ABSTRACT
OBJECTIVE To explore the methods of preoperative diagnosis, evaluation and surgical treatment of the subglottic web in children. METHODS We analyzed the clinical manifestations, electronic laryngoscopy results, tracheal endoscopy and airway CT results of 4 children cases with congenital laryngeal cartilaginous subglottic web (1 case of type IV and 3 cases of type III) from August 2014 to March 2018. All of the 4 patients underwent a laryngofissure plus submucosal resection of cartilage web and short-term stenting. RESULTS Two cases underwent preoperative tracheotomy at 13 month old, 1 case at 6 month old. One case underwent tracheotomy at the same time of laryngoplasty. Two children indwelled the stents for 7 days and 11 days after operation and removed the stent by themselves. Other 2 cases removed the stent by the doctor at 14 day after operation. After removing the stents, the 4 cases underwent a pluging of the tracheotomy instantaneously. After 3 to 5 months of continuously pluging of the tracheotomy, all cases successfully removed the tracheal cannula. CONCLUSION For children with congenital laryngeal cartilaginous subglottic web of type III or type IV, the operation of laryngofissure plus submucosal resection of cartilage web and short-term stenting is the good choice with a high extubation rate and no complications.
ABSTRACT
OBJECTIVE@#By watching the effects of cochlear implants in the children with cochlear nerve defects, to evaluate the relationship and efficiency of HRCT AND MRI in diagnostic for cochlear nerve defects.@*METHOD@#The imaging dates and the post-operative effects of the 10 cochlear nerve defect patients were retrospectively analyzed.@*RESULT@#Three patients with bilateral IAC stenosis by HRCT and cochlear nerve defects by MRI but no other abnormal. Seven other patients showed normal IAC by HRCT including 1 showed type IP- I plus vestibular semi circular canal dysplasia. These 7 patients MRI showed 3 bilateral cochlear nerve absent and 4 bilateral cochlear nerve dysplasia. Ten cases of children after 12-32 month follow-up, 3 patients began speaking simple language, whose MAIS scale, CAP and SIR scores improved. One case just began speaking but pronunciation vague. Four cases had reactions to sounds, and can say monosyllabic words. Two cases without effects (1 CI abolished). Compared with other patients with normal cochlear nerve, the effects of the 10 cases were disappointed.@*CONCLUSION@#The effects of cochlear implant for the patients with cochlear nerve defects were poor. The preoperative MRI as sessment including oblique sagittal view for cochlear nerve is necessary. The preoperative communication with the parents telling ineffective result possibility is important.
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Cochlear Implantation , Cochlear Implants , Cochlear Nerve , Congenital Abnormalities , Retrospective StudiesABSTRACT
OBJECTIVE@#To evaluate the applicative value of computer assisted navigation system in endoscopic sinus and skull base surgery.@*METHOD@#Forty-nine endoscopic surgery procedures were performed with the help of computer assisted navigation system, among which there were 25 cases of recurrent sinusitis and nasal polyps, 9 cases of nasal and sinus tumour, 7 cases of cerebrospinal fluid rhinorrhea, 2 cases of meningoencephalocele, 4 cases of congenital choanal atresia, 1 case of pituitary tumor and 1 case of foreign body in middle cranial fossa.@*RESULT@#The preoperative time was 5-13 minutes for preparation, 7 minutes in average. The target error was less than or equal to 1.5 mm. All the 49 cases had successful surgery without complications.@*CONCLUSION@#Computer assisted navigation system can help the surgeon to determine the sinus, skull base and adjacent anatomic landmarks correctly, improve surgical accuracy and safety, and reduce intraoperative and postoperative complications.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Computer Systems , Paranasal Sinuses , General Surgery , Skull Base , General Surgery , Surgery, Computer-Assisted , MethodsABSTRACT
<p><b>OBJECTIVE</b>To study the efficacy and safety of Naoxintong capsule treatment of stroke recovery with Qi-deficiency and blood-stasis syndrome (cerebral infarction), and to compared the non-inferiority analysis with the positive drug Tongxinluo capsule.</p><p><b>METHOD</b>Taking Tongxinluo capsules as control, randomized, double-blind, controlled, multi-center clinical experiments were studied. The evaluating indexes included the decrease of integral value of stroke patients, changes in traditional Chinese medicine, the improvement of the patient viability status (disability level), Chinese stroke scale (CSS), activities of daily living (DAL) scale and barthel index (BI ) points.</p><p><b>RESULT</b>The total effect of the two groups, Chinese and other symptoms, showed no significant statistical significance.</p><p><b>CONCLUSION</b>Naoxintong capsule stroke recovery, with Qi-deficiency and blood-stasis syndrome (cerebral infarction) has a therapeutic effect, and more secure.</p>