OBJECTIVETo study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma.

METHODSA retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved. All had 55-75 Gy radiotherapy according to their need.

RESULTSA total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05).

CONCLUSIONOnly a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.

Adolescent ; Adult ; Aged ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; physiopathology ; surgery ; Hypopharynx ; surgery ; Larynx ; physiopathology ; Male ; Middle Aged ; Survival Rate

OBJECTIVE: Study for surgical approaches on anterior skull base tumors. METHOD: All 37 cases with anterior skull base tumors were surgically treated. Twenty-one cases were treated with anterior craniofacial approaches: Frontal subcranial combined with total maxillectomy in 8 cases or/with orbital exenteration in 5 cases, combined with lateral rhinotomy in 1 cases, combined with naso translocation with medial maxillectomy in 7 cases. Partial or total maxillary swing combined with naso pyramid translocation in 13 cases. Frontonasal, fronto-orbital and midface degloving in one case respectively. RESULT: Of the 27 malignant cases the 3 and 5-year survival rates were 81.9% (22/27) and 62.9% (17/27) respectively, and one tumor free case living well more than 9 years. There were no recurrence in 10 cases with benign tumor. CONCLUSIONS Various craniofacial approaches except lateral rhinotomy provide directly satisfactory tumor exposure and facilitate enbloc resection of the naso paranasal sinus tumor with intracranial extension. Partial or total maxillary swing combined with naso pyramid translocation is good for tumor involving the skull base without intracranial invasion. The fronto-nasal pyramid translocation is good for removal of the upper part of nasal tumor with intracranial extension on well developed frontal sinus. The fronto orbital approach is proper for removal of fronto-sphenoid tumor and midface degloving may be used in selected cases.
Adolescent ; Adult ; Aged ; Craniotomy ; methods ; Female ; Frontal Bone ; surgery ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Skull Base ; surgery ; Skull Base Neoplasms ; surgery ; Young Adult

Objective:To evaluate and screen the anti-atrial ifbrillation drug with multiion channel targets by micro-electrode chip technology in a rapid atrial pacing (RAP) rabbit model.
Methods:A total of 32 rabbits were randomly divided into 4 groups, n=8 in each group. Potassium channel blocker (TEA) group, Potassium channel blocker (BaCl2) group, Potassium channel blocker (CdCl2) group and Amiodarone group.
The electrode was inserted into right atrium via internal jugular vein with rapid right atrial pacing (600 beat/min) and the effect of each anti-atrial ifbrillation drug on ifeld action potential (fAPD) were measured in different groups.
Results:With 24 hour RAP, the fAPD was prolonged from (176.67 ± 8.66) ms to (196.11 ± 10.76) ms, P=0.012 in TEA group;from (182.22 ± 12.87) ms to (191.11 ± 13.09) ms, P=0.039 in BaCl2 group;from (178.33±7.85) ms to (206.67 ± 9.70) ms, P=0.0015 in CdCl2 group;from (167.38 ± 13.67) ms to (185 ± 15.14) ms, P=0.002 in Amiodarone group.
Conclusion: RAP induced atrial fibrillation in experimental rabbit model is a simple and feasible method for screening the anti-atrial fibrillation drugs, combining with micro-electrode chip technology, it might be used for developing the new product.