Objective To explore the application value of low-temperature plasma bipolar forceps in open thyroid cancer surgery.Methods The clinical data of 30 patients with differentiated thyroid cancer treated with low-temperature plasma bipolar forceps by our team from May 2021 to October 2024 were retrospectively analyzed.And 30 patients with differentiated thyroid cancer treated with monopolar electrocautery+ultrasonic scalpel were selected as the control group.The surgical procedures for both groups were thyroid lobectomy,isthmus resection+ipsilateral level Ⅵ lymph node dissection.The age,gender,body mass index(BMI),tumor TNM stage,operation time,intraoperative blood loss,48 h postoperative drainage volume,and surgical complications of the two groups were compared.Results There were no significant differences in age,gender,BMI,and tumor TNM stage between the two groups.The operation time,intraoperative blood loss,48 h postoperative drainage volume,and the incidence of postoperative transient hypoparathyroidism in the low-temperature plasma bipolar forceps group were significantly less than those in the control group(P＜0.05).There were no occurrences of postoperative subcutaneous hematoma,permanent recurrent laryngeal nerve palsy,and permanent hypoparathyroidism in both groups.Conclusion In thyroid cancer surgery,low-temperature plasma bipolar forceps can not only achieve fine detailed operations,but also effectively protect the blood supply of the recurrent laryngeal nerve,superior laryngeal nerve,and parathyroid glands.It has less trauma and a faster postoperative recovery,and is worthy of clinical promotion and application.

Objective To evaluate the safety,efficacy,and long-term outcomes of transoral ro-botic surgery(TORS)for the resection of parapharyngeal space tumors(PPST).Methods A retro-spective analysis was conducted on clinical data from 16 patients who underwent TORS for PPST re-section.Surgical outcomes,postoperative pathological findings,and complication rates were ob-served.Follow-up evaluations were performed to assess patient satisfaction,swallowing function re-covery,and tumor recurrence.Results Except for one patient who required an additional neck inci-sion,the remaining 15 patients successfully completed the surgery via the oral route.None of the pa-tients underwent tracheotomy or mandibulotomy.The mean surgical duration was 43.9 minutes,with an average tumor diameter of 4.5 cm resected.The mean intraoperative blood loss was 35.3 mL.Patients resumed oral intake after an average of 3.8 days and had a mean postoperative hospital stay of 8.3 days.Postoperative pathological examination revealed that the most common tumor type was pleomorphic adenoma(56.2％,9/16),followed by schwannoma(25.0％,4/16),with one case of basal cell adenoma,cyst,and lipoma,respectively.One patient experienced transient Horner's syndrome,two had wound dehiscence that healed spontaneously,and one had spontaneous wound healing after drainage tube dislodgement.With a mean follow-up of 79.5 months,no tumor recurrence or severe complications were observed.All patients had good swallowing function and were satisfied with the surgical outcomes.Conclusion TORS for PPST resection offers advantages such as clear surgical visualization,direct surgical access,minimal blood loss,reduced trauma,favorable cosmetic re-sults,and rapid postoperative recovery.It also demonstrates good long-term outcomes,with high safety and efficacy.

Objective To explore the application value of low-temperature plasma bipolar forceps in open thyroid cancer surgery.Methods The clinical data of 30 patients with differentiated thyroid cancer treated with low-temperature plasma bipolar forceps by our team from May 2021 to October 2024 were retrospectively analyzed.And 30 patients with differentiated thyroid cancer treated with monopolar electrocautery+ultrasonic scalpel were selected as the control group.The surgical procedures for both groups were thyroid lobectomy,isthmus resection+ipsilateral level Ⅵ lymph node dissection.The age,gender,body mass index(BMI),tumor TNM stage,operation time,intraoperative blood loss,48 h postoperative drainage volume,and surgical complications of the two groups were compared.Results There were no significant differences in age,gender,BMI,and tumor TNM stage between the two groups.The operation time,intraoperative blood loss,48 h postoperative drainage volume,and the incidence of postoperative transient hypoparathyroidism in the low-temperature plasma bipolar forceps group were significantly less than those in the control group(P＜0.05).There were no occurrences of postoperative subcutaneous hematoma,permanent recurrent laryngeal nerve palsy,and permanent hypoparathyroidism in both groups.Conclusion In thyroid cancer surgery,low-temperature plasma bipolar forceps can not only achieve fine detailed operations,but also effectively protect the blood supply of the recurrent laryngeal nerve,superior laryngeal nerve,and parathyroid glands.It has less trauma and a faster postoperative recovery,and is worthy of clinical promotion and application.

Objective:To explore the effects of enhanced recovery after surgery (ERAS) in perioperative nursing among pharyngolaryngeal neoplasm patients undergoing transoral robotic surgery with Da Vinci surgical system.Methods:From June 2016 to December 2018, this study selected 44 pharyngolaryngeal neoplasm patients undergoing transoral robotic and minimally invasive surgery with Da Vinci surgical system in Otolaryngology Head and Neck Surgery of Beijing Anzhen Hospital affiliated to Capital Medical University as subjects by convenience sampling. All of patients were divided into experimental group and control group with the method of random table, 22 cases in each group. Control group carried out routine nursing, while experimental group implemented ERAS nursing. This study compared the indexes of postoperative recovery and the score of Visual Analogue Scale (VAS) of patients between two groups.Results:In experimental group, the time of getting out of bed, removing drainage tube, taking food, indwelling nasogastric tube and hospital stay after surgery was shorter than those in control group with statistical differences ( P<0.05) . The score of VAS of control group one day after surgery was higher than that in experimental group with a statistical difference ( P<0.05) . Conclusions:ERAS for pharyngolaryngeal neoplasm patients undergoing transoral robotic surgery with Da Vinci surgical system can promote their postoperative rehabilitation.

Objective? To study the clinical observation and nursing strategies for myelosuppression caused by induction chemotherapy for stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancers. Methods? The clinical data of 8 patients admitted during March 2015 to June 2017 who developed myelosuppression after induction chemotherapy using taxol + cisplatin + fluorouracil (TPF) were retrospectively analyzed for nursing strategies. Key nursing strategies included in the analysis were basic care, psychological care, condition observation and monitoring, medication care, infection prevention, infection management, prevention and treatment of anemia and bleeding, diet care and activity care. Results? After induction chemotherapy, 8 out of 15 (53.33%) stage Ⅲ and stage Ⅳ laryngeal and hypopharyngeal cancer patients developed myelosuppression, among which 3 patients showedⅢ-Ⅳ degree myelosuppression. Granulocyte colony stimulating factor (CSF) was administered by intramuscular injection to manage reduced granulocyte level in 2 cases. The granulocyte level in both patients went back to normal after 3-5 days. Platelet and recombinant human thrombopoietin were administered by intravenous injection to manage reduced platelet in 1 case. The platelet level of the patient started to increase after 3 days. All patients successfully recovered from myelosuppression before being discharged. Conclusions? For stageⅢ and stageⅣ laryngeal and hypopharyngeal cancer patients who developed myelosuppression after chemotherapy, enhanced basic care, psychological care and close observation of condition developments are essential to the patients' smooth recovery from myelosuppression.

Objective: To investigate the indication, feasibility, and safety of da Vinci robotic surgical system in pharyngolaryngeal tumor resection. Methods: Thirty patients were diagnosed with pharyngolaryngeal tumors and treated with a transoral robotic surgery (TORS) in Beijing Anzhen Hospital from June 1, 2016 through November 30, 2017. Inclusion criteria included lesions of the oropharynx (n=13), parapharyngeal space (n=7), larynx (n=6) and hypopharynx (n=4). Twenty cases were males and ten cases were females. The median age was 56 years old (ranging from 30 to 81 years). Results: The robotic surgeries were performed successfully on 30 patients. One patient (3.3%) underwent TORS combined with a neck incision. The mean operative time was 40.7 min. The mean blood loss was 15.8 ml. The mean recovery time for oral intake was 5.3 days. The mean hospital stay was 9 days. None of the patients underwent tracheotomy or mandible split. Postoperative pathological examination showed that 18 cases (60.0%) were malignant and 1 case (5.6%) had positive surgical margin. Sixteen cases received neck dissection. No serious complications occurred during or after the operation. There was no local recurrence, metastasis or death except for regional recurrences in 2 cases (11.1%) with a follow-up of 1 to 18 months(median 13 months). Conclusion Transoral robotic surgery is a feasible, safe and effective surgical procedure with clear operation field, rapid surgical access, minimally invasive surgery, lesser hemorrhage, good cosmetic effect and fast recovery.

Objective To analyze the differentially expressed genes produced by paclitaxel,cisplatin and 5-fluorouracil(TPF) regimen induction chemotherapy and the potentially functionally targeted genes of the induc ed chemotherapy in supraglottic laryngeal squamous cell carcinoma.Methods A total of 11 tissue samples from patients diagnosed as supraglottic carcinoma who didnt receive any treatment before were analyzed with microarray.The patients were divided into two groups based on their responses to the induction chemotherapy:7 were sensitive to chemotherapy and 4 were non-sensitive.Gene expressions were detected by Illumina Human HT-12 BeadChip.The bioinformatics analysis online was used to analyze the differentially expressed genes.Results A total of 1 554 differentially expressed genes related to chemosensitivity were found.Analyzed with GO database,the up-regulated genes included the functional sets of biological adhesion,immune system development and stem cell proliferation,and the down-regulated genes included the functional sets of cell junction organization,phosphorus metabolic process and cell morphogenesis involved in differentiation.Analyzed with KEGG database,the up-regulated pathways included p53,cell adhesion and Ras signaling pathways,and the down-regulated pathways included focal adhesion,endocytosis and ErbB signaling pathways.There were statistically significant differences in the expressions of MAPK10,PIK3R5 and JUN genes,which had biological significance,between sensitive patients and non-sensitive patients.Conclusion MAPK10,PIK3R5 and JUN may be considered as potentially functional genes of the induced chemotherapy in supraglottic carcinoma.

Objective To study the effects of compound factors of simulated weightlessness and noise in spaceship on auditory function ,and the expression of apoptotic marker Caspase -3 in inner ear in guinea pigs ,and study the influence of compound factor above on its hearing loss and apoptosis of inner ear .Methods Thirty -six guinea pigs were randomly divided into four groups ,6 in control group ,10 in simulated weightlessness with noise group (Group A) ,treatment estrogen group (Group B) and prevention estrogen (Group C) ,respectively .All the experiment groups were suspended posterior limb ,with the exposure of the simulated noise circumstance in space-ship .Estrogen prevention group received intramuscular injection of estradiol benzoate for 3 days before the experiment ,while estrogen treatment group was treated in the same way for 8 days from the beginning of experiment to 3 days after the experiment .Bilateral auditory brainstem response thresholds (ABR) were tested in pre- exposure ,post-exposure and 3 -day recovery respectively .Cochleae were obtoined for immunohistochemistry staining to observe the expression of the apoptotic marker Caspase -3 in inner ear .Results At the time point of post -exposure ,ABR threshold in Group B was lower than those in Group A by 14 .5 dB and Group C by 9 dB .For the ABR change of pre ,and post-exposure ,Group B was lower 12 .75 dB than those of in Group A and 7 .75 dB than in Group C .For the ABR change between pre ,and post-recovery ,ABR threshold of Group C was higher than those of in Group A by 14 .5 dB and in Group B by 7 dB .These differences were significant (P<0 .05) .The expression of Caspase-3 was positive in the hair cell ,spiral ganglion cells and stria vascularis of three groups in both post exposure and 3-day recovery .The expression of Caspase-3 in hair cell and stria vascularis was strongly positive in spiral ganglion cells in Group C in post -exposure ,while it was slightly positive in Group B .After 3 -day recovery ,Group A turned to negative ,while Group B and Group C were still in positive expression with an increase of that in post -ex-posure .Conclusion Estrogen treatment could effectively reduce the hearing loss and the apoptosis of inner ear in-duced by the compound factor of weightlessness and noise .Preventive use of estrogen could not produce an instant protection on the hearing loss induced by exposure ,and the apoptosis was enhanced .However ,it speeded up the procedure of recovery and reduced the apoptosis of inner ear .

OBJECTIVE: To Study the clinical features of congenital microtia and atresia . To evaluate the methods and results of the same microtia surgery, ear canal and middle ear reconstruction. METHOD: Statistically analysis of the data of the hospitalization microtia 62 ears of 58 cases of patient in our department from January 2005 to October 2010 waw conducted. These patients with congenital ear malformations are associated with aural atresia, ossicular chain abnormalities, severe conduction Deafness. All patients received preoperative temporal bone CT examination and reconstruction, hearing examination. Operation was given in two phases, first operation aim to form a line of ear, ear canal reconstruction, ear reconstruction, the second one aim to line of ear skin graft, cranial angle of the ear reconstruction. The preoperative and postoperative data were retrospectively analyzed. RESULT: The auricle plus external auditory canal, middle ear reconstruction came out with a good shape of the ear and the ear canal in close proximity to the normal population. Most patients' hearing were improved after surgery. CONCLUSION Surgeries of patients with congenital ear malformations and aural atresia should be carefully designed according to the three-dimensional reconstruction of multislice spiral CT reconstruction, which can provide information about surgery approach and middle ear abnormality. The whole ear shape and hearing ear after reconstruction are improved after the surgery.
Adolescent ; Angioplasty ; Congenital Microtia ; surgery ; Ear ; Ear Auricle ; abnormalities ; surgery ; Ear Canal ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Hearing ; Hearing Loss ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skin Transplantation ; Tomography, X-Ray Computed

OBJECTIVE To study the results of the reoperation for thyroid cancer. METHODS The clinical data of 288 cases who underwent reoperation for thyroid cancer were analyzed retrospectively. There were 69 male and 219 female. There were 249 cases (86.5 %) with papillary adenocarcinoma, 27 cases(9.4 %) with follicle adenocarcinoma, 6 cases (2 %) with medullar cancer, and 6 cases (2 %) with anaplastic cancer pathologically. The types of operation were lobectomy and near total lobectomy. The unilateral or bilateral neck dissections were performed in selected cases. RESULTS Pathological examination reveal that there were 63 cases of cancer residual in the ipsilateral side and 33 cases of the opposite side. The cervical node metastasis were present in 164 cases of patients at the same side. CONCLUSION The ipsilateral side lobaectomy and/or contralateral side near total lobectomy should be employed for the thyroid cancer patients. The neck dissection should be performed in most of the patients.