Endoscope-assisted lauromacrogol inject ion for hemangioma of pharynx and larynx / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the efficacy and safety of local lauromacrogol injection in the treatment of laryngopharyngeal hemangioma. METHODS A total of 10 patients suffering from hemangioma of pharynx and larynx from Aug 2015 to Mar 2018 were collected. Endoscope assisted local lauromacrogol injection under topical was used. The therapeutic effects were observed and analyzed.RESULTS All patients were followed up for 3 months to 1 year. Among them, 9 cases were cured and 1 was obviously effective for totally 1 to 4 (mean 1.9) injections. All patients complained of postoperative pain or foreign body sensation, 3 patients were significantly affected by local swelling of the injection site. 2 patients underwent tracheostomy and 1 patient returned to ward with endotracheal intubation postoperatively. No complications such as mucosal ulceration, fever, allergies occurred. CONCLUSION Lauromacrogol injection is a safe and effective method to treat hemangioma of pharynx and larynx.

Window partial laryngectomy with endoscopy for the treatment of stage T1b--T3 laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the operative effect and value of window partial laryngectomy with endoscopy for treatment of stage T1b--T3 laryngeal cancer.@*METHOD@#Twenty-seven cases with glottic laryngeal cancer were treated by window partial laryngectomy with endoscopy. After 3-year and 5-year survival rate and laryngeal functions (respiratory, pronunciation, swallowing function) recovery were evaluated.@*RESULT@#The 3- and 5-year survival rates were 83.3% (15/18) and 75.0% (9/12) respectively. The decannulation rate was 92.6% (25/27) 4 weeks after operation. Three months after decannulation of respiratory function evaluation: the march to fast runner 77.8% (21/27), the jogger 14.8 (4/27), who walk briskly 7.4% (2/27). All patients had recovered after four weeks swallowing without choking cough and satisfied with phonation. Local recurrence rates at 3 and 5 year after operation were 10.5% (2/19) and 15.4% (2/13) respectively.@*CONCLUSION@#The research shows that window partial laryngectomy with endoscopy was applicable to stage T1b--T2 and selecting T3 laryngeal cancer patients. Postoperative respiratory, pronunciation and swallowing function recovery rate is satisfactory.

The expression of MMP-2, E-cadherin in supraglottic carcinoma and their relationship with cervical lymph node metastasis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expressions of matrix metalloproteinase-2 (MMP-2) and E-cadherin in laryngeal carcinoma and their relationship with cervical lymph node metastasis.@*METHOD@#The expression of MMP-2 and E-cadherin in 10 cases of normal laryngeal mucosa and 48 cases of supraglottic carcinoma were detected by immunohistochemistry.@*RESULT@#The expression of MMP-2 in supraglottic carcinoma was significantly higher than that in normal laryngeal mucosa. The expression of MMP-2 in metastatic lymph nodes was significantly higher than that in nonmetastatic lymph nodes (P < 0.05). The expression of E-cadherin was significantly lower in supraglottic carcinoma than that in normal laryngeal mucosa. The expression of E-cadherin was significantly lower in metastatic lymph nodes than that in nonmetastatic lymph nodes (P < 0.05). There is a negative correlation between the expression of MMP-2 and E-cadherin (r = -0.41). Predicting the lymph node metastasis of laryngeal carcinoma with the index of MMP-2(+), E-cadherin(-) and MMP-2(+), E-cadherin(-). MMP-2(+) has the highest sensitivity, but the lowest specificity and positive predictive value. MMP-2(+), E-cadherin(-) has the highest specificity and positive predictive value, but the lowest sensitivity.@*CONCLUSION@#Expression of MMP-2 and E-cadherin can be used as a marker to predict lymph node metastasis of supraglottic carcinoma. Combined the detection of MMP-2 and E-cadherin can boost the accuracy of prediction of lymph node metastasis in supraglottic carcinoma and provide efficient assistance for resecting supraglottic carcinoma.

Local anesthesia in endoscopic sinus surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the feasibility of endoscopic sinus surgery under local anesthesia.METHODS A total of 810 patients underwent endoscopic sinus surgery from January 2000 to December 2007 with complete follow-up data were included in this study.Validity of anesthesia was evaluated using VAS(visual analogous scale).Operation time,bleeding quantity during operation,operation therapeutic efficacy,hospitalization cost and patient's evaluation to the operation were recorded.RESULTS The mean VAS score of local anesthesia was 3.18?0.46.Cases with no pain and mild pain accounted for 78.28%,with moderate pain 16.71%,and with severe pain 5.01%.The average bleeding quantity during operation,operation time,complication incidence,cure rate at 6 months after operation,hospitalization cost,patients' evaluation in local anesthesia were(43.25?27.46)ml,(41.14?9.479) min,1.78%,78%,4000～6000 yuan(RMB),9.28? 2.21 respectively.CONCLUSION For the endoscopic sinus surgery,most cases can be operated under local anesthesia if the indication were selected correctly and the sophisticated skills and advanced instrument were available.

Endoscopic nasal reshaping of the structure in structural rhinitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the methods and effects of endoscopic nasal structure reshaping for treatment of chronic rhinosinusitis(CRS). METHODS One hundred and twenty-three cases of CRS patients with abnormal anatomy in nasal cavity and sinus were treated by the Messerklinger approach. At the same time varieties of anatomical abnormalities were corrected,including:①submucous resection of nasal septum,②submusous middle turbinate resection,③submusous inferior turbinate resection,④Uncinate process resection ⑤deal with frontal recess and its adjacent cells. RESULTS All patients were followedup for 1 to 2 years. One hundred and six cases were successful,14 satisfied and 3 inefficient. The rate of full recovery was 97.56%. CONCLUSION Reshaping nasal structure during endoscopic surgery is a method worth recommendation for structural rhinitis.

Endoscopic surgery in nasal-skull base tumor / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the efficacy and feasibility of endoscopic surgery to manage the tumors involving naso-ethmoidal complex and anterior skull base.METHODS 19 cases of tumors involving nasal cavity,ethmoid sinus and anterior skull base were summarized retrospectively, including 3 cases of ethmoidal squamous carcinoma, 3 cases of esthesioneuroblastoma,3 cases of melanoma,1 case of plasmocytoma,2 cases of ethmoidal adenocarcinoma,4 cases of adenoid cystic carcinoma,2 cases of meningioma.RESULTS Tumors were totally removed in 18 cases and subtotally removed in 1 case,all the cases were followed up for 1 to 3 years.Of the 3 cases of melanoma,1 case died of brain metastases 1 year after surgery,1 case recurred 8 months after surgery,1 case of adenoid cystic carcinoma recurred 17 months after surgery.No recurrence were found in the rest 16 cases during 1-3 years of following-up.CONCLUSION Endoscopic surgery is a effective method for malignant tumors localized in nasal cavity and ethmoid sinus and benign anterior skull base tumors involving nasal cavity and sinuses.Indication must be carefully selected for malignant tumors and postoperative radiotherapy should be advised.