OBJECTIVE: To investigate the efficacy of cluster nursing intervention based on Enhanced Recovery After Surgery (ERAS) for xerostomia in chronic rhinosinusitis after nasal endoscopic surgery.
METHODS: A total of 80 patients with chronic rhinosinusitis who underwent functional nasal endoscopic surgery between January 2020 and December 2021 were selected and randomly divided into a control group (n = 40) and an experimental group (n = 40). Patients in the control group were treated with general nursing, while ERAS-based cluster nursing intervention was adopted for the experimental group, in addition to general nursing. Xerostomia stage and comfort level were observed at 2 h, 6 h, 24 h and 48 h after surgery; negative emotions before and after nursing were also observed.
RESULTS: After the intervention, the xerostomia stage and comfort level at 6, 24 and 48 after surgery were higher in the experimental group (p < 0.05). Negative emotions in the experimental group were lower after nursing (p < 0.001). The self-rating depression scale and self-rating anxiety scale scores increased after nursing in both two groups (p < 0.05).
CONCLUSIONS: Enhanced recovery after surgery-based cluster nursing intervention can alleviate xerostomia, improve patients\' comfort levels, reduce their negative emotions and accelerate postoperative recovery.
METHODS:

BACKGROUND: Nasal trauma presents a risk of foreign body invasion into the nasal cavity. However, in the early treatment stage of nasal trauma, patients and doctors are not always aware of possible foreign body invasion, resulting in delayed detection. We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow, purulent, and bloody discharge.
METHODS: Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment, resulting in a glass fragment retained in the nasal cavity adjacent to the orbit. After admission, computerized tomography (CT) confirmed the presence of the foreign body in the patient\'s left nasal-maxillary sinus. The nasal foreign body led to symptoms such as chronic sinusitis, nasal polyps, fungal infection, and deviated nasal septum. The foreign body was successfully removed by nasal endoscopy, polypectomy, sinus fungal removal, left middle turbinate conchoplasty, fenestration via the right inferior meatus, nasal endoscopic maxillary sinus cystectomy, and septolplasty. The operation was successful and without any complications.
CONCLUSIONS: CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma. Surgical planning should be tailored to the patient\'s specific situation. The surgical method should be carefully selected, and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.

Objective:To investigate the differences in the therapeutic effects of endoscopic surgery combined with chemotherapy and endoscopic surgery combined with radiotherapy in the treatment of early nasopharyngeal carcinoma, and to select individualized treatment strategy for early nasopharyngeal carcinoma. Methods:The clinical data of 68 patients with early nasopharyngeal carcinoma（T1-2N₀M₀） who received surgical treatment in a high-incidence area were retrospectively analyzed. According to different treatment methods, they were divided into the surgery + chemotherapy group（n=34, treated with endoscopic surgery combined with chemotherapy） and the surgery + radiotherapy group（n=34, treated with endoscopic surgery combined with radiotherapy）. Propensity score matching was used to match the patient data between the two groups at a 1∶1 ratio. Patients were followed up, and the survival rates and hematological toxicities were compared between the two groups. Results:Twenty-four cases in the surgery + chemotherapy group and 24 cases in the surgery + radiotherapy group were successfully matched. After matching, there was no statistically significant difference in T stage, and clinical stage between the two groups（all P>0.05）. The 3-year OS and DFS in the surgery + chemotherapy group were 100.0% and 95.8%, respectively, while the 3-year OS and DFS in the surgery + radiotherapy group were 100.0% and 100.0%, respectively, with no significant difference in survival rates between the two groups（both P>0.05）. After treatment, there was no statistically significant difference in bone marrow suppression between the surgery + chemotherapy group and the surgery + radiotherapy group （all P> 0.05） Conclusion:Endoscopic surgery combined with chemotherapy and surgery combined with radiotherapy have comparable clinical efficacy in the treatment of early nasopharyngeal carcinoma, but without radiotherapy-related complications, which is worth further investigation.
目的：探讨鼻内镜手术联合化疗和内镜手术联合放疗在早期鼻咽癌治疗疗效的差异，为早期鼻咽癌的治疗提供个体化的方案。 方法：回顾性分析高发区接受手术治疗的68例早期鼻咽癌（T1-2N₀M₀）患者临床资料，依据治疗方法的不同分为手术+化疗组（34例鼻内镜手术联合化疗）和手术+放疗组（34例鼻内镜手术联合放疗），采用倾向评分匹配法对2组患者资料按照1∶1比例进行匹配，对患者进行随访，比较2组的生存率和血液学毒性。 结果：手术+化疗组24例和手术+放疗组24例配对成功。匹配后2组患者T分期、临床分期差异均无统计学意义（P>0.05）。手术+化疗组3年的OS和DFS分别为100.0%和95.8%，手术+放疗组3年的OS和DFS分别为100.0%，2组生存率比较差异均无统计学意义（P>0.05）。2组治疗后的骨髓抑制情况比较，差异无统计学意义（P>0.05）。 结论：内镜手术联合化疗与手术联合放疗治疗早期鼻咽癌临床疗效相当，但无放疗并发症，值得进一步研究。.

Objective:To explore the influencing factors of adult spontaneous meningoencephalocele, which occurs in the lateral recess of sphenoid sinus, in order to improve the level of clinical diagnosis and treatment. Methods:The clinical data of 27 adults with spontaneous meningoencephalocele in lateral recess of sphenoid sinus in Department of the Otorhinolaryngology, the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2022 were retrospectively analyzed. Preoperative sinus CT and MRI were performed to confirm the diagnosis and location of meningoencephalocele. Results:①There were 0 cases of lateral recess of sphenoid sinus type Ⅰ, 8 cases of lateral recess of sphenoid sinus type Ⅱ and 19 cases of lateral recess of sphenoid sinus type Ⅲ. ②Among the 27 adult patients with spontaneous meningoencephalocele, 9 were male and 18 were female, and the onset age was 19-72 years old, with an average age of（50.7±12.4） years old. 18 cases were complicated with cerebrospinal fluid leakage, 11 cases with headache and dizziness, 3 cases with recurrent meningitis（complicated with cerebrospinal fluid leakage）, and 2 cases with epilepsy. ③There were 20 patients with intracranial hypertension, 17 patients with body mass index（BMI） ≥25 kg/m², and 8 patients with empty sella. Conclusion:Type Ⅲ of lateral recess of sphenoid sinus is the most common type in adult spontaneous meningoencephalocele, and intracranial hypertension and obesity are the influencing factors of this disease. Puncture, biopsy or operation should not be performed for patients suspected of spontaneous meningoencephalocele, and imaging examination should be performed to identify the source of the tumor.
目的：探讨好发于蝶窦外侧隐窝的成人自发性脑膜脑膨出的影响因素，以提高该病的临床诊疗水平。 方法：回顾性分析2017年1月-2022年12月郑州大学第一附属医院鼻科27例蝶窦外侧隐窝的成人自发性脑膜脑膨出的临床资料。术前行鼻窦CT及MRI明确诊断及定位脑膜脑膨出位置。 结果：①蝶窦外侧隐窝Ⅰ型0例，蝶窦外侧隐窝Ⅱ型8例，蝶窦外侧隐窝Ⅲ型19例。②27例好发于蝶窦外侧隐窝的成人自发性脑膜脑膨出患者中男9例，女18例，发病年龄19～72岁，平均（50.7±12.4）岁；18例合并有脑脊液漏，11例伴有头痛、头晕，3例反复发作脑膜炎（合并脑脊液漏），2例伴有癫痫发作。③20例伴有颅内高压，体重指数（BMI）≥25 kg/m²的患者有17例，合并空蝶鞍8例。 结论：成人自发性脑膜脑膨出中以蝶窦外侧隐窝Ⅲ型最常见，且颅内高压、肥胖为该病的影响因素，对怀疑自发性脑膜脑膨出者不可进行穿刺、活检或手术，必须完善影像学检查以明确肿物来源。.

Sinonasal inverted papilloma（SNIP） is a kind of benign tumor originating from the nasal cavity and paranasal sinuses, accounting for 70% of papillomas. The incidence of the disease is more common in males, with an average age of 50-60 years. It is most likely to occur in unilateral maxillary sinus and ethmoid sinus, followed by sphenoid sinus and frontal sinus.It has the characteristics of local invasion, high recurrence rate and malignant tendency, and most malignant transformation into squamous cell carcinoma. Endoscopic nasal resection and appropriate adjuvant therapy can help to reduce the recurrence rate and inhibit further deterioration. We report the results of a 10-year follow-up of a SNIP patient, including the clinical manifestations, recurrence course and treatment plan during the 10 years. The patient underwent multiple nasal endoscopic surgeries, and had a recurrence of multiple focal attachment pattern, and finally had direct invasion and distant metastasis. Tumor recurrence and further deterioration persisted despite the use of a comprehensive treatment.
摘要: 腔鼻窦内翻性乳头状瘤（sinonasal inverted papilloma，SNIP）是一种起源于鼻腔和鼻窦的良性肿瘤，占乳头状瘤的70%，人群中男性发病较多，平均发病年龄50～60岁，好发于单侧上颌窦及筛窦，其次是蝶窦和额窦，具有局部浸润、易复发和恶变倾向等特征，多恶变为鳞状细胞癌，鼻内镜手术切除和适当的辅助治疗有助于降低复发率和抑制肿瘤进展。本文报告了1例SNIP患者10年的随访结果，包括这10年的临床表现及复发过程、治疗方案，患者多次行鼻内镜手术，为多病灶附着模式的复发，最后出现直接侵犯及远处转移。尽管采用了综合的治疗方法，但肿瘤复发和恶化仍持续存在。.

This study presents an in-depth analysis on a machine-designed computational web-based information system, which was used to conduct nasal mucosal care before and after nasal endoscopic surgery for chronic sinusitis. The system was developed and implemented using the mainstream B/S structure model with a Java development framework and MySQL database. Sinus irrigation solution has been shown to be effective for postoperative flushing after nasal endoscopy, by eliminating mucosal edema and promoting mucosal epithelialization at the operative cavity, and it is currently a desirable method that deserves promotion. By comparing the time required for surgical cavity cleaning, the rinsing solution was shown to be key of the physical flushing effect in the initial period after nasal endoscopy. It could remove blood cemented and surgical cavity surface cemented skin and secretions. In addition, the sinus irrigation solution can accelerate the mucosal epithelialization of the operative cavity more effectively than compounded saline. It could effectively eliminate mucosal edema, restore its protective and defensive functions, and help local blood circulation, secretion absorption, mucosal growth, mucosal regeneration and repair, and mucus cilia removal.

暂无摘要。

Objective:Establish the anatomical parameters of the nasal septum and the area of each component in patients with nasal septum deviation, for the sake of guiding the scope of surgical resection for correction of nasal septum deviation. Methods:This is a retrospective study of 128 cases of sinus computer tomography images of patients with nasal septum deviation, marked 9 nasal septal anatomical locations, measured the area of the nasal septum and its components, and analyzed the trend of the percentage of the area of the nasal septum cartilage in the total area of the nasal septum with age. Results:The total area of the nasal septum in the 128 patients with nasal septum deviation is: （2951.96±305.91） mm², the area of nasal septal cartilage: （961.89±229.64） mm², the area of the vertical ethmoid plate: （1123.96±214.17） mm², the area of the vomerine: （652.77±108.09） mm². The area of male septum is larger than that of female. As age increases, the nasal septal cartilage gradually decreases, and the percentage of the nasal septal cartilage area in the total area of the nasal septum gradually decreases. Conclusion:Elderly people who undergo nasal septum correction should be carefully considered to grasp the scope of resection, and the influence of gender on the area of nasal septum should also be paid attention.
目的：构建鼻中隔偏曲患者鼻中隔及各组成部分面积解剖参数，指导鼻中隔偏曲矫正手术切除范围。 方法：回顾性研究128例鼻中隔偏曲患者鼻窦电子计算机断层扫描图像，标记9个鼻中隔解剖定位点，测量鼻中隔及各组成部分面积大小，分析鼻中隔软骨面积占鼻中隔总面积百分比随年龄变化趋势。 结果：128例鼻中隔偏曲患者鼻中隔总面积为（2951.96±305.91） mm²，鼻中隔软骨面积为（961.89±229.64） mm²，筛骨垂直板面积为（1123.96±214.17） mm²，犁骨面积为（652.77±108.09） mm²，男性鼻中隔面积大于女性，随年龄增加鼻中隔软骨逐渐减少，鼻中隔软骨面积占鼻中隔总面积的百分比逐渐下降。 结论：老年人行鼻中隔矫正术应慎重把握切除范围，性别因素对鼻中隔面积的影响也应得到重视。.

Ectopic teeth in the nasal cavity are a rare phenomenon. They are often associated with a variety of symptoms and future complications, ranging from nasal crusting and obstruction to chronic infections. In most reported cases, their removal is recommended. Here, we report a case of an ectopic intranasal tooth in a symptomatic adult. The tooth was removed endoscopically with good results.

BACKGROUND: Endoscopic access to the sellar region by videoendoscopy shows a low rate of surgical complications, with findings that indicate risk factors for reducing morbidities during and after the postoperative period.
OBJECTIVE: To evaluate, over a nine-year period, the acquisition of skills by the anterior skull base surgical team, according to the time of elimination of nasal crusts and/or the presence of morbidities in the postoperative follow-up of individuals treated in a tertiary public hospital.
METHODS: After confirming the diagnosis of skull base pathologies, the individuals in this study underwent endoscopic surgery according to the rostrocaudal or coronal axis. For the skull base reconstruction, the nasoseptal flap (associated or not with fascia lata with thigh fat) or free graft was used; clinical follow-up of individuals occurred for a minimum period of 12 months. To assess the impact of the surgical approach on patient clinical evolution, qualitative data related to smoking, post-nasal discharge, nasal flow, smell, taste, clinical symptoms of headache, cranial paresthesia, comorbidities and postoperative morbidities were obtained.
RESULTS: The most frequent diagnosis was pituitary macroadenoma (84.14%). The mean absence of crusts in this cohort was 124.45 days (confidence interval 95%=119.50-129.39). There was a low cerebrospinal fluid fistula rate (3%). Reconstruction with the nasoseptal flap with a fat graft was an independent variable that recorded the highest mean time for the elimination of nasal crusts (=145 days, confidence interval 95%=127.32-162.68). Allergic rhinitis and smoking were shown to be the most important and independent variables that increased the mean time to eliminate nasal crusts.
CONCLUSIONS: The mean time to eliminate nasal crusts did not change over the years during which the procedures were performed, demonstrating the adequate training of the surgical team. Debridement and nasal irrigation with saline solutions should be performed more frequently and effectively in patients with allergic rhinitis, smokers and those who received the nasoseptal flap and fascia lata graft with autologous fat.