Management of Adult Laryngeal Hemangioma With Low-Temperature Plasma Radiofrequency Coblation.

Objective: This study investigated the therapeutic effects of low-temperature plasma radiofrequency (LPRF) coblation on adult laryngeal hemangiomas (ALHs) using suspension laryngoscopy. Material and Methods: The clinical data of 23 patients with ALH treated by LPRF coblation were analyzed retrospectively. All patients underwent edge coagulation before ablation resection. Postoperative voice and swallowing were assessed. Results: The 23 ALHs were diagnosed clinically as 6 cavernous hemangiomas and 17 capillary fibroangiomas. All 23 cases achieved success after a single LPRF coblation, and there was no postoperative bleeding, dyspnea, dysphagia, dysphonia, or other complications. None required postoperative tracheotomy. The patients were followed for 1 year without recurrence. Before surgical intervention, only 2 (8.7%) of the 23 patients had mild (n = 1) or moderate (n = 1) dysphagia. Postoperative dysphagia was assessed at the 1- and 3-month follow-ups. At 1 month, 5 (21.7%) of 23 patients had mild dysphagia, including 3 (13.0%) reporting new mild dysphagia. However, at 3 months postoperatively, none of patients had any dysphagia. The mean Voice Handicap Index was 11.2 ± 3.7 preoperatively, 7.1 ± 2.8 at 1 month postoperatively, and 4.8 ± 3.1 at 3 months postoperatively; the mean maximum phonation time was 10.8 ± 3.7 seconds preoperatively and 12.6 ± 1.8 and 14.1 ± 3.9 seconds at 1 and 3 months postoperatively, respectively. Conclusions: LPRF coblation is an effective minimally invasive method for treating ALHs with better voice and swallowing recovery. Edge coagulation before ablation resection may reduce intraoperative bleeding.

Microwave ablation for the removal of pharyngeal benign lesions: A prospective pilot case series.

OBJECTIVE: We evaluated microwave ablation (MWA) for treatment of isolated pharyngeal benign lesions, in terms of technical feasibility, efficacy, and safety. METHODS: The patients with pharyngeal benign lesions were treated with endoscopic MWA with a 2450-MHz single cooled-shaft microwave antenna and sent for histological examination. Postoperative pain intensity was measured via visual analogue scale (VAS) on the 12th hour and the third postoperative days. RESULTS: Of the 137 patients with pharyngeal benign lesions who met the inclusion criteria. The most commonly involved site was the uvula (n = 66, 48.2%), followed by the lateral pharyngeal wall (n = 37, 27.0%), the nasopharyngeal posterior wall (n = 23, 16.8%) and the soft palate (n = 11, 8.0%). All of the procedures were completed using local anesthesia and were well-tolerated by the patients. The ablation time was 5-10 min, with an average duration of 6.3 ± 1.8 min. The most common pathology was papilloma (n = 96, 70.1%), followed by nasopharyngeal cysts (n = 21, 15.3%), polyp (n = 10, 7.3%), epidermoid cysts (n = 8, 5.8%) and Thornwaldt cysts (n = 2, 1.5%). The mean VAS pain score was 2.36 ± 1.08 on postoperative 12th hour and 1.21 ± 0.54 on postoperative third day. At the 6-month follow-up examination, there were no severe complications, such as recurrence, bleeding, or synechiae of the nasal cavity, eustachian tube injury, in any of the patients. CONCLUSIONS: The MWA for the treatment of isolated pharyngeal benign lesion is feasible and alternative to conventional surgical methods, it allows excision of the lesion while providing hemostasis, involves only a short ablation time and has a very low risk of complications. Most of our patients well-tolerate the procedure, which may be performed under local anesthesia in the outpatient setting.

The effect of concurrent nasal surgery on the eustachian tube function and myringoplasty outcomes.

OBJECTIVE: To investigate the Effect of concurrent nasal surgery on the eustachian tube function (ETF) and myringoplasty outcomes for the chronic perforations with coexistent nasal pathology. MATERIALS AND METHODS: We retrospectively reviewed the records of 93 patients with perforations who underwent same-day myringoplasty and nasal-septal surgery. Group A exhibited septal deviations (n = 34) and Group B inflammatory sinus disease (n = 59). Groups were compared with respect to pre- and postoperative air-bone gaps (ABGs), graft success rates and ETF (Eustachian tube score [ETS] and seven-item Eustachian Tube Dysfunction Questionnaire [ETDQ-7]) at 6 and 24 months. RESULTS: Graft success rates were 100.0% in Group A and 98.3% in Group B at 6 months postoperatively (P = 0.445). Graft success rates were 85.3% in Group A and 96.6% in Group B at 24 months postoperatively (P = 0.046), the re-perforation rate was significantly higher in Group A than in Group B (P = 0.015). Although the preoperative ETS was similar between two groups, the postoperative ETS in the Group B was significantly higher compared with Group A regardless of at postoperative 6th and 24th months. In addition, difference was significant for the patients with positive Valsalva maneuver among two groups at postoperative 24th months. Also, the improvement in the ETDQ-7 score in the B group was significantly higher than that in the A group at postoperative 6th and 24th months. CONCLUSIONS: Concurrent nasal surgery and myringoplasty is feasible. In addition, ESS improves ETF and thus long-term outcomes of myringoplasty for the chronic perforations with inflammatory sinus disease.

Association of fruit and vegetables with the risk of nasopharyngeal cancer: evidence from a meta-analysis.

Quantification of the association between the intake of vegetables and fruit and risk of nasopharyngeal cancer (NPC) is controversial. Thus, we conducted a meta-analysis to assess the relationship between vegetables and fruit and NPC risk. Pertinent studies were identified by a search in PubMed, Web of Knowledge and Wan Fang Med Online. Random-effects models were used to calculate summary relative risks (RRs) and the corresponding 95% confidence intervals (CIs). Publication bias was estimated using Egger's regression asymmetry test. Finally, 15 articles comprising 8208 NPC cases were included in this meta-analysis. The combined results showed that there was significant association between vegetables and fruit intake and NPC risk. The pooled RRs were 0.60 (95% CI = 0.47-0.76) for vegetables and 0.63 (95% CI = 0.56-0.70) for fruit. No publication bias was detected. Our analysis indicated that intake of vegetables and fruit may have a protective effect on NPC. Since the potential biases and confounders could not be ruled out completely in this meta-analysis, further studies are needed.

Association between tea and coffee consumption and risk of laryngeal cancer: a meta-analysis.

OBJECTIVE: Epidemiological studies evaluating the association of tea and coffee consumption and the risk of laryngeal cancer have produced inconsistent results. Thus, we conducted a meta-analysis to assess the relationship between tea and coffee consumption and laryngeal cancer risk. METHODS: Pertinent studies were identified by a search in PubMed, Web of Knowledge and Wan Fang Med Online. The random effect model was used based on heterogeneity test. Publication bias was estimated using Egger's regression asymmetry test. As a result, 11 articles were included in this meta-analysis. RESULTS: For tea consumption and laryngeal cancer, data from 8 studies including 2167 laryngeal cancer cases were used, and the pooled results suggested that highest tea consumption versus lowest level wasn't associated with the risk of laryngeal cancer [summary RR = 0.909, 95% CI = 0.674-1.227]. Eight studies comprising 2596 laryngeal cancer cases for coffee consumption and laryngeal cancer risk were included, and no association was found (summary RR = 1.218, 95% CI = 0.915-1.622). CONCLUSIONS: Finding from this meta-analysis suggested that tea and coffee consumption weren't associated with the risk of laryngeal cancer. Since the potential biases and confounders could not be ruled out completely in this meta-analysis, further studies are warranted to confirm this result.