Application of haemoglobin absorption spectral imaging in laryngeal papilloma surgery.

OBJECTIVE: This study compares the detection rates of haemoglobin absorption spectral imaging and white light imaging in laryngeal papilloma surgery. METHODS: Seventeen patients with laryngeal papilloma who underwent surgery in our department from September 2019 to September 2021 were selected. All patients underwent carbon dioxide laser surgery under a microscope. The lesion sites were explored in white light mode and haemoglobin absorption spectral imaging mode. The pharynx and larynx anatomical sites were evaluated using Derkay's all-position scoring system. The numbers and scores for lesions observed in the two modes were compared. RESULTS: In 17 cases, there were statistically significant differences in the numbers of laryngeal papillomas (Derkay score) detected by white light mode and haemoglobin absorption spectral imaging mode. In 9 of 17 patients (52.94 per cent), the haemoglobin absorption spectral imaging mode showed additional diseased tissues. CONCLUSION: The haemoglobin absorption spectral imaging mode can dynamically identify diseased tissues in carbon dioxide laser surgery under a microscope and improve the laryngeal papilloma detection rate.

Endoscope-Assisted Resection of Benign Parotid Tumors via Concealed Post-Auricular Sulcus Incision.

OBJECTIVES: To investigate the feasibility, safety, and effectiveness of endoscopic-assisted resection of benign parotid tumors via concealed post-auricular sulcus incision. METHODS: Between October 2019 and March 2021, eligible patients with diagnosed benign parotid tumors were prospectively included and randomly assigned to two groups: the endoscope-assisted post-auricular sulcus incision group (endoscope group) and the conventional Blair "S" incision group (conventional group). RESULTS: A total of 45 patients were finally included, including 24 subjects in the endoscope group and 21 subjects in the conventional group. No obvious differences were observed in basic information between these two groups of patients. The surgical incision length in endoscope group patients was 4.0 ± 0.4 cm, which was significantly shorter than that in conventional group patients, 10.3 ± 1.6 cm (p < 0.001). The total intraoperative blood loss, the first post-operative day drainage volume, the total post-operative drainage volume, and the total drainage days were all significantly lower in endoscope group patients than in conventional group patients (all p < 0.05). Among 3 months follow-ups, no local recurrence or residual tumor were found in both groups of patients, and there were none of them had permanent facial paralysis or parotid fistula. The self-evaluated appearance satisfaction VAS scores of endoscope group patients were all 0, which was significantly lower than that of conventional group patients, 4.7 ± 1.6 (p < 0.001). CONCLUSION: Compared with the conventional Blair "S" incision surgery, the endoscope-assisted resection of the benign parotid tumors via concealed post-auricular sulcus incision was safe and effective and showed advantages of faster recovery and better self-assessments of appearance satisfaction. LEVEL OF EVIDENCE: 2 Laryngoscope, 133:133-138, 2023.

Evaluation of endoscopic coblation treatment for obliteration of congenital pyriform sinus fistula.

BACKGROUND: Congenital pyriform sinus fistula is a very rare branchial apparatus malformation. Conventional open surgery for fistulectomy might fail to excise the lesion completely, leading to continual recurrence. The aim of this study was to provide an innovative endoscopic coblation technique for patients with pyriform sinus fistula and evaluate its intermediate-term effectiveness. METHODS: Retrospective case series with 112 patients (age range 3-36 years) between 2013 and 2016 and underwent endoscopic coblation of the sinus fistula. Data collected including patient demographics, presenting symptoms, diagnostic methods, prior and subsequent treatments, length of hospital stay, and recurrence were analyzed. RESULTS: Of the 112 cases, there were no postoperative complications observed except temporary reddish swelling in three patients. Four cases were lost to follow-up. Of 108 patients, 106 experienced no recurrence after their first endoscopic coblation of the sinus tract. The remaining two patients with recurrence in the follow-up were ultimately treated with recoblation without complications or further recurrences. Also, Endoscopic coblation can be used to treat seven patients with recurrence who had experienced open resection. In our series, median follow-up period was 1.5 years. CONCLUSION: Endoscopic coblation is an effective approach for most patients. We advocate using this minimally invasive technique as first line of treatment for pyriform sinus fistula.