Application of endoscopic ultrasonography in the diagnosis of early esophageal cancer / 国际肿瘤学杂志

Esophageal cancer is one of the most common malignant tumors in clinic, and its morbidity and mortality are always high. Staging is the main basis for comprehensive treatment and prognosis evaluation. Accurate staging is essential for proper diagnosis, individualized treatment and good prognosis. Related technologies of endoscopic ultrasonography can determine the depth of tumor invasion and local lymph node metastasis, which makes the diagnosis of esophageal cancer more accurate, and plays an increasingly important role in the diagnosis and treatment of early esophageal cancer.

Application of combined intracapsular and extracapsular hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in children with OSA / 临床耳鼻咽喉头颈外科杂志

Objective@#The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. @*Method@#We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. @*Result@#There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], t=12.687, P=0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, P=0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, P=0.017）, at the lower pole（χ²=11.961, P=0.001） and grade B（χ²=8.097, P=0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. @*Conclusion@#Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.

Application of combined intracapsular and extracapsular hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in children with OSA / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], =12.687, =0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, =0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, =0.017）, at the lower pole（χ²=11.961, =0.001） and grade B（χ²=8.097, =0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.

Treatment of glottic cancer involving the anterior commissure by transoral CO2 laser surgery / 中华耳鼻咽喉头颈外科杂志

Objective@#To study the clinical outcome of transoral CO2 laser surgery for glottic cancer involving the anterior commissure.@*Methods@#Thirty-two cases of glottic cancer involving the anterior commissure treated by transoral CO2 laser surgery between March 2009 and December 2013 were retrospectively reviewed. Among these cases, 27 were T1bM0M0, 5 were T2N0M0. All cases were followed-up for more than 3 years.@*Results@#All the 32 cases were successfully treated. Perioperative complications included injuries in the soft palate mucosa(13/32, 40.63%), loose incisors(3/32, 9.38%) and subcutaneous emphysema in the neck(2/32, 6.25%). During the follow-up period, granulation was found in all cases. Three cases had local recurrence. Two patients treated by a secondary transoral CO2 laser surgery and the other case had total laryngectomy, all three cases were followed up for 5 years without recurrence. Two cases had regional recurrence but no primary site recurrence. One patient was treated by neck dissection, and followed up for 5 years without recurrence. The other patient died of supraclavicular and mediastinal lymph node metastasis and lung metastasis 40 months after operation. The overall 5-year survival rate was 90.6%. There was no significant difference in survival rate between T1bN0M0(92.6%) and T2N0M0(80.0%) (Log Rank χ2=0.788, P=0.375). The overall 5-year local regional control rate was 84.4%. In T1bN0M0 lesions, the 5-year local regional control rate was 92.6%, which was significantly higher than that in T2N0M0 lesions(40.0%) (Log Rank χ2=9.504, P=0.002).@*Conclusion@#With appropriate surgical indication, detailed preoperative evaluation, good surgical skill, transoral CO2 laser surgery may achieve satisfactory outcome in the treatment of glottic cancer involving the anterior commissure.

Cervical esophagostomy improves the life quality of patients with dysphagia induced by radiotherapy for nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of cervical esophagostomy for the treatment of patients with dysphagia induced by radiotherapy, in order to improve the therapeutic effects.</p><p><b>METHODS</b>A retrospective study was performed on 53 nasopharyngeal carcinoma (NPC) patients with dysphagia, who received cervical esophagostomy. The nutritional status of these patients was measured at five given time before and after operation. The occurrence of pneumonia and reflux esophagitis before and after operation was recorded, and the quality of life based on SF-36 quality of life (QOL) scale was studied.</p><p><b>RESULTS</b>After operation, the nutritional status of these patients improved substantially, including the weight, levels of hemoglobin, total protein, albumin and transferring (P<0.05). The pneumonia-infection decreased from 60.38% (32/53) before operation to 15.22% (7/46) after operation (χ(2)=21.04, P<0.01). The incidences of reflux esophagitis decreased from 26.42% (14/53)without operation to 6.52% (3/46) after operation (χ(2)=5.00, P<0.01). Meanwhile, the status of physical health, mental health as well as physical function and social function of these patients were improved significantly at 1 month, 6 months, 1 year and 2 years after operation (P<0.05).</p><p><b>CONCLUSION</b>Cervical esophagostomy can improve the life quality of patients with dysphagia induced by radiotherapy for nasopharyngeal carcinoma.</p>

Clinical reseach of early laryngocarcinoma treatment by carbon dioxide laser microsurgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carci noma.@*METHOD@#A retrospective study of 112 patients with laryngocarcinoma treated. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society. After the patients were given the general anesthesia and oral intubation, the tumors in the study group were resected along the margin of the tumor under larynscope, and the safety margin was reserved as 3-5 mm. All the patients were followed-up for 12-62 months.@*RESULT@#Eight relapses were detected in 112 cases of glottic laryngeal carcinoma after CO2 laser surgery. The local recurernce rate was 7.14% (8/112),of the rate for T1a, T1b and T2 were 0.89%, 0.89% and 5.04% respectively, with significant differences among groups (chi2 = 5.306, P 0.01).@*CONCLUSION@#According to our reaserch, endoscopic CO2 laser sur gery is an effective treatment for early laryngocarcinoma.

Treatment for benign thyroid nodules with hoarseness as primary symptom / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of operation on Benign thyroid nodules with hoarseness as primary symptom.@*METHOD@#Twelve patients were underwent the operation of subtotal thyroidectomy and exposing of recurrent laryngeal nerve. We evaluating the effect by fibrolaryngoscope and voice acoustic analysis before and after operation.@*RESULT@#All the 12 patients underwent surgery successfully. The hoarseness improved obviously and vocal cords were reactivate. Jitter, shimmer and dysphonia severity index showed significant difference pre and one month after surgery.@*CONCLUSION@#Benign thyroid nodules could also cause vocal cord paralysis and hoarseness, the effect can be satisfying by subtotal thyroidectomy and exposing of recurrent laryngeal nerve if it can be early diagnosed.

Cervical chronic radiation ulceration reconstruction with flap after radiotherapy for nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the application of flaps or musculocutaneous flaps in repairing cervical postradiation ulcer (cpu) at nasopharyngeal carcinoma.@*METHOD@#Deltopectoral flaps and pectoralis major flaps were applied to repair cervical radiation ulceration with different size and depth in 19 cases.@*RESULT@#Twelve cases repaired with deltopectoral flaps and 7 cases repaired with pectoralis major flaps, impaired wound healing happened at distal end of one deltopectoral flap, and the wound was healing hy second intention after debridement and dressing change. All the other deltopectoral flaps and pectoralis major flaps stayed alive. Flaps stayed alive without the recurrence of ulcer after the long-term follow-up for one to ten years.@*CONCLUSION@#The effectiveness of cervical radiation ulceration reconstruction by deltopectoral flaps and pectoralis major flaps was proved. The reconstruction could prevent the recurrence of ulcer. Refer to the poor prognosis of chronic radiation ulceration with expectant treatment, precautions do count.

p53 and PCNA in non-small cell lung cancer / 国际肿瘤学杂志

p53 Gene and proliferating cell nuclear antigen (PCNA) are both related closely to the ra-diotherapy of non-small cell lung cancer(NSCLC). The life span of NSCLC patients with both p53 and PCNA positive is shorter than that of NSCLC patients with both p53 and PCNA negative. Studying the expression of p53 and PCNA in NSCLC, and their relationship with the radiosensitivity and prognosis of NSCLC can play a positive role in individualized treatment and increasing curative effect.

Concurrent radiotherapy and weekly chemotherapy with low-dose cisplatin and 5-fluorouracil for ad-vanced cervical cancer / 国际肿瘤学杂志

Objective To evaluate the therapeutic efficiency and side effect of concurrent radiotherapy and weekly chemotherapy with low-dose eisplatin(DDP) and 5-fluorouracil(5-FU) for advanced cervical canc-er. Methods 73 patients with advanced cervical cancer were randomized into two groups: 37 cases in the chemo-radiotherapy group received radiotherapy combined with DDP 40 mg and 5-FU 500 mg weekly for 6-7 weeks. 36 cases in the only radiotherapy group received radiotherapy alone. Radiotherapy was given with conven-tional fraction,the total tumor dose was 50 Gy. Results The rate of overall response and three-year survival and local recurrenc and distant metastasis for the chemo-radiotherapy group and the only radiotherapy group were 97.30%, 89. 19%, 8. 11% and 10. 81%, and those for the only radiotherapy group were 77.78%,66. 67% ,30.56% and 33.33%. The difference of the four groups was statistically significant ( P <0. 05). The rate of bone marrow inhibition and reaction of digestive tract in chemo-radiotherapy group were higher than those in simple radiotherapy group, but most reactions were grade 1 and grade 2, without statistically significant dife-renee between two groups. Conclusion Concurrent radiotherapy and weekly chemotherapy with low-dose cis-platin and 5-fluorouracil for advanced cervical cancer can significantly improve local control rate and survival rate, and have slight side effects.

Application of voice acoustic analysis in microlaryngoscopic surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the relationship between the effect of microlaryngoscopic surgery of vocal polyp and the change of all-parameters.Method:Acoustic parameters of 80 patients with vocal polyp were measured by Dr .Speech Sciente for Windows, and analyzed preoperatively and postoperatively.Result:The jitter, shimmer and NNE were different significantly between preoperative and postoperative,the NNE and shimmer were more sensitive than jitter.Conclusion:The NNE and shimmer of acoustic parameter are objective parameter to evaluate the effect of the microlaryngoscopic surgery of vocal polyp.