The Effects of Phonosurgery for Vocal Fold Nodule Combined with Botulinum Toxin of Type A Injection in Adults / 听力学及言语疾病杂志

Objective To investigate the effects of phonosurgery combined with botulinumtoxinof type A in-jection in adults with vocal nodules .Methods A total of 76 adults with diagnosis of vocal nodules were studied in this experiment .They were divided into two group according to the different treatments :the surgery group (n=40) ,and the group with the combined botulinum toxin of type A injection (n=36) .Preoperative and postoperative examinations consisted of electronic laryngoscope ,stroboscopic laryngoscope ,voice assessments of subjective and objective evaluations using GRBAS classification and voice disorder index (VHI) .The evaluation parameters were the longest phonation time (MPT) ,jitter and shimmer and dysphonia severity index (DSI) .The results from the two groups were compared .Results There were 5 cases cured ,28 cases improved and 7 cases of now effects in the surgery group .The effective rate was 82 .5％ .There were 30 cases cured and 6 cases improved in the combined in-jection group with the effective rate of 100％ .There were 22 cases with good glottis closure and 18 cases with incom-plete closure in the surgery group postoperatively ;in the combined injection group ,30 cases glottis closed well and 6 cases still closed incompletely .The differences of postoperative VHI ,MPT ,jitter ,shimmer and DSI in addition to G were significant different between the two groups .Conclusion Phonosurgery combined with botulinum toxin of type A injection is an effective way for the treatment of vocal fold nodules in adults .

Treatment of recurrent laryngeal papilloma by submucosal resection and the effect on prognosis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of submucosal resection by CO2 laser in the treatment of recurrent laryngeal papilloma and the effect on prognosis.@*METHOD@#A total of 11 patients diagnosed as recurrent laryngeal papilloma were included in this review. Papilloma was marked before operation and checked under fibro-laryngoscope. Papilloma was resected completely including the submucosal tissure with CO2 laser or microequipment. In widespread papilloma, false membrane in raw surface were cleared 7-10 days after operation. Surgical specimens (including membrane) were detected by routine pathology, HPV typing and immunohistochemical pathologic examination. The patients were checked once a month in the first 3 months after operation, and then once for every 3 months. Once the hoarseness and other symptoms aggravated or the disease was recurrent, the patients were treated immediately.@*RESULT@#HPV viral DNA was found in 10/11 cases, with HPV11 (7/11 cases) and HPV6 (3/11 cases). Cases with regards to follow-up, from 6 months to 1 year, 3 cases were followed up 1 year after operation, without recurrence. Five patients including 2 children were followed up 6 to 12 months after operation, without recurrence. Two children underwent 2 or 3 operations, were followed-up more than 6 months withouting recurrence.@*CONCLUSION@#Papilloma submucosal resection could decrease postoperative recurrence and is worth to be further investigated.

Clinical study on vocal cords spontaneous rehabilitation after CO2 laser surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the spontaneous rehabilitation and phonation quality of vocal cords after different types of CO2 laser microsurgery.@*METHOD@#Surgical procedures based on Remacle system Type I, Type II, Type III, Type IV and Type V a respectively. Three hundred and fifteen cases with hoarseness based on strobe laryngoscopy results were prospectively assigned to different group according to vocal lesions apperence,vocal vibration and imaging of larynx CT/MRI. Each group holded 63 cases. The investigation included the vocal cords morphological features,the patients' subjective feelings and objective results of vocal cords.@*RESULT@#There are no severe complications for all patients in perioperative period. Vocal scar found in Type I ,1 case; Type II, 9 cases ;Type III, 47 cases; Type IV, 61 cases and Type Va 63 cases respectively after surgery. The difference of Vocal scar formation after surgery between surgical procedures are statistical significance (χ2 = 222.24, P 0.05). This happened in shimmer parameter and the maximum phonation time (MPT) as jitter. There are no statistical significance between Type IV and Type Va on MPT (P > 0.05).@*CONCLUSION@#Morphological and functional rehabilitation of vocal cord will be affected obviously when the body layer is injured. The depth and range of the CO2 laser microsurgery are the key factors affecting the vocal rehabilitation.