Objective:Through integrated bioinformatics analysis,the goal of this work was to find new,characterised N7-methylguanosine modification-related long non-coding RNAs(m7G-lncRNAs)that might be used to predict the progn...Objective:Through integrated bioinformatics analysis,the goal of this work was to find new,characterised N7-methylguanosine modification-related long non-coding RNAs(m7G-lncRNAs)that might be used to predict the prognosis of laryngeal squamous cell carcinoma(LSCC).Methods:The clinical data and LSCC gene expression data for the current investigation were initially retrieved from the TCGA database&sanitised.Then,using co-expression analysis of m7G-associated mRNAs&lncRNAs&differential expression analysis(DEA)among LSCC&normal sample categories,we discovered lncRNAs that were connected to m7G.The prognosis prediction model was built for the training category using univariate&multivariate COX regression&LASSO regression analyses,&the model’s efficacy was checked against the test category data.In addition,we conducted DEA of prognostic m7G-lncRNAs among LSCC&normal sample categories&compiled a list of co-expression networks&the structure of prognosis m7G-lncRNAs.To compare the prognoses for individuals with LSCC in the high-&low-risk categories in the prognosis prediction model,survival and risk assessments were also carried out.Finally,we created a nomogram to accurately forecast the outcomes of LSCC patients&created receiver operating characteristic(ROC)curves to assess the prognosis prediction model’s predictive capability.Results:Using co-expression network analysis&differential expression analysis,we discovered 774 m7G-lncRNAs and 551 DEm7G-lncRNAs,respectively.We then constructed a prognosis prediction model for six m7G-lncRNAs(FLG−AS1,RHOA−IT1,AC020913.3,AC027307.2,AC010973.2 and AC010789.1),identified 32 DEPm7G-lncRNAs,analyzed the correlation between 32 DEPm7G-lncRNAs and 13 DEPm7G-mRNAs,and performed survival analyses and risk analyses of the prognosis prediction model to assess the prognostic performance of LSCC patients.By displaying ROC curves and a nomogram,we finally checked the prognosis prediction model's accuracy.Conclusion:By creating novel predictive lncRNA signatures for clinical diagnosis&therapy,our findings will contribute to understanding the pathogenetic process of LSCC.展开更多
BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior lar...BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior laryngeal nerve,which leads to several complications such as throat pain,and cough.CASE SUMMARY Patient concerns:A 52-year old woman presented with a 70 d history of throat pain and a 67 d history of non-productive cough.Three days after onset of pain,she was diagnosed with laryngeal herpes zoster.Flexible nasolaryngoscopy revealed multiple white ulcerated lesions on the left hemi epiglottis and the left supraglottic area.She was prescribed with 750 mg famciclovir a day for 7 d,and 150 mg pregabalin,100 mg tramadol and 10 mg nortriptyline a day for 67 d.However,despite of these medications,she complained of pain and persistent cough.Therefore,superior laryngeal nerve block under ultrasound guidance was performed.Three days after the intervention,the throat pain and cough disappeared.The patient remained symptom-free at 3 mo follow-up.CONCLUSION A superior laryngeal nerve block can be an effective option for treatment of pain and cough following laryngeal herpes zoster.展开更多
Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or po...Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.展开更多
Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The...Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients (60.97%). Histologically, it was a squamous cell carcinoma in 205 patients (95.34%). The most site invaded by the tumor was cricoid cartilage.T4 type was most found (45 patients or 40.90%) followed by the T3 type with 34.55%. There was no lymphadenopathy invasion (Type N0) in 74 patients (67.27%), capsular rupture was reported in five patients (6.77%), no evaluable metastasis in 110 patients (97.27%), and stage IVA predominated in 66 patients (60%). Conclusion: laryngeal cancer is a reality in our contexts, however, its incidence is poorly understood in Senegal. The main risk factors remain tobacco and alcohol. Histology confirms the diagnosis. Its management is multidisciplinary and must be early.展开更多
Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report t...Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report the case of a 77-year-old woman, with no reported pathological history. She also has no alcohol or tobacco intoxication, who presented with chronic dysphonia evolving for 2 months, associated with an altered general condition. The examination of the larynx by direct laryngoscopy and anatomical pathology study of the biopsies led to the diagnosis of laryngeal tuberculosis. A search for secondary sites revealed a concomitant pulmonary infection. The evolution was favorable under standard anti-tuberculosis treatment, with complete voice recovery and improved performance status. Laryngeal tuberculosis should be suspected in patients living in endemic areas and suffering from chronic dysphonia, even if they are not alcoholics or smokers.展开更多
BACKGROUND Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm.AIM To evaluate the circulating immune population and develop a nomogram for prediction of...BACKGROUND Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm.AIM To evaluate the circulating immune population and develop a nomogram for prediction of malignancy in patients with laryngeal neoplasm.METHODS A primary cohort of 156 patients was divided into laryngeal benign lesion,premalignant lesion and malignant lesion groups.Peripheral blood from patients was measured by blood routine test and flow cytometry.A nomogram was developed and applied to a validation cohort containing 55 consecutive patients.RESULTS Age,gender and seven circulating immune parameters exhibited significant differences between laryngeal benign lesion and premalignant lesion.The nomogram incorporated predictors,including gender,age,smoke index,proportions of monocytes,CD8+T cells,CD4+T cells,B cells and CD4/CD8+T cell ratio.It showed good discrimination between laryngeal premalignant lesion and malignant lesion,with a C-index of 0.844 for the primary cohort.Application of this nomogram in the validation cohort(C-index,0.804)still had good discrimination and good calibration.Decision curve analysis revealed that the nomogram was clinically useful.CONCLUSION This novel nomogram,incorporating both clinical risk factors and circulating immune parameters,could be appropriately applied in preoperative individualized prediction of malignancy in patients with laryngeal neoplasm.展开更多
Objective: To assess the efficacy of coblation in treating laryngeal papillomatosis and its effect on post operative voice outcome. Study Design: This is a retrospective study. Setting: Tertiary referral centre. Subje...Objective: To assess the efficacy of coblation in treating laryngeal papillomatosis and its effect on post operative voice outcome. Study Design: This is a retrospective study. Setting: Tertiary referral centre. Subjects and Methods: All the patients diagnosed with laryngeal papillomatosis between January 2013 to December 2016 were included in this study. Preoperative assessment was done with rigid and flexible laryngoscopy. PRAAT software was used for voice analysis. All patients underwent coblation assisted microlaryngeal surgery. Post operatively patients were followed up at 1 week, 15 days, 1 month, 3 months and 6 months with rigid laryngoscopy. Voice analysis was repeated after 3 months to assess the improvement in voice. Results: Coblation was found to be effective in treating laryngeal papillomatosis. In our series of seven patients, three patients underwent repeat procedure with coblation for recurrence. But longterm follow up these patients did not reveal any recurrence of laryngeal papillomatosis. Voice analysis revealed a significant improvement in measures of perturbation and maximum phonation time. Conclusion: Coblation is a promising alternative to the conventional methods for the treatment of laryngeal papillomas as it can achieve satisfactory disease clearance with good voice quality.展开更多
Objective: Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015.Methods: Data submitted from 501 cancer registries were checked and evaluated according to the criteria ...Objective: Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015.Methods: Data submitted from 501 cancer registries were checked and evaluated according to the criteria of data quality control and 368 registries’ data were qualified for the final analysis. Data were stratified by area(urban/rural), sex, age group and combined with national population data to estimate laryngeal cancer incidence and mortality in China, 2015. China population census in 2000 and Segi’s population were used for agestandardized.Results: The percentage of cases morphological verified(MV%) of laryngeal cancer was 74.18%. The percentage of death certificate-only cases(DCO%) was 2.10%. And the mortality to incidence(M/I) ratio was 0.55.About 25,300 new cases of laryngeal cancer were diagnosed in 2015 and 13,700 deaths were reported. The crude rate of laryngeal cancer was 1.84 per 100,000(males and females were 3.20 and 0.42 per 100,000, respectively).Age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 1.18 and 1.19 per 100,000, respectively. The cumulative incidence rate(0-74 years old) was 0.15%.The crude mortality rate was 1.00 per 100,000. Age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 0.61 and 0.61 per 100,000, respectively, with the cumulative rate(0-74 years old) was 0.07%. Incidence and mortality of laryngeal cancer in males were higher than those in females. And the rates in urban areas were higher than those in rural areas.Conclusions: The incidence and mortality of laryngeal cancer in China were low. And the rates were significantly higher in males than in females. Risk factor control and targeted prevention should be strengthened.展开更多
Objective: To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion. Methods: Laryngeal squamous cell carcinoma and paracancerous normal tissu...Objective: To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion. Methods: Laryngeal squamous cell carcinoma and paracancerous normal tissues were collected, total RNA was extracted from tissues, survivin, p53 and Ki-67 gene m RNA expression levels in laryngeal cancer and the adjacent tissues were detected by Real-time PCR. Human laryngeal cancer Hep-2 epithelial cells were selected, survivin gene was overexpressed, and cell proliferation was detected by MTT. p53 and Ki-67 gene expression changes in overexpressed survivin gene were detected by Western blot. Changes in Hep-2 cell invasive ability were studied when survivin was overexpressed as detected by Transwell invasion assay. Results: In the adjacent tissues, survivin, p53 and Ki-67 gene relative expression levels were 1.72 ± 0.9, 13.7 ± 5.7 and 5.7 ± 1.3, respectively; while in cancer tissues, gene relative expression levels were 53.7 ± 8.3, 66.7 ± 5.2 and 61.0 ± 3.1, respectively, which was significantly increased. As detected by MTT, relative cell survival rate within 12 h of survivin overexpression were: load control group,(88.5±1.6)%; overexpressed group,(90.3±1.9)%. Transwell invasion assay results indicated that overexpressed survivin could significantly increase the relative survival rate of cells. Conclusions: Expressions of p53, Ki67 and survivin are increased in cancer; and there is a positive correlation between survivin, p53 and Ki67 expressions in laryngeal carcinoma.展开更多
Objective: To discuss the effect and mechanism of miR-34 a on the proliferation, apoptosis and invasion of laryngeal carcinoma cells. Methods: The laryngeal squamous carcinoma Hep2 cells were transiently transfected w...Objective: To discuss the effect and mechanism of miR-34 a on the proliferation, apoptosis and invasion of laryngeal carcinoma cells. Methods: The laryngeal squamous carcinoma Hep2 cells were transiently transfected with miR-34 a mimics and miR-34 a NC. The MTT, colony-forming assay, Hoechst staining and Annexin V-PI double staining flow cytometry were employed to detect the effect of miR-34 a on the viability and apoptosis of laryngeal squamous carcinoma Hep2 cells; Transwell assay to defect the effect of miR-34 a on the migration and invasion of laryngeal squamous carcinoma Hep2 cells; western blot and RTPCR assay to defect the effect of miR-34 a mimics on the expression of survivin and Ki-67 m RNA in laryngeal squamous carcinoma Hep2 cells. Results: Compared with miR-34 a NC group, the cell viability in miR-34 mimics group was significantly decreased(P<0.01), the cell apoptosis rate was significantly increased(P<0.01), the abilities of cell migration and invasion were significantly reduced(P<0.01) and the expression of survivin and Ki-67 m RNA was significantly decreased(P<0.01). Conclusions: The increased expression of miR-34 a can induce the apoptosis of Hep2 laryngeal carcinoma cells and inhibit the cell proliferation and invasion, which is related to the down-regulated expression of survivin and Ki-67.展开更多
Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway(LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway du...Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway(LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway during general anesthesia. Use of LMA has some advantages when compared to endotracheal intubation, such as quick and ease of placement, a lesser requirement for neuromuscular blockade and a lower incidence of postoperative morbididy. However, the use of the LMA in laparoscopy is controversial, based on a concern about increased risk of regurgitation and pulmonary aspiration. The ability of these devices to provide optimal ventilation during laparoscopic procedures has been also questioned. The most important parameter to secure an adequate ventilation and oxygenation for the LMA under pneumoperitoneum condition is its seal pressure of airway. A good sealing pressure, not only state correct patient ventilation, but it reduces the potential risk of aspiration due to the better seal of airway. In addition, the LMAs incorporating a gastric access, permitting a safe anesthesia based on these commented points. We did a literature search to clarify if the use of LMA in preference to intubation provides inadequate ventilation or increase the risk of aspiration in patients undergoing laparoscopic cholecystectomy. We found evidence stating that LMA with drain channel achieves adequate ventilation for these procedures. Limited evidence was found to consider these devices completely safe against aspiration. However, we observed that the incidence of regurgitation and aspiration associated with the use of the LMA in laparoscopic surgery is very low.展开更多
BACKGROUND In esophageal squamous carcinoma,lymphadenectomy along the left recurrent laryngeal nerve(RLN)is recommended owing to its highly metastatic potential.However,this procedure is difficult due to limited worki...BACKGROUND In esophageal squamous carcinoma,lymphadenectomy along the left recurrent laryngeal nerve(RLN)is recommended owing to its highly metastatic potential.However,this procedure is difficult due to limited working space in the left upper mediastinum,and increases postoperative complications.AIM To present a novel method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the semi-prone position.METHODS The fundamental concept of this novel method is to exfoliate a bilateral pedicled nerve flap,which is a two-dimensional membrane,which includes the left RLN,lymph nodes(LNs)along the left RLN,and tracheoesophageal vessels,by suspending the esophagus to the dorsal side and pushing the trachea to the ventral side(named“bilateral exposure method”).Then,the hollow-out method is performed to transform the two-dimensional membrane to a three-dimensional structure,in which the left RLN and tracheoesophageal vessels are easily distinguished and preserved during lymphadenectomy along the left RLN.This novel method was retrospectively evaluated in 116 consecutive patients with esophageal squamous carcinoma from August 2016 to February 2018.RESULTS There were 58 patients in each group.No significant difference was found between the two groups in terms of age,gender,postoperative pneumonia,anastomotic fistula,and postoperative hospitalization.However,the number of dissected LNs along the left RLN in this novel method was significantly higher than that in the conventional method(4.17±0.359 vs 2.93±0.463,P=0.0447).Moreover,the operative time and the rate of postoperative hoarseness in the novel method were significantly lower than those in the conventional method(306.0±6.774 vs 335.2±7.750,P=0.0054;4/58 vs 12/58,P=0.0312).CONCLUSION This novel method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the semi-prone position is much safer and more effective.展开更多
In order to provide evidence for evidence-based medicine in the treatment and prognosis of laryngeal cancer in China, the meta-analysis electronically retrieved the case-control studies published in China about the Su...In order to provide evidence for evidence-based medicine in the treatment and prognosis of laryngeal cancer in China, the meta-analysis electronically retrieved the case-control studies published in China about the Survivin expression and its association with clinical pathological features in the tissues of laryngeal carcinoma. The results showed that a total of 25 case-control studies were finally included with 1333 cases of laryngeal cancer and 528 cases of controls. The difference in the expression of Survivin between the two groups was statistically significant [OR=18.34, 95% CI(11.82, 28.47), P<0.00001]. The difference in the expression of Survivin between laryngeal carcinoma patients with lymph node metastasis or not was statistically significant [OR=0.25, 95% CI(0.17, 0.37), P<0.00001]. The expression of Survivin in clinical Ⅰ–Ⅱ stage group was significantly lower than in the clinical stage Ⅲ–Ⅳ group [OR=0.24, 95% CI(0.18, 0.32), P<0.00001]. The expression of Survivin in patients with low/medium differentiation was significantly lower than that in those with high differentiation [OR=0.33, 95% CI(0.26, 0.43), P<0.00001]. The difference in the expression of Survivin among different T stages of laryngeal carcinoma was statistically significant [OR=0.35, 95% CI(0.21, 0.58), P<0.00001]. In conclusion, Survivin may play an important role in the occurrence and development of laryngeal carcinoma, and its high expression is related to the poor prognosis of patients with laryngeal cancer.展开更多
BACKGROUND Schwannoma rarely originates from the recurrent laryngeal nerve, and there are few reports on schwannoma originating from the recurrent nerve in the mediastinum. Herein, we present an extremely rare case of...BACKGROUND Schwannoma rarely originates from the recurrent laryngeal nerve, and there are few reports on schwannoma originating from the recurrent nerve in the mediastinum. Herein, we present an extremely rare case of schwannoma originating from the recurrent laryngeal nerve in the neck.CASE SUMMARY This is a case report of one patient diagnosed with thyroid cancer with schwannoma originating from the recurrent laryngeal nerve in the neck, which was incidentally found during a thyroidectomy, and a review of the literature.CONCLUSION Preoperative diagnostic examinations are of less use for detecting schwannoma originating from a recurrent laryngeal nerve in the neck in such small size, which may only incidentally be found during a thyroidectomy. Surgical excision with opening the capsule and shelling out the tumor is the treatment of choice. If the nerve is unable to be preserved, end-to-end recurrent laryngeal nerve anastomosis may be a simple and minimally invasive reconstruction procedure to improve phonation.展开更多
Background: Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and c...Background: Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinico?pathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis.Methods: We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat?sen University Cancer Center between January 1993 and December 2009. The Chi?square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3?, 5?, and 10?year overall survival(OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS.Results: No signiicant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3?, 5?, and 10?year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had signiicant efects on prognosis in patients with laryngeal cancer.Conclusions: The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had signiicantly shorter OS than patients with other ABO blood groups.展开更多
Recurrent laryngeal nerve(RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, ...Recurrent laryngeal nerve(RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring(IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes "high risk". There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency.展开更多
Background: Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice however associated hypotension has been reported as its major disadvantage. Etomidate,...Background: Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice however associated hypotension has been reported as its major disadvantage. Etomidate, which produces less hypotension, can be considered as an alternative agent for LMA insertion. Objectives: The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA. Ease of inserting LMA was also looked at. Material and Methods: It was a prospective randomized double blinded study. All ASA I and II patients of 15 - 60 years of age undergoing general anaesthesia with LMA for elective surgeries were included. Patients were induced with intravenous (I/V) fentanyl and induction agent either etomidate or propofol according to group randomization. LMA was inserted after 30 seconds. Intra-operative heart rate (HR), sys tolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), number of attempts and duration of LMA insertion were monitored. Results: There was no difference in the heart rate between the two groups. A significant drop was found for systolic blood pressure (SBP) in propofol group while diastolic blood pressure (DBP) was decreased in both the groups. In propofol group, successful insertion of LMA was achieved on the first attempt in 93.3% of patient as compared to 36.7% in etomidate group. Conclusion: Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction;however it may delay the insertion of laryngeal mask airway.展开更多
Objective:To explore the inhihitive and apoptosis inductive effect of IL-24 genes on CD133^+laryngeal cancer cells in Hep-2 line.Methods:Human peripheral blood monocytes were isolated.The total RNA was extracted by us...Objective:To explore the inhihitive and apoptosis inductive effect of IL-24 genes on CD133^+laryngeal cancer cells in Hep-2 line.Methods:Human peripheral blood monocytes were isolated.The total RNA was extracted by using Trizol method and reverse transcripted into cDNA using RT-PCR method.Primers P1 and P2 was designed for the amplification of human IL-24 genes.After confirmation of agarose gel electrophoresis tests,TA was cloned into pMD19-T simple vector.Nhe Ⅰ and Xho Ⅰ double digesting human IL-24 and pIRES2-ZsGreen1 and eukaryotic expression vector were used to establish the pIRES2-ZsGreen1-hIL-24 vector,and detected by enzyme digestion and gene sequencing methods.Flow cytometry(FCM) was used to isolate CD133^+ cells from Hep-2 cells.CD133^+ cells were transfected with pIRES2-ZsGreen1-hIL-24 through liposome 2000.After detection,MTT and FCM were used to observe the effect of IL-24 gene on CD133^+ laryngeal cancer Hep-2 cells.Results:Lipotin mediated transfection of recombinant pIRES2-ZsGreen1-hIL-24 plasmid into CD133^+ Hep-2 could expressed IL-24 gene in cells stably.MTT results showed that IL-24 transfected group was significantly suppressed compared to empty vector group and control group(P<0.05);FCM results showed that the apoptosis rate of experimental group increased significantly compared to empty vector group and control group(P<0.05).Conclusions:IL-24 gene expressions can inhibit proliferation of CD133^+laryngeal cells in Hep-2 line and promote their apoptosis.展开更多
BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their qua...BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their quality of life.We present an unusual case of LNI caused by the use of an LMA in percutaneous nephrolithotomy(PCNL).CASE SUMMARY A 49-year-old man presented to our hospital with a 3-year history of intermittent left lower back pain.Abdominal computed tomography showed a 25 mm×20 mm stone in the left renal pelvis.PCNL surgery using LMA was performed to remove the renal stone.The patient reported numbness on the tip of his tongue after the operation,but there were no signs of swelling or trauma.The patient was diagnosed with LNI after other possible causes were ruled out.The symptom of numbness eventually improved after conservative medical therapy for 1 wk.The patient completely recovered 3 wk after surgery.CONCLUSION This is the first case report describing LNI with the use of LMA in PCNL.In our case,an inappropriate LMA size,intraoperative movement,and a specific surgical position might be potential causes of this rare complication.展开更多
基金supported by a grant Hebei Provincial Health Commission project from the Foundation of Basic Research(No.20191843).
文摘Objective:Through integrated bioinformatics analysis,the goal of this work was to find new,characterised N7-methylguanosine modification-related long non-coding RNAs(m7G-lncRNAs)that might be used to predict the prognosis of laryngeal squamous cell carcinoma(LSCC).Methods:The clinical data and LSCC gene expression data for the current investigation were initially retrieved from the TCGA database&sanitised.Then,using co-expression analysis of m7G-associated mRNAs&lncRNAs&differential expression analysis(DEA)among LSCC&normal sample categories,we discovered lncRNAs that were connected to m7G.The prognosis prediction model was built for the training category using univariate&multivariate COX regression&LASSO regression analyses,&the model’s efficacy was checked against the test category data.In addition,we conducted DEA of prognostic m7G-lncRNAs among LSCC&normal sample categories&compiled a list of co-expression networks&the structure of prognosis m7G-lncRNAs.To compare the prognoses for individuals with LSCC in the high-&low-risk categories in the prognosis prediction model,survival and risk assessments were also carried out.Finally,we created a nomogram to accurately forecast the outcomes of LSCC patients&created receiver operating characteristic(ROC)curves to assess the prognosis prediction model’s predictive capability.Results:Using co-expression network analysis&differential expression analysis,we discovered 774 m7G-lncRNAs and 551 DEm7G-lncRNAs,respectively.We then constructed a prognosis prediction model for six m7G-lncRNAs(FLG−AS1,RHOA−IT1,AC020913.3,AC027307.2,AC010973.2 and AC010789.1),identified 32 DEPm7G-lncRNAs,analyzed the correlation between 32 DEPm7G-lncRNAs and 13 DEPm7G-mRNAs,and performed survival analyses and risk analyses of the prognosis prediction model to assess the prognostic performance of LSCC patients.By displaying ROC curves and a nomogram,we finally checked the prognosis prediction model's accuracy.Conclusion:By creating novel predictive lncRNA signatures for clinical diagnosis&therapy,our findings will contribute to understanding the pathogenetic process of LSCC.
文摘BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior laryngeal nerve,which leads to several complications such as throat pain,and cough.CASE SUMMARY Patient concerns:A 52-year old woman presented with a 70 d history of throat pain and a 67 d history of non-productive cough.Three days after onset of pain,she was diagnosed with laryngeal herpes zoster.Flexible nasolaryngoscopy revealed multiple white ulcerated lesions on the left hemi epiglottis and the left supraglottic area.She was prescribed with 750 mg famciclovir a day for 7 d,and 150 mg pregabalin,100 mg tramadol and 10 mg nortriptyline a day for 67 d.However,despite of these medications,she complained of pain and persistent cough.Therefore,superior laryngeal nerve block under ultrasound guidance was performed.Three days after the intervention,the throat pain and cough disappeared.The patient remained symptom-free at 3 mo follow-up.CONCLUSION A superior laryngeal nerve block can be an effective option for treatment of pain and cough following laryngeal herpes zoster.
文摘Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.
文摘Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients (60.97%). Histologically, it was a squamous cell carcinoma in 205 patients (95.34%). The most site invaded by the tumor was cricoid cartilage.T4 type was most found (45 patients or 40.90%) followed by the T3 type with 34.55%. There was no lymphadenopathy invasion (Type N0) in 74 patients (67.27%), capsular rupture was reported in five patients (6.77%), no evaluable metastasis in 110 patients (97.27%), and stage IVA predominated in 66 patients (60%). Conclusion: laryngeal cancer is a reality in our contexts, however, its incidence is poorly understood in Senegal. The main risk factors remain tobacco and alcohol. Histology confirms the diagnosis. Its management is multidisciplinary and must be early.
文摘Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report the case of a 77-year-old woman, with no reported pathological history. She also has no alcohol or tobacco intoxication, who presented with chronic dysphonia evolving for 2 months, associated with an altered general condition. The examination of the larynx by direct laryngoscopy and anatomical pathology study of the biopsies led to the diagnosis of laryngeal tuberculosis. A search for secondary sites revealed a concomitant pulmonary infection. The evolution was favorable under standard anti-tuberculosis treatment, with complete voice recovery and improved performance status. Laryngeal tuberculosis should be suspected in patients living in endemic areas and suffering from chronic dysphonia, even if they are not alcoholics or smokers.
基金Health and Family Planning Commission of Shanghai Municipality of China,No.2019SY059.
文摘BACKGROUND Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm.AIM To evaluate the circulating immune population and develop a nomogram for prediction of malignancy in patients with laryngeal neoplasm.METHODS A primary cohort of 156 patients was divided into laryngeal benign lesion,premalignant lesion and malignant lesion groups.Peripheral blood from patients was measured by blood routine test and flow cytometry.A nomogram was developed and applied to a validation cohort containing 55 consecutive patients.RESULTS Age,gender and seven circulating immune parameters exhibited significant differences between laryngeal benign lesion and premalignant lesion.The nomogram incorporated predictors,including gender,age,smoke index,proportions of monocytes,CD8+T cells,CD4+T cells,B cells and CD4/CD8+T cell ratio.It showed good discrimination between laryngeal premalignant lesion and malignant lesion,with a C-index of 0.844 for the primary cohort.Application of this nomogram in the validation cohort(C-index,0.804)still had good discrimination and good calibration.Decision curve analysis revealed that the nomogram was clinically useful.CONCLUSION This novel nomogram,incorporating both clinical risk factors and circulating immune parameters,could be appropriately applied in preoperative individualized prediction of malignancy in patients with laryngeal neoplasm.
文摘Objective: To assess the efficacy of coblation in treating laryngeal papillomatosis and its effect on post operative voice outcome. Study Design: This is a retrospective study. Setting: Tertiary referral centre. Subjects and Methods: All the patients diagnosed with laryngeal papillomatosis between January 2013 to December 2016 were included in this study. Preoperative assessment was done with rigid and flexible laryngoscopy. PRAAT software was used for voice analysis. All patients underwent coblation assisted microlaryngeal surgery. Post operatively patients were followed up at 1 week, 15 days, 1 month, 3 months and 6 months with rigid laryngoscopy. Voice analysis was repeated after 3 months to assess the improvement in voice. Results: Coblation was found to be effective in treating laryngeal papillomatosis. In our series of seven patients, three patients underwent repeat procedure with coblation for recurrence. But longterm follow up these patients did not reveal any recurrence of laryngeal papillomatosis. Voice analysis revealed a significant improvement in measures of perturbation and maximum phonation time. Conclusion: Coblation is a promising alternative to the conventional methods for the treatment of laryngeal papillomas as it can achieve satisfactory disease clearance with good voice quality.
基金supported by Major State Basic Innovation Program of the Chinese Academy of Medical Sciences (No. 2018-I2M-3-003).
文摘Objective: Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015.Methods: Data submitted from 501 cancer registries were checked and evaluated according to the criteria of data quality control and 368 registries’ data were qualified for the final analysis. Data were stratified by area(urban/rural), sex, age group and combined with national population data to estimate laryngeal cancer incidence and mortality in China, 2015. China population census in 2000 and Segi’s population were used for agestandardized.Results: The percentage of cases morphological verified(MV%) of laryngeal cancer was 74.18%. The percentage of death certificate-only cases(DCO%) was 2.10%. And the mortality to incidence(M/I) ratio was 0.55.About 25,300 new cases of laryngeal cancer were diagnosed in 2015 and 13,700 deaths were reported. The crude rate of laryngeal cancer was 1.84 per 100,000(males and females were 3.20 and 0.42 per 100,000, respectively).Age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 1.18 and 1.19 per 100,000, respectively. The cumulative incidence rate(0-74 years old) was 0.15%.The crude mortality rate was 1.00 per 100,000. Age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 0.61 and 0.61 per 100,000, respectively, with the cumulative rate(0-74 years old) was 0.07%. Incidence and mortality of laryngeal cancer in males were higher than those in females. And the rates in urban areas were higher than those in rural areas.Conclusions: The incidence and mortality of laryngeal cancer in China were low. And the rates were significantly higher in males than in females. Risk factor control and targeted prevention should be strengthened.
基金supported by Handan Science and Technology Bureau(No.1323108088)
文摘Objective: To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion. Methods: Laryngeal squamous cell carcinoma and paracancerous normal tissues were collected, total RNA was extracted from tissues, survivin, p53 and Ki-67 gene m RNA expression levels in laryngeal cancer and the adjacent tissues were detected by Real-time PCR. Human laryngeal cancer Hep-2 epithelial cells were selected, survivin gene was overexpressed, and cell proliferation was detected by MTT. p53 and Ki-67 gene expression changes in overexpressed survivin gene were detected by Western blot. Changes in Hep-2 cell invasive ability were studied when survivin was overexpressed as detected by Transwell invasion assay. Results: In the adjacent tissues, survivin, p53 and Ki-67 gene relative expression levels were 1.72 ± 0.9, 13.7 ± 5.7 and 5.7 ± 1.3, respectively; while in cancer tissues, gene relative expression levels were 53.7 ± 8.3, 66.7 ± 5.2 and 61.0 ± 3.1, respectively, which was significantly increased. As detected by MTT, relative cell survival rate within 12 h of survivin overexpression were: load control group,(88.5±1.6)%; overexpressed group,(90.3±1.9)%. Transwell invasion assay results indicated that overexpressed survivin could significantly increase the relative survival rate of cells. Conclusions: Expressions of p53, Ki67 and survivin are increased in cancer; and there is a positive correlation between survivin, p53 and Ki67 expressions in laryngeal carcinoma.
基金supported by Handan Science and Technology Bureau(Project No.1323108088)
文摘Objective: To discuss the effect and mechanism of miR-34 a on the proliferation, apoptosis and invasion of laryngeal carcinoma cells. Methods: The laryngeal squamous carcinoma Hep2 cells were transiently transfected with miR-34 a mimics and miR-34 a NC. The MTT, colony-forming assay, Hoechst staining and Annexin V-PI double staining flow cytometry were employed to detect the effect of miR-34 a on the viability and apoptosis of laryngeal squamous carcinoma Hep2 cells; Transwell assay to defect the effect of miR-34 a on the migration and invasion of laryngeal squamous carcinoma Hep2 cells; western blot and RTPCR assay to defect the effect of miR-34 a mimics on the expression of survivin and Ki-67 m RNA in laryngeal squamous carcinoma Hep2 cells. Results: Compared with miR-34 a NC group, the cell viability in miR-34 mimics group was significantly decreased(P<0.01), the cell apoptosis rate was significantly increased(P<0.01), the abilities of cell migration and invasion were significantly reduced(P<0.01) and the expression of survivin and Ki-67 m RNA was significantly decreased(P<0.01). Conclusions: The increased expression of miR-34 a can induce the apoptosis of Hep2 laryngeal carcinoma cells and inhibit the cell proliferation and invasion, which is related to the down-regulated expression of survivin and Ki-67.
文摘Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway(LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway during general anesthesia. Use of LMA has some advantages when compared to endotracheal intubation, such as quick and ease of placement, a lesser requirement for neuromuscular blockade and a lower incidence of postoperative morbididy. However, the use of the LMA in laparoscopy is controversial, based on a concern about increased risk of regurgitation and pulmonary aspiration. The ability of these devices to provide optimal ventilation during laparoscopic procedures has been also questioned. The most important parameter to secure an adequate ventilation and oxygenation for the LMA under pneumoperitoneum condition is its seal pressure of airway. A good sealing pressure, not only state correct patient ventilation, but it reduces the potential risk of aspiration due to the better seal of airway. In addition, the LMAs incorporating a gastric access, permitting a safe anesthesia based on these commented points. We did a literature search to clarify if the use of LMA in preference to intubation provides inadequate ventilation or increase the risk of aspiration in patients undergoing laparoscopic cholecystectomy. We found evidence stating that LMA with drain channel achieves adequate ventilation for these procedures. Limited evidence was found to consider these devices completely safe against aspiration. However, we observed that the incidence of regurgitation and aspiration associated with the use of the LMA in laparoscopic surgery is very low.
文摘BACKGROUND In esophageal squamous carcinoma,lymphadenectomy along the left recurrent laryngeal nerve(RLN)is recommended owing to its highly metastatic potential.However,this procedure is difficult due to limited working space in the left upper mediastinum,and increases postoperative complications.AIM To present a novel method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the semi-prone position.METHODS The fundamental concept of this novel method is to exfoliate a bilateral pedicled nerve flap,which is a two-dimensional membrane,which includes the left RLN,lymph nodes(LNs)along the left RLN,and tracheoesophageal vessels,by suspending the esophagus to the dorsal side and pushing the trachea to the ventral side(named“bilateral exposure method”).Then,the hollow-out method is performed to transform the two-dimensional membrane to a three-dimensional structure,in which the left RLN and tracheoesophageal vessels are easily distinguished and preserved during lymphadenectomy along the left RLN.This novel method was retrospectively evaluated in 116 consecutive patients with esophageal squamous carcinoma from August 2016 to February 2018.RESULTS There were 58 patients in each group.No significant difference was found between the two groups in terms of age,gender,postoperative pneumonia,anastomotic fistula,and postoperative hospitalization.However,the number of dissected LNs along the left RLN in this novel method was significantly higher than that in the conventional method(4.17±0.359 vs 2.93±0.463,P=0.0447).Moreover,the operative time and the rate of postoperative hoarseness in the novel method were significantly lower than those in the conventional method(306.0±6.774 vs 335.2±7.750,P=0.0054;4/58 vs 12/58,P=0.0312).CONCLUSION This novel method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the semi-prone position is much safer and more effective.
文摘In order to provide evidence for evidence-based medicine in the treatment and prognosis of laryngeal cancer in China, the meta-analysis electronically retrieved the case-control studies published in China about the Survivin expression and its association with clinical pathological features in the tissues of laryngeal carcinoma. The results showed that a total of 25 case-control studies were finally included with 1333 cases of laryngeal cancer and 528 cases of controls. The difference in the expression of Survivin between the two groups was statistically significant [OR=18.34, 95% CI(11.82, 28.47), P<0.00001]. The difference in the expression of Survivin between laryngeal carcinoma patients with lymph node metastasis or not was statistically significant [OR=0.25, 95% CI(0.17, 0.37), P<0.00001]. The expression of Survivin in clinical Ⅰ–Ⅱ stage group was significantly lower than in the clinical stage Ⅲ–Ⅳ group [OR=0.24, 95% CI(0.18, 0.32), P<0.00001]. The expression of Survivin in patients with low/medium differentiation was significantly lower than that in those with high differentiation [OR=0.33, 95% CI(0.26, 0.43), P<0.00001]. The difference in the expression of Survivin among different T stages of laryngeal carcinoma was statistically significant [OR=0.35, 95% CI(0.21, 0.58), P<0.00001]. In conclusion, Survivin may play an important role in the occurrence and development of laryngeal carcinoma, and its high expression is related to the poor prognosis of patients with laryngeal cancer.
文摘BACKGROUND Schwannoma rarely originates from the recurrent laryngeal nerve, and there are few reports on schwannoma originating from the recurrent nerve in the mediastinum. Herein, we present an extremely rare case of schwannoma originating from the recurrent laryngeal nerve in the neck.CASE SUMMARY This is a case report of one patient diagnosed with thyroid cancer with schwannoma originating from the recurrent laryngeal nerve in the neck, which was incidentally found during a thyroidectomy, and a review of the literature.CONCLUSION Preoperative diagnostic examinations are of less use for detecting schwannoma originating from a recurrent laryngeal nerve in the neck in such small size, which may only incidentally be found during a thyroidectomy. Surgical excision with opening the capsule and shelling out the tumor is the treatment of choice. If the nerve is unable to be preserved, end-to-end recurrent laryngeal nerve anastomosis may be a simple and minimally invasive reconstruction procedure to improve phonation.
基金supported by the grants from the National Natural Science Foundation of China(Grant No.81372437)the China International Medical Foundation(No.CIMF-F-H001-043)the Excellent Talents Project of Zhejiang Cancer Hospital,China(No.2013 to T.J.)
文摘Background: Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinico?pathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis.Methods: We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat?sen University Cancer Center between January 1993 and December 2009. The Chi?square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3?, 5?, and 10?year overall survival(OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS.Results: No signiicant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3?, 5?, and 10?year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had signiicant efects on prognosis in patients with laryngeal cancer.Conclusions: The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had signiicantly shorter OS than patients with other ABO blood groups.
文摘Recurrent laryngeal nerve(RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring(IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes "high risk". There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency.
文摘Background: Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice however associated hypotension has been reported as its major disadvantage. Etomidate, which produces less hypotension, can be considered as an alternative agent for LMA insertion. Objectives: The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA. Ease of inserting LMA was also looked at. Material and Methods: It was a prospective randomized double blinded study. All ASA I and II patients of 15 - 60 years of age undergoing general anaesthesia with LMA for elective surgeries were included. Patients were induced with intravenous (I/V) fentanyl and induction agent either etomidate or propofol according to group randomization. LMA was inserted after 30 seconds. Intra-operative heart rate (HR), sys tolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), number of attempts and duration of LMA insertion were monitored. Results: There was no difference in the heart rate between the two groups. A significant drop was found for systolic blood pressure (SBP) in propofol group while diastolic blood pressure (DBP) was decreased in both the groups. In propofol group, successful insertion of LMA was achieved on the first attempt in 93.3% of patient as compared to 36.7% in etomidate group. Conclusion: Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction;however it may delay the insertion of laryngeal mask airway.
基金supported by Jilin Province Natural Science Foundation of China.No:20130101151JCChinese Ministry of Education Projects of Doctoral New Teachers.No:20120061120092
文摘Objective:To explore the inhihitive and apoptosis inductive effect of IL-24 genes on CD133^+laryngeal cancer cells in Hep-2 line.Methods:Human peripheral blood monocytes were isolated.The total RNA was extracted by using Trizol method and reverse transcripted into cDNA using RT-PCR method.Primers P1 and P2 was designed for the amplification of human IL-24 genes.After confirmation of agarose gel electrophoresis tests,TA was cloned into pMD19-T simple vector.Nhe Ⅰ and Xho Ⅰ double digesting human IL-24 and pIRES2-ZsGreen1 and eukaryotic expression vector were used to establish the pIRES2-ZsGreen1-hIL-24 vector,and detected by enzyme digestion and gene sequencing methods.Flow cytometry(FCM) was used to isolate CD133^+ cells from Hep-2 cells.CD133^+ cells were transfected with pIRES2-ZsGreen1-hIL-24 through liposome 2000.After detection,MTT and FCM were used to observe the effect of IL-24 gene on CD133^+ laryngeal cancer Hep-2 cells.Results:Lipotin mediated transfection of recombinant pIRES2-ZsGreen1-hIL-24 plasmid into CD133^+ Hep-2 could expressed IL-24 gene in cells stably.MTT results showed that IL-24 transfected group was significantly suppressed compared to empty vector group and control group(P<0.05);FCM results showed that the apoptosis rate of experimental group increased significantly compared to empty vector group and control group(P<0.05).Conclusions:IL-24 gene expressions can inhibit proliferation of CD133^+laryngeal cells in Hep-2 line and promote their apoptosis.
文摘BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their quality of life.We present an unusual case of LNI caused by the use of an LMA in percutaneous nephrolithotomy(PCNL).CASE SUMMARY A 49-year-old man presented to our hospital with a 3-year history of intermittent left lower back pain.Abdominal computed tomography showed a 25 mm×20 mm stone in the left renal pelvis.PCNL surgery using LMA was performed to remove the renal stone.The patient reported numbness on the tip of his tongue after the operation,but there were no signs of swelling or trauma.The patient was diagnosed with LNI after other possible causes were ruled out.The symptom of numbness eventually improved after conservative medical therapy for 1 wk.The patient completely recovered 3 wk after surgery.CONCLUSION This is the first case report describing LNI with the use of LMA in PCNL.In our case,an inappropriate LMA size,intraoperative movement,and a specific surgical position might be potential causes of this rare complication.
