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Sphenoid sinus mucocele with unilateral blindness – a case report 蝶窦粘液囊肿伴单侧失明1例
Pub Date : 2021-12-20 DOI: 10.48095/ccorl2021243
Jozef Šulhin, Jakub Mičaník, J. Lubojacký, A. Kopecký, P. Matoušek, P. Komínek
Mucocele of the paranasal sinuses are benign cystic lesions filled with mucus. They occur in the sphenoid sinus in 1–2% of all paranasal sinuses, most often in the fourth decade of life. Clinical manifestations are non-specific, caused by pressure expansion into anatomical structures immediately adjacent to the sphenoid sinus. They are manifested by headaches, dropped eyelids, impaired movement of the globe, and impaired vision. In the differential dia­gnosis, it is necessary to distinguish them from tumour processes and processes propagating from the intracranium. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) play an important role in the dia­gnosis, the definitive dia­gnosis is determined by perioperative findings and histological examination. Curative surgical options include endoscopic transnasal sphenoidotomy with marsupialization. In this article, we present a case of a patient with a mucocele of the sphenoid sinus, which was the cause of unilateral blindness. Keywords: marsupialization – mucocele – sphenoid sinus – endoscopic transnasal sphenoidotomy
鼻窦黏液囊肿是充满黏液的良性囊性病变。它们发生在蝶窦,占所有副鼻窦的1-2%,最常发生在40岁左右。临床表现是非特异性的,由压力扩张到紧邻蝶窦的解剖结构引起。它们表现为头痛、眼皮下垂、眼球运动受损和视力受损。在鉴别诊断中,有必要将其与肿瘤进程和从颅内传播的进程区分开来。计算机断层扫描(CT)和磁共振成像(MRI)在诊断中起重要作用,最终诊断取决于围手术期的表现和组织学检查。治疗性手术选择包括内镜下经鼻蝶窦切开术加有袋化术。在这篇文章中,我们提出一个病例的病人与粘液囊肿的蝶窦,这是单侧失明的原因。关键词:有袋化-黏液囊肿-蝶窦-经鼻内镜蝶窦切开术
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引用次数: 0
The value of flexible endoscopy with Narrow Band Imaging for the evaluation of recurrence of laryngeal and hypopharyngeal tumours after radiotherapy 窄带软性内镜对喉、下咽肿瘤放疗后复发的评价价值
Pub Date : 2021-12-20 DOI: 10.48095/ccorl2021214
J. Šatanková, A. Švejdová, M. Vošmik, M. Černý, P. Kordač, M. Homoláč, V. Chrobok
Background: The dia­gnosis of recurrent upper aerodigestive tumours is difficult, especially in the case of previous curative radiotherapy (RT) or chemoradiotherapy (CRT). Progress in the dia­gnostics of head and neck cancer came with the development of optical endoscopic imaging methods. The aim of this study was to analyse the benefits of flexible Narrow Band Imaging (NBI) in the visualization of suspected recurrence of malignancy in patients after curative RT (CRT). Methods: A total of 58 examined patients in follow-up after curative RT or CRT for laryngeal and hypopharyngeal squamous cell carcinoma were enrolled in the study. All patients underwent transnasal flexible endoscopy in conventional white light and NBI in local anaesthesia. Changes in microvascular architecture (intraepithelial papillary capillary loops – IPCL) have been classified according to Ni. IPCL I–III were considered to be non-suspicious, and therefore no histopathological examination was indicated. IV and V type findings were verified using HDTV NBI intraoperatively with bio­psy sampling and subsequent histopathological correlation was performed. Results: Transnasal videoendoscopic examination with NBI revealed a suspicious finding (IPCL type IV and V) in 23/58 (39.7%) patients, non-suspicious finding (IPCL I–III) in 35/58 (60.3%). Histopathological examination verified the positive finding (precancerous or malignant changes) in 12/23 (52.2%) and negative finding in 11/23 (47.8%) cases. The sensitivity, specificity, positive and negative predictive value of flexible NBI endoscopy were 100%, 76.1%, 52.2% and 100% respectively. According to the Kappa index (K = 0.568), we proved a moderate concordance between flexible NBI endoscopy and histopathological results. Conclusions: Transnasal flexible endoscopy with NBI in outpatient settings contributes to an early detection of pathological changes also in post-radiation altered mucosa of the larynx and hypopharynx, while a correct interpretation of in NBI findings is required to reduce the incidence of false positive results. Keywords: squamous cell carcinoma – Larynx – radiotherapy – narrow band imaging – Ni classification – hypopharynx
背景:复发上消化道肿瘤的诊断是困难的,特别是在既往治疗性放疗(RT)或放化疗(CRT)的情况下。随着光学内窥镜成像方法的发展,头颈癌的诊断也取得了进展。本研究的目的是分析柔性窄带成像(NBI)在治疗性放射治疗(CRT)后疑似恶性肿瘤复发的可视化中的益处。方法:对58例喉部和下咽鳞状细胞癌经放疗或CRT治疗后随访的患者进行研究。所有患者均在常规白光下行经鼻软性内窥镜检查,局部麻醉下行NBI。微血管结构的改变(上皮内乳头状毛细血管袢- IPCL)已根据Ni分类。IPCL I-III被认为是不可疑的,因此没有进行组织病理学检查。术中采用HDTV NBI对IV型和V型结果进行验证,并进行活检和随后的组织病理学相关性分析。结果:经鼻内镜NBI检查发现可疑发现(IPCL IV型和V型)23/58(39.7%),非可疑发现(IPCL I-III型)35/58(60.3%)。组织病理学检查证实12/23(52.2%)的阳性发现(癌前或恶性改变),11/23(47.8%)的阴性发现。柔性NBI内镜的敏感性为100%,特异性为76.1%,阳性预测值为52.2%,阴性预测值为100%。根据Kappa指数(K = 0.568),我们证明了柔性NBI内窥镜检查结果与组织病理学结果之间的中度一致性。结论:门诊使用经鼻柔性内窥镜检查NBI有助于早期发现放射后改变的喉和下咽粘膜的病理变化,同时需要正确解释NBI的发现,以减少假阳性结果的发生率。关键词:鳞状细胞癌-喉部-放射治疗-窄带成像- Ni分型-下咽
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引用次数: 0
“The Laryngectomee Guide” in Slovak 斯洛伐克语的《喉切除术指南》
Pub Date : 2021-12-20 DOI: 10.48095/ccorl2021246
I. Brook, M. Tedla
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引用次数: 0
Course variations of the internal carotid artery and their significance in pharyngeal surgery 颈内动脉的病程变化及其在咽部手术中的意义
Pub Date : 2021-12-20 DOI: 10.48095/ccorl2021234
Peter Kántor, V. Procházka, P. Komínek
The internal carotid artery is one of the major vessels of the neck. It usually originates from the common carotid artery at the level of the 3rd–4th cervical vertebra and continues perpendicularly to the skull base in the neurovascular bundle. During common surgical procedures in the pharynx, such as adenoidectomy or tonsillectomy, the artery is usually in a safe distance from the pharyngeal wall and the risk of injury is low. However, several anatomical variations have been described that may cause medialization of the vessel closer to the pharyngeal wall, which significantly increases the risk of injury and occurrence of life-threatening haemorrhage. Keywords: internal carotid artery – tonsillectomy – haemorrhage – adenoidectomy – vascular anomalies
颈内动脉是颈部的主要血管之一。它通常起源于颈总动脉在第3 - 4颈椎的水平,并继续垂直于颅底的神经血管束。在咽部的常见外科手术中,如腺样体切除术或扁桃体切除术,动脉通常与咽壁处于安全距离,损伤的风险较低。然而,一些解剖变异可能导致靠近咽壁的血管内侧化,这显著增加了损伤和发生危及生命的出血的风险。关键词:颈内动脉扁桃体切除术出血腺样体切除术血管异常
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引用次数: 0
Erdheim-Chester disease – case report 厄德海姆-切斯特病1例报告
Pub Date : 2021-09-27 DOI: 10.48095/ccorl2021177
Katarína Pilarčíková, K. Sláviková, L. Plank, Magdaléna Puchertová, M. Babinec, T. Barta, M. Profant
Summary Erdheim-Chester disease (ECD) belongs to the malignant polyostotic sclerotic forms of non-Langerhans histiocytosis. During abnormal prolipheration of pathologic histiocytes (foam cells), involved structures become hypertrophic with increased density followed by scarring. Mostly the diaphysis and metaphysis of long bones of lower limbs with typical pain are involved. According to the WHO, the disease is classified as histiocytic neoplasia. We refer on a 74-year-old female patient with expansive process in the region of upper clivus and sphenoidal bone on the right side. Histological testing confirmed this very rare disease that affects about 600 patients over the world. Key words Erdheim-Chester – foamy histiocytes – sclerosis – fibrosis
Erdheim-Chester病(ECD)属于非朗格汉斯组织细胞增多症的恶性多骨增生硬化形式。在病理组织细胞(泡沫细胞)的异常增殖过程中,相关结构变得肥大,密度增加,随后形成瘢痕。主要累及下肢长骨干和干骺端,伴有典型的疼痛。根据世界卫生组织,这种疾病被归类为组织细胞瘤。我们报告一位74岁的女性患者,右侧上斜坡和蝶骨区域出现扩张性突起。组织学检测证实了这种非常罕见的疾病,全世界约有600名患者受到影响。关键词Erdheim-Chester泡沫组织细胞硬化纤维化
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引用次数: 0
Acute vertigo in the ENT emergency 急性眩晕在耳鼻喉科急诊
Pub Date : 2021-09-27 DOI: 10.48095/ccorl2021146
Václav Albrecht, L. Školoudík, Peter Sila, J. Mejzlík, M. Janouch, V. Chrobok
Summary Introduction: Acute vertigo ranks among the common reasons for visiting the emergency department. The aim of this study was to evaluate the rate of peripheral vestibular syndrome (PVS) in patients with acute vertigo examined at the ENT emergency department and to compare the agreement of physical ENT examination with video-assisted vestibular testing. Methods: Patients eamined at the ENT emergency department from January to December 2019 were evaluated retrospectively. The patients who underwent basic ENT examination without video-assisted vestibular testing form group A. The patients who underwent basic ENT examination which was followed by video head impulse test (vHIT) and videonystagmography in the next four days form group B. Results: A total of 117 patients with acute vertigo were included in group A, PVS was found in 31 patients (27%). In total, 50 patients were included in group B; PVS was found in 15 patients (30%), vestibular neuronitis was dia­gnosed most often (10 patients). The difference in the dia­gnosis of PVS by basic ENT examination (27 patients, 54%) and by video-assisted vestibular testing (15 patients, 30%) was statistically significant (P = 0.0030). The gain of the lateral (P = 0.0101) and superior (P = 0.0043) semicircular canal proved to be statistically significant, while vHIT was lower in PVS in comparison to other causes of vertigo. Conclusion: After basic ENT examination, PVS as a cause of acute vertigo was dia­gnosed in 27%. Video-assisted vestibular testing proved a statistically significant lower incidence of PVS in comparison to basic ENT examination. Accessibility of video- -assisted vestibular testing in the emergency department might allow for higher accuracy in the dia­gnosis of acute vertigo. Key words acute vertigo – vestibular function tests – video head impulse test – videonystagmography
简介:急性眩晕是急诊科就诊的常见原因之一。本研究的目的是评估在耳鼻喉科急诊科检查的急性眩晕患者中外周前庭综合征(PVS)的发生率,并比较耳鼻喉科物理检查与视频辅助前庭检查的一致性。方法:回顾性分析2019年1月至12月在耳鼻喉科急诊科检查的患者。A组为基础耳鼻喉科检查,未进行视频辅助前庭检查的患者;b组为基础耳鼻喉科检查后4天内进行视频头冲试验(vHIT)和视频眼震图检查的患者。结果:A组共117例急性眩晕患者,其中31例(27%)出现PVS。B组共50例;PVS 15例(30%),前庭神经炎是最常见的诊断(10例)。基础耳鼻喉科检查(27例,54%)与视频辅助前庭检查(15例,30%)诊断PVS的差异有统计学意义(P = 0.0030)。侧半规管(P = 0.0101)和上半规管(P = 0.0043)的增加具有统计学意义,而vHIT在PVS中较其他原因的眩晕更低。结论:经基础耳鼻喉科检查,27%的患者诊断为PVS引起的急性眩晕。与基础耳鼻喉科检查相比,视频辅助前庭检查证明PVS的发生率有统计学意义。急诊科视频辅助前庭测试的可及性可能会提高急性眩晕诊断的准确性。关键词急性眩晕;前庭功能测试;视频头脉冲测试
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引用次数: 0
The professional journal Otorhinolaryngology and Phoniatrics celebrates 70 years 专业期刊《耳鼻咽喉与音科学》庆祝70周年
Pub Date : 2021-09-27 DOI: 10.48095/ccorl2021139
J. Astl, M. Zábrodský, D. Kalfeřt
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引用次数: 0
Ultrasound-guided percutaneous ethanol injection therapy of neck cysts as an alternative to surgery 超声引导下经皮乙醇注射治疗颈部囊肿替代手术
Pub Date : 2021-09-27 DOI: 10.48095/ccorl2021181
M. Halenka, Richard Salzmann, H. Munteanu, Martin Brož, J. Schovanek, Z. Fryšák
Summary Introduction: Some extrathyroidal cervical cystic lesions can be treated in selected situations by minimally invasive, low-risk method – ultrasound--guided percutaneous ethanol injection therapy (US-PEIT). Here we present 6 cases of neck cysts of various origins – ranula, thyroglossal duct cyst, branchial cleft cyst, midline neck cyst of the pyramidal lobe and dermoid cyst. Method and material: The cohort consisted of 6 patients (mean age 58 ± 13.3 years), who were followed for recurrent cervical cysts located outside the thyroid gland. The cysts were visible, palpable, aesthetically unpleasant and also mechanically compressing the surrounding tissue. After repeated evacuations, they filled in again. The patients repeatedly refused the recommended surgery and demanded an alternative solution. US-PEIT of thyroid cysts is used worldwide as a full-fledged alternative to surgical treatment. We used the same procedure for the treatment of presented neck cysts. Results: The initial volume of cysts was 2–35 mL (mean 17.7 mL); the patients underwent 1–6 sclerotization sessions (mean 3.6). The patients were followed for 12 months; the final volume of solid residue was 0.1–2 mL (mean 1 mL) representing volume reduction by 80–99% (mean 92%). Therapeutic success (volume reduction > 50%) was achieved in all patients. Conclusion: US-PEIT of cervical cysts as an alternative to surgery can be used especially in elderly patients with increased surgical risk or in patients refusing surgery. In middle-aged and older adults, the possibility of a necrotic metastatic lymph node should always be considered. Therefore, a benign cytological examination and an unsuspecting ultrasonographic and CT finding are the basic conditions before performing the ethanol ablation. Key words neck cysts – ultrasound-guided percutaneous ethanol injection therapy
简介:一些甲状腺外宫颈囊性病变可在特定情况下采用微创、低风险的方法——超声引导下经皮乙醇注射治疗(US-PEIT)。本文报告了6例不同来源的颈部囊肿,包括颈部毛囊囊肿、甲状舌管囊肿、鳃裂囊肿、锥体叶中线颈部囊肿和皮样囊肿。方法与材料:对6例甲状腺外复发性宫颈囊肿患者进行随访,平均年龄58±13.3岁。囊肿是可见的,可触及的,美学上不愉快,也机械压迫周围组织。在多次疏散后,他们再次填充。患者一再拒绝推荐的手术,并要求另一种解决方案。甲状腺囊肿的US-PEIT在世界范围内被用作手术治疗的全面替代方案。我们用同样的方法治疗颈部囊肿。结果:囊肿初始体积2 ~ 35 mL,平均17.7 mL;患者接受1-6次硬化疗程(平均3.6次)。随访12个月;固体残渣最终体积为0.1-2 mL(平均1 mL),体积减少80-99%(平均92%)。所有患者均获得治疗成功(体积减小> 50%)。结论:US-PEIT检查宫颈囊肿可作为手术的替代方法,尤其适用于手术风险增高的老年患者或拒绝手术的患者。在中老年人,坏死转移淋巴结的可能性应始终考虑。因此,良性细胞学检查和不怀疑的超声和CT发现是进行乙醇消融前的基本条件。关键词颈部囊肿超声引导经皮乙醇注射治疗
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引用次数: 0
Comment: Evaluation of speech in patients after cochlear implantation – Motol Speech Scale 评价:人工耳蜗植入术后患者的语言能力- motel语言量表
Pub Date : 2021-09-27 DOI: 10.48095/ccorl2021191
J. Dršata
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引用次数: 0
Gastric choristoma of hypopharynx in neonate 新生儿下咽胃脉络瘤
Pub Date : 2021-09-27 DOI: 10.48095/ccorl2021174
Kristýna Vaněčková, Z. Prouzová, M. Jurovčík, Lucie Gernertová, J. Skřivan
Summary Gastric choristoma is composed of the ectopic microscopically normal cells of gastric mucosa and can be located anywhere in the gastrointestinal tract. Choristomas are mostly clinically silent or present with minimal symptoms and are usually dia­gnosed in adulthood. This case report presents a neonate who experienced difficulty breathing, dyspnea, orotracheal intubation and an early surgery in the postnatal period due to a specific localization and size of its tumor. Key words gastric choristoma – benign tumor – heterotophy – neonate
胃粘膜瘤是由胃粘膜的异位显微镜下正常细胞组成,可位于胃肠道的任何部位。脉管瘤大多临床无症状或症状轻微,通常在成年期被诊断出来。本病例报告一例新生儿由于肿瘤的特定位置和大小,在产后经历了呼吸困难、呼吸困难、口气管插管和早期手术。【关键词】胃内膜瘤;良性肿瘤;异养性
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引用次数: 0
期刊
Otorinolaryngologie a foniatrie
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