Clinical efficacy of Conbercept combined with vitrectomy for proliferative vitreoretinopathy after choroidal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical effect of Conbercept combined with vitrectomy in the treatment of proliferative vitreoretinopathy(PVR)after choroidal detachment. <p>METHODS: From January 2015 to January 2018, 66 eyes of 64 patients with PVR were treated in our hospital. All the patients were randomly divided into control group(32 cases, 34 eyes)and observation group(32 cases, 32 eyes). The control group was treated with routine vitreoretinal surgery. The observation group was treated with routine vitreoretinal surgery combined with intravitreal injection of conbercept. The clinical efficacy, operative duration, intraoperative bleeding, incidence of iatrogenic holes and the best corrected visual acuity(BCVA), subfoveal choroidal thickness before and after treatment were compared between the two groups. <p>RESULTS: After 3-6mo follow-up, the total effective rate in the observation group(94%)was significantly higher than that in the control group(74%), and the difference was statistically significant(<i>P</i><0.05). The duration of operation in the observation group was significantly shorter than that in the control group, and the incidence of intraoperative hemorrhage and iatrogenic hiatus were significantly lower in the observation group than in the control group(<i>P</i><0.05). Before treatment, there was no significant difference in serum VEGF level and bFGF content between the two groups(<i>P</i>>0.05). After treatment, the above indexes were lower than those before treatment. The levels of serum VEGF and bFGF in the observation group were significantly lower than those in the control group(<i>P</i><0.05). Before treatment, there was no significant difference in the thickness of subfoveal choroid and BCVA between the two groups(<i>P</i>>0.05). The BCVA of the two groups was significantly higher than that before treatment. The thickness of subfoveal choroid in the observation group was significantly lower than that before surgery(<i>P</i><0.05), and the thickness of the subfoveal choroid in the observation group was significantly lower than that in the control group(<i>P</i><0.05). <p>CONCLUSION: Vitrectomy combined with intravitreal injection of conbercept in the treatment of PVR after choroidal detachment has a good effect. It can effectively shorten the operation time, reduce the incidence of intraoperative hemorrhage and iatrogenic hole, and reduce the level of serum VEGF and bFGF content. Improve the visual acuity and reduce the thickness of choroid.

Surgical management of tumor in the conjunctive area among neck, thorax and axilla / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the surgical management of tumors in the conjunctive area among the neck, thorax and axilla and its efficacy.</p><p><b>METHODS</b>From Oct. 1999 to March 2006, eleven cases with benign tumors in the area between the neck, thorax and axilla were collected and analysed. Among them, five neurilemmoma, three neurofibroma, two chondroma and one meningioma, respectively. CT scans showed that the neck, thorax and axilla were affected simultaneously more or less. In this group, direct invasion to the vertebra was found in 4 cases, and spinal compression in one patient. After the disarticulation and displacement of the clavicle, the tumor was removed with the structures of importance in the neck, thorax and axilla under direct views. A bypass was constructed between the axillary vein and the medial end of the subclavian vein.</p><p><b>RESULTS</b>All these tumors were completely removed, injury of vertebral artery was encounter in two cases, and immediate repair was successfully carried out. No other serious complications were found in this group. During the follow-up period from 3 months to 3 years and 5 months, local recurrence was found in no patient.</p><p><b>CONCLUSIONS</b>Benign tumors in the area between neck, thorax and axilla could be successfully dissected and removed with displacement of the medial portion of the clavicle.</p>

Diagnosis and surgical management of metastatic diseases in retropharyngeal space / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the symptoms and surgical management results of metastatic disease in the retropharyngeal space.</p><p><b>METHODS</b>Six patients with malignant tumors were collected, in which enlarged lymph nodes presented both in neck and retropharyngeal space. They consisted of two supraglottic carcinoma (T3N2MO), one thyroid carcinoma (TXN2MO), one nasal melanoma (TXN2MO), one oropharyngeal carcinoma (T2N2M0) and one hypopharyngeal carcinoma (T3N2MO). The enlarged nodes in the retropharyngeal space were measured with CT and (or) MRI, which ranged from 1.5-2.5 cm in diameter. Based on the control of the primary and neck disease, the mass in the retropharyngeal space was dissected and sent for pathologic exam separately.</p><p><b>RESULTS</b>Metastasis in the retropharyngeal space was pathologically proved in all of them, along with the involved internal jugular lymph nodes of 3/15, 3/17, 4/19, 5/19, 6/20, and 6/23, respectively. No serious complications occurred, such as fistula and central nerve damage. The patient with hypopharyngeal carcinoma died of lung metastasis 2 years after operation. The one suffering nasal malignant melanoma was out of follow-up in the 14th months. The patient with oropharyngeal carcinoma locally relapsed in the 18th months and died at the 24th months postoperatively. The rest was alive with tumor free within the follow-up period from 2 to 4 years.</p><p><b>CONCLUSIONS</b>CT or Mifi are the mainstay of diagnosis of the metastatic disease in the retropharyngeal space and can he surgically controlled with safety.</p>

Complications of tracheoesophageal puncture for Blom-Singer voice restoration after total laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate causes and treatment of complications of tracheoesophageal puncture for Blom-Singer voice restoration after total laryngectomy.</p><p><b>METHODS</b>From 1986 to 2004, one hundred and fifty one cases with Blom-Singer technique after total laryngectomy for voice restoration were retrospectively analyzed.</p><p><b>RESULTS</b>All cases were followed up from 6 months to 15 years. Among 151 cases, 138 cases got successful phonation and the total success rate of voice restoration was 91.4%. Of the 151 cases, 15 cases occurred complications. The rate of complications was 9.9%. The common complications included fistula granulations, infection, and leakage. Twelve cases got successful treatment accordingly, and the other 3 cases failed in phonation.</p><p><b>CONCLUSIONS</b>The procedure of tracheoesophageal puncture for voice restoration is relatively simple and has low complications. this method had high phonation success and good phonation quality, which is one of the best way to make laryngectomee to speak.</p>

Forty-three tracheal stricture with Ni-Ti shape memory alloy stent / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the application of Ni-Ti shape memory alloy stent for treating tracheal stricture, including its indications and complications.</p><p><b>METHODS</b>Forty-three patients clinical data were analyzed, among them, 15 suffered from tumor; 7 trauma; 4 granulation; 1 Wegener's granuloma, 2 rhinoscleroma, 1 without clear diagnosis; 7 were relapsing polychondritis; 1 were respiratory amyloidosis; 4 were tracheobronchial tuberculosis, 5 were tracheobronchomalacia. The stricture degree: Level I: 15 patients, Level II:24 patients, Level III:4 patients. The location of stricture in 5 patients extended to the subglottis area. All patients had tracheal stricture and accepted the treatment with Ni-Ti shape memory alloy stent.</p><p><b>RESULTS</b>Forty-two patients breathed freely after the operation, 1 patient died after surgery. The tracheostoma in 18 patients was closed 34 days after operation. Among the remaining 8 patients with tracheostoma:3 patients left hospital with tracheal cannula; 1 patient died,2 patients were found stent shifted and no evident breath improving; 2 patients were found granulation and had secondary operation with laser.</p><p><b>CONCLUSION</b>Ni-Ti shape memory alloy stent can expand the tracheal stricture quickly and thus improve the breath effectively, which is minimally invasive and simple. It can be used as a method in the treatment of tracheal stricture.</p>