Drug treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery for early glottic carcinoma / 中国医师进修杂志

Objective:to investigate the efficacy of drugs in the treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery in early glottic carcinoma.Methods:Thirty-two cases of laryngeal granulomacoming from 289 patients with early glottic carcinoma treated by plasma radiofrequency surgery under endoscope-supported laryngoscopefrom January 2011 to January 2021 in Dalian Municipal Central Hospital were enrolled. All patients were given oral treatment of zinc gluconate tablets (70 grams per tablet, containing 10 grams of zinc). The usage was 3 tablets each time, twice a day. If the granulation was located in the vocal cord, 20 mg of esomeprazolec was added twice a day, and taken orally on an empty stomach. The total course of treatment was 6-12 weeks.Results:Follow-up and reexamination of electronic laryngoscope showed that the granulation of all patients began to become smaller after 3 weeks of drug treatment and gradually disappeared after 6-12 weeks. After the granulation disappeared, the drug was stopped, and there was no recurrence.Two patients developed nausea and epigastric discomfort after oral administration of zinc gluconate tablets for 3 weeks, and the discomfort disappeared after reducing the dose.Conclusions:Oral administration of zinc gluconate tablets alone or in combination with esomeprazoleis an effective, safe and low recurrence method for laryngeal granuloma after hypothermic plasma radiofrequency ablation in early glottic carcinoma.

Application of individualized selection of local skin flaps for primary repair of partial nasal alar defects / 中国医师进修杂志

Objective:To explore the possibility of repairing partial nasal alar defects with individualized design of localized skin flaps.Methods:The clinical data of 38 patients with nasal alar region tumor from October 2015 to June 2019 in Dalian Municipal Central Hospital were retrospectively analyzed, including 5 cases with intradermal nevus, 8 cases with junction nevus, 21 cases with basal cell carcinoma, 3 cases with trichoepithelioma, and 1 case with nasal alar sulcus fistula combined with infection. Surgical treatment with local anaesthesia was applied, and intraoperative freezing pathology was used to confirm the diagnosis and determine the safe margin. There was no nasal alar cartilage infiltration in all patients. The defect areas after resection of nasal alar lesions ranged from 1.0 cm × 1.0 cm to 3.0 cm × 2.5 cm. Local skin flap was aesthetically designed in accordance with the location and size of the nasal alar defect to primarily repair the defect. Among them, 15 cases were repaired with pedicled nasolabial groove flap, 10 cases with modified rhomboid flap, 6 cases with rotatory nasolabial groove flap, 5 cases with V-Y push flap, and 2 cases with double lobe flap.Results:One case had blood transportation obstacle after operation caused by compression and bandaging, 1 case had postoperative infection. Healing of the two cases delayed after treatment, and other patients healed properly. All the flaps survived without facial deformity, and the cosmetic effect was good.Conclusions:The primary repair of the nasal alar defect needs to follow the aesthetic requirements of the nose and face, which varies with diseases and experience of doctors. Flap selection should be individualized to achieve both the purpose of repairing defects and beauty.

Clinical, significance of the nomenclature for nasal septum tail: A preliminary study / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe and summarize the abnormal morphological appearance of nasal septum tail during adenoidectomies, and to have a preliminary study on its clinical significance.@*METHOD@#One hundred and eighty-three children were shown with abnormality on nasal septum tail in 2892 cases with adenoid hypertrophy who received adenoidectomies in our department.@*RESULT@#The abnormalities of nasal septum tail can be classified into two types: del tails and columnar ones. All children suffered from nasal septum tail received radiofrequency ablation and all had a good postoperative recovery.@*CONCLUSION@#The presence of these two types of nasal septum tail may be related to adenoid hypertrophy, adenoiditis, sinusitis, and some congenital malformations.

A preliminary study on the superiority of using of coblation during the maxillary sinus operation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Observed the using of coblation during the maxillary sinus operation, to investigate the superiority of its clinical application.@*METHOD@#Selecting 46 patients with the maxillary sinus lesions of sinusitis, nasal polyps and nasal inverted papilloma as research objects, the control group used high speed cutting drill, the research group used coblation separately for functional endoscopic sinus surgery. Six months postoperative follow-up, observeing the subjective symptoms and objective examination.@*RESULT@#Subjective symptoms and objective examination scores of two groups of patients improved significantly. Compared with the control group, the operation time, bleeding volume and postoperative examination time are reduced in the study group of patients. Endoscopic examinations of the study group are better than the control group.@*CONCLUSION@#Using coblation for the maxillary sinus operation, treatment are more thorough, more minimally invasive, shorten operation time, reduce bleeding and recheck time after surgery, is worthy of clinical use.

Analysis of monitoring results of Mattress-type of sleep monitoring system in elderly patients with OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS.@*METHOD@#One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed.@*RESULT@#Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant.@*CONCLUSION@#The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.

Nasopharynx pleomorphic adenoma report / 临床耳鼻咽喉头颈外科杂志

The patient was a 42 years old female. And the reason why she was addmited to the hospital was progressive bilateral nasal congestion for one year, and bilateral nasal bleeding for one day. Physical examination showed no surgical contraindication so the patient got the nasal endoscope by plasma radiofrequency ablation surgery with general anesthesia on 3rd Dec. 2013. And the result of potholegical examination was nasopharynx pleomorphic adenoma.

Coblation treatment for laryngopharynx hemangioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect and feasibility of coblation treatment for laryngopharynx hemangioma.@*METHOD@#Retrospectively analyzed 24 cases with coblation treatment for laryngopharynx hemangioma in recent years.@*RESULT@#Twenty-four patients were treated with coblation, follow-ups range 6 months to 24 months after surgry. Recurrence occurred in 2 months after surgry in one patient who was cured with coblation for second time. There was incomplete vocal cord paralysis in another patient because of wide range angeioma.@*CONCLUSION@#Coblation treatment for laryngopharynx hemangioma was an ideal way to less bleeding, less damage and more clearfield of vision.

Right non recurrent laryngeal nerve during thyroid surgery: one case report / 临床耳鼻咽喉头颈外科杂志

A 56 years old female was admitted to our department with complaint of a painless cervical mass. Clinical feature:there was a painless mass above left lobe of thyroid gland, which was about 3.0 cm x 2.5 cm in size, and could move with swallowing action. B-mode ultrasound features: there was a solid mass in left lobe of thyroid gland, which was about 3.2 cm. Nodule was found in isthmus, accompanied with lymphadenovarix on the left neck possibly be MCA. fT3: 4.64 pmol/L, fT4:16.56 pmol/L,TSH:3.74 mIU/L, anti-TG:17.75 U/ml, anti-TPO:40.77 U/ml. Pathological result of the neoplasm: papillocarcinoma. Clinical diagnosis: papillary thyroid carcinoma.

Radiofrequency coblation for treatment of abnormal sensation of throat induced by the hypertrophy of lingual tonsil / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of the present study was to evaluate the effects of radiofrequency coblation surgery for treatment of abnormal sensation of throat induced by the hypertrophy of lingual tonsil.@*METHOD@#Three hundred and seven patients affected by abnormal sensation of throat induced by the hypertrophy of lingual tonsil were enrolled. Radiofrequency coblation was performed on all patients under nasal endoscopy. A comprehensive statistics were obtained from all the participants regarding the recovery of wound surface, postoperative pain, intra and postoperative bleeding and the effects of the procedure.@*RESULT@#The VAS score of abnormal sensation of throat was reduced from (9.3 +/- 0.6) to (3.7 +/- 2.4) (P<0.05) after the operation. 84.4% of the abnormal sensation dis appeared, no recurrence within six month; 6.8% of the abnormal sensation largely reduced within six month; 4.6% of the abnormal sensation reduced within six month. There was no significant postoperative pain. 3.6% (11/307) of patients experienced postoperative hemorrhage. The follow-up period ranged from 6 to 36 months, there was no recurrence.@*CONCLUSION@#Radiofrequency coblation is a useful surgical technique, as effective as,or even superior to,other surgical techniques when dealing with patients suffering from abnormal sensation of throat induced by the hypertrophy of lingual tonsil with potentially fewer adverse effects and subsequently improved quality of life for patients.

Chordoma originated from sphenoid sinus, encroach on sella, metasella and clivus: one case report / 临床耳鼻咽喉头颈外科杂志

The purpose is to report a case of chordoma, which orignated from sphenoid sinus and encroach on sella, metasella and clivus. We comprehensively analyzed the CT and MRI information and diffrentiated the illness from the commonly encountered diseases of sphenoid sinus and sellato improve the accuracy before surgery.

Nasal mucosa recovery after endoscopic surgery using the plasma radiofrequency ablation at low temperature for treatment of nasal inverted papilloma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To assess the therapeutic effect and study the role of nasal mucosa epithelization after endoscopic surgery using the plasma radiofrequency ablation at low temperature in patients with nasal inverted papilloma.@*METHOD@#The clinical data of 104 patients with nasal inverted papilloma underwent endoscopic surgery u sing the plasma radiofrequency ablation at low temperature from July, 2008 to July, 2012 were analyzed,and the recovery of mucosa was observed under nasal endoscope.@*RESULT@#The mucosa recovery extent showed a decreasing trend from mucosa pattern degree I to III, where the difference was statistically significant by chi-square test between groups (P < 0.05). The average epithelialization time was 2.7 months. It showed a significantly decreasing trend among average epithelialization time of different degrees of mucosa (P < 0.05). The nasal mucosa of most patients completed epithelialization 2.9 months after surgery.@*CONCLUSION@#It is safe and effective to treat nasal inverted papilloma with plasma radiofrequency ablation at low temperature. The patients should be followed up with regular reexamination for at least three months after surgery.

Clinical observation of coblation under endoscopy on epiglottis cyst / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect of the coblation under endoscopy on epiglottis cyst.@*METHOD@#One hundred and ninety-three patients with epiglottis cyst were treated with coblation under endoscopy. Follow-up study was performed from 1 month to 6 months after treatments.@*RESULT@#All 193 cases with epiglottis cyst were primary cured without serious complication and the cure rate was 100%. Moreover, the minor hemorrhage (1-5 ml) was observed.@*CONCLUSION@#The coblation under endoscopy on epiglottis cyst was safe, effective and minimally invasive.

The progress of nasal endoscopic surgery with imaging-guided system / 临床耳鼻咽喉头颈外科杂志

The aim of this paper is to introduce state-of-the-art endoscopic surgery with imaging-guided system in terms of indication, preoperative registration and intraoperative imaging and to describe future development trend.

The application of micro-sensitive mattress type sleep monitor in the diagnosis of OSAHS in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children.@*METHOD@#The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared.@*RESULT@#By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01).@*CONCLUSION@#Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.

Lingual thyroglossal duct cyst treatment by low temperature coblation on endoscope / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the treatment for lingual thyroglossal duct cyst by low temperature coblation on endoscope.@*METHOD@#Eleven cases of lingual thyroglossal duct cyst were treated by low temperature coblation on endoscope,to observe the curative effect and complication.@*RESULT@#Eleven cases of lingual thyroglossal duct cyst were satisfied after operation, without serious complication. There were no recurrence during a followed up for 1-3 years after operation.@*CONCLUSION@#The operation for lingual thyroglossal duct cyst by low temperature coblation on endoscope was easy,safe and effective.

Thyroglossal cyst of double cyst: one case report / 临床耳鼻咽喉头颈外科杂志

A 5 years old boy was referred to our department with complaints of a painless midline neck swelling. Clinical feature: there was a painless swelling above the middle of thyroid cartilage, it was about 2.0 cm x 0.5 cm, and it was soft. And its boundary was clear. The skin temperature is normal. B-mode ultrasound features: there is a cystic mass in the front of the neck, it is about 2.3 cm x 1.0 cm, and be apart from the skin is 0.3 cm. It is showed that another cystic mass behind this one, is about 1.9 cm x 0.7 cm. The borders are clear, and no blood flow signal is detected. The thyroid was not abnormal. Pathology results showed the wall of cyst and there were pectin in the cyst. Diagnosis: thyroglossal cyst of double cyst.

Pilomatricoma behind and below the ear: one case report / 临床耳鼻咽喉头颈外科杂志

A 6 years old boy came to our department with a complaint of a growing goitre behind and below the right ear that started 4 years ago. Clinical features: there was a 2.0 cm x 1.5 cm nontender goitre behind and below the right ear, protruding from the skin with clear boundary. The temperature and color of the skin covered the goitre were normal. B-mode ultrasound features: there was a mass under the skin with the size of 2.0 cm x 0.8 cm showing strong echo. The borders of the mass were unclear, and no signal of blood flow was detected. Pathology diagnosis: pilomatricoma.

The progress of the nonspecific immune therapy of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

The article describes immune disorder mechanisms of allergic rhinitis and the progress and clinical application status of the nonspecific immune therapy of allergic rhinitis, which can raise people's understanding about the nonspecific immune therapy of this disease.

Coblation-assisting uvulopalatopharyngoplasty combining coblation-channeling of the tongue for patients with severe OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic efficacy of coblation-assisting uvulopalatopharyngoplasty (CAUPPP) combining with coblation-channeling of the tongue (CCT) for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#A retrospective analysis was made on patients with severe OSAHS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apnea-hypopnea index (AHI) were beyond 40/h and lowest arterial oxygen saturation (LSaO2) were under or equal to 80%. Surgical approach: The UPPP was performed to decrease the size of soft palate with coblation and coblation-channeling in the soft palate and decrease the size of tongue by CCT. All patients were followed up for 6 to 12 months and underwent polysomnography (PSG).@*RESULT@#Subjective symptoms of patients improved more significantly than that of preoperation. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared with the preoperative data, AHI values were significantly decreased (P<0.01) and the lowest oxygen saturations increased significantly (P<0.01) and the effective rate was 91.7%.@*CONCLUSION@#There are usually multiple obstruction levels in patients with severe OSAHS and the traditional surgical treatment is not ideal. This study demonstrated that with the assistance of coblation, combining CAUPPP with CCT for patients with severe OSAHS is an effective surgical method. It has less blood loss, minimally invasive, retained the normal function of the soft palate, etc., should be widely applied.

Low-temperature plasma assisted via mouth for surgery treating styloid process syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the low-temperature plasma assisted way and the traditional method in surgery treating styloid process syndrome.@*METHOD@#The clinical data from 23 patients who have a typical syndrome and need surgery treating, thirteen patients had been treated by low-temperature plasma way and the left cases by traditional one. Comparing operation time, amount of bleeding, degree of pain,time of the fake membrane falling and effort estimating.@*RESULT@#The difference of operation time,amount of bleeding and degree of pain between low-temperature plasma and tradition in the two operation procedures is significant (P 0.05). And one patient who used the traditional operation bled when he was at home.@*CONCLUSION@#The two operation procedures are both effective. The low-temperature plasma assisted via mouth for surgery treating elongated styloid process has a big advantage in operation time, amount of bleeding and degree of pain. For the more, it reserves the function and morphology of tonsil; which is more simple, convenient, safe and tiny wound.