Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P₂₅, P₇₅), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.
Male ; Female ; Humans ; Adult ; Middle Aged ; Thyroidectomy/adverse effects* ; Robotic Surgical Procedures/adverse effects* ; Retrospective Studies ; Blood Loss, Surgical ; Hypesthesia/surgery* ; Neck Dissection/adverse effects* ; Thyroid Neoplasms/surgery* ; Pain, Postoperative/surgery* ; Postoperative Complications/etiology*

OBJECTIVE: To explore clinical symptoms and X-ray imaging features of cervical instability in young adult represented by postgraduates with a master's degree in medicine. METHODS: Totally 91 postgraduates with a master's degree in medicine were investigated from September to December 2021, including 45 males and 46 females;aged from 22 to 30 years old with an average of (25.30±2.18) years old. The cervical spondylosis-related discomfort symptoms of the subjects were collected and examined by the examiner for neck and shoulder tenderness point examination and cervical vertebra positive and lateral and functional X-ray radiography. According to the results of X-ray examination, the subjects were divided into stable cervical group and unstable cervical group. RESULTS: Among 91 subjects, there were 50 patients with cervical instability, accounting for 54.90% of total number of subjects. The cervical curvature was abnormal in 78 patients, accounting for 85.70% of total number of subjects. Among 50 patients with cervical instability, 50 patients were diagnosed as cervical instability on the basis of angular displaxement(AD)≥ 11 °, including 13 cases of C_3,4 instability, 30 cases of C_4,5 instability and 7 cases of C_5,6 instability;and 5 cases were diagnosed as cervical instability based on horizontal displacement(HD)≥ 3.5 mm, including 1 case of C_3,4 instability and 4 cases of C_4,5 instability. Compared with stable cervical group, the number of discomfort symptoms of neck pain, headache and shoulder pain in instability group was significantly higher than that of in stable cervical group(P<0.05);and the number of tenderness in spinous process space of C_4,5 and C_5,6, 2 cm adjacent to the spinous process of C₂-C₅ and the superior angle of the scapula (the stop point of levator scapulae) in the instability group was significantly higher than that in the stable cervical group (P<0.05);and the cervical curvature in the instability group was significantly lower than that in stable cervical group(P<0.05). CONCLUSION The incidence of cervical instability in young adult represented by postgraduates with a master's degree in medicine is high, they are mainly diagnosed as cervical instability on the basis of vertebral angular displacement ≥ 11°, and the instability segments are concentrated on C_3,4, C_4,5 and C_5,6 segments, the occurrence of cervical instability is often accompanied by abnormalities of cervical curvature. Most of clinical manifestations are head, neck and shoulder pain, especially neck pain in unstable segment.
Male ; Female ; Humans ; Young Adult ; Adult ; Neck Pain/etiology* ; Shoulder Pain ; Spinal Diseases ; Radiography ; Spondylosis/diagnostic imaging* ; Joint Instability/diagnostic imaging* ; Cervical Vertebrae/diagnostic imaging*

Cervical Vertebrae ; Humans ; Neck/diagnostic imaging* ; Neck Pain/etiology*

OBJECTIVETo evaluate the clinical efficacy of warming-needle moxibustion on cervical headache.

METHODSSixty-one patients of cervical headache were randomly divided into a warming-needle moxibustion group (30 cases) and an acupuncture group (31 cases). Tianzhu (BL 10), Fengchi (GB 20), Wangu (GB 12), Tianyou (TE 16), Hegu (LI 4), Taichong (LR 3) and Zulinqi (GB 41) were selected in the two groups. Patients in the acupuncture group were treated with acupuncture; patients in the warming-needle moxibustion group were treated with warming-needle moxibustion at Tianzhu (BL 10), Fengchi (GB 20) and Wangu (GB 12) and acupuncture at the remaining acupoints. The treatment was given once every other day, 3 times a week, and totally 4-week treatment was given. The duration and frequency of headache, numerical rating scale (NRS) of headache and cervical range of motion (ROM) were compared before and after treatment in the two groups; also the efficacy of the two groups was evaluated.

RESULTSAfter treatment, the duration and frequency of headache, headache NRS.and cervical ROM score were improved in both groups (all P < 0.05), which were more significant in the warming-needle moxibustion group (all P < 0.05). The total effective rate was 84.3% (25/30) in the warming-needle moxibustion group, which was significantly superior to 61.3% (19/31) in the acupuncture group (P < 0.05).

CONCLUSIONThe warming-needle moxibustion presents significant efficacy on cervical headache, which can obviously improve headache symptoms and cervical ROM.

Acupuncture Points ; Adult ; Cervical Vertebrae ; physiopathology ; Female ; Headache ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Neck Pain ; complications ; physiopathology ; therapy ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the efficacy among acupuncture based on "jin" theory, regular acupuncture and western medication.

METHODSA total of 95 cases, by using incomplete randomization method, were divided into a "jin" theory acupuncture group (32 cases), a regular acupuncture group (31 cases) and a medication group (32 cases). Patients in the "jin" theory acupuncture group were treated with acupuncture based on "jin" theory which included the "gather" and "knot" points on the affected side: positive reacted points, Fengchi (GB 20), Tianrong (SI 17), Tianyou (TE16) and Yiming (EX-HN14) as the main acupoints, while the Ermen (TE 21), Tinggong (SI 19) and Tinghui (GB 2) and zhigou (TE 6) as the auxiliary acpoints; the treatment was given once a day. Patients in the regular acupuncture group were treated with regular acupuncture at Tinggong (SI 19), Tin- ghui (GB 2) and Ermen (TE 21) and other matched acupoints based on syndrome differentiation, once a day. Pa- tients in the medication group were treated with oral administration of betahistine mesylate, three times a day. Ten days of treatment were taken as one session in three groups, and totally 2 sessions were given. Visual analogue scale (VAS), tinnitus handicap inventory (THD), and tinnitus severity assessment scale (TSIS) were evaluated before and after treatment; also the clinical efficacy was compared among three groups.

RESULTSThere are 5 drop-out cases du- ring the study. After the treatment, the VAS, THI and TSIS were improved in three groups (all P < 0.05); the VAS, THI and TSIS in the "jin" theory acupuncture group were lower than those in the regular acupuncture group and medication group (P < 0.05, P < 0.01). The total effective rate was 90.0% (27/30), 80.0% (24/30) and 63.3% (19/30), which was higher in the "jin" theory acupuncture group (P < 0.05, P < 0.01).

CONCLUSIONThe acupuncture based on "jin" theory is superior to regular acupuncture and western medication for cervical tinnitus.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Neck Pain ; complications ; Tinnitus ; etiology ; therapy ; Treatment Outcome

OBJECTIVETo evaluate the short-term and long-term effects on treatment of neck pain caused by cervical spondylosis with the combination of acupuncture and moxibustion with seed-size moxa cone.

METHODSOne hundred and forty-five patients of neck pain were randomly divided into an acupuncture-moxibustion group (49 cases), an acupuncture group (48 cases) and a moxibustion group (48 cases). Acupoints of Bailao (Extra), Dazhui (GV 14), Jianzhongshu (SI15) and Zhongzhu (TE 3) were adopted for all the 3 groups. Acupuncture was applied at all the acupoints with 20 min needling retention for the acupuncture group. Moxibustion with seed-size moxa cone was used with 5 cones on each point for the moxibustion group. And both acupuncture and moxibustion with seed-size moxa cone were adopted for the acupuncture-moxibustion group. The treatment was applied once every 3 days, and 10 treatments should be finished within 4 weeks. Follow-up should be carried out for 3 months. The short-term and long-term effects were evaluated with the scores of Northwick Park Pain Questionnaire (NPQ) and McGill Pain Questionnaire (MPQ) as the indices of therapeutic effect.

RESULTSThe NPQ score and MPQ score of all the 3 groups after the treating course and the 3-month follow-up were both decreased when compared with those before the treatment (all P<0. 05). The scores of NPQ and MPQ the acupuncture-moxibustion group were lower than that of the other two groups. And the difference had obvious significance (P<0. 05). High efficiency of pain relieving for cervical spondylosis could be found in all the 3 groups, which showed that short-term and long-term effects were good for all the 3 groups. And the highest curative effect could be found in acupuncture-moxibustion group.

CONCLUSIONCombination of acupuncture and moxibustion with seed-size moxa cone has reached a superior effect in short-term and long-term for neck pain caused by cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Neck Pain ; etiology ; therapy ; Spondylosis ; complications ; Treatment Outcome ; Young Adult

No abstract available.
Cervical Vertebrae/*injuries ; Humans ; Male ; Middle Aged ; Neck Pain/*etiology ; Spinal Fractures/*diagnosis ; Spondylitis, Ankylosing/*complications

There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.
Case-Control Studies ; Chronic Disease ; Evaluation Studies as Topic ; Facial Pain ; etiology ; physiopathology ; Female ; Humans ; Neck Pain ; etiology ; physiopathology ; Sensory Thresholds ; Skin ; physiopathology ; Statistics, Nonparametric ; Thermosensing ; Trigeminal Nerve Injuries ; complications ; physiopathology ; Whiplash Injuries ; complications ; physiopathology

OBJECTIVETo evaluate the method, safety and short-term efficacy of ultrasound-guided percutaneous laser ablation (PLA) for benign solid thyroid nodule (BSTN).

METHODSThe treatment group consisting of 12 patients with single BSTN were treated with ultrasound-guided PLA. After treatment, the size and blood flow signals in conventional ultrasonography, the ablation extent of lesions in contrast-enhanced ultrasonography (CEUS), and the related complications and thyroid function were assessed in comparison with the the baseline. A control group including 12 untreated patients with single BSTN was followed-up in the same manner as in the treatment group.

RESULTSIn the treatment group, all the 12 patients completed the treatment successfully. During the follow-up, the volume of the nodules was reduced gradually (P<0.05), and blood flow signals in the nodules disappeared. Eleven nodules were non-enhanced in CEUS immediately after the treatment, and the complete ablation rate was 91.7%. During the operation, 3 patients complained of intolerable pain, which was ameliorated or totally relieved after appropriate treatment. The thyroid function showed no significant changes after the treatment (P>0.05). The control group followed up for 6 months showed no significant changes in the nodule volume or thyroid function in comparison with the baseline (P>0.05).

CONCLUSIONUltrasound-guided PLA is a safe and effective minimally invasive treatment of BSTN without obvious adverse effect on thyroid function.

Adult ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; adverse effects ; methods ; Male ; Middle Aged ; Neck Pain ; etiology ; Pilot Projects ; Thyroid Gland ; diagnostic imaging ; pathology ; surgery ; Thyroid Nodule ; diagnostic imaging ; pathology ; surgery ; Treatment Outcome ; Ultrasonography, Doppler, Color ; Ultrasonography, Interventional

OBJECTIVETo compare the temperature distribution of both sides of shoulder, provide objective reference for the application thermoview in the diagnosis of cervicodynia in teenagers.

METHODSForty-five adolescents with cervicodynias from March 2009 to December 2009 were collected. There were 23 males and 22 females, with an average age of 21 years (ranged from 19 to 22 years). The course of disease ranged from 2 to 20 weeks (averaged 13 weeks). C7 horizontal line were used to divide the back into the neck area and shoulders area, and the midline to subdivide the chosen area into left and right area. Thermal infrared imaging was used to observe the temperature both sides of neck and shoulders, the data was analyzed by the computer.

RESULTSThe temperature of shoulder was higher than neck. There were significant differences in the highest and average temperature both of the left and right side of neck and shoulder (P < 0.05), but no difference in the lowest temperature both of left and right side of neck.

CONCLUSIONThe thermal infrared imaging is important for diagnosing cervical imbalance syndrome, finding the sign of abnormal muscle metabolism of shoulder and providing the basis for prevention.

Adult ; Body Temperature ; Female ; Humans ; Infrared Rays ; Male ; Neck ; Neck Pain ; diagnosis ; etiology ; physiopathology ; Shoulder ; Young Adult