Objective:To explore whether a portable monitor device（PMD） can be used to evaluate the efficacy of supraglottoplasty（SGP） in neonates with severe laryngomalacia（LM）. Methods:A retrospective analysis of 11 neonates diagnosed as severe LM treated in our hospital from January 2020 to November 2023 was performed. All neonates underwent SGP under general anesthesia and overnight PMD monitoring before and after surgery.The changes of sleep monitoring parameters before and after surgery were compared, SPSS 18.0 statistical software was applied and Wilcoxon symbolic-rank l test was used. P<0.05 showed statistical difference. Results:One week after surgery, the obstructive apnea-hypopnea index（OAHI）, obstructive apnea index（OAI）, oxygen desaturationindex（ODI） of 11 children were lower than those before operation, and the minimum pulse oximetry saturation（SpO2） was higher than that before operation, P<0.05, the difference was statistically significant, and there was no significant difference in sleep apnea hypopnea index（AHI） compared with that before operation. One month after surgery, AHI, OAHI, OAI and ODI were lower than those before operation, and the minimum SpO2 and mean SpO2 were higher than those before operation, P<0.05, the difference was statistically significant. Conclusion:Some parameters of PMD examination can be used to evaluate the efficacy of SGP in neonatal severe LM, which is an important auxiliary means for the evaluation of neonatal LM.
Humans ; Retrospective Studies ; Laryngomalacia/surgery* ; Infant, Newborn ; Male ; Female ; Postoperative Period ; Sleep Apnea, Obstructive/surgery* ; Oximetry ; Polysomnography ; Glottis/surgery* ; Infant ; Treatment Outcome

Subglottic cyst is a rare cause of laryngeal tinnitus in infants and young children, and only a few cases have been reported at home and abroad. In this paper, we report the clinical characteristics and treatment experience of three cases of subglottic cysts in Children's Hospital of Nanjing Medical University. All the 3 childrem were prematurechildren, with a history of tracheal intubation, and the main symptoms were coughing and wheezing.Electronic nasopharyngolaryngoscopy revealed spherical neoplasm under the glottis. Neck computed tomography （CT） showed a slightly hypodense shadow with poorly defined borders, and no significant enhancement was observed after enhancement. Under the self-retaining laryngoscope, the new organisms were clamped and nibbled, and the cyst wall was cauterized by low temperature plasma. There was no recurrence in postoperative follow-up.
Child, Preschool ; Humans ; Infant ; Cysts/surgery* ; Glottis/surgery* ; Laryngeal Diseases/surgery* ; Laryngoscopy/methods* ; Larynx

Objective: To evaluate the effectiveness of mucosal flap combined with silicone keel for preventing and treating anterior commissure adhesion in canines and clinical cases. Methods: A prospective experiment was performed from November 2019 to June 2021. Twenty five canines were randomly divided into 5 groups(A, B, C, D, E). Group A, B, C, D received anterior commissure injury by CO₂ laser, then separately treated with free mucosal flap-keel complex,intralaryngeal mucosal flap-keel complex, silicone keels and without treatment, group E didn't injure the vocal cord after intubation. The keel was removed after 2 weeks, the larynx was harvested after 4 weeks. The effectiveness of anterior commissure adhesion prevention was evaluated by manifestation under laryngoscope, standard vocal cord length and standard glottic area. A retrospective analysis was performed on sixteen patients with anterior commissure lesion, who underwent mucosal flap-keel technique in Huashan Hospital of Fudan University from January 2019 to January 2021 (10 cases with free mucosal flap-keel complex and 6 cases with intralaryngeal mucosal flap-keel complex). All the patients underwent evaluation of laryngeal function included manifestation under laryngoscope each month and voice analysis before and 3 month after surgery. SPSS 20.0 software was used for statistical analysis. Results: No surgery accident or complication happened in canines and patients. The standard vocal cord length and standard glottic area after 4 weeks in group B were significantly higher than those in group A, C, D (H_{standard vocal cord length}=31.688, H_{standard glottic area}=16.444, P<0.05). The standard vocal cord length and standard glottic area after 4 weeks in group A were also significantly higher than those in group C, D(H_{standard vocal cord length}=20.936, H_{standard glottic area}=11.786, P<0.05). The standard vocal cord length and standard glottic area after 4 weeks in group A, B, E were not significantly different to that before surgery(t_{A left standard vocal cord length}=2.636, t_{A right standard vocal cord length}=2.582, t_{B left standard vocal cord length}=2.707, t_{B right standard vocal cord length}=2.673, t_{E left standard vocal cord length}=0.370, t_{E right standard vocal cord length}=0.821, t_{A standard glottic area}=2.731, t_{B standard glottic area}=2.753, t_{E standard glottic area}=-0.529, P>0.05). The standard vocal cord length and standard glottic area after 4 weeks in group C, D were significantly lower than those before surgery(t_{C left standard vocal cord length}=16.137, t_{C right standard vocal cord length}=13.984, t_{D left standard vocal cord length}=11.903, t_{D right standard vocal cord length}=14.587, t_{C standard glottic area}=10.280, t_{D standard glottic area}=22.974, P<0.05). During 6-18 months of follow-up in clinical patients, no one developed a glottic web. Three months after surgery, Jitter, Shimmer, noise to harmonic ratio(NHR), the maximum phonation time(MPT)in all patients were significantly different from preoperative(t_{intralaryngeal mucosal flap jitter}=24.885, t_{intralaryngeal mucosal flap shimmer}=22.643, t_{intralaryngeal mucosal flap NHR}=6.202, t_{intralaryngeal mucosal flap MPT}=-9.661, t_{free mucosal flap jitter}=25.459, t_{free mucosal flap shimmer}=18.683, t_{free mucosal flap NHR}=5.705, t_{free mucosal flap MPT}=-20.840, P<0.05). Conclusion: Mucosal flap combined with silicone keel is an effective technique for preventing and treating anterior commissure adhesion. The effect of pedicled intralaryngea lmucosal flap is better.
Animals ; Dogs ; Free Tissue Flaps ; Glottis ; Humans ; Laryngeal Neoplasms/surgery* ; Prospective Studies ; Retrospective Studies ; Vocal Cords/surgery*

Transoral laser microsurgery (TLM) has developed more than 40 years in the treatment of laryngeal cancer. TLM is especially important in the minimally invasive surgery of laryngeal carcinoma. Compared with the traditional open surgery, it is a major breakthrough, which has the significant advantages such as safety, effectiveness, low rate of local recurrence and high rate of larynx preservation. Not only can cure early laryngeal cancer, but also more and more the use of TLM in advanced supraglottic and glottic laryngeal cancer were reported. This article will review the characteristics, indications, superiority, surgical options and efficacy of the TLM in laryngeal carcinomas.
Carcinoma, Squamous Cell ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Laser Therapy ; Microsurgery ; Neoplasm Recurrence, Local ; Organ Sparing Treatments ; Otorhinolaryngologic Surgical Procedures

T1 glottic carcinoma is part of early laryngeal carcinoma which involves the vocal cords, including anterior commissure or posterior commissure. We analyzed the treatment options of T1 glottic carcinoma by reviewing the related literatures about T1 glottic carcinoma treated by conservative surgery (open surgery and laser microsurgery), radiotherapy, robot surgery, photodynamic treatment.
Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; therapy ; Laser Therapy ; Microsurgery ; Vocal Cords

Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Minimally Invasive Surgical Procedures

OBJECTIVE: To systematically analyze the local recurrence of CO₂ laser surgery for early glottic cancer and without anterior commissure involvement. METHOD: By searching CBM, CNKI, wanfang, weipu, PubMed, Embase, OVID, and Springer database, the retrospective clinical studies were included according to inclusion and exclusion criteria. Meta analysis of extracted data was carried out by RevMan 5.0 software. RESULT: By analyzing the 1900 cases from 14 retrospective studies using Meta analysis, it was indicated that local recurrence rate of AC+ group was significantly higher than that of AC- group [OR = 3.00, 95% CI (2.31, 3.89), P < 0.01] for early glottic cancer. Local recurrence rates between AC+ group and AC- group for glottic cancer of Tis and T₁b stage showed no statistically significant difference, while those for glottic cancer of T₁a and T₂ stage showed statistically significant difference. CONCUSION Local recurrence rate of CO₂laser surgery for early glottic cancer was related with anterior commissure involvement.
Carbon Dioxide ; Databases, Factual ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laser Therapy ; Neoplasm Recurrence, Local ; Retrospective Studies

In recent years, radiofrequency ablation technique is widely used in Otolaryngology Head and Neck Surgery clinical work, domestic scholars preliminary study the efficacy to early glottic cancer. The review will discuss the definition and the main treatment strategy of early glottic cancer, theory and history of radiofrequency ablation technique, vocal endoscopic surgical procedures and safety margin, Clinical observation of radiofrequency ablation technique to treat early glottic cancer.
Catheter Ablation ; Endoscopy ; Glottis ; physiology ; Humans ; Laryngeal Neoplasms ; surgery ; Treatment Outcome

OBJECTIVE: To analyze the recurrencerelative factors of early glottic carcinoma after carbon dioxide laser treatment. METHOD: A retrospective analysis of 134 early glottic carcinoma patients' clinical data was taken to analyze the relationships between recurrence and gender, age, pathologic degree, T stage, involvement of anterior commissure and involvement of thyroarytenoid muscle. RESULT: Recurrent ratio of well-differentiated, middle-differentiated and poorly-differentiated squamous cell carcinoma were 11.83%, 18.42% and 33.33% (P > 0.05) respectively. Recurrent ratio of T1a, T1b, T2 were 13.24%, 18.92%, 23.08% (P > 0.05) respectively. The recurrent rate was 33.33% of tumors offended the anterior commissure, versus 5.43% with no involvement of anterior commissure (P < 0.01). The recurrent rate was 59.09% of tumors offended the thyroarytenoid muscle, versus 5.36% with no involvement of thyroarytenoid muscle (P < 0.01). Unvaried and multivariate analysis indicated that the involvement of anterior commissure and the involvement of thyroarytenoid muscle were the factors of recurrence. CONCLUSION Recurrence of early glottic carcinoma after carbon dioxide laser treatment is effected by the involvement of anterior commissure and the involvement of thyroarytenoid muscle. Resection can be performed conservatively according to evaluation of macroscopic tumour extension.
Carcinoma, Squamous Cell ; surgery ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Laser Therapy ; Lasers, Gas ; Microsurgery ; Neoplasm Recurrence, Local ; Retrospective Studies

OBJECTIVE: To investigate the feasibility and clinical characteristics of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma. METHOD: Forty-five patients with laryngeal squamaous cell carcinoma in T1-2 stage received small partial laryngectomy without tracheotomy. RESULT: All patients were primarily healed and were hospitalized for an average of 11.5 days post-operatively. In all patients, the function of respiration and the reflection of cough were normal, and laryngeal obstruction did not happen. The only postoperative complication was subcutaneous emphysema noted in 29 patients. Among them, subcutaneous emphysema extincted after 4-6 days in 26 patiens, only 3 patiens suffered from delayed healing because the subcutaneous emphysema extincted after 2 weeks. Mild subcutaneous emphysema did not affect the function of respiration and deglutition, healing of wound, and psychology of patients. All patients had been followed-up for 1-13 years. Only 2 patients died of tumor recurrence or metastasis. The function of respiration and deglutition were normal in the living patients, and no implanting metastasis on surface of trachea were found. CONCLUSION The theoretical foundation of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma has been well established. This surgical technique is feasible, safe and effective. It can significantly improve clinical outcome of T1-2 stage glottic carcinoma with minimal invasiveness. Furthermore, it can obviously abate the surgical, physiological and psychological trauma on patients.
Adult ; Aged ; Aged, 80 and over ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Tracheotomy