Expression and significance of MTDH and MMP-9 in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the expression changes of metadherin (MTDH) and matrix metalloproteinase-9 (MMP-9) in the laryngeal squamous cell carcinoma tissues and to investigate the significance.@*METHOD@#The expression of MTDH and MMP-9 in 54 cases of laryngeal squamous cell carcinoma tissues(observation group) and 30 cases of para-carcinoma tissues (control group) was examined by immunohistochemical method, the correlation between them and their correlations with the clinicopathological parameters were analyzed.@*RESULT@#The positive expression rates of MTDH in the observation group and control group were 64.8% (35/54) and 6.7% (2/30), respectively; the positive expression rates of MMP-9 in the observation group and control group were 70.4% (38/ 54) and 13.3% (4/30), respectively; and there was a statistically significant difference between two groups (all P < 0.01). In the laryngeal squamous cell carcinoma tissues, the expression of MTDH protein was related with degree of differentiation, lymph-node metastasis and TNM stage (all P < 0.05); and the expression of MMP-9 protein was related lymph-node metastasis and TNM stage (all P < 0.05). The expression of MTDH was positively correlated with MMP-9 in the laryngeal squamous cell carcinoma tissues (r = 0.371, P < 0.01).@*CONCLUSION@#The high expression of MTDH and MMP-9 was closely related to the occurrence, development and metastasis of laryngeal squamous cell carcinoma, joint detection of the two proteins was valuable for early diagnosis and prognosis of laryngeal squamous cell carcinoma.

The clinic experience and literature review with 1 case of chronic tracheoesophageal fistula / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians.@*METHOD@#To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF.@*RESULT@#After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later ,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation.@*CONCLUSION@#If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.

Application of longus colli muscle flap in the repair of pyriform sinus perforation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the result of repair of pyriform sinus perforation using longus colli muscle flap and to provide a new material of esophageal perforation repair.</p><p><b>METHODS</b>A retrospective clinical analysis was conducted on eight cases with pyriform sinus perforation from 2003-2013. Of the patients, 5 were males and 3 females, aged 45 to 68 years with a median age of 51 years. The causes included the esophagoscopy surgery (5 cases), anesthesia intubation (2 cases) and one case of swallowing foreign body. The duration were from seven days to 8 months, with a median duration of one month. All patients were associated with significant neck pain and swallowing pain. The complications were happened in all cases, including high fever in 5 cases, subcutaneous emphysema or mediastinal emphysema in 5 cases , and mediastinal abscess in 3 cases. The longus colli muscle flap was used to repair the perforation.</p><p><b>RESULTS</b>The success rate of surgical repair was 100% in all 8 cases. No recurrence or esophageal stricture occured during the follow-up of six months to 10 years. Three cases complicated by mediastinal abscess and 1 case by piriform sinus-mediastinum -pleural fistula, which cured after combined treatment.</p><p><b>CONCLUSIONS</b>Traumatic pyriform sinus perforation may cause serious complications. Early surgical repair is needed. The longus colli muscle flap is an ideal material for the repair of pyriform sinus perforation.</p>

Treatment of cervical esophageal perforation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the repair of cervical esophageal perforation using cervical muscle flap and provide a new material of esophageal perforation repair.@*METHOD@#To report 12 cases of cervical esophageal perforation among which 8 cases was repaired using cervical muscle flap.@*RESULT@#100% success rate of surgical repair was observed with all 12 cases. No case of recurrence or esophageal stricture occurred by follow-up six months to 10 years.@*CONCLUSION@#Traumatic cervical esophageal perforation easily had serious complications, with high mortality rates and the prognosis was poor. Early intervention of surgical repair could improve the survival rate of patients.

The relationship between pleomorphic adenocarcinoma and dermatomyositis (with a case report and review of the literatures) / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The purpose of this article is to improve the understanding of complications of pleomorphic adenocarcinoma, and the possibility of complicated with dermatomyositis. In order to explore whether there is a certain relationship between the two diseases.@*METHOD@#Reported one patient in our hospital with the diagnosis of pleomorphic adenocarcinoma complicated dermatomyositis, and clarified the diagnosis and treatment of these two diseases during hospitalization. Reviewed the latest clinical literature relevant to pleomorphic adenocarcinoma and dermatomyositis.@*RESULT@#The patients underwent superficial parotidectomy treatment. The postoperation pathologic and immunohistochemical examination confirmed the diagnosis of pleomorphic adenocarcinoma. Dermatomyositis improved better after the operation.@*CONCLUSION@#Pleomorphic adenocarcinoma has the possibility of complicated with dermatomyositis which may misdiagnosis in clinical practice. Summarize the latest diagnosis progress of pleomorphic adenocarcinoma and the surgical treatment of the tumor. Also discuss the standards of clinical diagnosis and treatment of dermatomyositis. Analysis there may be a relationship between the two diseases on autoimmune mechanism.

Utilization of functional neck dissection for treatment of recurrent branchial cleft anomalies / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the utilization of functional neck dissection for treatment of recurrent branchial cleft anomalies.@*METHOD@#Fifteen patients with recurrent branchial cleft anomalies (fistula and cyst) undergoing functional neck dissection were retrospectively analyzed.@*RESULT@#Complications included 2 incisions secondary healing, 1 postoperative choking persisting for 1 months and 1 Horner's syndrome. There was no recurrence after a follow up from 2 months to 6 years,except 2 cases were lost to follow-up.@*CONCLUSION@#Functional neck dissection is an effective and safe surgical management for recurrent second and third branchial cleft anomalies(fistula and cyst).

Investigation of the surgical approach for resecting infratemporal fossa pterygomaxillary fossa-parapharyngeal space tumor / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the optimal surgical approach for resecting infratemporal fossa-pterygomaxillary fossa-parapharyngeal space tumor. The aim of this study is to enhance therapeutic effect and reduce complications and sequelae.@*METHOD@#Sixty-six patients with infratemporal fossa-pterygomaxillary fossa-parapharyngeal space tumor were analyzed retrospectively from 1998-2004, including complains, symptoms, physical signs; histodiagnosis, image examinations and surgical approaches.@*RESULT@#No recurrence was found in fifty benign tumor cases after 2 to 5 years, while in 16 cases with malignant tumor, four patients died in one year, 8 cases died in 2 to 4 years, and only 4 patients' survival time exceeded 4 years.@*CONCLUSION@#Extended maxillectomy is suitable for resecting primary carcinoma of maxillary sinus invading pterygomaxillary fossa, infratemporal fossa and /or parapharyngeal space tumor. also midface degloving approach is suitable for nasal primary cavity, nasal sinuses, nasopharynx and/or pterygomaxillary fossa tumor and localized malignant tumor. Trans-cervical combining mandibular split swing approach is suitable for parapharyngeal space tumor invading pterygomaxillary fossa and/or infratemporal fossa tumor. Trans-cervical jaw combining mandibulotomy is suitable for resecting parapharyngeal space, infratemporal fossa tumor for invading lateral skull base and pterygomaxillary fossa tumor.

Diagnosis and therapy of bronchial foreign body in aged patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the proper diagnosis and therapy method in aged patients with bronchial foreign body.@*METHOD@#A retrospective analysis was performed on 15 aged patients with bronchial foreign body by clinical characteristics. The experience of diagnosis and therapy in these cases were summarized.@*RESULT@#Misdiagnosed or missed diagnosis were found in 6 of 15 aged patients with bronchial foreign body. Three bronchial foreign bodies were taken out successfully under topical anesthesia. Twelve bronchial foreign bodies were taken out under topical anesthesia and balanced anesthesia. No complications happened in all case.@*CONCLUSION@#Clinical manifestation of bronchial foreign body is often unrepresentative in most aged patients. The chest X-ray of most cases can not show actual appearance of foreign bodies. In addition, history of foreign body in bronchus is often uncertain. So bronchial foreign bodies have often been misdiagnosed or missed diagnosed in aged patients. Suitable anesthesia method is the key to taking out bronchial foreign body in aged patients.

The expressions and significance of CK2 in normal laryngeal mucosa, laryngeal precancerosis and laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of protein kinase CK2 and its relationship with the development, progress, invasion and metastasis of squamous cell carcinoma of larynx (LSCC).@*METHOD@#Immunohistochemical SP staining method was used to assess the expression of CK2 in 18 cases of normal laryngeal mucosa, 14 cases of polyp of vocal cord, 11 cases of larynx papilloma and 50 cases of LSCC patients. And RT-PCR was used to detect the expression of CK2alpha mRNA and CK2beta mRNA in 50 cases of LSCG patients. The relationship between CK2alpha and CK2p was evaluated.@*RESULT@#The positive expression rate of CK2alpha and CK2beta in normal laryngeal mucosa, polyp of vocal cord and tissues close to carcinoma by 1.0 cm, nonmetastatic lymph nodes were lower than that in tissues close to carcinoma by 0.5 cm and laryngeal papilloma. The positive expression rate of CK2alpha and CK2beta in laryngeal carcinoma and metastatic lymph nodes were the highest among the groups. The expression rate of CK2alpha and CK2beta in tissues of laryngeal carcinoma and metastatic lymph nodes of neck was significantly higher than that of laryngeal papilloma and tissues close to carcinoma by 0.5 cm (P < 0.05). In the group of LSCC, the expression of CK2alpha in G2 and in G3 was significantly higher than that in G1 (P < 0.05). While the age of the patients, TNM stage and lymphatic metastasis didn't change in the expression of CK2alpha obviously. The expression of CK2beta correlates to the differentiation grading and lymphatic metastasis in LSCC patients, but not to the age and TNM stage. The result from RT-PCR was highly consistent with that from immunohistochemical SP staining. There was a positive correlation between the expression of CK2alpha in LSCC patients and that of CK2beta.@*CONCLUSION@#The over expression of protein kinase CK2 may be an accelerator to the formation and development of LSCC. Protein kinase CK2 may be one of the predictors for the malignant grade of LSCC. To inhibit the over expression might be new therapeutic methods for LSCC.

Relationship between the Expression of CD44v6 and Development, Progress, Invasion and Metastasis of Laryngeal Carcinoma / 华中科技大学学报（医学）（英德文版）

Summary: The expression of CD44v6 and its relationship with the development, progress, invasion and metastasis of laryngeal carcinoma was investigated. The expression and content of CD44v6 mRNA in tissuess were detected by both RT-PCR and FCM which were respectively extracted from normal laryngeal mucosa, leukoplakia of larynx, laryngeal papilloma, polyp of vocal cord, tissues of laryngeal carcinoma, metastatic and nonmetastatic lymph nodes of neck, and tissues close to carcinoma. The outcome of RT-PCR indicated that the expression rate of CD44v6 mRNA involved in tissues of laryngeal carcinoma and metastatic lymph nodes of neck was the highest (90 %-100 %) compared with that of leukoplakia of larynx, laryngeal papilloma, tissues close to carcinoma by 0.5 cm (55.56 %-60.00 %) and that of normal laryngeal mucosa, polyp of vocal cord, nonmetastatic lymph nodes and tissues close to carcinoma by 1.0 cm was the lowest ( 13.33 %-20 %). The result from FCM was highly consistent with that from RT-PCR. It was suggested that CD44v6 was closely related with the development, progress, invasion and metastasis of laryngeal carcinoma. The outcome from the tissues close to carcinoma by different distance could do help to the determination of incisal edge in surgery abstractly.