Clinical Characteristics and Prognosis of Infants and Children <3 Years of Age With Thyroglossal Duct Cyst Complicated With a Parapharyngeal Mass: A Case Series Study.

Thyroglossal duct cysts (TGDCs) are congenital and developmental abnormalities in infants and young children. This retrospective case series study examined the characteristics of 7 patients <3 years (mean age, 1.9 years) with TGDC complicated with a parapharyngeal mass treated at one hospital between January 2019 and 2022. Four patients had a painless mass around the neck, 2 had a painless mass associated with snoring, and 1 presented repeated swelling and pain. B-ultrasound suggested 6 cases of TGDC and 1 possible lymphangioma. All patients were treated with Sistrunk surgery to remove the TGDC. Six patients had no cyst recurrence during follow-up (6 months to 2 years). In conclusion, TGDC complicated with a parapharyngeal mass has complex and variable clinical manifestations. Completely removing the cyst while sparing thyroid cartilage and surrounding vascular and neuroanatomical structures is important to avoid complications. The patients are likely to be free from recurrence after surgery.

Smart nano generation of transgenic algae expressing white spot syndrome virus in shrimps for inner ear-oral infection treatments using the spotted hyena optimizer (SHO)-Long short-term memory algorithm.

Nanotechnology offers a promising avenue to amplify the effectiveness and precision of using transgenic algae in managing WSSV in shrimp by possibly crafting nano-carriers for targeted therapeutic agent delivery or modifying algae cells at a molecular level. Leveraging the capabilities of nano-scale interventions, this study could explore innovative means to manipulate cellular processes, control biological interactions, and enhance treatment efficacy while minimizing undesirable impacts in aquatic environments. The White Spot Syndrome Virus (WSSV) is a double-stranded DNA virus with a tail and rod form that belongs to theNimaviridaefamily. There is no workable way to manage this illness at the moment. This research proposes a new model based on the Long Short-Term Memory (LSTM) and Spotted Hyena Optimizer (SHO) method to control the inner ear-oral infection, utilizing transgenic algae (Chlamydomonas reinhardtii). It is pretty tricky to modify the weight matrix in LSTM. The output will be more accurate if the weight of the neurons is exact. Histological examinations and nested polymerase chain reaction (PCR) testing were performed on the challenged shrimp every 4 h to assess the degree of white spot disease. The SHO-LSTM has shown the highest accuracy and Roc value (98.12% and 0.93, respectively) and the lowest error values (MSE = 0.182 and MAE = 0.48). The hybrid optimized model improves the overall inner ear-oral linked neurological diseases detection ratio. Additionally, with the slightest technical complexity, it effectively controls the forecast factors required to anticipate the ENT. Algal cells were found to be particularly well-suited for inner ear-oral infections, and shrimps fed a transgenic line had the best survival ratio in WSSV infection studies, with 87% of the shrimp surviving. This shows that using this line would effectively stop the spread of WSSV in shrimp populations.

The Bridging Effect of Controlled-Release Glial Cell-Derived Neurotrophic Factor Microcapsules within Nerve Conduits on Rat Facial Nerve Regeneration.

Objectives: The study is aimed at exploring the effect of the controlled release of the glial-derived neurotrophic factor (GDNF) on nerve regeneration. Methods: The PLGA/chitosan composite nerve conduit was used to bridge the dissected trunk of the rat facial nerve. GDNF microcapsules were loaded into the nerve conduit. Nine weeks after surgery, the facial nerve zygomatic and buccal branches were labeled with fluorescent indicators. The incorrectly grown facial neurons were reversed and counted. The facial nerve functional recovery was assessed by measuring the maximum evoked potential. Results: The nerve conduit was filled with different regenerating factors, such as the GDNF, GDNF microcapsules, or saline (control). The number of incorrectly regenerated neurons was lower with the nerve conduits filled with GDNF microcapsules than with those supplied with just the GDNF. However, neither the GDNF nor GDNF microcapsules affected the number of regenerated neurons. The functional recovery of the facial nerve was the best, with the nerve conduit filled with GDNF microcapsules closest to the healthy uncut facial nerve. Conclusion: The stable slow-release GNDF microcapsule inside the biodegradable nerve conduit can reduce the extent of incorrect growth of the facial nerve neuron when bridging the dissected rat facial nerve trunk. The technique has a good effect on functional nerve recovery.

[Children's OSAHS caused by the huge fibrolipoma in pharynx nasalis: a case report].

We reported a case of children's OSAHS caused by the huge fibrolipoma in pharynx nasalis. The patient was a 10-years-old child who went to the hospital with the chief complaint of "Snoring and mouth breathing during sleep for 10 years". Imaging tests found one huge tumor in pharynx nasalis before the operation. The tumor was resected totally. The postoperative pathological diagnosis was fibrolipoma. No recurrence was noted during the follow-up visit one year postoperatively. The clinical features, diagnosis, treatment, pathology and prognosis were reviewed herein.

Expression of purinergic receptor P2Y4 in Schwann cell following nerve regeneration.

OBJECTIVE: Emerging evidences suggested an important role of purinergic receptor P2Y4 in nerve system. The present study aims to investigate the localization and possible function of P2Y4 receptor in recurrent laryngeal nerve (RLN) following regeneration. METHODS: Right RLN of fifty Sprague-Dawley rats was cut and immediately repaired with PLGA/chitosan nerve conduit. Immunofluorescence, real-time qPCR and Western blot were used to detect the expression alterations of P2Y4 receptor. RESULTS: Weak immunostaining signals of P2Y4 receptor were located on the plasmalemma of Schwann cell (SC) with regular arrangement of axons in normal RLN. On the post-injury 4th day, the sprouting axons regrowed along the degenerated SCs intensively expressing P2Y4 receptor. On the post-injury 7th day, the regenerating axons existed in multicellular cords of P2Y4 receptor-positive SCs occupying the nerve gap. On the post-injury 14th day, the axons grew along the bands of P2Y4 receptor-positive SCs exhibiting the regularly parallel distribution. On the post-injury 30th day, mild immunostaining signals of P2Y4 receptor still existed on SC surface, and the regenerated axons were located inside the remodeled endoneurium tube. In accordance with immunofluorescence findings, the transcription and protein expression levels of P2Y4 were significantly increased after the injury and the peak value appeared on the post-injury 7th day, compared to control group (P < 0.05). CONCLUSION: Data from the present study suggested a potential role of P2Y4 receptors in functional modulation of SCs in the regeneration of RLN.

A Prospective Study of the Surgical Outcome of Simple Uvulopalatopharyngoplasty (UPPP), UPPP Combined With Genioglossus Advancement or Tongue Base Advancement for Obstructive Sleep Apnea Hypopnea Syndrome Patients With Multilevel Obstruction.

OBJECTIVES: To investigate the surgical outcomes of different uvulopalatopharyngoplasty (UPPP). METHODS: All subjects underwent overnight polysomnography and were evaluated using the Epworth sleepiness scale (ESS), the Quebec sleep questionnaire and the snoring scale at the baseline and 3 and 12 months following operation. The primary endpoint was the overall effective rate representing the sum of the surgical success rate and effective rate. RESULTS: The overall effective rate at 12 months post surgery was 55.6% for simple UPPP, 95.8% for UPPP+GA, and 92.3% for UPPP+TBA. The surgical success rate at 3 and 12 months postoperation for UPPP+GA or UPPP+TBA was significantly higher than simple UPPP (P<0.05). Marked improvement was observed in all patients in the snoring scale score and the ESS score 3 and 12 months following surgery compared to the baseline (P<0.05 in all). CONCLUSION: UPPP, UPPP+GA, and UPPP+TBA are all effective in improving the surgical outcome of obstructive sleep apnea hypopnea syndrome (OSAHS) patients with multilevel obstruction. UPPP+TBA appears to be the most effective in treating OSAHS patients.

Effects of bleomycin A5 on caspase-3, P53, bcl-2 expression and telomerase activity in vascular endothelial cells.

OBJECTIVE: The aim of this study was to investigate the molecular mechanism of bleomycin A5 in inducing the apoptosis of human umbilical vein endothelial cells (ECV304). MATERIALS AND METHODS: ECV304 cells were cultured and passaged, and then were divided into control group and three treatment groups. The later three groups were treated with 15, 75, and 150 µg/ml bleomycin A5 for 24 hours, respectively. The expressions of caspase-3, p53, and bcl-2 in ECV304 cells were detected by flow cytometry, and the activity of telomerase was determined using telomere repeat amplification protocol (TRAP)-silver staining method. RESULTS: After treatment with different concentrations of bleomycin A5, the expression of caspase-3 in ECV304 cells was increased. It was significantly decreased with the increase of bleomycin A5 concentration, but the difference between 75 µg/ml and 150 µg/ml groups was not significant. Bleomycin A5 could significantly increase the expression of p53, with concentration dependence. It had no obvious effect on bcl-2 expression. There was high expression of telomerase in control group. After treatment with different concentration of bleomycin A5, the telomerase activity was significantly decreased. CONCLUSION: Bleomycin A5 can increase caspase-3 and p53 levels and inhibit telomerase activity to induce ECV304 apoptosis.

Proapoptotic effect and the mechanism of action of pingyangmycin on cavernous hemangiomas.

This study aimed to investigate the proapoptotic effects and the mechanism of action of pingyangmycin (PY) on cavernous hemangioma. The rat spleen was used as a model of cavernous hemangioma. PY was injected into the spleen and the pathological changes were observed at different time-points. Apoptosis was detected using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and transmission electron microscopy (TEM). The expression levels of the apoptosis-related protein, caspase-3, were determined using immunohistochemistry and image analysis. Rats injected with normal saline were the control group. Injection of normal saline did not damage rat spleens. On days 2 and 5 following PY injection, the spleens exhibited slight swelling. On days 8 and 14, atrophic changes were observed and the splenic sinus endothelial cells were damaged. At various time-points following PY injection, the apoptotic cells were observed by TEM. The TUNEL assay showed that apoptosis occurred widely among the splenic sinus endothelial cells and other splenic cells. The apoptotic rate and caspase-3 expression levels increased with prolonged PY exposure. PY induced apoptosis of splenic sinus endothelial cells through the caspase-3 activation pathway, and resulted in endothelial cell necrosis and fibroblast hyperplasia.

Role of AQP1 in inner ear in motion sickness.

Inner ear is critical for the development of motion sickness (MS). The present work was designed to test the role of aquaporins (AQPs) in inner ear in MS. After repetitive stimulus of rotation, the MS symptom was steadily alleviated in mice. After repetitive stimulus of rotation, several AQPs mRNA levels including AQP1, AQP2, AQP3, AQP4, AQP6, AQP7, and AQP9 in the inner ears of mice were analyzed. It was found that AQP1 mRNA level was increased remarkably, which was reconfirmed by Western blotting analysis. In addition, the relationship between AQP1 expression and MS sensitivity was studied and it was shown that AQP1 mRNA level was negatively related to MS index in mice. We sought to examine the function of AQP1 in inner ear using an RNAi approach to reduce the AQP1 protein expression in vivo. It was first observed that AQP1 knockdown in inner ear resulted in a significant increase of MS sensitivity in mice. In conclusion, after repetitive stimulus of rotation, the alleviation of MS symptom in mice was, at least in part, due to the upregulation of AQP1 expression in inner ear. In addition, the sensitivity to MS in mice was, at least in part, dependent on the expression of AQP1 in inner ear. AQP1 in inner ear plays an important role in the development of MS, and might be a potential target for the prevention or management of MS.

Laryngeal reinnervation using ansa cervicalis for thyroid surgery-related unilateral vocal fold paralysis: a long-term outcome analysis of 237 cases.

OBJECTIVE: To evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery. SUMMARY OF BACKGROUND DATA: UVFP remains a serious complication of thyroid surgery. Up to now, a completely satisfactory surgical treatment of UVFP has been elusive. METHODS: From Jan. 1996 to Jan. 2008, a total of 237 UVFP patients who underwent ansa cervicalis main branch-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled as UVFP group; another 237 age- and gender-matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and electromyography were performed preoperatively and postoperatively. The mean follow-up period was 5.2±2.7 years, ranging from 2 to 12 years. RESULTS: Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved in the UVFP group (P<0.001, postoperative vs. preoperative). The postoperative parameters of vocal function were also significantly improved in the UVFP group (P<0.001) and showed no statistical differences compared to the control group (P>0.05, respectively). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. CONCLUSIONS: Delayed laryngeal reinnervation with the main branch of ansa cervicalis is a feasible and effective approach for treatment of thyroid surgery-related UVFP; it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality.

Contralateral ansa cervicalis-to-recurrent laryngeal nerve anastomosis for unilateral vocal fold paralysis: a long-term outcome analysis of 56 cases.

OBJECTIVES/HYPOTHESIS: To evaluate the long-term efficacy of contralateral ansa cervicalis-to-recurrent laryngeal nerve (RLN) anastomosis for unilateral vocal fold paralysis (UVFP), when the ansa cervicalis on the side of the paralyzed vocal fold was absent or there was any question about its viability. STUDY DESIGN: We retrospectively reviewed 56 consecutive cases of delayed laryngeal reinnervation with contralateral ansa cervicalis for UVFP. METHODS: Between January 1996 and January 2008, a total of 56 UVFP patients were enrolled in this study. All patients underwent contralateral ansa cervicalis-to-RLN anastomosis. Videostroboscopy, acoustic analysis, perceptual evaluation and maximum phonation time (MPT), and laryngeal electromyography (LEMG) were performed pre- and postoperatively. RESULTS: Analysis of videostroboscopic findings indicated that the glottic closure, vocal fold edge, vocal fold position, phase symmetry, and regularity were significantly improved (P < .001, post- vs. preoperative). Perceptual evaluation of dysphonia severity showed that overall grade, roughness, breathiness, asthenia, and strain were also significantly decreased postoperatively (P < .001). Postoperative values of jitter (local), shimmer (local), and mean noise-to-harmonics ratio were significantly lower than the corresponding preoperative values (P < .001). The postoperative MPT value was significantly longer than the preoperative one (P < .001). LEMG showed that there was a significant postoperative improvement in voluntary motor-unit recruitment during phonation (P < .001). CONCLUSIONS: In cases with a lack of viable ansa cervicalis on the side of a paralyzed vocal fold, contralateral ansa cervicalis-to-RLN anastomosis is a feasible and effective approach in the treatment of UVFP and can restore physiologic laryngeal phonatory function.

[The influence of denervation on myofiber morphology of the adductor and abductor in patients with recurrent laryngeal nerve paralysis].

OBJECTIVE: To investigate the influence of denervation on myofiber morphology of the adductor and the abductor in patients with recurrent laryngeal nerve (RLN) paralysis and to provide experimental evidence for the clinical feasibility of RLN repair. METHOD: Adductor muscles were acquired from the lateral cricoarytenoid muscle (LCAM) and abductor muscles from the posterior cricoarytenoid muscle(PCAM). Normal human PCAM and LCAM are treated as control group (n = 7). Thirty-eight cases of PCAM with damaged RLN were divided into five groups according to the duration of their RLN damage: 0.5-1 year (7 cases), > 1-2 years (10 cases), > 2-3 years (8 cases), > 3-6 years (8 cases) and > 6 years (5 cases); twenty-nine cases of LCAM were also divided into five groups: 0.5-1 year (7 cases), > 1-2 years (6 cases); > 2-3 years (6 cases), > 3-6 years (6 cases) and > 6 years group(4 cases). They were all stained with HE and Masson three-color staining, the fiber cross-sectional area of muscle tissue and collagen connective tissue were quantitative analyzed. The changes of myofiber morphology of adductor and abductor muscles after the loss of the RLN were analyzed with image analysis system. RESULT: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation. (1) Difference between the denervated groups of LCAM of 0.5-1 year, > 1-2 years and > 2-3 years groups were not significant (P > 0.05). Fiber cross-sectional area of > 3-6 years group decreased most obviously with significantly difference compared with > 2-3 years group (P < 0.05); (2) There were obvious difference between the control group, 0.5-1 year group, > 1-2 years group, > 2-3 years group and > 3-6 years of PCAM(P < 0.05); (3) There was no significant difference between the group of > 3-6 years and > 6 years of two kinds of laryngeal intrinsic muscle (P > 0.05); (4) Fiber cross-sectional area of each group of the LCAM after 1 year denervation were significantly greater than that of the PCAM under same conditions (P < 0.05). CONCLUSION: The influence of denervation on myofiber morphology following denervation is different between the abductor and adductor owing to the different fiber type composition and functional properties. The rate of muscle atrophy of the adductor is slower than that of the abductor. To restore the structure and function of denervated laryngeal muscles better, the recurrent laryngeal nerve injury repair surgery for PCA muscle function recovery should be carried out within 1 year after denervation while the surgery for LCA muscle function recovery should be carried out within 3 years after denervation.

[The expression of myosin heavy chain isoforms of human normal laryngeal muscles and the difference between the adductor and abductor].

OBJECTIVE: To investigate the expression of myosin heavy chain (MHC) in normal laryngeal muscle and the difference between the adductor and abductor. METHOD: Seven patients with total laryngectomy were enrolled in this study. The adductor muscles were acquired from the lateral cricoarytenoid (LCA) muscle and the abductor muscles were acquired from the posterior cricoarytenoid (PCA) muscle. The expression of myosin heavy chain were detected with fluorescent quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence staining respectively. RESULT: (1) MHC-II b was expressed in laryngeal muscles at mRNA levels, and not expressed at the protein level; (2) At both mRNA level and protein level, the expression of MHC-I was higher in the PCA muscles than in the LCA muscles while MHC-II level was higher in the LCA muscles than in the PCA muscles. CONCLUSION: (1) MHC-II b protein was not expressed in human laryngeal muscles; (2) Phenotypic differences were significant in laryngeal adductor and abductor muscles based on their different functions. PCA contained larger percentage of MHC-I fibers, while LCA contained more MHC-II fibers.

[Effects of two surgical techniques for vocal cord cyst].

OBJECTIVE: To compare the effectiveness of vocal cord cyst excision with electronic laryngoscope (EL) and self-retaining laryngoscope (SRM). METHOD: Nightly-two patients, diagnosed as vocal cord cyst with strobolaryngoscope or electronic laryngoscope, were randomly divided into two groups. One group was 48 cases treated with electronic laryngoscope and another group was 44 cases treated with self-retaining laryngoscope. Electronic laryngoscopy examination and voice function assessments were performed to all patients, preoperatively and postoperatively at one week, three months and six months. RESULT: One failed cases under SRM, difficult exposure of glottic portion, were treated under EL. The recurrence rate of the two groups was of no statistical significance in three months after operation. Voice function assessment of the two groups was of no statistical significance at one week, three months and six months after operation. CONCLUSION: The operation under electronic laryngoscope is a minimal invasive procedure to the laryngeal mucosa. Electronic laryngoscope had advantages such as clear view, accurate operation. Furthermore, it can be used for those that could not be treated under self-retaining laryngoscope.

[Glottic measurement and vocal evaluation after three surgical techniques in the treatment of bilateral vocal cord paralysis].

OBJECTIVE: To evaluate postoperative glottic area and vocal quality of three various surgical techniques for treating bilateral vocal cord paralysis, including laser arytenoidectomy (Group A, 24 cases), reinnervation of the posterior cricoarytenoid muscle by phrenic nerve (Group B, 9 cases) and arytenoidectomy accompanying lateral cordopexy by extralaryngeal approach (Woodman's procedure, Group C, 13 cases). METHODS: 46 cases suffered from bilateral recurrent laryngeal nerve injury were included in our study. The pre-postoperative glottic measurement and vocal acoustic parameters were analyzed. RESULTS: The decannulated cases in group A and group B and group C were 22, 8, 13 respectively. The post-operative mean maximal glottic area was (47.2 +/- 7.4) mm2, (78.3 +/- 16.0) mm2, (48.1 +/- 6.5) mm2 respectively. Group B cases glottic area was larger than that of group A and group C (t value were 4.46 and 3.85, P value were 0.000 and 0.001). No significant difference was found between group A and group C (t = 1.68, P = 0.101). After surgery, in group A, 17 cases voice quality was the same compared with that of before surgery, and 7 cases voice quality had become worse; In group B, the voice quality had become better in 5 cases, completely recovered in 1 case, and had not change in 3 cases; In group C, the voice quality had become deteriorated in 10 cases and no change in 3 cases. And in group B, ipsilateral diaphragm paralysis in 9 cases after surgery, whose vital capacity and forced vital capacity had decreased to 72%-84%, 76%-84% of that before the surgery respectively; and the diaphragm mobility had recovered by 35%-76% respectively, while vital capacity and forced vital capacity had become 93%-97%, 91%-98% of that before the surgery. In Group B, all cases' pulmonary function was normal half a year postoperatively. CONCLUSIONS: Reinnervation of the posterior cricoarytenoid muscle by phrenic nerve seems to be best procedure with better post-operative voice and larger glottic area. Although the sufficient airway for decannulation can be acquired in Group A and Group C, but most of patients in Group A had pre-operative vocal level and badly abnormal in Group C.

[Intratumor bleomycin-A5 injection under electrolaryngoscope for treatment of large laryngopharyngeal and laryngeal hemangioma].

OBJECTIVE: To study the therapeutic effect of bleomycin-A5 injection under eletrolaryngoscope for treatment of large laryngopharyngeal and laryngeal hemangioma. METHODS: Intratumor bleomycin-A5 injection under eletrolaryngoscope was performed in 18 cases of large laryngopharyngeal and laryngeal hemangioma with surface anaesthesia, for totally 7 to 14 (mean 10.2) injections in each case. RESULTS: Twelve patients were cured and 6 showed obvious improvement. Follow-up of the patients for over one year found no recurrence of the hemangioma. CONCLUSION: Bleomycin-A5 injection is a minimal invasive procedure for treatment of large laryngopharyngeal and laryngeal hemangioma, causing less pain and better preserving the laryngeal function without the necessity of tracheotomy.