Application of gastric pharyngeal anastomosis assisted by laparoscope and a report of 4 cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical application of gastric pharyngeal anastomosis assisted by laparoscope.@*METHOD@#Apply laparoscope in the gastric pharyngeal anastomosis for 4 cases of advanced hypopharyngeal carcinoma and cervical esophageal carcinoma patients.@*RESULT@#Gastric pharyngeal anastomosis assisted by laparoscope were successfully completed in all 4 patients, all patients avoided thoracotomy or laparotomy, one patient occurred pharyngeal fistula, and died six months later. One patient had cervical lymph node metastasis a year and a half later, without treatment again because of economicissue. The remaining two patients were still alive, one patient had survived 3 years and a half after operation, the other had survived 2 years and a half after operation.@*CONCLUSION@#Gastric pharyngeal anastomosis assisted by laparoscope is feasible. It can reduce the operation wound, improve the safety of operation and patients' life quality.

Small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the feasibility and clinical characteristics of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma.@*METHOD@#Forty-five patients with laryngeal squamaous cell carcinoma in T1-2 stage received small partial laryngectomy without tracheotomy.@*RESULT@#All patients were primarily healed and were hospitalized for an average of 11.5 days post-operatively. In all patients, the function of respiration and the reflection of cough were normal, and laryngeal obstruction did not happen. The only postoperative complication was subcutaneous emphysema noted in 29 patients. Among them, subcutaneous emphysema extincted after 4-6 days in 26 patiens, only 3 patiens suffered from delayed healing because the subcutaneous emphysema extincted after 2 weeks. Mild subcutaneous emphysema did not affect the function of respiration and deglutition, healing of wound, and psychology of patients. All patients had been followed-up for 1-13 years. Only 2 patients died of tumor recurrence or metastasis. The function of respiration and deglutition were normal in the living patients, and no implanting metastasis on surface of trachea were found.@*CONCLUSION@#The theoretical foundation of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma has been well established. This surgical technique is feasible, safe and effective. It can significantly improve clinical outcome of T1-2 stage glottic carcinoma with minimal invasiveness. Furthermore, it can obviously abate the surgical, physiological and psychological trauma on patients.

Laryngeal function preservation in the surgical treatment of cervical esophageal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the indication and the methods of hypopharyngeal and esophageal reconstruction in the surgical treatment of cervical esophageal carcinoma with laryngeal function preservation. To explore the reasons of err inhaling after gastric-pharyngeal anastomosis and its prevention and treatment.@*METHOD@#Clinical data of nine patients who underwent surgical treatment of cervical esophageal carcinoma with laryngeal function preservation from 1998 to 2006 were analyzed retrospectively. The patients without preoperative hoarseness included two cases of pure cervical esophageal carcinoma, six cases of cervical esophageal carcinoma involved hypopharynx and one cases of cervical-thoracic esophageal poly primary malignant carcinoma. Eight patients were carried out total laryngeal function preservation and one patient was carried out partial laryngeal function preservation. The methods of hypopharyngeal and cervical esophageal reconstruction included gastric-pharyngeal anastomosis (seven patients), free forearm flap (one patient) and pectoralis major myocutaneous flap (one patient).@*RESULT@#Good laryngeal function in four patients, moderate laryngeal function in two patients and bad laryngeal function in three patients. Everyone in seven patients underwent gastric-pharyngeal anastomosis had a very degree of gastric countercurrent, temporalitive disappearance of cough reflex and err inhaling, five of them laryngeal paralysis. The higher anastomosis gob, the heavier err inhaling. One patient with free forearm flap died of lethal haemorrhage. One patient with pectoralis major myocutaneous flap occurred anastomosis gob stricture.@*CONCLUSION@#Patients with pure cervical esophageal carcinoma and cervical esophageal carcinoma involved hypopharynx less than 1 cm from the entrance of esophagus are feasible to undergo total laryngeal function preservation operation, while elder patients with cervical esophageal carcinoma involved hypopharynx more than 1 cm from the entrance of esophagus are feasible to undergo partial laryngeal function preservation operation or no laryngeal function preservation operation instead of total laryngeal function preservation operation. Err inhaling is nearly relevant to the disorder of deglutition function of the pharynx-esophagus and err inhaling prevention function of the larynx.

The effects of arsenic trioxide on the cell cycle and microfilament cytoskeleton in human nasopharyngeal carcinoma cell line / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the effects of arsenic trioxide (As2O3) on the cell cycle and microfilament cytoskeleton in human nasopharyngeal carcinoma cell line(CNE1),as well as possible mechanisms. METHODS The variation of cell cycle and microfilament cytoskeleton in CNE1 were observed using the flow cytometry (FCM),the laser scanning confocal microscopy(LSCM)and technology of fluorescence.RESULTS FCM showed that the proportion of G1 phase cells significantly increased in cells exposed to 2 and 4?mol/L As2O3(P

Application of posterior canal wall reconstruction and mastoid obliteration / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the obliteration of the old mastoid cavity and reconstruction of the posterior canal wall after radical mastoidectomy. Method:Posterior canal wall reconstruction and mastoid obliteration of 11 ears of 10 patients with old mastoid cavity for 1 to 6 years after radical mastoidectomy were done using the pedicle postauricular composite skin flap (PPCSF),and their tympanoplasty were performed at the same time. Follow-up was performed at 3 to 30 months. Result:All PPCSFs survived. The old mastoid cavity of 11 ears vanished and reconstructed posterior canal wall remained in normal position without retraction. The drying ear time took 2 to 3 weeks postoperatively,and the symptoms of the radical cavity disease after radical mastoidectomy were cleared up nearly,and the average hearing threshold decreased 13.6 dB HL. The otorrhea and perforation of tympanic membrane resulted from infection happened to 1 of 11 ears three month after the operation. Conclusion: The PPCSF is an effective method in the obliteration of old mastoid cavity and reconstruction of the posterior canal wall. It can reduce drying ear time postoperatively, treat the radical cavity disease after radical mastoidectomy and is beneficial to the tympanoplasty at the posterior external at the same time.