[Development of Gun-type Tube-Guide Device of Laser Fiber].

With the development of laryngeal microsurgery, the requirements for the flexibility and convenience of surgical instruments are increasing. The research on related instruments has important value for the clinical application of laryngeal microsurgery. We have redesigned a gun-type tube-guide device of laser fiber by comparing the shortcomings of existing laser fiber introducers. The innovation of this design lies in its rotating nut device with adjustable laser angle and pre-bent tip. The corresponding in vitro laryngeal model experiment can realize multi-angle rotation of the instrument in the laryngeal cavity, which greatly increases the scope of laser surgery. During the operation, the rotating nut can be directly adjusted to avoid repeatedly removing the instrument to adjust the angle, which greatly improves the practicability and simplicity of the operation, which is worthy of further clinical research and promotion.

The utility of narrow band imaging in endoscopic diagnosis of laryngopharyngeal reflux.

OBJECTIVE: This study assessed the utility of narrow band imaging (NBI) in patients with symptoms of laryngopharyngeal reflux (LPR) and tried to quantitatively evaluate the signs found under the NBI Laryngoscope. METHODS: Patients with and without LPR symptoms completed reflux symptom index (RSI) questionnaires prior to enrolment. The throat was examined by standard white light endoscopy followed by NBI. LPR status was determined using the reflux finding score and the RSI. Laryngoscope images and videos from 70 subjects with LPR and 70 control subjects without LPR were obtained. Features seen only by NBI were compared between the two groups. Then the RGB values of the throat mucosa of the two groups were measured by Photoshop software, and finally statistical analysis was performed. RESULTS: In total, 140 patients were eligible for final analysis (LPR group mean age = 50.0, 47 males; control group mean age = 44.8, 45 males). A significantly higher proportion of patients with LPR had increased vascularity, green spots, contact ulcers and granulomas. Of these, increased vascularity and green spots can only be found under NBI, and the prevalence rates in the LPR group were found to be 92.8% and 88.6% (P < 0.05), respectively. In the control group, the prevalence rates of increased vascularity and green spots were 21.4% and 7.1%, respectively (P < 0.05). The RGB value of the LPR group was generally higher than that of the control group. The difference is statistically significant (P < 0.05). CONCLUSION: LPR presents vascularity and green spots with high specificity and sensitivity under NBI which can play a role in the auxiliary diagnosis of LPR.

The usefulness of narrow-band imaging for the diagnosis and treatment of vocal fold leukoplakia.

OBJECTIVE: This research was aimed to explore the efficacy of narrow-band imaging (NBI) on distinguishing the degree of dysplasia of vocal fold leukoplakia. METHODS: Patients were examined by flexible endoscopy, under white light endoscopy (WLE) and NBI. 78 lesions were divided into two groups according to the NBI classification. Group 1: non-dysplasia (ND), including squamous hyperplasia with hyperkeratosis or parakeratosis; Group 2: squamous hyperplasia with mild or moderate dysplasia (MD) or severe dysplasia (SD), or carcinoma in situ (CIS). RESULTS: The diagnostic accuracy of NBI for Group 1 and Group 2 was 69.70% (23/33) and 95.56% (43/45), respectively, and the kappa index was 0.711 and a p value < .05, which was considered statistically significant. CONCLUSIONS: The NBI could roughly estimate the degree of dysplasia. Differentiating between ND, MD, SD, and CIS, which may be useful for clinicians on selecting suitable therapies.