Adult ; Ear Canal ; Female ; Hearing Loss, Conductive ; surgery ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Postoperative Period ; Tympanoplasty

Objective To investigate the feasibility and clinical effect for percutaneous microwave ablation of type I substernal goiter under the guidance of ultrasound . Methods Thirteen patients with type I substernal goiter were selected . All patients underwent percutaneous microwave ablation treatment under the guidance of ultrasound . Thirteen patients with 47 medals nodules were performed ultrasound guided percutaneous microwave ablation . Intraoperative heat blocking blood flow was used to prevent severe hemorrhage .Liquid isolation belt and leverage from methods were used to effectively prevent surrounding important structures against heat damage .Small amount of residual method was used to avoid tracheal collapse . All patients were followed up post‐operative 1 ,3 ,6 ,12 months by monitoring of thyroid nodule volume change , adverse reactions , and postoperative complications . Results Thirteen patients with 47 medals nodules were successfully performed percutaneous microwave ablation guided by ultrasound . Among them ,2 patients performed the second treatment for too large volume of goiter ,tracheal displacement and poor physical tolerance of older . The postoperative ultrasound contrast and color Doppler showed that the lesions were completely inactivated . No obvious complications occurred in all 13 patients , and no permanent hoarseness occured . The symptoms of cervical oppression and discomfort disappeared for all patients within 1-4 months after surgery . Thirteen patients were followed up for 12 months after the operation . The thyroid function was normal and the volume reduction rate of thyroid nodules was (85 ± 31)% . Conclusions Percutaneous microwave ablation of type I substernal goiter under ultrasonic guidance is a safe and effective method to reduce the thyroid nodules with no serious complications . It is worth to be popularized in clinical practice .

Objective To investigate the treatment and prognosis of patients with papillary thyroid microcarcinoma. Methods The clinical and following-up data of 124 patients with papillary thyroid microcarcinoma treated at the Department of Head and Neck Surgery of Cancer Centre, SUN Yat-sen University from Jan 1990 to Dec 1999 were analyzed retrospectively for mortality and survival rate ( KaplanMeier). A multivariate analysis was performed in these patients by Cox proportional hazard model. Results The overall 10-year and 15-year survival rate of all 124 patients with papillary thyroid microcarcinoma were 94.9% and 92.5% respectively. The univariate analysis showed the prognostic factors significantly influencing the survival of patients included age (being worse for those of 35 years and older) at presentation, and the status of distant metastasis ( all P ＜ 0. 05 ) , while gender, incidentally found at surgery, the size of primary tumor, the status of neck lymph node metastasis, recurrence after a primary resection, and the extent of surgical resection did not significantly effect the prognosis. Multivariate analysis showed the age more than 35 years at presentation was an independent risk factor indicating worse prognosis (P = 0. 045 ). Conclusioas The prognosis of patients with papillary thyroid microcarcinoma is satisfactory, but that is poor for those patients 35 years old and up at presentation and with distant metastasis.

Adult ; Cochlear Implantation ; Female ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Meniere Disease ; complications ; surgery

Adolescent ; Adult ; Audiometry, Pure-Tone ; Cartilage ; surgery ; Child ; Female ; Hearing Loss, Conductive ; surgery ; Humans ; Male ; Middle Aged ; Myringoplasty ; methods ; Periosteum ; surgery ; Retrospective Studies ; Tympanic Membrane Perforation ; surgery ; Young Adult

Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVE To investigate the relationship between the skin prick test and clinical characteristics in patients with chronic sinusitis with nasal polyps(CRSwNP).METHODS Sixty cases with CRSwNP and 40 control samples underwent skin prick test with standardized allergens provided by AllergoPhamar Company,the results and their clinical characteristics are analyzed.RESULTS The positive rate of skin prick test was 81.7% and 17.5% in CRSwNP group and control group respectively(?2 =40.104,?

Objective To develop an easy-to-use nomogram to assist clinicians in predicting major postoperative morbidity in those non-small-cell lung canccr patients who underwent VATS lobectomy.Methods A perspective multi-center study was developed to analyze the major postoperative complications of 612 non-small-cell lung cancer patients who underwent VATS lobectomy.Muhivariable logistic regression was used to model postoperative morbidity and built the nomogram to accurately predict the major complications.Results There were 606 (99％) survivors and 6 (1％) mortality.A total of 32 patients suffered from major complications.Using logistic regression to predict major complications,preoperative model for ASA score,age ≥70 years and operation time ＞ 150 nin were found to be the significant predictors(P ＜ 0.05) of morbidity and were included in our model.Conclusion We propose a nomogram to enable clinicians to better estimate morbidity in patients with VATS lobectomy.

Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal lesions around the trachea.MethodsThe study was retrospective, between September 2009 to July 2010, 34 consecutive patients with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin underwent EBUS-TBNA.Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up.ResultsOf the 34 patients, EBUS-TBNA achieved definitive diagnosis in 28 patients (82.4％), 10 were diagnosed as malignancies, 18 were diagnosed as benign.The sensitivity, specificity,and accuracy of EBUS-TBNA in distinguishing benign from malignant mediastinal lesions were 90.9％, 100％, and 97.1％,respectively.EBUS was well tolerated by all of the patients with no complications.ConclusionEBUS-TBNA of mediastinal lesions around the trachea is a minimally invasive safe diagnostic technique with high yield.

Objective To review the experience d EBUS-TBNA for staging of lung cancer and the value in diagnosing thoracic diseases in our single center.Methods The data of 343 patients who underwent EBUS-TBNA from September 2009 to August 2011 in our institution were retrospectively reviewed.There were 219 males and 124 females with an average age of (59.4 ± 13.6 ) years.Based on their primary indication,patyients were divided into three categories:group A:with known or strongly suspected lung cancer and enlarged mediastinal lymph nodes on chest radiographic examination ( short axis ≥ 1.0cm) ; group B:with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin; and group C:with pulmonary parenchymal mass located close to the central airways.Results The average short axis diameter of the thoracic lesions was ( 1.94 ± 1.01 ) cm ( range from 0.5 to 8.0cm),and 2.66 punctures were performed per lesion.In group A ( n =208 ),151 patients were confirmed to have mediestinal lymph nodes metastasis while 51 showed negative results.Four patients were diagnosed as tuberculosis and two were confirmed to be stage Ⅱ sarcoidosis.37 in the 51 patients with negative EBUS-TBNA underwent thoracoscopic or thoracotomy for pulmonary resection and mediastinal lymph node dissection.Postoperative pathology confirmed that 32 patients did not have lymph nodes metastases.The diagnostic sensitivity,specificity,accuracy,positive predictive and negative predictive of EBUS-TBNA for the mediastiral staging of lung cancer were 96.8％ (151/156),100.0％ (32/32),97.3％ ( 183/188 ),100％ ( 151/151 ) and 86.5％ (32/37),respectively.In group B ( n =94),22 patients had malignancy and 72 had benign diseases.Thirteen patients received operative validation in the 23 cases which were diagnosed as proliferative lymph nodes by EBUS-TBNA,and by further operation two and three patients were confirmed as malignancy and other benign diseases respectively.The sensitivity,negative predictive value ( NPV ) and accuracy of EBUS-TBNA in distinguishing malignant mediastinal diseases was 88.0％ (22/25)、100％ (73/73) 、95.9％ (70/73)and 97.9％ (92/94),respectively.In group C( n =41 ),malignant diagnosis was achieved in 33 patients,while 4 patients confirmed as malignancy by further operations in the other 8 negative cases.The diagnostic sensitivity and accuracy of EBUS-TBNA for the diagnosis of unknown pulmonary parenchymal mass were 89.2％ (33/37) and 90.2％ (37/41),respectively.All the procedures were uneventful and no complication occurred.Conclusion EBUS-TBNA is a highly effective and safe procedure in the diagnosis of thoracic diseases and staging.of lung cancer.