Exploration of feasibility and safety of transoral robotic surgery in pharyngolaryngeal tumors / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the indication, feasibility, and safety of da Vinci robotic surgical system in pharyngolaryngeal tumor resection. @*Methods@#Thirty patients were diagnosed with pharyngolaryngeal tumors and treated with a transoral robotic surgery (TORS) in Beijing Anzhen Hospital from June 1, 2016 through November 30, 2017. Inclusion criteria included lesions of the oropharynx (n=13), parapharyngeal space (n=7), larynx (n=6) and hypopharynx (n=4). Twenty cases were males and ten cases were females. The median age was 56 years old (ranging from 30 to 81 years). @*Results@#The robotic surgeries were performed successfully on 30 patients. One patient (3.3%) underwent TORS combined with a neck incision. The mean operative time was 40.7 min. The mean blood loss was 15.8 ml. The mean recovery time for oral intake was 5.3 days. The mean hospital stay was 9 days. None of the patients underwent tracheotomy or mandible split. Postoperative pathological examination showed that 18 cases (60.0%) were malignant and 1 case (5.6%) had positive surgical margin. Sixteen cases received neck dissection. No serious complications occurred during or after the operation. There was no local recurrence, metastasis or death except for regional recurrences in 2 cases (11.1%) with a follow-up of 1 to 18 months(median 13 months). @*Conclusion@#Transoral robotic surgery is a feasible, safe and effective surgical procedure with clear operation field, rapid surgical access, minimally invasive surgery, lesser hemorrhage, good cosmetic effect and fast recovery.

Effects of Estrogen on the Expression of Caspase-3 in Guinea Pigs Inner Ear under the Compound Factors of Simulated Weightlessness and Noise in Spaceship / 听力学及言语疾病杂志

Objective To study the effects of compound factors of simulated weightlessness and noise in spaceship on auditory function ,and the expression of apoptotic marker Caspase -3 in inner ear in guinea pigs ,and study the influence of compound factor above on its hearing loss and apoptosis of inner ear .Methods Thirty -six guinea pigs were randomly divided into four groups ,6 in control group ,10 in simulated weightlessness with noise group (Group A) ,treatment estrogen group (Group B) and prevention estrogen (Group C) ,respectively .All the experiment groups were suspended posterior limb ,with the exposure of the simulated noise circumstance in space-ship .Estrogen prevention group received intramuscular injection of estradiol benzoate for 3 days before the experiment ,while estrogen treatment group was treated in the same way for 8 days from the beginning of experiment to 3 days after the experiment .Bilateral auditory brainstem response thresholds (ABR) were tested in pre- exposure ,post-exposure and 3 -day recovery respectively .Cochleae were obtoined for immunohistochemistry staining to observe the expression of the apoptotic marker Caspase -3 in inner ear .Results At the time point of post -exposure ,ABR threshold in Group B was lower than those in Group A by 14 .5 dB and Group C by 9 dB .For the ABR change of pre ,and post-exposure ,Group B was lower 12 .75 dB than those of in Group A and 7 .75 dB than in Group C .For the ABR change between pre ,and post-recovery ,ABR threshold of Group C was higher than those of in Group A by 14 .5 dB and in Group B by 7 dB .These differences were significant (P<0 .05) .The expression of Caspase-3 was positive in the hair cell ,spiral ganglion cells and stria vascularis of three groups in both post exposure and 3-day recovery .The expression of Caspase-3 in hair cell and stria vascularis was strongly positive in spiral ganglion cells in Group C in post -exposure ,while it was slightly positive in Group B .After 3 -day recovery ,Group A turned to negative ,while Group B and Group C were still in positive expression with an increase of that in post -ex-posure .Conclusion Estrogen treatment could effectively reduce the hearing loss and the apoptosis of inner ear in-duced by the compound factor of weightlessness and noise .Preventive use of estrogen could not produce an instant protection on the hearing loss induced by exposure ,and the apoptosis was enhanced .However ,it speeded up the procedure of recovery and reduced the apoptosis of inner ear .

The ear angioplasty and hearing reconstruction of microtia / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To Study the clinical features of congenital microtia and atresia . To evaluate the methods and results of the same microtia surgery, ear canal and middle ear reconstruction.@*METHOD@#Statistically analysis of the data of the hospitalization microtia 62 ears of 58 cases of patient in our department from January 2005 to October 2010 waw conducted. These patients with congenital ear malformations are associated with aural atresia, ossicular chain abnormalities, severe conduction Deafness. All patients received preoperative temporal bone CT examination and reconstruction, hearing examination. Operation was given in two phases, first operation aim to form a line of ear, ear canal reconstruction, ear reconstruction, the second one aim to line of ear skin graft, cranial angle of the ear reconstruction. The preoperative and postoperative data were retrospectively analyzed.@*RESULT@#The auricle plus external auditory canal, middle ear reconstruction came out with a good shape of the ear and the ear canal in close proximity to the normal population. Most patients' hearing were improved after surgery.@*CONCLUSION@#Surgeries of patients with congenital ear malformations and aural atresia should be carefully designed according to the three-dimensional reconstruction of multislice spiral CT reconstruction, which can provide information about surgery approach and middle ear abnormality. The whole ear shape and hearing ear after reconstruction are improved after the surgery.

A study on cells proliferation and invasiveness of Hep-2 inhibited by RNA interference mediated PIK3CA gene silencing / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the effects of RNA interference mediated PIK3CA gene silencing on the proliferation and invasiveness of laryngeal squamous cell carcinoma(LSCC) cells, and investigate the feasibility of PIK3CA gene as a potential therapeutic target in the treatment of LSCC. METHODS The lentiviral vector system expressing short hairpin RNA targeting PIK3CA gene(PIK3C-shRNA)was constructed and transfected subsequently into Hep-2 cells mediated by liposome in vitro. The expression of PIK3CA gene was detected by real-time RT-PCR and Western blot respectively. The proliferation of Hep-2 cells was measured by MTT, colony formation, and cell growth curve. The invasive power was determined by Boyden chamber model in vitro. RESULTS The lentiviral vector system expressing short hairpin PIK3CA- shRNA was constructed successfully. Compared with the control groups, the mRNA and protein expression of PIK3CA were significantly down-regulated(75% and 70% respectively)in the experimental group (P

Reoperation for thyroid cancer / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the results of the reoperation for thyroid cancer. METHODS The clinical data of 288 cases who underwent reoperation for thyroid cancer were analyzed retrospectively. There were 69 male and 219 female. There were 249 cases (86.5 %) with papillary adenocarcinoma, 27 cases(9.4 %) with follicle adenocarcinoma, 6 cases (2 %) with medullar cancer, and 6 cases (2 %) with anaplastic cancer pathologically. The types of operation were lobectomy and near total lobectomy. The unilateral or bilateral neck dissections were performed in selected cases. RESULTS Pathological examination reveal that there were 63 cases of cancer residual in the ipsilateral side and 33 cases of the opposite side. The cervical node metastasis were present in 164 cases of patients at the same side. CONCLUSION The ipsilateral side lobaectomy and/or contralateral side near total lobectomy should be employed for the thyroid cancer patients. The neck dissection should be performed in most of the patients.