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Paranasal Sinus Fungus Ball, Anatomical Variations and Dental Pathologies: Is There Any Relation? 副鼻窦真菌球、解剖变异与口腔病理有关系吗?
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2022.2021-11-8
Bayram Şahi̇n, Ş. Çomoğlu, Said Sönmez, K. Değer, Meryem Nesil Keleş Türel
Objective: The purpose of this study was to investigate the relationship between anatomical variations and the fungus ball (FB), and the association between odontogenic etiologies and the maxillary sinus FB. Methods: We analyzed the clinical records of 66 patients who underwent endoscopic sinus surgery for FB. The anatomical variations determined were nasal septal deviation (NSD) and direction, presence of Onodi and Haller cell, concha bullosa and lateral recess of the sphenoid sinus. Further, dental X-ray records were reviewed to detect any possible odontogenic etiologies in patients with maxillary sinus FBs. Results: There were 41 female and 25 male patients. Positive fungal culture was found in 60 patients (91%) and the causative fungus was Aspergillus species in all cases. The correlation between NSD and localization of the maxillary sinus FB was statistically significant (p=0.0409). Maxillary sinus FB was more common on the concave side of the NSD. Presence of dental pathologies was significantly associated with maxillary sinus FB compared to the healthy side (p=0.0011). For sphenoid sinus FB, NSD was detected in a similar number for both the affected and unaffected side and there were no significant correlations (p>0.05). However, the relationship between sphenoid sinus FB and presence of lateral recess was significant (p=0.0262). Conclusion: Our study revealed that the maxillary sinus FB was more common on the concave side of the deviated septum. Also, dental pathologies or a presence of dental treatment history were associated with maxillary sinus FB.
目的:探讨上颌窦真菌球的解剖变异与真菌球的关系,以及牙源性病因与真菌球的关系。方法:我们分析66例接受鼻内窥镜手术治疗FB的患者的临床记录。解剖变异包括鼻中隔偏曲(NSD)和方向,Onodi和Haller细胞的存在,鼻甲大泡和蝶窦外侧隐窝。此外,回顾了牙科x线记录,以发现上颌窦FBs患者的任何可能的牙源性病因。结果:女性41例,男性25例。真菌培养阳性60例(91%),病原菌均为曲霉属。NSD与上颌窦FB定位的相关性有统计学意义(p=0.0409)。上颌窦FB多见于NSD的凹侧。与健康侧相比,口腔病变的存在与上颌窦FB显著相关(p=0.0011)。对于蝶窦FB, NSD在受病侧和未受病侧的检出率相似,无显著相关性(p < 0.05)。然而,蝶窦FB与侧隐窝的存在有显著的关系(p=0.0262)。结论:上颌窦FB多见于偏隔凹侧。此外,口腔病理或牙科治疗史的存在与上颌窦FB有关。
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引用次数: 3
Estimation of Serum Levels of Heavy Metals in Patients with Chronic Invasive Fungal Rhinosinusitis Before the COVID-19 Era: A Pilot Study 新冠肺炎时代前慢性侵袭性真菌性鼻炎患者血清重金属水平的初步评估
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2022.2021-11-12
S. Kajal, J. Quadri, Prankur Verma, Ramya Thota, K. Sikka, Shivam Pandey, A. Thakar, H. Verma
Objective: Various metals play role in the survival and pathogenesis of the invasive fungal disease. The objectives of this study were to compare the levels of heavy metals in patients with chronic invasive fungal rhinosinusitis (CIFR) and healthy controls, and to analyze their role in disease outcome. Methods: Twenty-three patients (15 with invasive mucormycosis and 8 with invasive aspergillosis, Group 1), and 14 healthy controls (Group 2) were recruited. Blood samples were collected from each group into ion-free tubes and analyzed for serum levels of Nickel (Ni), Copper (Cu), Zinc (Zn), Gallium (Ga), Arsenic (As), Selenium (Se), Rubidium (Rb), Strontium (Sr), Cadmium (Cd), and Lead (Pb). The final outcome of the patients during their hospital stay was categorized clinico-radiologically as improved or worsened, or death. Results: The levels of all metals were higher in Group 1 except for As and Pb. However, the differences in Cu (p=0.0026), Ga (p=0.002), Cd (p=0.0027), and Pb (p=0.0075) levels were significant. Higher levels of Zn (p=0.009), Se (p=0.020), and Rb (p=0.016) were seen in the invasive aspergillosis subgroup. Although Zn (p=0.035), As (p=0.022), and Sr (p=0.002) levels were higher in patients with improved outcome, subgroup analysis showed no differences. Conclusion: The levels of some heavy metals in CIFR significantly differ from those of the general population and also vary with the type of the disease and its outcome. These levels may not have a direct effect on the outcome of the patient, but they do play a role in the pathogenesis of the invading fungus.
目的:各种金属在侵袭性真菌病的生存和发病机制中发挥作用。本研究的目的是比较慢性侵袭性真菌性鼻窦炎(CIFR)患者和健康对照组的重金属水平,并分析它们在疾病结果中的作用。方法:23例患者(侵袭性毛霉菌病15例,侵袭性曲霉菌病8例,第1组)和14名健康对照(第2组)被招募。将每组的血样收集到无离子管中,并分析血清中镍(Ni)、铜(Cu)、锌(Zn)、镓(Ga)、砷(As)、硒(Se)、铷(Rb)、锶(Sr)、镉(Cd)和铅(Pb)的水平。患者在住院期间的最终结果在临床放射学上被归类为改善或恶化,或死亡。结果:除As和Pb外,第1组所有金属含量均较高。然而,Cu(p=0.0026)、Ga(p=0.002)、Cd(p=0.0027)和Pb(p=0.0075)水平的差异是显著的。侵袭性曲霉菌病亚组的Zn(p=0.009)、Se(p=0.020)和Rb(p=0.016)水平较高。尽管Zn(p=0.035)、As(p=0.022)和Sr(p=0.002)水平在预后改善的患者中较高,但亚组分析显示没有差异。结论:CIFR患者的某些重金属水平与普通人群有显著差异,也因疾病类型和结果而异。这些水平可能对患者的预后没有直接影响,但它们确实在入侵真菌的发病机制中发挥了作用。
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引用次数: 0
Challenging Removal of Embedded Fishbone in Tongue: Multimodal Technique, Surgical Approach and Consideration of Migration 挑战性去除舌内嵌鱼骨:多模式技术,手术入路和对迁移的考虑
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2021.2021-6-5
Fathiyah Idris, F. Kin, F. Zaki, M. Baki
Fishbone ingestion is a common occurrence and patients present with various symptoms, posing challenges to the attending physicians. Here, we present two unique cases of patients with an unexpected rapidly migrating fishbone in the tongue. The first patient was operated transorally because of a foreign body embedded in the genioglossus muscle. In the second patient, CT scan located a fishbone embedded in the left hyoglossus muscle; however, the fishbone had to be relocated intraoperatively using bedside ultrasound guidance and was eventually found embedded within the mylohyoid muscle. The fishbone was successfully removed via transcervical approach following a failed transoral approach.
鱼骨摄入是一种常见的情况,患者会出现各种症状,这给主治医生带来了挑战。在这里,我们介绍了两个独特的病例,患者的舌头出现了意想不到的快速迁移的鱼骨。第一例患者因颏舌肌内有异物而经口手术。在第二例患者中,CT扫描定位了嵌入左舌舌肌的鱼骨;然而,鱼骨不得不在手术中使用床边超声引导进行重新定位,最终发现嵌入了下颌舌骨肌内。鱼骨在经口入路失败后通过经颈入路成功取出。
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引用次数: 0
A Rare Sinonasal Malignancy: Biphenotypic Sinonasal Sarcoma 罕见的鼻窦恶性肿瘤:双表型鼻窦肉瘤
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2022.2021-11-9
Esra Aydın Sudabatmaz, M. A. Abakay, A. Koçbıyık, I. Sayin, Z. Yazıcı
Biphenotypic sinonasal sarcoma (BSNS), which has been described in the recent years, is a low-grade spindle cell sinonasal sarcoma characterized by rare neural and myogenic features. It has a slow growth pattern; does not metastasize, but local recurrences are common after surgery. Non-specificity of examination findings and symptoms and similarities of its histopathological features with other spindle cell sarcomas, neural tumors, and skeletal muscle-derived tumors involving the nasal cavity make the diagnosis difficult. Therefore, histopathological features should be evaluated together with immunophenotyping and molecular studies for differential diagnosis. There are very few BSNS cases or case series in the literature. In this report, we reported our clinical approach to a case with BSNS in the right nasal cavity and the histopathological features of the disease in the light of the current literature.
近年来出现的双表型鼻窦肉瘤(BSNS)是一种低度梭形细胞鼻窦肉瘤,具有罕见的神经和肌源性特征。它具有缓慢的增长模式;不会转移,但手术后局部复发很常见。检查结果和症状的非特异性,以及其组织病理学特征与其他梭形细胞肉瘤、神经肿瘤和涉及鼻腔的骨骼肌衍生肿瘤的相似性,使诊断变得困难。因此,组织病理学特征应与免疫表型和分子研究一起进行评估,以进行鉴别诊断。文献中很少有BSNS病例或病例系列。在本报告中,我们根据现有文献报道了我们对一例右鼻腔BSNS病例的临床治疗方法以及该疾病的组织病理学特征。
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引用次数: 1
Primary Laryngeal Tuberculosis Manifesting as Irregular Vocal Fold Lesion 原发性喉结核表现为不规则声带病变
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2021.2021-7-1
Lu Guan, Tey Kai Jun, M. Azman, M. Baki
Laryngeal tuberculosis is rare despite its close anatomical and physiological proximity to the lungs. It constitutes less than 1% of extrapulmonary tuberculosis. The symptoms of laryngeal tuberculosis are non-specific and mimic other laryngeal pathologies. The recent evolving and atypical endoscopic laryngeal features cause a diagnostic dilemma and delay in treatment. In this report, we presented three patients with distinct age and medical history, and hoarseness. Flexible videolaryngoscopy showed similar findings in the three cases, with irregular mucosa involving the entire length of the vocal fold, unilaterally in two cases and bilaterally in one. Mucosal waves were typically absent on laryngostroboscopy examination. The routine workup for pulmonary tuberculosis was unremarkable. The usage of Mycobacterium tuberculosis complex (MTBC) and rifampicin resistance (Xpert MTB/RIF) assay that detects Mycobacterium tuberculosis in the tissue biopsy specimens has helped in the rapid diagnosis of primary laryngeal tuberculosis and timely commencement of anti-tuberculous therapy. The clinical course and response to treatment were diverse in which two cases showed good response whilst the third developed disseminated tuberculosis despite optimal therapy.
喉结核是罕见的,尽管其密切解剖和生理接近肺。它占肺外结核的不到1%。喉部结核的症状是非特异性的,与其他喉部病变相似。最近演变和不典型的内镜喉部特征导致诊断困境和延迟治疗。在这个报告中,我们提出了三个年龄和病史不同的患者,并且声音嘶哑。三例软性视像喉镜检查结果相似,粘膜不规则,累及整个声带长度,单侧2例,双侧1例。喉部频闪镜检查未见粘膜波。肺结核的常规检查无显著差异。使用结核分枝杆菌复体(MTBC)和利福平耐药性(Xpert MTB/RIF)检测组织活检标本中的结核分枝杆菌,有助于快速诊断原发性喉部结核并及时开始抗结核治疗。临床过程和对治疗的反应是多种多样的,其中2例表现出良好的反应,而第三例发展为播散性结核病,尽管最佳治疗。
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引用次数: 2
Ethical Dilemmas in the Management of Head and Neck Cancers in the Era of the COVID-19 Pandemic 新冠肺炎大流行时代头颈部肿瘤治疗的伦理困境
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2022.2021-11-7
R. Dhanani, M. Wasif, H. Pasha, S. K. Ghaloo, Engr. Dr. Muntazir Hussain, Abdul Basit Shah Vardag
Coronavirus disease 2019 (COVID-19) has emerged as an unforeseen challenge for head and neck cancer care providers. A similar challenge is also faced by other oncological fields, but the severity of this challenge is highest in otolaryngology because of the need for additional precautionary measures and curbs on the possibility of aerosol forming interventions related to the upper aerodigestive tract. In this narrative review, provision of ethical and consistent care on moral and professional grounds to head and neck cancer patients during the pandemic are discussed for professionals who provide head and neck oncology care.
2019冠状病毒病(新冠肺炎)已成为癌症头部和颈部护理人员的一个不可预见的挑战。其他肿瘤学领域也面临着类似的挑战,但耳鼻喉科面临的挑战最为严重,因为需要采取额外的预防措施,并限制与上气消化道相关的气溶胶形成干预措施的可能性。在这篇叙述性综述中,讨论了在大流行期间为头部和颈部癌症患者提供基于道德和专业理由的道德和一致性护理,以供提供头部和颈部肿瘤护理的专业人员使用。
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引用次数: 1
Management of Basal Cell Carcinomas: Clinical Experience 基底细胞癌的治疗:临床经验
IF 0.6 Pub Date : 2022-03-01 DOI: 10.4274/tao.2022.2021-6-11
Irfan Kara, Alperen Vural, M. Ünlü, Furkan Şan, Gülten Benan Göçer, Muhammed Gazi Yıldız
Objective: Basal cell carcinomas (BCC) mostly originate from the head and neck region. Main goal in BCC treatment is to achieve both aesthetic and functional results while observing the principles of tumor surgery. We report our experience regarding the clinical, histopathological features and surgical treatment results of head and neck basal cell carcinomas in the light of the literature. Methods: Files of patients with head and neck BCCs treated surgically in two university hospitals were retrospectively analyzed. Sociodemographic variables, location and size of tumor, pathological subtype, recurrence ratio, complications and technique of reconstruction were evaluated. Results: We analyzed 119 tumoral lesions in 105 patients of whom 55 (52.4%) were male and 50 (47.6%) were female. Their mean age was 67.3±12 years. The nasal region was the most common location area (n=42, 35.3%). Mean tumor size was 12.6 mm and tumor size range was 2–85 mm. The most commonly used reconstruction techniques were flap surgery, followed by primary closure, and skin grafts. Conclusion: It is important to remove the tumor with a clear surgical margin at least 4 mm and evaluate the five surgical margins with frozen sections intraoperatively. Operations are often performed under local anesthesia and are well tolerated by patients. The most common flaps used in the reconstruction are not only easy to learn but also sufficient in most cases. Skin grafts are good choices in defects located in the cavum concha and the external meatus.
目的:基底细胞癌主要起源于头颈部。BCC治疗的主要目标是在遵守肿瘤手术原则的同时达到美观和功能的效果。我们根据文献报道了我们关于头颈部基底细胞癌的临床、组织病理学特征和手术治疗结果的经验。方法:回顾性分析两所大学医院手术治疗头颈部基底细胞癌的病例资料。评估了社会形态变量、肿瘤的位置和大小、病理亚型、复发率、并发症和重建技术。结果:我们分析了105例患者的119个肿瘤病变,其中55例(52.4%)为男性,50例(47.6%)为女性。平均年龄67.3±12岁。鼻区是最常见的位置区域(n=42,35.3%)。平均肿瘤大小为12.6 mm,肿瘤大小范围为2–85 mm。最常用的重建技术是皮瓣手术,然后是初次闭合和皮肤移植。结论:重要的是在术中以至少4mm的清晰手术边缘切除肿瘤,并用冷冻切片评估五种手术边缘。手术通常在局部麻醉下进行,患者耐受性良好。重建中使用的最常见的皮瓣不仅易于学习,而且在大多数情况下也足够了。皮肤移植物是很好的选择,在缺陷位于腔甲和外耳道。
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引用次数: 0
Caffeine Enhances the Balance System and Postural Balance in Short Time in Healthy Individuals 咖啡因在短时间内增强健康个体的平衡系统和姿势平衡
IF 0.6 Pub Date : 2021-12-01 DOI: 10.4274/tao.2021.2021-4-17
Bunyamin Cildir, Büşra Altın, S. Aksoy
Objective: This study aimed to explore the effects of caffeine on balance function by determining the extent to which caffeine consumption affects postural sway and balance control in healthy individuals. Methods: Thirty healthy participants aged 20–35 years without any vestibular disorder were enrolled in this study. The participants were randomly divided into two groups, and those in Group 1 were given two cups of regular coffee (300–350 mg) while those in Group 2 were given two cups of decaffeinated coffee. The sensory organization test, the head shake sensory organization test, the limits of stability test, and the adaptation test were performed on all participants before and after coffee intake using computerized dynamic posturography. Results: The sensory organization test composite scores (p=0.001) and the head shake condition 5 (C5) equilibrium scores (p=0.001) of the participants in Group 1 showed a statistically significant increase after coffee intake while the composite scores (p=0.001) and the head shake condition (C5) equilibrium scores (p=0.001) of those in Group 2 showed a statistically significant decrease. There was a statistically significant difference between the two groups in the equilibrium scores in the pitch plane (p=0.001), the yaw plane (p=0.001), and the roll plane (p=0.001) of C5 after coffee intake. Conclusion: Consumption of an appropriate dose of caffeine may enhance body position, postural stability, and voluntary motor control ability. The combined use of the sensory organization test, the head shake sensory organization test, the adaptation test, and the limits of stability test in evaluating the balance mechanism in individuals with normal vestibular findings provides detailed information about postural sway.
目的:本研究旨在通过确定咖啡因摄入在多大程度上影响健康人的姿势摇摆和平衡控制,探讨咖啡因对平衡功能的影响。方法:30名年龄在20-35岁,无任何前庭功能障碍的健康受试者参加本研究。参与者被随机分为两组,第一组的人喝两杯普通咖啡(300-350毫克),第二组的人喝两杯不含咖啡因的咖啡。采用计算机动态体位仪对所有受试者在咖啡摄入前后进行感觉组织测试、摇头感觉组织测试、稳定性极限测试和适应性测试。结果:第一组受试者的感觉组织测试综合得分(p=0.001)和摇头条件5 (C5)平衡得分(p=0.001)在咖啡摄入后有统计学意义的提高,而第二组受试者的综合得分(p=0.001)和摇头条件5 (C5)平衡得分(p=0.001)有统计学意义的降低。咖啡摄入后两组C5在俯仰面(p=0.001)、偏航面(p=0.001)、滚转面(p=0.001)的平衡得分差异有统计学意义。结论:摄入适当剂量的咖啡因可以增强体位、姿势稳定性和自主运动控制能力。综合使用感觉组织测试、头摇感觉组织测试、适应测试和稳定性极限测试来评估前庭功能正常个体的平衡机制,提供了有关体位摇摆的详细信息。
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引用次数: 3
Mycobiome in the Middle Ear Cavity with and Without Otitis Media with Effusion 中耳炎伴和不伴中耳炎伴积液的中耳腔菌群
IF 0.6 Pub Date : 2021-12-01 DOI: 10.4274/tao.2021.2021-10-4
R. Durmaz, B. Durmaz, O. Arı, Olkar Abdulmajed, Serdal Çelik, M. Kalcıoğlu
Objective: No data have yet been published revealing the composition and the diversity of fungal communities (mycobiome) in the human middle ear cavity. The presented study investigated the mycobiome in the middle ear cavities of individuals with healthy middle ears and patients with otitis media with effusion. Methods: A total of 77 middle ear and four adenoid samples were collected from 47 individuals (35 children and 12 adults) in Group 1 and from 20 children in Group 2. The mycobiome profile was analyzed with nuclear ribosomal internal transcribed spacer 2 (ITS2) based metabarcoding using an Illumina MiSeq metagenomics kit. Results: ITS2-based metabarcoding detected 14 different genera and 17 different species with a mean relative abundance of ≥1% in the samples analyzed. Mycobiome profile was similar between the adenoid tissue and the middle ear cavity, between Groups 1 and Group 2, and between children and adults. Fusarium, Stemphylium, Candida, and Cladosporium were the most abundant genera detected in all samples. The mean relative abundances of the genera Candida and Fusarium were remarkably higher in Group 2 compared to Group 1. Conclusion: The species Candida glaebosa, Candida cretensis, Aspergillus ruber, Penicillium desertorum, and Rhizopus arrhizus were significantly more abundant in patients with otitis media with effusion (OME), raising the possibility that they affect the pathogenesis of OME.
目的:目前尚无资料揭示人类中耳腔真菌群落(mycobiome)的组成和多样性。本研究调查了健康中耳个体和中耳炎伴积液患者中耳腔中的真菌群。方法:1组47例(儿童35例,成人12例),2组20例(儿童20例),共采集77例中耳和4例腺样体标本。使用Illumina MiSeq宏基因组学试剂盒,利用基于核糖体内部转录间隔2 (ITS2)的元条形码分析真菌组谱。结果:基于its2的元条形码检测到14个属和17个种,平均相对丰度≥1%。腺样体组织和中耳腔、1组和2组、儿童和成人之间的真菌组谱相似。镰刀菌属、茎孢菌属、念珠菌属和枝孢菌属是所有样品中检出最多的属。2组假丝酵母菌属和镰刀菌属的平均相对丰度显著高于1组。结论:青绿假丝酵母、cretensis假丝酵母、橡胶曲霉、desertorpenicillium、arrhizopus在渗出性中耳炎(OME)患者中数量显著增加,可能影响OME的发病机制。
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引用次数: 1
En Bloc Resection of Supraglottic Carcinomas with Transoral Laser Microsurgery 经口激光显微手术整块切除声门上癌
IF 0.6 Pub Date : 2021-12-01 DOI: 10.4274/tao.2021.2021-8-13
Kerem Öztürk, Arın Öztürk, Goksel Turhal
Objective: Complete en bloc supraglottic tumor excision with transoral laser microsurgery (TLM) can be achieved with good postoperative outcomes. We report surgical feasibility and the postsurgical outcomes of en bloc resection of supraglottic laryngeal squamous cell carcinomas (LSCC) with TLM. Methods: Seventeen patients who underwent TLM for supraglottic laryngeal cancer were included in the study. Demographic and pathological data, clinic and follow-up outcomes of the patients were reviewed and analyzed. Results: Type 1 TLM was performed in three patients, type 2a in one patient, type 3b in 12 patients, and type 4b in one patient. Negative surgical margins were achieved in all of the cases. Re-excision or any adjuvant treatment for positive resection margins was not required in any of the cases. Eight patients received adjuvant radiotherapy due to lymph node metastasis. Mean follow-up time was 33.8±15.7 months (range: 10–65 months). None of the patients had recurrence or distant metastasis. Conclusion: The transoral approach with the use of CO2 laser and microscopy offers complete tumor excision for treating supraglottic LSCC. The three-dimensional structure of the supraglottis can be achieved with adequate exposure. En bloc resection is possible with safe margins.
目的:经口激光显微手术(TLM)可实现声门上肿瘤整体切除,术后效果良好。我们报告用TLM整体切除声门上喉部鳞状细胞癌(LSCC)的手术可行性和术后结果。方法:选取17例声门上喉癌行TLM治疗的患者作为研究对象。回顾和分析患者的人口学、病理资料、临床和随访结果。结果:1型TLM患者3例,2a型1例,3b型12例,4b型1例。所有病例的切缘均为阴性。所有病例均不需要再切除或任何辅助治疗。8例患者因淋巴结转移接受辅助放疗。平均随访时间33.8±15.7个月(范围:10 ~ 65个月)。所有患者均无复发或远处转移。结论:经口入路结合CO2激光和显微术治疗声门上LSCC是一种完全切除的方法。声门上的三维结构可以通过充分的暴露来实现。在安全边缘的情况下,整体切除是可能的。
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引用次数: 0
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Turkish Archives of Otorhinolaryngology
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