[Endoscopic coblation assisted arytenoidectomy in the treatment of bilateral vocal cord paralysis].

OBJECTIVE: To introduce a new surgical technique for the treatment of bilateral vocal cord paralysis. METHODS: Twenty-nine patients with bilateral vocal cord paralysis treated in Dalian Municipal Central Hospital between 2008 and 2012 were retrospectively studied. Coblation assisted arytenoidectomy was performed in all cases. The pre and postoperative glottic measurement and vocal acoustic parameters were analyzed. RESULTS: All patients were decanulated 1 week after operation. Three months later, the mean glottic area increased from (21.9 +/- 4.7) to (40.3 +/- 5.2) mm2 (t = 5.74. P < 0.05); the width of maximal glottic chink increased from (1.47 +/- 0.37) to (4.82 +/- 0.54) mm (t = 6.24, P < 0.05). Twenty-six patients (89.7%) satisfied with the voice quality. Acoustic parameters (F0, jitter, shimmer) were no significant difference (P > 0. 05) , but there was a significant difference in maximum phonation time (P < 0.05). During three months to 3.5 years follow-up, the patients had a stable airway and effective phonation. CONCLUSIONS: Endoscopic coblation assisted arytenoidectomy is a new surgical method for the treatment of patients with bilateral vocal cord paralysis, which is efficient, minimally invasive and safe.

[Coblation treatment for laryngeal papilloma in adult].

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.

[Preliminary investigation of coblation for early glottic carcinoma].

OBJECTIVE: To establish whether Coblation is a suitable modality for removal of early glottic carcinoma. METHODS: Fourteen patients with early glottic carcinoma (Tis-T2) without lymph node metastasis underwent resection of laryngeal cancer lesions using transoral endoscopic coblation (TEC), without pre- or post-operative radiotherapy and chemotherapy. RESULTS: No severe complication such as bleeding and dyspnea occurred in the cases. Only mild postoperative pain happened to the patients. All patients could eat and pronounce on the surgery day. With following-up of 25 - 37 months, no recurrence was observed in 13 cases. One case, with poorly differentiated squamous cell lesion in the anterior commissure invading subglottic, recurred 3 months postoperatively. The patient received the re-resection of laryngeal lesion by coblation, but another recurrence happened to the patient 6 months postoperatively, and then was cured by partial laryngectomy, with recurrence-free survival 21 months postoperatively. CONCLUSION: The observation suggests that transoral endoscopic coblation is a reliable and safe modality for the resection of early glottic carcinoma.

[Comparative analysis of polysomnography and micro-sensitive mattress-sleep monitor used for obstructive sleep apnea hypopnea syndrome].

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.

[Endoscopic surgery using the low-temperature plasma radiofrequency for nasopharyngeal angiofibroma].

OBJECTIVE: To evaluate the feasibility of endoscopic surgery using the low-temperature plasma radiofrequency for nasopharyngeal angiofibroma (NA). METHODS: The clinical data of 4 patients treated between December 2005 and August 2009 were retrospectively analyzed. The tumor in one patient was at stage I and three patients were at stage II, all these patients were treated by endoscopic surgery using the low-temperature plasma radiofrequency under controlled hypotension anesthesia. Preoperative angiography and embolisation were underwent in all patients. Bipolar coagulation was used to help hemostasis during operation. RESULTS: The tumor in all 4 patients was completely removed. The operation time was 60, 80, 110, 90 min respectively. The blood loss was 250, 250, 320, 280 ml respectively. Neither blood transfusion nor complications were encountered perioperatively. Follow-up ranged from 6 months to 4 years, none of the patients recurred. CONCLUSIONS: Endoscopic surgery using low-temperature plasma radiofrequency for nasopharyngeal angiofibroma has many advantages such as less bleeding and total tumor removal. It is a minimally invasive surgical method for nasopharyngeal angiofibroma.

[Endoscopic surgery using the low-temperature plasma radiofrequency for nasal hemangioma].

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.

[Endoscopic surgery using the low-temperature plasma radiofrequency for nasal inverted papilloma].

OBJECTIVE: To evaluate the effect of endoscopic surgery using the low-temperature plasma radiofrequency for nasal inverted papilloma. Methods In a retrospective study, clinical data of 8 patients underwent endoscopic surgery were analyzed since July 2008. Tumor stage according to Krouse was T1:1, T2:6, T3:1, T4:0, respectively. T1 and T2 lesions were completed excised using the low-temperature plasma radiofrequency, T3 lesions were excised using microdebrider combined with plasma radiofrequency. RESULTS: The average blood loss was about 20 ml, with the exception of one patients with recurrent nasal inverted papilloma about 200 ml. Shorter operative time, minimal postoperative pain, epithelization of nasal cavity was seen 2 months postoperatively. There were no complications. All patients were followed-up for 2-6 months, with no recurrence. CONCLUSIONS: Surgical treatment of nasal inverted papilloma using low-temperature plasma radiofrequency had following advantages: less blood loss, complete en bloc tumor resection, mild injury, short surgery time, mild postoperative pain. In summary, low-temperature plasma radiofrequency is a minimally invasive treatment for nasal inverted papilloma.

[Expression of monocyte chemotactic protein 1 and vascular endothelial growth factor in nasal polyps].

OBJECTIVE: To evaluate the relationship between the expression of monocyte chemotactic protein 1 (MCP-1) and vascular endothelial growth factor (VEGF) in nasal polyp (NP) tissues and the role of MCP-1 in the formation of nasal polyps. METHODS: Forty nasal polyp tissues obtained from NP patients were used to detect the expression of MCP-1 and VEGF at the levels of protein and mRNA by immunohistochemical and in situ hybridization assay. Twenty-five inferior turbinate (IT) samples obtained from chronic rhinitis patients were used as control. RESULTS: The expression of MCP-1 and VEGF was higher in NP tissue than in IT at protein and mRNA levels (P <0.01). The expression of these two cytokines was positively correlated(r = 0.871, P <0.05). CONCLUSIONS: MCP-1 and VEGF were involved in the formation of nasal polyps.