Comprehensive analysis and treatment of intraoral thyroglossal duct cysts with intraoperative techniques: a 7-case series review in a tertiary care center.

OBJECTIVE: Intraoral thyroglossal duct cyst is a relatively rare clinical disease. This article reviews the diagnosis and treatment process of 7 patients and explores the clinical characteristics of diagnosis and treatment of intraoral thyroglossal duct cyst in combination with past literature reports. METHOD: A retrospective analysis was conducted on 7 cases of intraoral thyroglossal duct cyst admitted to the Otolaryngology ward of Dalian Municipal Central Hospital from January 2017 to January 2024. The cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods, and postoperative complications. All cases were followed up, and the latest follow-up results were recorded. RESULTS: Among the 7 cases, 6 patients underwent laryngoscopic and radiological examinations before surgery, and 1 child was found to have a cyst during surgery. All cases were diagnosed with intraoral thyroglossal duct cyst and treated with plasma radiofrequency surgery. None of the patients had postoperative complications, and no recurrence was found in the six-month follow-up after discharge. CONCLUSION: Intraoral thyroglossal duct cyst is rare in clinical practice. It is important to pay attention to its differential diagnosis clinically, and careful review of images is required before surgery. Cryoablation with low-temperature plasma radiofrequency is not only minimally invasive and has a quick recovery but also has few complications and a low recurrence rate. It is a safe and effective treatment method that is worthy of clinical promotion. LEVEL OF EVIDENCE: Level 3.

Significance of Nasopharyngeal Cavity Area in Individuals with Adenoid Hypertrophy Assessed by Cone Beam Computed Tomography.

Objective: To determine the significance of the nasopharyngeal cavity area (S) in diagnosing and treating adenoid hypertrophy (AH) in children by measuring it with cone beam computed tomography (CBCT). Methods: A retrospective analysis was conducted on the clinical data of eighty-five 5- to 6-year-old children with AH admitted to the Department of Otorhinolaryngology at Dalian Central Hospital between January 2022 and April 2023. Of the 85 patients, 48 were male and 37 were female; all had been diagnosed with AH and underwent surgery. Sleeping with open-mouth breathing was frequently accompanied by clinical manifestations such as chronic sinusitis in most patients. Every patient was subjected to a CBCT examination of the nasopharynx and 3D airway reconstruction. The adenoid thickness (A) and nasopharyngeal cavity width (N) were measured in the sagittal plane, while the S was measured in the coronal plane. The factors that had a significant impact on S's size was analyzed using linear regression. Results: S and age, A, N, height, weight, BMI, allergic rhinitis, deviated nasal septum, and enlarged turbinate hypertrophy did not differ significantly (P > .05). However, there was a significant linear relationship between A/N and chronic sinusitis (R2 = 0.948, P < .01). Regression equation: S = -4.115 × A/N × 100-5.037 × 1/0 (with chronic sinusitis/without chronic sinusitis) +418. 097. The calculated S in individuals with A/N = 70% and no chronic sinusitis was 130 mm2. Conclusion: The S can be used as an important imaging index for diagnosing and evaluating the severity of AH in minors. When a child exhibits clinical signs of AH but A/N ≤ 70%, it is difficult to determine whether surgical intervention is necessary. At this time, CBCT is required to measure the nasopharyngeal cavity's size. When S ≤ 130 mm2, the patient should actively undertake surgical treatment.

Diagnosis and Treatment of Double Thyroglossal Duct Cyst.

This retrospective study aimed to investigate clinical diagnostic and management characteristics of double thyroglossal duct cyst (TDC) cases. Seventy-eight patients diagnosed with TDCs who were admitted to the inpatient ward of the Department of Otolaryngology, Dalian Central Municipal Hospital from June 2008 to October 2021 were included in the study. Ultimately, 67 of these patients were diagnosed with single TDCs and 11 patients with double TDCs. Each patient underwent computed tomography and color doppler ultrasound imaging of their neck masses, thyroid color doppler ultrasound imaging, and surgical cyst removal through the classic Sistrunk procedure. All surgically excised specimens were sent to the pathology lab for examination and were confirmed to contain TDCs. Two of the 67 patients with single TDCs experienced postoperative complications related to infections within the operative area, whereas no patients with double TDCs experienced postoperative infection, excessive bleeding, or other surgical complications. All cases were followed up for 1 to 3 years after surgery with no cyst recurrence observed. Double TDCs may present on physical examination as unilateral neck masses that interfere with tongue extension and movement and swallowing that can be identified using imaging methods. Correct clinical diagnosis and complete surgical removal of cysts are key measures for ensuring successful treatment outcomes for patients with TDCs.

Clinical Diagnosis and Treatment of Primary Laryngeal Neuroendocrine Carcinoma.

OBJECTIVE: This study aims to investigate the clinical diagnosis and treatment characteristics of primary laryngeal neuroendocrine carcinoma. PATIENTS AND METHODS: A retrospective analysis was performed for the data of 6 patients with primary laryngeal neuroendocrine carcinoma admitted to the Department of Otorhinolaryngology of Dalian Central Hospital from September 2015 to January 2022, all of whom were male patients. And laryngoscopy showed that 4 had a similar appearance to hemangioma, 1 had nodular hyperplasia, and 1 was papilloma-like. The site of onset was located on the laryngeal surface of the epiglottis in 3 cases, situated in the aryepiglottic fold in 2 cases, and the posterior ventricular zone in 1 case. Five patients underwent surgery, including 4 by transoral endoscopic cryogenic plasma radiofrequency mass resection; one underwent a cervical lymph node dissection and supraglottic horizontal hemilaryngectomy. The remaining 1 case was treated in another hospital after the pathological diagnosis was confirmed by biopsy. All patients had no cervical lymph node metastases and were not supplemented with chemoradiotherapy. RESULTS: The postoperative pathological diagnosis of all 5 patients was neuroendocrine carcinoma. No cancer cells were seen at the margins and base. One patient was lost to follow-up after treatment in another hospitals and the rest were followed up for 6 months to 6 years. One patient had removed laryngeal tumor and epiglottis by a low-temperature plasma radiofrequency ablation, recurrence 1 year after surgery, and no recurrence for 5 years after supraglottic horizontal hemilaryngectomy combined with prophylactic cervical lymph node dissection, no recurrence for the other 4 patients after 6 months to 4 years of follow-up. CONCLUSION: The common sites of laryngeal neuroendocrine carcinoma are the laryngeal surface of the epiglottis and the aryepiglottic fold. The appearance of the tumor is mainly similar to that of hemangioma. Moreover, a common pathological classification is atypical carcinoid tumors, where early detection and surgical treatment can achieve a good therapeutic effect.

The experience of treatment of coblation assisted surgical approach to Eagle's syndrome.

OBJECTIVE: This article aimed to Summarize our therapeutic experience with Transoral coblation assisted surgical approach used for treatment of Eagle's syndrome. METHODS: sixty-two consecutive patients, from 2010 to 2015, underwent coblation assisted surgical treatment to remove elongated styloid process transorally. Outcomes were assessed in terms of intraoperative and postoperative complications, patients' evolution and efficiency of treatment. RESULTS: The amount of bleeding was 1ml~4ml, average 2.7ml, unilateral operation time was 3min to 10min, average 6.2min, bilateral for 7min to 15min, average 13.5min. no bleeding and complications after operation. Pseudo membrane completely off the 14days or so, the cure rate was 58.1%, the efficiency of 30.6%. CONCLUSION: In order to get a good curative effect, we should pay attention to the accurate diagnosis, choose the appropriate way of intubation and mouth opening device, pay attention to the details of the operation, maximize the effect of coblation to achieve a more minimally invasive treatment effect.

[Clinical, significance of the nomenclature for nasal septum tail: A preliminary study].

OBJECTIVE: To observe and summarize the abnormal morphological appearance of nasal septum tail during adenoidectomies, and to have a preliminary study on its clinical significance. METHOD: One hundred and eighty-three children were shown with abnormality on nasal septum tail in 2892 cases with adenoid hypertrophy who received adenoidectomies in our department. RESULT: The abnormalities of nasal septum tail can be classified into two types: del tails and columnar ones. All children suffered from nasal septum tail received radiofrequency ablation and all had a good postoperative recovery. CONCLUSION: The presence of these two types of nasal septum tail may be related to adenoid hypertrophy, adenoiditis, sinusitis, and some congenital malformations.

[A preliminary study on the superiority of using of coblation during the maxillary sinus operation].

OBJECTIVE: Observed the using of coblation during the maxillary sinus operation, to investigate the superiority of its clinical application. METHOD: Selecting 46 patients with the maxillary sinus lesions of sinusitis, nasal polyps and nasal inverted papilloma as research objects, the control group used high speed cutting drill, the research group used coblation separately for functional endoscopic sinus surgery. Six months postoperative follow-up, observeing the subjective symptoms and objective examination. RESULT: Subjective symptoms and objective examination scores of two groups of patients improved significantly. Compared with the control group, the operation time, bleeding volume and postoperative examination time are reduced in the study group of patients. Endoscopic examinations of the study group are better than the control group. CONCLUSION: Using coblation for the maxillary sinus operation, treatment are more thorough, more minimally invasive, shorten operation time, reduce bleeding and recheck time after surgery, is worthy of clinical use.

[Nasopharynx pleomorphic adenoma report].

The patient was a 42 years old female. And the reason why she was addmited to the hospital was progressive bilateral nasal congestion for one year, and bilateral nasal bleeding for one day. Physical examination showed no surgical contraindication so the patient got the nasal endoscope by plasma radiofrequency ablation surgery with general anesthesia on 3rd Dec. 2013. And the result of potholegical examination was nasopharynx pleomorphic adenoma.

[Coblation treatment for laryngopharynx hemangioma].

OBJECTIVE: To evaluate the effect and feasibility of coblation treatment for laryngopharynx hemangioma. METHOD: Retrospectively analyzed 24 cases with coblation treatment for laryngopharynx hemangioma in recent years. RESULT: Twenty-four patients were treated with coblation, follow-ups range 6 months to 24 months after surgry. Recurrence occurred in 2 months after surgry in one patient who was cured with coblation for second time. There was incomplete vocal cord paralysis in another patient because of wide range angeioma. CONCLUSION: Coblation treatment for laryngopharynx hemangioma was an ideal way to less bleeding, less damage and more clearfield of vision.

[Right non recurrent laryngeal nerve during thyroid surgery: one case report].

A 56 years old female was admitted to our department with complaint of a painless cervical mass. Clinical feature:there was a painless mass above left lobe of thyroid gland, which was about 3.0 cm x 2.5 cm in size, and could move with swallowing action. B-mode ultrasound features: there was a solid mass in left lobe of thyroid gland, which was about 3.2 cm. Nodule was found in isthmus, accompanied with lymphadenovarix on the left neck possibly be MCA. fT3: 4.64 pmol/L, fT4:16.56 pmol/L,TSH:3.74 mIU/L, anti-TG:17.75 U/ml, anti-TPO:40.77 U/ml. Pathological result of the neoplasm: papillocarcinoma. Clinical diagnosis: papillary thyroid carcinoma.

[Analysis of monitoring results of Mattress-type of sleep monitoring system in elderly patients with OSAHS].

OBJECTIVE: To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS. METHOD: One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed. RESULT: Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant. CONCLUSION: The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.

[Thyroglossal cyst of double cyst: one case report].

A 5 years old boy was referred to our department with complaints of a painless midline neck swelling. Clinical feature: there was a painless swelling above the middle of thyroid cartilage, it was about 2.0 cm x 0.5 cm, and it was soft. And its boundary was clear. The skin temperature is normal. B-mode ultrasound features: there is a cystic mass in the front of the neck, it is about 2.3 cm x 1.0 cm, and be apart from the skin is 0.3 cm. It is showed that another cystic mass behind this one, is about 1.9 cm x 0.7 cm. The borders are clear, and no blood flow signal is detected. The thyroid was not abnormal. Pathology results showed the wall of cyst and there were pectin in the cyst. Diagnosis: thyroglossal cyst of double cyst.

[Nasal mucosa recovery after endoscopic surgery using the plasma radiofrequency ablation at low temperature for treatment of nasal inverted papilloma].

OBJECTIVE: To assess the therapeutic effect and study the role of nasal mucosa epithelization after endoscopic surgery using the plasma radiofrequency ablation at low temperature in patients with nasal inverted papilloma. METHOD: The clinical data of 104 patients with nasal inverted papilloma underwent endoscopic surgery u sing the plasma radiofrequency ablation at low temperature from July, 2008 to July, 2012 were analyzed,and the recovery of mucosa was observed under nasal endoscope. RESULT: The mucosa recovery extent showed a decreasing trend from mucosa pattern degree I to III, where the difference was statistically significant by chi-square test between groups (P < 0.05). The average epithelialization time was 2.7 months. It showed a significantly decreasing trend among average epithelialization time of different degrees of mucosa (P < 0.05). The nasal mucosa of most patients completed epithelialization 2.9 months after surgery. CONCLUSION: It is safe and effective to treat nasal inverted papilloma with plasma radiofrequency ablation at low temperature. The patients should be followed up with regular reexamination for at least three months after surgery.

[Radiofrequency coblation for treatment of abnormal sensation of throat induced by the hypertrophy of lingual tonsil].

OBJECTIVE: The aim of the present study was to evaluate the effects of radiofrequency coblation surgery for treatment of abnormal sensation of throat induced by the hypertrophy of lingual tonsil. METHOD: Three hundred and seven patients affected by abnormal sensation of throat induced by the hypertrophy of lingual tonsil were enrolled. Radiofrequency coblation was performed on all patients under nasal endoscopy. A comprehensive statistics were obtained from all the participants regarding the recovery of wound surface, postoperative pain, intra and postoperative bleeding and the effects of the procedure. RESULT: The VAS score of abnormal sensation of throat was reduced from (9.3 +/- 0.6) to (3.7 +/- 2.4) (P<0.05) after the operation. 84.4% of the abnormal sensation dis appeared, no recurrence within six month; 6.8% of the abnormal sensation largely reduced within six month; 4.6% of the abnormal sensation reduced within six month. There was no significant postoperative pain. 3.6% (11/307) of patients experienced postoperative hemorrhage. The follow-up period ranged from 6 to 36 months, there was no recurrence. CONCLUSION: Radiofrequency coblation is a useful surgical technique, as effective as,or even superior to,other surgical techniques when dealing with patients suffering from abnormal sensation of throat induced by the hypertrophy of lingual tonsil with potentially fewer adverse effects and subsequently improved quality of life for patients.

[Chordoma originated from sphenoid sinus, encroach on sella, metasella and clivus: one case report].

The purpose is to report a case of chordoma, which orignated from sphenoid sinus and encroach on sella, metasella and clivus. We comprehensively analyzed the CT and MRI information and diffrentiated the illness from the commonly encountered diseases of sphenoid sinus and sellato improve the accuracy before surgery.

[Lingual thyroglossal duct cyst treatment by low temperature coblation on endoscope].

OBJECTIVE: To investigate the treatment for lingual thyroglossal duct cyst by low temperature coblation on endoscope. METHOD: Eleven cases of lingual thyroglossal duct cyst were treated by low temperature coblation on endoscope,to observe the curative effect and complication. RESULT: Eleven cases of lingual thyroglossal duct cyst were satisfied after operation, without serious complication. There were no recurrence during a followed up for 1-3 years after operation. CONCLUSION: The operation for lingual thyroglossal duct cyst by low temperature coblation on endoscope was easy,safe and effective.

[The application of micro-sensitive mattress type sleep monitor in the diagnosis of OSAHS in children].

OBJECTIVE: To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children. METHOD: The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared. RESULT: By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01). CONCLUSION: Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.

[Clinical observation of coblation under endoscopy on epiglottis cyst].

OBJECTIVE: To evaluate the effect of the coblation under endoscopy on epiglottis cyst. METHOD: One hundred and ninety-three patients with epiglottis cyst were treated with coblation under endoscopy. Follow-up study was performed from 1 month to 6 months after treatments. RESULT: All 193 cases with epiglottis cyst were primary cured without serious complication and the cure rate was 100%. Moreover, the minor hemorrhage (1-5 ml) was observed. CONCLUSION: The coblation under endoscopy on epiglottis cyst was safe, effective and minimally invasive.