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 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

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

OBJECTIVE: To explore the value of computer-aided design/computeraided manufacturing (CAD/CAM) technology for individual reconstruction of the thyroid cartilage defects. METHOD: Select the 20 New Zealand white rabbits (male or female). Randomly divided into two groups. Group A in the pre-operative CT scan of the throat, three-dimensional reconstruction of the thyroid cartilage imaging, surgical removal of either side of the thyroid cartilage, defect implanted in the use of CAD/CAM technology and mirror technology to produce personalized restorative materials; Group B surgical resection either side of the thyroid cartilage, defect implanted production of non-personalized probably according to the experimental animals unilateral thyroid cartilage repair materials. After surgery by gross observation, electronic laryngoscopy observed experimental animals throat. RESULT: General check and electronic laryngoscopy show: the use of CAD/CAM technology to prepare the individual repair materials throat plays better supporting role than the non personalized materials. CONCLUSION CAD/CAM technology before surgery designed to provide a personalized solid model to improve the accuracy of the surgery, time saving surgery to reduce surgical complications.
Animals ; Computer-Aided Design ; Female ; Image Processing, Computer-Assisted ; Male ; Prostheses and Implants ; Rabbits ; Reconstructive Surgical Procedures ; Thyroid Cartilage ; surgery ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the operative effect and value of window partial laryngectomy with endoscopy for treatment of stage T1b--T3 laryngeal cancer. METHOD: Twenty-seven cases with glottic laryngeal cancer were treated by window partial laryngectomy with endoscopy. After 3-year and 5-year survival rate and laryngeal functions (respiratory, pronunciation, swallowing function) recovery were evaluated. RESULT: The 3- and 5-year survival rates were 83.3% (15/18) and 75.0% (9/12) respectively. The decannulation rate was 92.6% (25/27) 4 weeks after operation. Three months after decannulation of respiratory function evaluation: the march to fast runner 77.8% (21/27), the jogger 14.8 (4/27), who walk briskly 7.4% (2/27). All patients had recovered after four weeks swallowing without choking cough and satisfied with phonation. Local recurrence rates at 3 and 5 year after operation were 10.5% (2/19) and 15.4% (2/13) respectively. CONCLUSION The research shows that window partial laryngectomy with endoscopy was applicable to stage T1b--T2 and selecting T3 laryngeal cancer patients. Postoperative respiratory, pronunciation and swallowing function recovery rate is satisfactory.
Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Survival Rate ; Thyroid Cartilage ; surgery ; Treatment Outcome