[ABSTRACT]OBJECTIVETo investigate the relationship between self-assessment of Voice Handicap Index (VHI) and objective detection of Dysphonia Severity Index (DSI) in vocal ford polyp patients.METHODSAll 104 vocal cord polyp patients assessed the Chinese version of VHI scale by themselves. The DSI was calculated by acoustic analysis of DIVAS2.5. The correlation between VHI and DSI was analyzed in Pearson test.RESULTS There was no significant difference in each index of VHI scale score by side and shape, but the Shimmer of larger or wide-base polyps was more severe. The female patients' function, physiology, and VHI total score were higher than that of male patients, but the DSI was lower than that of male patients. The physiology score was higher in bilateral vocal cord polyp patients, so as well as DSI. There was no significant correlation between each item of VHI scale score and DSI.CONCLUSIONNeither the current subjective VHI nor objective DSI in clinical assessment of voice disorders disability is ideal, further research and better evaluation methods should be further explored.

OBJECTIVE: To compare the advantages and disadvantages of real time recurrent laryngeal nerve (RLN) monitoring and conventional exposure during thyroid operation by Meta analysis. METHOD: The published articles of randomized controlled clinical trials were searched in data bases to compare the therapeutic outcomes of using real-time RLN monitoring and conventional exposure in thyroid surgery. The quality of the searched original studies was assessed and the outcomes which are in line with the requirements were analyzed. RESULT: Six articles met the inclusion criteria, which contained 12,646 RLN in total. There were 5,535 cases in the RLN monitoring group and 7,111 cases in the conventional exposure group. The results of Meta analysis showed that: the transient injury rate of the RLN in the monitoring group (OR=0.60, 95% CI=0.49-0.73, P<0.01) was lower than that in the conventional exposure group, but the permanent injury rate of the RLN in two groups had no statistical difference (OR=0.90, 95 % CI= 0.57-1.40, P>0.05). The RLN identification rate also had no statistical difference between the two groups (OR=9.79, 95% CI=0.17-548. 64, P>0.05). CONCLUSION The transient injury rate of the RLN is lower in the monitoring group than that in conventional exposure group, but the permanent injury rate and the RLN identification rate had no statistical difference between the two groups. The intraoperative nerve monitoring was useful in the prevention of the RLN injury in thyroid surgery.
Humans ; Monitoring, Intraoperative ; Parathyroid Glands ; Quality of Life ; Recurrent Laryngeal Nerve ; Recurrent Laryngeal Nerve Injuries ; prevention & control ; Thyroid Gland ; surgery ; Thyroidectomy ; adverse effects

Objective To investigate the application of the straight head-hanging test in the diagnosis of the benign paroxysmal positional vertigo (BPPV ) .Methods The clinical manifestations of 324 patients with benign paroxysmal positional vertigo treated in our department from July 2009 to April 2014 were retrospectively analyzed . All of the patients were tested by Dix -Hallpike and roll test first ,then the straight head-hanging test was carried out .Results Of the 324 cases ,53 cases(16 .36% ) had signs of simultaneous multiple canal involvement ,and 27 ca‐ses of them could be triggered the symptom of vertigo in the straight head -hanging test .In patients with single semicircular canal BPPV ,85 cases (26 .2% )were evoked vertigo with or without positional nystagmus by Dix -Hallpike tests and 120 cases (37 .04% )were triggered the symptom of vertigo with or without nystagmus through roll test ,another 66 cases(20 .37% ) were induced vertigo with or without nystagmus in the straight head-hanging test .66 patients with positive straight head-hanging test were rotated along the sagittal plane for repositional treat‐ment .When these patients were re-evaluated at one week and 3 months ,the total improvement were 86 .36% (57/66) and 83 .33% (55/66) ,respectively .Conclusion The straight head -hanging test can improve the diagnostic rate and it is especially helpful for the diagnosis of superior semicircular canal benign paroxysmal positional vertigo . In patients with a history of typical vertigo ,the straight head -hanging test should be performed if they showed negative Dix -Hallpike test and roll test.

[ABSTRACT]OBJECTIVETo assess the efficacy of proton pump inhibitor (PPI) on the treatment for laryngeal contact granuloma.METHODSSixty seven patients with laryngeal contact granuloma who were diagnosed in our department from March 2010 to October 2014 were enrolled in this study and all patients received PPI therapy, meanwhile the clinical data of the patients was analyzed. The follow-up period was at least half a year.RESULTS The 67 patients were treated well with the PPI. Fifty patients were cured, 11 patients were obvious improved, 4 patients were improved and 2 patients were invalid. The total efficacy rate was 97.01%. The average time of PPI used in small lesion group was shorter than that in large lesion group.CONCLUSIONPPI is effective for laryngeal contact granuloma, it can be recommended the first choice for the treatment of the disease.

A new surgical technique for the treatment of obstructive sleep apnea syndrome (OSAS) was introduced, especially for those patients with oropharyngeal obstruction. This procedure was intended to relieve the obstruction in oropharynx and enlarge the space of oropharyngeal air duct without destroying its normal anatomical structure and physiological function. In this study Fujita type I was found in 56 of 62 cases by Muller's test. Laser assisted velopharyngoplasty was carried out on all of the patients with preservation of total or part of the uvula. No nasal pharyngeal adhesion or oro nasal cavity backward flow was found after the operation. Snoring disappeared in 29 cases and alleviated in 30 cases with a total effective rate of 95% in all of 62 patients. Our study indicated that based on the constitutional features of oropharyngeal cavity and velopalatal muscles, our surgical design and reconstruction method were able to elevate the venlopalate and, therefore, enlarge the space of the oropharynx effectively.

The feasibility of partial tonsillectomy was reviewed. Compared with total tonsillectomy, partial tonsillectomy has the advantages of less postoperative pain, lower postoperative bleeding rate and faster recovery. Partial tonsillectomy has a potential for tonsil regrowth and its efficacy in treating sleep-disordered breathing in children is still controversial.
Humans ; Sleep Apnea, Obstructive ; surgery ; Tonsillectomy ; adverse effects ; methods

OBJECTIVE: To discuss the effect of age on hyoid movement and the openness of UES in swallowing process, and to investigate the correlation between hyoid movement and openness of UES. METHOD: The X-ray dynamic swallowing videofluoroscopy was performed on 100 healthy adult volunteers(20-74 years). They were divided into three groups: young (ages 20 to 45), middle-aged (45 to 65) and older (65 and up). Then the software Avidemux 2. 5 and Image J were used to measure the time and distance of hyoid movement, and the maximal opening of the UES in swallowing process. RESULT: The time of hyoid moving to the maximal displacement was delayed along with the ages, and there were significant differences among the three groups (P<. 05). The staying time of hyoid in the maximal displacement gradually shortened along with the ages, and there was significant difference between young and older group, so was the middle-aged and older group(P<0. 05). The maximum antedisplacement of hyoid decreased with age, and significant differences were found between young and the middle-aged group and between oung and older group (P<0. 05). The maximal degree of UES opening decreased with the increase of age, and significant difference was found between young and older group (P<0. 05). The upper displacement of hyoid was not related to UES opening(P>0. 05), however, the antedisplacement of hyoid had significant relation to UES opening in the three groups (P<0. 05). CONCLUSION In swallowing process, the time and space parameters of hyoid movement and the maximal degree of UES opening were related to age. There was significant difference between the antedisplacement of hyoid and the openness of UES (P<0. 05).
Adult ; Aged ; Deglutition ; Esophageal Sphincter, Upper ; physiology ; Humans ; Hyoid Bone ; physiology ; Middle Aged ; Movement ; Software ; Young Adult

OBJECTIVE: To investigate the effect of nasal surgery alone for OSAHS using Meta-analysis. METHOD: The published articles were searched from PubMed, Chinese Biomedical Literature CD-ROM databases, China Academic Journals Full-text database. The quality of the searched original studies were assessed and the outcomes with the requirements were analyzed. RESULT: Nineteen articles and 621 cases were finally included, including 15 English literatures and 4 Chinese literatures. The results of Meta analysis showed that: (1)The weighted mean between pre-and postoperative AHI was no significantly difference [weighted mean difference (WMD) = 0. 11, 95% CI (-0. 02,0. 23), P>0. 05]. (2) The nasal surgery alone significantly reduced theEpworth sleepiness scale scores in thirteen studies [WMD=0. 94,95% CI (0. 62,1. 26), P<. 01]. CONCLUSION The meta-analyses show that nasal surgery alone can effectively improve the subjective clinical symptoms of patients with OSAHS. However, nasal surgery alone has a limited efficacy in treating OSAHS.
China ; Humans ; Nasal Surgical Procedures ; Sleep Apnea, Obstructive ; surgery

The main purpose of this paper was to review the role of the hyoid movement in the swallowing process and the effect of swallowing posture, age, gender, bolus properties on the hyoid movement. The displacement of the hyoid bone was divided into vertical and forward displacement. The vertical displacement of the hyoid bone contributes primarily to epiglottic and laryngeal closure, while the anterior displacement contributes primarily to opening of the UES. The dysphagia patients often experienced a reduction in hyoid bone displacement. Therefore, further research on the movement of the hyoid bone in the deglutition, especially the relationship between anterior displacement and UES opening is necessary.
Age Factors ; Deglutition ; physiology ; Deglutition Disorders ; physiopathology ; Epiglottis ; physiology ; Female ; Humans ; Hyoid Bone ; physiology ; Larynx ; physiology ; Male ; Movement ; physiology ; Sex Factors

Objective To evaluate the effectivene ss of CO 2 laser laryngeal microsurgery for benign and malignant laryngeal lesion s. Methods From January 1999 to June 2003, a total of 313 pa tients with benign or malignant laryngeal lesions underwent CO 2 laser laryngea l microsurgery in our hospital. There were 186 men and 127 women. The mean age w as 43.5 years ( range from 14 to 76 ) . Vocal cord polyps were found in 236 pati ents ( including 9 cases with Reinke's edema), vocal cord nodules in 30 cases. T h e vocal cord polyps or nodules were cut or vaporized using the CO 2 laser. Ther e were 27 cases with leukoplakia,ke-ratosis, or hyperplasia of the vocal cords, and 20 cases with T1a glottic cancer. The leukoplakia, keratosis, or hyperplasia lesions were excised with the method of demucosation,and the T1a glottic cance r were removed with the methods of demucosation or cor-dectomy using the CO 2 laser.Results All the lesions were removed in one procedure.Th ere was no or less bleeding during operation and the operating fields were clear. No severe complications such as dyspnea, bleeding occurred after operati on. CO 2 laser provided exquisite precision in laryngeal microsurgery. The woun ds of the larynx were healing well after CO 2 laser surgery. The effective rate s were 100% for the vocal cord polyps or nodules, and 92.6% for leukoplakia, ker atosis, or hyperplasia lesions. The recurrence rate was 10% for the T1a glottic cancer at 6 months after operation.Conclusion CO 2 laser laryngeal microsurgery has the ad vantages of less bleeding, clear operating fields, high effective cure rate, and increasing the surgical precision. It also broaden the indications for laryngea l microsurgery and should be used widely.