ABSTRACT
Objective To explore the correlation between the patients with hypopharyngeal squamous cell carcinoma of the selective neck lymph dissection of lymph nodes detected quantity and prognosis.Methods Retrospective analysis of the clinical data of 96 cases underwent selective dissection of cervical lymph node in patients with squamous cell carcinoma of the hypopharynx.Results All patients with unilateral selective neck dissection of lymph nodes detected a number of 19.3 ± 11.0,the number of positive lymph nodes 0.8 ± 0.6.Preoperative radiotherapy patients (43 eases) was detected in lymph nodes and the number of positive lymph nodes was 13.8 ± 7.9 and 0.2 ± 0.2,without radiotherapy patients (53 cases) of lymph nodes detected number 23.2 ± 11.9 and 1.0 ± 0.2,the comparison between the two (P ＜ 0.01).According to the number of positive lymph nodes were divided into ≤ 15 group (42 cases) and ＞ 15 group (54 cases),＞ 15 group,the overall survival rate at 3 years and 3 years disease free survival rate and neck control rate was significandy higher than that of ≤ 15 group [70.4％(38/54) vs.38.1％(16/42),61.1％(33/54) vs.33.3％ (14/42),96.3％(52/54) vs.76.2％(32/42)] (P ＜ 0.01 or ＜ 0.05).Multivariate analysis showed that lymph nodes detected a number ＞ 15 was the survival rate of the independent risk factors for overall survival in patients with and without effect (P ＜ 0.05).Conclusion Selective neck dissection of lymph nodes detected number can be used to predict prognosis in patients with squamous cell carcinoma of the hypopharynx.
ABSTRACT
Objective To compare the upper airway changes after H-uvulopalatopharyngoplasty (H-UPPP) combined with transpalatal advancement pharyngoplasty (PA) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Eighty-six patients with OSAHS were selected,39 patients were treated with H-UPPP alone (control group),and 47 patients were treated with H-UPPP combined with PA (observation group).The upper airway changes were measured by CT and apnea hypopnea index (AHI) change in the 2 groups were compared before and after operation.Results The surgery effective rate in observation group was 80.9％ (38/47),in control group was 56.4％ (22/39),there was statistical difference (P ＜ 0.05).The AHI depressed value before and after operation in observation group and control group were (40.5 ± 14.6) times/h and (16.7 ± 12.0) times/h respectively,the hard palate length depressed value were (5.5 ± 3.2) mm and (1.6 ± 0.2) mm respectively,the anteroposterior diameter incremental value of hard palate were (3.6 ± 2.3) mm and (-1.6 ± 3.4) mm respectively,the anteroposterior diameter incremental value of palate and pharynx were (1.6 ± 1.2) mm and (-1.2 ± 1.8) mm respectively,the above indexes in observation group were significantly better than those in control group,there were statistical differences (P ＜ 0.05).The minimum diameter incremental value of retropalatal airway in control group was (13.2 ± 3.1) mm,in observation group was (4.9 ± 1.6) mm,there was statistical difference (P ＜ 0.05).Conclusion H-UPPP combined with PA offers benefit over H-UPPP alone in patients with OSAHS,which may be achieved by increasing anteroposterior diameter of palate and pharynx.