1.Subglottic cysts in infants: a report of 3 cases and literature review.
Chenxi LUO ; Qiulan SHI ; Qi LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):986-992
		                        		
		                        			
		                        			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
		                        			
		                        		
		                        	
2.Preventing and treating anterior commissure adhesion with mucosal flap: a study in canines and clinical cases.
Jia Ying LI ; Xu Mao LI ; Xi Dong CUI ; Xin Qi HU ; Peng Cheng YU ; Guang Bin SUN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2022;57(2):161-167
		                        		
		                        			
		                        			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 (Hstandard vocal cord length=31.688, Hstandard 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(Hstandard vocal cord length=20.936, Hstandard 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(tA left standard vocal cord length=2.636, tA right standard vocal cord length=2.582, tB left standard vocal cord length=2.707, tB right standard vocal cord length=2.673, tE left standard vocal cord length=0.370, tE right standard vocal cord length=0.821, tA standard glottic area=2.731, tB standard glottic area=2.753, tE 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(tC left standard vocal cord length=16.137, tC right standard vocal cord length=13.984, tD left standard vocal cord length=11.903, tD right standard vocal cord length=14.587, tC standard glottic area=10.280, tD 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(tintralaryngeal mucosal flap jitter=24.885, tintralaryngeal mucosal flap shimmer=22.643, tintralaryngeal mucosal flap NHR=6.202, tintralaryngeal mucosal flap MPT=-9.661, tfree mucosal flap jitter=25.459, tfree mucosal flap shimmer=18.683, tfree mucosal flap NHR=5.705, tfree 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*
		                        			
		                        		
		                        	
3.Single stage transoral cordectomy and medialization thyroplasty in early glottic squamous cell carcinoma: A case report
Joyce Anne F Regalado-Go ; Terrence Jason Flores ; Al E. Santiago
Philippine Journal of Otolaryngology Head and Neck Surgery 2021;36(2):40-43
		                        		
		                        			Objective:
		                        			To present the case of a 78-year-old man with Glottic SCCa stage I who underwent single stage transoral cordectomy type IV with medialization thyroplasty under general anesthesia.
		                        		
		                        			Methods:
		                        			Design: Case Report.
Setting: Tertiary Government Training Hospital.
Patient: One.
		                        		
		                        			Results:
		                        			Postoperatively, patient was able to phonate and gave a VHI score of 12 and GRBAS score of 4. He was able to resume oral feeding without any signs of aspiration. Postoperative flexible laryngoscopy showed fully mobile vocal cords with good approximation in the midline.
		                        		
		                        			Conclusion
		                        			 This report suggests that vocal cord medialization via thyroplasty may be performed after cordectomy in a single stage, providing acceptable postoperative voice as well as good swallowing outcome
		                        		
		                        		
		                        		
		                        			Laryngoplasty
		                        			;
		                        		
		                        			 Laryngeal Neoplasms
		                        			;
		                        		
		                        			 Carcinoma, Squamous Cell
		                        			;
		                        		
		                        			 Glottis
		                        			;
		                        		
		                        			 Vocal Cords
		                        			
		                        		
		                        	
4.Comparison of fiberoptic bronchoscope and video stylet during endotracheal intubation: simulation study
Journal of the Korean Society of Emergency Medicine 2019;30(4):296-300
		                        		
		                        			
		                        			OBJECTIVE: The UE Video Stylet VL400-S2 (UE Medical Devices, Newton, MA, USA) and Ambu aScope (Ambu, Copenhagen, Denmark) were recently introduced rigid video stylets and single-use fiberoptic bronchoscopes, respectively. To compare the utility of the two sets of equipment, this study conducted a randomized cross-over study using a manikin. METHODS: Twenty-eight novice doctors performed tracheal intubation on an airway trainer manikin (Laerdal, Stavanger, Norway). The sequence of intubation devices was randomized. The following data were measured and recorded: time to complete tracheal intubation (primary end point), overall success rate, time to see the glottis, and time to tube passage. RESULTS: The video stylet (24 seconds; interquartile range [IQR] 18–36) showed a significantly shorter completion time of the tracheal intubation than the fiberoptic bronchoscope (43 seconds; IQR, 32–84) (P<0.001). The overall success rate of tracheal intubation was 96.4% (27/28) in the video stylet and 82.1% (23/28) in the fiberoptic bronchoscope, and the cumulative success rate over time to complete intubation was significantly higher in the video stylet (P<0.001). CONCLUSION: The video stylet was superior to the fiberoptic bronchoscope in terms of the time to complete and the cumulative success rate of intubation for novice operators in manikin model. Further research will be needed to determine the degree of education required to use fiberoptic bronchoscopy.
		                        		
		                        		
		                        		
		                        			Bronchoscopes
		                        			;
		                        		
		                        			Bronchoscopy
		                        			;
		                        		
		                        			Cross-Over Studies
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Intubation
		                        			;
		                        		
		                        			Intubation, Intratracheal
		                        			;
		                        		
		                        			Manikins
		                        			;
		                        		
		                        			Microscopy, Video
		                        			
		                        		
		                        	
5.A Case of Neurofibroma of the Vocal Cord
Cheong Se WON ; Sung Su PARK ; Tae Hyun SHIN ; Min Su KIM
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2019;30(1):72-75
		                        		
		                        			
		                        			Solitary neurofibroma of the glottis is extremely rare and accounts for only 0.1–1.5% of benign laryngeal tumors. Aryepiglottic fold is the most frequent involved site followed by arytenoids and ventricular folds. There have been few reports of neurofibroma of the true vocal cord. We report a case of neurofibroma which was deeply embedded in the vocal cord and misdiagnosed as muscle tension dysphonia with a review of literatures.
		                        		
		                        		
		                        		
		                        			Dysphonia
		                        			;
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Larynx
		                        			;
		                        		
		                        			Muscle Tonus
		                        			;
		                        		
		                        			Neurofibroma
		                        			;
		                        		
		                        			Vocal Cords
		                        			
		                        		
		                        	
6.Treatment of Carcinoma in Situ of Glottis by KTP Fiberoptic Laryngeal Laser Surgery Under Local Anesthesia
Yun Ji LEE ; Eunsang LEE ; Ki Nam PARK ; Seung Won LEE
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2019;30(1):53-56
		                        		
		                        			
		                        			The optimal treatments of carcinoma in situ of glottis include radiotherapy, laser surgery and vertical partial laryngectomy. Conventional surgical treatments need general anesthesia and radiotherapy has several complications. Recently, the effectiveness of 532 nm potassium titanyl phosphate (KTP) laser has been proven and widely used in vocal fold diseases even some cases of vocal fold dysplasia. A patient with difficult laryngeal exposure underwent fiberoptic laryngeal laser surgery using KTP laser under local anesthesia, showed improved voice outcome and the glottic lesion was removed successfully without local recurrence and regional metastasis 18 months after surgery.
		                        		
		                        		
		                        		
		                        			Anesthesia, General
		                        			;
		                        		
		                        			Anesthesia, Local
		                        			;
		                        		
		                        			Carcinoma in Situ
		                        			;
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Laryngectomy
		                        			;
		                        		
		                        			Laser Therapy
		                        			;
		                        		
		                        			Lasers, Solid-State
		                        			;
		                        		
		                        			Neoplasm Metastasis
		                        			;
		                        		
		                        			Potassium
		                        			;
		                        		
		                        			Radiotherapy
		                        			;
		                        		
		                        			Recurrence
		                        			;
		                        		
		                        			Vocal Cords
		                        			;
		                        		
		                        			Voice
		                        			
		                        		
		                        	
7.Impacts of Different Nostril for Nasotracheal Intubation with Video Laryngoscopy.
Lei WANG ; Jing Hu SUI ; Xiao Ming DENG ; Wen Li XU ; Ke Yu CHEN ; Ling Xin WEI ; Dong YANG
Acta Academiae Medicinae Sinicae 2019;41(3):379-382
		                        		
		                        			
		                        			Objective To compare the impacts of different nostril on nasotracheal intubation with video laryngoscopy.Methods Totally 120 ASA grade I maxillofacial surgery patients were equally randomized into two groups:group A(left nostril)and group B(right nostril).After rapid induction of anesthesia,the nasal intubation was completed by Tosight video laryngoscope,and the success rate of the first attempt of the tube passing through the nasal cavity was recorded and compared between these two groups.In addition,time of tube through nasal cavity,time of glottis exposure,total intubation time,intubation success rate,and nasal bleeding were recorded.Results The success rate of the first attempt of tube passing through the nasal cavity was not significantly different between groups A and B(84.7% . 81.7%;=0.202,=0.653).The time of tube passing through nasal cavity [(7.3±4.6)s .(7.5±4.1)s;=-0.223,=0.824] and the time of glottic exposure [(6.6±1.4)s .(6.7±1.4)s;=-0.348,=0.728] had no significant differences between two groups.The success rates of first intubation attempt were 100% in both groups.The total intubation time was(35.1±9.2)s in group A and(34.0±7.8)s in group B(=0.663,=0.509).Intubation-related epistaxis was found in 16 cases(27.1%)in group A and in 17 cases(28.3%)in group B( =0.022,=0.882).Conclusion Different nasal approaches have no effect on nasal intubation.
		                        		
		                        		
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intubation, Intratracheal
		                        			;
		                        		
		                        			methods
		                        			;
		                        		
		                        			Laryngoscopes
		                        			;
		                        		
		                        			Laryngoscopy
		                        			;
		                        		
		                        			Nasal Cavity
		                        			;
		                        		
		                        			Oral Surgical Procedures
		                        			
		                        		
		                        	
8.Hypofractionated radiotherapy for early glottic cancer: a retrospective interim analysis of a single institution
Jeong Won LEE ; Jeong Eun LEE ; Junhee PARK ; Jin Ho SOHN ; Dongbin AHN
Radiation Oncology Journal 2019;37(2):82-90
		                        		
		                        			
		                        			PURPOSE: To evaluate the results of hypofractionated radiotherapy (HFX) for early glottic cancer. MATERIALS AND METHODS: Eighty-five patients with cT1-2N0M0 squamous cell carcinoma of the glottis who had undergone HFX, performed using intensity-modulated radiotherapy (IMRT, n = 66) and three-dimensional conformal radiotherapy (3D CRT, n = 19) were analyzed. For all patients, radiotherapy was administered at 60.75 Gy in 27 fractions. Forty-three patients received a simultaneous integrated boost (SIB) of 2.3–2.5 Gy per tumor fraction. RESULTS: The median follow-up duration was 29.9 months (range, 5.5 to 76.5 months). All patients achieved complete remission at a median of 50 days after the end of radiotherapy (range, 14 to 206 days). The 5-year rates for locoregional recurrence-free survival was 88.1%, and the 5-year overall survival rate was 86.2%. T2 stage was a prognostic factor for locoregional recurrence-free survival after radiotherapy (p = 0.002). SIB for the tumor did not affect disease control and survival (p = 0.191 and p = 0.387, respectively). No patients experienced acute or chronic toxicities of ≥grade 3. IMRT significantly decreased the dose administered to the carotid artery as opposed to 3D CRT (V₃₅, p < 0.001; V₅₀, p < 0.001). CONCLUSIONS: Patients treated with HFX achieved acceptable locoregional disease control rates and overall survival rates compared with previous HFX studies. A fraction size of 2.25 Gy provided good disease control regardless of SIB administration.
		                        		
		                        		
		                        		
		                        			Carcinoma, Squamous Cell
		                        			;
		                        		
		                        			Carotid Arteries
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Radiotherapy
		                        			;
		                        		
		                        			Radiotherapy, Conformal
		                        			;
		                        		
		                        			Radiotherapy, Intensity-Modulated
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Survival Rate
		                        			
		                        		
		                        	
9.Comparison of clinical performance of i-gelⓇ and Baska MaskⓇ during laparoscopic cholecystectomy
So Ron CHOI ; Tae Young LEE ; Sung Wan KIM ; Sang Yoong PARK ; Chan Jong CHUNG ; Jeong Ho KIM
Korean Journal of Anesthesiology 2019;72(6):576-582
		                        		
		                        			
		                        			BACKGROUND: The supraglottic airway device is an appropriate alternative to tracheal intubation in laparoscopic surgery. We compared the Baska MaskⓇ with i-gelⓇ by measuring the oropharyngeal leak pressure (OLP) and hemodynamic and respiratory parameters during laparoscopic cholecystectomy.METHODS: A total of 97 patients were randomly allocated to either i-gel group (n = 49) or Baska Mask group (n = 48). Insertion time, number of insertion attempts, fiber-optic view of the glottis, and OLP were recorded. Heart rate, mean arterial pressure, peak airway pressure (PAP), lung compliance, and perioperative complications were assessed before, during, and after pneumoperitoneum.RESULTS: There were no significant differences between the two groups regarding demographic data, insertion time, fiber-optic view of the glottis, and the use of airway manipulation. The OLP was higher in the Baska Mask group than in the i-gel group (29.6 ± 6.8 cmH₂O and 26.7 ± 4.5 cmH₂O, respectively; P = 0.014). Heart rate, mean arterial pressure, PAP, and lung compliance were not significantly different between the groups. The incidence of perioperative complications was small and not statistically significant.CONCLUSIONS: Both the i-gel and Baska Mask provided a satisfactory airway during laparoscopic cholecystectomy. Compared with the i-gel, the Baska Mask demonstrated a higher OLP.
		                        		
		                        		
		                        		
		                        			Arterial Pressure
		                        			;
		                        		
		                        			Cholecystectomy
		                        			;
		                        		
		                        			Cholecystectomy, Laparoscopic
		                        			;
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Heart Rate
		                        			;
		                        		
		                        			Hemodynamics
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Intubation
		                        			;
		                        		
		                        			Laparoscopy
		                        			;
		                        		
		                        			Laryngeal Masks
		                        			;
		                        		
		                        			Lung Compliance
		                        			;
		                        		
		                        			Masks
		                        			;
		                        		
		                        			Pneumoperitoneum
		                        			
		                        		
		                        	
10.Intensity-modulated radiotherapy for stage I glottic cancer: a short-term outcomes compared with three-dimensional conformal radiotherapy
Ick Joon CHO ; Woong Ki CHUNG ; Joon Kyoo LEE ; Min Cheol LEE ; Jayeong PAEK ; Yong Hyub KIM ; Jae Uk JEONG ; Mee Sun YOON ; Ju Young SONG ; Taek Keun NAM ; Sung Ja AHN ; Dong Hoon LEE ; Tae Mi YOON ; Sang Chul LIM
Radiation Oncology Journal 2019;37(4):271-278
		                        		
		                        			
		                        			PURPOSE: To investigate the differences in treatment outcomes between two radiation techniques, intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT).MATERIALS AND METHODS: We retrospectively analyzed 160 (IMRT = 23, 3DCRT = 137) patients with stage I glottic cancer treated from January 2005 through December 2016. The IMRT was performed with TomoTherapy (16 patients), volumetric-modulated arc therapy (6 patients), and step-and-shoot technique (1 patient), respectively. The 3DCRT was performed with bilateral parallel opposing fields. The median follow-up duration was 30 months (range, 31 to 42 months) in the IMRT group and 65 months (range, 20 to 143 months) in the 3DCRT group.RESULTS: The 5-year overall survival and 3-year local control rates of the 160 patients were 95.7% and 91.4%, respectively. There was no significant difference in 3-year local control rates between the IMRT and 3DCRT groups (94.4% vs. 91.0%; p = 0.587). Thirteen of 137 patients in the 3DCRT group had recurrences. In the IMRT group, one patient had a recurrence at the true vocal cord. Patients treated with IMRT had less grade 2 skin reaction than the 3DCRT group, but this had no statistical significance (4.3% vs. 21.2%; p = 0.080).CONCLUSION: IMRT had comparable outcomes with 3DCRT, and a trend of less acute skin reaction in stage I glottic cancer patients
		                        		
		                        		
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Glottis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Laryngeal Neoplasms
		                        			;
		                        		
		                        			Radiotherapy, Conformal
		                        			;
		                        		
		                        			Radiotherapy, Intensity-Modulated
		                        			;
		                        		
		                        			Recurrence
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Skin
		                        			;
		                        		
		                        			Vocal Cords
		                        			
		                        		
		                        	
            

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