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Objective: To study the clinical characters and the mode of treatment, and to analyze the prognosis of patients with sinonasal adenoid cystic carcinoma., Methods: The clinical data were analyzed retrospectively in 40 patients with sinonasal adenoid cystic carcinoma. The characters of survival rate, local recurrence and distant metastasis in these patients were analyzed using Kaplan-Meier method and Log-rank test., Results: The maxillary sinus was the most common site of origin and account for 80% of all patients. Five-year and ten-year overall survival rate were 76.9% and 61.6% respectively. Five-year and ten-year disease-free survival rate were 44.2% and 23.0%. Five-year local recurrence rate and distant metastasis rate were 45.0% and 23.0%, respectively. The most common site of distant metastasis was lung. Presence of distant metastasis correlated with decreased 5-year survival (chi2=7.26, P=0.007). The distant metastasis rate of preoperative treatment (18.2%) seemed lower than that of postoperative treatment (38.9%), but there was no significant difference in the two groups (chi2=1.37, P=0.24). The combined therapy mainly composed of surgery was adopted to treat the local recurrence. Five-year survival rate after development of local recurrence was 60.0%., Conclusions: Distant metastasis is an important factor affecting the prognosis of the patients with sinonasal adenoid cystic carcinoma. Combined therapy composed of surgery and radiation was the first choice of treatment to the patients with sinonasal adenoid cystic carcinoma. Radiation can play an important role in the treatment. The combined therapy mainly composed of surgery should be adopted in the patients with local recurrence to improve the survival rate.

Objective: To evaluate the extensive and degree of physical rehabilitation improvement of the quality of life in laryngectomees., Methods: Forty nine patients who underwent total laryngectomies were trained by esophageal voice rehabilitation successfully. The questionnaires of performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of head and neck cancer therapy (FACT-H&N) were answered by them before esophageal voice training and 3 months after successful vocal rehabilitation., Results: Total laryngectomy deteriorated the quality of life in laryngectomees. The mean scores of PSS-HN scale and FACT-H&N questionnaire were lower than the criteria scores after patients underwent total laryngectomy, the mean score were 131. 4,90.6 respectively, the difference was significant statistically (t =53. 673, P <0.001) , (t = 67.44, P <0.001). After successful esophageal speech training, the mean scores of the laryngectomees were improved both in PSS-HN scale and FACT-H&N which were 240.4 and 103.7 respectively, the difference was significant statistically (t = 18.209, P < 0.001) , (t = 21.389, P<0.001)., Conclusions: The quality of life in laryngectomees can be improved by physical rehabilitation and the esophageal voice training.

Objective: To assess the feasibility of sentinel lymph node (SLN) radiolocalization in stage in head and neck squamous cell carcinoma and to gain insight as to whether the sentinel lymph node could be prognostic of regional micrometastatic disease., Methods: A prospective trial was made on the application sentinel lymph node radiolocalization in 10 patients with NO squamous cell carcinoma of the head and neck region. For each patient a peritumoral submucosal injection of filtered technetium 99m prepared with dextran colloid (99mTc-DX) was performed immediately. After 30 minutes, focal areas of accumulation corresponding to sentinel lymph nodes (SLN) were marked on the skin surface. The SLN was localized by lymphoscintigraphy and intraoperatively through the intact skin by a hand-held gamma-probe. SLN was defined as the count of lymph node could be detected 4 times more than that of background. Complete neck dissections were performed, and SLNs were identified for later histological evaluation and comparison to the remaining lymphadenectomy specimen., Results: SLN radiolocalization accurately identified one or more SLNs in the ten cases. 3 of 10 cases revealed occult metastatic disease. Therefore the negative metastasis rate was 30% (3/10). The positive rate of SLN and nonsentinel lymph node (NSLN) were 22.7% (5/22) and 0.4% (1/247) respectively. Serial sectioning (SS) and immunohistochemical (IHC) on SLNs would reduce the false-negative rate of sentinel lymph node biopsy (SLNB). There was no instance in which SLN was negative for micrometastatic disease while being positive in a nonsentinel lymph node., Conclusions: SLN evaluation in NO neck in squamous cell carcinoma of the head and neck is accurately feasible and seems to adequately predict the presence of occult metastasis. Although SLN radiolocalization in head and neck squamous cell carcinoma may potentially reduce the time, cost, and morbidity of regional lymph node management, more experience with technique is required before its role can be determined.