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1.
Artigo em Chinês | MEDLINE | ID: mdl-32086926

RESUMO

Objective:The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux (LPR), the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. Method:From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A (18-<40 years, n=86), group B (40-<60 years, n=107) and group C (≥60 years, n=65). The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Result:Among the three groups, group C had the highest diagnostic rate(93.85%). There was no significant difference in RFS score among the three groups (P>0.05), RSI score was significantly different (P<0.05), RSI score of group A and group B was higher than that of group C (P<0.05). According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. Conclusion:The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.


Assuntos
Fatores Etários , Refluxo Laringofaríngeo/diagnóstico , Adolescente , Adulto , Idoso , Humanos , Laringe/fisiopatologia , Pessoa de Meia-Idade , Faringe/fisiopatologia , Adulto Jovem
2.
Artigo em Chinês | MEDLINE | ID: mdl-32074753

RESUMO

Objective: Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT). Methods: We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software. Results: A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01). Conclusions: SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.


Assuntos
Neoplasias Hipofaríngeas/terapia , Quimiorradioterapia , Terapia Combinada , Humanos , Neoplasias Hipofaríngeas/cirurgia , Hipofaringe , Laringe , Taxa de Sobrevida
3.
Cir. pediátr ; 33(1): 51-54, ene. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-186139

RESUMO

Introducción: El tratamiento de la tiroides lingual es controvertido y debe individualizarse. Las opciones incluyen el reemplazo hormonal, cirugía en presencia de hemorragia y obstrucción de la vía aérea o digestiva, y la terapia con radioisótopos. Caso clínico: Niña de 8 años de edad, con molestias a la deglución. Se observa masa rosada, muy vascularizada, no dolorosa ni ulcerada, que protruye desde la base de la lengua y cierra prácticamente toda la orofaringe. Ecografía informa ausencia de tejido tiroideo en su posición normal. Tomografía axial computarizada cervical comprueba el diagnóstico y la obstrucción faríngea. Se indicó tratamiento sustitutivo de las hormonas tiroideas. Ante la progresión de los síntomas de disfagia, se indicó cirugía. Se describe la exéresis tiroidea por vía cervical, suprahioidea, con reimplante de láminas de tejido tiroideo. Evolucionó sin complicaciones y se mantiene tratamiento sustitutivo, con excelente estado clínico después de cuatro años


Introduction: The treatment of lingual thyroid is controversial and should be individualized. Options include hormonal replacement, surgery in the presence of bleeding and obstruction of the airway and the digestive tract, and radioisotope therapy. Clinical case: 8-year-old girl presenting with discomfort when swallowing. A pink, well-vascularized mass, not painful or ulcerated, protruding from the base of the tongue and virtually closing the whole oropharynx, was observed. Absence of thyroid tissue in its normal posi-tion was reported by the ultrasound department. Cervical computed axial tomography confirmed the diagnosis and the presence of pharyngeal ob-struction. Thyroid hormone replacement was established. As a result of dysphagia symptom progression, surgery was indicated. Thyroid removal was performed by means of a cervicotomy, with re-implantation of thyroid tissue laminas. The postoperative course was uneventful and replacement treatment was maintained, with an excellent clinical status four years later


Assuntos
Humanos , Feminino , Criança , Tireoide Lingual/diagnóstico por imagem , Tireoide Lingual/cirurgia , Obstrução das Vias Respiratórias/complicações , Radioisótopos/uso terapêutico , Tireoide Lingual/tratamento farmacológico , Transtornos de Deglutição/complicações , Tomografia Computadorizada de Emissão , Laringe/diagnóstico por imagem , Laringe/patologia , Cintilografia
4.
HNO ; 68(1): 59-68, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31950226

RESUMO

Transoral laser microsurgery (TLM) for treatment of laryngeal cancer has reduced temporary tracheotomies, increased organ preservation rates, and improved functional results. Gold standard for laser-based transoral resection of laryngeal cancer is the application of CO2 lasers. Oncologically safe radical resection and postoperative voice outcome must be weighed up individually. Angiolytic laser effects enable modification of the tumor micromilieu by targeted obliteration of microvessels and antagonization of angiogenesis with preservation of vibrating laryngeal tissue for good voice function. Introduction of the German S3 guideline on diagnosis, treatment, and follow-up of laryngeal cancer is a critical step towards national evidence-based standardization. Internationally, the evidence for treatment of laryngeal mucosal dysplasia and T1a cancer with angiolytic potassium titanyl phosphate (KTP) lasers is increasing. Angiolytic lasers are also used for juvenile papillomatosis and suspension microlaryngoscopy under general anesthesia or local anesthesia in selected patients.


Assuntos
Neoplasias Laríngeas , Laringe , Terapia a Laser , Microcirurgia , Adolescente , Humanos , Neoplasias Laríngeas/cirurgia , Laringoscopia , Laringe/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
6.
Codas ; 32(1): e20180216, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31721923

RESUMO

PURPOSE: This study aimed to compare the fiberoptic endoscopic findings of oropharyngeal swallowing of distinct food consistencies in Amyotrophic Lateral Sclerosis (ALS). METHODS: This was a retrospective clinical study of a convenience sample of 20 individuals (13 males and seven females aged 34 to 78 years old) with a diagnosis of ALS and oropharyngeal dysphagia confirmed by clinical and objective evaluation of swallowing, regardless of the bulbar or skeletal type and of the time of neurological diagnosis. The fiberoptic endoscopic evaluation of swallowing (FEES) of the liquid (N = 18), thickened liquid (N = 19) and pureed samples (N = 20) in a volume of 5 ml were analyzed. Data related to posterior oral spillage, pharyngeal residues, laryngeal penetration and/or aspiration after swallowing the three food consistencies were analyzed statistically by the Friedman ANOVA test. RESULTS: No impairment of laryngeal sensitivity was found in this population. There was no statistically significant difference in posterior oral spillage, penetration and/or aspiration between food consistencies. There was a statistically significant difference only related to pharyngeal residues of the thickened liquid and pureed consistency. CONCLUSION: Among the fiberoptic endoscopic findings of swallowing in ALS, only pharyngeal residues had a higher frequency depending on the consistency of food.


Assuntos
Esclerose Amiotrófica Lateral/complicações , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Laringoscopia/métodos , Adulto , Idoso , Deglutição , Endoscopia do Sistema Digestório , Feminino , Alimentos/classificação , Humanos , Laringe , Masculino , Pessoa de Meia-Idade , Orofaringe , Estudos Retrospectivos
7.
Anaesthesia ; 75(2): 179-186, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31631314

RESUMO

The aim of this study was to evaluate the effectiveness of cricoid and paralaryngeal force for oesophageal entrance occlusion during induction of anaesthesia. Seventy-four patients were included in this randomised, crossover study. The relative position of the glottis and outer anteroposterior diameter of the upper oesophageal entrance were assessed at baseline, after the application of 30 N cricoid and paralaryngeal force, and after induction of anaesthesia. The occlusion rate of the oesophageal entrance with cricoid and paralaryngeal force was assessed during direct laryngoscopy. The relative position of the upper oesophageal entrance to the glottis changed in 45 out of 74 patients after induction of anaesthesia and during direct laryngoscopy compared with the awake state. The application of cricoid and paralaryngeal force decreased the mean (SD) diameter of the upper oesophageal entrance to a similar degree in awake (8.5 (2.1) mm to 6.4 (1.7) mm and 6.5 (1.6) mm, respectively; p < 0.001) and anaesthetised (8.7 (2.2) mm to 6.5 (1.7) mm and (6.7 (1.9) mm, respectively; p < 0.001) states. During direct laryngoscopy, the occlusion rate of the oesophageal entrance was greater with cricoid compared with paralaryngeal force (46/74 vs. 26/74, respectively; p = 0.002). The relative position of the upper oesophageal entrance to the glottis may change after induction of anaesthesia and during direct laryngoscopy. Cricoid and paralaryngeal force both decrease the diameter of the upper oesophageal entrance in awake and anaesthetised states. Occlusion of the oesophageal entrance is achieved more frequently with cricoid force compared with paralaryngeal force during direct laryngoscopy.


Assuntos
Anestesia/métodos , Cartilagem Cricoide/anatomia & histologia , Esôfago/anatomia & histologia , Laringoscopia/métodos , Laringe/anatomia & histologia , Ultrassonografia/métodos , Estudos Cross-Over , Feminino , Humanos , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Pressão
8.
Ann Otol Rhinol Laryngol ; 129(2): 101-109, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31522512

RESUMO

OBJECTIVE: To assess the prevalence of microlaryngeal teaching course in Accreditation Council for Graduate Medical Education (ACGME)-accredited otolaryngology residency programs in an effort to evaluate the nature, perceived value and barriers to implementation of microlaryngeal courses. METHOD: A 14-question survey to all ACGME-accredited otolaryngology programs in the United States. RESULT: Out of 119 ACGME-accredited otolaryngology programs identified on the ACGME Fellowship and Residency Electronic Interactive Database, responses were received from 67 programs (56%). Although 90% of respondents indicated that instruction courses in one discipline or another existed at their institution for their otolaryngology residents, only 33% indicated that their program offers a hands-on instruction course in microlaryngeal surgery. Of those programs that offered a microlaryngeal surgery course, 100% felt the residents appreciated the course; 95% of those programs that did not have a course felt their residents would appreciate a microlaryngeal course at their institution if they were able to offer one. Among programs without a microlaryngeal teaching course, the largest perceived barriers were cost and availability of appropriate equipment. CONCLUSION: Microlaryngeal courses for otolaryngology residency training are limited in availability in the United States, and there is variability in training across the country. All respondents in our survey indicated the value in these courses for microlaryngeal surgical skill training. There is a clear role for increasing availability of low-cost microlaryngeal stations and courses.


Assuntos
Dissecação/educação , Internato e Residência/métodos , Laringe/cirurgia , Otolaringologia/educação , Acreditação , Currículo , Humanos , Microcirurgia/educação , Inquéritos e Questionários , Estados Unidos
9.
J Photochem Photobiol B ; 202: 111724, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31785446

RESUMO

Laser induced autofluorescence (LIAF) lifetime is useful to distinguish between normal laryngeal tissues and squamous cell carcinoma (SCC) based on variations of their biochemical composition and structure alterations. LIAF was collected from samples constituted by pairs of normal and malignant tissue, which were excised from three patients. Exclusion criteria for samples harvest were: (i) macroscopic changes of normal vocal cord observed during surgery; (ii) previous surgical intervention on vocal cord, (iii) patients treated only with chemotherapy or radiotherapy for carcinoma. Inclusion conditions: men, aged 57-68, non-smokers. A pulsed laser diode excited LIAF at 375 nm and 31 MHz repetition rate; beam full-time width at half-maximum was 87 ps at an average power of 0.49 mW. Mean LIAF lifetime for normal tissues was (3.75 ± 0.49) ns and for malignant (4.37 ± 0.85) ns: it is longer in malignant than in normal tissue. Variance analysis made with Fisher's test has shown no significant difference between patients for normal tissues; the same was true for malignant. Though, when malignant tissue was compared to normal for the same patients as well as between patients, a significant difference (significance level of 5%) was evidenced. Time-resolved LIAF may allow better differentiation between normal and malignant tissues in patients diagnosed with larynx SCC.


Assuntos
Laringe/efeitos da radiação , Lasers , Idoso , Análise de Variância , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Laringe/química , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias
10.
J Oral Rehabil ; 47(3): 339-345, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31705814

RESUMO

BACKGROUND: Movement of the hyoid and laryngeal complex is critical for preventing aspiration, as well as smooth bolus passage through the pharynx. We have developed a non-invasive system for measuring laryngeal movement during swallowing with a bend sensor and have already reported the time coordination between the signal waveform from the sensor and hyoid movement. OBJECTIVE: The aim of this study was to clarify the quantitative association between the output value of the sensor and hyoid movement during swallowing. METHODS: A small bend sensor was fixed on the skin surface along the midline of the neck of 13 healthy men (mean age, 30.8 ± 4.5 years). Laryngeal and hyoid movements during swallowing of 5 mL of water were recorded synchronously by the bend sensor and videofluorography. The relationship between the bend sensor output value (LM value) and hyoid position (x- and y-axis displacements) by videofluorography from the onset to the offset of the signal waveform was analysed for all tasks and for each task using Pearson's correlation coefficients. RESULTS: There was a positive correlation between the LM value and hyoid position for all tasks (x-axis displacement: r = .647, y-axis displacement: r = .233). In particular, there was a moderate to high correlation between the LM value and x-axis displacement for each task (.453 ≤ r ≤ .934). CONCLUSION: The LM value can be a quantitative parameter of anterior hyoid movement during swallowing that might be associated with bolus flow and upper oesophageal sphincter opening.


Assuntos
Deglutição , Laringe , Adulto , Esfíncter Esofágico Superior , Humanos , Osso Hioide , Masculino , Movimento
11.
Ann Otol Rhinol Laryngol ; 129(1): 46-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31466464

RESUMO

OBJECTIVES: To assess and compare the face (FV) and content validity (CV) of three ex vivo animal models for simulation training in pediatric laryngotracheal reconstruction (LTR). METHODS: Feasibility of performing LTR was assessed on the head and neck of three different animals (lamb/suckling-pig/rabbit) and laryngeal dimensions and qualitative observations were recorded. A 19-item five-point Likert scale questionnaire was completed for each model to assess FV and CV. Data was prospectively collected and analyzed using descriptive and nonparametric statistics. RESULTS: All three models were suitable for LTR simulation with laryngeal dimensions corresponding to 0-2 years (rabbit), 5-10 (pig) and >10 years (lamb model). Five trainees and five expert pediatric otolaryngologists performed LTR on each model. The overall median FV score was 5 for the lamb model (IQR 4-5), 3 for the rabbit (IQR 2-3), and 4 for the pig (IQR 4-4). The overall median CV score was 5 for the lamb (IQR 5-5), 2 for the rabbit (IQR 2-3), and 4 for the pig model (IQR 4-4). Comparison of the models demonstrated the lamb to be favored as the most realistic and practical model for simulation training in pediatric LTR, with both the lamb and the porcine model attaining validation thresholds. CONCLUSION: Our study is the first comparative validation assessment of animal models for use in pediatric LTR simulation and it supports the use of ex vivo lamb and porcine models for use in LTR surgical skills training. The lamb model was the favored simulation model while the rabbit was considered inferior for simulation training in pediatric LTR. LEVEL OF EVIDENCE: 3b.


Assuntos
Laringe/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/educação , Procedimentos Cirúrgicos Reconstrutivos/educação , Treinamento por Simulação , Traqueia/cirurgia , Animais , Criança , Pré-Escolar , Humanos , Lactente , Laringoestenose/cirurgia , Modelos Animais , Pediatria/educação , Coelhos , Ovinos , Suínos , Estenose Traqueal/cirurgia
12.
Vestn Otorinolaringol ; 84(5): 38-43, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793525

RESUMO

AIM: To evaluate the velocity of vocal fold movements by duplex Doppler scanning in adults during breathing, talking and phonation. METHODS: Twenty healthy volunteers (18 women and 2 men) without of voice problems were investigated with scanners Logic-7 or Aloka 1100 by the linear transducer 7-10 MHz. The thyroid cartilage was used as an acoustic window. The dependence between the vocal fold velocity and volume and pitch of the voice were estimated using Spearman correlation. RESULTS: The velocity of movements of the vocal folds during breathing was from 5 to 16 cm/s, during talking and phonation - from 9 to 110 cm/s. Coefficient of Spearman correlation between the voice pitch and the vocal fold velocity was +0.9±0.1 an average, between volume of the voice and the vocal fold velocity was - 0.7±0.1. CONCLUSION: Duplex Doppler ultrasound scanning of the larynx allows measuring the velocity of vocal fold's movements during breathing, conversation and phonation. The fold's velocity increases with increasing of the voice volume and decreases with increasing the voice pitch. Duplex Doppler ultrasound scanning may be useful for early detection of disorders of mobility of the vocal folds.


Assuntos
Prega Vocal , Adulto , Feminino , Humanos , Laringe , Masculino , Fonação , Vibração , Voz
14.
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 384-388, Out.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1024143

RESUMO

Introduction: The understanding of normal vocal production is essential to guide any voice professional as it is fundamental to understand the effects of the posterior glottal gap on the vocal quality. Objective: The aim of the present study was to verify the association between glottic closure, acoustic parameters, and some characteristics of the videolaryngostroboscopy of young women without vocal complaints nor laryngeal disorders. Methods: This is a cross-sectional study with 56 women between 20 and 30 years old who underwent videolaryngostroboscopy. The acoustic parameters of the vowel /a:/ were analyzed using the Praat software, Release 4.6.10 (Paul Boersman and David Weenik, Amsterdam, Netherlands). Statistical Analysis: The chi-squared, Fischer, and Kruskall-Wallis tests were applied, with 5% significance. Results: Significant occurrence of posterior glottal gap (85.71%, p < 0.001), of normal vocal folds vibration amplitude (82.14%, p < 0.001), and of absence of significant constriction of the laryngeal vestibule (98.21%, p < 0.001); no significant association of the glottic closure with the vocal acoustic parameters; no significant association of glottic closure, vocal folds vibration amplitude, and constriction of the laryngeal vestibule. Conclusion: There was a predominance of posterior glottal gap, normal vocal folds vibration amplitude, and absence of laryngeal vestibule constriction, and no relation with the acoustic parameters, suggesting that the posterior glottal gap did not generate impact on the vocal production of the young adult women studied (AU)


Assuntos
Humanos , Feminino , Adulto , Voz/fisiologia , Glote/fisiologia , Acústica da Fala , Prega Vocal/fisiologia , Qualidade da Voz/fisiologia , Estudos Transversais , Laringoscopia/métodos , Laringe/fisiologia
15.
BMC Evol Biol ; 19(1): 233, 2019 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881941

RESUMO

BACKGROUND: Palaeognathae is a basal clade within Aves and include the large and flightless ratites and the smaller, volant tinamous. Although much research has been conducted on various aspects of palaeognath morphology, ecology, and evolutionary history, there are still areas which require investigation. This study aimed to fill gaps in our knowledge of the Southern Cassowary, Casuarius casuarius, for which information on the skeletal systems of the syrinx, hyoid and larynx is lacking - despite these structures having been recognised as performing key functional roles associated with vocalisation, respiration and feeding. Previous research into the syrinx and hyoid have also indicated these structures to be valuable for determining evolutionary relationships among neognath taxa, and thus suggest they would also be informative for palaeognath phylogenetic analyses, which still exhibits strong conflict between morphological and molecular trees. RESULTS: The morphology of the syrinx, hyoid and larynx of C. casuarius is described from CT scans. The syrinx is of the simple tracheo-bronchial syrinx type, lacking specialised elements such as the pessulus; the hyoid is relatively short with longer ceratobranchials compared to epibranchials; and the larynx is comprised of entirely cartilaginous, standard avian anatomical elements including a concave, basin-like cricoid and fused cricoid wings. As in the larynx, both the syrinx and hyoid lack ossification and all three structures were most similar to Dromaius. We documented substantial variation across palaeognaths in the skeletal character states of the syrinx, hyoid, and larynx, using both the literature and novel observations (e.g. of C. casuarius). Notably, new synapomorphies linking Dinornithiformes and Tinamidae are identified, consistent with the molecular evidence for this clade. These shared morphological character traits include the ossification of the cricoid and arytenoid cartilages, and an additional cranial character, the articulation between the maxillary process of the nasal and the maxilla. CONCLUSION: Syrinx, hyoid and larynx characters of palaeognaths display greater concordance with molecular trees than do other morphological traits. These structures might therefore be less prone to homoplasy related to flightlessness and gigantism, compared to typical morphological traits emphasised in previous phylogenetic studies.


Assuntos
Laringe/anatomia & histologia , Paleógnatas/anatomia & histologia , Paleógnatas/genética , Filogenia , Animais , Evolução Biológica , Feminino , Glote/anatomia & histologia , Masculino , Orofaringe/anatomia & histologia , Paleógnatas/classificação , Vocalização Animal
16.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(12): 912-918, 2019 Dec 07.
Artigo em Chinês | MEDLINE | ID: mdl-31887817

RESUMO

Objective: To establish a New Zealand rabbit animal model of laryngopharyngeal reflux disease (LPRD) using esophageal balloon together with metal internal stent dilation and to investigate the changes of mucosa. Methods: 20 New Zealand rabbits were randomly divided into experimental group and control group, with 10 in each group. Balloon dilatation and metal internal stent dilation were carried out in experimental group to reproduce the animal model of LPRD.The middle of balloon was placed at the lower esophageal sphincter (LES) while the stent was placed at the upper esophageal sphincter (UES). The guide wire was placed in the control group, but the balloon was not expanded and the stent was not placed. The general condition, pH value of hypopharynx, laryngeal histopathology and changes of pepsin content of New Zealand rabbits were observed regularly. The difference between experimental group and control group was compared. Results: The 24-hour Dx-pH monitoring results showed that the number of reflux episodes(20.0[9.5, 35.0], 13.0[6.5, 22.0]), and the percent time below pH 5.5 (1.36%[0.60%, 4.57%], 1.36%[0.43%, 2.77%]) in the experimental group at the 2nd and 4th week were significantly different from those in the control group (0[0,3.0], 1.0[0.5, 3.8]; 0[0, 0.01%], 0[0, 0], respectively, all P<0.01), suggesting that the experimental group New Zealand rabbits developed LPRD. Compared with the control group under microscope, lymphocytes infiltration and submucosal gland hyperplasia increased in the mucosa of the throat of the experimental group. The results of pepsin immunohistochemical staining between the two groups were statistically significant (P=0.014). Conclusion: The use of balloon dilatation of the LES combined with metal stent dilatation of the UES can successfully establish a laryngopharyngeal reflux model, and lesions in the throat tissue can be observed.


Assuntos
Modelos Animais de Doenças , Refluxo Laringofaríngeo , Laringe , Animais , Esfíncter Esofágico Inferior , Monitoramento do pH Esofágico , Laringe/fisiopatologia , Pepsina A , Coelhos
17.
Medicine (Baltimore) ; 98(51): e18177, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860963

RESUMO

INTRODUCTION: Laryngeal adenoid cystic carcinoma (LACC) is an extremely rare malignant neoplasm. The etiology of LACC remains unknown, and it is characterized by multiple recurrences, slow progression, and late distant metastasis. This study aimed to provide more information regarding the characteristics, diagnosis, and treatment of LACC by analyzing 3 clinical cases and reviewing the literature on this topic. PATIENT CONCERNS: Here, we present all 3 cases of LACC within the period between 2010 and 2019. Dyspnea was the most commonly observed symptom in these patients, followed by hoarseness, pharyngeal paresthesia, and difficulty swallowing. DIAGNOSIS: All patients were pathologically confirmed as LACC. INTERVENTIONS: All the patients underwent a combined therapy of surgical resection plus external irradiation. OUTCOMES: The follow-up time was between 2 and 6 years; no local recurrence occurred in any of the 3 patients. Lung metastasis was found in 1 patient 6 years after surgery. CONCLUSION: LACC is usually a slowly progressing cancer; the main treatment methods are surgery and radiotherapy, and the adequate radiotherapy dose should usually be greater than 60 Gy. The 5-year disease-specific survival rate is high; however, distant metastasis may still occur in patients with LACC even beyond 5 years after treatment. Therefore, patients with LACC require long-term surveillance.


Assuntos
Carcinoma Adenoide Cístico/diagnóstico , Neoplasias Laríngeas/diagnóstico , Adulto , Idoso , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/terapia , Terapia Combinada , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Laringe/patologia , Masculino , Pessoa de Meia-Idade
19.
Laryngorhinootologie ; 98(10): 725-741, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31610600

RESUMO

This article is intended to give an overview of the surgery for laryngeal malignancies and the current state of transoral endoscopic laryngeal surgery. The current therapy concepts in transoral endoscopic laryngeal surgery are presented in combination with the various possibilities of reconstruction. The adequate oncological treatment under functional aspects described plays the decisive role here: treatment goals beyond the cure of the tumor disease are the functional maintenance of the larynx with simultaneous preservation of the voice. In general, the diagnosis and treatment of (pre-) cancerous lesions of the laryngeal mucosa is demanding and requires a great deal of experience of the attending laryngologist. Updated classification systems support level-based categorization. In transoral endoscopic laryngeal surgery, resection using cold instruments and the CO2 laser are currently among the traditional methods, although newer methods such as the angiolytic laser can be used to ablate these lesions. Transoral endoscopic laryngeal surgery is a highly endoscopic-microscopic procedure in (pre-) cancerous lesions, which may presumably continue to evolve from the microlaryngoscopic approach over the next few years due to the introduction of new instruments and high-resolution imaging techniques. Robot-assisted surgery has also found its way into the transoral endoscopic treatment of laryngeal carcinoma. Only in the next few years, however, will it become clear to what extent this technique can supplement, replace or clarify surgical methods, since the individualized surgical strategy currently has a priority position for every single patient.


Assuntos
Neoplasias Laríngeas , Laringe , Lasers de Gás , Humanos , Laringoscopia , Laringe/cirurgia , Terapia a Laser
20.
Curr Med Sci ; 39(5): 810-815, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612400

RESUMO

Total laryngectomy affects the speaking functions of many patients. Speech deprivation has great impacts on the quality of life of patients, especially on self-efficacy. Learning esophageal speech represents a way to help laryngectomees speak again. The purpose of this study was to determine the influence of collective esophageal speech training on self-efficacy of laryngectomees. In this study, 28 patients and 30 family members were included. The participants received information about training via telephone or a WeChat group. Collective esophageal speech training was used to educate laryngectomees on esophageal speech. Before and after collective esophageal speech training, all participants completed the General Self-Efficacy Scale (GSES) to assess their perceptions on self-efficacy. Through the training, laryngectomees recovered their speech. After the training, the self-efficacy scores of laryngectomees were higher than those before the training, with significant differences noted (T<0.05). However, family members' scores did not change significantly. In conclusion, collective esophageal speech training is not only convenient and economical, but also improves self-efficacy and confidence of laryngectomees. Greater self-efficacy is helpful for laryngectomees to master esophageal speech and improve their quality of life. In addition, more attention should be focused on improving the self-efficacy of family members and making them give full play to their talent and potential on laryngectomees' voice rehabilitation.


Assuntos
Laringectomia/reabilitação , Psicoterapia de Grupo/métodos , Autoeficácia , Fonoterapia/métodos , Voz Esofágica/métodos , Família/psicologia , Feminino , Humanos , Linguagem , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Laringe/patologia , Laringe/cirurgia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Voz Esofágica/psicologia , Inquéritos e Questionários , Resultado do Tratamento
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