Radiofrequency Coblation-Assisted Transoral Surgery for the Treatment of Oropharyngeal Squamous Cell Carcinoma: A Comparative Study with Open Surgery.

Objective: Radiofrequency coblation (RFC) is a relatively new method that has opened up new perspectives in treating oropharyngeal squamous cell carcinoma (OPSCC). Our study was designed to explore the feasibility and effectiveness of RFC-assisted transoral surgery (RFC-TOS) for primary OPSCC. Methods: Sixty-nine cases of OPSCC from February 2005 to November 2020 were retrospectively analyzed, including 31 in the RFC-TOS group and 38 in the open surgery group. No difference was observed in demographic and oncological characteristics. Results: The significance between the RFC-TOS group and the open surgery group was proved in intraoperative bleeding volume (34.10 ± 10.10 ml vs. 193.68 ± 21.00 ml, P < 0.001), durations of surgery (79.58 ± 8.45 min vs. 217.87 ± 17.65 min, P < 0.001), time to resume oral feeding (1.64 ± 0.41 d vs. 11.58 ± 1.41 d, P < 0.001), duration of hospitalization (7.84 ± 0.66 d vs. 15.66 ± 1.62 d, P < 0.001), and the total costs (22846.22 ± 1821.55¥ vs. 41792.24 ± 4150.86¥, P < 0.001). The rates of 5-year overall survival (OS), 5-yeardisease-specific survival (DSS), and 5-year local control rate (LC) were 69.1%, 71.7%, and 75.7%, respectively, in the RFC-TOS group and 71.0%, 73.4%, and 73.7% in the open surgery group (P > 0.05). Conclusions: RFC-TOS is a feasible alternative transoral approach for OPSCC. The reported perioperative and oncologic outcomes are satisfactory.

Nasopharyngeal tube effects on alleviating sleep hypoxemia during the first night following velopharyngeal surgery in patients with obstructive sleep apnea syndrome.

STUDY OBJECTIVES: To investigate the feasibility and effectiveness of nasopharyngeal tube (NPT) insertion in alleviating sleep hypoxemia during the first night after velopharyngeal surgery in patients with obstructive sleep apnea syndrome (OSAS). METHODS: In this prospective nonblinded, randomized, controlled study, 46 patients with obstructive sleep apnea syndrome (OSAS) who underwent velopharyngeal surgery were enrolled and randomly allocated to the control group (with no NPT insertion) and the NPT insertion group. Both groups underwent overnight pulse oximetry tests during the first postoperative night. RESULTS: One patient in the NPT insertion group was excluded because of involuntary self-removal of NPT during sleep. A total of 45 patients with OSAS were included for analysis, with 23 in the control group and 22 in the NPT insertion group. No significant differences in preoperative baseline information were found between the two groups. Compared with the patients in the control group, those patients in the NPT insertion group showed a significantly higher value of the lowest oxygen saturation of oximetry during the first postoperative night (85.0 ± 4.0% vs 79.3 ± 8.0%) (P = .005). The percentage of patients with lowest oxygen saturation of oximetry < 80% in the NPT insertion group was only 9.1% (2 of 22), which was significantly lower than 39.1% (9 of 23) in the control group (P = .035). No patient reported unbearable discomfort related to NPT insertion. The most common mild discomfort was occasional pharyngeal foreign body sensation (6 of 22, 27.3%). CONCLUSIONS: NPT insertion could lessen the severity of sleep hypoxemia during the first night after velopharyngeal surgery in patients with OSAS and showed excellent compliance. This method could be a potential alternative option for decreasing the risks of complications related to severe sleep hypoxemia during the early postoperative days. CITATION: Zhang J, Guan S, Zhang C, Du X, Li T, Xiao S. Nasopharyngeal tube effects on alleviating sleep hypoxemia during the first night following velopharyngeal surgery in patients with obstructive sleep apnea syndrome. J Clin Sleep Med. 2023;19(2):303-308.

Reduced circulating growth hormone and insulin-like growth factor-1 and delayed growth of premature rats are aggravated by longer daily duration of chronic intermittent hypoxia exposure.

Objective: This study mainly aimed to investigate the effect of daily duration of chronic intermittent hypoxia (CIH) exposure on circulating growth hormone (GH)/insulin-like growth factor-1 (IGF-1) concentrations and body weight changes of premature rats. Methods: 40 healthy male SD rats aged six weeks were enrolled in this study. These rats were randomly divided into four groups (n = 10 per group), including normal control (NC) group (normal oxygen exposure every day), CIH-1 group (daily CIH exposure for 2 h), CIH-2 group (daily CIH exposure for 4 h), and CIH-3 group (daily CIH exposure for 8 h). The serum GH/IGF-1 concentrations and body weights in all rats were determined after 30 days of normal oxygen or CIH exposure. Results: No significant difference was found with respect to the baseline body weight among the four groups of rats. After establishments of animal models with a duration of 30 days, significant differences were found respect to body weight, body weight changes, and serum GH/IGF-1 concentrations among the four groups of rats with a same trend (all P < 0.05): the highest values were all in NC group rats, followed CIH-1 group, CIH-2 group, and CIH-3 group rats. Among all the rats, the body weight changes correlated significantly with both serum GH and IGF-1 concentrations (both P < 0.05). Conclusion: CIH decreases circulating GH/IGF-1 concentrations and causes growth delay in premature rats. Such effects could be aggravated by increased daily duration of CIH exposures.

Nasal septal foreign body as a complication of dental root canal therapy: A case report.

BACKGROUND: Currently, there have been no reports on foreign bodies found in the nasal septum after dental root canal therapy. Herein, we present an unusual case of a foreign body found in the nasal septum, which occurred after dental root canal therapy and two unsuccessful surgeries. CASE SUMMARY: A 55-year-old man was referred to our department due to slight nasal discomfort that persisted for about 1 wk. Before consulting our department, the patient visited three different hospitals/clinics and underwent two surgeries that were not successful in removing a foreign body completely. A computed tomography scan was performed to detect the shift of the foreign body from dental root to the nasal septum, which resulted in the healing of oral inflammation and nasal septum discomfort. An endoscopic foreign body extraction surgery (3rd removal surgery) was then successfully performed, using a needle as the reference. No nasal reconstruction was required after the operation. Postoperative healing was uneventful. CONCLUSION: Medical healthcare professionals should consider past medical history when dealing with foreign body cases. During septal foreign body extraction surgery, a needle could be used as a helpful reference.

Knowledge of laryngopharyngeal reflux disease among otolaryngologists in 3A hospitals in Beijing.

OBJECTIVE: This study aimed to evaluate knowledge of laryngopharyngeal reflux disease (LPRD) among otolaryngologists in 3A hospitals in Beijing. METHODS: A cross-sectional questionnaire survey of LPRD knowledge was conducted with otolaryngologists in 40 3A hospitals in Beijing. A response rate of <80% was obtained from one hospital, so data from 331 valid questionnaires from the other 39 hospitals were analysed. RESULTS: The most common source of LPRD knowledge was academic lectures (80.1%). The most commonly known risk factors, symptoms, clinical signs and associated diseases were unhealthy eating habits (49.2%), foreign body sensation in the pharynx (71.0%), hyperaemia (42.3%) and pharyngolaryngitis (63.7%), respectively. Only 57.7% of otolaryngologists knew about 24-hour pH monitoring as a gold standard diagnostic test for LPRD. The most commonly known treatment option was medication (93.1%). Most physicians (86.7%) had made a clinical diagnosis of LPRD; however, only 59.9% of them had followed up the treatment outcomes. The most common treatment provided was medication (82.6%). CONCLUSIONS: Knowledge of LPRD among otolaryngologists in 3A hospitals in Beijing was insufficient. Educational programs are needed to increase the knowledge of LPRD among otolaryngologists.

Therapeutic efficacy of carboxyamidotriazole on 2,4,6-trinitrobenzene sulfonic acid-induced colitis model is associated with the inhibition of NLRP3 inflammasome and NF-κB activation.

Excess proinflammatory cytokines owing to the activation of NF-κB and NLRP3 inflammasome play the key role in inflammatory bowel disease (IBD). Previously, we reported the anti-inflammatory activity of carboxyamidotriazole (CAI) resulting from decreasing cytokines. Therefore, we investigated the therapeutic effects of CAI in 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced rat colitis and the involvement of CAI action with NLRP3 inflammasome and NF-κB pathway. CAI was orally administered to TNBS-induced colitis rat. The severity of colitis was assessed, and NLRP3 inflammasome, NF-κB pathway and cytokines were determined. Our results showed that CAI significantly reduced weight loss and disease activity index (DAI) scores in colitis rats and alleviated the colonic macroscopic signs and pathological damage. In addition, the intestinal inflammatory markers and permeability index were markedly ameliorated by CAI treatment. The decreased levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß, IL-6, IL-18 were also detected in the colon tissues of CAI-treated colitis rats. Moreover, the activation of NLRP3 inflammasome in inflamed colon was significantly suppressed by showing an obvious reduction in the NLRP3 and activated caspase-1 levels. Furthermore, CAI reduced NF-κB p65 expression and IκBα phosphorylation and degradation in colitis rats. Therefore, CAI attenuates TNBS-induced colitis, which may be attributed to its inhibition of NLRP3 inflammasome and NF-κB activation, and down-regulation of proinflammatory cytokines. These results provide further understanding of the intestinal anti-inflammatory effect of CAI and highlight it as a potential drug for the treatment of IBD.

Therapeutic Effect of Carboxyamidotriazole on Adjuvant Arthritis in Rats.

OBJECTIVE: To study the effect of carboxyamidotriazole (CAI) on adjuvant arthritis (AA) in rats. METHODS: The rats were randomly divided into normal group,two vehicle groups (polyethylene glycol 400 control and normal sodium control group), CAI-treated groups (10, 20, and 40 mg/kg) and positive control dexamethasone group. Freund's completed adjuvant was used to induce AA in rats. The arthritis index (AI) was scored, and X-ray check of the hind limbs and histopathological examination were performed. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 in the inflamed paw tissues were measured. RESULTS: The administration of CAI significantly decreased the AI, restored the body weights, and ameliorated the radiological and histopathological features of joint destruction in AA rats (P<0.05, P<0.01). In addition, CAI reduced the TNF-α, IL-1ß, and IL-6 levels in the inflamed paw tissues (P<0.05, P<0.01). CONCLUSION: CAI has therapeutic effect on AA rats, which may be achieved by decreasing the pro-inflammatory cytokines at the site of inflammation.