The significance of anastomosing the recurrent laryngeal nerve in the thyroidectomy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the advantage of exposure recurrent laryngeal nerve (RLN) in thyroid surgery and to detect the methods of avoiding nerve damage.@*METHOD@#Two hundred and thirty thyroidectomy cases were studied from June 2003 to May 2006 retrospectively. One hundred and nine cases were operated with total lobectomies, 59 cases with lobectomies and gorge gland, 44 cases with subtotal thyroidectomy, 18 cases with total thyroidectomy. RLN were exposed during operation and vocal cord were supervised before and after surgery by laryngoscope.@*RESULT@#Two hundred and ninety-two RLNs were exposed including 156 of right and 136 of left, and 134 nerves gone along the tracheoesophageal groove and 158 deviated it. One hundred and ninety-seven (67.5%) gone under the artery and 60 up (20.5%), 24 (8.2%) through two artery branches, and the nerve branch across the artery branch were 11(3.8%). One hundred and eighty-five (63.4%) RLNs had branches into laryngeal, 107 (36.6%) RLNs had no branches. Eight cases came with hoarseness postoperatively, seven cases recovered, one improved for the other vocal cord surpassed compensation after 6 months.@*CONCLUSION@#Anastomosing the recurrent laryngeal nerve in the thyroidectomy was available and could protect RLN.

Relationship of CPAP pressure titration methods and CPAP compliance / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the relationship between the methods of CPAP pressure titration (under whole night PSG or by auto-set) and CPAP compliance. METHODS Forty-five patients with serious OSAHS who had been diagnosed in our sleep lab between 2001 and 2004 and were willing to try CPAP treatment were enrolled. They were divided into A and B group according to their wills: pressure titration under whole night PSG in lab (group A) or by auto-set in their families (group B). After pressure titration, patients and their families were educated for the knowledge of CPAP treatment in OSAHS patients. Questionnaires about QOL before CPAP treatment and half year later were carried out on the phone. The decreased score was used to evaluate the effect of CPAP treatment. The hours of per day using machine were used to evaluate the compliance of CPAP. RESULTS Group A and group B got the similar decreased score (14 VS 14.3) , compliance (4.91h VS 4.97h) and adherence (85.7 % VS 88 %) . CONCLUSION OSAHS patients under go pressure titration either in lab with PSG or in their home with auto-set have the same effect and same compliance of CPAP treatment. That means the simple auto-titration can substitute the traditional titration under whole night in lab.