2.Application of philosophy on comprehensive analysis of adenoid hypertrophy space occupying effect in meticulous adenoidectomy.
Yuanyuan LU ; Qingxiang ZHANG ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(13):1209-1212
OBJECTIVE:
To achieve targeted and meticulous surgery of adenoid hypertrophy, a comprehensive analysis of adenoid hypertrophy space occupying effect and morphological evaluation were conducted and the clinical results were retrospectively analyzed.
METHOD:
One hundred and sixty-three children with adenoid hypertrophy were treated in our department from May 2013 to May 2014. All children received three examinations preoperatively, including: Nasopharyngo-fiberoscopy, Audiometry and Tympanometry. Based on the results, space occupying effect of adenoid hypertrophy was divided into three types: vertical hypertrophy type, horizontal hypertrophy type and vertical & horizontal hypertrophy type. We assumed the causal relationship with vertical hypertrophy type to snoring (nasal blockage) and horizontal hypertrophy type to secretory otitis media respectively. All children received transoral endoscopic adenoidectomy with radiofrequency ablation.
RESULT:
The postoperative followup of these children for 6 to 12 months showed that the vertical hypertrophy type and horizontal hypertrophy type children all recovered from the syndromes of snoring (nasal blockage) and secretory otitis media respectively. The nasopharyngo-fiberoscopy showed that the nasopharyngeal space was smooth and the bilateral choanas opened well. No recurrence was found.
CONCLUSION
The philosophy of comprehensive analysis on adenoid hypertrophy space occupying effect could help the surgeons understand adenoid hypertrophy better and can guide the adenoidectomy more meticulously.
Acoustic Impedance Tests
;
Adenoidectomy
;
Adenoids
;
pathology
;
surgery
;
Child
;
Endoscopy
;
Humans
;
Hypertrophy
;
Nasal Obstruction
;
diagnosis
;
Nasopharynx
;
pathology
;
Otitis Media with Effusion
;
diagnosis
;
Recurrence
;
Retrospective Studies
;
Snoring
;
diagnosis
4.Treatment of recurrent laryngeal papilloma by submucosal resection and the effect on prognosis.
Huiying HU ; Qingxiang ZHANG ; Guoyan SUN ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(21):1873-1877
OBJECTIVE:
To investigate the efficacy of submucosal resection by CO2 laser in the treatment of recurrent laryngeal papilloma and the effect on prognosis.
METHOD:
A total of 11 patients diagnosed as recurrent laryngeal papilloma were included in this review. Papilloma was marked before operation and checked under fibro-laryngoscope. Papilloma was resected completely including the submucosal tissure with CO2 laser or microequipment. In widespread papilloma, false membrane in raw surface were cleared 7-10 days after operation. Surgical specimens (including membrane) were detected by routine pathology, HPV typing and immunohistochemical pathologic examination. The patients were checked once a month in the first 3 months after operation, and then once for every 3 months. Once the hoarseness and other symptoms aggravated or the disease was recurrent, the patients were treated immediately.
RESULT:
HPV viral DNA was found in 10/11 cases, with HPV11 (7/11 cases) and HPV6 (3/11 cases). Cases with regards to follow-up, from 6 months to 1 year, 3 cases were followed up 1 year after operation, without recurrence. Five patients including 2 children were followed up 6 to 12 months after operation, without recurrence. Two children underwent 2 or 3 operations, were followed-up more than 6 months withouting recurrence.
CONCLUSION
Papilloma submucosal resection could decrease postoperative recurrence and is worth to be further investigated.
Child
;
DNA, Viral
;
blood
;
Human papillomavirus 11
;
isolation & purification
;
Human papillomavirus 6
;
isolation & purification
;
Humans
;
Laryngeal Neoplasms
;
diagnosis
;
surgery
;
Laryngoscopes
;
Lasers, Gas
;
Neoplasm Recurrence, Local
;
Papilloma
;
diagnosis
;
surgery
;
virology
;
Papillomavirus Infections
;
diagnosis
;
surgery
;
Postoperative Period
;
Prognosis
;
Respiratory Tract Infections
;
diagnosis
;
surgery
5.Thyroid operation after the discussion on drainage technology.
Haidong ZHANG ; Danchun GONG ; Qingxiang ZHANG ; Yaqun LIU ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(2):194-196
OBJECTIVE:
To investigate the possibility of thyroidectomy/lobectomy without drainage after surgery.
METHOD:
Eighty-eight consecutive cases with thyroid mass have been underwent operations including: lobectomy group(42 cases), thyroid lobectomy with contralateral partial thyroidectomy group (17 cases) and total thyroidectomy group (29 cases) from 2013. 06 to 2014. 06 in Nanjing Tongren Hospital. FIfteen patients with thyroid operation in other hospital were collected from 2014. 01 to 2014. 06, the recovery of postoperative incision were compared.
RESULTS:
Eighty-four cases were smoothly discharged from hospital except 4 thyroidectomy cases suffered from a small amount of effusion in surgical cavity. Our postoperative wound recovery were more in line with the principle of cosmetology compared with other hospital operation group.
CONCLUSION
Drainage following thyroidectomy is not essential, if the thyroid surgery is meticulous in each step of the surgery, and can increase the effect of beauty.
Drainage
;
methods
;
Humans
;
Postoperative Period
;
Thyroid Diseases
;
Thyroidectomy
6.Clinical study on vocal cords spontaneous rehabilitation after CO2 laser surgery.
Qingxiang ZHANG ; Huiying HU ; Guoyan SUN ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(19):1472-1476
OBJECTIVE:
To study the spontaneous rehabilitation and phonation quality of vocal cords after different types of CO2 laser microsurgery.
METHOD:
Surgical procedures based on Remacle system Type I, Type II, Type III, Type IV and Type V a respectively. Three hundred and fifteen cases with hoarseness based on strobe laryngoscopy results were prospectively assigned to different group according to vocal lesions apperence,vocal vibration and imaging of larynx CT/MRI. Each group holded 63 cases. The investigation included the vocal cords morphological features,the patients' subjective feelings and objective results of vocal cords.
RESULT:
There are no severe complications for all patients in perioperative period. Vocal scar found in Type I ,1 case; Type II, 9 cases ;Type III, 47 cases; Type IV, 61 cases and Type Va 63 cases respectively after surgery. The difference of Vocal scar formation after surgery between surgical procedures are statistical significance (χ2 = 222.24, P < 0.05). Hoarseness improved after the surgery in 59 cases of Type I , 51 cases of Type II, 43 cases of Type III, 21 cases of Type IV and 17 cases of Type Va. There are statistically significance (χ2 = 89.46, P < 0.05) between different surgical procedures. The parameters of strobe laryngoscope: there are statistical significance on jitter between procedures (F 44.51, P < 0.05), but without difference within Type I and Type II (P > 0.05). This happened in shimmer parameter and the maximum phonation time (MPT) as jitter. There are no statistical significance between Type IV and Type Va on MPT (P > 0.05).
CONCLUSION
Morphological and functional rehabilitation of vocal cord will be affected obviously when the body layer is injured. The depth and range of the CO2 laser microsurgery are the key factors affecting the vocal rehabilitation.
Cicatrix
;
Hoarseness
;
therapy
;
Humans
;
Laryngoscopes
;
Laryngoscopy
;
Laser Therapy
;
Lasers, Gas
;
Microsurgery
;
Phonation
;
Vocal Cords
;
physiology
;
surgery
7.The preventive and therapeutic effect of Bushen Jiedu prescription on radiation induced sex hormone disorder
Xue ZHAO ; Yunshuang YANG ; Rong ZHANG ; Zhenkun KUANG ; Lei DU ; Lei YU ; Pengzhan SHI
Chinese Journal of Radiological Medicine and Protection 2017;37(8):565-569
Objective To investigate the preventive and therapeutic effect of Bushen Jiedu prescription on ionizing radiation induced sex hormone disorder.Methods Totally 72 adult rats with half male and half female were randonly divided into 6 groups,including control group,radiation group,Bushen Jiedu prescription group with male and female,with 12 rats in each group.After adaptive breeding for 2 d,the rats of Bushen Jiedu prescription group were given 0.2 ml water soluble granules of Bushen Jiedu prescription (1.38 g/ml) by gavage once a day for 10 days.At 11 d,the rats were irradiated by 5 Gy of 60Co γ-rays.24 h after radiation,6 rats in each group were executed to measure the level of sex hormone.The other rats were further gavaged with Bushen Jiedu prescription or its control once a day for 14 d,then were executed for sex hormone testing.Results At 1 d after radiation,the estrogen (E2) of female of Bushen Jiedu prescription group was significantly higher than that of radiation group (t =2.686,P < 0.01).Compared with control group,the levels of follicule-stimulating hormone (FSH) (t =4.305,4.642,P <0.01) of male and female,the levels of luteinizing hormone (LH) of male radiation group,and Bushen Jiedu prescription group were increased (t =4.537,2.336,P < 0.01).At 14 d after radiation,the levels of testosterone and luteinizing hormone in male rats of radiation group was higher than those in control group (t =-3.730,2.963,P < 0.05),and the levels of E2 and progesterone of female was lower than those in control group (t =-5.424,-3.178,-2.690,-3.215,P<0.01).Conclusions Ionizing radiation can induced sex hormone disorder,and Bushen Jiedu prescription can effectively inhibit this alteration,which indicates that Bushen Jiedu prescription is an ideal radiation protectant.
8.Long-term efficacy of nasal endoscopic opticnerve decompression for traumatic optic neuropathy.
Qingxiang ZHANG ; Honggang LU ; Guangfei LI ; Shanchun GONG ; Yunli WANG ; Wei MENG ; Yuanyaun LU ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(12):1082-1085
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
10.Study on mutations of the PDS gene in large vestibular aqueduct syndrome
Li LEI ; Demin HAN ; Zhenkun YU ; Xiaonong ZHU ; Xiuwu CHEN ; Yanshun DU ; Liping ZHAO ; Jilong CHENG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2006;0(03):-
OBJECTIVE To analyze for mutations of the PDS gene in patients with sensorineural hearing loss associated with enlarged vestibular aqueduct and analyze the molecular pathogenesis of enlarged vestibular aqueducts. METHODS Eighteen sporadic cases of large vestibular aqueduct syndrome and twelve control individuals with normal hearing were included in this study. Exons 6 and 9 of the PDS gene in all subjects were amplified by polymerase chain reaction and analyzed by direct DNA sequencing. RESULTS Analysis revealed 2 single base changes in exon 6 of one patient with large vestibular aqueduct syndrome. One was a G→C transversion at nucleotide position 611, and the other was a T→G transversion at nucleotide position 612, resulting in a predicted Gly→Ala substitution at position 204. No mutation in exons 6 and 9 of the PDS gene was found in the PDS gene of the control individuals. CONCLUSION Mutations of the PDS gene are responsible for the large vestibular aqueduct syndrome. Analysis of the PDS leftover sequence in patients with large vestibular aqueduct syndrome is the next step in elucidating the complicated causes of this disease.