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Current Medical Science 2023年第6期43卷 1258-1259页

作者： Xin LUO Xue-kun HUANG Ya-na ZHANG Qin-tai YANG Department of Otolaryngology-Head and Neck Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510630China Department of Allergy The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510630China naso-orbital-maxilla and skull base center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510630China

Chronic rhinosinusitis with nasal polyps(CRSw-NP)is a multifactorial and heterogeneous disorder of the sinonasal mucosa,characterized by a high relapse rate after medical and surgical treatments[1].Endoscopic sinus surgery(ESS)is the preferred treatment for CRSwNP in patients who have failed to respond to medical therapy[2].However,the postoperative complications will impair the recovery of patients,and accompanying post-operative outpatient visits may contribute to patient discomfort[3]Suppressing postoperative mucosa edema and improving mucosa recovery is critical to reducing the disease relapse after ESS.The steroid-eluting sinus stent(SESS)represents a promising emerging therapy for CRSwNP.

关键词： Surgery operative treatment

Multimodal cardiac imaging assisted tumor characterization and surgical planning of a patient with rare primary cardiac paraganglioma

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Journal of Geriatric Cardiology 2024年第2期21卷 246-250页

作者： Shu-Yu MENG Li-Qun WANG Hao-Dan DANG Lin ZHANG Sheng-Li JIANG Bo-Han LIU Department of Ultrasound Diagnosis the First Medical CenterChinese PLA General HospitalBeijingChina Department of Nuclear Medicine the First Medical CenterChinese PLA General HospitalBeijingChina Department of Pathology the First Medical CenterChinese PLA General HospitalBeijingChina Department of Cardiovascular Surgery the First Medical CenterChinese PLA General HospitalBeijingChina

Paragangliomas,also known as pheochromocytomas(1–9 cases per million),arise in the paraganglia.[1]Pheochromocytomas occur in the adrenal glands,while paragangliomas occur elsewhere.[2]Paragangliomas originate from paraganglion cells,which are derived from the neural ectoderm of the nerves and migrate along both sides of the median axis from the base of the skull to the pelvis during embryonic development.

关键词： glioma cardiac nerves

Endoscopic Approach to Remove Intra-extracranial Tumors in Various skull base Regions： 10-year Experience of a Single center

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Chinese Medical Journal 2017年第24期130卷 2933-2940页

作者： Qiu-Hang Zhang Zhen-Lin Wang Hong-Chuan Guo Feng Kong Bo Yan Ming-Chu Li Ge Chen Jian-Tao Liang Yu-Hai Bao Feng Ling Department of Neurosurgery Skull Base Surgery Center Xuanwu Hospital Capital Medical University Beijing 100053 China Department of Otorhinolaryngology Head and Neck Surgery Skull Base Surgery Center Xuanwu Hospital Capital Medical University Beijing 100053 China

Background：Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base.Herein,we described a pure endoscopic transnasal or transoral approach （ETA） for the removal of intra-extracranial tumors in various skull base regions.Methods：Retrospectively,clinical data,major surgical complications,pre-and postoperative images,and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed.Results：Gross total tumor removal was achieved in 80/85 cases （94.1%） in this study.All 37 cases with tumors in anterior skull base and all 14 cases with tumors in jugular foramen received total tumor removal.Thirteen and three cases with tumors in clivus received total and subtotal tumor removal,respectively.Total and subtotal tumor removal was performed for 16 cases and 2 cases in lateral skull base,respectively.The complications in this study included：cerebrospinal fluid leakage （n =3）,meningitis （n =3）,and new cranial nerve deficits （n =3;recovered in 3 months after surgery）.In the follow-up period of40-151 months （median：77 months）,seven patients （8.8%） out of the 80 cases of total tumor removal experienced recurrence.Conclusions：Complete resection of intra-extracranial growing tumors in various skull base regions can be achieved via the pure ETA in one stage in selected cases.Surgical procedure for radical removal of tumors is feasible and safe.

关键词： Endoscopy： lntra-extracranial Growth Neoplasm skull base Surgery

Focal incidental colorectal fluorodeoxyglucose uptake:Should it be spotlighted?

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World Journal of Clinical Cases 2024年第15期12卷 2466-2474页

作者： Haejun Lee Kyung-Hoon Hwang Department of Nuclear Medicine Gachon University College of MedicineGil Medical CenterIncheon 21565South Korea

Fluorine-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)has emerged as a cornerstone in cancer evaluation imaging,with a well-established history spanning several years.This imaging modality,encompassing the examination of the body from the base of the skull to the upper thighs,comprehensively covers the chest and abdominopelvic regions in a singular scan,allowing for a holistic assessment of nearly the entire body,including areas of marginal interest.The inherent advantage of this expansive scan range lies in its potential to unveil unexpected incidental abnormal hypermetabolic areas.The identification of incidental focal FDG uptake within colorectal regions during PET/CT scans is not an uncommon occurrence,albeit fraught with challenges associated with non-specific FDG uptake.The presence of benign colorectal lesions or physiological uptake poses a particular obstacle,as these may manifest with FDG uptake levels that mimic malignancy.Consequently,physicians are confronted with a diagnostic dilemma when encountering abnormal FDG uptake in unexpected colorectal areas.Existing studies have presented divergent results concerning these uptakes.Standardized uptake value and its derivatives have served as pivotal metrics in quantifying FDG uptake in PET images.In this article,we aim to succinctly explore the distinctive characteristics of FDG,delve into imaging findings,and elucidate the clinical significance of incidental focal colorectal uptake.This discussion aims to contribute valuable insights into the nuanced interpretation of such findings,fostering a comprehensive understanding.

关键词： Focal Incidental Colorectal Fluorodeoxyglucose Positron emission tomography Hypermetabolism

Unexpected focal fluorodeoxyglucose uptake in main organs;pass through or pass by?

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World Journal of Clinical Cases 2024年第11期12卷 1885-1899页

作者： Haejun Lee Kyung-Hoon Hwang Department of Nuclear Medicine Gachon University College of MedicineGil Medical CenterIncheon 21565South Korea

Since the inception of fluorine-18 fluorodeoxyglucose(F-18 FDG),positron emission tomography/computed tomography(PET/CT)utilizing F-18 FDG has become widely accepted as a valuable imaging modality in the field of oncology,with global prevalence in clinical practice.Given that a single Torso PET/CT scan encompasses the anatomical region from the skull base to the upper thigh,the detection of incidental abnormal focal hypermetabolism in areas of limited clinical interest is both feasible and not uncommon.Numerous investigations have been undertaken to delineate the distinctive features of these findings,yet the outcomes have proven inconclusive.The incongruent results of these studies present a challenge for physicians,leaving them uncertain about the appropriate course of action.This article provides a succinct overview of the characteristics of fluorodeoxyglucose,followed by a comprehensive discussion of the imaging findings and clinical significance associated with incidental focal abnormal F-18 FDG activity in several representative organs.In conclusion,while the prevalence of unrecognized malignancy varies across organs,malignancies account for a substantial proportion,ranging from approximately one-third to over half,of incidental focal uptake.In light of these rates,physicians are urged to exercise vigilance in not disregarding unexpected uptake,facilitating more assured clinical decisions,and advocating for further active evaluation.

关键词： Incidental Focal Incidentaloma Fluorodeoxyglucose Positron emission tomography Hypermetabolism

The association between radiological spreading pattern and clinical outcomes in necrotizing external otitis

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Journal of Otology 2022年第3期17卷 156-163页

作者： W.Leentje van der Meer Ahmed B.Bayoumy Josje J.Otten Jerome J.Waterval Henricus P.M.Kunst Alida A.Postma Department of Radiology&Nuclear Medicine Maastricht University Medical Centerthe Netherlands Department of Otorhinolaryngology and Head and Neck Surgery Maastricht University Medical Centerthe Netherlands Department of Otorhinolaryngology and Head and Neck Surgery Radboud Institute for Health SciencesRadboud University Medical Centerthe Netherlands School for Mental Health&Neuroscience Maastricht UniversityMaastrichtthe Netherlands Dutch Academic Alliance skull base Pathology Maastricht University Medical Center+Radboud University Medical CenterMaastricht/Nijmegenthe Netherlands

Objectives: Necrotizing external otitis(NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread patterns.Methods: Retrospective chart review from 2010 to 2019 with NEO patients, who were divided into two cohorts: single spreading patterns(group A) or complex spreading patterns(group B) as diagnosed by CT.Clinical symptoms, diagnostic and treatment delay, course of disease, complications, and duration of antibiotic exposure were retrospectively collected from patient records.Results: 41 NEO patients were included, of which 27 patients belonged to group A(66%). The diseaserelated mortality rate was 12.2% among the entire cohort, no differences were found between group A and B. Higher rates of N.VII(42.9% vs 14.8% P = 0.047) and N. IX palsies were found in group B compared to group A(28.6% vs 3.7%, P = 0.039). The median duration of antibiotic use was significantly different for a complex spreading pattern, clinical recovery and hospitalizations. Complications were associated with higher diagnostic delay and with a complex spread pattern. The median duration of follow-up was 12.0(IQR 6.0-19.5) months.Conclusion: NEO is a severe disease, with significant mortality and morbidity(cranial nerve palsies). The radiological spread pattern may assist in predicting clinical outcome. Furthermore, complex spread patterns are associated with higher rates of clinical nerve palsies(N. VII and N.IX), complications, surgery rates and longer duration of antibiotic use. Diagnostic delay was associated with mortality, complications and facial palsies.

关键词： Necrotizing external otitis Malignant external otitis skull base osteomyelitis Clinical manifestation Spreading routes Antibiotic exposure Facial nerve palsy

Integration of an enhanced recovery after surgery program for patients undergoing pituitary surgery

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 330-338页

作者： Stephanie Flukes llya Laufer Jennifer Cracchiolo Eliza Geer Andrew L.Lin Jess Brallier Van Tsui Anoushka Afonso Viviane Tabar Marc A.Cohen Head and Neck Service Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkNYUSA Department of Neurosurgery Memorial Sloan Kettering Cancer CenterNew YorkNYUSA Multidisciplinary Pituitary and skull base Tumor center Memorial Sloan Kettering Cancer CenterNew YorkNYUSA Department of Medicine Memorial Sloan Kettering Cancer CenterNew YorkNYUSA Department of Anesthesiology and Critical Care Medicine Memorial Sloan Kettering Cancer CenterNew YorkNYUSA

Evidence-based enhanced recovery after surgery(ERAS)programs aim to improve patient outcomes and shorten hospital stays.The objective of this study is to describe the development,implementation,and evolution of an ERAS protocol to optimize the perioperative management for patients undergoing endoscopic skull base surgery for pituitary tumors.A systematic review of the literature was performed,best practices were discussed with stakeholders,and institutional guidelines were established and implemented.Key performance indicators(KPI)were measured and patient-reported outcome surveys were collected.The ERAS protocol was introduced successfully at our institution.We describe the process of initiation of the program and the perioperative management of our patients.We demonstrated the feasibility of integration of ERAS protocols for pituitary tumors with multidisciplinary engagement,with a particular emphasis on the use of data informatics and metrics to monitor outcomes.We expect that this approach will translate to improved quality of care for these often-complex patients.

关键词： Enhanced recovery after surgery Endoscopic skull base surgery Pituitary surgery Outcomes improvement

Perioperative management of endoscopic transsphenoidal pituitary surgery

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第2期6卷 84-93页

作者： Martin Hanson Hao Li Eliza Geer Sasan Karimi Viviane Tabar Marc A.Cohen Multidisciplinary Pituitary and skull base Tumour Program Memorial Sloan Kettering Cancer Center1275 York AveNew YorkNYUSA

The contemporary embrace of endoscopic technology in the approach to the anterior skull base has altered the perioperative landscape for patients requiring pituitary surgery.Utility of a multi-disciplinary unit in management decisions facilitates the delivery of optimal care.Evolution of technology and surgical expertise in pituitary surgery mandates ongoing review of all components of the care central to these patients.The many areas of potential variability in the pre,intra and post-operative timeline of pituitary surgery are readily identifiable.Core undertakings and contemporary controversies in the peri-operative management of patients undergoing endoscopic transsphenoidal pituitary surgery are assessed against the available literature with a view to providing guidance for the best evidence-based practice.

关键词： Pituitary Pituitary surgery Endoscopic skull base surgery Perioperative management

Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

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Neural Regeneration Research 2015年第6期10卷 989-995页

作者： Yi-ke Li Juan-mei Yang Yi-bo Huang Dong-dong Ren Fang-lu Chi Department of Otology and skull base Surgery Eye Ear Nose & Throat HospitalFudan University Shanghai Auditory Medical center Key Laboratory of Hearing Science Ministry of Health Department of Hearing and Speech Sciences Vanderbilt University

The morphological changes that occur in the taste buds after denervation are not well under- stood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups： control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection ＋ lingual nerve transection. Rats were allowed up to 42 days of re- covery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection ＋ lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

关键词： nerve regeneration gustation cytokeratin tongue epithelium immunohistochemistry taste bud trigeminal nerve disorder NSFC grants neural regeneration

Otolithic organ function in patients with profound sensorineural hearing loss

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Journal of Otology 2016年第2期11卷 73-77页

作者： Yujuan Zhou Yongzhen Wu Jing Wang Department of Otology and skull base Surgery Eye Ear Nose & Throat Hospital Fudan University Shanghai Auditory Medical center Key Laboratory of Hearing Science Ministry of Health

Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.

关键词： Profound sensorineural hearing loss PSHL Otolithic organs Vestibular-evoked myogenic potential VEMP