Adenocarcinoma ; Humans ; Practice Guidelines as Topic ; Thyroid Neoplasms ; diagnosis ; therapy

OBJECTIVE: To analyze the long-term efficacy of nasal endoscopic opticnerve decompression for traumatic optic neuropathy(TON) and to explore its possible influencing factors. METHOD: To summarize the clinical data of 39 cases underwent transnasal decompression, which were followed-up for more than 1 year. The data, including optic canal CT scanning, flashed-elicited visual-evoked potential (FVEP), preoperational vision and visual field examination were reviewed. Nasal endoscopic optic nerve decompression was preformed. Whether or not optic nerve sheath incision decided to perform was according to preoperative CT and situations in operation. Postoperative follow-up including vision, visual field, funduscopy, nasal endoscopy were performed. RESULT: Total efficacy rate was 30. 77% (12/39), inefficacy rate was 69. 23%(27/39). The efficacy rate was 85. 71% with better than nolight perception, and the efficacy rate was 18. 75% with nolight perception, the clinical effect in the group of preoperative better than nolight perception was better than that of nolight perception, the difference was statistically significant (P<0. 05). The efficacy rate was 34. 38% with duration of less than 7 days from the traumatic point to the operation point, and the efficacy rate was 14. 29% for more than 7 days, but the difference was not statistically significant (P> 0. 05). The efficacy rate was 26. 32% with optic nerve sheathincision, while the efficacy rate was 35. 00% without optic nerve sheath incision, and there was no statistically significant difference (P>0. 05); Postoperative vision tended to stabilize until about 6 months post-operation, without complications. CONCLUSION The long-term efficacy of nasal endoscopic opticnerve decompression for TON was certain; The efficacy with preoperative residual vision was better than that of nolight perception, the factor of long or short duration from the trauma point to the operation point and the factor of optic nerve sheath incision didn't influence long curative effect. To avoid the secondary damage to the optic nerve after trauma was the key to increase long curative effect in TON.
Decompression, Surgical ; Endoscopy ; Humans ; Neurosurgical Procedures ; Nose ; surgery ; Optic Nerve ; surgery ; Optic Nerve Injuries ; surgery ; Postoperative Period ; Tomography, X-Ray Computed ; Treatment Outcome ; Visual Acuity

OBJECTIVE: To discuss the clinical efficacy of adenoidectomy and tonsillectomy for the OSAHS children with sinusitis. METHOD: Reviewing 112 cases of children with OSAHS, in which the 80 patients without chronic sinusitis, 32 ones with chronic sinusitis. Among them, 103 cases of children with adenoidectomy, tonsil resection, 9 cases adenoidectomy only. We did questionnaire survey before and after surgeryand also did post-surgery clinical follow-up. RESULT: The effective rate was 90.0% for the OSAHS children without sinusitis after adenoid and tonsil ectomy surgery, while the effective rate was 46.9% for the ones with sinusitis, the efficiency was significant different in the two groups after surgery; the 16.1% children after tonsil ectomy surgery complained the incidence of pharyngeal foreign body sensation and pharyngeal lymphoid hyperplasia in children was 23.2%. CONCLUSION The efficiency was aviable for the OSAHS children without sinusitis after surgery; The efficiency was not aviable enough for the OSAHS children with sinusitis after surgery, so the latter one need adjuvant drug treatment; We also should be attention to the pharyngeal foreign body sensation and the lymphoid hyperplasia in children after tonsillectomy.
Adenoidectomy ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Sinusitis ; complications ; therapy ; Sleep Apnea, Obstructive ; complications ; surgery ; Tonsillectomy ; Treatment Outcome

OBJECTIVE: To observe the recovery process of facial behavior and function in rat, and then to supply reliable functional parameters for the researches in such fields. METHOD: Rat models of facial nerve paralysis were set up by sectioning and anastomosis of facial nerve. The behavioral change included whisker movement and blink reflex were observed weekly. Electroneurography (ENoG) and blink reflex (BR) were examined dynamically and all data were analyzed by statistic soft ware. RESULT: Postoperatively, the whisker movement ceased, blink reflex was lost or sluggish but the fibrillation of vibrissae appeared. Whisker movement and evoke blink reflex were seen 1-2 months following operation gradually, which subsequently increased in intensity and frequency. Mass contraction of the periauricular muscles were observed at the same time as eye closure 2 month following operation. The latency of compound muscle action potential (CMAP) at experimental side began to prolong at 21 day, reached climax at 1 month and was stabilized at 3-4 month postoperatively, but it could not get full recovery. The latencies of 28-63 day were longer than other time points (P<0.05). The amplitude and intensity didn't change characteristically. The R1 can be observed repetitively, which disappeared at 7-14 day and gradually recovered 1 month following operation. At experimental side, the R1-type wave (R1oris) in orbicularis oris could be observed at the same time as R1 recorded 2 month following operation, which indicated the facial synkinesis, one hyperkinetic post-paralytic sequela happened. Then the latency of both R1 and R1oris decreased concomitantly. There were correlations between them, but only the significant difference of R1oris latency presented between 2 month and other time points (P<0.05). CONCLUSION It is concluded that the methods of ENoG and BR could examine the recovery process of facial movement, which would help studying the pathophysiological mechanism of facial nerve injury and regeneration after being revised.
Anastomosis, Surgical ; Animals ; Blinking ; Facial Nerve ; surgery ; Facial Nerve Injuries ; physiopathology ; surgery ; Facial Paralysis ; physiopathology ; surgery ; Male ; Rats ; Rats, Sprague-Dawley ; Recovery of Function

Objective:To explore the surgical intervention strategy for metastatic cervical lymph nodes surrounding the carotid artery in head and neck squamous cell carcinoma.Methods:A total of 62 patients with advanced head and neck tumors and carotid wrap by disease treated in Department of Otorhinolaryngology and Head and Neck Surgery, the Affiliated BenQ Hospital of Nanjing Medical University between June 2019 and December 2023 were reviewed, of whom 9 patients presented with metastatic squamous cell carcinoma in cervical lymph nodes of unknown primary or with no recurrence of primary lesion and all the 9 patients were males, aged from 48 to 79 years old, with≤level 2 of Eastern Cooperative Oncology Group-Performance Status (ECOG-PS). Radiographically common carotid artery (CCA) and/or internal carotid artery (ICA) were surrounded by≥270° with tumor. All the 9 patients received implantation of covered stent in carotid artery and radical resection of metastatic cervical lymph nodes. The success rate, complications, surgery-related complications, local recurrence rate, quality of life (QOL) and overall survival (OS) were analyzed. The QOL of patients was compared by paired rank sum test, and P<0.05 indicated statistically significant difference. The OS was analyzed by Kaplan-Meier. Results:The success rate of stent implantation was 100%, with no implantation-related complications. R0 resection was performed in 8 cases and R1 resection in 1 case. The QOL of patients after surgery was improved, and the improvements in "pain", "mood" and "anxiety" were statistically significant( Z values were -2.236, -2.460 and -2.200, respectively, and all P values were<0.05). Follow-up was 1-18 months, with a median of 7 months, and 1 case was lost to follow-up. Local recurrence occurred in 3 patients with an incidence of 37.5% (3/8). OS was 59.9% at 12 months after surgery. Conclusion:Implantation of covered stent in carotid artery combined with radical resection is an effective method for the treatment of cervical lymph node metastasis.

Objective To investigate the protection of the parathyroid in the total thyroidectomy to avoid the postoperative permanent hypoparathyroidism.Methods Forty-three consecutive cases underwent total thyroidectomy from June 2013 to June 2014 in Nanjing Tongren Hospital were reviewed.Of them 26 cases with malignant and 17 cases with benign thyroid diseases.Results Intraoperatively,all 4 parathyroid glands were identified in 27 cases,3 parathyroids in 10 cases and 2 parathyroids in 6 cases.Intraoperative parathyroid transplantation was performed in 6 cases,including 5 cases with 1 parathyroid transplantation and 1 case with 2 parathyroid transplantation.With the follow-up of 1-3 months after surgery,10 cases presented with transient hypocalcemia,8 cases with temporary hypoparathyroidism and no case with permanent hypoparathyroidism.Conclusion Accurate identification and conservation in situ or auto-transplantation in total thyroidectomy could be effective for prevention of postoperative permanent hypoparathyroidism.

Objective Thyroid lobectomy can be programmed to operate as "step by step".Each step must be performed meticulously with quality control,so as to minimize the complications of surgery.Methods From May 2013 to Auguest 2014,the meticulous thyroid operation was conducted in 72 cases (144 lobectomies).Pre-and post-operative evaluations by strobe laryngoscopy,parathyroid hormone (PTH),and blood calcium examinations were conducted in all cases.Results Four cases (5.6％) had transient recurrent laryngeal nerve paralysis after surgery,but no permanent recurrent laryngeal nerve paralysis.There was no transient or permanent superior laryngeal nerve paralysis.Transient hypoparathyroidism occurred in 10 cases,with no permanent hypoparathyroidism.No case presented with postoperative bleeding or infection.Conclusions " Meticulous operation of thyroid lobectomy" may minimize effectively the complication of surgery.

Objective: To investigate the significance of circulating tumor cells (CTC) in squamous cell carcinoma of the head and neck (HNSCC). Methods: Twenty-four patients with HNSCC treated between October 2016 and July 2017 in our department were selected (experimental group), including 23 males and 1 females, aged 47-81 years. There were 14 cases of squamous cell carcinoma of larynx and 10 cases of hypopharynx, including I-Ⅱ stage (5 cases) and Ⅲ- Ⅳ stage (19 cases). All patients were primary and/or relapsed after treatment. Nine healthy volunteers were selected as control group. A novel in vivo capture technique (CellCellector system) was used to detect CTC. SPSS23.0 was used for statistical analysis. Results: The total capture rate of CTC in patients with HNSCC before treatment was 70.8% (17/24), with 40% (2/5) for patients at I-Ⅱ stage, and 78.9% (15/19) for patients at Ⅲ- Ⅳ stage, and was 0 in patients of control group. The total capture rate of CTC in patients with HNSCC after treatment was 50% (8/16). There was no significant correlation between CTC and age, sex, location of tumor or lymph node metastasis (P>0.05). CTC was related to tumor staging and tumor differentiation (P<0.05). The positive rate of EGFRVⅢ in CTC was 26.3% (5/19). Conclusions The CellCollector system is a very efficient way of detecting CTC, and CTC plays an important role in the occurrence, progression and metastasis of HNSCC.