[Preliminary application of indocyanine green fluorescence imaging technology in nasal endoscopic tumor surgery].

Objective:To preliminarily study the practical value of Indocyanine green（ICG） molecular fluorescence imaging technology in nasal endoscopic tumor surgery. Methods:Five patients with tumors related to nasal sinuses, orbital wall and skull base in the Department of Otolaryngology head and Neck Surgery, General Hospital of Xinjiang Military Command from December 2022 to April 2023 were enrolled. Among them, 3 were benign tumors and 2 were malignant tumors. All patients underwent surgery under the guidance of ICG molecular fluorescence imaging. ICG was administered intravenously through cubital vein at a dose of 0.5 mg/kg 12 to 24 h before surgery. Tumors were labeled by fluorescence imaging during the operation. surgeons cleared the tumor tissue strictly according to the labeled range and depth, malignant tumors were further expanded and cleaned according to pathology results. Results:All 5 patients achieved accurate tumor localization with the aid of fluorescence imaging technology. Resections were performed with reference to fluorescent labeling boundaries, all patients achieved complete tumor cleanup or negative margins. Conclusion:For tumor-related surgery under nasal endoscopy, ICG molecular fluorescence imaging technology can not only achieve accurate real-time positioning, but also provide evidence for surgeons to judge tumor boundaries. Therefore, we believe that the technology should have certain practical value in nasal endoscopic tumor surgery.

Application of Biologic Graft in Nasal Septal Perforation Repair.

Objective: To explore the clinical outcome when biomaterials are used to repair nasal septal perforations. Methods: A total of 12 patients were treated. The nasal septum was dissected via endoscopic approach. A 4 cm × 7 cm biologic graft (Biodesign® Tissue Graft) was folded to form a double layer, was placed over the perforation, and was affixed into place using suture. Results: Follow-up ranged from 2 to 8 months after the operation. One patient was not completely healed and presented with a remaining defect of about 2 mm × 8 mm in the upper part of the nasal septum. The remaining 11 patients healed completely. Conclusion: Using a biologic graft to repair nasal septal perforations is an easy operation as it prevents the need to take autologous tissue from the patient, allows for a repair to be performed without creating septal flaps, and has good histocompatibility. It is a safe and effective method that can be used clinically.

Research on the efficacy of laryngendoscopic low-temperature plasma ablation on early glottic cancer.

PURPOSE: To evaluate the efficacy and safety of self-retaining laryngendoscope-assisted low-temperature plasma ablation (LTPA) in the treatment of patients with early glottic cancer. METHODS: The clinical data of 84 patients with early glottic cancer treated in our department from May 2013 to May 2016 were collected. All patients were divided into the Plasma group (n=42, treated with the laryngendoscopic LTPA) and the Laryngofissure group (n=42, treated with traditional laryngofissure). The operation conditions, pain and cough visual analogue scale (VAS) scores, postoperative complications, mucosal recovery and voice recovery indexes were compared between the two groups, the postoperative recurrence rate was recorded, and the patients were followed up for tumor recurrence and survival. RESULTS: In the Plasma group, the operation time was significantly shorter than that in the Laryngofissure group, the amount of intraoperative bleeding was significantly less than that in the Laryngofissure group (p<0.001), and the postoperative hospitalization time was also significantly shorter than that in the Laryngofissure group. The postoperative pain and cough VAS scores in the Plasma group were obviously lower than those in the Laryngofissure group. The proportion of smooth vocal mucosa after operation in the Plasma group was evidently higher than that in the Laryngofissure group. In Plasma group, the voice parameters Jitter, Shimmer and harmonic to noise ratio (HNR) were all remarkably superior to those in the Laryngofissure group. The overall survival (OS) and progression-free survival (PFS) had no statistically significant differences between the two groups according to the log-rank test. CONCLUSIONS: Self-retaining laryngendoscope-assisted LTPA has definite efficacy in the treatment of early glottic cancer, after which the recurrence rate and survival rate are similar to those after open laryngofissure, but LTPA is characterized by short operation time, less postoperative bleeding, quick recovery of patients and better voice recovery.

[Successful perform of prolonged cardiopulmonary and cerebral resuscitation on repeated cardiac arrest: one case report].

Cardiac arrest (CA) is the most serious clinical emergency situation and cardiopulmonary-cerebral resuscitation (CPCR) performed on site with high quality is the optional therapy for its management. It has been reported that prolonging the resuscitation time after 30-minute failed conventional cardiopulmonary resuscitation (CPR) could improve the in-hospital survival rate of CA patients, and how to improve the out-hospital survival rate and survival quality of these patients is a research hot focus at present. A male patient admitted to Emergency Center of Shihezi People's Hospital reported in Xinjiang in this study had two CAs. In 2002, he experienced Adams-Strokes syndrome due to acute myocardial infarction (AMI) and survived after 35-minute of successful CPR. The criminal vessel was judged to re-canalize clinically 2 hours after thrombolytic therapy with urokinase, and he was cured and discharged from hospital 25 days later. In 2016, the second CA insult him and after the 185-minute CPR, he survived but experienced the post-CA syndrome. As long as 7-day continuous mild hypothermia was performed, the temperature of displacement fluids in continuous blood purification (CBP) was adjusted to 35 centigrade to achieve the goal of brain protection management requirements. He was cured and discharged from hospital 75 days later. During the 9-month follow-up, he did well in activities of daily living and could engage in routine housework. This paper introduces the treatment process of the patient in detail, and provides experience for clinical treatment.

[Simultaneous multiple plane operations in treating severe obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: To investigate the effect and clinical value of simultaneous multiple plane operations in treating severe OSAHS. METHOD: The clinical data of 93 patients with severe OSAHS were retrospectively analyzed. According to different obstruction plane, all the patients were performed different multiple planes of operations. Operations were finished in the same term. All patients underwent PSG examination before operation and 6-month, 1 year after surgical treatment separately. RESULT: No severe complication occurred. According to the assessment guidelines, the response rate was 100% in 6-month and 91.40% in 1-year respectively. CONCLUSION: Most OSAHS have multi-level obstructions in upper airway caliber, such as nasal, nasopharyngeal, velo-pharyngeal and tongue-pharyngeal obstruction. Simultaneous multiple plane operations which based on multiple plane obstruction can improve curative effect.

[Preventing recurrent laryngeal nerve lesions by anastomosing it during thyroid surgery].

OBJECTIVE: To study how to prevent recurrent laryngeal nerve (RLN) lesions by anastomosing it during thyroid surgery. METHOD: In the present study 517 patients with thyroid diseases underwent thyroid surgery from January 1993 to May 2005, with RLNs of 163 cases (187 sides, A group) anatomized and RLNs of 354 cases (438 sides. B group) not anatomized. The RLN in B group were protected generally during thyroid surgery. RLNs of A group were anatomized partly or totally. RESULT: (1) In A group RLNs of 123 cases were partly anatomized and 64 totally. None of all RLNs was injuried. (2) B group 3 sides of 3 cases of all RLNs was injuried. The rate of RLN's lesion is 0.7%, which is significantly higher in A group than in B group. CONCLUSION: Anastomosing RLN during thyroid surgery may prevent its lesions. The length of anatomized RLN must vary with the area and position of thyroid pathological changes. The RLN needn't be anatomized in these patients with the benign thyroid pathological changes which is far away trachea-oesophagus channel.