larynx located did not recurrent during follow-up 1 year and their phonation were recoverd normally. The other two cases are during follow-up. One cases of laryngeal trauma foreign body has been oprated, her vocal cords moved normally and the glottic could be closed completely., Conclusion: Through lateral thyroid lamina split or partial resection approach, the paraglottic space can be exposed clearly and the cyst or foreign body can be easily removed under direct visualization. The operation provides minimal trauma without deformity in laryngeal framework, and postoperative complication to enter the laryngeal mucosa. It proves to be an effective approach to benign lesion at paraglottic space.

Objective: To find out the prevalence of pneumatization of perpendicular plate of the ethmoid bone, and to discuss the diagnosis and management of perpendicular plate mucocele (nasal septal mucocele)., Methods: The CT data from 32 patients with septal deviation were reviewed, and an unusual case of perpendicular plate mucocele was reported., Results: Six cases (6/32, 18%) were found to have pneumatization of perpendicular plate of the ethmoid bone, with 2 located in the anterior portion (frontal-septal pneumatization), and 4 located in the posterior portion (spheno-septal pneumatization). A patient with perpendicular plate mucocele was treated by the technique of marsupialization under nasal endoscope. This patient was followed-up for 10 months without recurrence., Conclusion: As a kind of variation of nasal septum, the clinical significance of pneumatization of perpendicular plate should be emphasized. We reported the first case of perpendicular plate mucocele, originated possibly from the pneumatization of perpendicular plate of the ethmoid bone. Marsupialization under endoscope was considered to be the initial management for this unusual disease.

Objective: To evaluate endoscopic surgery for sphenoidal and ethmoidal mucoceles., Method: Seventeen patients diagnosed as having paranasal sinus mucoceles underwent attempted endoscopic marsupialization between 1989 and 1995. Ten of the mucoceles were in the sphenoid sinus, seven in the ethmoid sinus. Postoperative endoscopic follow-up period varied from 3 to 9 years., Result: All the sphenoidal and ethmoidal mucoceles were satisfactorily approached endoscopically. Postoperative endoscopic examination manifested all the operating cavity was satisfactorily marsupialized. The symptoms were improved or relieved in 15 patients. None of the patients undergoing endoscopic surgery had significant complications., Conclusion: Our results show that endoscopic surgery seems to be a safe, valuable way for management of sphenoidal and ethmoidal mucoceles.

Objective: The purpose of this study is to review isolated sphenoid sinus disease, to establish correct diagnosis and to treat it effectively in the future., Method: 26 patients underwent endoscopic surgery, in which 20 sphenoid sinus mucocoeles were removed and 6 sphenoid sinuses were explored. 3 sphenoid sinus mucocoeles were removed by external approach, 1 patient underwent skull base surgery and decompression of optic nerve., Result: 24 patients were free from disease postoperatively within 0.5-4 years follow-up, 2 patients underwent re-operation because of recurrence, 1 patient was undergoing radiotherapy, 3 patients could not contact., Conclusion: This study shows that CT not only makes contribution to establish correct diagnosis but also plays an important role in surgery of isolated sphenoid sinus disease. Endoscopic surgery is valuable in treatment for benign disease of sphenoid sinus.

We have analyzed the clinical data of 27 cases of sphenoid inflammatory neoplasms and sphenoid sinus tumors including inflammations (12 cases), benign tumors (10 cases) and malignant tumors (5 cases). The characteristics of sphenoid inflammatory neoplasms were compared with those of sphenoid sinus tumors. On CT scanning and magnetic resonance imaging (MRI) we found that sinusitis resulted in much less bony erosion than tumors on CT scanning and that the T2-signal intensity on MRI increased much more in sinusitis than in tumors. We have discussed the indications of various operative approaches and suggested that the approach of external ethmoidectomy is a method of choice.

Mucocele of appendix comprises 0.07%-0.3% of the resection of appendix. Three such cases were encountered over the past four years at MMH. Tumor mass could be palpated before operation in two of our cases. The third case was found incidentally during sigmoid cancer resection. Mucocele of the appendix should be differentiated from submucosal lesion such as leiomyoma, lipoma, lymphoma in the cecum or appendiceal abscess. Recent advances of ultrasound, CAT scan as well as angiography have made correct preoperative diagnosis possible, yet literature still shows diverse opinion about its etiology (neoplastic vs. obstructive). Although most authors favor simple appendectomy for the management of this disease, some surgeons still think it should be managed aggressively with colectomy. Rupture of mucocele might result in pseudomyxoma peritonei and possibly a fetal outcome. Avoidance of iatrogenic rupture of appendix is essential. Aggressive removal of accessible masses and implants was suggested in the literature.