Retrospective analysis of 188 cases of parapharyngeal space tumors / 临床耳鼻咽喉头颈外科杂志

To explore the diagnosis,treatment,surgical approach and prognosis of parapharyngeal space tumors.The clinical data of 188 patients with parapharyngeal space tumor who were treated from January 2007 to December 2016 were analyzed retrospectively.All patients underwent imaging examination before operation.Surgical approach was as follows:transcervical approach applied in 159 cases,endoscopic-assisted transnasal approach in 9 cases,transcervical-transmandibular approach in 8 cases,transcervical-transparotid approach in 8 cases,transoral approach in 7 cases,and infratemporal fossa approach in 4 case.Of the 188 cases,the tumor was benign in nature in 168 cases(89%)and malignant in 20 cases(11%).Complications occurred in 28(15%)patients,with the most common symptom being hoarseness.168 cases of benign tumors were followed up for 10 months to 10 years,and 3 cases were lost and 4 cases had recurrence.All cases underwent re-operation.Patients with malignant tumors received combined treatment after surgery,and 3 cases were lost to follow-up,1 case died of recurrence 9 months after surgery,the rest survived.Surgery is the preferred method for treating parapharyngeal space tumors and postoperative recurrence rate is pretty low.Endoscopy provides a new surgical management method,helping to reduce postoperative complications and recurrence rate.

Preliminary research on the regeneration of injured rabbit vocal folds after the transplantation of human amniotic epithelial cells / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the survival, growth and distribution of human amniotic epithelial cells (hAEC) after injected into injured rabbit vocal folds, in addition, to assess the ability of hAEC to affect the components of lamina propria extracellular matrix (ECM) and prevent vocal fold scarring.</p><p><b>METHODS</b>hAEC were isolated from human amnion and marked by Lenti-EGFP. Fifteen New Zealand rabbits were used for this experiment. EGFP-hAEC was injected into the left injured vocal folds in thirteen rabbits, and the contralateral thirteen vocal folds experienced an injured procedure only ("injured untreated control"), and four vocal folds were left as untreated controls. The survival, distribution, differentiation potential and secretion function of hAEC were examined by immunofluorescence method. HE staining and immunohistochemical staining were performed for the evaluation of collagen and fibronectin respectively.</p><p><b>RESULTS</b>hAEC showed a cobblestone-like growth. After implanted into the injured vocal folds, hAEC could survive in vocal fold lamina propria for 2 months. The immunofluorescence analysis showed the evidence of hAEC differentiation into muscle cells as well as secretion the ECM protein. Three months postoperatively, the density of collagen was higher in the injured untreated control folds than that in the injured vocal folds injected with hAEC and the untreated controls. Besides, the content of fibronectin in the injured untreated control group was significantly increased.</p><p><b>CONCLUSIONS</b>hAEC survived in the vocal folds lamina propria, and had the potentiality to differentiate into vocal folds tissue and secret some ECM components. The histological improvement caused by the injected cells demonstrate that hAEC had the ability to promote the repairment and regeneration of injured vocal folds.</p>

Study on the stability of perceptual evaluation of voice quality / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the factors that influence the stability of evaluation results judged by a jury through a standard research on perceptual evaluation measurements of voice quality.</p><p><b>METHODS</b>Voice samples from 300 patients with dysphonia and 100 control subjects with normal voice were recorded and assessed by a jury composed of 6 experienced listeners from different hospitals. The voice samples were discourse voices and ordered randomly 3 times, and the mean of 3 evaluations using visual analogue scale were the final results. The jury was instructed to classify voice samples according to the G (grade), R (rough) and B (breathy) components of the GRBAS scale on a 4-point scale ranging from 0 for normal to 3 for severe dysphonia. Κ value was used to analyze the concordance of evaluation results and regression analysis was used to research the effects of the extent of voice disorder to the stability of perceptual evaluation.</p><p><b>RESULTS</b>The discordance of evaluation existed both between the jury and in listeners themselves. The concordance of listeners themselves of each evaluation parameter was not bad, good, or even very good, and the concordance of evaluation of G was the best (κ value: 0.46 - 0.85), then R (κ value: 0.41 - 0.84) and B (κ value: 0.41 - 0.81). The concordance between the jury was worse than that in themselves. And except a listener whose concordance of evaluation was under the requirement, the concordance of evaluation of G was the best (κ value: 0.43 - 0.96), then R (κ value: 0.33 - 0.78) and B (κ value: 0.002 - 0.45). The stability of evaluation of normal voice and severe voice disorder was better than mild and moderate voice disorder.</p><p><b>CONCLUSIONS</b>The discordance between the jury was the main factor that influence the stability of perceptual evaluation. The evaluation parameters and extent of voice disorder will influence the stability of perceptual evaluation of the jury.</p>