Pharyngocutaneous fistula following total laryngectomy in patients with advanced stage hypopharyngeal or laryngeal carcinomas / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the locations, predisposing factors, managements and outcomes of pharyngocutaneous fistula (PCF) following total laryngectomy in patients with advanced stage hypopharyngeal or laryngeal carcinomas.@*METHOD@#One hundred and ninety-eight patients with advanced hypopharyngeal or laryngeal carcinomas who were performed by total laryngectomy were analyzed retrospectively. The multiple predisposing factors, including age, sex, preoperative radiotherapy, previous tracheostomy, stage, differentiation, site, neck dissection and postoperative fever, were analyzed.@*RESULT@#The incidence of PCF was 16.7%. The situations of orificium fistulae lied in 69.7% superior segment, 21.2% inferior and 9.1% middle segment respectively. The incidence of PCF was 24.7% in hypopharynx and 11.6% in larynx respectively. There were significant differences between them. The differences of postoperative continuous fever beyond 5 days were statistical significance between the group of PCF and no PCF. In them, 28 patients of PCF were healed spontaneously and 5 of them were healed by surgical operation.@*CONCLUSION@#PCF is often situated in tongue base and post-superior of trachea stoma. Tumor locations and postoperative fever are important predisposition.

Laryngeal functional reconstruction with pedunculated musculocutaneous flap of platysma after partial laryngectomy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the value of laryngeal functional reconstruction with pedunculated musculocutaneous flap of platysma after partial laryngectomy.@*METHOD@#Fifty-four cases with glottic carcinoma were operated by partial or enlarged partial laryngectomy, and reconstructed laryngeal function with pedunculated musculocutaneous flap of platysma.@*RESULT@#All the cases regained the swallow, vocalization and breath. The rate of extubation was 100%, and the 5-year survival rate was 92.59%.@*CONCLUSION@#Application of pedunculated musculocutaneous flap of platysma to reconstruct laryngeal function is one of the effective method after partial laryngectomy.

Massive concha bullosa pyocele with orbital extension--a case report and review of the literature / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the complication of common anatomic variant of the middle turbinate-concha bullosa.@*METHOD@#We present a 35 years old man with inner canthus proptosis and orbital pain who was diagnosed to be a pyocele originated from concha bullosa by CT and operation.@*RESULT@#Concha bullosa can develop to a pyocele. Direct extension of the mass from the nose into the orbit may occur. Good therapeutic effect was obtained by endoscopic operation.@*CONCLUSION@#Concha bullosa can result in obstruction of middle meatus and lead to sinusitis. Polyps or mucocele may also occur to Concha bullosa itself. Pyocele of concha bullosa can develop to such a massive extent that it leads to orbital complication. Endoscopic operation is best treatment to this disease.

Homozygous deletions of MTS1/p16 gene in laryngeal squamous cell carcinoma / 基础医学与临床

To study the status of homozygous deletions of MTS1/p16 gene in squamous cell carcinoma of the larynx (LSCC) and to discuss the relations of homozygous deletions to the pathological grade and clinical stage of the tumor,Fifty-nine primary LSCC were examined for homozygous deletions of the MTS1/p16 gene by comparative PCR.Three specimens were eliminated for being incapable of comparison with others.Homozygous deletions of the MTS1/p16 gene were found in 9 of 56 tumors (16.07%).The rates of homozygous deletions of MTS1/p16 gene in well,medially,poorly differentiated tumors were 17.24%(5/29),11.76%(2/17),and 20.00%(2/10) respectively.There had no significant difference in various pathological grades of tumors.Homozygous deletions rates of tumors in stagesⅠ～Ⅱand in stagesⅢ～Ⅳwere 5.41% (2/37) and 36.84%(7/19) respectively.The rate of homozygous deletions in stages Ⅲ～Ⅳtumors was significantly higher than that in stagesⅠ～Ⅱ(P＜0.01).Homozygous deletions of the MTS1/p16 gene were correlated well with clinical stages.Our data suggested that homozygous deletions of MTS1/p16 gene might be one of the genetic events in the development of the tumor and might play a role in malignant progression of LSCC.