Apoptosis in chronic tonsillitis and tonsillar hypertrophy.

Related Articles

Apoptosis in chronic tonsillitis and tonsillar hypertrophy.

Int J Pediatr Otorhinolaryngol. 2015 Feb;79(2):191-5

Authors: Önal M, Yılmaz T, Bilgiç E, Müftüoğlu SF, Kuşçu O, Günaydın RÖ

Abstract
OBJECTIVE: Chronic tonsillitis is the persistent inflammation of the tonsillar tissue that occurs due to recurrent, acute or subclinical infection. The recurrent and chronic inflammation of palatine tonsils sometimes results in hypertrophy. Apoptosis provides an important balance between lymphocytes in tonsillar lymphoid tissue. The aim of this study is to investigate the apoptosis in tonsillar diseases.
METHODS: 43 patients with chronic tonsilitis and tonsillar hypertrophy underwent tonsillectomy. The specimens were examined immunohistochemically for apoptosis. Tonsils were assembled into groups according to their size. Specimens were compared for their apoptotic cell count.
RESULTS: The apoptosis difference between the tonsil size groups is not statistically significant (p>0.05). However, when the study group was divided into two at age 6, the difference was not statistically significant for patients at and below 6 years of age; but, the difference was statistically significant for patients above 6 years of age (p<0.05). The comparison of apoptosis in microcompartments of tonsil tissue (intrafollicular, interfollicular, subepithelial and intraepithelial) between tonsil size stages and between chronic tonsillitis and tonsillar hypertrophy groups revealed no statistical significance (p>0.05). There was a statistically significant positive correlation between intrafollicular and interfollicular, interfollicular and intraepithelial & subepithelial and intraepithelial areas (p<0.05).
CONCLUSIONS: In the light of these findings, it was concluded that apoptosis played a role in the tonsillar hypertrophy and atrophy. Apoptosis functioned to balance lymphocyte proliferation in tonsil tissue. The association of apoptosis with tonsillar hypertrophy seemed to be age-dependent.

PMID: 25555639 [PubMed - indexed for MEDLINE]

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[Impact of Microsurgical Exstirpation of Vestibular Schwannomas on the Sense of Taste].

[Impact of Microsurgical Exstirpation of Vestibular Schwannomas on the Sense of Taste].

Laryngorhinootologie. 2015 Oct 28;

Authors: Boeßert P, Hempel JM, van Ewijk R, Mann WJ, Haxel BR

Abstract
Patients with single sided vestibular schwannoma may report about a taste dysfunction apart from the well known cardinal symptoms. Very few data are published so far on that topic. The aim of this study was to investigate the influence of microsurgery for vestibular schwannomas on taste perception prospectively using a well validated taste test. 25 patients could be included in the study. No ageusia was claimed by the patients. In average a decrease of the taste score postoperatively could be detected on the tumor as well as on the non treated side. The differences were not statistically significant. But a subgroup of ¼ of the subjects revealed a new onset of side difference in the taste score that was not present before surgery. In all those cases the treated side showed a clinically significant reduced taste score of 6,2 in average. Within this subgroup the temporal access was overpresented in contrast to the whole group. This may indicate an influence of the choosen approach and that for the position of the tumor to the change of the taste score. The observations should be verified on a greater collective.

PMID: 26509472 [PubMed - as supplied by publisher]

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Postmarketing Safety Surveillance and Reevaluation of Danhong Injection: Clinical Study of 30888 Cases.

Postmarketing Safety Surveillance and Reevaluation of Danhong Injection: Clinical Study of 30888 Cases.

Evid Based Complement Alternat Med. 2015;2015:610846

Authors: Li XL, Tang JF, Li WX, Li CX, Zhao T, Zhao BC, Wang Y, Zhang H, Chen XF, Xu T, Zhu MJ

Abstract
Traditional Chinese medicine injections (TCMIs) have played an irreplaceable role for treating some clinical emergency, severe illness, and infectious diseases in China. In recent years, the incidence rates of adverse drug reactions (ADRs) of TCMIs have increased year by year. Danhong injection (DHI) is one representative TCMI comprised of Danshen and Honghua for treating cardiovascular and cerebrovascular diseases in clinic. In present study, the postmarketing safety surveillance and reevaluation of DHI were reported. Total 30888 patients in 37 hospitals from 6 provinces participated in the study. The results showed that the ADR incidence rate of DHI was 3.50‰. Seventeen kinds of new adverse reactions of DHI were found. The main type of ADRs of DHI was type A (including sweating, dizziness, headache, flushing, vasodilation, eye hemorrhage, faintness, chest pain, palpitations, breathlessness, anxious, nausea, flatulence, vomiting, hypotension, hypertension, local numbness, dyspnea, joint disease, and tinnitus) accounting for 57.75%. The severities of most ADRs of DHI were mild and moderate reactions accounting for 25.93% and 66.67%, respectively. The main disposition of ADRs of DHI was drug withdrawal and without any treatments. The results can provide basis for amendment and improvement of the instructions of DHI, as well as demonstration and reference for the postmarketing safety surveillance and reevaluation of other TCMIs. And the rationality, scientificity, and safety of clinical applications of TCMIs could be improved.

PMID: 26508981 [PubMed]

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Anatomical relationship between BL23 and the posterior ramus of the L2 spinal nerve.

Anatomical relationship between BL23 and the posterior ramus of the L2 spinal nerve.

Acupunct Med. 2015 Oct 27;

Authors: Umemoto K, Saito T, Naito M, Hayashi S, Yakura T, Steinke H, Nakano T

Abstract
BACKGROUND: The acupuncture point BL23 is located in the region of the posterior ramus of the second lumbar spinal nerve (L2) and has historically been used to treat conditions such as lower back pain, pollakiuria, erectile dysfunction, dysmenorrhoea, tinnitus, and vertigo. Some of these treatment effects have been hypothesised to be mediated by the sympathetic nervous system. It was recently discovered that the posterior ramus of the spinal nerve (PRSN) at L2 forms not two but three branches.
OBJECTIVE: To examine the relationship between the acupuncture point BL23 and the L2 PRSN in order to consider the pathways possibly affected by BL23 acupuncture.
METHODS: Acupuncture needles were inserted through the skin at BL23 to a depth of 3 cm a total of 13 times in eight donor cadavers (seven right-sided, six left-sided). Leaving the needle in place, ventral dissection was performed to determine the PRSN anatomy between the L1 and L3 spinal segments. In four cadavers, the relationship between the L2 spinal nerve and sympathetic branches was additionally evaluated. Following dissection, three-dimensional (3D) data were acquired using a photo scanner and 3D structural images were created using 3D computer graphics software. One additional (female) cadaver was studied without insertion of an acupuncture needle (due to significant scoliosis).
RESULTS: The L2 PRSN was divided into medial, intermediate and lateral branches. The needle inserted at BL23 came to lie in the region of the intermediate or lateral branches in all cases. Rami communicantes were found between the L2 spinal nerve and sympathetic trunk with fibres going on to supply the superior hypogastric plexus.
CONCLUSIONS: Our findings suggest that acupuncture needles inserted at BL23 come into close proximity with the intermediate or lateral branch of the L2 PRSN, which could result in stimulation of both the somatic and sympathetic nervous systems.

PMID: 26508662 [PubMed - as supplied by publisher]

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[Clinical analysis of Ginkgo biloba injection combined with traditional therapy in treatment of explosive deafness].

[Clinical analysis of Ginkgo biloba injection combined with traditional therapy in treatment of explosive deafness].

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2015 Apr;33(4):279-81

Authors: Tan J, Peng H

Abstract
OBJECTIVE: To investigate the clinical efficacy of Ginkgo biloba injection combined with traditional therapy in the treatment of explosive deafness.
METHODS: Fifty-six (98 ears) participants who were all coal miners were selected. These patients were diagnosed with explosive deafness. and admitted to the otolaryngology department of our hospital from May 2010 to October 2013. They were.equally divided into control group and treatment group according to the therapeutic method. The patients in the control group only received traditional therapy, such as hyperbaric oxygen, while the patients in the treatment group were given Ginkgo biloba injection in addition to the therapy for the control group. The improvement in hearing was recorded and compared between the two groups.
RESULTS: The rate of improvement in tinnitus symptom in the treatment group was 78.0% (32/41), significantly higher than that in the control group (55.6%, 25/45) (χ2=4.857, P<0.05); compared with the treatment group (93.5%, 43/46), the control group had a significant lower overall response rate at 76.9% (40/52) (χ2=5.160, P<0.05).
CONCLUSION: Compared with traditional therapy alone, combined ginkgo biloba extract injection and traditional therapy can significantly improve tinnitus symptom and overall response rate in the treatment of explosive deafness in coal miners, which suggests that the combination therapy is worthy of clinical application.

PMID: 26506778 [PubMed - in process]

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The clinical characteristics of congenital laryngeal saccular cysts.

The clinical characteristics of congenital laryngeal saccular cysts.

Acta Otolaryngol. 2015 Oct 27;:1-4

Authors: Xiao Y, Wang J, Ma L, Han D

Abstract
CONCLUSION: The first step when treating newborns and infants with hoarseness and dyspnea is to consider the possibility of CLSCs. The appropriate operation can then be chosen based on the cyst sub-type. Complete resection of the cyst wall is the key to preventing recurrence.
BACKGROUND: A laryngeal saccular cyst is an unusual congenital lesion that appears clinically during the neonatal period or early infancy. Because few reports on congenital laryngeal saccular cysts (CLSCs) exist, this study investigated the clinical features of patients with a history of CLSCs to determine the clinical characteristics of this disease.
METHODS: The data from 28 CLSC patients admitted to Beijing Tongren Hospital from July 2004 to September 2014 were reviewed. Gender, age at onset of symptoms, number of surgical procedures performed, effect of the operation, and CLSC classification were analyzed.
RESULTS: CLSCs accounted for 0.79% of laryngeal operations during the study period. Of the cases examined, 35.7% (10/28) had first been treated as laryngomalacia. With respect to cyst type, 17.9% (5/28) were anterior laryngeal saccular cysts, and 82.1% (23/28) were lateral saccular cysts. The patients underwent a total of 53 surgeries, including 21 procedures performed at other hospitals. The time to recurrence of the cysts following needle aspiration ranged from 5-10 days. The time to recurrence after the roof of the cyst was excised ranged from 1-10 months. There were no recurrences after the complete resection of the cyst wall using a CO2 laser and microsuturing of the wound surfaces via an endoscopic procedure, which is much better than the 41% of endoscopic de-roofing cases which recurred reported by Mitchell et al.

PMID: 26507793 [PubMed - as supplied by publisher]

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Tongue motor training support system.

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Tongue motor training support system.

Conf Proc IEEE Eng Med Biol Soc. 2014;2014:3582-5

Authors: Sasaki M, Onishi K, Nakayama A, Kamata K, Stefanov D, Yamaguchi M

Abstract
In this paper, we introduce a new tongue-training system that can be used for improvement of the tongue's range of motion and muscle strength after dysphagia. The training process is organized in game-like manner. Initially, we analyzed surface electromyography (EMG) signals of the suprahyoid muscles of five subjects during tongue-training motions. This test revealed that four types tongue training motions and a swallowing motion could be classified with 93.5% accuracy. Recognized EMG signals during tongue motions were designed to allow control of a mouse cursor via intentional tongue motions. Results demonstrated that simple PC games could be played by tongue motions, achieving in this way efficient, enjoyable and pleasant tongue training. Using the proposed method, dysphagia patients can choose games that suit their preferences and/or state of mind. It is expected that the proposed system will be an efficient tool for long-term tongue motor training and maintaining patients' motivation.

PMID: 25570765 [PubMed - indexed for MEDLINE]

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Dysphagia Post Subcortical and Supratentorial Stroke.

Dysphagia Post Subcortical and Supratentorial Stroke.

J Stroke Cerebrovasc Dis. 2015 Oct 21;

Authors: Wan P, Chen X, Zhu L, Xu S, Huang L, Li X, Ye Q, Ding R

Abstract
BACKGROUND: Studies have recognized that the damage in the subcortical and supratentorial regions may affect voluntary and involuntary aspects of the swallowing function. The current study attempted to explore the dysphagia characteristics in patients with subcortical and supratentorial stroke.
METHODS: Twelve post first or second subcortical and supratentorial stroke patients were included in the study. The location of the stroke was ascertained by computed tomography and magnetic resonance imaging. The characteristics of swallowing disorder were assessed by video fluoroscopic swallowing assessment/fiberoptic endoscopic evaluation of swallowing. The following main parameters were analyzed: oral transit time, pharyngeal delay time, presence of cricopharyngeal muscle achalasia (CMA), distance of laryngeal elevation, the amounts of vallecular residue and pyriform sinus residue (PSR), and the extent of pharyngeal contraction.
RESULTS: Eighty-three percent of the 12 patients were found suffering from pharyngeal dysphagia, with 50% having 50%-100% PSRs, 50% having pharyngeal delay, and 41.6% cases demonstrating CMA. Simple regression analysis showed PSRs were most strongly associated with CMA. Pharyngeal delay in the study can be caused by infarcts of basal ganglia/thalamus, infarcts of sensory tract, infarcts of swallowing motor pathways in the centrum semiovale, or a combination of the three.
CONCLUSION: Subcortical and supratentorial stroke may result in pharyngeal dysphagia such as PSR and pharyngeal delay. PSR was mainly caused by CMA.

PMID: 26508684 [PubMed - as supplied by publisher]

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Tongue motor training support system.

Related Articles

Tongue motor training support system.

Conf Proc IEEE Eng Med Biol Soc. 2014;2014:3582-5

Authors: Sasaki M, Onishi K, Nakayama A, Kamata K, Stefanov D, Yamaguchi M

Abstract
In this paper, we introduce a new tongue-training system that can be used for improvement of the tongue's range of motion and muscle strength after dysphagia. The training process is organized in game-like manner. Initially, we analyzed surface electromyography (EMG) signals of the suprahyoid muscles of five subjects during tongue-training motions. This test revealed that four types tongue training motions and a swallowing motion could be classified with 93.5% accuracy. Recognized EMG signals during tongue motions were designed to allow control of a mouse cursor via intentional tongue motions. Results demonstrated that simple PC games could be played by tongue motions, achieving in this way efficient, enjoyable and pleasant tongue training. Using the proposed method, dysphagia patients can choose games that suit their preferences and/or state of mind. It is expected that the proposed system will be an efficient tool for long-term tongue motor training and maintaining patients' motivation.

PMID: 25570765 [PubMed - indexed for MEDLINE]

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The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

Related Articles

The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

Acta Otorhinolaryngol Ital. 2014 Apr;34(2):105-10

Authors: Farneti D, Fattori B, Nacci A, Mancini V, Simonelli M, Ruoppolo G, Genovese E

Abstract
This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not significant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team.

PMID: 24843220 [PubMed - indexed for MEDLINE]

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A systematic review of tongue base suspension techniques as an isolated procedure or combined with uvulopalatopharyngoplasty in obstructive sleep apnea.

A systematic review of tongue base suspension techniques as an isolated procedure or combined with uvulopalatopharyngoplasty in obstructive sleep apnea.

Eur Arch Otorhinolaryngol. 2015 Oct 27;

Authors: Bostanci A, Turhan M

Abstract
We aimed to evaluate existing research into the effectiveness and safety of two tongue base suspension (TBS) techniques (Repose(®) system and modified TBS) with or without uvulopalatopharyngoplasty (UPPP) in obstructive sleep apnea. The literature review was performed using PubMed database. Searched terms used included the keywords "sleep apnea", "surgery", "tongue", "tongue base", "suspension", "Repose", "uvulopalatopharyngoplasty", and "hypopharynx". Levels of evidences and grades of recommendations were determined according to the hierarchy proposed by Oxford Centre for Evidence-based Medicine. Seven studies including 113 patients met the eligibility criteria for TBS as a stand-alone procedure. Four of seven studies including 62 patients used the Repose(®), and three studies including 51 patients used the modified TBS. The success rates were higher in the studies that used modified technique (74.5 %) than those that used the Repose(®) (25.8 %), (p < 0.001). Ten studies including 300 patients met the eligibility criteria for TBS combined with UPPP. Seven of ten studies including 176 patients used the Repose(®), and three studies including 124 patients used the modified TBS. The success rates in this group were similar between the modified TBS (73.4 %) and Repose(®) (67.6 %), (p = 0.341). When aggregate data of 413 patients were compared, the modified TBS was found to be associated with significantly higher success rates (73.7 vs. 56.7 %, p < 0.001). The evidence supports primarily grade C recommendations for the benefits of both techniques with or without UPPP; although there is a trend toward improved outcome with modified technique.

PMID: 26507000 [PubMed - as supplied by publisher]

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Translation and validation of EORTC QLQ-H&N 35 into Moroccan Arabic for ENT head and neck cancer patients in Morocco.

Translation and validation of EORTC QLQ-H&N 35 into Moroccan Arabic for ENT head and neck cancer patients in Morocco.

Eur Arch Otorhinolaryngol. 2015 Oct 27;

Authors: Ouattassi N, Benmansour N, ElFakir S, Nejjari C, Alami MN

Abstract
Disease-specific quality of life (QOL) measures have enhanced the capacity of outcome measures to evaluate subtle changes and differences between groups. As many of the QOL measures have been developed in English, they require translation to ensure their usefulness in a multi-cultural and/or international society. Published guidelines provide formal methods to achieve cross-culturally comparable versions of a QOL tool. The aim of this study was to adapt the head and neck specific module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-H&N 35 questionnaire) into Moroccan Arabic and to determine its psychometric properties. After translation, back translation and pretesting of the pre-final version, the translated version was submitted to a committee of professionals composed by otolaryngologists and epidemiologists. The psychometric properties were tested in patients with ENT cancer. Internal consistency was tested using Cronbach's alpha and the test-retest reliability using interclass correlation coefficients. Construct validity was assessed by examining item convergent and divergent validity. It was also tested using Spearman's correlation between QLQ-H&N 35 scales and EQ-5D. The study was conducted in 120 patients. The Moroccan version was internally reliable, Cronbach's α ranged from 0.71 for "trouble with social contact" to 0.94 for "senses impairment", indicating good internal consistency. Test-retest reliability was assessed using the intra-class correlation coefficient, which ranged from 0.64 for "speech trouble" to 0.89 for "physical activities". The instrument demonstrated a good construct and concomitant validity. We have developed a semantically equivalent translation with cultural adaptation of EORTC QLQ-H&N 35 questionnaire. The assessment of its measurement properties showed that it is quite reliable and a valid measure of the effect of cancer on the quality of life in Moroccan patients.

PMID: 26506999 [PubMed - as supplied by publisher]

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Early laryngeal outcome of prolonged intubation using an anatomical tube: a double blind, randomised study.

Early laryngeal outcome of prolonged intubation using an anatomical tube: a double blind, randomised study.

Eur Arch Otorhinolaryngol. 2015 Oct 27;

Authors: Nordang L, Lindholm CE, Larsson J, Linder A

Abstract
The objective of this study was to study the short-term impact on larynx by a newly designed anatomical tube. A prospective randomised trial of a newly designed anatomical tube versus a standard endotracheal tube in patients operated under general anaesthesia for at least 12 h. Seventy adults were included and randomised to either type of tube. The patients were evaluated by means of fibre-optic laryngoscopy and VAS-rating of symptoms on two occasions in the first post-operative week. The evaluating investigators and the patients were blinded to the type of tube used. 27 cases and 23 controls had complete data for evaluation. Age, gender and intubation times were comparable. Symptoms such as hoarseness, coughing, and pain were rated above 30 % of maximum during at least one of the first post-operative days by 21 and 19 patients, respectively. At the first examination (within 24 h), 38 % of patients in the anatomical tube group stated no hoarseness; compared to 13 % of the controls (p = 0.057). Fibre-optic laryngoscopy showed some kind of pathology in all the patients examined within 24 h of extubation. After 3-6 days, seven patients with the anatomical tube and four patients in the control group showed complete resolution of the lesions, and the changes were limited to redness in the vocal process area in another seven and four, respectively. The differences between the groups did not attain statistical significance. The study shows considerable short-term laryngeal morbidity after prolonged intubation, and the anatomical tube only showed an advantage concerning hoarseness. Further improvement of the endotracheal tubes and intubation routines are still needed.

PMID: 26506998 [PubMed - as supplied by publisher]

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Oral Motor Intervention Improved the Oral Feeding in Preterm Infants: Evidence Based on a Meta-Analysis With Trial Sequential Analysis.

Related Articles

Oral Motor Intervention Improved the Oral Feeding in Preterm Infants: Evidence Based on a Meta-Analysis With Trial Sequential Analysis.

Medicine (Baltimore). 2015 Aug;94(31):e1310

Authors: Tian X, Yi LJ, Zhang L, Zhou JG, Ma L, Ou YX, Shuai T, Zeng Z, Song GM

Abstract
Oral feeding for preterm infants has been a thorny problem worldwide. To improve the efficacy of oral feeding in preterm infants, oral motor intervention (OMI), which consists of nonnutritive sucking, oral stimulation, and oral support, was developed. Published studies demonstrated that OMI may be as an alternative treatment to solve this problem; however, these results remain controversial. We conducted a meta-analysis with trial sequential analysis (TSA) to objectively evaluate the potential of OMI for improving the current status of oral feeding in preterm infants.A search of PubMed, EMBASE, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure was performed to capture relevant citations until at the end of October, 2014. Lists of references of eligible studies and reviews were also hand-checked to include any latent studies. Two independent investigators screened literature, extracted data, and assessed the methodology, and then a meta-analysis and TSA was performed by using Reviewer Manager (RevMan) 5.3 and TSA 0.9 beta, respectively.A total of 11 randomized controlled trials (RCTs), which included 855 participants, were incorporated into our meta-analysis. The meta-analyses suggested that OMI is associated with the reduced transition time (ie, the time needed from tube feeding to totally oral feeding) (mean difference [MD], -4.03; 95% confidence interval [CI], -5.22 to -2.84), shorten hospital stays (MD, -3.64; 95% CI, -5.57 to -1.71), increased feeding efficiency (MD, 0.08; 95% CI, 0.36-1.27), and intake of milk (MD, 0.14; 95% CI, 0.06-0.21) rather than weight gain. Results of TSA for each outcomes of interest confirmed these pooled results.With present evidences, OMI can be as an alternative to improve the condition of transition time, length of hospital stays, feeding efficiency, and intake of milk in preterm infants. However, the pooled results may be impaired due to low quality included, and thus, well-designed and large RCTs were needed to further established effects.

PMID: 26252313 [PubMed - indexed for MEDLINE]

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[HPV-associated head and neck cancer : Mutational signature and genomic aberrations].

[HPV-associated head and neck cancer : Mutational signature and genomic aberrations].

HNO. 2015 Oct 27;

Authors: Wagner S, Würdemann N, Hübbers C, Reuschenbach M, Prigge ES, Wichmann G, Hess J, Dietz A, Dürst M, Tinhofer I, von Knebel-Döberitz M, Wittekindt C, Klussmann JP

Abstract
A significantly increasing proportion of oropharyngeal head and neck carcinomas (OSCC) in North America and Europe are associated with human papillomavirus (HPV) infections. HPV-related OSCC is regarded as a distinct tumor type with regard to its cellular, biologic, and clinical characteristics. Patients with HPV-related OSCC have significantly better local control, but higher rates of regional lymph node and distant metastases as compared to patients with HPV-negative OSCC. Classical molecular genetic investigations demonstrated specific chromosomal aberration signatures in HPV-related OSCC, and recent developments in next generation sequencing (NGS) technology have rendered possible the sequencing of entire genomes, and thus detection of specific mutations, in just a few days. Initial data from The Cancer Genome Atlas (TCGA) project obtained by using genome-wide high throughput methods have confirmed that HPV-related OSCC contain fewer, albeit more specific mutations than HPV-negative tumors. Additionally, these data revealed the presence of specific-potentially therapeutically targetable-activating driver mutations in subgroups of HPV-positive OSCC, some of which have a prognostic impact. Specific targeted NGS technologies provide new possibilities for identification of diagnostic, prognostic, and predictive biomarkers and the development of personalized cancer treatment. Patients with HPV-positive tumors are likely to profit from these developments in the future, since the genetic alterations are relatively homogenous and frequently lead to signal pathway activation. There is an urgent need for network research activities to carry out the necessary basic research in prospective cohort studies.

PMID: 26507715 [PubMed - as supplied by publisher]

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[HPV infection in oral, pharyngeal and laryngeal papillomas].

[HPV infection in oral, pharyngeal and laryngeal papillomas].

HNO. 2015 Oct 27;

Authors: Andratschke M, Hagedorn H, Nerlich AG

Abstract
BACKGROUND: HPV infections play a major role in the pathogenesis of squamous cell carcinomas of the head and neck. Regarding benign papillomas, the role of HPV is still uncertain.
MATERIALS AND METHODS: To clarify this issue, 100 exophytic papillomas of the oral cavity, pharynx and larynx were subjected to histopathological and molecular pathological examination. Excision biopsies were taken from 62 male and 38 female patients with an age range of 18 to 87 years. Biopsies were tested for p16 expression by immunohistochemistry and analyzed for HPV subtypes 6/11 (low-risk), 16/18 and 31/33/53 (high-risk) by chromogenic in situ hybridization.
RESULTS: HPV infections were verified molecularly in 34 % of biopsies; in all cases with the low-risk HPV subtypes 6/11. Only one case showed infection with both 6/11 and 31/33/53 subtypes, but not subtype 16/18; whereas expression of p16 was found in 67 %. The rate of positive molecular verification of HPV infection (in situ hybridization) was highest in the laryngeal lesions with 61.1 %, followed by the oral cavity with 52.9 %, and lowest in pharyngeal lesions (21.5 %). Recurrent papillomas were seen in 18 cases (18 %), of which 14  were molecularly positive for HPV (in situ hybridization). A correlation between inflammatory infiltration and HPV infection could be verified in 82 %.
CONCLUSION: Our data demonstrate an important role of HPV infection for the development of benign papillomas of the head and neck region. Furthermore, there is a positive correlation between HPV infection and recurrent papillomas. Therefore, a molecular morphological HPV analysis of papillomas could provide important prognostic data.

PMID: 26507714 [PubMed - as supplied by publisher]

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[Submental artery island flaps for reconstruction in the head and neck region].

[Submental artery island flaps for reconstruction in the head and neck region].

HNO. 2015 Oct 27;

Authors: Bruchhage KL, Wollenberg B, Schröder U

Abstract
BACKGROUND: Reconstruction of defects after extirpation of head and neck neoplasms is a highly challenging and complex surgical undertaking. Commonly used techniques, such as the radial forearm flap or anterior lateral thigh flap, have numerous disadvantages, e.g., donor-site morbidity, poor color match for cutaneous reconstruction, and excessive tissue bulk for intraoral reconstruction. Use of a submental artery island flap is a relatively new and increasingly performed option for reconstruction in the head and neck region.
MATERIALS AND METHODS: From March 2013 to August 2015, 12 patients were treated with a submental island flap after surgical resection of intraoral carcinomas or cutaneous neoplasms of the lower half of the face.
CASE DESCRIPTION: This paper reports on two cases. The first case describes reconstruction of the floor of the mouth using a pull-through technique after resection of a squamous cell carcinoma. The submental flap was pedicled on the contralateral side, since neck dissection of regions I-V had been performed on the ipsilateral side. The second case is a reconstruction of the lower midface with parts of the upper lip, after removal of a cutaneous spinalioma. In a N0 neck, no neck dissection was performed. The flap healed without problems in both patients, leading to a very good functional and cosmetic outcome.
CONCLUSION: The submental island flap demonstrates reliability and versatility for head and neck reconstructions. Its minimal donor site morbidity, excellent cosmetic match, pliability, and relative ease of dissection and application confer a definite advantage over distant flaps.

PMID: 26507713 [PubMed - as supplied by publisher]

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Evaluation of pharyngeal function in dogs with laryngeal paralysis before and after unilateral arytenoid lateralization.

Evaluation of pharyngeal function in dogs with laryngeal paralysis before and after unilateral arytenoid lateralization.

Vet Surg. 2015 Oct 28;

Authors: Andrade N, Kent M, Howerth EW, Radlinsky MG

Abstract
OBJECTIVE: To evaluate pharyngeal and laryngeal function using esophagography, topical pharyngeal/laryngeal sensitivity testing, and electromyography (EMG) in normal and dogs with idiopathic laryngeal paralysis (ILP) before and after unilateral arytenoid lateralization.
STUDY: Prospective controlled cohort study.
ANIMALS: Dogs with laryngeal paralysis (ILP; n = 8) and age/breed-matched (AB, n = 8) and young breed-matched dogs (B, n = 8) were recruited.
METHODS: Evaluation consisted of esophagography, topical pharyngeal/laryngeal sensitivity testing, and electrodiagnostic testing. Esophagography was performed with liquid and canned phases. Pharyngeal and laryngeal sensitivity was tested by applying a cotton-tipped applicator to the mucosa of pharynx/larynx at anesthetic induction. In all dogs, electrophysiological testing included EMG, direct evoked muscle potentials, motor nerve conduction velocities, and F wave testing. These were performed in the thoracic/pelvic limbs, extrinsic laryngeal muscles, epaxial, and masticatory muscles.
RESULTS: Topical pharyngeal and laryngeal sensitivity testing was decreased in LP dogs compared with age-matched healthy control dogs. Esophagram showed dysmotility in the cranial and caudal esophagus. Gastroesophageal reflux was significantly higher in ILP dogs compared with the other 2 groups (P < .03). In all affected dogs, EMG abnormalities were limited to the interosseous muscles of both pelvic and thoracic limbs bilaterally.
CONCLUSION: Dogs with ILP not only have recurrent laryngeal nerve (RLN) and pararecurrent laryngeal nerve (pRLN) dysfunction, but may also have concurrent cranial laryngeal nerve dysfunction.

PMID: 26509938 [PubMed - as supplied by publisher]

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Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion.

Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion.

Respir Med. 2015 Oct 22;

Authors: Hartley NA, Petty BE, Johnson B, Thibeault SL

Abstract
BACKGROUND: Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis.
METHODS: Self-reported medical questionnaires, demographic and lifestyle attributes of CC and PVFM cases from a disease-specific outcomes database were compared to US population data and published normative values. Univariate comparison and multivariate regression modelling of age, sex, alcohol intake, smoking, Reflux Symptom Index (RSI), Voice Handicap Index (VHI), and Generalized Anxiety Disorder 7-item Scale (GAD-7) determined distinguishing features between the clinical groups, including odds ratios for presenting with CC versus PVFM.
RESULTS: Clinical profiles developed from 283 (128 CC, 155 PVFM) adults (18-91years) were significantly different from the general population across each demographic, lifestyle and clinical variable (all p < .01), with the exception of obesity. Age (55.39 ± 13.54 vs 45.07 ± 16.51years, p < .01) and mean RSI score (21.5 ± 9.02 vs 18.1 ± 9.08, p < .01) most reliably distinguished CC from PVFM, with those aged 60-69 years (OR = 9.45) most likely to be diagnosed with CC.
CONCLUSIONS: Standard clinical profiles of CC and PVFM are distinct from the general population, aiding determination of relative probabilities and risk factors in the differential diagnostic process. Variations between CC and PVFM were subtle, reliably distinguished by age and relative severity of laryngopharyngeal reflux symptomatology.

PMID: 26507903 [PubMed - as supplied by publisher]

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[HPV infection in oral, pharyngeal and laryngeal papillomas].

[HPV infection in oral, pharyngeal and laryngeal papillomas].

HNO. 2015 Oct 27;

Authors: Andratschke M, Hagedorn H, Nerlich AG

Abstract
BACKGROUND: HPV infections play a major role in the pathogenesis of squamous cell carcinomas of the head and neck. Regarding benign papillomas, the role of HPV is still uncertain.
MATERIALS AND METHODS: To clarify this issue, 100 exophytic papillomas of the oral cavity, pharynx and larynx were subjected to histopathological and molecular pathological examination. Excision biopsies were taken from 62 male and 38 female patients with an age range of 18 to 87 years. Biopsies were tested for p16 expression by immunohistochemistry and analyzed for HPV subtypes 6/11 (low-risk), 16/18 and 31/33/53 (high-risk) by chromogenic in situ hybridization.
RESULTS: HPV infections were verified molecularly in 34 % of biopsies; in all cases with the low-risk HPV subtypes 6/11. Only one case showed infection with both 6/11 and 31/33/53 subtypes, but not subtype 16/18; whereas expression of p16 was found in 67 %. The rate of positive molecular verification of HPV infection (in situ hybridization) was highest in the laryngeal lesions with 61.1 %, followed by the oral cavity with 52.9 %, and lowest in pharyngeal lesions (21.5 %). Recurrent papillomas were seen in 18 cases (18 %), of which 14  were molecularly positive for HPV (in situ hybridization). A correlation between inflammatory infiltration and HPV infection could be verified in 82 %.
CONCLUSION: Our data demonstrate an important role of HPV infection for the development of benign papillomas of the head and neck region. Furthermore, there is a positive correlation between HPV infection and recurrent papillomas. Therefore, a molecular morphological HPV analysis of papillomas could provide important prognostic data.

PMID: 26507714 [PubMed - as supplied by publisher]

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Vascularized composite allotransplantation: a new concept in musculoskeletal regeneration.

Vascularized composite allotransplantation: a new concept in musculoskeletal regeneration.

J Mater Sci Mater Med. 2015 Dec;26(12):266

Authors: Siemionow M

Abstract
Over the past 20 years, the fields of biomaterial sciences and tissue engineering have evolved into new clinically relevant applications including regenerative medicine and cell based therapies. Tissue engineering therapies are based on different types of materials and scaffolds combined with cells and submitted to engineering processes in order to create bio-scaffolds which will improve or replace biological functions. Despite the effort, only a few therapies, such as bone, cartilage and nerve, succeeded in clinical applications. Furthermore, the major drawback in standard application of these therapies was the critical size defects which could be covered with engineered materials, as well as inability to provide sustainable vascular supply to the created bio-scaffolds. In 1998, the first successful hand transplantation was performed in France, and the field of vascularized composite allotransplantation (VCA) was introduced into the armamentarium of reconstructive surgery (Dubernard in Am J Transplant 5(6):1580-1, 2005; Petruzzo et al. in Am J Transplant 6(7):1718-24, 2006; Lanzetta et al. in Transplantation 79(9):1210-4, 2005). As a result, a new generation of transplants including hand, face, larynx abdominal wall, lower extremities and penile transplantation became available to patients who had lost these unique organs and were previously unable to achieve restored function using standard reconstructive procedures. Ethical debate on the need for life-long immunosuppressive therapy to prevent rejection of the VCA overshadowed the success of face and hand transplants. Thus, a new, challenging opportunity developed to combine approaches of tissue engineering and regenerative medicine and ultimately restore the framework, function, aesthetics and survival of the VSA transplants. This overview presents the unique opportunities of merging established and new technologies into the burgeoning field of reconstructive transplantation.

PMID: 26507199 [PubMed - in process]

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Early laryngeal outcome of prolonged intubation using an anatomical tube: a double blind, randomised study.

Early laryngeal outcome of prolonged intubation using an anatomical tube: a double blind, randomised study.

Eur Arch Otorhinolaryngol. 2015 Oct 27;

Authors: Nordang L, Lindholm CE, Larsson J, Linder A

Abstract
The objective of this study was to study the short-term impact on larynx by a newly designed anatomical tube. A prospective randomised trial of a newly designed anatomical tube versus a standard endotracheal tube in patients operated under general anaesthesia for at least 12 h. Seventy adults were included and randomised to either type of tube. The patients were evaluated by means of fibre-optic laryngoscopy and VAS-rating of symptoms on two occasions in the first post-operative week. The evaluating investigators and the patients were blinded to the type of tube used. 27 cases and 23 controls had complete data for evaluation. Age, gender and intubation times were comparable. Symptoms such as hoarseness, coughing, and pain were rated above 30 % of maximum during at least one of the first post-operative days by 21 and 19 patients, respectively. At the first examination (within 24 h), 38 % of patients in the anatomical tube group stated no hoarseness; compared to 13 % of the controls (p = 0.057). Fibre-optic laryngoscopy showed some kind of pathology in all the patients examined within 24 h of extubation. After 3-6 days, seven patients with the anatomical tube and four patients in the control group showed complete resolution of the lesions, and the changes were limited to redness in the vocal process area in another seven and four, respectively. The differences between the groups did not attain statistical significance. The study shows considerable short-term laryngeal morbidity after prolonged intubation, and the anatomical tube only showed an advantage concerning hoarseness. Further improvement of the endotracheal tubes and intubation routines are still needed.

PMID: 26506998 [PubMed - as supplied by publisher]

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Transoral laser microsurgery for recurrent laryngeal carcinoma after primary treatment: A systematic review and meta-analysis.

Transoral laser microsurgery for recurrent laryngeal carcinoma after primary treatment: A systematic review and meta-analysis.

J Cancer Res Ther. 2015 Aug;11 Suppl:c173-8

Authors: Zhong A, Xu X, Fan H, Wang L, Niu Y

Abstract
PURPOSE: To evaluate the efficacy and oncologic outcomes of transoral laser microsurgery (TLM) for recurrent laryngeal carcinoma after previous treatment.
MATERIALS AND METHODS: A systematic search in PubMed was performed using mesh word for "laryngeal cancer," crossed with "recurrent," and "TLM." The primary endpoints, including overall survival (OS) rate, local control rate, and disease-specific survival (DSS) were summarized using RevMan software. Adverse events and complications were recorded if reported.
RESULTS: The pooled odds ratios (ORs) for main outcomes, including local control, 5-year OS, and DSS were 3.08 (95% confidential indexed [95% CI], 1.88-5.05), 2.29 (95% CI, 1.42-3.67), and 5.05 (95% CI, 2.75-9.27), respectively. The pooled OR for functional outcome, larynx preservation, was 3.82 (95% CI, 2.46-5.94), whereas the pooled risk difference of local recurrence was 45% (95% CI, 26-64%).
CONCLUSIONS: It seems that TLM is an effective option for recurrent laryngeal cancer with regard to the high incidence of OS, local control, and especially organ preservation. However, more prospective studies are needed to confirm its efficiency.

PMID: 26506871 [PubMed - in process]

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A20 controls intestinal homeostasis through cell-specific activities.

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A20 controls intestinal homeostasis through cell-specific activities.

Nat Commun. 2014;5:5103

Authors: Vereecke L, Vieira-Silva S, Billiet T, van Es JH, Mc Guire C, Slowicka K, Sze M, van den Born M, De Hertogh G, Clevers H, Raes J, Rutgeerts P, Vermeire S, Beyaert R, van Loo G

Abstract
The transcription factor NF-κB is indispensable for intestinal immune homeostasis, but contributes to chronic inflammation and inflammatory bowel disease (IBD). A20, an inhibitor of both NF-κB and apoptotic signalling, was identified as a susceptibility gene for multiple inflammatory diseases, including IBD. Despite absence of spontaneous intestinal inflammation in intestinal epithelial cell (IEC) specific A20 knockout mice, we found additional myeloid-specific A20 deletion to synergistically drive intestinal pathology through cell-specific mechanisms. A20 ensures intestinal barrier stability by preventing cytokine-induced IEC apoptosis, while A20 prevents excessive cytokine production in myeloid cells. Combining IEC and myeloid A20 deletion induces ileitis and severe colitis, characterized by IEC apoptosis, Paneth and goblet cell loss, epithelial hyperproliferation and intestinal microbiota dysbiosis. Continuous epithelial cell death and regeneration in an inflammatory environment sensitizes cells for neoplastic transformation and the development of colorectal tumours in aged mice.

PMID: 25267258 [PubMed - indexed for MEDLINE]

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Manikin model with breathing tube for wire-guided percutaneous cricothyrotomy in patients applying an intermaxillary fixation.

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Manikin model with breathing tube for wire-guided percutaneous cricothyrotomy in patients applying an intermaxillary fixation.

J Craniofac Surg. 2014 Sep;25(5):1846-8

Authors: Hwang K, Kim HJ, Kim YC, Choi YS, Hwang SW

Abstract
Jaw fracture surgery or orthognathic surgery usually involves the application of an intermaxillary fixation (IMF). Obstructions that cannot be relieved by suction require an immediate release of IMF wires, but releasing the IMF may damage the surgical alignment of the facial bones. The mean time taken to release the jaws was an average of 2 minutes 9 seconds by hospital staff involved in caring for these patients. The aims of this study were to introduce a training model for wire-guided percutaneous cricothyrotomy in the patients applying an IMF and to perform the procedure for medical students. Our model consisted of a facial mannequin, a plastic breathing tube, 2 rolls of tapes, and a reservoir bag. The inner parts of the 2 used rolls of tape represent tracheal/cricoid rings (1-inch width for thyroid and half-inch width for cricoid), and the space between them represents the cricothyroid membrane, which is wrapped with Peha-Haft. A surgeon demonstrated the technique on the model, and then, 60 medical students who had never attended airway-training courses applied the Melker cricothyrotomy kit on the model. All 60 students completed the procedure successfully. The mean (SD) time needed to insert a cricothyrotomy catheter of the medical students was 175 (50) seconds (range, 76-297 s). Most of the students (54; 90%) performed it within 4 minutes; more than half (33; 55%), within 3 minutes. With our manikin model and Melker cricothyrotomy kit, 60 medical students completed the procedure successfully. This model can be useful to cricothyrotomy training for medical personnel.

PMID: 25203581 [PubMed - indexed for MEDLINE]

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Quantitative measurement of vocal fold vibration in male radio performers and healthy controls using high-speed videoendoscopy.

Related Articles

Quantitative measurement of vocal fold vibration in male radio performers and healthy controls using high-speed videoendoscopy.

PLoS One. 2014;9(6):e101128

Authors: Warhurst S, McCabe P, Heard R, Yiu E, Wang G, Madill C

Abstract
PURPOSE: Acoustic and perceptual studies show a number of differences between the voices of radio performers and controls. Despite this, the vocal fold kinematics underlying these differences are largely unknown. Using high-speed videoendoscopy, this study sought to determine whether the vocal vibration features of radio performers differed from those of non-performing controls.
METHOD: Using high-speed videoendoscopy, recordings of a mid-phonatory/i/ in 16 male radio performers (aged 25-52 years) and 16 age-matched controls (aged 25-52 years) were collected. Videos were extracted and analysed semi-automatically using High-Speed Video Program, obtaining measures of fundamental frequency (f0), open quotient and speed quotient. Post-hoc analyses of sound pressure level (SPL) were also performed (n = 19). Pearson's correlations were calculated between SPL and both speed and open quotients.
RESULTS: Male radio performers had a significantly higher speed quotient than their matched controls (t = 3.308, p = 0.005). No significant differences were found for f0 or open quotient. No significant correlation was found between either open or speed quotient with SPL.
DISCUSSION: A higher speed quotient in male radio performers suggests that their vocal fold vibration was characterised by a higher ratio of glottal opening to closing times than controls. This result may explain findings of better voice quality, higher equivalent sound level and greater spectral tilt seen in previous research. Open quotient was not significantly different between groups, indicating that the durations of complete vocal fold closure were not different between the radio performers and controls. Further validation of these results is required to determine the aetiology of the higher speed quotient result and its implications for voice training and clinical management in performers.

PMID: 24971625 [PubMed - indexed for MEDLINE]

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Anterior Transpetrosal Approach Combined with Partial Posterior Petrosectomy for Petroclival Meningiomas with Posterior Extension.

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Anterior Transpetrosal Approach Combined with Partial Posterior Petrosectomy for Petroclival Meningiomas with Posterior Extension.

World Neurosurg. 2015 Aug;84(2):574-9

Authors: Shibao S, Borghei-Razavi H, Orii M, Yoshida K

Abstract
BACKGROUND: An anterior transpetrosal approach (ATPA) is suitable for treating upper petroclival lesions. However, the limit of the ATPA is reached when the tumor extends posterolaterally over the internal auditory canal (IAC) along the petrous edge. In such cases, ligation of the posterior part of the superior petrosal sinus (SPS) is necessary. To overcome this limitation, we combined the ATPA with a partial posterior petrosectomy in 8 patients who had petroclival meningiomas extending posterolaterally over the IAC.
METHODS: We resected only the Trautmann triangle in addition to the Kawase triangle to secure the space to ligate the posterior portion of the SPS. Because the tympanic cavity and bony labyrinth of the ear were not exposed, we were able to preserve hearing function and lower the risk of cerebrospinal fluid leakage. Furthermore, this approach enables easy ligation of the SPS and the tentorium posterior to the tumor attachment. This combined technique also allows visualization of the petrosal vein, which is important for surgery of the posterior fossa.
RESULTS: Total and near-total tumor removal was achieved in 6 patients (75%) with no permanent complications and no cerebrospinal fluid leakage. Postoperative hearing impairment was not found in any of the patients who underwent this surgery.
CONCLUSIONS: The ATPA combined with partial posterior petrosectomy is an effective method for removal of complicated petroclival meningiomas that extend posterolaterally over the IAC along the petrous edge.

PMID: 25841755 [PubMed - indexed for MEDLINE]

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Deciding factors in the treatment of Class II division 1 cases with and without single-jaw extractions.

Related Articles

Deciding factors in the treatment of Class II division 1 cases with and without single-jaw extractions.

Int Orthod. 2014 Jun;12(2):239-48

Authors: Afaf HD, Bahije L, Zaoui F, Abouqal R, Rerhrhaye W

Abstract
Extraction of two upper premolars in Class II division 1 occlusions often constitutes a therapeutic compromise for the orthodontic practitioner. The aim of our study was to compare the initial occlusal and cephalometric severity of Class II division 1 malocclusions in two groups of patients treated with and without extraction of two upper premolars and thus determine the factor or factors determining this therapeutic option. Examination of the casts and cephalometric analysis of 31 patients presenting a Class II division 1 malocclusion were made. The non-extraction group comprised 16 patients and the group undergoing extraction of two upper premolars comprised 15 patients. Discriminant analysis was applied using binary decision trees in order to identify the variable which best distinguished the two groups. Maxillary incisor-canine crowding was selected to discriminate between the patients at pretreatment stage; 93.5% of the patients were correctly classified using this factor.

PMID: 24820698 [PubMed - indexed for MEDLINE]

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The clinical characteristics of congenital laryngeal saccular cysts.

The clinical characteristics of congenital laryngeal saccular cysts.

Acta Otolaryngol. 2015 Oct 27;:1-4

Authors: Xiao Y, Wang J, Ma L, Han D

Abstract
CONCLUSION: The first step when treating newborns and infants with hoarseness and dyspnea is to consider the possibility of CLSCs. The appropriate operation can then be chosen based on the cyst sub-type. Complete resection of the cyst wall is the key to preventing recurrence.
BACKGROUND: A laryngeal saccular cyst is an unusual congenital lesion that appears clinically during the neonatal period or early infancy. Because few reports on congenital laryngeal saccular cysts (CLSCs) exist, this study investigated the clinical features of patients with a history of CLSCs to determine the clinical characteristics of this disease.
METHODS: The data from 28 CLSC patients admitted to Beijing Tongren Hospital from July 2004 to September 2014 were reviewed. Gender, age at onset of symptoms, number of surgical procedures performed, effect of the operation, and CLSC classification were analyzed.
RESULTS: CLSCs accounted for 0.79% of laryngeal operations during the study period. Of the cases examined, 35.7% (10/28) had first been treated as laryngomalacia. With respect to cyst type, 17.9% (5/28) were anterior laryngeal saccular cysts, and 82.1% (23/28) were lateral saccular cysts. The patients underwent a total of 53 surgeries, including 21 procedures performed at other hospitals. The time to recurrence of the cysts following needle aspiration ranged from 5-10 days. The time to recurrence after the roof of the cyst was excised ranged from 1-10 months. There were no recurrences after the complete resection of the cyst wall using a CO2 laser and microsuturing of the wound surfaces via an endoscopic procedure, which is much better than the 41% of endoscopic de-roofing cases which recurred reported by Mitchell et al.

PMID: 26507793 [PubMed - as supplied by publisher]

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