1.Diagnosis and treatment of special type of laryngeal foreign body with granuloma in children.
Dezhen TU ; Zongtong LIN ; Ling SHEN ; Deping CHEN ; Zhongjie YANG ; Qiaoyu LIAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):163-167
Objective:This article explores the diagnosis and treatment of a special type of laryngeal foreign body with granuloma in children, providing a clinical reference for standardized diagnosis and treatment. Methods:This article retrospectively analyzes one case admitted to our department and five other cases reported in relevant literature involving a special type of laryngeal foreign body with granuloma in children. It summarizes the clinical characteristics of this disease and explores its diagnosis and treatment. Results:①A total of 6 cases were misdiagnosed and had a long course of illness. Five cases had no clear history of foreign body at the first visit. One case had foreign body history but no foreign body was found. ②The clinical symptoms were diverse, which could be hoarseness, cough, wheezing, dyspnea, or no symptoms. ③A total of 3 cases were diagnosed by laryngoscopy, and 3 cases were diagnosed by laryngoscopy and imaging examination. ④Foreign bodies that were not wrapped in granulomas, were removed first and then the granulomas were treated; foreign bodies wrapped in granulomas were removed after the removal of granulomas. Conclusion:A special type of laryngeal foreign body with granuloma may lack of accurate foreign body history, resulting in long-term retention of foreign bodies, leading to granuloma formation and misdiagnosis. Electronic laryngoscopy combined with CT examination contribute to early diagnosis. Low temperature plasma under endoscope and anesthetic laryngoscope is conducive to the exposure and precise removal of foreign bodies and avoids tracheotomy to a certain extent.
Child
;
Child, Preschool
;
Female
;
Humans
;
Infant
;
Male
;
Foreign Bodies/surgery*
;
Granuloma, Foreign-Body/therapy*
;
Larynx/pathology*
;
Retrospective Studies
2.Content and development of pharyngology and laryngology.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(11):1001-1005
Pharyngology and laryngology is an important subspecialty of Otolaryngology Head and Neck Surgery. It involves congenital diseases, trauma and foreign bodies, inflammatory diseases, obstructive sleep apnea, benign lesions, laryngeal nerve and cricoarytenoid joint diseases, swallowing disorders, laryngopharyngeal reflux diseases, voice medicine, as well as laryngeal microsurgery and endoscopic surgical treatment of benign and malignant tumors of this area. The disease spectrum is wide and involves many surgical techniques and methods.
Humans
;
Otolaryngology
;
Larynx/surgery*
3.The consensus among experts on the diagnosis and treatment of pediatric vocal cord paralysis.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):765-770
Pediatric vocal ford paralysis is a vocal cord movement disorder caused by damage to the pediatric laryngeal motor nerves.It is mainly characterized by voice, breathing,and swallowing difficulties,and in severe cases,it can lead to choking in affected children. Currently, the diagnosis and treatment of this condition pose a significant challenge for pediatric otolaryngologists, as the goal is to minimize damage to the vocal folds and laryngeal framework.In order to standardize the diagnosis and treatment of pediatric vocal cord paralysis, the Pediatric Otolaryngology Committee of the Chinese Medical Association,in collaboration with multiple children's medical centers nationwide, have formulated this consensus document.
Humans
;
Child
;
Vocal Cord Paralysis/therapy*
;
Consensus
;
Vocal Cords/surgery*
;
Larynx
;
Voice
;
Laryngeal Diseases/complications*
4.Significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma.
Jin WU ; Guohua HU ; Minmin LI ; Zhihai WANG ; Wei MA ; Xiaoqiang WANG ; Jiang ZHU ; Min PAN ; Quan ZENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(9):715-728
Objective:To evaluate the clinical significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma. Methods:Patients with locally advanced HPSCC(cT3-T4aN0-N3M0) were eligible. All received 2 cycles of pembrolizumab combined with docetaxel and platinum neoadjuvant induction therapy. After two cycles, the efficacy was evaluated, followed by radical chemoradiotherapy or surgery and adjuvant chemoradiotherapy according to the efficacy. The primary endpoints were objective response rate(ORR) ,larynx-preservation(LP) rate at 3 months post-treatment and the adverse reactions during neoadjuvant therapy. Results:From December 2021 to December 2022, 10 patients with locally advanced HPSCC(cT3-T4aN0-N3M0) were enrolled. After 2 cycles of the neoadjuvant therapy, 2 patients achieved complete response(CR), 7 patients achieved partial response(PR), 1 patient was stable disease(SD), objective response rate(ORR) was 90%, and disease control rate(DCR) was 100%. 5 patients received radical chemoradiotherapy, 5 patients received surgery and adjuvant chemoradiotherapy, four of them received partial laryngectomy and partial hypopharyngeal resection surgery, and one of them received total laryngectomy and partial hypopharyngeal resection surgery. All patients were able to withstand adverse reactions of neoadjuvant therapy and successfully completed the whole treatment of HPSCC without grade 3-4 treatment-related adverse reactions. There was no recurrence or metastasis during 3-18 months of follow-up. 1 patient died of severe pneumonia 3 months after the completion of radical chemoradiotherapy. At 3 months after treatment, the larynx-preservation rate was 80%. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy has good short-term efficacy and the adverse reactions were tolerable. It can improve the larynx-preservation rate of patients with locally advanced HPSCC, thus improving the prognosis and quality of life of patients.
Humans
;
Squamous Cell Carcinoma of Head and Neck/etiology*
;
Neoadjuvant Therapy
;
Quality of Life
;
Cisplatin
;
Treatment Outcome
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Larynx
;
Head and Neck Neoplasms
;
Immunotherapy
5.Extranodal NK/T cell lymphoma, nasal type involving the larynx and digestive tract: a case report and literature review.
Sijie MA ; Xingjian CHEN ; Zengping LIU ; Yufen GUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):920-923
Extranodal NK/T cell lymphoma, nasal type(ENKTL) is a highly aggressive malignant tumor derived from NK cells. This article reports a case of ENKTL invading the larynx and digestive tract. The clinical clinical manifestations include hoarseness and intranasal masses.
Humans
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Lymphoma, Extranodal NK-T-Cell/pathology*
;
Nose/pathology*
;
Nose Neoplasms/pathology*
;
Larynx/pathology*
;
Gastrointestinal Tract/pathology*
6.A case report of primary extubation by partial cricotracheal resection for severe subglottic stenosis.
Qingxiang ZHANG ; Yaqun LIU ; Jie MENG ; Mingjing CAI ; Dongdong HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):924-926
This patient suffered from severe subglottic stenosis(grade Ⅳb). During partial cricotracheal resection, we cut through the cricothyroid membrane and the cricoid arch along the line from the lower edge of the thyroid cartilage to 5 mm of the inferior thyroid cartilage corner anteromedially. This can protect the cricothyroid joint, effectively protect the recurrent laryngeal nerve, and also support the airway. Strictly adhere to airway separation, avoid excessive separation of scars, and combine with reasonable postoperative management to achieve a safe extubation.
Humans
;
Constriction, Pathologic/surgery*
;
Trachea/surgery*
;
Airway Extubation
;
Laryngostenosis/surgery*
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Larynx/surgery*
;
Cricoid Cartilage/surgery*
;
Treatment Outcome
7.Diagnosis and treatment of disorders of laryngeal airway in children and prospect.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):939-942
This paper focuses on the diagnosis and treatment of disorders of laryngeal airway in children, including congenital anomalies, infection, and tumor of the larynx to provide a new technology for managing these diseases. Based on the characteristic of them, the pediatric upper airway is dedicated to the clinical evaluation of airway obstruction and the assessment of the compromised pediatric airway, including clinical evaluation of symptoms, diagnostic endoscopy, and imaging examination. Information on endoscopic techniques used for dealing with different degrees of pediatric airway comprised is provided, also this techniques could diagnose what kinds of airway disorder. For example, determining the a particular laryngeal cleft at the initial otolaryngology encounter, flexible laryngoscopy should be performed. In order to define the extent of any identified cleft, the rigid bronchoscopy should be completed to evaluate for classification of laryngeal cleft including typeⅠ, Ⅱ, Ⅲa, Ⅲb, Ⅳa, Ⅳb under general anesthesia. The decision to pursue any therapy for the disorders of laryngeal airway in children should be based on the severity of the patient's symptoms, endoscopic and imaging examination. There are two medical treatments including nonsurgical therapy and surgical therapy. For example the laryngeal cleft, approximately half of type 1 and select type 2 patients can be managed entirely with nonsurgical therapy. Medical management is multifaceted. Under recommendations from the feeding team, a modified diet with thickened feeds and possibly altered feeding position should be initiated. Endoscopic surgical repair is the current gold standard for definitive repair of type 1, the majority of type 2, and selected type 3 clefts. Finally, information on new techniques used into the future for dealing with the diagnosis and treatment of disorders of laryngeal airway in children in this paper.
Child
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Humans
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Infant
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Larynx/surgery*
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Laryngoscopy
;
Endoscopy
;
Bronchoscopy
;
Congenital Abnormalities/surgery*
8.Application of endoscopic surgical repair through bracing laryngoscope in children with type Ⅲ laryngeal clefts.
Yitian HUANG ; Hongbing YAO ; Xinye TANG ; Yang YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):948-952
Objective:To analyze the efficacy of endoscopic surgical repair in the treatment of type Ⅲ laryngeal clefts and to explore the feasibility of the treatment for type Ⅲ laryngeal clefts. Methods:The clinical data of 6 children with type Ⅲ laryngeal clefts who underwent endoscopic surgical repair in our department from June 2018 to January 2023 were analyzed retrospectively. The operation was performed under combined intravenous and general anesthesia,preserving the spontaneous breathing of the children. With the assistance of 4 mm/0° endoscope, radiofrequency knife or laryngeal scissors were used to make fresh wounds along the edge of laryngeal clefts,and cotton pads infiltrated with adrenaline (1:10 000) were used to compress the wound. 6-0 PDP suture was used to suture 3-6 stitches according to the extent of laryngeal clefts. Modified barium swallowing test (MBS) was performed 3 months after operation. Results:All the children were successfully treated with endoscopic surgical repair. After surgery, 2 cases were transferred to pediatric intensive care unit (ICU) for 7 days of monitoring, and the rest were transferred back to the general ward. There were no postoperative complications. The symptoms of dysphagia, laryngitis and recurrent pneumonia were improved in all children. According to the follow-up results of postoperative MBS,no aspiration was found in all children, and 2 children had intermittent cough when drinking large amounts of water. During the follow-up, there were 2 cases of recurrence, and the cracks were completely repaired after the second endoscopic surgical repair treatment,and no recurrence has been observed so far. Conclusion:Endoscopic surgical repair can be applied to some children with type Ⅲ laryngeal clefts with less intraoperative bleeding and fewer operative complications. It can significantly improve the symptoms such as swallowing dysfunction and recurrent pneumonia. It is a safe and effective surgical treatment.
Child
;
Humans
;
Laryngoscopy/methods*
;
Laryngoscopes
;
Retrospective Studies
;
Larynx/surgery*
;
Pneumonia
;
Congenital Abnormalities/surgery*
9.Analysis of cases of laryngeal airway diseases in infants.
Qiaoyu LIAO ; Zongtong LIN ; Ling SHEN ; Zhongjie YANG ; Xinzhong GAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):953-957
Objective:To analyze the clinical data of laryngeal airway diseases in infants and provide reference for the standardized diagnosis and treatment of the disease. Methods:From June 2022 to August 2023, analyze the clinical data of 4 cases of children with laryngeal airway diseases recently admitted to Department of Otolaryngology, Fuzhou Children's Hospital of Fujian Province, and summarize the experience and lessons of diagnosis and treatment by consulting relevant literature. Results:Three cases had symptoms such as laryngeal wheezing, dyspnea, backward growth and development, etc. After electronic laryngoscopy, the first case was diagnosed with laryngeal softening (severe, type Ⅱ), and the angular incision was performed. While cases 2, 3 diagnosed with case 2 and 3 were diagnosed with laryngeal cyst and underwent laryngeal cyst resection. All three cases underwent low-temperature plasma surgery under visual laryngoscope, and the symptoms were relieved after operation. Case 4 was laryngeal wheezing and dyspnea after extubation under general anesthesia. The electronic laryngoscopy showeded early stage of globetic stenosis, and endoscopic pseudomembrane clamping was performed, and the postoperative symptoms were relieved. Conclusion:Infants and young children with laryngeal airway diseases should pay attention to the early symptoms and be diagnosed by electronic laryngoscopy as soon as possible. With good curative effect and few complications, low-temperature plasma surgery under visual laryngoscope is recommended. The formation of pseudomembrane under the gluteal caused by tracheal intubation causes rapid onset and rapid development. The pseudomembrane extraction by clamping is convenient and fast, with good curative effect.
Infant
;
Child
;
Humans
;
Child, Preschool
;
Respiratory Sounds/etiology*
;
Larynx
;
Laryngeal Diseases/surgery*
;
Laryngoscopy
;
Intubation, Intratracheal/adverse effects*
;
Dyspnea/surgery*
;
Cysts/surgery*
10.Piriform sinus hamartoma in children: a case report and literature review.
Zhiying ZHOU ; Wenxin CHEN ; Jia LIU ; Yong FU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):964-971
Objective:To investigate the clinical manifestations and treatment of laryngopharynx hamartoma in children. Methods:The clinical data of a child with piriform sinus hamartoma treated in our hospital were analyzed retrospectively. The age, gender, clinical manifestations, auxiliary examination, location of the tumor and surgical methods were analyzed. Results:The patient had a good prognosis after surgery, and no tumor recurrence was found after 1 year of follow-up. Conclusion:Laryngopharynx hamartoma is rare in children. It should be considered in children with laryngeal dysfunction and upper airway obstruction. Complete resection of the tumor is the key to postoperative recurrence.
Child
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Humans
;
Hamartoma/surgery*
;
Larynx/pathology*
;
Neoplasm Recurrence, Local/pathology*
;
Pyriform Sinus/pathology*
;
Retrospective Studies
;
Male
;
Female

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