Diagnosis and treatment of the cartilaginous subglottic web in children / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the methods of preoperative diagnosis, evaluation and surgical treatment of the subglottic web in children. METHODS We analyzed the clinical manifestations, electronic laryngoscopy results, tracheal endoscopy and airway CT results of 4 children cases with congenital laryngeal cartilaginous subglottic web (1 case of type IV and 3 cases of type III) from August 2014 to March 2018. All of the 4 patients underwent a laryngofissure plus submucosal resection of cartilage web and short-term stenting. RESULTS Two cases underwent preoperative tracheotomy at 13 month old, 1 case at 6 month old. One case underwent tracheotomy at the same time of laryngoplasty. Two children indwelled the stents for 7 days and 11 days after operation and removed the stent by themselves. Other 2 cases removed the stent by the doctor at 14 day after operation. After removing the stents, the 4 cases underwent a pluging of the tracheotomy instantaneously. After 3 to 5 months of continuously pluging of the tracheotomy, all cases successfully removed the tracheal cannula. CONCLUSION For children with congenital laryngeal cartilaginous subglottic web of type III or type IV, the operation of laryngofissure plus submucosal resection of cartilage web and short-term stenting is the good choice with a high extubation rate and no complications.

Differentiated thyroid cancer in children: a series of 29 cases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the best administration for the differentiated thyroid cancer in children under 14 years by reviewing of their clinical characteristics, treatment methods and results.</p><p><b>METHODS</b>Clinical data of 29 patients under 14 years with differentiated thyroid cancer in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine between January 1998 and July 2014 were reviewed respectively.</p><p><b>RESULTS</b>Neck mass was the chief complaint in 27 of 29 patients. Unilateral thyroid carcinoma was found in 16 cases, and bilateral in 13 cases. Solid tumor with multiple punctate calcification was observed in 21 cases (72.4%). Cervical lymph nodes enlargement was found in 24 cases (82.8%), and 15 cases (62.5%) were bilateral. Among 20 patients received primary thyroid surgery in our hospital, 18 cases presented with T2 or advanced diseases and 16 cases had cervical lymph nodes enlargement. The resection of unilateral lobe with isthmus was performed in 2 cases, and total thyroidectomy in 18 patients, including 1 case with partial trachea resection. Neck dissection was performed in 16 patients. Of 9 patients received primary thyroid surgery in other hospitals, 8 cases presented with cervical lymph node enlargement after surgery and 6 cases with pulmonary metastasis, of them 5 patients received neck dissection, 4 patients underwent resection of residual thyroid cancer plus neck dissection. Twenty-seven of all patients were treated postoperatively with 131I. All patients received follow-up, and the meaning follow-up time was 6 years and 10 months (0.5 years-16 years). No cases with death, local recurrence, and metastasis were observed in the follow-up period.</p><p><b>CONCLUSIONS</b>Differentiated thyroid cancer is more invasive in children compared with adults. Comprehensive treatment including total thyroidectomy, neck dissection and postoperative 131I therapy may be a basic approach for the differentiated thyroid cancer in children.</p>

The spiral ganglion degeneration and the expression of EFR3A in the cochlea of the deaf mice induced by co-administration of kanamycin and furosemide / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the spiral ganglion degeneration and the expression of EFR3A in the cochlea of the deaf mice induced by co-administration of kanamycin and furosemide.</p><p><b>METHODS</b>Eight weeks old C57BL/6J mice were administered with a single dose of kanamycin followed by furosemide, then fluorescent immunohistochemistry staining and transmission electron microscopy were applied to observe the SGNs' degeneration process and extent characteristics at 1, 5, 15, 30 and 60 days following treatment. We detected the expression of EFR3A during the degeneration of SGNs via fluorescent immunohistochemistry and western blotting.</p><p><b>RESULTS</b>Co-administration of kanamycin and furosemide quickly induced cochlear hair cell death in mice, and then caused progressive degeneration of SGNs. Our results showed that the abnormal morphology of SGNs occurredat day 5 following administration, and the number of SGNs began to decrease at day 15. Compared to the control group, it was found the remarkable increase of the EFR3A protein at the fifth day after co-administration, then decreased to the nearly normal at 15 days following treatment, and no further significant changes thereafter.</p><p><b>CONCLUSION</b>The changes of the EFR3A protein expression in the spiral ganglion of the cochlea in mice are coincidence with the time of the SGNs degeneration to happen, which imply that EFR3A may play an important role in the occurrence of the SGNs' degeneration in the cochlea in mice following hair cells loss.</p>

The diagnosis and management of laryngotracheal stenosis in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical etiopathogenesis, the diagnose and the treatment of laryngotracheal stenosis in children.@*METHOD@#Six patients with laryngotracheal stenosis who had been surgically were reviewed.@*RESULT@#Three cases of congenital laryngeal cyst, among 2 cases were treated by undertaken endoscopic, one case was treated by laryngofissure. One case with congenital laryngeal web was treated by undertaken endoscopic with CO2 laser resection. One case with congenital tongue base cyst was treated by direct laryngoscope with puncture. One case with congenital cricoiddysplasty was treated by laryngotracheotomy with stent. One case of traumatic granuloma of trachea was treated by fence-form tracheotomy and inserting T-shape tube. Four patients were successfully decannulated, one patient was cured, one patient were followed-up.@*CONCLUSION@#The early diagnosis of laryngotracheal stenosis in children was important. The different methods of surgical used here for the laryngotracheal stenosis proved to be effective. The functions of laryngotracheal would been recovered with good voices and satisfactory airway.

Ultrastructural change of chicken basilar papilla during a prolonged administration of kanamycin / 中国组织工程研究

BACKGROUND: Although some studies have been done on the functional change of cochlea in chickens during prolonged administration of kanamycin,few studies on ultrastructural changes in chicken cochlea have been reported.OBJECTIVE: To observe ultrastructural changes of the chicken basilar papilla following poisoning with prolonged administration of kanamycin.DESIGN: A completely randomized design and controlled observation.SETTING: Affiliated Xinhua Hospital, Shanghai Second Medical University.MATERIALS:The experiment was conducted in Xinhua Hospital Affiliated to Medical College, Shanghai Jiao Tong University from June 2001 to August 2003. Newly born Roman chickens (n=78), of either sex, provided by Shanghai Guixing Breeding Chick Farm, were used as subjects.METHODS: 200 mg/kg kanamycin was injected into muscles daily at day 3 after birth for 10 days. Then they were divided into 3 groups randomly:①typical application group: The chickens were applied with drugs no longer, and then killed at days 1, 3,7, 10 and 15, 6 chickens in each time phase. ②prolonged application group: 200 mg/kg kanamycin per day were injected into muscles continuously, and then killed at days 13, 17, 20, 25and 30, 6 chickens in each time phase. ③control group: The chickens were not treated with any drug. They were assigned into 3, 13 and 33 days groups with 6 chickens in each time phase. When the chickens were killed they were at the same age with the experime ntal animals at days 0, 10 and 30 of kanamycin treatment. All the experimental animals were studied with auditory brain-stem response (ABR) and scanning electron microscopy in chicken basilar papilla to observe ultrastructural change of cochlea, threshold, latency and amplitude of ABR wave I.MAIN OUTCOME MEASURES: ①Ultrastructural change of the chicken basilar papilla, and ② ABR result of chicken.RESULTS: A total of 78 Roman chickens were involved in the result analysis, without dropout. ①Outcome of ABR: Loss and recovery of chicken ABR threshold value was similar between within continuous administration for 20 days and administration for 10 days plus 10 days of recovery (drug withdrawal group). Twenty days after administration, ABR threshold significantly increased again. ②Outcome of scanning electron microscopy: At the end of 10-day kanamycin administration, hair cells in 40％ proximal chicken basilar papilla were destroyedand disappeared completely. Although continuous administration was performed, the hair cells began to regenerate and repair after damage. Within the 20-day continuous administration, the regenerated hair cells of basilar papilla developed maturity, which was mostly coincident with the administration for 10 days group. At day 25, regenerated hair cells of proximal basilar papilla were injured once again. At day 30, most of the regenerated hair cells were destroyed and disappeared.CONCLUSION: Prolonged administration of kanamycin obviously prevents the full repair of chicken basilar papilla damaged by kanamycin poisoning.

The Expression of Ephrin A2 during the Reinnervation and the Regeneration of the Hair Cells in the Chick Cochlea following Kanamycin Ototoxicity / 听力学及言语疾病杂志

Objective To investigate the role of Ephrin A2 in the regeneration and reinnervation of hair cells in the chick cochlea following kanamycin ototoxicity.Methods 66 newly hatched Roman chickens (3 days old) were randomly divided into experimental group and control groups. Experimental chickens (n=48) received intramuscular kanamycin (200 mg/kg:Sigma,St Louis,MO) for 10 consecutive days and were subsequently sacrificed 2 days before the last injection,and 1,3,7,10,15,21,30,and 60 days after the last injection (n=6 per subgroup). Control chickens (n=18) were untreated and sacrificed 3,13 and 43 days after hatching (n=6 per subgroup). Ephrin A2 protein expression in acoustic ganglia was determined by western blot analysis in all chickens after sacrifice. Results Ephrin A2 protein expression was found and the protein level was almost same in acoustical ganglia of all normal chickens. After kanamycin exposure,the Ephrin A2 protein expression level in the cochlea of the experiment chickens from 2 to 7 days after last kanamycin injection was lower than that in control chickens,respectively. Ephrin A2 expression increased obviously at 15 days after kanamycin last injection. By 30 days after the cessation of kanamycin treatment,the level of Ephrin A2 protein approximated to that in normal control group.Conclusion The expression of Ephrin A2 protein in the acoustical ganglia basically synchronizes with the regeneration and the reinnervation of the hair cells in the chicken cochlea following kanamycin damage,indicating that Ephrin A2 may play an important role in this process.