Effects of hepatocyte growth factor-transfected mesenchymal stem cell transplantation in canine injured vocal folds.

This study aimed to assess the efficacy of hepatocyte growth factor (HGF)-transfected adipose-derived mesenchymal stem cell (ADSC) transplantation in the injured vocal folds (VFs) of canines. A lentiviral vector encoding HGF was successfully produced via Gateway cloning, which was used to infect ADSCs. Four weeks after transoral laser microsurgery (type II) with CO2 laser, the beagles of each group were injected with HGF-transfected ADSCs or uninfected ADSCs into VFs. The results showed that the retention of HGF-transfected ADSCs in the VFs persisted about three months post-injection. The VFs in the HGF-transfected ADSCs group exhibited a closer-to-normal structure with less collagen deposition and higher amounts of hyaluronic acid (HA) in the third month. The short microvilli in the HGF-transfected ADSCs group showed a dense and uniform distribution. These results revealed that HGF-transfected ADSC is a potential treatment option for injured VFs.

Surgical and Functional Outcome After Endoscopic Resection Via Transthyrohyoid for Early Glottic Cancer.

Transthyrohyoid access to the larynx for endoscopic resection (TTER) for early-stage glottic cancer in patients with difficult laryngeal exposure (DLE) has recently been developed. However, little is known about the postoperative conditions of patients. Twelve early-stage glottic cancer patients with DLE who received TTER were retrospectively reviewed. Clinical information was collected during the perioperative period. Functional outcome was evaluated using Voice Handicap Index-10 (VHI-10) and Eating Assessment Tool-10 (EAT-10) preoperatively and 12 months after surgery. None of the patients experienced serious complications after TTER. The tracheotomy tube was removed in all patients. The 3-year local control rate was 91.6%. The VHI-10 score decreased from 18.92 to 11.75 (p < .001), and the EAT-10 scores of the 3 patients changed slightly. Thus, TTER may be a good option for early-stage glottic cancer patients with DLE.

The Thermal Damage of Canine Vocal Fold by CO2 Laser Under Different Laser Emission Mode.

OBJECTIVE: The purpose of this study is to review the differences between continuous wave (CW) and UltraPulse (UP) on thermal damage of the laser with different power. METHODS: Four adult beagle dogs underwent transoral laser microsurgery (TLM) using CO2 laser. The laser emission mode and power was CW (3 W, 5 W, and 8 W) and UP (3 W and 5 W), respectively. The tissue from 4 animals was evaluated histologically on postoperative days 1 and 3. The thermal damage of the laser was measured using slide scan system via SlideViewer version 1.5.5.2 software. RESULTS: All dogs underwent TLM uneventfully. Under microscope examined, the laser damage area was composed of 2 parts: the vaporized zone (VPZ) and thermal damage area. The thermal damage area can be divided into thermal coagulative necrosis area (TCN) and hydropic degeneration area. The width of VPZ and TCN in UP mode was less than that in CW mode (P < .01). The data indicate that lower laser power created less thermal damage (P < .01). In addition, the width of VPZ on postoperative day 3 was less than that on postoperative day 1 (P < .01). CONCLUSION: CO2 laser with UP and lower power could decrease the laser thermal damage and may offer more prompt wound healing.

Endoscopic frontal trephination verse the osteoplastic flap in patients with frontal sinus disease after bifrontal craniotomy.

OBJECTIVE: We review the clinical outcome of endoscopic frontal trephination and osteoplastic flap in patients with frontal sinus disease after bifrontal craniotomy. METHODS: The clinical data of patients with frontal sinus disease after bifrontal craniotomy between 2008 and 2018 were studied. RESULTS: Twenty-two patients underwent trephination and 15 patients had osteoplastic flap. The mean operation time was 101.5 min for osteoplactic flap, statistically shorter than that of the trephination (p < 0.05). The blood loss during the trephination was significantly lower than that of the osteoplactis flap (mean, 29.6 ± 11.5 versus 96.3 ± 46.8 ml; p < 0.01). The postoperative hospital stay was 2.2 ± 0.7 days for patients of the trephination and 3.7 ± 1.6 days for patients of the osteoplastic flap, and this difference was statistically significant (p < 0.01). No complication and recurrence in all 37 patients. CONCLUSIONS: Both endoscopic frontal trephination and the osteoplastic flap are safe and highly effective in patients with frontal sinus disease after bifrontal craniotomy. However, the trephination can cause lower blood loss and require shorter postoperative stay while it takes shorter time to complete the osteoplactis flap.

Clinical analysis of Kimura's disease in 24 cases from China.

BACKGROUND: We reviewed details of Chinese Kimura's disease (KD) cases. A full clinical analysis was subsequently performed to improve the accuracy of clinical diagnosis and treatment of KD. METHODS: A total of 24 patients with pathologically confirmed KD treated between March 2008 and March 2018 were reviewed retrospectively for clinical and histopathological analysis. RESULTS: In the 24 KD cases, 20 were male and 4 were female with the age of onset ranging from 5 to 65 years. Lesion diameter ranged from 0.6 cm to 7 cm with unilateral involvement being more popular (79%). Imaging examination had a high detection rate for KD involving the parotid gland and subcutaneous but had low specificity. Microscopic analysis indicated that KD mainly involved subcutaneous soft tissue and lymph nodes. The prominent feature of lymphoid tissue was germinal center hyperplasia surrounded by several lobules associated with hyperplastic vascular structures. Out of the 24 patients, 11 experienced recurrence of disease after treatment (surgical resection: 46.2%, surgical resection followed by oral corticosteroids: 71.4% and surgical resection combined with radiotherapy: 0%). CONCLUSIONS: Our analysis revealed clinical, imaging, and histological characteristics of KD. A better understanding of the disease will help clinicians reduce misdiagnosis and improve the diagnostic rate upon patient first clinical visit.

Development and Validation of a Low-Cost and Simple Simulator for Microlaryngeal Surgery.

OBJECTIVES: The simulation of microlaryngeal skills is rarely seen in surgical training, but it is particularly important in phonomicrosurgery. This study described and validated the laryngeal surgical simulator through surgical training. METHODS: A simple and low-cost simulator was developed for the fixation of the suspension laryngoscope and porcine larynges. Twenty participants with work skills and experience did preparation before training, and performed suture and carbon dioxide (CO2) laser cordectomy for simulator evaluation. The results were proposed by the aspects of time taken for each procedure, the global rating scale, a procedure-specific assessment, and a post-simulation questionnaire. RESULTS: All participants completed the preparation within 9 minutes and reached the conclusion that the microlaryngeal surgical simulator was helpful in improving their surgical skills. The performance of experts was superior to that of novices in both suture and CO2 laser cordectomy. CONCLUSION: This simulator could be easily assembled and was successfully validated by microlaryngeal surgical training both subjectively and objectively. It may be helpful to clinicians in microlaryngeal skills.