OBJECTIVE: To explore the effective method to treat the glottic carcinoma invading the anterior commissure, we observed the difference of three kinds of operation to the anterior commissure of dogs by semiconductor laser. METHOD: Twelve dogs were divided into 3 groups at random, A: to cauterize to the thyroid cartilage's inner membrane of the anterior commissure, the right ventricular bands and vocal cord, the anterior and 1/3 of the left vocal cord; B: to cauterize part of the thyroid cartilage of the anterior commissure besides A; C: to open a window about 5 mm x 5 mm on the thyroid cartilage of the anterior commissure besides B. To take photos to observe the dogs' laryngeal wound with digital camera or electrolaryngoscope immediately, 1 week and 4 weeks, then to record the hoarseness, body weight and complications etc. RESULT: All the dogs' laser surgery were completed successfully. To observe the gross specimen, it was identical between the extent of excising and the design preoperation. One week later, the neonatal membrane covered the wound incomplete. Edematization, inflammatory reaction, pseudomembrane and the hoarseness were not heavy too. No obvious complication in group A. The neonatal membrane covered the wound incomplete. Edema, inflammatory reaction, pseudomembrane and granulation can be seen in group B. Exudation was heavy in local, erosion and infected, the hoarseness was severe. No other obvious complications in C. Different extent of adhesion could be seen at the anterior commissure in group A, B and C after 4 weeks, the laryngeal web formed, and the length of vocal cord was shorter than before. The color and luster of anterior commissure membrane was normal basically, the inflammatory reaction was not heavy in A and B groups. The anterior commissural membrane appeared the dark red chronic inflammatory reaction; the window was closed by neonatal membrane completely and had no infection in group C. To observe the gross specimen: the wound of anterior commissure was covered by prosthetic epithelia completely in three groups. The window was closed by complete membrane at the anterior commissure. The No. 1- 3 dog's conditions of hoarseness in three groups after 4 weeks: slight in A group, little severe in B and C group. The change of weight was not obvious at the pre or postoperative in group A and B. No obvious complication happened in each group postoperation. CONCLUSION The three operative methods have satisfied effects,the recovery of wound can cure well finally and no severe complications happened. It is valuable in clinic.
Animals ; Arytenoid Cartilage ; surgery ; Dogs ; Larynx ; surgery ; Laser Therapy ; methods ; Lasers, Semiconductor ; Thyroid Cartilage ; surgery ; Vocal Cords ; surgery

Adult ; Female ; Humans ; Laryngeal Diseases ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Thyroid Cartilage ; surgery

We designed a study to determine if the tracheal tube cuff inflation in the oropharynx improves the success rate of blind nasotracheal intubation in normal, paralyzed patients because of lacking of controlled study about it. In prospective, randomized fashion, 100 ASA I or II patients undergoing elective oral surgery were studied. The trachea was intubated once keeping the tracheal tube cuff deflated throughout the maneuver and once using the technique of tracheal tube cuff inflation in the oropbarynx. A maximum of two attempts was allowed for each technique. If the first attempt was failed, the second attempt was tried with an addition of application of thyroid cartilage compression in each technique. Witb the tracheal tube cuff inflated, the success rate was significantly higher than the cuff-deflated technique(p<0.05). A application of thyroid cartilage compression increased the success rate of the blind nasotracheal intubation in each technique, but it was more useful in the cuff inflation technique(p<0.05). Time taken to intubate the trachea was longer in the cuff inflation technique. We suggest that, in normal paralyzed patients, the tracheal tube cuff inflation in the oropharynx increases the success rate of blind nasotracheal intubation.
Humans ; Inflation, Economic* ; Intubation* ; Oropharynx* ; Prospective Studies ; Surgery, Oral ; Thyroid Cartilage ; Trachea

Cornus ; Deglutition Disorders ; Humans ; Laryngeal Diseases ; Neck Injuries ; Thyroid Cartilage/surgery*

OBJECTIVETo observe the result of relaxation laryngoplasty in the management of mutational falsetto.

METHODSThe thyroplasty type 3 was applied and improved (the saturation was improved in the traditional operation, which the thyroid cartilage stick was cut off and overlapped without saturation in improved group 1, while the thyroid cartilage stick was not cut off and overlapped inward without saturation in improved group 2) in 30 adult patients who failed in voice modification. Preoperative and postoperative fundamental frequency (F0), normalised noise energy (NNE) and reading essay were compared.

RESULTSF0 dropped significantly from the preoperative mean of (276.5 +/- 46.7) Hz [see equation in text] to the postoperative mean of (127.5 +/- 32.1) Hz in one month (t = 13.68, P < 0.001), while the NNE dropped significantly from the preoperative mean of (-10.9 +/- 4.9) dB to the postoperative mean of (-7.7 +/- 4.1) dB, the difference was statistically significant (t = 4.07, P < 0.001). In the three kinds of operation, the postoperative F0 in the improved group 1 dropped most significantly (compared with traditional operation group t = 2.64, P< 0.05). The postoperative NNE in the improved group 2 increased minimally. The difference was not significant statistically compared with other two kinds of operations (P > 0.05). The pitch dropped in all cases during reading aloud and conversation, while the voice breaks was disappeared.

CONCLUSIONSRelaxation laryngoplasty was proved to be an efficient procedure in the surgical management of mutational falsetto.It was a preferable option for the patients who failed in voice modification. The improved operation profited to recover natural intonation and lighten the hoarseness due to glottic incompetence.

Adolescent ; Adult ; Humans ; Laryngoplasty ; methods ; Larynx ; surgery ; Male ; Thyroid Cartilage ; surgery ; Voice Disorders ; surgery ; Voice Quality ; Young Adult

OBJECTIVETo evaluate the effect of conservative surgical management on patients with subglottic cancer.

METHODSNine cases with subglottic carcinoma were treated surgically from 1984 to 1999. There were T2N0 lesions in 2 cases, T3N0-1 in 3 cases and T4N0-1 in 4 cases. All the cases underwent partial laryngectomy including partial cricoid resection. Variations of a pedicled thyroid cartilage flap were used for reconstruct the cricoid defect. The pedicle based muscle was thyrohyoid, sterno-thyroid or inferior constrictor. Unilateral neck dissection was performed on 7 cases and bilateral on two.

RESULTSThe function of phonation were preserved in all cases. Eight of nine 8/9 were decanulated. Normal deglutition were achieved for all patients. The 3 and 5 year survival rates were 8/9 and 6/9, respectively.

CONCLUSIONPedicled thyroid cartilage flap is appropriate for reconstruction of the cricoid defect in the conservative surgery of selected subglottic carcinoma.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Thyroid Cartilage ; transplantation

OBJECTIVE: To discuss the method of recurrent laryngeal nerve anatomy of thyroid surgery, for avoiding recurrent laryngeal nerve injury. METHOD: Recurrent laryngeal nerve of all 247 cases were found along tracheoesophageal groove or angle of thyroid cartilage, in front of the recurrent laryngeal nerve showed up next to the thyroid cartilage angle and cricothyroid membrane, or down to thyroid anatomy revealed under the lower pole artery and vein, and not have to deliberately look for a branch of the recurrent laryngeal nerve, a total of 258 recurrent laryngeal nerve were found. RESULT: Among two hundred and forty-seven cases, the recurrent laryngeal nerve injury was two cases, injury rate was 0.8%. And the two cases were incomplete injury, which about a month were back to normal, and significant deviation was found with no pre-conventional anatomy of of recurrent laryngeal nerve of 276 cases (P < 0.05). CONCLUSION Conventional recurrent laryngeal nerve anatomy in thyroid surgery could effectively avoiding recurrent laryngeal nerve injury.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Recurrent Laryngeal Nerve ; anatomy & histology ; surgery ; Thyroid Cartilage ; surgery ; Thyroid Gland ; surgery ; Young Adult

OBJECTIVETo discuss the methodology and therapeutic effect of hyoid suspension in association with uvulopalatopharyngoplasty (UPPP) in the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSSixty-nine patients with severe OSAHS (apnea hyponea index, AHI > 30) were treated with hyoid suspension and UPPP. Sixty-one patients were followed for 6 months (48 of them for 12 months). Polysomnogram (PSG) tests were performed and an Epworth sleepiness scale (ESS) was recorded preoperatively and postoperatively in these patients.

RESULTSAfter the surgery,the snoring of the patients disappeared or was alleviated to varing degrees. Eighteen patients underwent fiberoptic nasopharyngolaryngoscopic examination. Twelve of them showed palatopharyngeal and glossopharyngeal stenosis was improved 6 months after surgery. Six patients showed no change, but had no glossoptosis. Fourteen patients underwent fiberoptic nasopharyngolaryngoscopic examination 1 year after surgery, with no recurrence of the stenosis being found. A decrease of 50% in the AHI was considered effective, and in patients the effective rate was 78.7% (48/61) 6 months after the operation and 75.0% (36/48) 1 year after the operation. The average AHI decreased from 44.8 to 15.1 and 17.2, and the minimum arterial oxygen saturation average increased from 0.512 to 0.880 and 0.730. Matching t tests were utilized and the results of follow-up indicated that there was a significant improvement in the indexes in those cases which could be followed up (P < 0.01). The average of the ESS was 6.7 six months after operation and 7.2 one year after operation, with a significant decrease compared to the preoperative (16.6) data (P < 0.01).

CONCLUSIONSModified hyoid suspension in association with UPPP has the advantage of a simple operation, short hospitalization and less expense, and the effect of the operation was significant. Patients with palatopharyngeal and glossopharyngeal stenosis should be chosen for this operation.

Adult ; Aged ; Female ; Humans ; Hyoid Bone ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Thyroid Cartilage ; surgery ; Uvula ; surgery

Adult ; Aged ; Airway Obstruction ; therapy ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Diseases ; therapy ; Male ; Middle Aged ; Punctures ; methods ; Thyroid Cartilage ; surgery

Cartilage ; pathology ; Catheter Ablation ; adverse effects ; methods ; Female ; Humans ; Laryngeal Nerves ; Microwaves ; Middle Aged ; Necrosis ; Thyroid Gland ; surgery ; Trachea ; pathology ; Vocal Cord Paralysis ; etiology