RESUMO
OBJECTIVE: To evaluate the effect and feasibility of coblation treatment for laryngeal papilloma in adult. METHODS: A total of 18 patients with laryngeal papilloma treated by coblation from April 2008 to June 2010 was retrospectively analysed. There were 4 cases of multiple laryngeal papilloma and 14 cases of single laryngeal papilloma. All of these patients were treated with CoblatorTM Reflex #7070 under general anesthesia without tracheotomy. RESULTS: The volumes of blood loss during surgery varied from 1 ml to 10 ml, 2 ml on average. There was no postoperative bleeding or other complications. Follow-ups ranged from 6 months to 33 months after surgery, median 18 months. Recurrence occurred 4 months and 8 months after surgery in two patients. They were treated with coblation for the second time and followed up for 4 months and 12 months respectively. Recurrence occurred again in one patient. CONCLUSION: Coblation under suspension laryngoscope for laryngeal papilloma in adult was an ideal way due to less bleeding and less damage.
Assuntos
Ablação por Cateter , Neoplasias Laríngeas/cirurgia , Papiloma/cirurgia , Adulto , Idoso , Feminino , Humanos , Hipotermia Induzida , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traqueotomia/métodos , Adulto JovemRESUMO
OBJECTIVE: To evaluate the effect of endoscopic surgery using the low-temperature plasma radiofrequency for nasal hemangioma. METHODS: Clinical data of 15 patients treated between October 2007 and October 2009 under endoscopic surgery using the low-temperature plasma radiofrequency were retrospectively studied. RESULTS: All tumors in 15 patients were completely removed. The blood loss was 1 - 150 ml and the average blood loss was about 15 ml, only gelatin sponge was used to protect the wound after operation. There was no additional packing to stop bleeding. No complications were seen. The patients had mild postoperative pain. All patients were followed-up from 2 months to 2 years, no recurrence was found. CONCLUSIONS: Endoscopic surgery using low-temperature plasma radiofrequency for nasal hemangioma has following advantages such as simplicity, minimal invasion and so on. It is a viable surgical method for the treatment of nasal hemangioma.
Assuntos
Ablação por Cateter/métodos , Hemangioma/cirurgia , Neoplasias Nasais/cirurgia , Adulto , Idoso , Endoscopia , Feminino , Humanos , Hipotermia Induzida , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: To assess the efficiency of mattress-type micro sensitive monitor (MMSM) in sleep monitoring. METHODS: Forty patients diagnosed as obstructive sleep apnea-hypopnea syndrome (OSAHS) by polysomnography (PSG) were randomly chosen, then received MMSM examination within 2 - 5 days. The results of both methods were compared, using the respiratory disturbance index, sleep efficiency, and obstructive factors as indicators. RESULTS: All 40 patients were diagnosed as OSAHS, which were consistent with the results of PSG. There was no statistical difference when comparing the apnea hypopnea index (AHI, x(-) ± s, 35.6 ± 21.3 and 37.6 ± 18.8, respectively) and the ratio of rapid eyes movement (REM) stage (15.0 ± 4.5)% and (15.8 ± 6.3)%, respectively (t were 1.867 and 1.014, P > 0.01). Some statistical sense was found when patients'deep sleep, shallow sleep and sleep efficiency were compared (P < 0.01). According to the severity diagnosed by PSG, patients with mild, moderate and severe OSAHS were 11, 7 and 22 cases, respectively, Comparing by MMSM, 2, 19 and 19 cases, respectively. Among seventeen volunteers diagnosed by PSG as normal subjects, 2 of them were diagnosed as mild OSAHS. The sensitivity of MMSM was 100.0% and the specificity was 88.2%. CONCLUSIONS: With regard to the diagnosis of OSAHS, MMSM is well consistent with PSG. The MMSM can be applied clinically as a monitor technique.
Assuntos
Polissonografia/instrumentação , Apneia Obstrutiva do Sono/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Apneia Obstrutiva do Sono/fisiopatologiaRESUMO
OBJECTIVE: To assess the accuracy of pulse transit time (PTT) in classification of apnea events, and collect data for clinical application reference. METHODS: Thirty-two obstructive sleep apnea-hypopnea syndrome (OSAHS) patients included in the research had Polysomnography (PSG), and 10 305 apnea events were recorded. All the events were analyzed by PTT and esophageal pressure (Pes) respectively. The results were analyzed to assess the accuracy of PTT and compare the accuracy of pulse transit time between REM stage and NREM stage, and analyze the correlation between age, body mass index (BMI), apnea hypopnea index (AHI) and concordance rate in every patient. RESULTS: The total concordance rate between PTT and Pes in classification of apnea was 96.7% (9970/10305). The sensitivities of PTT in detecting central, mixed and obstructive apnea were 88.0%, 91.3% and 97.8% respectively and the specificities were 99.8%, 97.8% and 92.8% respectively. The false determinations of apnea events mainly concentrated on the false determinations between the obstructive and mixed apnea. There was no statistical significant between the accuracy of PTT in different sleep stages. There was a negative relationship between the age, BMI, Lowest SaO2, AHI and the concordance rate. CONCLUSIONS: There was good concordance between PTT and Pes in classification of apnea. PTT had very high sensitivity and specificity in detecting all kinds of apnea. This study showed that PTT can detect respiratory drive noninvasively with high accuracy.