1.Diagnosis and treatment of special type of laryngeal foreign body with granuloma in children.
Dezhen TU ; Zongtong LIN ; Ling SHEN ; Deping CHEN ; Zhongjie YANG ; Qiaoyu LIAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):163-167
Objective:This article explores the diagnosis and treatment of a special type of laryngeal foreign body with granuloma in children, providing a clinical reference for standardized diagnosis and treatment. Methods:This article retrospectively analyzes one case admitted to our department and five other cases reported in relevant literature involving a special type of laryngeal foreign body with granuloma in children. It summarizes the clinical characteristics of this disease and explores its diagnosis and treatment. Results:①A total of 6 cases were misdiagnosed and had a long course of illness. Five cases had no clear history of foreign body at the first visit. One case had foreign body history but no foreign body was found. ②The clinical symptoms were diverse, which could be hoarseness, cough, wheezing, dyspnea, or no symptoms. ③A total of 3 cases were diagnosed by laryngoscopy, and 3 cases were diagnosed by laryngoscopy and imaging examination. ④Foreign bodies that were not wrapped in granulomas, were removed first and then the granulomas were treated; foreign bodies wrapped in granulomas were removed after the removal of granulomas. Conclusion:A special type of laryngeal foreign body with granuloma may lack of accurate foreign body history, resulting in long-term retention of foreign bodies, leading to granuloma formation and misdiagnosis. Electronic laryngoscopy combined with CT examination contribute to early diagnosis. Low temperature plasma under endoscope and anesthetic laryngoscope is conducive to the exposure and precise removal of foreign bodies and avoids tracheotomy to a certain extent.
Child
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Child, Preschool
;
Female
;
Humans
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Infant
;
Male
;
Foreign Bodies/surgery*
;
Granuloma, Foreign-Body/therapy*
;
Larynx/pathology*
;
Retrospective Studies
2.Content and development of pharyngology and laryngology.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(11):1001-1005
Pharyngology and laryngology is an important subspecialty of Otolaryngology Head and Neck Surgery. It involves congenital diseases, trauma and foreign bodies, inflammatory diseases, obstructive sleep apnea, benign lesions, laryngeal nerve and cricoarytenoid joint diseases, swallowing disorders, laryngopharyngeal reflux diseases, voice medicine, as well as laryngeal microsurgery and endoscopic surgical treatment of benign and malignant tumors of this area. The disease spectrum is wide and involves many surgical techniques and methods.
Humans
;
Otolaryngology
;
Larynx/surgery*
3.Indications and complications prevention and management of phaseⅡ implantation of Provox Vega voice prosthesis after total laryngectomy.
Chun Ping WU ; Xiao Hui YUAN ; Duo ZHANG ; Ling CHEN ; Lei TAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(1):52-58
Objective: To explore the indications and management of common postoperative complications of phase II tracheoesophageal puncture (TEP) for Provox Vega voice prosthesis after total laryngectomy. Methods: The clinical data of 20 patients undergoing phase II TEP for Provox Vega voice prosthesis in our hospital between May 2021 and January 2022 were analyzed. Among them, there were 19 males and 1 female, aged from 37 to 76 years, with an average age of (60.0±8.4)years. The surgical indications and the prevention and treatment of common postoperative complications were summarized. Descriptive analysis was used in this research. Results: The basic surgical indications were as following: after total laryngectomy, there was no stenosis of the stoma and esophagus entrance, no scar constitution, no mouth opening restriction, no stiffness and backward restraint of the neck after radiotherapy, and more than half a year apart surgery or radiotherapy. Among the 20 patients, 18 underwent implantation successfuly, 1 failed in the operation, and for 1 patient, the prosthesis was removed due to bleeding 1 week after implantation. The common postoperative complications included TEP fistula infection (2 cases), the TEP fistula bleeding(1 case), deep neck (prevertebral) abscess (1 case), granulation at the inner side of the TEP fistula (1 case), invagination of the prosthesis (2 cases) and leakage around the prosthesis (2 cases). All patients were cured with different interventions. Conclusions: The Provox Vega voice prosthesis is generally safe for phase Ⅱ implantatione, but implantation indications need to be established. Common postoperative complications can be solved through preventive and remedial interventions.
Male
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Humans
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Female
;
Larynx, Artificial/adverse effects*
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Laryngectomy/adverse effects*
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Prosthesis Implantation/adverse effects*
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Esophagus/surgery*
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Postoperative Complications/etiology*
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Prosthesis Design
7.The consensus among experts on the diagnosis and treatment of pediatric vocal cord paralysis.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):765-770
Pediatric vocal ford paralysis is a vocal cord movement disorder caused by damage to the pediatric laryngeal motor nerves.It is mainly characterized by voice, breathing,and swallowing difficulties,and in severe cases,it can lead to choking in affected children. Currently, the diagnosis and treatment of this condition pose a significant challenge for pediatric otolaryngologists, as the goal is to minimize damage to the vocal folds and laryngeal framework.In order to standardize the diagnosis and treatment of pediatric vocal cord paralysis, the Pediatric Otolaryngology Committee of the Chinese Medical Association,in collaboration with multiple children's medical centers nationwide, have formulated this consensus document.
Humans
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Child
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Vocal Cord Paralysis/therapy*
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Consensus
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Vocal Cords/surgery*
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Larynx
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Voice
;
Laryngeal Diseases/complications*
8.A case report of primary extubation by partial cricotracheal resection for severe subglottic stenosis.
Qingxiang ZHANG ; Yaqun LIU ; Jie MENG ; Mingjing CAI ; Dongdong HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):924-926
This patient suffered from severe subglottic stenosis(grade Ⅳb). During partial cricotracheal resection, we cut through the cricothyroid membrane and the cricoid arch along the line from the lower edge of the thyroid cartilage to 5 mm of the inferior thyroid cartilage corner anteromedially. This can protect the cricothyroid joint, effectively protect the recurrent laryngeal nerve, and also support the airway. Strictly adhere to airway separation, avoid excessive separation of scars, and combine with reasonable postoperative management to achieve a safe extubation.
Humans
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Constriction, Pathologic/surgery*
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Trachea/surgery*
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Airway Extubation
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Laryngostenosis/surgery*
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Larynx/surgery*
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Cricoid Cartilage/surgery*
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Treatment Outcome
9.Diagnosis and treatment of disorders of laryngeal airway in children and prospect.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):939-942
This paper focuses on the diagnosis and treatment of disorders of laryngeal airway in children, including congenital anomalies, infection, and tumor of the larynx to provide a new technology for managing these diseases. Based on the characteristic of them, the pediatric upper airway is dedicated to the clinical evaluation of airway obstruction and the assessment of the compromised pediatric airway, including clinical evaluation of symptoms, diagnostic endoscopy, and imaging examination. Information on endoscopic techniques used for dealing with different degrees of pediatric airway comprised is provided, also this techniques could diagnose what kinds of airway disorder. For example, determining the a particular laryngeal cleft at the initial otolaryngology encounter, flexible laryngoscopy should be performed. In order to define the extent of any identified cleft, the rigid bronchoscopy should be completed to evaluate for classification of laryngeal cleft including typeⅠ, Ⅱ, Ⅲa, Ⅲb, Ⅳa, Ⅳb under general anesthesia. The decision to pursue any therapy for the disorders of laryngeal airway in children should be based on the severity of the patient's symptoms, endoscopic and imaging examination. There are two medical treatments including nonsurgical therapy and surgical therapy. For example the laryngeal cleft, approximately half of type 1 and select type 2 patients can be managed entirely with nonsurgical therapy. Medical management is multifaceted. Under recommendations from the feeding team, a modified diet with thickened feeds and possibly altered feeding position should be initiated. Endoscopic surgical repair is the current gold standard for definitive repair of type 1, the majority of type 2, and selected type 3 clefts. Finally, information on new techniques used into the future for dealing with the diagnosis and treatment of disorders of laryngeal airway in children in this paper.
Child
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Humans
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Infant
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Larynx/surgery*
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Laryngoscopy
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Endoscopy
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Bronchoscopy
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Congenital Abnormalities/surgery*
10.Application of endoscopic surgical repair through bracing laryngoscope in children with type Ⅲ laryngeal clefts.
Yitian HUANG ; Hongbing YAO ; Xinye TANG ; Yang YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):948-952
Objective:To analyze the efficacy of endoscopic surgical repair in the treatment of type Ⅲ laryngeal clefts and to explore the feasibility of the treatment for type Ⅲ laryngeal clefts. Methods:The clinical data of 6 children with type Ⅲ laryngeal clefts who underwent endoscopic surgical repair in our department from June 2018 to January 2023 were analyzed retrospectively. The operation was performed under combined intravenous and general anesthesia,preserving the spontaneous breathing of the children. With the assistance of 4 mm/0° endoscope, radiofrequency knife or laryngeal scissors were used to make fresh wounds along the edge of laryngeal clefts,and cotton pads infiltrated with adrenaline (1:10 000) were used to compress the wound. 6-0 PDP suture was used to suture 3-6 stitches according to the extent of laryngeal clefts. Modified barium swallowing test (MBS) was performed 3 months after operation. Results:All the children were successfully treated with endoscopic surgical repair. After surgery, 2 cases were transferred to pediatric intensive care unit (ICU) for 7 days of monitoring, and the rest were transferred back to the general ward. There were no postoperative complications. The symptoms of dysphagia, laryngitis and recurrent pneumonia were improved in all children. According to the follow-up results of postoperative MBS,no aspiration was found in all children, and 2 children had intermittent cough when drinking large amounts of water. During the follow-up, there were 2 cases of recurrence, and the cracks were completely repaired after the second endoscopic surgical repair treatment,and no recurrence has been observed so far. Conclusion:Endoscopic surgical repair can be applied to some children with type Ⅲ laryngeal clefts with less intraoperative bleeding and fewer operative complications. It can significantly improve the symptoms such as swallowing dysfunction and recurrent pneumonia. It is a safe and effective surgical treatment.
Child
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Humans
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Laryngoscopy/methods*
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Laryngoscopes
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Retrospective Studies
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Larynx/surgery*
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Pneumonia
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Congenital Abnormalities/surgery*

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