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OBJECTIVES: To evaluate the anatomic and functional outcomes of type1 tympanoplasty with endoscopic modified butterfly cartilage-perichondrium technique. METHODS: In our modification, perichondrium was elevated circumferentially till the attached part of the composite graft was approximately same size and shape of the perforation, cartilage was trimmed based on the perforation but 0.5 mm larger. Cartilage portion of the graft was placed medial to the edge of the perforation, then perichondrium was rolled out and draped on the circumferential raw surface of remaining tympanic membrane around. RESULTS: At 4 months postop, the anatomic integrity rate of the tympanic membrane perforation for small & medium sized perforation and large sized perforation group were 100 % and 94 % (p > 0.05). For the small & medium perforation group, the mean pre and 4 months postop ACs were 30 ± 8 dB and 18 ± 6.4 dB (p < 0.01). The mean pre and 4 months postop ABGs were 19 ± 11 dB and 9 ± 3 dB (p < 0.01). For the large perforation group, the mean pre and 4 months postop ACs were 43 ± 12.5 dB and 21.5 ± 7 dB (p < 0.01). The mean pre and 4 months postop ABGs were 34 ± 8.5 dB and 12.5 ± 6 dB (p < 0.01). The differences of mean 4 months postop ACs and mean 4 months postop ABGs between the two groups were not significant (p > 0.05). CONCLUSIONS: Compared to the conventional inlay butterfly cartilage tympanoplasty technique, large or marginal perforations can be sealed more securely by this modification.
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Objective: To observe the functional and esthetic results of endoscope-assisted septo-rhinoplasty via intranasal approach. Methods: The clinical data of 12 patients with septal deviation and nasal deformity in the University of Hong Kong-Shenzhen Hospital from June 2021 to June 2022 were analyzed, including 8 males and 4 females, aging 28 to 58 years. All patients were operated under general anesthesia. The septal deviation was corrected by hemitransfixion incision, combined with intercartilaginous incision and other intranasal or extranasal incisions to perform osteotomy, hump resection and saddle nose correction. Patient satisfaction with postoperative functional and aesthetic improvements was assessed through Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and Visual Analogue Scale (VAS).SPSS 25 software was used for statistical analysis. Results: The correction of nasal septum deviation was satisfactory in all 12 patients. Nasal obstruction was relieved, with NOSE score and VAS score of nasal ventilation decreased [(21.67±10.30) vs (70.83±14.12), (1.83±1.03) vs (8.33±0.89), t value was 9.49 and 16.30, respectively, both P<0.05]. The nasal appearance of 10 patients with crooked nose deformity was improved, with ROE score and VAS score of nasal appearance increased [(21.30±2.31) vs (8.10±3.31), (8.90±0.99) vs (3.80±1.62), t value was -11.85 and -9.33, respectively, both P<0.05];The nasal vestibule morphology of 2 patients with abnormal nasal vestibule was improved. During the follow-up of 12 to 24 months, no postoperative complication such as nasal septum perforation, nasal cavity adhesion or nasal dorsal collapse occurred in all patients. Conclusion: Endoscope-assisted septo-rhinoplasty via intranasal approach can resolve both functional and esthetic problems at the same time, improving outcomes while reducing surgical trauma.
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Obstrução Nasal , Rinoplastia , Feminino , Masculino , Humanos , Obstrução Nasal/cirurgia , Nariz , Anestesia Geral , EndoscópiosRESUMO
Objective: To evaluate the application of three-staged paramendian forehead flap technique in reconstruction of severe full-thickness nasal defect. Methods: Clinical data of 7 cases with nasal reconstruction by three-staged forehead flap technique in the First Affiliated Hospital of Xinjiang Medical University and HongKong University Shenzhen Hospital between June 2016 and October 2019 was retrospectively reviewed. All were males aged from 10 to 71 years. There were 4 cases of basal cell carcinoma of the external nose, 2 cases of traumatic nasal defects and 1 case of large rhinophyma. All the operations were performed with the paramedian forehead flap in three stages. In stage â , full layered forehead flap was transposed to the nasal detect. Lining flaps were reconstructed with folded forehead skin (n=4), turn-over flap plus septal chondro mucosal pivotal flap (n=2), or bipedicled vestibular skin and nasal mucosa advancement flap (n=1). According to the reconstruction mode of the lining flaps, whether to implant cartilage to reconstruct the external nasal stent at stage â was determined. At stage â ¡, the folded flaps were partly or completely separated from the covering flaps along the free edges of nasal alar. All the excess soft tissue including subcutaneous fat and frontalis muscle were excised, cartilage grafts were placed or sculpted to make an ideal nasal contour. The covering flaps were then returned on the recontoured, three-dimensional recipient bed. At stage â ¢, the pedicles were divided. Descriptive statistical method was used to analyze the data. Results: In all cases, restoration of the nasal contour was remarkably good, no flap necrosis occurred. All patients were followed up for 6 months to 2 years, and the appearance and function of the nose recovered well. All patients were satisfied with their final aesthetic results. Conclusions: Three-staged paramedian forehead flap technique ensures maximal blood supply for the lining flap and the inserted cartilage graft, and restores an ideal three-dimensional nasal contour for reconstruction of large full thickness nasal defects.
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Neoplasias Nasais , Rinoplastia , Neoplasias Cutâneas , Idoso , Testa/cirurgia , Humanos , Masculino , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Retalhos CirúrgicosRESUMO
Reduction in DNA repair capacity is associated with increased rates of birth defects, cancer, and accelerated aging. According to some earlier studies, genetic polymorphisms in DNA repair genes might influence the repair activities of the enzymes predisposing individuals to cancer risk. Owing to the presence of these genetic variants, inter-individual and ethnic differences in DNA repair capacity have been observed in various populations. Polymorphisms in DNA repair genes and differences in repair capacity between individuals have been widely reported in different cancers. We conducted a case-control study to examine the role of genetic polymorphisms in XRCC1 Gln632Gln (rs3547), Arg399Gln (rs25487), Arg280His (rs25489), Arg194Trp (rs1799782) in the risk of laryngeal cancer in different ethnic groups in Xinjiang. This study included 58 laryngeal cancer patients and 120 healthy controls age- and sex-matched without cancer. The genotypes of XRCC1Gln632Gln (rs3547), Arg399Gln (rs25487), Arg280His (rs25489) and Arg194Trp (rs1799782) were analyzed by PCR-RFLP, and the odds ratio (OR) and 95% confidence interval (CI) were calculated using an unconditional logistic regression model. C/T (hybrid) and T/T (mutant) genotypes of XRCC1 Arg280His (rs25489) revealed no statistical significance in the risk of laryngeal cancer (P>0.05), whereas the genotypes of XRCC1 Gln632Gln (rs3547), Arg399Gln (rs25487), Arg280His (rs25489), Arg194Trp (rs1799782) showed a higher risk than the controls (P<0.01) in Han, Uygur, and Kazak nations. In conclusion, the current study suggests that XRCC1 Gln632Gln (rs3547), Arg399Gln (rs25487), and Arg194Trp (rs1799782) polymorphisms may be associated with laryngeal cancer risk in the Han, Uygur, and Kazakh populations in Xinjiang. Individuals carrying genotype Arg/Gln+Gln/Gln showed a greater risk than those carrying Arg/Arg for laryngeal cancer in the Han, Uygur and Kazakh ethnic groups, and the odds ratios are 1.47, 1.32, and 0.77.
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Objective To systematically review and quantify current evidence regarding the association of GJB2 mutation status with outcomes of pediatric cochlear implantation. Data Sources PubMed, Embase, and the Cochrane Library were searched for "GJB2,""pediatric hearing loss," and "cochlear implantation" and their synonyms, with no language restrictions, until December 2, 2015. Review Methods Studies were included that investigated the status of GJB2 mutation and its predictive value for outcomes of pediatric cochlear implantation. Speech recognition scores, Infant-Toddler Meaningful Auditory Integration Scale, Speech Intelligibility Rating, and Categorized Auditory Performance were pooled using weighted mean differences, and a 95% confidence interval. Results Eighteen studies met the inclusion criteria. The differences between GJB2-related deafness and non- GJB2-related deafness due to unidentified causes and other types of genetic deafness without additional disabilities were not statistically significant ( P = .15 and P = .30, respectively); however, the difference between GJB2-related deafness and acquired hearing loss due to environmental etiologies was statistically significant and favored GJB2-related deafness ( P = .03). Conclusion GJB2-related deafness leads to significantly better cochlear implantation outcomes when compared with acquired deafness caused by environmental etiologies. However, GJB2 mutation is not associated with a significantly better prognosis when compared with those whose deafness results from either nonsyndromic hearing loss of unknown origin or other types of genetic mutations in the absence of other neurologic deficits.
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Implante Coclear , Conexinas/genética , Surdez/genética , Surdez/cirurgia , Conexina 26 , Humanos , MutaçãoRESUMO
OBJECTIVES: To compare the hearing outcomes of stapedotomy vs cochlear implantation in patients with advanced otosclerosis. DATA SOURCES: PubMed, EMBASE, and The Cochrane Library were searched for the terms otosclerosis, stapedotomy, and cochlear implantation and their synonyms with no language restrictions up to March 10, 2015. METHODS: Studies comparing the hearing outcomes of stapedotomy with cochlear implantation and studies comparing the hearing outcomes of primary cochlear implantation with salvage cochlear implantation after an unsuccessful stapedotomy in patients with advanced otosclerosis were included. Postoperative speech recognition scores were compared using the weighted mean difference and a 95% confidence interval. RESULTS: Only 4 studies met our inclusion criteria. Cochlear implantation leads to significantly better speech recognition scores than stapedotomy (P < .0001). However, this appears to be due to the variability in outcomes after stapedotomy. Cochlear implantation does not lead to superior speech recognition scores compared with the subgroup of successful cases of stapedotomy plus hearing aid (P = .47). There is also no significant difference with respect to speech recognition between primary cochlear implantation and those secondary to a failed stapedotomy (P = .22). CONCLUSIONS: Cochlear implantation leads to a statistically greater and consistent improvement in speech recognition scores. Stapedotomy is not universally effective; however, it yields good results comparable to cochlear implantations in at least half of patients. For cases of unsuccessful stapedotomy, the option of cochlear implantation is still open, and the results obtained through salvage cochlear implantation are as good as those of primary cochlear implantation.
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Implante Coclear/métodos , Otosclerose/cirurgia , Cirurgia do Estribo/métodos , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Terapia de SalvaçãoRESUMO
Objective. To discuss the safety and efficacy of Foley catheter removal of blunt pediatric esophageal foreign bodies. Methods. Analyzing our first 17 cases of pediatric esophageal foreign bodies removed by Foley catheter method in respect of the efficacy, removal methods, and complications. We also reviewed related literature and discussed the background, current status, and technical matters that need attention of this method. Results. In three-year period between May 2010 and May 2013, in 16 out of 17 children blunt radiopaque foreign bodies impacted in the esophagus were successfully removed by a Foley catheter. There were no complications. In one patient, the foreign body was advanced into stomach and came out with stool 2 days later. Conclusions. The technique is safe, rapid, and cost-effective procedure and applicable for blunt, flat foreign bodies impacted in the esophagus.
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BACKGROUND: The objective of this study was to conduct a systematic review and meta-analysis to compare the oncologic and functional outcomes between transoral laser surgery (TLS) and radiotherapy (RT). METHODS: An electronic library search of the relevant English- and Chinese-language literature was conducted. Potentially eligible articles were reviewed. Qualified articles were selected and evaluated. RESULTS: No significant differences were identified between TLS and RT with respect to local control, overall survival, disease-specific survival, and posttreatment voice quality. However, larynx preservation was significantly higher in patients initially treated with TLS than those initially treated with RT. CONCLUSIONS: The approach for optimal treatment of T1a glottic cancer remains unanswered. This results from the relatively inconclusive evidence obtained from the current literature. Properly designed, prospective, randomized, or well-controlled studies will be required. Similar methodologies for treatment and reporting need to be established to make a valid and meaningful comparison between studies.