Anti-EGFR monoclonal antibodies in locally advanced head and neck squamous cell carcinoma: a Meta-analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To perform a Meta-analysis of all randomized controlled trials that compared the efficacy and adverse events profile of Mabs for LA HNSCC.@*METHOD@#Several databases were searched, including CBM, PUBMED, EMBASE, and CENTRAL. Primary outcomes included overall response rate (ORR), overall survival (OS), progression-free survival (PFS). Secondary outcomes included serious adverse events, such as grade 3-4 skin reaction, dysphagia, mucositis, and nausea/vomiting. The results were expressed as relative ratio (RR) or hazard rate (HR) with their corresponding 95% CI.@*RESULT@#The final analysis included 10 trials. The primary analyses indicated that Mabs did not improve ORR and PFS, except OS for locoregionally advanced (LA) HNSCC [ORR 1.21, 95% CI (0.97 - 1.49); PFS 0.87, 95% CI (0.75 - 1.01); OS 0.82, 95% CI (0.71 - 0.95)]. Analysis of adverse effects demonstrated that grade 3 - 4 skin reaction ERR 1.87, 95% CI (1.11 - 3.16)] was statistically significantly associated with Mabs except dysphagia ERR 0. 95, 95% CI (0.75 - 1.19)], Mucositis ERR 1.03, 95% CI (0.67 - 1.57)], and nausea/vomiting ERR 1.15, 95% CI (0.71 - 1.86)].@*CONCLUSION@#Anti-EGFR Mabs may be satisfactory for improving OS of LA HNSCC. During the Mabs therapy, skin reaction should be much more monitored.

Clinicopathologic features and risk factors of bilateral cervical lymph node metastasis in head and neck squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features and associated risk factors for bilateral neck node metastasis (BNM) in head and neck squamous cell carcinoma (HNSCC).</p><p><b>METHODS</b>Two hundred eighty-six cases with HNSCC were retrospectively studied, including 83 cases of oral tongue cancers, 101 cases of hypopharyngeal cancers and 102 cases of supraglottic laryngeal cancers. All patients had unilateral or bilateral cervical lymph node metastasis confirmed by postoperative pathologic examinations. The following factors were evaluated to determine the risk for BNM in HNSCC: T staging, size, location, trans-midline condition, growth pattern, pathologic grading and infiltration of primary tumors; N staging; the size, number and extracapsular spread (ECS) of ipsilateral metastatic nodes; the number of involved levels on the ipsilateral neck. Chi-square test and logistic regression test were used for statistical analysis.</p><p><b>RESULTS</b>BNM was found in 86 (30.1%) of 286 patients with HNSCC, including 52 (18.2%) cases of contralateral occult neck node metastasis. The incidence of BNM was 35.6% (36/101) in hypopharyngeal cancer, 31.4% (32/102) in supraglottic laryngeal cancer and 21.7% (18/83) in oral tongue cancer, respectively. N staging, the number and ECS of ipsilateral metastatic nodes, and the number of involved levels on the ipsilateral neck were important factors contributing to BNM. Multiple logistic regression analysis revealed that midline passing of primary tumor was associated with BNM in oral tongue cancer. The midline passing and ECS of ipsilateral metastatic node were key factors for BNM in hypopharyngeal and supraglottic laryngeal cancers. T staging, size and midline passing of primary tumor were closely related to BNM in oral tongue cancer. T staging and midline passing were associated with BNM in hypopharyngeal cancer. Midline passing was an important factor related to BNM in supraglottic laryngeal cancer.</p><p><b>CONCLUSION</b>Midline passing of primary tumor is the most important factor determining BNM in hypopharyngeal, supraglottic laryngeal and oral tongue cancers, whereas ECS of ipsilateral metastatic node is the most important factor impacting BNM in hypopharyngeal and supraglottic laryngeal cancers.</p>

An objective evaluation of nasal airway obstruction by enlarged adenoids in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical application value of nasal airway obstruction objectively and quantificationally by acoustic rhinometry (AR) in children with adenoid hypertrophy.@*METHOD@#Thirty patients with adenoid hypertrophy were examined with AR and questionnaire at preoperative and eight weeks after surgery. The values of AR were compared with those of 27 normal controls.@*RESULT@#There were significant differences between preoperative and postoperative in NAR and NPV (P 0.05); There were significant differences in NAR, NPV, MCSA between the patient group and the control group (P 0.05); There was negative correlation between MCSA and symptom scores (r = -0. 519, P 0.05).@*CONCLUSION@#Acoustic rhinometry was an objective and quantitative method for evaluating nasal airway in children with adenoid hypertrophy. In interpretation the relationships of the results of acoustic rhinometry reflection measurements and subjective symptoms, MCSA should be the main reference.

Phonation Assessment for Alaryngeal Speakers with Different Vowels / 听力学及言语疾病杂志

Objective To compare the alaryngeal speakers'voice acoustic parameters and intra-tracheal pressure when they spoke different vowels.Methods 24 patients after tracheo-esophageal shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy and 16 esophageal speakers enrolled in this study. The voice acoustic parameters were measured when they spoke soft /a/ and soft /i/. The intra-tracheal pressure of 20 TE speakers was measured when spoke /a/ and /i/.Results There were no significant differences between vowel /a/ and /i/ in the two alaryngeal speaker group. The pressure of TE speakers after Shang's procedrue for comfortable /i/ was higher than that for /a/, and there was significant difference.Conclusion There were the same clinical meanings in evaluating alaryngeal voice acoustic aspect. when using vowel /a/ and /i/. However when using different vowel, the intrtracheal pressure was different in TE speakers.