Clinical application of combined infratemporal fossa approaches for internal carotid artery in petrous bone reconstruction for large lateral skull base tumors / 中华耳鼻咽喉头颈外科杂志

Objective: By summarizing the technical points and therapeutic outcomes of combing infratemporal fossa approach (IFA) and internal carotid artery (ICA) reconstruction for the colossal skull base tumor invading ICA in petrous bone, the clinical application value was discussed. Methods: Five patients (2 males, 3 females,aging from 27 to 55 years old) who received surgeries between July 2015 and May 2017 for lateral skull base pathology involved petrous ICA using technique combined IFA and pre-reconstruction, were reviewed. Results: Among the five patients, three were paraganglioma of head and neck, one was carotid aneurysms, and one was recurrent adenoid cystic carcinoma (ACC). The median tumor size in the largest cross-section was 60 mm × 51 mm (range, 28 mm × 22 mm-72 mm × 58 mm). Complete excision was achieved with IFA and ICA reconstruction. The median blood loss volume was 1 000 ml (range, 600-2 500 ml). Four cases showed no new long-term neurologic sequelae, while one showed hemiplegia due to graft vessel occlusion. Except for the one with ACC having facial nerve cut, others achieved good facial nerve function of HB grade Ⅰ to Ⅱ during 3 to 12 months, follow-up. No tumor recurrence was observed over the median duration of follow-up for above 36 months (range, 36-58 months). Conclusion: For lesions involved superior part of ICA, which is unable to separate from ICA, IFA and ICA reconstruction can achieve complete excision.

The application of magnetic resonance imaging-guided microwave ablation for lung cancer

Context: It is necessary to explore a minimally invasive, effective, and efficient treatment for those lung cancer patients who are poor candidates for surgery. Aim: This study aimed to investigate the application of microwave ablation (MWA) in the treatment of lung cancer. Settings and Design: A total of 43 patients with 44 pulmonary lesions were examined following identical procedures before being randomly divided into two groups. The experimental group consists of 17 patients with a total of 18 pulmonary lesions, while the control group consists of 26 patients with a total of 26 pulmonary lesions. Materials and Methods: The experimental group was treated using magnetic resonance imaging (MRI)-guided MWA while the control group was treated using computer tomography (CT)-guided MWA. A transverse relaxation time-turbo spin echo (T2-TSE) sequence was used for signal collection in the experimental group to determine puncture location and microwave needle position while T2-TSE, T1-turbo field echo, and diffusion-weighted MRI (DWI) sequences were used for timely efficacy evaluation. Whereas in the control group, CT axial scanning was performed to serve similar purposes. Statistical Analysis Used: A nonparametric Wilcoxon test, median (M [25%, 75%]). Results: All of the 44 lesions were successfully located on the first attempt. The mean time for scanning and locating lung lesions under MRI and CT guidance were 64.53 and 42.96 min, the mean times of positioning were 12 and 18 min, and the mean durations of MWA were 12.48 and 15.06 min, respectively. Conclusions: As a minimally invasive method for treating lung tumors, MRI-guided MWA requires fewer localization scans, a shorter MWA duration, no radiation, real-time observation of the curative effect, and it prevents overtreatment

Effect of Early Weight-bearing on Appropriate Population with Intertrochanteric Fracture after Surgery / 中国康复理论与实践

Objective:To observe the effect of early weight-bearing on the appropriate population with intertrochanteric fracture after surgery. Methods:From April, 2017 to December, 2018, a total of 45 patients with Evans-Jensen type II intertrochanteric fracture and fracture reduction as positive medial cortex support (PMCS) after proximal femoral nail anti-rotation (PFNA) fixation were randomly divided into control group (n = 22) and experimental group (n = 23). Weight-bearing as tolerated (WBAT) was initiated from six weeks after surgery in the control group, and within 48 h after surgery in the experimental group. The frequency of WBAT in two groups increased gradually from three times a day for ten minutes a time to five times a day for 20 minutes a time until clinical healing of fracture. The length of stay, hospital cost, the fracture healing time and the complication incidence were compared between two groups, as well as the scores of Visual Analogue Scale (VAS) and Harris Hip Score at six weeks, three months and six months after surgery. Results:Compared with the control group, the length of stay was shorter (t = 3.716, P < 0.01), the hospital cost was lower, but no significant difference was found (t = 1.540, P > 0.05), and the fracture healing time was shorter (t = 6.248, P < 0.001) in the experimental group. The complication incidence was lower in the experimental group, but there was no significant difference (χ2= 2.198, P > 0.05). Six weeks, three months and six months after surgery, there was no significant difference in the score of VAS between two groups (t < 1.330, P > 0.05). The score of Harris Hip Score was significantly higher in the experimental group than in the control group six weeks after surgery (t = -5.115, P < 0.001), however, no significant difference was found in other time points (|t| < 1.799, P > 0.05). Conclusion:Early weight-bearing within 48 h after PFNA fixation for Evans-Jensen type II intertrochanteric fractures and reduction with PMCS could shorten the length of stay, shorten the bony healing time and promote early recovery of hip function.

Clinical and electrophysiological profiles in early recognition of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes syndrome / 中华医学杂志(英文版)

Background@#The detection of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome at early stage is challenging for neurologists. Since polyneuropathy could be the first manifestation, it could be misdiagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP). The present study aimed to determine the clinical and electrophysiological features of POEMS syndrome to distinguish from CIDP.@*Methods@#The data of a group of patients with POEMS (n = 17) and patients with CIDP (n = 17) in Zhongshan Hospital Fudan University from January 2015 to September 2017 were analyzed in this retrospective study. The clinical features, neurological symptoms, and electrophysiological findings were compared between the two groups.@*Results@#Clinically, patients with POEMS demonstrated significantly more neuropathic pain in the lower extremities than patients with CIDP (58.8% vs. 11.8%, P = 0.01). Multisystem features like edema, skin change, organomegaly, and thrombocytosis were also pointed towards the diagnosis of POEMS syndrome. Electrophysiologically, terminal latency index (TLI) was significantly higher in patients with POEMS than that in patients with CIDP (median nerve: 0.39 [0.17–0.52] vs. 0.30 (0.07–0.69), Z = –2.413, P = 0.016; ulnar nerve: 0.55 [0.23–0.78] vs. 0.42 [0.12–0.70], Z = –2.034, P = 0.042). Patients with POEMS demonstrated a higher frequency of absent compound muscle action potential of the tibial nerve (52.9% vs. 17.6%, P = 0.031), less conduction block (ulnar nerve: 0 vs. 35.3%, P = 0.018), and less temporal dispersion (median nerve: 17.6% vs. 58.8%, P = 0.032) than CIDP group. The combination of positive serum monoclonal protein and high TLI (if either one or both were present) discriminated POEMS from CIDP with a sensitivity of 94.1% and 47.1% and specificity of 76.5% and 100.0%, respectively.@*Conclusions@#POEMS syndrome could be distinguished from CIDP through typical clinical and electrophysiological characteristics in practice. The combination of serum monoclonal protein and high TLI might raise the sensitivity of detecting POEMS syndrome.

Clinical and electrophysiological profiles in early recognition of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes syndrome / 中华医学杂志(英文版)

BACKGROUND@#The detection of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome at early stage is challenging for neurologists. Since polyneuropathy could be the first manifestation, it could be misdiagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP). The present study aimed to determine the clinical and electrophysiological features of POEMS syndrome to distinguish from CIDP.@*METHODS@#The data of a group of patients with POEMS (n = 17) and patients with CIDP (n = 17) in Zhongshan Hospital Fudan University from January 2015 to September 2017 were analyzed in this retrospective study. The clinical features, neurological symptoms, and electrophysiological findings were compared between the two groups.@*RESULTS@#Clinically, patients with POEMS demonstrated significantly more neuropathic pain in the lower extremities than patients with CIDP (58.8% vs. 11.8%, P = 0.01). Multisystem features like edema, skin change, organomegaly, and thrombocytosis were also pointed towards the diagnosis of POEMS syndrome. Electrophysiologically, terminal latency index (TLI) was significantly higher in patients with POEMS than that in patients with CIDP (median nerve: 0.39 [0.17-0.52] vs. 0.30 (0.07-0.69), Z = -2.413, P = 0.016; ulnar nerve: 0.55 [0.23-0.78] vs. 0.42 [0.12-0.70], Z = -2.034, P = 0.042). Patients with POEMS demonstrated a higher frequency of absent compound muscle action potential of the tibial nerve (52.9% vs. 17.6%, P = 0.031), less conduction block (ulnar nerve: 0 vs. 35.3%, P = 0.018), and less temporal dispersion (median nerve: 17.6% vs. 58.8%, P = 0.032) than CIDP group. The combination of positive serum monoclonal protein and high TLI (if either one or both were present) discriminated POEMS from CIDP with a sensitivity of 94.1% and 47.1% and specificity of 76.5% and 100.0%, respectively.@*CONCLUSIONS@#POEMS syndrome could be distinguished from CIDP through typical clinical and electrophysiological characteristics in practice. The combination of serum monoclonal protein and high TLI might raise the sensitivity of detecting POEMS syndrome.

Design and Realization of Independent Calling Device for Patients with Amyotrophic Lateral Sclerosis / 中国康复理论与实践

@#Objective To design a device for the patients with amyotrophic lateral sclerosis (ALS), who are disable to speak and move, to call for the nurses independently when necessary. Methods The electroencephalographic signals were collected and processed with TGAM, and the extracted attention characteristic values were transmitted to a computer with Bluetooth. The loudspeaker would call the nurses when the attention characteristic value exceeds the normal range. Results In the testing process of 20 participants in 10 tests, the success rate was 81.5%, and the average misjudged frequence was 0.2 within 20 min. Conclusion The device can be used in the nursing of the patients with ALS to meet the needs of daily nursing work.

Intratympanic versus systemic steroid treatment for idiopathic sudden hearing loss: a meta-analysis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To assess the effectiveness and safety of intratympanic versus systemic steroid therapy in the initial treatment of idiopathic sudden hearing loss.</p><p><b>METHODS</b>An extensive search of the literature was performed in Pubmed and other available database from January, 1980 to November, 2011. After filtering by the criteria of Cochrane Collaboration, a meta-analysis was conducted.</p><p><b>RESULTS</b>Nine studies met the criteria for meta-analysis, for idiopathic sudden hearing loss patients without diabetes received intratympanic steroid therapy, the improvement rate (RR = 1.11,95% CI = 0.96-1.28, P = 0.15) did not show any significance when compared with the patients received systemic therapy. While a significant difference of improvement rate occurred between intratympanic and systemic steroid therapy in the idiopathic sudden hearing loss patients with diabetes (RR = 1.24, 95% CI = 1.02-1.50, P = 0.03).</p><p><b>CONCLUSION</b>For the initial therapy of idiopathic sudden hearing loss patients without diabetes, systemic steroid treatment still remains the first choice, but for the idiopathic sudden hearing loss patients with diabetes, intratympanic steroid treatment should be used for the initial treatment.</p>

Quality of life survey on patients with peripheral facial paralysis by using Chinese version of the FaCE scale / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the health related quality of life (QOL) status of patients with peripheral facial paralysis.</p><p><b>METHODS</b>By introducing, translating and adjusting of the FaCE (Facial Clinimetric Evaluation) scale, a Chinese version came into being. The scale was further strictly tested in eighty-one patients with peripheral facial paralysis and thirty healthy volunteers.</p><p><b>RESULTS</b>The feasibility, reliability, validity and responsibility of Chinese version of FaCE scale all passed the test. The split-half reliability, Cronbach's alpha and intraclass correlation coefficient were 0.79, 0.88 and 0.87, respectively. The criteria validity calculated between FaCE and SF-36 was 0.41 (P < 0.05). Factor analysis of the construct validity showed that the 15 items were classified into six domains, which were in accordance with the original version. Every domain was sensitive and effective to discriminate between patient population and healthy population (P < 0.05). Chinese version of FaCE scale showed significant correlation with HBGS and SBGS scores (r = -0.40 and 0.42, P < 0.05).</p><p><b>CONCLUSION</b>Chinese version of the FaCE scale can effectively assess QOL status of patients with facial paralysis in China.</p>

Diagnosis and treatment of facial nerve schwannoma in patients with normal facial nerve function or slight facial palsy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of facial nerve schwannomas with facial nerve function House-Brackmann grade (HB) ≤ grade II.</p><p><b>METHODS</b>A retrospective study was conducted in Peking Union Medical College Hospital. We reviewed eight cases of facial nerve schwannomas with facial nerve function HB ≤ grade II, which were diagnosed and managed between Jan 1996 and March 2011.</p><p><b>RESULTS</b>The initial presenting symptoms of the eight patients were not facial paralysis. Eight patients were misdiagnosed and six had mistreatment histry. CT and(or) MRI results in all patients showed that the tumors originated from different part of the facial nerves. All patients received operation. Facial nerves were completely preserved in four patients because of easy separation of the tumors from the facial nerves in surgery, facial function was gradeII-III over 17 - 180 months' follow-up. The tumors were attached with the facial nerves in two patients with wide extension involving cochlea and labyrinth, therefore the tumors were removed together with the attached facial nerves, and the nerves were repaired by using the greater auricular nerves. Facial function was grade VI over 56 - 79 months' follow-up. One patient refused to sacrifice the facial nerve, wide decompression of facial nerve and tumor was undertaken, facial function was grade III over 8 months' follow-up. One chorda tympani neuroma was removed with the branch of the facial nerve, facial function was grade II over 8 months' follow-up.</p><p><b>CONCLUSIONS</b>The facial nerve schwannomas with facial nerve function HB ≤ grade II is difficult to diagnosis. The therapy strategy should depend on the patients' choice, position of the tumor and adherences of the tumor to facial nerve. Facial nerve could be preserved if the tumor is easy to be separated from the facial nerve during operation, if not, total remove the tumor and nerve repairment are indicted when invasion into the inner ear canal, cerebro pontine angle, cochlea or labyrinth. If patients refuse to sacrifice the facial nerve, facial nerve decompression and periodic follow-up are recommended.</p>

Facial paralysis induced by herpes simplex virus type 1 and the study of facial neurons apoptosis in mice / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the apoptosis of facial motor neurons and the expression of apoptosis-related genes, Bcl-2 and Bax, in the animal model of viral facial paralysis.</p><p><b>METHODS</b>Total of 84 Balb/c mice were divided into viral inoculation group and nerve transaction group. The animals were executed 1, 3, 7, 10, 15, 20 and 30 days after being operated respectively. The histopathological features of facial neurons in brain stem were observed by HE and Nissl stain. The changes of facial neuronal apoptosis were observed by TUNEL. The changes of expression of Bcl-2 and Bax genes in facial neurons were observed by immunohistochemistry staining.</p><p><b>RESULTS</b>After nerve transection, increased apoptotic cells were found in homolateral facial motor nucleus and the peak appeared at 10 and 15 days. The level of Bcl-2 expression in neurons declined while the expression of Bax increased gradually. Correspondingly, the ratio of Bcl-2/Bax declined. In the viral inoculation group, no visible change of apoptosis and Bax expression, but the level of Bcl-2 and the ratio of Bcl-2/Bax increased gradually.</p><p><b>CONCLUSIONS</b>Comparing to axotomy, facial motor nucleus in HSV-1 infective animal model are free of apoptosis. Both the mild form of lesion and the ability to block apoptosis of HSV-1 are likely to be involved into the phenomenon. Bcl-2 and Bax might interfere with the apoptotic response.</p>

Three-dimensional anatomical research on sellar region for transnasal endoscopic surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop a new method to explore the three-dimensional characteristics of anatomical structures at the sellar region in transnasal endoscopic surgery.</p><p><b>METHODS</b>(1) The MicronTracker binocular visual navigation system was modified, and the tool's accuracy was tested by comparing the vernier caliper and turntable. (2) The basis nasi plane and median sagittal plane were used as datum plane, S point (the lateral margin point of nasal spine) and M point (maxillary line midpoint) were used as datum point to orientate the structures. The pitching angle, direction angle and distance of the important structures were measured by the tool designed by us based on the MicronTracker binocular visual navigation system and made a computer graphics model.</p><p><b>RESULTS</b>(1) The tool's accuracy had no statistical difference as compared with vernier caliper and turntable. (2) The pitching angle, direction angle and distance of the important structures were obtained. (3) 3D-max 9.0 and AutoCAD-2008 were used to set up three-dimensional anatomical model of the anatomical structures.</p><p><b>CONCLUSION</b>Based on the familiar point and datum of the skull, the orientation data of the important structures could be obtained and the three-dimensional model of the sella region anatomical structures could be constructed.</p>

DR image denoising based on Laplace-Impact mixture model / 中国医疗器械杂志

A novel DR image denoising algorithm based on Laplace-Impact mixture model in dual-tree complex wavelet domain is proposed in this paper. It uses local variance to build probability density function of Laplace-Impact model fitted to the distribution of high-frequency subband coefficients well. Within Laplace-Impact framework, this paper describes a novel method for image denoising based on designing minimum mean squared error (MMSE) estimators, which relies on strong correlation between amplitudes of nearby coefficients. The experimental results show that the algorithm proposed in this paper outperforms several state-of-art denoising methods such as Bayes least squared Gaussian scale mixture and Laplace prior.

Effects of CD4+ T cell transplantation on facial motoneuron survival in nude mice model with facial nerve axotomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the specific T cell subpopulation and the relationship with facial motoneuron in immune deficiency mouse model with facial nerve paralysis, so as to find information for new strategy of facial palsy treatment.</p><p><b>METHODS</b>Firstly, purifying the CD4+ T cell from wild type mouse and reestablishing the immune function of nude mouse by infusing the CD4+ T cell through the tail vein a week before the surgery. Then the all nude mouse (BALB/c background) and wild type mouse (BALB/c background) were subjected to a right facial nerve axotomy. Then the mouse was studied by application and assessment with fluorogold retro tracer at specific time. After collecting the slices of brain stem three days post the operation, the facial motoneurons was observed under fluorescence microscope, then analyzed and counted with the software Image Pro Plus5. 1.</p><p><b>RESULTS</b>The number of survival facial motoneuron in the group with CD4+ T cell transplantation and control group was (3444.5 +/- 84.2, x +/- s) and (3013.2 +/- 65.3) respectively. There was significant difference of the number of survival facial motoneurons between nude mouse transplanted with CD4+ T cell and PBS at three days post the operation (t = 5.52, P = 0.0003). But there was no significant difference of survival facial motoneurons between nude mouse transplanted with CD4+ T cell and wild type mouse three days post the operation (t = 0.49, P = 0.6347). It was the transplantation of CD4+ T cell that rescued the survival facial motoneuron to the level of wild type.</p><p><b>CONCLUSIONS</b>CD4+ T cell have the ability to rescue the injuring facial motoneuron from death. It may suggest that there is a critical role of the specific T cell subpopulation in facial nerve repair and regeneration.</p>

Surgical treatment in otogenic facial nerve palsy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the character of facial nerve palsy due to four different auris diseases including chronic otitis media, Hunt syndrome, tumor and physical or chemical factors, and to discuss the principles of the surgical management of otogenic facial nerve palsy.</p><p><b>METHODS</b>The clinical characters of 24 patients with otogenic facial nerve palsy because of the four different auris diseases were retrospectively analyzed, all the cases were performed surgical management from October 1991 to March 2007. Facial nerve function was evaluated with House-Brackmann (HB) grading system.</p><p><b>RESULTS</b>The 24 patients including 10 males and 14 females were analysis, of whom 12 cases due to cholesteatoma, 3 cases due to chronic otitis media, 3 cases due to Hunt syndrome, 2 cases resulted from acute otitis media, 2 cases due to physical or chemical factors and 2 cases due to tumor. All cases were treated with operations included facial nerve decompression, lesion resection with facial nerve decompression and lesion resection without facial nerve decompression, 1 patient's facial nerve was resected because of the tumor. According to HB grade system, I degree recovery was attained in 4 cases, while II degree in 10 cases, III degree in 6 cases, IV degree in 2 cases, V degree in 2 cases and VI degree in 1 case.</p><p><b>CONCLUSIONS</b>Removing the lesions completely was the basic factor to the surgery of otogenic facial palsy, moreover, it was important to have facial nerve decompression soon after lesion removal.</p>

Quality of life survey on patients with chronic rhinosinusitis by using Chinese version of the 22-item sinonasal outcome test (SNOT-22) / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the health-related quality of life (QOL) status of patients with chronic rhinosinusitis.</p><p><b>METHODS</b>Sixty four patients with chronic rhinosinusitis and twenty healthy volunteers were enrolled, and their QOL scores were assessed by using SF-36 questionnaire (Chinese version) and SNOT-22 questionnaire translated into Chinese.</p><p><b>RESULTS</b>The feasibility, reliability, validity, and responsibility of Chinese version of SNOT-22 questionnaire all passed the test. It showed that by Chinese version of SNOT-22 questionnaire the most five important items affecting health status were nasal obstruction, runny nose, loss of smell or taste, dizziness and post-nasal discharge respectively. The coefficient of correlation was 0. 233 between the SNOT-22 questionnaire and the Lund-MacKay CT score of patients with chronic rhinosinusitis.</p><p><b>CONCLUSIONS</b>Chinese version of SNOT-22 questionnaire can effectively assess the QOL status of patients with chronic rhinosinusitis. It showed less correlation between the SNOT-22 questionnaire and the Lund-MacKay CT score of patients with chronic rhinosinusitis.</p>

Clinical analysis of primary facial nerve neuroma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features of facial nerve neuroma about its diagnosis and management.</p><p><b>METHODS</b>Ten patients with facial nerve neuroma were analyzed retrospectively from February 1993 to August 2005. The period of follow-up varied from 1.5 years to 10 years (mean 5 years). Facial nerve function was evaluated with House-Brackmann grading system.</p><p><b>RESULTS</b>The patients complained of facial paralysis in 7 cases, otitis media in 1 case, a mass in parotid gland in 1 case and a mass on the side of the orbital on face in 1 case. Seven patients were undergone either CT scan or MRI or both. Image studies revealed mass located along the facial nerve course from the nerve endings to the intracranial parts. All the patients accepted the surgery. Intraoperative findings showed that the tumor location matched the image findings. Postoperative pathological diagnosis demonstrated 8 Schwannoma, 2 neurofibroma. There was partial tumor resection in 1 patient accepted and his nerve function was unchanged. Four patients were undergone facial nerve graft but 1 case failed while facial nerve function was improved in 3 other patients. Two patients underwent tumor resection while the continuity of facial nerve was preserved as result their facial nerve function improved respectively. No facial nerve reconstruction was done on other 2 patients.</p><p><b>CONCLUSIONS</b>Multiple origins of facial nerve neuroma were noted and the most common system was facial nerve palsy. The decision on how to treat these patients should be individualized and based on initial facial function, growth rate, surgical experience and informed patient consent. The more effective methods need being seeked for the management of facial nerve neuroma.</p>

Complications of tracheoesophageal puncture for Blom-Singer voice restoration after total laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate causes and treatment of complications of tracheoesophageal puncture for Blom-Singer voice restoration after total laryngectomy.</p><p><b>METHODS</b>From 1986 to 2004, one hundred and fifty one cases with Blom-Singer technique after total laryngectomy for voice restoration were retrospectively analyzed.</p><p><b>RESULTS</b>All cases were followed up from 6 months to 15 years. Among 151 cases, 138 cases got successful phonation and the total success rate of voice restoration was 91.4%. Of the 151 cases, 15 cases occurred complications. The rate of complications was 9.9%. The common complications included fistula granulations, infection, and leakage. Twelve cases got successful treatment accordingly, and the other 3 cases failed in phonation.</p><p><b>CONCLUSIONS</b>The procedure of tracheoesophageal puncture for voice restoration is relatively simple and has low complications. this method had high phonation success and good phonation quality, which is one of the best way to make laryngectomee to speak.</p>