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Objective. Radiofrequency coblation (RFC) is a relatively new method that has opened up new perspectives in treating oropharyngeal squamous cell carcinoma (OPSCC). Our study was designed to explore the feasibility and effectiveness of RFC-assisted transoral surgery (RFC-TOS) for primary OPSCC. Methods. Sixty-nine cases of OPSCC from February 2005 to November 2020 were retrospectively analyzed, including 31 in the RFC-TOS group and 38 in the open surgery group. No difference was observed in demographic and oncological characteristics. Results. The significance between the RFC-TOS group and the open surgery group was proved in intraoperative bleeding volume (34.10 ± 10.10 ml vs. 193.68 ± 21.00 ml, P < 0.001 ), durations of surgery (79.58 ± 8.45 min vs. 217.87 ± 17.65 min, P < 0.001 ), time to resume oral feeding (1.64 ± 0.41 d vs. 11.58 ± 1.41 d, P < 0.001 ), duration of hospitalization (7.84 ± 0.66 d vs. 15.66 ± 1.62 d, P < 0.001 ), and the total costs (22846.22 ± 1821.55¥ vs. 41792.24 ± 4150.86¥, P < 0.001 ). The rates of 5-year overall survival (OS), 5-yeardisease-specific survival (DSS), and 5-year local control rate (LC) were 69.1%, 71.7%, and 75.7%, respectively, in the RFC-TOS group and 71.0%, 73.4%, and 73.7% in the open surgery group ( P > 0.05 ). Conclusions. RFC-TOS is a feasible alternative transoral approach for OPSCC. The reported perioperative and oncologic outcomes are satisfactory.

STUDY OBJECTIVES: To compare the efficiency of a TCM scoring system that includes 3 independent predictors obtained by physical examination, computed tomography, and polysomnography with the standard Friedman staging system that includes only physical examination variables for predicting surgical outcomes in patients with obstructive sleep apnea syndrome who undergo velopharyngeal surgery. METHODS: This prospective study was carried out in 265 patients with obstructive sleep apnea syndrome who underwent velopharyngeal surgery. All these patients were re-examined with polysomnography for evaluation of surgical outcomes at least 3 months after surgery. The efficacies in the surgical outcome prediction of 2 systems were calculated and compared. RESULTS: The overall response rate and cure rate was 63.8% (169/265) and 22.3% (59/265), respectively. There were 32 patients with Friedman stage I, with a response rate and cure rate of 81.3% (26/32) and 28.1% (9/32), respectively, and 70 patients with TCM scores of

Radiofrequency coblation (RFC) is a relatively new device that has been used in several transoral procedures. Currently, clinical data on its use for excising lingual thyroglossal duct cyst (LTGDC) are lacking. Herein, we conducted this retrospective case series to explore the feasibility and efficacy of RFC-assisted transoral surgery (RFC-TOS) in excising LTGDC. A total of 12 LTGDC patients between 2013 and 2020 were retrospectively studied. The cysts of these patients were all fully removed along the boundary to the depth of the hyoid using RFC wands. All surgeries were completed within 30 minutes. Only one patient had an intra-operative blood loss of more than 10 ml. All patients started oral feeding on the operation day. The mean post-operative hospital stay was only 3.3 days (range 1-8 days). No surgical-related short-term and long-term complications were observed. One patient was lost to follow up, and no recurrences occurred during a mean follow-up period of 52.7 months among the other 11 patients. Therefore, we believe that RFC is a reliable tool in transoral operation for treating LTGDC. LTGDC patients who underwent RFC-TOS showed quick recovery, low risks of complications, and excellent clinical and functional outcomes.

To investigate the feasibility and effectiveness of nasopharyngeal tube (NPT) insertion in alleviating sleep hypoxemia during the first night after velopharyngeal surgery in patients with obstructive sleep apnea syndrome (OSAS).In this prospective nonblinded randomized controlled study, 46 patients with OSAS who underwent velopharyngeal surgery were enrolled and randomly allocated to the control group (with no NPT insertion) and the NPT insertion group. Both groups underwent overnight pulse oximetry tests during the first postoperative night.One patient in the NPT insertion group was excluded because of involuntary self-removal of NPT during sleep. A total of 45 patients with OSAS were included for analysis, with 23 in the control group and 22 in the NPT insertion group. No significant differences in preoperative baseline information were found between the two groups. Compared with the patients in the control group, those patients in the NPT insertion group showed a significantly higher value of the lowest oxygen saturation (O-LSAT) during the first postoperative night (85.0±4.0% vs. 79.3±8.0%) (NPT insertion could lessen the severity of sleep hypoxemia during the first night after velopharyngeal surgery in patients with OSAS, and showed excellent compliance. This method could be a potential alternative option for decreasing the risks of complications related to severe sleep hypoxemia during the early postoperative days.

BACKGROUND Ear molding is a safe and effective way to treat babies born with ear deformities. In this study, the authors explored the long-term effectiveness of ear molding and determined the factors that relate to recurrence. METHODS A retrospective review of 200 consecutive infants treated with the EarWell System from March of 2018 to August of 2019 was performed. Immediate and long-term effectiveness was evaluated and compared. RESULTS A total of 190 children (314 ears) were included. The mean age at presentation was 16.2 days (range, 0 to 100 days). The most common deformity was constricted ear [172 ears (54.8 percent)], and the rarest deformity was cryptotia [four ears (1.3 percent)]. At the completion of treatment, 10 constricted ears were evaluated to be unsuccessful. The immediate success rates of mild and severe constricted ears were 95.7 percent and 93.1 percent, respectively. The average long-term follow-up was 336 days (range, 180 to 660 days) after completion of treatment. Twenty-two ears (7.2 percent) reverted to their original shape. The long-term success rates of severe constricted ears and prominent ears decreased most significantly, 83.3 percent (p = 0.030) and 66.7 percent (p = 0.042), respectively. Family history led to a decrease of long-term effectiveness of prominent ears. Age at application, sex, duration of molding, and retention taping were not correlated to the long-term outcome. CONCLUSIONS Long-term follow-up demonstrated that in a percentage of babies, the ear deformities did recur after an initially successful treatment. Severe constricted ears and prominent ears are most likely to relapse. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.

Background Currently, there have been no reports on foreign bodies found in the nasal septum after dental root canal therapy. Herein, we present an unusual case of a foreign body found in the nasal septum, which occurred after dental root canal therapy and two unsuccessful surgeries. Case summary A 55-year-old man was referred to our department due to slight nasal discomfort that persisted for about 1 wk. Before consulting our department, the patient visited three different hospitals/clinics and underwent two surgeries that were not successful in removing a foreign body completely. A computed tomography scan was performed to detect the shift of the foreign body from dental root to the nasal septum, which resulted in the healing of oral inflammation and nasal septum discomfort. An endoscopic foreign body extraction surgery (3rd removal surgery) was then successfully performed, using a needle as the reference. No nasal reconstruction was required after the operation. Postoperative healing was uneventful. Conclusion Medical healthcare professionals should consider past medical history when dealing with foreign body cases. During septal foreign body extraction surgery, a needle could be used as a helpful reference.

Recent studies have reported the crucial role of stanniocalcin-2 (STC2) in hepatocellular carcinoma; however, its role in head and neck squamous cell carcinoma (HNSCC) remains elusive. In this study, microRNA-206 (miR-206) was predicted to target STC2 gene. The study herein aimed to elucidate the effect of miR-206 on HNSCC by targeting STC2. STC2 was highly expressed in HNSCC tissues and cells. By targeting STC2, miR-206 decreased mRNA and protein expression of STC2. Importantly, our study showed that miR-206 blocked the Akt signaling pathway by inhibiting STC2. Intriguingly, our data from in vitro and in vivo experiments suggested that miR-206 overexpression led to decreased cell proliferation and increased cell apoptosis and autophagy, as well as suppressed tumor growth; whereas, STC2 silencing reversed the effects of miR-206 inhibitor on those biological behaviors. In this study, we investigated the antioncogenic effect of miR-206 on HNSCC by targeting STC2, and highlighted miR-206/STC2 aixs as potential therapeutic targets for HNSCC.

OBJECTIVE To explore the feasibility and efficacy of transoral radiofrequency coblation surgery (TRS) in the treatment of adult laryngopharyngeal vascular lesion (LVL). METHODS A total of 15 patients with LVL were retrospectively studied, including 11 capillary lesions and five cavernous lesions (there was one case with two separate lesions). All of the lesions were treated with TRS alone (capillary lesion) or with a combination of TRS and sclerotherapy (cavernous lesion). The treatment efficacy was evaluated according to the modified Achauer criteria: grade 1, no change in size; grade 2, a decrease of

Hemorrhage is the most common complication caused by transoral laryngopharyngeal surgery. It is believed that proper management of the superior laryngeal artery (SLA), the main feeding artery for the larynx and pharynx, may reduce intra- and postoperative hemorrhage incidence. The aim of this study was to illustrate the anatomy of the SLA via transoral endoscopic approach.Fourteen sides of SLA from heads of seven fresh-frozen and silicone-injected cadavers were dissected. Transoral dissections were performed for the intra-laryngeal segment of SLA, and transcervical dissections were performed to confirm the anatomical measurements.SLA had a slightly descending course from the origin to the larynx, and there was a major branch supplying the epiglottis, named pharyngo-epiglottic artery (PEA). Parallel with the internal superior laryngeal nerve (ISLN), SLA passed through the thyrohyoid membrane and ended into the hypopharynx. The distance from SLA to the superior horn of thyroid cartilage (SHTC) was (9.11 ± 0.58)mm on the left and (9.01 ± 0.37)mm on the right; the distance from SLA to the inferior margin of the hyoid bone (IMHB) was (2.00 ± 0.11)mm on the left and (1.95 ± 0.08)mm on the right; the distance from SLA to ISLN was (5.98 ± 0.48)mm on the left and (5.78 ± 0.36)mm on the right. No significant difference was found between bilateral sides (SHTC, SMTC, and IMHB could be regarded as anatomical landmarks to locate SLA when applying a transoral approach. Moreover, a complete understanding of the detailed anatomy of the superior laryngeal artery may improve the detection of hemostasis in transoral laryngeal or hypo-pharyngeal surgery.

ObjectivesThis study aimed to investigate the status of the current knowledge about laryngopharyngeal reflux disease (LPRD) among Chinese otolaryngologists.DesignMulti-centre cross-sectional survey.Setting220 medical centres in different regions of China.ParticipantsA total of 2254 otolaryngologists from 220 medical centres in China who were successfully on-site surveyed between November 2019 and December 2020.Main outcome measuresAwareness about LPRD included knowledge about risk factors, symptoms, laryngoscope signs, related diseases, current diagnostic methods and treatments.ResultsThe percentage of participants who had heard of LPRD was 96.4%, with academic conferences as the most common source of information (73.3%). The most commonly known risk factor, symptom, laryngoscope sign, related disease, diagnostic method and treatment were alcohol consumption (44.0%), pharyngeal foreign body sensation (66.9%), hyperaemia (52.4%), pharyngolaryngitis (54.8%), pH monitoring (47.6%) and medication (82.1%), respectively. Only 28.3% of all participants knew that 24 h pH or multichannel intraluminal impedance pH monitoring was the most accurate diagnostic test. As many as 73.1% of all participants knew that proton pump inhibitors were the first-line treatment drugs. An analysis of the overall status of awareness using a scoring system suggested that otolaryngologists were better aware owing to more access, working at 3A hospitals, and postgraduate or above educational background (all pConclusionAlthough the majority of Chinese otolaryngologists had heard of LPRD, their overall awareness about the disease was not encouraging. More efforts are needed to increase the knowledge about LPRD among this group of physicians.Trial registration numberChiCTR1900025581

OBJECTIVE: To summarize and analyze the clinical diagnosis and surgical treatment of patients with tumors involving the root of neck. METHOD: We retrospectively analyzed the clinical data of 73 patients with tumors involving the root of neck in Peking University First Hospital Otorhinolaryngology Head and Neck Surgery department. Data collected included clinical manifestations, preoperative imaging evaluation, surgical approach selection, postoperative pathological types, postoperative complications and prognosis. RESULT: The most frequent symptom was a painless cervical mass(36 cases) and dysphagia(16 cases). All patients underwent preoperative enhanced CT scan or MRI, which would be helpful to evaluate the tumor size, shape, location, relationship with surrounding structures, especially important blood vessels, and secondary changes. The postoperative pathological diagnosis included 37 cases of benign and 36 cases of malignant. The most common benign tumor was retrosternal goiter in 17 cases, and the most common malignant tumor was cervical esophageal cancer in 15 cases. Nonsurgical treatment was performed in 3 cases, while surgical treatment was performed in 70 cases, including 61 cases (87.1%)with cervical approach, 9 cases (12.9%)with combined cervicothoracic approach, 67 cases of complete tumor resection and 3 cases of palliative resection. Sixteen cases cooperated with thoracic surgerons, and 1 case with orthopedic surgerons. Surgical complications occurred in 16 cases (22.9%). Seven patients were lost to follow-up, and 66 patients were followed up for 3 months to 15 years. None of the 35 patients with benign tumors had recurrence, and among the 31 patients with malignant tumors, the 3-year survival rate was 48.4% and the 5-year survival rate was 32.3%. CONCLUSION: Tumors involving the root of neck are challenging to diagnose and treat due to the complex regional anatomy and a variety of pathological types, with comparable proportion of benign and malignant tumors. Surgery is the first choice, but it requires careful preoperative assessment. Surgical approaches include cervical approach and combined cervicothoracic approach, which should be determined according to the pathology, size and surrounding structure of the tumor, as well as the habits of the surgeon. Most benign tumors can be excised by the cervical approach. The combined cervicothoracic approach is suitable for malignant tumors with unclear boundaries and close adhesion of important blood vessels and nerves. Proper treatment of large vessels is the key to complete resection of tumors. There are many complications in the operation of this site, so it is necessary to fully communicate with the patient before operation, and sometimes multidisciplinary cooperation is needed.

A small heat exchanger with segmental baffles and two tube passes was built and experimented to investigate the shellside heat transfer enhancement in our previous research. In the present paper, t...

In the present work, the comprehensive two-dimensional numerical model is constructed with ANSYS Fluent for the unsteady conjugate heat transfer of magnetic refrigerator with Gd plates. To express the reciprocating piston movements and magneto-caloric effect, etc., several user-defined functions are compiled. With current model, the reciprocating magnetic refrigerator in the literature is simulated under room temperature conditions and its refrigeration mechanism is analyzed. Besides, the effect of cycling period (τ) on maximal temperature span (ΔT max ) is numerically investigated and different channel widths (w) are adopted for the effects of heat transfer enhancement. Computation results indicate that current comprehensive model could match well with public experimental data and the ΔT max is effectively improved with smaller w at the cost of substantial increase of pressure difference. Moreover, the ΔT max generated by narrower channels varies convexly with the τ, and the peak ΔT max increases with a decreasing w.

Objective This study aimed to evaluate knowledge of laryngopharyngeal reflux disease (LPRD) among otolaryngologists in 3A hospitals in Beijing. Methods A cross-sectional questionnaire survey of LPRD knowledge was conducted with otolaryngologists in 40 3A hospitals in Beijing. A response rate of Results The most common source of LPRD knowledge was academic lectures (80.1%). The most commonly known risk factors, symptoms, clinical signs and associated diseases were unhealthy eating habits (49.2%), foreign body sensation in the pharynx (71.0%), hyperaemia (42.3%) and pharyngolaryngitis (63.7%), respectively. Only 57.7% of otolaryngologists knew about 24-hour pH monitoring as a gold standard diagnostic test for LPRD. The most commonly known treatment option was medication (93.1%). Most physicians (86.7%) had made a clinical diagnosis of LPRD; however, only 59.9% of them had followed up the treatment outcomes. The most common treatment provided was medication (82.6%). Conclusions Knowledge of LPRD among otolaryngologists in 3A hospitals in Beijing was insufficient. Educational programs are needed to increase the knowledge of LPRD among otolaryngologists.

Objective It is essential to characterize underlying molecular mechanism associated with head and neck squamous cell carcinoma (HNSCC) and identify promising therapeutic targets. Herein, we explored role of homeobox transcript antisense RNA (HOTAIR) in HNSCC to regulate stanniocalcin‐2 (STC2) by sponging microRNA‐206 (miR‐206). Methods HNSCC‐related differentially expressed genes and regulation network amongst HOTAIR, miR‐206 and STC2 were identified. Next, effect of HOTAIR on cell biological functions of HNSCC was identified after transfection of cells with HOTAIR overexpressed plasmids or siRNA against HOTAIR. PI3K/AKT signalling pathway‐related gene expression was measured after miR‐206 and STC2 were suppressed. Cell invasion, migration and proliferation were assessed. Finally, tumour growth was assessed to determine the effects of HOTAIR/miR‐206/STC2 axis in vivo. Results HOTAIR specifically bound to miR‐206 and miR‐206 targeted STC2. Downregulated HOTAIR or upregulated miR‐206 suppressed HNSCC cell proliferation, invasion and migration. miR‐206 inhibited PI3K/AKT signalling pathway by down‐regulating STC2. Besides, silenced HOTAIR or overexpressed miR‐206 repressed the tumour growth of nude mice with HNSCC. Conclusion HOTAIR regulated HNSCC cell biological functions by binding to miR‐206 through STC2.

Heterogeneous sensor network-based medical decision making could facilitate the patient diagnosis process. In this paper, we present an intelligent approach for vocal folds damage detection based on patient's vowel voices using heterogeneous sensor network. Based on human voice samples and Hidden Markov Model, we show that transformed voice samples (linearly combined samples) follow Gaussian distribution, further we demonstrate that a type-2 fuzzy membership function (MF), i.e., a Gaussian MF with uncertain mean, is most appropriate to model the transformed voices samples, which motivates us to use a nonlinear signal processing technique, interval type-2 fuzzy logic systems, to handle this problem. We also apply Short-Time-Fourier-Transform (STFT) and Singular-Value-Decomposition (SVD) to the vowel voice samples, and observe that the power decay rate could be used as an identifier in vocal folds damage detection. Two fuzzy classifiers, a Bayesian classifier and a linear classifier, are designed for vocal folds damage detection based on human vowel voices /a:/ and /i:/ only, and the fuzzy classifiers are compared against the Bayesian classifier and linear classifier. Simulation results show that an interval type-2 fuzzy classifier performs the best of the four classifiers. HighlightsHeterogeneous sensor network-based medical decision making could facilitate the patient diagnosis process.Two fuzzy classifiers, a Bayesian classifier and a linear classifier, are designed for vocal folds damage detection.Interval type-2 fuzzy classifier performs the best of the four classifiers.

Purpose. To evaluate the value of Brodsky tonsil scale in predicting the objective tonsil volume and to identify the potential factors that might interfere with the accuracy of prediction. Methods. A total of 87 adult patients who underwent single tonsillectomy or uvulopalatopharyngoplasty (UPPP) procedure including tonsillectomy in our hospital between Jan 2015 and Dec 2016 were included. The data of Brodsky tonsil scale evaluated preoperatively and objective tonsil volume evaluated postoperatively were collected for analysis. Results. Among the 87 adult patients included, 85 patients underwent bilateral tonsillectomy, while only 2 underwent unilateral procedure. Therefore, a total of 172 tonsils were included. Significant positive correlations were established between Brodsky scale and objective volume for either right (R = 0.647), left (R = 0.664), or overall tonsils (R = 0.654) (all p<0.001). However, volume overlaps could be found between 2+ and 3+ tonsils. Age [odds ratio (OR) = 4.053, p=0.003] and body mass index (BMI; OR=1.740, p=0.044) were found to be independent factors that could influence the consistency between the Brodsky scale and objective volume. As a result, a formula “Index = -1.409+1.399×age+0.554×BMI” was constructed for the evaluation of the consistency. Conclusion. Tonsil grading was significantly correlated with tonsil volume; preoperative tonsil grading that reflected the real tonsil volume was regarded as the protocol for the evaluation of the tonsil size. Age and BMI were independent factors that could affect the consistency between tonsil grade and tonsil volume. A mathematical model was estimated to predict the consistency accurately.

Tubomanometry (TMM) is a relatively novel method for testing the eustachian tube (ET) function, which is speculated to be closely related to otitis media with effusion (OME). The purpose of this study is to explore the predictive power of TMM value for medication outcomes in adult acute OME. A cohort of 41 adult acute OME patients with 53 affected ears was studied retrospectively. All these patients completed a 2-week treatment including oral Myrtol Standardized Enteric capsules, nasal steroid, and oral antihistamine. The results showed that the response rate was 41.5% (22/53). The ratio of tympanometry C and TMM value differed significantly between responders and non-responders (P

To investigate the replacement therapy of rPTH(1-84) (recombinant human parathyroid hormone (1-84)) to hypothyroidism in established rat model.Rat model of hypothyroidism was established by resecting parathyroids. A total of 30 rats with removal of parathyroids were divided into 6 groups randomly, 5 in each group, and applied respectively with saline injection (negative control group), calcitriol treatment (positive control group) and quadripartite PTH administration with dose of 20, 40, 80 and 160 µg/kg (experimental groups). Saline and rPTH(1-84) were injected subcutaneously daily. Calcitriol was gavaged once a day. Sham-operation was conducted in 5 rats of negative control group. To verify the authenticity of the rat model with hypothyroidism, the serum was insolated centrifugally from rat blood that was obtained from angular vein at specific time to measure calcium and phosphorus concentration. Urine in 12 hours was collected by metabolic cages and the calcium concentration was measured. After 10-week drug treatment, the experiment was terminated and bilateral femoral bone and L2-5 lumbar vertebra were removed from rats. Bone mineral density (BMD)of bilateral femoral bone and lumbar vertebra was analyzed by dual X-ray absorptiometry (DXA). The concentration of bone alkaline phosphatase (BALP) in serum was determined by radioimmunoassay.The rat model with hypothyroidism was obtained by excising parathyroid gland and was verified by monitoring calcium and phosphorus concentration subsequently. Administration of rPTH(1-84) in the dose of 80 or 160 µg/kg made serum calcium and phosphorus back to normal levels, with no significant difference between the doses (P0.05). The BMD in each group of rats with rPTH(1-84) administration was increased significantly (P0.05). The levels of urinary calcium and serum BALP in rats of maximum rPTH(1-84) injection group (160 µg/kg) were higher than those of normal control group (P0.05). The rats treated with calcitriol had normal calcium levels and showed the increase of BMD and phosphorus concentration compared with normal control group (P0.05). The amount of urinary calcium also exceeded the other groups (P0.05), but no with significant difference in BMD of bilateral femoral bone and lumbar vertebra between negative control group and normal control group (P0.05).Calcium and phosphorus return to normal level by administration of rPTH(1-84) in the dose of 80 µg/kg or 160 µg/kg, with increase in BMD. Calcitriol can return the level of calcium to normal and increase BMD, but can not correspondingly decrease the phosphorus concentration and increase the excretion of calcium in urine.

Objective Two cases of first branchial cleft fistula with internal opening on the Eustachian tube are reported and the diagnosis, management and embryological hypothesis are discussed. Design Retrospective study and review of the literature. Results Both patients were young boys with first branchial cleft anomaly clearly identified by computed tomography fistulography scan and direct Methylene Blue dye injection. In both cases, surgical removal revealed a fistula with internal opening located on the Eustachian tube near the nasopharynx. Discussion The main embryological theories and classification are reviewed. A connection between the theories of first branchial apparatus development and the classification by Work might explain the reported clinical association.

To investigate the prognostic factors relevant to sudden sensorineural hearing loss.The internationally accepted standardized clinical research methods, unified design, and unified program were adopted to conduct the prospective clinical multi-center study. The sudden deafness patients between 18 to 65 years old, with the course of this disorder less than two weeks, and without any medical treatments were collected, and then, divided into four types according to the hearing curve: type A, acute sensorineural hearing loss in low tone frequencies; type B, acute sensorineural hearing loss in high tone frequencies; type C, acute sensorineural hearing loss in all frequencies; and type D, total deafness. The factors, in terms of age, gender, type of initial audiogram, time delay before the first visit, and severity of hearing loss, were included in the analyses.A total of 1 024 cases with single side sudden deafness were collected in the study from 33 hospitals in China from August 2007 to October 2011, inclusive of for 492 males (48.05%) and 532 females (51.95%). The average age was (41.2 ± 12.8) years old. There were 553 cases (54.00%) in left ear, and 471 cases (46.00%) in right ear. The curative effects of different types were shown as follows: the type in low tone frequencies had the highest rate of 90.73%, the type in all frequencies was 82.59%; the type of total deafness was 70.29%; and the type in high tone frequencies had the lowest rate of 65.96%. It had significant difference of the effective rate between different types (χ(2) = 231.58, P = 0.000). Age, time delay before first visit, and severity of initial hearing loss were significantly correlated with hearing improvement.Initial audiogram of SSNHL might predict hearing recovery. The young in age and a short time delay before starting treatment are positive prognostic factors for hearing recovery in SSNHL. The initial severity of hearing loss is negative prognostic factor of hearing recovery.

Congenital median dermoid is an uncommon disease. Surgery is the main curative treatment. To review a clinical case and to summarise the characteristics and treatment experience of this disease, referring to the related literature, it is expected that we can provide more clinical thought and therapeutic method for congenital median dermoid fistula of nasal dorsum.

In this paper, the spectrum map of speech samples is used to identify patients with vocal polypus. Comparing the spectrum map with impulse response in wireless communication channels, statistical characteristic root-mean square-delay spread (RMSD) and standard deviation (SD) are employed to describe the speech frequency domain characteristics. Fuzzy logic system (FLS) is used to make polypus patients diagnosis. RMSD and SD are used as two antecedents and fuzzy rules are designed based on the data we collected from polypus patients and normal people. Based on the real data, we demonstrate that the FLS could be used in polypus patients’ diagnosis with very low probability of miss detection and 0% false alarm rate.

Moxifloxacin was generally well tolerated and highly effective in the treatment of acute bacterial rhinosinusitis (ABS). The incidence of adverse events (AEs) and adverse drug reactions (ADRs) was low. The effectiveness, safety, and tolerability information collected in this study confirm the clinical safety profile of moxifloxacin and its benefit as a treatment option for ABS.To assess the effectiveness, safety, and tolerability of moxifloxacin under daily life treatment conditions in patients with ABS.The study was carried out in China between September 2005 and May 2007. Patients with ABS were treated with moxifloxacin tablets 400 mg once daily for a duration that was left to the physician's discretion. Data were collected on demography, diagnosis of infection, pretreatment, concomitant diseases and medications, moxifloxacin therapy, course of symptoms during investigations, and final assessment of therapy.In all, 578 patients with ABS treated with moxifloxacin were valid for effectiveness analysis. An improvement was observed in 98.8% (n = 571/578) of the patients. Cure was documented in 89.4% (n = 517/578) of the patients. The physicians' overall tolerability rating was 'very good' or 'good' in 92.9% (n = 537/578) of patients. The incidence rates of AEs and ADRs were 1.5% (n = 10/681) and 0.6% (n = 4/681), respectively. No serious AE was reported.

Since standard aminoglycoside treatment progressively causes hearing disturbance with hair cell degeneration, systemic use of the drugs is limited. Adeno-associated virus (AAV)-based vectors have been of great interest because they mediate stable transgene expression in a variety of postmitotic cells with minimal toxicity. In this study, we investigated the effects of regulated AAV1-mediated glial cell line-derived neurotrophic factor (GDNF) expression in the cochlea on aminoglycoside-induced damage. AAV1-based vectors encoding GDNF or vectors encoding GDNF with an rtTA2s-S2 Tet-on regulation system were directly microinjected into the rat cochleae through the round window at 5 x 10(10) genome copies/body. Seven days after the virus injection, a dose of 333 mg/kg of kanamycin was subcutaneously given twice daily for 12 consecutive days. GDNF expression in the cochlea was confirmed and successfully modulated by the Tet-on system. Monitoring of the auditory brain stem response revealed an improvement of cochlear function after GDNF transduction over the frequencies tested. Damaged spiral ganglion cells and hair cells were significantly reduced by GDNF expression. Our results suggest that AAV1-mediated expression of GDNF using a regulated expression system in the cochlea is a promising strategy to protect the cochlea from aminoglycoside-induced damage.

Various surgical procedures are widely used for treating obstructive sleep apnea hypopnea syndrome (OSAHS) currently. The most prominent advantage of surgery is the excellent long-term adherence, which is just the main limitation for the first-line treatment of continuous positive airway pressure (CPAP). However, nearly all the surgical procedures used now usually could not cure this disease completely. The success rate of the uvulopalatopharyngoplasty, which is the most widely used procedure, can only reach to 40% - 50% in terms of AHI Therefore, there are some opinions that the surgery should not be applied for treating this disease. In fact, the outcomes of surgical treatments should not be only evaluated basing on some of the objective results. In this article, the clinical significance of surgery based on objective and subjective data, and the effects on long-term consequences, the combination of surgery with CPAP, and the possible prospects of surgical treatments for this disease will be discussed. This may help us to redefine the clinical efficacy of surgery for the treatment of OSAHS.

To investigate the efficacy of suspension laryngoscopic surgery for benign laryngotracheal stenosis (LTS).Thirty-two patients (aged from 5 to 70 years with a median of 36 years) with benign LTS were studied retrospectively who were treated by suspension laryngoscopic surgery with or without assistance of CO₂ Laser for LTS. Stents were placed in 17 cases. Among 32 patients, 13 cases were with LST in Cotton I, 8 cases in Cotton II, and 11 cases in Cotton III; 23 were with single level narrow, and 9 cases with multi-level narrow; the average narrow length was 1.3 cm and the average diameter at maximum stenosis was 0.5 cm; and 19 cases underwent tracheostomy before surgery.Follow-up period ranged from 1 to 18 years with median time of 10 years. Twenty-six patients (81.2%) were successfully decannulated with good airway patency and effective phonation. Six cases failed and 1 case of them was changed to open surgery. Among 17 cases with stent placement, 4 cases were applied additionally with T tube (effective rate of 50.0%), 1 case with laryngeal keel, 12 cases with stents alone (effective rate of 66.7%). Stent-related complications occurred in 2 cases. Patients with cotton I-II had a successful rate of 100% (21/21), while patients with Cotton III showed poor effectiveness (5/11), with a statistical significant difference between two groups (χ² = 14.098, P = 0.001). The patients with single level LTS were successfully treated by suspension laryngoscopic surgery with 100% successful rate (23/23), while the patients with multi-level LTS showed poor effectiveness (3/9), with a statistical significant difference between two groups (χ² = 18.872, P = 0.000) .Suspension laryngoscopic microsurgery can treat single level LTS with good results and also can be used as a pre-surgery in treatment of multi-level LTS with the virtue of minimal trauma and short recovery time. Application of stents can be helpful for suspension laryngoscope surgery for LST.

The purpose of this study was to analyzed the histopathologic spectrum and clinical features of the tumors originated from the inferior nasal turbinates.Clinical data of 34 patients with tumours of the inferior nasal turbinates, treated from Jan. 1998 to Dec. 2012, were retrospectively reviewed. Of the 34 patients, 18 male and 16 female, aged from 25 years to 76 years (mean: 45.6yr).(1) Pathology : Of the 34 patients, 23 (67.6%) were benign and 11 (32.4%) were malignant. Hemangiomas were the most frequent benign tumour accounting for 18/23 (78.3%) in benign tumour and for 52.9% in all the tumors originated from inferior nasal turbinates. Other benign tumours included inverted papilloma, squamous papillomas and extrapleural solitary neurofibroma tumor. The most common malignant tumour was non-Hodgkin's lymphoma accounting for 6/11 (54.5%) in malignant tumour and for 17.6% in all the tumors. Other malignant tumour included squamous cell carcinoma, melanoma and undifferentiated carcinoma. (2) Distribution: Most tumors (31/34) arose from unilateral turbinates. Hemangiomas is the commonest tumor originated from anterior part of the turbinate in 14 cases of 18 (77.8%). NHL and melanoma involved through turbinates. 3. Symtoms: Nasal obstruction was the most common symtom (25/34, 73.5%). Epistaxis and bloody nasal discharge were the chief complaint in hemangiomas.1. The most common benign and malignant tumors of the inferior turbinate were hemangioma and NHL. The majority of the hemangiomas (14/18) arose from the anterior part of the inferior turbinate. NHL or melanoma often presented progressive, unilateral or bilateral diffuse enlargement of the inferior turbinate with poor vascular contractile reactivity to the ephedrine.

To investigate the method of surgical management for cervical esophageal carcinoma and the feasibility of the operation with preservation of laryngeal function.Sixteen patients with cervical esophageal carcinoma who received surgical treatment were reviewed in our retrospective study. Removal of total hypopharynx and larynx and the inversion stripping esophagectomy were conducted in thirteen patients, of which one underwent the reconstraction with residual larynx and tracheal flap and the other twelve patients underwent the reconstraction with gastric-pharyngeal anastomosis. One patient received the cervical esophagectomy and partial hypopharyngectomy with laryngotracheal flap. The inversion stripping esophagectomy with laryngeal function preservation were conducted in two patients, who received the reconstraction with gastric-pharyngeal anastomosis and preserved total larynx. All the patients were carried out the bilateral neck dissections.The surgical resection rate was 100% and no operative death occurred. The postoperative complications included pulmonary infection in two cases, anastomotic fistula in two cases, anastomotic stenosis in two cases and congestive heart failure in one case. The retained rate of the laryngeal function is 12.5%. The 3-year survival rate is 30.7%, and the 5-year survival rate is 23.1%.The surgical treatment of cervical esophageal carcinoma is possible. The inversion stripping esophagectomy without thoracotomy is performed to resect the tumor. The esophageal defect could be reconstructed by laryngotracheal flap or gastric-pharyngeal anastomosis. The laryngeal function should be remained as far as possible according to the location and extension of the tumor.

To analyze the clinical manifestations of three cases of cervical necrotizing fasciitis caused by klebsiella pneumoniae and to analyze the published articles concerning the relationship between invasive klebsiella syndrome and necrotizing fasciitis in Chinese Mainland.We have retrospectively analyzed three cases of cervical necrotizing fasciitis caused by klebsiella pneumoniae treated in our department between 2003 and 2012. We also reviewed the Chinese-language scientific literature included in the WanFang data by searching with the following key words: necrotizing fasciitis, klebsiella pneumoniae and liver abscess.These patients recovered uneventfully without obvious complications or disseminated infection foci. Sporadic cases of invasive klebsiella syndrome were reported without necrotizing fasciitis involvement in Chinese Mainland.Cervical necrotizing fasciitis caused by klebsiella pneumoniae may give rise to disseminated infection but there has been no such case report in Chinese Mainland.

We aimed to identify the different courses of first branchial cleft anomalies and to discuss the management and classification of these anomalies.Twenty-four patients with first branchial cleft anomalies were reviewed. The courses of first branchial cleft anomalies and their corresponding managements were analyzed. Each case was classified according to Olsen's criteria and Works criteria.According to Olsen's criteria, 3 types of first branchial cleft anomalies are identified: cysts (n = 4), sinuses (n = 13), and fistulas (n = 7). The internal opening was in the external auditory meatus in 16 cases. Two fistulas were parallel to the external auditory canal and the Eustachian tube, with the internal openings on the Eustachian tube. Fourteen cases had close relations to the parotid gland and dissection of the facial nerve had to be done in the operation. Temporary weakness of the mandibular branch of facial nerve occurred in 2 cases. Salivary fistula of the parotid gland occurred in one patient, which was managed by pressure dressing for two weeks. Canal stenosis occurred in one patient, who underwent canalplasty after three months. The presence of squamous epithelium was reported in all cases, adnexal skin structures in 6 cases, and cartilage in 14 cases. The specimens of the fistula which extended to the nasopharynx were reported as tracts lined with squamous epithelium (the external part) and ciliated columnar epithelium (the internal part). According to Work's criteria, 9 cases were classified as Type I lesions, 13 cases were classified as Type II lesions, and two special cases could not be classified. The average follow-up was 83 months (ranging from 12 to 152 months). No recurrence was found.First branchial cleft anomalies have high variability in the courses. If a patient is suspected to have first branchial anomalies, the external auditory canal must be examined for the internal opening. CT should be done to understand the extension of the lesion. For cases without internal openings in the external auditory canal, CT fistulography should be done to demonstrate the courses, followed by corresponding treatment. Two special cases might be classified as a new type of lesions.

To determine the most appropriate form of selective neck dissection(SND) in the hypopharyngeal cancer with cervical lymph node metastasis.We have retrospectively analyzed the distribution and prevalence of cervical metastasis in 26 patients with hypopharyngeal squamous cell carcinoma from January 1998 to December 2008. All the patients underwent SND as part of the primary treatment. There were 34 elective SNDs and 17 therapeutic SNDs from 11 node-negative hypopharyngeal cancers and others node-positive.Occult metastasis was found in 6 patients (55%) with cervical metastasis confined to level II and III. Clinical node-positive necks were all pathologically identified with 6.7%, 66.7%, 86.7%, 46.7%, and 20.0% of the prevalence of metastasis to level I, II, III, IV and V respectively. The regional recurrences were found in 4 patients during the follow-up, which were all from cN+ patients. No patient experienced level I recurrence.The results of this study suggest that SND (I-III) may be feasible for the treatment of cN0 hypopharyngeal cancer, which needs a larger sample to verify. Meanwhile, from our data, it has a satisfactory result to perform SND (II-V) with adjuvant radiotherapy for the cN+ patients.

In this paper, we present a new approach for throat polyps detection based on patient’s vowel voices using fuzzy classifiers. Based on human voice samples and Hidden Markov Model, we show that transformed voice samples (linearly combined samples) follow Gussian distribution, further we demonstrate that a type-2 fuzzy membership function (MF), i.e., a Gaussian MF with uncertain mean, is most appropriate to model the transformed voices samples. We also apply Short-Time-Fourier-Transform (STFT) and Singular-Value-Decomposition (SVD) to the vowel voice samples, and observe that the power decay rate could be used as an identifier in throat polyps detection. Two fuzzy classifiers and a Bayesian classifier are designed for throat polyps detection based on human vowel voices /a:/ and /i:/ only, and the fuzzy classifiers are compared against the Bayesian classifier. Simulation results show that an interval type-2 fuzzy classifier performs the best of the three classifiers.

Fas ligand (FasL) gene therapy may provide a new efficient therapeutic model for head and neck squamous cell cancer (HNSCC). Acid ceramidase (AC) may not play an important role in the sensitivity of HNSCC cell lines to Fas-induced apoptosis.The aims of this study were to investigate the efficacy of FasL gene therapy for HNSCC in vitro and to determine whether the expression of AC in different kinds of HNSCC cell lines is related to the sensitivity of HNSCC cell lines to Fas-mediated apoptotic induction.Three HNSCC cell lines (Hep-2, MMSI, and SCCVII) were transfected with pEGFP-FasL, a plasmid containing a modified human FasL gene fused to enhanced green fluorescent protein (GFP). pEGFP-C1, a plasmid containing the GFP gene alone, was used as a control. Cell death was observed by fluorescence imaging and quantified using a tetrazolium-based (MTS) assay. SCCVII cells were analyzed by flow cytometry to determine the presence of apoptotic induction. Hep-2 and MMSI cells were evaluated by quantitative real-time PCR to evaluate the expression of AC.Transfection of pEGFP-FasL plasmid was shown to be able to induce cell death, the sensitivity of Fas-mediated apoptosis in HNSCC was different, and the level of AC did not correlate with the sensitivity of HNSCC cells to Fas-induced apoptosis.

Background Apoptosis induced by Fas/FasL system has been proposed as a gene therapy methold for various cancers. Methods We used adeno-associated virus–expressing enhanced green fluorescent protein (EGFP)-human FasL (AAV-EGFP-hFasL) to deliver FasL into Hep-2 cells, cytotoxicity was detected by MTS assay , apoptosis was confirmed by flow cytometry. We also treated the xenograft of Hep-2 tumor in nude mice with intratumoral injection of AAV-EGFP-hFasL. The size of the xenograft, the apoptosis in the xenograft, and the survival rate of the inoculated mice were then evaluated. Results Hep-2 cells infected with AAV-EGFP-hFasL showed increased apoptosis rate and killing effect compared with AAV-EGFP–infected cells. In addition intratumoral injections of AAV-EGFP-hFasL into Hep-2 xenografts induced significant growth suppression of tumors. Conclusion Our findings suggest that the introduction of FasL into head and neck squamous cell carcinoma may induce significant apoptosis, and adeno-associated virus may be a useful vehicle for gene therapy. © 2012 Wiley Periodicals, Inc. Head Neck, 2012

To explore the causes, clinical features, diagnosis and treatment of cervical extensive necrotizing fasciitis, a rare clinical occurrence, and to improve the clinical recognition and appreciation of it.Two cases of cervical extensive necrotizing fasciitis were studied and relevant literatures were reviewed. The causes, clinical manifestation, experience of diagnosis and treatment were summarized.One of two cases was secondary to foreign body of hypopharynx, and the other with unknown cause. Apathy, crepitation and diffuse swelling and rubor following with abscess formation on the neck are main characteristics. Mixed synergistic infection was confirmed by drainage culturing. All two cases were treated actively by large dosage and effective broad spectrum antibiotics, and sustaining therapy and surgical treatment, including local incision and drainage, aggressive surgical debridement and tracheotomy.Cervical extensive necrotizing fasciitis is a potentially life-threatening soft tissue infection. The keys of successful treatment were early diagnosis and surgical intervention. Rational antibiotics application and systemic supporting therapeutics were also recommended.

The aims of this study were to evaluate the expression of enhanced green fluorescent protein (EGFP) driven by 6 different promoters, including cytomegalovirus IE enhancer and chicken beta-actin promoter (CAG), cytomegalovirus promoter (CMV), neuron-specific enolase promoter (NSE), myosin 7A promoter (Myo), elongation factor 1alpha promoter (EF-1alpha), and Rous sarcoma virus promoter (RSV), and assess the dose response of CAG promoter to transgene expression in the cochlea. Serotype 1 adeno-associated virus (AAV1) vectors with various constructs were transduced into the cochleae, and the level of EGFP expression was examined. We found the highest EGFP expression in the inner hair cells and other cochlear cells when CAG promoter was used. The CMV and NSE promoter drove the higher EGFP expression, but only a marginal activity was observed in EF-1alpha promoter driven constructs. RSV promoter failed to driven the EGFP expression. Myo promoter driven EGFP was exclusively expressed in the inner hair cells of the cochlea. When driven by CAG promoter, reporter gene expression was detected in inner hair cells at a dose as low as 3x10(7) genome copies, and continued to increase in a dose-dependent manner. Our data showed that individual promoter has different ability to drive reporter gene expression in the cochlear cells. Our results might provide important information with regard to the role of promoters in regulating transgene expression and for the proper design of vectors for gene expression and gene therapy.

Compare coblation tonsillectomy with blunt dissection tonsillectomy to see if there is any difference in intraoperative bleeding, operating time, postoperative pain, tonsillar fossae healing and return to normal diet and activities.A randomised control trial was carried out to compare coblation tonsillectomy with blunt dissection tonsillectomy in 56 patients. The same surgeon operated on them all, using Arthro Care EVac 70 Wand for coblation tonsillectomy, and routine instruments for blunt dissection tonsillectomy.Coblation tonsillectomy was fast and resulted in little intraoperative bleeding. Significant reduction in postoperative pain was found in the patients with coblation tonsillectomy. Patients who had coblation tonsillectomy returned to their normal diet sooner than those who underwent blunt dissection tonsillectomy. Slower healing of the tonsillar fossae was found in the coblation group. One patient in the coblation group suffered from secondary haemorrhage.Coblation tonsillectomy is easy to perform with little intraoperative bleeding. It offers significant advantages in the postoperative period, with rapid return to a normal diet and reduction in postoperative pain. But it need more time for healing of the tonsillar fossae.

To explore the reason and treatment of cerebrovascular accident on perioperative period of head and neck surgery.We retrospectively analyzed 8 cases. All of them manifested cerebrovascular accident on perioperative period of head and neck surgery.Reasons of cerebrovascular accident on perioperative period of head and neck surgery including rupture of blood vessel or deligation in 3 cases, detachment of the thrombus in 1 case, cerebral hemorrhage in 1 case, complicated causes in 3 cases.Head and neck surgery patients may undergo cerebrovascular accident of perioperative period during surgery, injury or rupture of blood vessels is the most important reason. Avoiding injury the major blood vessels during surgery is key point. But unfortunately, for cases of complicated reason, it is very difficult for the surgeons to prevent patients from those accidents.

To evaluate the efficiency of EGF-R targeted polypeptide gene delivery system and inhibitory effect of p21WAF1 on squamous cell carcinoma of larynx.The EGF-R targeting polypeptide gene delivery system was constructed and a therapeutic gene of p21WAF1 were transfected into Hep-2 cells with the new gene delivery system. The growth curve of transfected Hep-2 cells and flow cytometric analysis were applied to assess the transferring and expression of exogenous genes and inhibitory effect on Hep-2 cells.With the transferring of p21WAF1 gene, the growth of Hep-2 cells was inhibited significantly by 79%, and the apoptosis was observed by means of flow cytometric analysis.EGF-R targeting polypeptide gene delivery system could transfer the therapeutic gene into targeted EGF-R expressing Hep-2 cells and the expression of p21WAF1 could inhibit the growth of Hep-2 cells and induced the cells to apoptosis.

To observe the effect of 125I seeds implants in advanced head and neck cancer.Treatment fields were designed to encompass the tumor/edema volume with a 2-3 cm margin, based on assessment of diagnostic CT images, 125I seeds were inserted into there and permanent left there for brachytherapy in 5 patients with advanced head and neck cancer including recurrent oropharyngeal cancer, supraglottic cancer and occult cancer.Local tumor were controlled evidently and the patients suffering were alleviated, but 1 case occurred skin necrosis and 1 case occurred skin necrosis combined with internal carotid rupture.Permanent 125I implants offer useful pallition for patients with advanced recurrent head and neck cancer but need prevention fatal complication.