Objective To establish an effective post-operative oral care procedure for patients with oral cavity cancer.Methods Eighty five post-operational patients with oral cavity cancer admitted to Sichuan Cancer Hospital during March 2011 and March 2013 were randomly divided into control group (42cases) and study group (43 cases).Patients in control group were given routine oral care,and those in study group received a special care procedure:normal saline washing + dioxogen cleaning + normal saline washing + normal saline gargle.Oral cleanliness,oral and lung infections were observed in both groups,and SPSS 17.0 was used for statistical analysis.Results Oral cleanliness,rates of oral infection and lung infection at d3 after operation,time of infections,the delayed wound healing and operating comfort were improved in the study group (Z/t/x2 =-2.48,4.57,4.64,2.36,2.25,-2.51,4.18,respectively; all P ＜ 0.05).Conclusion The oral care procedure containing normal saline washing + dioxogen cleaning +normal saline washing + normal saline gargle can improve oral cleanliness early after operation,reduce complications and increase the operating comfort.

Objective To explore the application effects and safety of forward recovery concept on swallowing training in patients with partial laryngectomy above cricoid.Methods The study investigated 60 patients with partial laryngectomy above cricoid,and they were divided into intervention group (n =30) and control group (n =30) using block randomization.The patients of control group started the rehabilitation training after seven days of the operation as usual;the patients of intervention group received forward recovery during the whole perioperative period including psychological intervention,theoretical training,simulation training,and practical training.Swallowing function,compliance,incision pain,incidence of pneumonia,and extubation rate were compared between the two groups.Results The patients of intervention group had better swallowing function after eight weeks of the operation (Z =-2.202,P ＜ 0.05),much more extubation case (x2 =9.017,P ＜ 0.05),better compliance after 1,4,8 weeks of the operation (P ＜ 0.05).The incision pain and incidence of pneumonia had no statistical significance (P ＞ 0.05).Conclusions The forward recovery can significantly improve the compliance and the recovery of swallowing function,but has no effects on incision pain or incidence of pneumonia among the patients with partial laryngectomy above cricoid.

Objective To investigate the factors associated with oral infections in patients with oral cancer undergoing radiotherapy.Methods Clinical data of 241 patients with oral cancer undergoing radiotherapy between March 2012 and May 2014 in sichuan cancer hospital were reviewed.Univariate and multivariate analyses were performed to determine the factors related to oral infection occurring in the patients.SPSS 17.0 software was used to analyze the data.Results Ninety-three (38.59％) of 241 cases had oral infection.Among the 93 cases,49 (52.69％) cases presented with fungal infections,44 (47.31％) cases with bacterial infection,and 38 (40.86％) cases with mixed infection.Oral infection occurred since the fifth week after radiotherapy in 55 (59.14％) patients.Multivariate Logistic regression analysis showed that the risk factors for oral infection after radiotherapy were the late stage of cancer,poor oral health habits,the coexistence of multiple treatments,city dwellers and surgical history (all P ＜0.05).Conclusions Oral infections commonly occur in the late period of radiotherapy.The late stage of cancer,poor oral health habits,the coexistence of multiple treatments,city dwellers and surgical history are key risk factors for oral infection in patients with oral cancer undergoing radiotherapy.

Objective To analyze and summarize the perioperative care of double flap repair of free tissue for head and neck tumors patients with multiple sites defect. Methods From January 2014 to March 2017, 8 head and neck tumors patients with multiple sites defect who underwent the double flap repair of free tissue were selected as the research objected. We established the medical and nursing integrated management group care in perioperative period to care the patient including preoperative scientific and systematic evaluation, careful preoperative preparation, intraoperative cooperation and postoperative target nutrition management, fine management, special oral management, diverse tube nursing, individual nursing care, functional exercise and observation in disease. Results Through meticulous nursing management, 8 patients were successfully discharged from hospital. Conclusions Patients with multiple site defects in head and neck tumors are rare. The features of this kind of patient included high risk of surgery, serious traums, more complications, long time for healing. Targeted perioperative care is the key to successful recovery of patients.

Objective:To examine the posterior sternocleidomastoid border approach which elevated whole sternocleidomastoid in gasless transaxillary endoscopic thyroidectomy.Methods:The clinical data of 46 patients with papillary thyroid carcinoma treated with gasless transaxillary endoscopic thyroidectomy from May 2019 to June 2020 at Department of Head and Neck Surgery, Sichuan Cancer Hospital was analyzed retrospectively. There were 9 males and 37 females, aged (38.6±12.0) years (range: 19 to 74 years). Fourteen and 32 cases performed posterior sternocleidomastoid border and sternocleidomastoid fascia approach, respectively. Comparative analysis were performed on clinical characters, surgical outcomes, postoperative complications, postoperative pain score, and quality-of-life of postoperative 1 month by t test, Wilcoxon rank sum test, Fisher exact test and χ 2 test,respectively. Resuts Complete exposure of central compartment was higher (11/14 vs. 34.4%(11/32),χ2=7.624, P=0.006), more lymph nodes was retrieved (4.2±2.9 vs. 2.0±2.5, t=2.663, P=0.011) in posterior sternocleidomastoid border approach. There were no significant differences between groups in postoperative complications such as recurrent laryngeal nerve palsy (1/14 vs. 3.1%(1/32), P=0.521) and transient hypoparathyroidism (0 vs. 6.2%(2/32), P=1) and pains and quality-of-life. Conclusion:Posterior sternocleidomastoid border approach of gasless transaxillary endoscopic thyroidectomy is safe and reliable and has the advantage of central compartment dissection without increasing trauma.

Objective To investigate the effects of the doctor-nurse integration management mode on the treatment efficacy in oral squamous cell carcinoma patients after free flaps reconstruction. Methods Totally 117 patients were assigned into the control group (n=60) and the experimental group (n=57) according to chronological order. The control group was treated with routine management mode, while the experimental group was treated with the doctor-nurse integration management mode. The indicatiors of patients'anxiety, rehabilitaion, postoperative complications, satisfaction, average hospitalization duration and bed turnover rate were compared between the two groups. Results The differences between the two groups in the score of Self-rating Anxiety Scale (SAS), flap necrosis, the mastery of perioperative knowledge, safisfaction, average hospitalization duration, bed turnover rate and quality of life were statistically significant (P< 0.05). Conclusions The medical integration management mode in oral squamous cell carcinoma patients after free flap reconstruction helps alleviate the anxiety, reduces the incidence of postoperative complications, improves medical quality, improves the quality of life and satisfaction in patients.

Objective:To examine the posterior sternocleidomastoid border approach which elevated whole sternocleidomastoid in gasless transaxillary endoscopic thyroidectomy.Methods:The clinical data of 46 patients with papillary thyroid carcinoma treated with gasless transaxillary endoscopic thyroidectomy from May 2019 to June 2020 at Department of Head and Neck Surgery, Sichuan Cancer Hospital was analyzed retrospectively. There were 9 males and 37 females, aged (38.6±12.0) years (range: 19 to 74 years). Fourteen and 32 cases performed posterior sternocleidomastoid border and sternocleidomastoid fascia approach, respectively. Comparative analysis were performed on clinical characters, surgical outcomes, postoperative complications, postoperative pain score, and quality-of-life of postoperative 1 month by t test, Wilcoxon rank sum test, Fisher exact test and χ 2 test,respectively. Resuts Complete exposure of central compartment was higher (11/14 vs. 34.4%(11/32),χ2=7.624, P=0.006), more lymph nodes was retrieved (4.2±2.9 vs. 2.0±2.5, t=2.663, P=0.011) in posterior sternocleidomastoid border approach. There were no significant differences between groups in postoperative complications such as recurrent laryngeal nerve palsy (1/14 vs. 3.1%(1/32), P=0.521) and transient hypoparathyroidism (0 vs. 6.2%(2/32), P=1) and pains and quality-of-life. Conclusion:Posterior sternocleidomastoid border approach of gasless transaxillary endoscopic thyroidectomy is safe and reliable and has the advantage of central compartment dissection without increasing trauma.

Thyroid tumors are one of the most common diseases, and the thyroidectomy surgery increases. The outpatient surgery is the new trend in clinic. Is it suited for the thyroidectomy? In this article, we will analyse the setting of hospital, surgeon, surgery, patients, and so on, to prove the safety for the outpatient thyroidectomy. After the analysis, the safety of outpatient thyroidectomy surgery will be ensured only if strictly controlling the condition of hospital, surgeons and patients, and following the relation indications.

Objective: To investigate the application of virtual reality technology in the preoperative evaluation of complex head and neck carcinoma and he value of virtual reality technology in surgical treatment of head and neck carcinoma. Methods: The image data of eight patients with complex head and neck carcinoma treated from December 2016 to May 2017 was acquired. The data were put into virtual reality system to built the three-dimensional anatomical model of carcinoma and to created the surgical scene. The process of surgery was stimulated by recognizing the relationship between tumor and surrounding important structures. Finally all patients were treated with surgery. And two typical cases were reported. Results: With the help of virtual reality, surgeons could adequately assess the condition of carcinoma and the security of operation and ensured the safety of operations. Conclusions Virtual reality can provide the surgeons with the sensory experience in virtual surgery scenes and achieve the man-computer cooperation and stereoscopic assessment, which will ensure the safety of surgery. Virtual reality has a huge impact on guiding the traditional surgical procedure of head and neck carcinoma.

Objective: To review and summarize recent update on preoperative diagnostic criteria, treatment and postoperative follow-up for medullary thyroid carcinoma. Methods: The relevant literatures and guidelines about medullary thyroid carcinoma were analyzed and summarized. Results: In the early stages of the disease radical surgery still dominated. Ultrasound results suggested that prophylactic lateral neck dissection was required for patients with high risk factors or high levels of carcinoembryonic antigen and calcitonin need prophylactic. Early hereditary medullary carcinoma could receive prophylactic thyroidectomy based on RET gene test results. Advanced progressive medullary thyroid carcinoma could be treated with palliative surgery,molecular targeted drugs and chemotherapy. Conclusions The prognosis of medullary thyroid carcinoma is poor and lymph node metastasis is easy to occur early. The extent of initial operation should be enough. Locally advanced or distant metastatic medullary thyroid carcinoma can be treated with palliative surgery,molecular targeted drugs and chemotherapy.