Objective:Compare the difference of Pharyngocutaneous fistula after total laryngectomy using thyroid gland flap and traditional strip muscle repair, find an effective way to reduce Pharyngocutaneous fistula after total laryngectomy. Methods:Sixty patients with locally advanced laryngeal malignancies were randomly divided into two groups with 30 cases in each group. After total laryngectomy, the experimental group was repaired with thyroid gland flap, and the control group was repaired with traditional strap muscle. Data of gender, age, intraoperative blood loss, operation time, neck lymph node dissection, combined diabetes mellitus, postoperative hypoproteinemia, tumor stage, repair mode and postoperative Pharyngocutaneous fistula were collected in the two groups. The incidence of Pharyngocutaneous fistula in the two groups was compared, and the independent risk factors of Pharyngocutaneous fistula after total laryngectomy were found by logistic regression analysis. Results:The incidence of Pharyngocutaneous fistula after total laryngectomy was 3.3%（1/30） in patients with thyroid gland flap repair and 26.7% （8/30） in patients with traditional strip muscle repair, with statistically significant difference（P<0.05）. There was no significant correlation between gender, age, maximum tumor diameter, blood loss, operation time and Pharyngocutaneous fistula. Hypoproteinemia and repair mode were correlated with pharyngocutaneous fistula. Repair mode is an independent risk factor for Pharyngocutaneous fistula after total laryngectomy. Conclusion:The occurrence of Pharyngocutaneous fistula after total laryngectomy was decreased significantly by using pedicle thyroid flap compare to traditional surgery.The Pedicle thyroid flap can be considered as an effective clinical repairment to reduce postoperative Pharyngocutaneous fistula.
Humans ; Laryngectomy/methods* ; Male ; Cutaneous Fistula/prevention & control* ; Female ; Postoperative Complications/etiology* ; Surgical Flaps ; Laryngeal Neoplasms/surgery* ; Middle Aged ; Thyroid Gland/surgery* ; Pharyngeal Diseases/prevention & control* ; Fistula/prevention & control* ; Risk Factors

Objective:To analyze the clinical data of laryngeal airway diseases in infants and provide reference for the standardized diagnosis and treatment of the disease. Methods:From June 2022 to August 2023, analyze the clinical data of 4 cases of children with laryngeal airway diseases recently admitted to Department of Otolaryngology, Fuzhou Children's Hospital of Fujian Province, and summarize the experience and lessons of diagnosis and treatment by consulting relevant literature. Results:Three cases had symptoms such as laryngeal wheezing, dyspnea, backward growth and development, etc. After electronic laryngoscopy, the first case was diagnosed with laryngeal softening （severe, type Ⅱ）, and the angular incision was performed. While cases 2, 3 diagnosed with case 2 and 3 were diagnosed with laryngeal cyst and underwent laryngeal cyst resection. All three cases underwent low-temperature plasma surgery under visual laryngoscope, and the symptoms were relieved after operation. Case 4 was laryngeal wheezing and dyspnea after extubation under general anesthesia. The electronic laryngoscopy showeded early stage of globetic stenosis, and endoscopic pseudomembrane clamping was performed, and the postoperative symptoms were relieved. Conclusion:Infants and young children with laryngeal airway diseases should pay attention to the early symptoms and be diagnosed by electronic laryngoscopy as soon as possible. With good curative effect and few complications, low-temperature plasma surgery under visual laryngoscope is recommended. The formation of pseudomembrane under the gluteal caused by tracheal intubation causes rapid onset and rapid development. The pseudomembrane extraction by clamping is convenient and fast, with good curative effect.
Infant ; Child ; Humans ; Child, Preschool ; Respiratory Sounds/etiology* ; Larynx ; Laryngeal Diseases/surgery* ; Laryngoscopy ; Intubation, Intratracheal/adverse effects* ; Dyspnea/surgery* ; Cysts/surgery*

Congenital laryngomalacia is the most common disease causing laryngeal stridor in infants. The pathogenesis has not yet been clearly concluded. It may be related to abnormal development of laryngeal cartilage anatomical structure, neuromuscular dysfunction, gastroesophageal and laryngeal reflux disease, etc. The typical manifestations of the disease are inspiratory laryngeal stridor and feeding difficulties, which can be divided into mild, moderate and severe according to the severity of symptoms. The diagnosis is mainly based on clinical symptoms, signs and endoscopy, among which endoscopy is an important diagnostic basis. The treatment of laryngomalacia depends on the severity of symptoms. Mild and some moderate congenital laryngomalacia children can be relieved by conservative treatment, and severe and some moderate congenital laryngomalacia children should be treated by surgery. Supraglottic plasty is the main surgical method, which can effectively improve the symptoms of laryngeal stridor, dyspnea, feeding difficulties and growth retardation in most children, and the surgical effect is good.
Infant ; Child ; Humans ; Laryngomalacia/therapy* ; Respiratory Sounds/etiology* ; Larynx/surgery* ; Laryngeal Diseases/surgery* ; Endoscopy/adverse effects* ; Laryngismus

Objective: To investigate outcomes of laryngotracheal reconstruction (LTR)with anterior and posterior costal cartilage grafts in severe pediatric subglottic stenosis (SGS) or laryngeal web (LW). Methods: A review of patients with severe subglottic stenosis or laryngeal web between January 2020 and January 2022 was performed. Demographic features including gender, age at diagnosis, age at surgery, etiology, airway support, and other comorbidities were collected preoperatively. Patients were evaluated in surgical site, breathing, swallowing, phonation and complications postoperatively.Descriptive analysis was used in this research. Results: Eight patients were included: six with grade Ⅲ SGS following Cotton-Myer grading scale, and two with type Ⅲ LW following Cohen's classification. All patients underwent LTR with anterior and posterior costal cartilage grafts. Five patients underwent single-stage LTR (ssLTR), and three patients underwent double-stage LTR (dsLTR). Seven out of eight patients were able to successfully extubate or decannulate with normal swallowing function; four patients had mild hoarseness, and three had moderate hoarseness. One patient failed in extubation, and underwent tracheotomy. Conclusions: LTR with anterior and posterior costal cartilage grafts is an effective and safe treatment for severe SGS or LW. Careful preoperative assessment of disease severity and overall medical status will help selection between ssLTR and dsLTR, thereby maximizing patient outcomes for both modalities.
Child ; Humans ; Constriction, Pathologic/complications* ; Costal Cartilage ; Hoarseness ; Laryngeal Diseases/complications* ; Laryngostenosis/etiology* ; Retrospective Studies ; Treatment Outcome

Conjunctival Diseases/etiology* ; Humans ; Laryngeal Diseases/etiology*

Objective: To investigate the reduction effect of hoding cricoarytenoid joint reduction with visual laryngoscope under intravenous anesthesia. Methods: The therapeutic effects of 40 patients with arytenoid dislocation(AD)treated by closed reduction in the single center from January 2020 to September 2021 were retrospectively analyzed, including 21 males and 19 females, median age 48 years. The etiology, symptoms, preoperative evaluation methods, reduction mode, reduction times, and the recovery of arytenoid cartilage movement and sound after reduction were evaluated and analyzed. Results: All patients had obvious hoarseness and breath sound before treatment. Under stroboscopic laryngoscope or electronic nasopharyngoscope, different degrees of vocal cord movement disorder and poor glottic closure can be seen. There were 28 cases of left dislocation, 9 cases of right dislocation and 3 cases of bilateral dislocation. The etiology of dislocation of cricoarytenoid joint: 25 cases (62.5%) of tracheal intubation under general anesthesia were the most common causes, was as follows by laryngeal trauma, gastroscopy, cough, vomiting and so on. Among them, 28 cases of reduction were initially diagnosed in our department, and 12 cases were diagnosed later after failure of reduction treatment. Of the 40 patients, 6 underwent reduction 24 hours after dislocation; 18 cases from 3 days to 1 month; 7 cases from 1 to 3 months; 6 cases were reset in 3~6 months; Over 6 months in 3 cases. After one reduction, 10 cases (10/40, 25%) recovered normal pronunciation, 14 cases (14/40, 35%) recovered normal pronunciation after two reduction, 10 cases (10/40, 25%) recovered normal pronunciation after three times, 2 cases (2/40, 5%) recovered normal pronunciation after four times, and 1 case (2.5%) recovered normal pronunciation after five times. Thin slice CT scan of larynx and cricoarytenoid joint reconstruction showed the types of AD: subluxation in 37 cases (92.5%) and total dislocation in 3 cases; 28 cases of left dislocation, 9 cases of right dislocation and 3 cases of bilateral dislocation; 29 cases (72.5%) had posterior dislocation and 11 cases (27.5%) had anterior dislocation. All patients were treated by intravenous anesthesia with arytenoid cartilage clamped by cricoarytenoid joint reduction forceps under visual laryngoscope. The curative effect was evaluated by stroboscopic laryngoscope and/or voice analysis at 1-2 weeks after operation. The vocal cord movement returned to normal and the pronunciation was good in 37 cases (92.5%). Conclusions: Hoding cricoarytenoid joint reduction with the vision laryngoscope under intravenous anesthesia is easy to operate and the reduction effect is more stable. It is a effective method for AD.
Anesthesia, Intravenous/adverse effects* ; Arytenoid Cartilage/injuries* ; Female ; Humans ; Intubation, Intratracheal/adverse effects* ; Joint Dislocations/therapy* ; Laryngeal Diseases/etiology* ; Laryngoscopes/adverse effects* ; Male ; Middle Aged ; Retrospective Studies

Airway Obstruction ; diagnosis ; etiology ; Aspergillosis ; complications ; diagnosis ; Humans ; Laryngeal Diseases ; complications ; diagnosis ; microbiology ; Larynx

Adolescent ; Adult ; Chronic Disease ; Female ; Humans ; Laryngeal Diseases ; etiology ; therapy ; Male ; Middle Aged ; Occupational Diseases ; therapy ; Singing ; Young Adult

OBJECTIVE: To study the anatomic characteristics of recurrent laryngeal nerve during thyroid surgery. METHOD: A retrospective review of surgical data of 307 patients undertook thyroid surgery was conducted. RESULT: Total 342 recurrent laryngeal nerves were identified during the surgery(184 on the right side, left 158). 215 (62.9%) nerves were deep to the inferior thyroid artery, 106(31.0%)were superficial to the artery, 21(7.5%) were between the arterial branches. A nerve bifurcation was found in 203(59.4%). None of nerve bifurcation was found in 136(39.8%). 3(0.9%)were confirmed to hold non-recurrent laryngeal nerves during operations. No patient showed permanent laryngeal recurrent nerve paralysis postoperatively. CONCLUSION The careful dissection and protection of the recurrent laryngeal nerve was an effective method to prevent its injury during thyroid surgery.
Arteries ; Cranial Nerve Diseases ; etiology ; prevention & control ; Dissection ; Humans ; Postoperative Period ; Recurrent Laryngeal Nerve ; Retrospective Studies ; Thyroid Gland ; surgery ; Thyroidectomy ; Vocal Cord Paralysis

OBJECTIVETo discuss the effect of electric coagulation through bronchoscopy in diagnosis and treatment of congenital vallecular cyst in children.

METHODTen cases of congenital vallecular cyst in the study with age ranged from 21 days to 4 years and 10 months were treated with electric coagulation through bronchoscopy. The therapeutic effect was evaluated by endoscopic and clinical manifestation. And all the patients were followed-up for 6-12 months.

RESULTAll the patients obtained 3-5 times electric coagulation. After the operation, the cyst decreased in size, epiglottis softening was subsided, uplift uncompression, dyspnea and laryngeal stridor were improved obviously. After follow-up periods of 6-12 months, no capsule wall were left, and the activity of the epiglottis resumed.No severe complication was found in any patient.

CONCLUSIONElectric coagulation through bronchoscopy is a simple, effective and safe method to treat congenital vallecular cyst in children.

Bronchoscopy ; methods ; Child, Preschool ; Cysts ; congenital ; diagnosis ; surgery ; Dyspnea ; etiology ; physiopathology ; Electrocoagulation ; Epiglottis ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Laryngeal Diseases ; congenital ; diagnosis ; surgery ; Male ; Respiratory Sounds ; etiology ; physiopathology ; Retrospective Studies ; Treatment Outcome