Clinical application of carbon nanoparticles suspension in operation of papillary thyroid carcinoma / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to evaluate the application of carbon nanoparticle lymphatic tracer in total thyroidectomy and bilateral Central District's thyroidectomy for papillary thyroid carcinoma. Sixty-four patients with cN0 papillary thyroid carcinoma that primary treated were random divided into two groups: Trial group and control group. Carbon nanoparticles suspension was injected into the thyroid gland of trial group patients.After ten minutes, total thyroidectomy plus bilateral central neck dissection was performed in the all patients. The black stained tissue in the dissection specimen of trial group was separated. The control group underwent total thyroidectomy plus bilateral central neck dissection. Total lymph node and parathyroid gland in the black stained tissue，and non-black stained tissue in the central compartment dissection specimen of trial group and central compartment dissection specimen of control group were counted respectively.Total lymph node, the mis-cut parathyroid glands in the adipose tissue of central lymph node，post-operative blood calcium and parathyroid hormone（PTH）of two groups were contrasted and analyzed. There are 235 lymph nodes in the black-stained tissue of central compartment dissection specimen of trial group.No parathyroid gland was found in the black-stained tissue.Five lymph nodes and 2 parathyroid glands were found in the non-black stained tissue of central compartment dissection specimen of trial group. There were 164 lymph nodes and 9 parathyroid glands in central compartment dissection specimen of control group. There is statistic difference between the number of lymph nodes in black stain tissue and that of control group（=8.291, =0.000）.Rate of staining lymph node were 97.9 percent. No parathyroid glands were found in the black stained tissue. Nine mis-cut parathyroid glands（7.0%） were observed in the control group，while 2（1.6%） in the trial group（<0.05）.None permanent hypocalcemia and PTH decrease were observed in the two groups.There were 10 patients（31.3%） with temporary hypocalcemia and 9 patients（28.1%）with temporary PTH decrease respectively in the control group，and there was 1 patient（3.1%） and 1 patient（3.1%） respectively in the trial group（<0.05）. The effect of nano-carbon is ideal, and the parathyroid gland can not be stained black. It can distinguish the thyroid tissue from the surrounding lymphoid adipose tissue and clearly mark the Central District lymph nodes, reduce the risk of parathyroid gland injury during thyroid cancer. Neck dissection in the central region can improve the efficiency of lymph node dissection, protect the parathyroid gland and reduce the risk of postoperative complications.

Clinical application of carbon nanoparticles suspension in operation of papillary thyroid carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective@#The aim of this study is to evaluate the application of carbon nanoparticle lymphatic tracer in total thyroidectomy and bilateral Central District's thyroidectomy for papillary thyroid carcinoma.@*Method@#Sixty-four patients with cN0 papillary thyroid carcinoma that primary treated were random divided into two groups: Trial group and control group. Carbon nanoparticles suspension was injected into the thyroid gland of trial group patients.After ten minutes, total thyroidectomy plus bilateral central neck dissection was performed in the all patients. The black stained tissue in the dissection specimen of trial group was separated. The control group underwent total thyroidectomy plus bilateral central neck dissection. Total lymph node and parathyroid gland in the black stained tissue，and non-black stained tissue in the central compartment dissection specimen of trial group and central compartment dissection specimen of control group were counted respectively.Total lymph node, the mis-cut parathyroid glands in the adipose tissue of central lymph node，post-operative blood calcium and parathyroid hormone（PTH）of two groups were contrasted and analyzed.@*Result@#There are 235 lymph nodes in the black-stained tissue of central compartment dissection specimen of trial group.No parathyroid gland was found in the black-stained tissue.Five lymph nodes and 2 parathyroid glands were found in the non-black stained tissue of central compartment dissection specimen of trial group. There were 164 lymph nodes and 9 parathyroid glands in central compartment dissection specimen of control group. There is statistic difference between the number of lymph nodes in black stain tissue and that of control group（t=8.291, P=0.000）.Rate of staining lymph node were 97.9 percent. No parathyroid glands were found in the black stained tissue. Nine mis-cut parathyroid glands（7.0%） were observed in the control group，while 2（1.6%） in the trial group（P<0.05）.None permanent hypocalcemia and PTH decrease were observed in the two groups.There were 10 patients（31.3%） with temporary hypocalcemia and 9 patients（28.1%）with temporary PTH decrease respectively in the control group，and there was 1 patient（3.1%） and 1 patient（3.1%） respectively in the trial group（P<0.05）. @*Conclusion@#The effect of nano-carbon is ideal, and the parathyroid gland can not be stained black. It can distinguish the thyroid tissue from the surrounding lymphoid adipose tissue and clearly mark the Central District lymph nodes, reduce the risk of parathyroid gland injury during thyroid cancer. Neck dissection in the central region can improve the efficiency of lymph node dissection, protect the parathyroid gland and reduce the risk of postoperative complications.

Influence of RhoC on Apoptosis and Cancer-stem-cell-marker-ALDH1A1 and Morphology in Hep2 Laryngeal Squamous Carcinoma Cell / 医学研究杂志

Objective To investigate the effects of RhoC on biological behavior in the laryngeal squamous carcinoma.Methods By delivering exogenous gene into Hep2 laryngeal squamous carcinoma cell line,we alternatively repressed and strengthened the expression of RhoC.We tested the apoptosis of Hep2 tumor cell line with TUNEL,visualized tumor cells shape by staining cell skeleton with Alexa fluor phalloidin,measured the mRNA of CSC marker ALDH1A1 with QPCR.Results After repressing the expression of RhoC in Hep2 cell line,the apoptosis of cancer cells was elevated,the expression of CSC marker ALDH1A1 was significantly decreased.RhoC impacted the shapes of Hep2.Conclusion RhoC havd a positive role in LSCC metastasis.RhoC is a promising target of anti-metastases in LSC.

Clinical features of inflammatory myofibroblastic tumor in the head and neck / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical characteristics of inflammatory myofibroblastic tumor (IMT) in head and neck and to discuss its treatment.</p><p><b>METHODS</b>Twenty-seven cases of IMT in head and neck diagnosed at the Chinese PLA General Hospital from 2004 to 2012 were analyzed retrospectively. Among the 27 patients, 12 males and 15 females, age ranged from 8 to 77 years, with a median 43 years old. Treatment included: 1 with radiotherapy, 22 with surgery, 3 with surgery and postoperative radiotherapy, one with concurrent chemoradiotherapy followed by surgery. Of the 27 cases, 5 located in the neck, 6 in the nasal and paranasal sinus, 4 in the temporal bone, 3 in the throat, 2 in the parotid gland, 2 in the lower pharynx, 1 in the mandible, 1 in the maxilla, 1 in the masseter muscle, 1 in the amygdala and 1 in the pharynx nasalis.</p><p><b>RESULTS</b>Following-up time was 4-85 months, with a median of 26 months. Six cases lost follow-up, 1 case with malignant transformation and died, 16 cases survived with no recurrence, 4 cases relapsed, of whom 2 were alive with tumors and 2 died.</p><p><b>CONCLUSIONS</b>IMT in the head and neck has a tendency to be malignancy, with certain recurrence rate and mortality. Radical excision is still the first choice of treatment for IMT in head and neck.</p>

Research of postoperative quality of life of laryngeal carcinoma patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore and compare the effect of clinical characters on quality of life (QOL) of laryngeal carcinoma postoperative patients.@*METHOD@#We performed a retrospective cohort follow up study of 303 patients who underwent operation for laryngeal carcinoma. The Chinese version of the general and the head and neck specific quality of life questionnaires of the European Organization for the Research and Treatment of Cancer (EORTC QLQ-C30 and EORTC QLQ-H&H35) were used to measure the quality of life of those patients in the cohort, to study the relationship between QOL and clinical factors.@*RESULT@#In the 303 cases, there were 78 cases retaining the permanent tracheostomies (59 total laryngectomy and 19 partial laryngectomy); 4 patient retain the nasal feed pipe. Female patients were worse than male patients in the domain of physical function and global QOL (P<0.05). Older patients were worse than younger patients in the domain of physical function and speech (P<0.05). Patients with glottic tumors experience better global QOL than their peers with under glottic or supraglottic tumors. The patients with supraglottic tumor have more problem with swallowings (P<0.05). Earlier stage patients have better suitation in many domains than later stage patients, but III stage have more difficulty with swallowing than IV stage. Patients who accepted minimally invasive operation and laryngofissure have better QOL than those accepted partial laryngectomy or total laryngectomy; total laryngectomee have more problems with physical, emotion function, global QOL, sense, speech, cough and morbid feeling than patients with partial laryngectomy, but less problem with fatigue, pain, dyspnea, swollowing and dry mouth; Patients with partial horizontal laryngectomy have more difficulty with swallowing. In the multivariable analysis, the operation mode was an independent factor to speech problem. Patients who accepted neck dissction have more negative outcomes than patients without neck dissection. In the univariable analysis, the permanent tracheostomy was a notable factor which affected many domains in the quality of life; multivariable analysis showed that permanent tracheostomy was an important factor which worked on global quality of life.@*CONCLUSION@#The quality of life was affected by many clinical factors. The operation mode was an independent factor which affect speech problem. Decannulation after partial laryngectomy was very important to keep the quality of life.

Retrospective analyses of postoperative survival of laryngeal carcinoma patients at late stage / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the postoperative survival rate of laryngeal carcinoma patient at stage III or IV whom accepted partial laryngectomy and total laryngectomy.@*METHOD@#We performed a retrospective cohort follow-up study of 126 patients of stage III or IV who underwent operation for laryngeal carcinoma in Chinese PLA General Hospital between January, 2005 and December, 2009. Survival rates were calculated by product-limit method.@*RESULT@#There were 80 patients at stage III and 46 patient at stage IV. Sixty five patients underwent partial laryngectomy and 61 patients underwent total laryngectomy. There were 24 patients in whole group died in the 5 years, 15 of them underwent partial and 9 accepted total laryngectomy. The 5-years survival rate of partial and total group were 62.58% and 68.74% respectively. The survival curve of both groups had no significant difference (P < 0.05).@*CONCLUSION@#For laryngeal carcinoma patients at later stage, with suitable operative indication, the partial laryngectomy could achieve an acceptable effect as well as total laryngectomy.

Retrospective analysis of the treatment of recurrent congenital fistula or cyst in lateral cervical part / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analysis the therapeutic procedure on the recurrent congenital fistula or cyst in lateral cervical part.@*METHOD@#Thirty-nine cases with recurrent congenital fistula or cyst in lateral cervical part were enrolled in this study including 12 cases from the first branchial cleft, 6 from the second branchial cleft and 21 from the third branchial cleft.@*RESULT@#All the cases underwent fistula or cyst excision for 2 to 5 times in their whole therapeutic process, not counting the incision and drainage. During 9 months to 17 years follow-up, fistula or cyst in 6 cases relapsed,including 1 fistula from the first branchial cleft,3 fistulae from the second branchial cleft, 1 fistula and 1 cyst from the third branchial cleft, respectively. One case with recurrent fistula from the first branchial cleft was diagnosed temporal verrucous carcinoma six months after the third fistula excision operation and died one year after the forth operation probably due to the intracranial metastasis of temporal bone verrucous carcinoma. In two cases, the fistulae went through the thyroid gland to the piriform fossa and both the fistulae and part of the thyroid glands were resected. In the patients whose inner orificium fistulae were found and ligated effectively,no recurrence occurred during the followed-up period.@*CONCLUSION@#The key point to cure the recurrent congenital fistula or cyst in lateral cervical part lies in proper occasion of operation, stain tracing in operation and reasonable program of operation.

Clinical observation of 116 cases of laryngofissure avoiding tracheotomy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical effect of laryngofissure without tracheotomy.@*METHOD@#One hundred and sixteen cases of laryngofissure without tracheotomy in our department were analyzed retrospectively.@*RESULT@#Of 116 cases, 101 cases had the laryngeal carcinoma; 9 cases had laryngeal stenosis; 6 cases had benign tumor of larynx. All the incisions were healed by first intention; and postoperative duration of hospital stay were 7 to 20 days. Three cases recurred in 101 cases of laryngeal carcinoma (2.97%), and underwent reoperation,the 5 year survival rate was 100%. One case recurred in 9 cases of laryngeal stenosis, and underwent reoperation of laryngoplasty with T-tube implanted. No recurrence in 6 cases of benign tumor of larynx.@*CONCLUSION@#Laryngofissure with out tracheotomy have the advantage of less trauma, fast rehabilitation and no destroying the normal respiratory functions. It is completely feasible so long as surgeons grasp the adaption of operation strictly and select suitable cases.

Clinical observation of 116 cases of laryngofissure avoiding tracheotomy / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the clinical effect of laryngofissure without tracheotomy.Method:One hundred and sixteen cases of laryngofissure without tracheotomy in our department were analyzed retrospectively.Result:Of 116 cases, 101 cases had the laryngeal carcinoma; 9 cases had laryngeal stenosis; 6 cases had benign tumor of larynx. All the incisions were healed by first intention; and postoperative duration of hospital stay were 7 to 20 days. Three cases recurred in 101 cases of laryngeal carcinoma (2.97%), and underwent reoperation,the 5 year survival rate was 100%. One case recurred in 9 cases of laryngeal stenosis, and underwent reoperarion of laryngoplasty with T-tube implanted. No recurrence in 6 cases of benign tumor of larynx.Conclusion:Laryngofissure without tracheotomy have the advantage of less trauma , fast rehabilitation and no destroying the normal respiratory functions. It is completely feasible so long as surgeons grasp the adaption of operation strictly and select suitable cases.

Observe the curative effect of n-Butyl cyanoacrylate injection in treating laryngopharynx hemangioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the clinical effectiveness of injection n-Butyl cyanoacrylate (NBCA) in treating laryngopharynx hemangioma.@*METHOD@#Thirty cases of laryngopharynx hemangioma who received NBCA injection were obtained from our department 1998-2007. Twenty-five cases had tracheotomy under General anesthesia, and NBCA was injected into hemangioma by direct laryngoscopy. NBCA was mixed with iodide, and the concentration was 25.00% to 33.33%, NBCA dosage was 0.5 ml to 2.0 ml. There were 5 cases whose hemangioma confined to oropharynx didn't have tracheotomy, and they were injected straightly with the speculum oris. We observed the shedding of hemangioma in different time.@*RESULT@#Hemangioma with diameter less than 1 cm, shedded in about 1 month. However, hemangioma with diameter more than 4 cm, shedded in a period more than 3.5 month. No recurrence was observed in the follow up of 3 months to seven years.@*CONCLUSION@#Avoiding dissection of neck and repetitious operation, NBCA injection could be a safe, simple and effective therapy for laryngopharynx hemangioma.