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Rashid M, Karim MN, Saleem H, Najam A, Aasim U, Hashmi MA, Javed M, Ullah Z. A Novel Technique for Thyroplasty Type 1, With Prolene Mesh Implant. J Voice 2024; 38:532-537. [PMID: 34706848 DOI: 10.1016/j.jvoice.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze the efficacy of a modified approach to thyroplasty type one using prolene mesh implant. STUDY DESIGN Interventional study. PLACE AND DURATION OF STUDY Combined Military Hospital Kharian, Pakistan, in Ent department, from July 2020 to Jan 2021. METHODOLOGY Medialization thyroplasty with prolene mesh was performed on the patients satisfying the inclusion criteria. They were analyzed objectively as well as subjectively in terms of Mean Maximum phonation time, maximum word count, and visual analog score about the quality of voice. Data analysis was done with SPSS version 20. Pre-operative and post-operative records were compared using paired sample t-test. RESULTS A total of 39 patients underwent vocal cord medialization with prolene mesh implant. The Mean age for medialization was 41.09 + 13.37. 23 patients were females and 15 were males. 26 patients had unilateral and 13 patients had bilateral vocal dysfunction. 18 of them had vocal dysfunction due to thyroidectomy, eight had idiopathic causes and 13 had miscellaneous. The improvement in mean visual analog score was 2.87 postoperatively. Median maximum phonation time increased about five seconds postoperatively, seven seconds in males, and 4.5 seconds for females. The maximum word count increased from 11.33 preoperatively to 18.28 postoperatively. There were no major complications observed in our study. CONCLUSION These results were comparable to many other studies for vocal cord medialization with different implant materials. But prolene mesh implant offers an easily available yet cost-effective alternative with similar benefits. LEVEL OF EVIDENCE III (Treatment benefits: Non-randomized controlled cohort/follow-up study).
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Affiliation(s)
- Muhammad Rashid
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan.
| | | | - Humaira Saleem
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Atif Najam
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Umer Aasim
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Muhammad Ali Hashmi
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Maaza Javed
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Zakir Ullah
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
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Ye Z, Liu L, Liang X, Fu W. Professor FU Wenbin's experience of "acupuncture-moxibustion-consolidation" holistic idea in treatment of laryngeal herpes zoster with vocal cord paralysis. Zhongguo Zhen Jiu 2024; 44:195-199. [PMID: 38373766 DOI: 10.13703/j.0255-2930.20230528-k0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
This paper introduces professor FU Wenbin's clinical experience in the treatment of laryngeal herpes zoster with vocal cord paralysis, using the holistic mode of treatment, in which, acupuncture, moxibustion and consolidation regimens are integrated. Regarding the core pathogenesis of the disease, the invaded exogenous toxic heat is transformed into fire that flows to the throat. Soothing liver and releasing heat is the general principle of treatment, guiding the entire process of treatment. For acupuncture regimen, the filiform needling is used and the acupoint prescription is composed of Baihui (GV 20), Yintang (GV 24+), Lianquan (CV 23), the four-gate points (bilateral Hegu [LI 4] and Taichong [LR 3]), the group points for conducting qi back to the primary (Zhongwan [CV 12], Xiawan [CV 10], Qihai [CV 6] and Guanyuan [CV 4]), as well as bilateral Fengchi (GB 20), Wangu (GB 12) and Yifeng (TE 17). Besides, the pricking technique is delivered to the posterior wall of the pharynx for soothing the liver, regulating the spirit, reducing the heat and benefiting the throat. For the moxibustion regimen, moxibustion is applied to Fengchi (GB 20), Feishu (BL 13), the four-flower points (bilateral Geshu [BL 17] and Danshu [BL 19]), Shenshu (BL 23) and Mingmen (GV 4), which nourishes the spleen and stomach and reduces the heat pathogen through the heating action of moxibustion specially. In the stage of consolidation, the bloodletting and cupping technique is used at Xinshu (BL 15), Ganshu (BL 18) and Jianjing (GB 21) to eliminate the liver stagnation and the intradermal needling is delivered to sustain the needling stimulation and consolidate the therapeutic effect.
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Affiliation(s)
- Ziyu Ye
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of CM, Guangzhou 510006, Guangdong Province, China.
| | - Lu Liu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of CM, Guangzhou 510006, Guangdong Province, China
| | - Xuesong Liang
- Guangdong Provincial Hospital of TCM, Guangzhou 510120
| | - Wenbin Fu
- Guangdong Provincial Hospital of TCM, Guangzhou 510120.
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Kirsch A, Gerstenberger C, Jakubaß B, Tschernitz M, Perkins JD, Groselj‐Strele A, Lanmüller H, Jarvis JC, Kniesburges S, Döllinger M, Gugatschka M. Bilateral Functional Electrical Stimulation for the Treatment of Presbyphonia in a Sheep Model. Laryngoscope 2024; 134:848-854. [PMID: 37597167 PMCID: PMC10952233 DOI: 10.1002/lary.30984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES The aim of the study was to increase muscle volume and improve phonation characteristics of the aged ovine larynx by functional electrical stimulation (FES) using a minimally invasive surgical procedure. METHODS Stimulation electrodes were placed bilaterally near the terminal adduction branch of the recurrent laryngeal nerves (RLN). The electrodes were connected to battery powered pulse generators implanted subcutaneously at the neck region. Training patterns were programmed by an external programmer using a bidirectional radio frequency link. Training sessions were repeated automatically by the implant every other day for 1 week followed by every day for 8 weeks in the awake animal. Another group of animals were used as sham, with electrodes positioned but not connected to an implant. Outcome parameters included gene expression analysis, histological assessment of muscle fiber size, functional analysis, and volumetric measurements based on three-dimensional reconstructions of the entire thyroarytenoid muscle (TAM). RESULTS Increase in minimal muscle fiber diameter and an improvement in vocal efficiency were observed following FES, compared with sham animals. CONCLUSION This is the first study to demonstrate beneficial effects in the TAM of FES at molecular, histological, and functional levels. FES of the terminal branches of the RLN reversed the effects of age-related changes and improved vocal efficiency. LEVEL OF EVIDENCE NA Laryngoscope, 134:848-854, 2024.
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Affiliation(s)
- Andrijana Kirsch
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
| | - Claus Gerstenberger
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
| | - Bernhard Jakubaß
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Magdalena Tschernitz
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
| | | | - Andrea Groselj‐Strele
- Core Facility Computational Bioanalytics, Center for Medical ResearchMedical University of GrazGrazAustria
| | - Hermann Lanmüller
- Center of Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Jonathan C. Jarvis
- School of Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Stefan Kniesburges
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Markus Gugatschka
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
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Yaguchi H, Miyagawa S, Mukai T, Sakuta K. Palatal prolapse during nasal expiration in patients with myasthenia gravis. Muscle Nerve 2024; 69:222-226. [PMID: 38018268 DOI: 10.1002/mus.28009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION/AIMS We have encountered patients with myasthenia gravis (MG) who exhibited palatal prolapse (PP) during nasal expiration in the supine position while awake. This may be an overlooked cause of dyspnea in MG patients. This study aimed to examine and describe the characteristics of MG patients with PP. METHODS We reviewed the medical records of 183 consecutive patients who were diagnosed with MG in our hospital from 2012 to 2021. Thirty-two patients underwent laryngoscopy because of bulbar symptoms. Eight of these patients (25%) exhibited PP on laryngoscopy. Clinical features of these eight patients were retrospectively characterized. RESULTS Median age of the eight patients with PP was 70 years. Six were men. Median body mass index was 21.6 kg/m2 . All patients exhibited PP in the supine position but not the sitting position. Although no patient had abnormal findings on spirometry nor chest computed tomography, six reported dyspnea or difficulty with nasal expiration only in the supine position. PP improved in all four patients who underwent edrophonium testing. All eight patients eventually improved after immunotherapy. DISCUSSION PP during nasal expiration may be a cause of dyspnea in MG patients, along with respiratory muscle impairment, lung disease, and vocal cord paralysis. Laryngoscopy in the supine position is required to confirm.
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Affiliation(s)
- Hiroshi Yaguchi
- Department of Neurology, The Jikei University Kashiwa Hospital, Kashiwa-shi, Chiba, Japan
| | - Shinji Miyagawa
- Department of Neurology, The Jikei University Kashiwa Hospital, Kashiwa-shi, Chiba, Japan
| | - Taiji Mukai
- Department of Neurology, The Jikei University Kashiwa Hospital, Kashiwa-shi, Chiba, Japan
- Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan
| | - Kenichi Sakuta
- Department of Neurology, The Jikei University Kashiwa Hospital, Kashiwa-shi, Chiba, Japan
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Lee S, Fujiwara Y, Gyobu K, Tamura T, Toyokawa T, Miki Y, Yoshii M, Kasashiima H, Fukuoka T, Shibutani M, Osugi H, Maeda K. Evaluation of Intraoperative Neural Monitoring During Thoracoscopic Surgery for Esophageal Cancer. Anticancer Res 2024; 44:157-166. [PMID: 38159987 DOI: 10.21873/anticanres.16798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND/AIM Recurrent laryngeal nerve paralysis (RLNP) induces aspiration pneumonia and reduces the patient's quality of life. To decrease the incidence of RLNP, we performed intraoperative neural monitoring (IONM) during thoracoscopic surgery for esophageal cancer and evaluated its usefulness. PATIENTS AND METHODS A total of 737 consecutive patients who underwent thoracoscopic surgery for esophageal cancer were enrolled in this study. Between May 1995 and March 2016, thoracoscopic esophagectomies were performed using video-assisted thoracoscopic surgery (VATS) with a small incision, whereas from April to June 2023, we used positive pressure pneumothorax with port placement only [minimum invasive esophagectomy (MIE)]. A total of 110 consecutive patients who underwent thoracoscopic surgery with IONM (IONM group) were retrospectively compared with those who underwent VATS or MIE without IONM (No-IONM group). RESULTS The incidence of RLNP [Clavien-Dindo (CD) classification of ≥1] on postoperative day (POD) 5 was 13.9% in the IONM group, which was significantly lower than that of the no-IONM group (31.2%, p<0.001). Even when comparing only patients who underwent MIE, the incidence of RLNP on POD5 was 13.9% in the IONM group, which was significantly lower than that in the no-IONM group (26.2%, p=0.035). The incidence of postoperative pneumonia (CD ≥2) was 10.9% in the IONM group, which was significantly lower than that in the no-IONM group (26.1%, p=0.005). Bilateral RLNP did not occur in any of the IONM groups. CONCLUSION IONM is a useful tool for reducing RLNP incidence and postoperative pneumonia after thoracoscopic surgery for esophageal cancer.
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Affiliation(s)
- Shigeru Lee
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan;
| | - Yushi Fujiwara
- Department of Gastroenterological Surgery, Keiyukaisapporo Hospital, Sapporo, Japan
| | - Ken Gyobu
- Department of Gastroenterological Surgery, Minamiosaka Hospital, Osaka, Japan
| | - Tatsuro Tamura
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Toyokawa
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yuichiro Miki
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Mami Yoshii
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Kasashiima
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Tatsunari Fukuoka
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Masatsune Shibutani
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Harushi Osugi
- Department of Surgery, Kamifukuoka General Hospital, Fujimino, Japan
| | - Kiyoshi Maeda
- Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Xu Z, Mao Z, Chen S, Mo Z, Zhou J, Chen Z, Zarnegar R, Fahey Iii TJ, Wang W, Teng L. Long-term impact of prophylactic central neck dissection in non-invasive classic papillary thyroid carcinoma. Eur J Surg Oncol 2024; 50:107305. [PMID: 38070466 DOI: 10.1016/j.ejso.2023.107305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/01/2023] [Accepted: 11/24/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND The utilization of prophylactic central neck dissection (pCND) in cases of non-invasive clinical node-negative (cN0) papillary thyroid carcinoma (PTC) remains a topic of debate, with a dearth of long-term evidence. MATERIALS AND METHODS We retrospectively reviewed 1181 cN0 PTC patients from 1997 to 2011. Of these, 641 underwent pCND (pCND + group) and 540 did not (pCND-group). Propensity score matching (PSM) was used to identify similar patients. Event-free survival and long-term complications including permanent hyperparathyroidism and permanent recurrent laryngeal nerve (RLN) paralysis were analyzed after PSM. RESULTS The pCND + group had more aggressive characteristics. In the matched cohort after PSM, the 5-year, 10-year, and 15-year EFS rates were 98.9 %, 98.2 %, and 97.1 % for the pCND + group, and 97.7 %, 97.1 %, and 97.1 % for the pCND-group, respectively. There was no statistically significant difference in EFS rates between the two groups (Log Rank P = 0.38). There was no statistically significant difference in the incidence of permanent hyperparathyroidism (3.3 % vs. 1.5 %, P = 0.08) and permanent RLN paralysis (1.7 % vs. 0.9 %, P = 0.13) between the pCND+ and pCND- groups. CONCLUSION Our study, with a median follow-up duration of 107 months, indicates that pCND does not lead to a significant reduction in nodal recurrence among non-invasive cN0 PTC patients.
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Affiliation(s)
- Zehang Xu
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Zhuochao Mao
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Shitu Chen
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Zhe Mo
- Department of Environmental and Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
| | - Jie Zhou
- Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Zhendong Chen
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Rasa Zarnegar
- Department of Surgery, New York Presbyterian Hospital, and Weill Medical College of Cornell University, 525 East 68th Street, Room F-2024, New York, 10065, NY, USA.
| | - Thomas J Fahey Iii
- Department of Surgery, New York Presbyterian Hospital, and Weill Medical College of Cornell University, 525 East 68th Street, Room F-2024, New York, 10065, NY, USA.
| | - Weibin Wang
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Lisong Teng
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
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Douglas CM, Menon R, Montgomery J, Townsley R, Hilmi O, Buchanan MA, Robertson S, Petropoulakis L, Soraghan JJ, Lakany H, Mackenzie K. Vocal cord movement: can it be accurately graded? Ann R Coll Surg Engl 2024; 106:36-40. [PMID: 36263913 PMCID: PMC10757873 DOI: 10.1308/rcsann.2022.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2022] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Flexible nasendoscopy (FNE) is the principal assessment method for vocal cord movement. Because the procedure is inherently subjective it may not be possible for clinicians to grade the degree of vocal cord movement reliably. The aim of this study was to assess the accuracy and consistency of grading vocal cord movement as viewed via FNE. METHODS Thirty FNE videos, without sound or clinical information, were assessed by six consultant head and neck surgeons. The surgeons were asked to assess and grade right and left vocal cord movement independently, based on a five-category scale. This process was repeated three times on separate occasions. Agreement and reliability were assessed. RESULTS Mean overall observed inter-rater agreement was 67.7% (sd 1.9) with the five-category scale, increasing to 91.4% (sd 1.9) when a three-category scale was derived. Mean overall observed intra-rater agreement was 78.3% (sd 9.7) for five categories, increasing to 93.1% (sd 3.3) for three categories. Discriminating vocal cord motion was less reliable using the five-category scale (k = 0.52) than with the three-category scale (k = 0.68). CONCLUSIONS This study demonstrates quantitatively that it is challenging to accurately and consistently grade subtle differences in vocal cord movement, as proven by the reduced agreement and reliability when using a five-point scale instead of a three-point scale. The study highlights the need for an objective measure to help in the assessment of vocal cord movement.
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Affiliation(s)
| | - R Menon
- University of Strathclyde, UK
| | | | | | - O Hilmi
- NHS Greater Glasgow and Clyde, UK
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Meneghesso S, Saetti R, Silvestrini M. Endoscopic posterior ventricular cordectomy with contact diode laser: how I do it. Eur Arch Otorhinolaryngol 2023; 280:5661-5664. [PMID: 37773529 PMCID: PMC10620266 DOI: 10.1007/s00405-023-08234-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The treatment of bilateral vocal fold paralysis is mainly surgical and several procedures can be used to guarantee adequate breathing. Furthermore, other causes of the narrowing of the natural airways could coexist and the treatment should consider all of them. METHODS A supraglottic extension of posterior cordectomy to the false homolateral chord is described, which provides a further widening of the airway while maintaining acceptable voice quality. CONCLUSION Endoscopic posterior ventricular cordectomy performed by contact diode laser may be a viable and safe option, especially in those patients who present bilateral vocal fold paralysis associated with various degrees of laryngospasm.
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Affiliation(s)
- Stefano Meneghesso
- Otorhinolaryngology-Head and Neck Department, University Hospital of Verona, Verona, Italy.
| | - Roberto Saetti
- Department of Otolaryngology, Ospedale San Bortolo, Vicenza, Italy
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Lee J, Kim SH, Hong H. Comparison of Various Thyroidectomy Approaches: A Retrospective Cross-sectional Study. Surg Laparosc Endosc Percutan Tech 2023; 33:632-639. [PMID: 37934829 DOI: 10.1097/sle.0000000000001243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/19/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND To avoid anterior neck scarring, numerous remote-access techniques to approach the thyroid gland (Remote access approach) have been described, including the transaxillary approach (TA), bilateral axillo-breast approach (BABA), and transoral robotic thyroidectomy (TORT). Popular worldwide, Remote access approachs have unique characteristics, advantages, and disadvantages. Herein, we investigated the characteristics of these distinct thyroidectomy approaches to aid surgeons in selecting the most appropriate method for patients. PATIENTS AND METHODS In total, 2351 cases of patients who underwent thyroidectomy between 2019 and 2021 were reviewed, including 1973, 281, 66, and 31 patients who underwent the conventional transcervical approach (TCA), TA, BABA, and TORT, respectively. Demographic characteristics, outcomes, and complications associated with these procedures were compared. The data were analyzed using the Student t test and the χ 2 test. Kruskal-Wallis and Mann-Whitney U tests were used if normality was not found. RESULTS Central lymph nodes (LNs) were retrieved mostly in patients who underwent lobectomy through TORT (mean: 9.4, P < 0.001). Metastatic central LNs were found more frequently (mean: 1.9 in lobectomy, 3.7 in total thyroidectomy) in patients who underwent lobectomy through TCA and TORT than in those who underwent lobectomy through other approaches (mean: 1.4 and 2.4, respectively, P < 0.05). BABA group patients had significantly fewer central LNs retrieved than those in other groups in lobectomy and total thyroidectomy (mean: 4.8 and 6.2, respectively, P < 0.05). Stimulated thyroglobulin levels did not differ among the 4 groups. The incidence of transient vocal cord palsy was statistically higher in the BABA group (5 cases, 7.5%) than in the other groups; however, all patients recovered. No difference was found in permanent vocal cord palsy (0.4% in TCA) or hypoparathyroidism (1.3% to 3.1%) among the 4 groups. The tumor size was significantly larger in the BABA group than in the other groups, with 10.6% of the patients having tumors larger than 4 cm. Total thyroidectomy was performed more frequently in the BABA group (51.8%) than in the other groups ( P = 0.005). The path of the external branch of the superior laryngeal nerve was more evident in TA, and the Cernea type was confirmed and preserved in 90.6% of TA cases. CONCLUSIONS Owing to the differences in working space and direction of the surgical field, TA was advantageous for preserving the external branch of the superior laryngeal nerve, whereas BABA was effective for total thyroidectomy and excision of large goiters. TORT was beneficial for central compartment neck dissection. These characteristics should be considered when choosing the best approach to improving cosmesis, function, and recurrence.
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Affiliation(s)
- Jeonghun Lee
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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Hamilton NJI, Saccente-Kennedy B, Ambler G. The use of basic fibroblast growth factor to improve vocal function: A systematic review and meta-analysis. Clin Otolaryngol 2023; 48:725-733. [PMID: 37246756 DOI: 10.1111/coa.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examines if intralaryngeal injection of basic fibroblast growth factor 2 (FGF2) can improve voice outcomes in those with vocal disability. DESIGN A Systematic review of original human studies reporting voice outcomes following intra-laryngeal injection of basic fibroblast growth factor 2 in those with vocal dysfunction. Databases searched were Medline (1946-July 2022), Embase (1947-July 2022), Cochrane database and Google Scholar. SETTING Secondary or tertiary care centres that undertook the management of voice pathology Hospital. PARTICIPANTS Inclusion criteria were original human studies reporting voice outcome measurements following intralaryngeal injection of FGF2 to treat vocal fold atrophy, vocal fold scarring, vocal fold sulcus or vocal fold palsy. Articles not written in English, studies that did not include human subjects and studies where voice outcome measures were not recorded before and after FGF2 injection were excluded from the review. MAIN OUTCOME MEASURES The primary outcome measure was maximum phonation time. Secondary outcome measures included acoustic analysis, glottic closure, mucosal wave formation, voice handicap index and GRBAS scale. RESULTS Fourteen articles were included out of a search of 1023 and one article was included from scanning reference lists. All studies had a single arm design without control groups. Conditions treated were vocal fold atrophy (n = 186), vocal cord paralysis (n = 74), vocal fold fibrosis (n = 74) and vocal fold sulcus (n = 56). A meta-analysis of six articles reporting on the use of FGF2 in patients with vocal fold atrophy showed a significant increase of mean maximum phonation time of 5.2 s (95% CI: 3.4-7.0) at 3-6 months following injection. A significant improvement in maximum phonation time, voice handicap index and glottic closure was found following injection in most studies assessed. No major adverse events were reported following injection. CONCLUSIONS To date, intralaryngeal injection of basic FGF2 appears to be safe and it may be able to improve voice outcomes in those with vocal dysfunction, especially vocal fold atrophy. Randomised controlled trials are needed to further evaluate efficacy and support the wider use of this therapy.
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Affiliation(s)
- Nick J I Hamilton
- UCL Division of Surgery and Interventional Sciences, Head & Neck Academic Centre, University College London, London, UK
- Department of Laryngology, Royal National Ear Nose & Throat Hospital, University College London Hospitals NHS Trust, London, UK
| | - Brian Saccente-Kennedy
- Department of Laryngology, Royal National Ear Nose & Throat Hospital, University College London Hospitals NHS Trust, London, UK
| | - Gareth Ambler
- UCL Department of Statistical Science, University College London, London, UK
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Trozzi M, Torsello M, Meucci D, Micardi M, Tropiano ML, Balduzzi S, Ossandon Avetikian A, Salvati A, Bottero S. Pediatric Bilateral Vocal Cord Immobility: New Treatment With Preservation of Voice. Laryngoscope 2023; 133:2325-2332. [PMID: 36579686 DOI: 10.1002/lary.30535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/25/2022] [Accepted: 12/08/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Pediatric bilateral vocal cord immobility (BVCI) represents a severe life-threatening condition that often causes severe dyspnea. Endoscopic arytenoid lateral abduction (EALA) is a relatively new, secure, minimal-invasive surgical technique. The present prospective observational study aims to evaluate the effects of EALA in terms of respiratory function, voice quality, and swallowing capabilities. METHODS Twenty-one pediatric patients with BVCI underwent EALA. Eleven out of 21 patients had tracheostomy at the time of surgery. Pre and postoperative functional assessments included endoscopic evaluation, maximum phonation time, pediatric Voice Handicap Index (pVHI), GIRBAS Scale criteria, and Montreal Children's Hospital Feeding scale (MCH-Feeding scale). peak tidal inspiratory flow or peak inspiratory flow (PIF) and number of desaturations/hour (ODI/h) were evaluated in patients without tracheostomy. RESULTS Postoperative endoscopy showed glottic airway improvement in all patients. Average time for decannulation was 4.6 weeks. One patient has not yet been decannulated. No major complications occurred. In patients without tracheostomy, we observed a significant improvement of ODI/h and PIF after surgery (p < 0.05) as expected. PVHI, MCH-Feeding scale, and GIRBAS score significantly worsened 1 month after surgical intervention (p < 0.05). One year after surgery, however, all values, except for B and A parameters of the GIRBAS score, returned to levels comparable to those preoperative. CONCLUSIONS EALA represents a simple, safe and effective solution in pediatric patients with BVCI, avoiding tracheostomy, allowing early decannulation, preserving swallowing function, and maintaining good quality voice. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2325-2332, 2023.
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Affiliation(s)
- Marilena Trozzi
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Miriam Torsello
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Duino Meucci
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Mariella Micardi
- Audiology and Otosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria L Tropiano
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sara Balduzzi
- Department of Diagnostic, Clinical and Public Health Medicine, Modena and Reggio Emilia University Hospital, Modena, Italy
| | | | - Antonio Salvati
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sergio Bottero
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Matsui S, Iwatani S, Morisada N, Takenouchi T, Yoshimoto S. Vocal cord paralysis in autosomal dominant spinal muscular atrophy due to BICD2. Congenit Anom (Kyoto) 2023; 63:52-53. [PMID: 36517450 DOI: 10.1111/cga.12500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/23/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Sachiko Matsui
- Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Sota Iwatani
- Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Naoya Morisada
- Department of Clinical Genetics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Seiji Yoshimoto
- Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
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13
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Krähschütz K, Jeleff-Wölfler O, Wollenberg B, Hofauer B, Bolooki A. [Vocal cord paresis and pathologic tibial shaft fracture]. HNO 2023; 71:119-121. [PMID: 36400851 DOI: 10.1007/s00106-022-01244-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Kathrin Krähschütz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Olivia Jeleff-Wölfler
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Barbara Wollenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Benedikt Hofauer
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Amir Bolooki
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
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14
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Sakthivel S, Prabhu V. Optimal Deep Learning-Based Vocal Fold Disorder Detection and Classification Model on High-Speed Video Endoscopy. J Healthc Eng 2022; 2022:4248938. [PMID: 36353680 PMCID: PMC9640237 DOI: 10.1155/2022/4248938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/04/2022] [Accepted: 09/21/2022] [Indexed: 08/08/2023]
Abstract
The use of high-speed video-endoscopy (HSV) in the study of phonatory processes linked to speech needs the precise identification of vocal fold boundaries at the time of vibration. The HSV is a unique laryngeal imaging technology that captures intracycle vocal fold vibrations at a higher frame rate without the need for auditory inputs. The HSV is also effective in identifying the vibrational characteristics of the vocal folds with an increased temporal resolution during retained phonation and flowing speech. Clinically significant vocal fold vibratory characteristics in running speech can be retrieved by creating automated algorithms for extracting HSV-based vocal fold vibration data. The best deep learning-based diagnosis and categorization of vocal fold abnormalities is due to the usage of HSV (ODL-VFDDC). The suggested ODL-VFDDC technique starts with temporal segmentation and motion correction to identify vocalized regions from the HSV recording and gathers the position of movable vocal folds across frames. The attributes gathered are fed into the deep belief network (DBN) model. Furthermore, the agricultural fertility algorithm (AFA) is used to optimize the hyperparameter tuning of the DBN model, which improves classification results. In terms of vocal fold disorder classification, the testing results demonstrated that the ODL-VFDDC technique beats the other existing methodologies. The farmland fertility algorithm (FFA) is then used to accurately determine the glottal limits of vibrating vocal folds. The suggested method has successfully tracked the speech fold boundaries across frames with minimum processing cost and high resilience to picture noise. This method gives a way to look at how the vocal folds move during a connected speech that is completely done by itself.
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Affiliation(s)
- S. Sakthivel
- Department of Computer Science and Engineering, Vel Tech High Tech Dr. Rangarajan Dr. Sakunthala Engineering College, Avadi, Chennai, India
| | - V. Prabhu
- Department of Electronics and Communication Engineering, Vel Tech Multi Tech Dr. Rangarajan Dr. Sakunthala Engineering College, Chennai, India
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15
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Stager SV, Maryn Y. Glottal Stop Production in Controls and Patients With Unilateral Vocal Fold Paresis/Paralysis. J Speech Lang Hear Res 2022; 65:3392-3404. [PMID: 36044894 DOI: 10.1044/2022_jslhr-21-00599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSES The purposes of this study were to determine whether the acoustic measures from glottal stops distinguished between controls and patients with unilateral vocal fold paresis/paralysis (UVFP) at initial evaluation and posttreatment/observation, to explore the types of false vocal fold (FVF) movement during glottal stop production in UVFP, and to assess the agreement between normalization of various measures and reported voice normalization. METHOD Patients with UVFP and controls were recorded acoustically and laryngoscopically speaking two sets of five repeated /i/s, controls once and patients with UVFP initially and posttreatment/observation. Averaged intensity differences and slopes for offsets (maximum voicing intensity to minimum glottal stop intensity) and onsets (minimum glottal stop intensity to maximum voicing intensity) were measured. FVF movements were rated separately for paretic and nonparetic sides. Patients were asked to report voice normalization posttreatment/observation. Cohen's kappas were calculated for agreements between patient-reported voice normalization and normalization of Voice-Related Quality of Life (V-RQOL), translaryngeal flow, four acoustic measures of glottal stop production, and FVF movement. RESULTS Significant differences (analysis of variance [ANOVA]; p < .014) were found for all acoustic measures between controls and patients with UVFP and between patients with UVFP initially and posttreatment/observation (paired t tests; p < .05). In addition, 78% of UVFP patients had no FVF movement on the paretic side initially, and 42% had bilateral dynamic FVF movement posttreatment/observation. Cohen's kappa showed moderate agreement between voice normalization and V-RQOL, slight agreement with offset measures, and fair agreement with onset measures. CONCLUSION This study provided proof of concept for using acoustic measures of glottal stops to distinguish between controls and patients with UVFP, both initially and posttreatment/observation.
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Affiliation(s)
- Sheila V Stager
- Division of Otolaryngology, Department of Surgery, GW Medical Faculty Associates Voice Treatment Center, Washington, DC
| | - Youri Maryn
- ENT Department, European Institute for ORL-HNS, GZA Hospital Sint-Augustinus, Antwerp, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Belgium
- School of Speech Therapy, Faculty of Psychology and Educational Sciences, Université Catholique Louvain, Louvain-La-Neuve, Belgium
- Department of Speech-Language Therapy and Audiology, University College Ghent, Belgium
- Phonanium, Lokeren, Belgium
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16
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Weng JW, Yu J, Jin F, Peng YG, Zhou JJ, Chen Y, Zhang J, Hei MY. [Clinical characteristics of 14 cases of neonatal tracheotomy in neonatal intensive care unit]. Zhonghua Er Ke Za Zhi 2022; 60:815-819. [PMID: 35922194 DOI: 10.3760/cma.j.cn112140-20220226-00152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze the clinical characteristics of neonatal tracheotomy in neonatal intensive care unit (NICU). Methods: This single-center retrospective study included 14 neonates admitted to NICU of Beijing Children's Hospital, Capital Medical University from January 2016 to August 2021, and were<28 days of age on admission, who met the criteria of tracheotomy and finally completed the procedure. The clinical characteristics including age, weight, duration of ventilation, etiology of tracheotomy, length of hospital stay and prognosis were summarized and analyzed. Wilcoxon signed-rank test was used to compare the weight gain velocity and the duration of ventilation before and after tracheotomy. Paired t-test was used to compare the hospitalization length before and after tracheotomy. Spearman correlation was used to analyze the correlation between the clinical characteristics and outcomes. Results: For the 14 neonates, the gestational age was (38±4) weeks and birth weight was (2 824±949) g. Nine of them were male. The age on transportation was 16 (6, 25) d. A total of 10 neonates were on invasive ventilation on admission, the other 4 were on nasal continuous positive airway pressure support. Bilateral vocal cord paralysis (7 cases) was the commonest cause of tracheotomy. The age on operation was 33 (22, 44) d. There were statistically significant differences in duration of ventilation and weight gain velocity before and after operation (19.00 (10.50, 34.00) vs. 0.86 (0.06, 3.25) d, 1.66 (-0.16, 5.54) vs. 4.69 (2.30, 9.32) g/(kg·d), Z=3.01 and -1.98, both P<0.05). The total hospital stay in NICU was (37±12) d. One neonate died during hospitalization. The existence of pneumonia on admission was positively correlated to NICU stay length (r=0.57, P=0.027), the pre-operational weight gain velocity was negatively correlated to the post-operational NICU stay length (r=-0.73, P=0.020). There were 4 neonates de-cannulated during 7-38 months after the tracheotomy, and 5 neonates still wearing the tracheal cannulation during 15-66 months after the tracheotomy. Two neonates died and 2 neonates lost follow-up after discharge. All neonates could not vocalize normally before de-cannulation, and the language development obviously lagged behind the normal age group after de-cannulation. Conclusions: Bilateral vocal cord paralysis is the commonest cause of neonatal tracheotomy. The benefit of tracheotomy for NICU neonates with surgical indications is obvious, especially in facilitating extubation and improving weight gain.
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Affiliation(s)
- J W Weng
- Department of Neonatology, Neonatal Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - J Yu
- Department of Neonatology, Neonatal Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - F Jin
- Department of Neonatology, Neonatal Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Y G Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, National Center for Children's Health,Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - J J Zhou
- Department of Neonatology, Neonatal Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Y Chen
- Department of Neonatology, Neonatal Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - J Zhang
- Department of Otorhinolaryngology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - M Y Hei
- Department of Neonatology, Neonatal Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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17
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程 超, 钟 建, 仇 书, 杨 李, 刘 大. [Application of multimodal combined surgical strategy in children with intractable laryngeal airway obstruction]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:592-596. [PMID: 35959576 PMCID: PMC10128205 DOI: 10.13201/j.issn.2096-7993.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Indexed: 06/15/2023]
Abstract
Objective:To explore the selection of surgical methods and intraoperative strategies for the treatment of children with intractable laryngeal airway obstruction, and to provide new options for the diagnosis and treatment of children with intractable laryngeal airway obstruction. Methods:The clinical data of 12 children with intractable laryngeal airway obstruction treated by our team from January 2005 to December 2021 were retrospective analyzed. All the children were treated with minimally invasive surgery under rigid bronchoscope or suspension laryngoscope combined with electronic endoscope. The surgical methods included laryngeal microsurgery, plasma ablation, balloon dilatation, drug-eluting stents, laser ablation, endoscopic snare, etc. The patients were followed up after operation. Results:All patients completed the operation under general anesthesia, and there were no intraoperative or postoperative complications. Except for one patient with bilateral vocal cord paralysis who failed to extubation due to restenosis, the others were successfully extubated after operation. Among them, 9 cases of benign space-occupying obstruction were followed up for 5-60 months without recurrence, and 2 cases of malignant tumor-induced obstruction were followed up for 24 months(acinar cell carcinoma) and 36 months(mucoepidermoid carcinoma) without recurrence. Conclusion:Endoscopic multi-operation is effective for children with intractable obstruction. Compared with traditional thoracotomy, endoscopic multi-operation strategies has the advantages of less trauma, faster and safer. For different sizes, locations and pathological types of obstruction, different surgical equipment and methods should be combined.
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Affiliation(s)
- 超 程
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,510000)Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510000, China
| | - 建文 钟
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,510000)Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510000, China
| | - 书要 仇
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,510000)Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510000, China
| | - 李强 杨
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,510000)Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510000, China
| | - 大波 刘
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,510000)Department of Pediatric Otolaryngology, Shenzhen Hospital, Southern Medical University, Shenzhen, 510000, China
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18
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Pan PC, Savidge C, Amsellem P, Hamilton S. Comparison between propofol and alfaxalone anesthesia for the evaluation of laryngeal function in healthy dogs utilizing computerized software. PLoS One 2022; 17:e0270812. [PMID: 35789223 PMCID: PMC9255722 DOI: 10.1371/journal.pone.0270812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/17/2022] [Indexed: 11/24/2022] Open
Abstract
Laryngeal paralysis is a well-documented cause of upper respiratory tract obstruction in canines. Diagnosis of laryngeal paralysis is usually made by visual evaluation of laryngeal motion whilst patients are under a light-plane of anesthesia. However, in human studies of laryngeal function evaluation, it has been shown that subjective scoring can lead to significant interobserver variance, which may cause false diagnosis. In this study, we propose to introduce a more objective method of assessing laryngeal function using GlotAnTools and Tracker software to directly measure laryngeal motion in anaesthetized patients. Additionally, two anesthetic agents, alfaxalone and propofol, were compared in this study to assess their relative effect on laryngeal motion and thus their suitability for use in this diagnostic process. This study was a two-stage, cross-over, 1:1 randomization, with two active treatment arms. Ten beagles (10–18 months, five males and five females) were exposed to both anesthetic agents and laryngeal motion was recorded using videoendoscopy. GlotAnTools and Tracker software were applied to the recorded images to measure glottal gap area (A) and length (L). A normalized measure of laryngeal function–computed as A/L–was created, representing the "elongatedness" of the rima glottidis. The glottal gap area was significantly reduced in dogs receiving alfaxalone. This study objectively establishes that alfaxalone impacted laryngeal motion significantly more than propofol and confirms the capability of these computational methods to detect differences in laryngeal motion.
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Affiliation(s)
- Po-ching Pan
- Department of Companion Animal, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
- * E-mail:
| | - Christine Savidge
- Department of Companion Animal, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Pierre Amsellem
- Department of Companion Animal, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Stephanie Hamilton
- Department of Companion Animal, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Brooks JA, Abdelhamid Ahmed AH, Al-Qurayshi Z, Kamani D, Kyriazidis N, Hammon RJ, Ma H, Sritharan N, Wasserman I, Trinh LN, Iwata AJ, Saito Y, Soylu S, Randolph GW. Recurrent Laryngeal Nerve Invasion by Thyroid Cancer: Laryngeal Function and Survival Outcomes. Laryngoscope 2022; 132:2285-2292. [PMID: 35363394 DOI: 10.1002/lary.30115] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/11/2022] [Accepted: 03/21/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recurrent laryngeal nerve (RLN) invasion by thyroid carcinoma represents an advanced disease status with potentially significant co-morbidity. METHODS In a retrospective single-center study, we included patients with invaded RLNs operated on while using nerve monitoring techniques. We studied pre-, intra-, and postoperative parameters associated with postoperative vocal cord paralysis (VCP); 5-year recurrence-free survival (RFS); and 5-year overall survival (OS) in addition to two subgroup analyses of postoperative VCP in patients without preoperative VCP and based on source of RLN invasion. RESULTS Of 65 patients with 66 nerves-at-risk, 39.3% reported preoperative voice complaints. Preoperative VCP was documented in 43.5%. The RLN was invaded by primary tumor in 59.3% and nodal metastasis in 30.5%. Papillary thyroid carcinoma was the most common pathologic subtype (80%). After 6 months, 81.8% had VCP. Complete tumor resection of the RLN was not associated with 5-year RFS (p = 0.24) or 5-year OS (p = 0.9). Resecting the RLN did not offer statistically significant benefit on 5-year RFS (p = 0.5) or 5-year OS (p = 0.38). Radioactive Iodine (RAI) administration was associated with improvement in 5-year RFS (p = 0.006) and 5-year OS (p = 0.004). Patients without preoperative VCP had higher IONM amplitude compared with patients with VCP. After a mean follow-up of 65.8 months, 35.9% of patients had distant metastases, whereas 36.4% had recurrence. CONCLUSION Preoperative VCP accompanies less than half of patients with RLN invasion. Invaded RLNs may have existent electrophysiologic stimulability. Complete tumor resection and RLN resection were not associated with better 5-year RFS or OS, but postoperative RAI was. LEVEL OF EVIDENCE 4 Laryngoscope, 2022.
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Affiliation(s)
- Jennifer A Brooks
- Department of Otolaryngology-Head & Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Amr H Abdelhamid Ahmed
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Zaid Al-Qurayshi
- Department of Otolaryngology-Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Dipti Kamani
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Natalia Kyriazidis
- Department of Otolaryngology-Head & Neck Surgery, State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Rebecca Jean Hammon
- Department of Head and Neck Surgery, Northwest Permanente, Portland, Oregon, USA
| | - Hongzhi Ma
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology-Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Niranjan Sritharan
- Department of Otolaryngology-Head and Neck Surgery, Westmead & Nepean Hospitals, Sydney, Australia
| | - Isaac Wasserman
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Lily N Trinh
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Ayaka J Iwata
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Santa Clara Medical Center, California, USA
| | - Yoshiyuki Saito
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Selen Soylu
- Department of General Surgery, Basaksehir Cam and Sakura City Hospital., Istanbul, Turkey
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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20
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Chiu KL, Lien CF, Wang CC, Wang CC, Hwang TZ, Shih YC, Yu WHV, Wu CW, Dionigi G, Huang TY, Chiang FY. Intraoperative EMG recovery patterns and outcomes after RLN traction-related amplitude decrease during monitored thyroidectomy. Front Endocrinol (Lausanne) 2022; 13:888381. [PMID: 36034434 PMCID: PMC9403328 DOI: 10.3389/fendo.2022.888381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Traction injury is the most common type of recurrent laryngeal nerve (RLN) injury in thyroid surgery. Intraoperative neuromonitoring (IONM) facilitates early detection of adverse electromyography (EMG) effect, and this corrective maneuver can reduce severe and repeated nerve injury. This study aimed to evaluate intraoperative patterns and outcomes of EMG decrease and recovery by traction injury. METHODS 644 patients received nerve monitored thyroidectomy with 1142 RLNs at risk were enrolled. Intermittent IONM with stimulating dissecting instrument (real-time during surgical procedure) and trans-thyroid cartilage EMG recording method (without electrode malpositioning issue) were used for nerve stimulation and signal recording. When an EMG amplitude showed a decrease of >50% during RLN dissection, the surgical maneuver was paused immediately. Nerve dissection was restarted when the EMG amplitude was stable. RESULTS 44/1142 (3.9%) RLNs exhibited a >50% EMG amplitude decrease during RLN dissection and all (100%) showed gradual progressive amplitude recovery within a few minutes after releasing thyroid traction (10 recovered from LOS; 34 recovered from a 51-90% amplitude decrease). Three EMG recovery patterns were noted, A-complete EMG recovery (n=14, 32%); B-incomplete EMG recovery with an injury point (n=16, 36%); C-incomplete EMG recovery without an injury point (n=14, 32%). Patients with postoperative weak or fixed vocal cord mobility in A, B, and C were 0(0%), 7(44%), and 2(14%), respectively. Complete EMG recovery was found in 14 nerves, and incomplete recovery was found in another 30 nerves. Temporary vocal cord palsy was found in 6 nerves due to unavoidable repeated traction. CONCLUSION Early detection of traction-related RLN amplitude decrease allows monitoring of intraoperative EMG signal recovery during thyroid surgery. Different recovery patterns show different vocal cord function outcomes. To elucidate the recovery patterns can assist surgeons in the intraoperative decision making and postoperative management.
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Affiliation(s)
- Kuan-Lin Chiu
- Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Ching-Feng Lien
- Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Chun Wang
- Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Chung Wang
- Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Tzer-Zen Hwang
- Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chen Shih
- Department of Otolaryngology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Wing-Hei Viola Yu
- Department of Otorhinolaryngology-Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Che-Wei Wu
- Department of Otorhinolaryngology-Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Gianlorenzo Dionigi
- Division of General Surgery, Endocrine Surgery Section, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Tzu-Yen Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- *Correspondence: Tzu-Yen Huang, ; Feng-Yu Chiang,
| | - Feng-Yu Chiang
- Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- *Correspondence: Tzu-Yen Huang, ; Feng-Yu Chiang,
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21
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Lehrer E, Jubés S, Casanova-Mollà J. Parálisis de cuerda vocal tras vacunación contra el SARS-CoV-2. Med Clin (Barc) 2022; 159:e5-e6. [PMID: 35190198 PMCID: PMC8802156 DOI: 10.1016/j.medcli.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Eduardo Lehrer
- Servicio de Otorrinolaringología, Hospital Clínic de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España.
| | - Sara Jubés
- Servicio de Otorrinolaringología, Hospital Clínic de Barcelona, Barcelona, España
| | - Jordi Casanova-Mollà
- Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España
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22
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Deshpande A, Tey CS, Chanani N, Landry A, Raymond M, Sebelik M, Shashidharan S, Wolf M, Raol N. The utility of handheld ultrasound as a point-of-care screening tool to assess vocal fold impairment following congenital heart surgery. Int J Pediatr Otorhinolaryngol 2021; 148:110825. [PMID: 34252699 DOI: 10.1016/j.ijporl.2021.110825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/10/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Vocal fold motion impairment (VFMI) is a known potential complication of congenital heart surgery (CHS). Flexible nasolaryngoscopy (FNL) is the gold standard for evaluation of vocal fold movement but has risks, including epistaxis, desaturation, and changes in heart rate. Laryngeal ultrasound (LUS) has begun to emerge as a diagnostic tool and has been shown to have high accuracy in the evaluation of VFMI. We sought to assess the utility of hand-held LUS as a point-of-care screening tool to assess VFMI in pediatric patients following congenital heart surgery. METHODS Using a prospective cohort design, children under 18 years who were undergoing congenital heart surgery at a tertiary care pediatric hospital were enrolled. All patients underwent postoperative LUS and FNL. All studies were reviewed by two otolaryngology reviewers blinded to the clinical diagnosis. Higher quality studies were reviewed by two cardiology reviewers also blinded to the clinical diagnosis. Accuracy and inter-rater reliability were calculated. RESULTS Sixty-two children were screened. Fourteen children with VFMI were identified via FNL. When comparing LUS and FNL, both individual accuracy (90.3% and 75.8%) and interrater agreement (79% overall, 96% for high quality videos) were high for the otolaryngology reviewers. The cardiology reviewers were able to obtain 100% accuracy for high quality videos. CONCLUSION Handheld LUS has utility as a point-of-care screening tool to assess VFMI. This may have benefit in low-resource settings, for universal screening in cardiac intensive care units, or in settings where otolaryngology consultation may be difficult to obtain.
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Affiliation(s)
- Anita Deshpande
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Emory University, USA
| | - Ching Siong Tey
- School of Medicine, Department of Pediatrics, Emory University, USA
| | - Nikhil Chanani
- School of Medicine, Department of Pediatrics, Emory University, USA; Children's Healthcare of Atlanta, USA
| | - April Landry
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Emory University, USA; Children's Healthcare of Atlanta, USA
| | - Mallory Raymond
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Emory University, USA
| | - Merry Sebelik
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Emory University, USA
| | - Subhadra Shashidharan
- School of Medicine, Department of Cardiothoracic Surgery, Emory University, USA; Children's Healthcare of Atlanta, USA
| | - Michael Wolf
- School of Medicine, Department of Pediatrics, Emory University, USA; Children's Healthcare of Atlanta, USA
| | - Nikhila Raol
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Emory University, USA; Children's Healthcare of Atlanta, USA.
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23
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Hansen K, Nolte A, Klussmann JP. Vocal cord augmentation with autologous fat in unilateral vocal cord paralysis. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 3:103-104. [PMID: 34053889 DOI: 10.1016/j.anorl.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/14/2021] [Indexed: 11/19/2022]
Affiliation(s)
- K Hansen
- University of Cologne, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Cologne, Germany.
| | - A Nolte
- University of Cologne, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Cologne, Germany.
| | - J P Klussmann
- University of Cologne, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Cologne, Germany.
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24
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Zeleník K, Formánek M, Walderová R, Formánková D, Komínek P. Author's reply to Letter to the Editor: "Five-year results of vocal fold augmentation using autologous fat or calcium hydroxylapatite". Eur Arch Otorhinolaryngol 2021; 278:2161-2162. [PMID: 33811548 DOI: 10.1007/s00405-021-06784-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Karol Zeleník
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 70800, Ostrava, Czech Republic.
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300, Ostrava, Czech Republic.
| | - Martin Formánek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 70800, Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300, Ostrava, Czech Republic
| | - Radana Walderová
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 70800, Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300, Ostrava, Czech Republic
| | - Debora Formánková
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 70800, Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300, Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 70800, Ostrava, Czech Republic
- Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300, Ostrava, Czech Republic
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25
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Zahradnikova P, Fědorová L, Babala J, Béder I, Staník J, Králik R. Thyroid surgery in children: our experience. Rozhl Chir 2021; 100:21-26. [PMID: 33691419 DOI: 10.33699/pis.2021.100.1.21-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Thyroid surgery in children is a rare operation. The aim of our paper is to point out the specifics of thyroid surgery in children. METHODS Retrospective analysis of patients hospitalized at the Department of Paediatric Surgery, Faculty of Medicine, Comenius University and National Institute of Childrens Diseases in Bratislava during a 10-year period (20072016) who underwent thyroid surgeries. RESULTS The retrospective analysis included 81 patients: 66 (81%) girls and 15 (19%) boys. The mean age of the patients was 14 years ±8 months (range 418 years). The most common indications for thyroid surgery were: a nodule in 36 (44.4%) patients, Graves Basedow thyrotoxicosis in 19 (23.5%) patients, and suspected thyroid carcinoma in 11 (13.6%) patients. Cervical lymph node metastases (mts) were diagnosed in 9 (11.1%) patients, and distant pulmonary metastases in 5 (6.17%) patients. Total thyroidectomy (TTE) was performed in 43 (53%) patients, total lobectomy (TL) in 20 (24.7%) patients. Extended surgery on regional lymph nodes was performed in 9 (11.1%) patients. Eight (9.9%) patients underwent reoperation. A total of 12 (14.8%) patients experienced postoperative complications. Unilateral transient recurrent laryngeal nerve (RLN) paralysis occurred in 2 patients, and permanent in one patient. Transient postoperative hypoparathyroidism with hypocalcaemia was reported in 8 (9.9%) patients; no permanent condition of this type was observed. CONCLUSION Multidisciplinary collaboration ensures that optimal surgical results are achieved in the patients. Experience of the surgeon performing thyroid surgery in children remains crucial.
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26
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Wilson A, Kimball EE, Sayce L, Luo H, Khosla SM, Rousseau B. Medialization Laryngoplasty: A Review for Speech-Language Pathologists. J Speech Lang Hear Res 2021; 64:481-490. [PMID: 33524276 PMCID: PMC8632480 DOI: 10.1044/2020_jslhr-20-00344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/18/2020] [Accepted: 11/17/2020] [Indexed: 05/26/2023]
Abstract
Purpose The purpose of this study is to familiarize speech-language-pathologists with the current state of the science regarding medialization laryngoplasty in the treatment of voice disorders, with emphasis on current evidence-based practice, voice outcomes, and future directions for research. Method A literature review was performed in PubMed and Embase using the keywords vocal fold/cord and laryngoplasty, thyroplasty, augmentation, or laryngeal framework. Articles published between 2010 and 2020 were reviewed for data about clinical applications, technical approach, voice-related outcomes, and basic science or clinical innovations with the potential to improve patient care. A synthesis of data was performed from articles meeting the outlined search criteria. Conclusions As key members in the multidisciplinary care of voice disorders, speech-language pathologists need to be informed of current research in medialization laryngoplasty, a procedure commonly used for patients with glottic insufficiency. Advances in anesthetic technique, office-based procedures, and the development of materials with increased bio-tolerability over the past decade have led to innovations in treatment and improved patient outcomes. Recent applications of computational and bioengineering approaches have the potential to provide new directions in the refinement of currently available techniques and the improvement of patient-based treatment outcomes.
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Affiliation(s)
- Azure Wilson
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Emily E. Kimball
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
| | - Lea Sayce
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Haoxiang Luo
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
| | - Sid M. Khosla
- Department of Otolaryngology Head and Neck Surgery, University of Cincinnati College of Medicine, OH
- Neurosensory Disorder Center at UC Gardner Neuroscience Institute, Cincinnati, OH
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
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27
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Gauer RL. Otolaryngeal and Oropharyngeal Conditions: Dysphonia. FP Essent 2021; 501:11-16. [PMID: 33595263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dysphonia is any alteration of voice quality or vocal effort that impairs communication and affects quality of life. In patients with dysphonia, voice qualities often are described as tremulous, hoarse, strained, or raspy, with altered pitch, breathiness, or vocal fatigue. Dysphonia is a sign of an underlying disease process. Up to one-third of individuals will experience dysphonia in their lifetime. The evaluation includes a history, physical examination, and, in some cases, laryngoscopy. The most common cause of dysphonia is acute laryngitis, with the majority of cases lasting fewer than 3 weeks. Longer duration of symptoms occurs with chronic laryngitis, laryngopharyngeal reflux, muscle tension dysphonia, benign vocal fold lesions, vocal fold paresis or paralysis, and spasmodic dysphonia. Laryngeal malignancy is uncommon; the major risk factors are smoking and concurrent alcohol use. Laryngoscopy should be performed in all patients with dysphonia that does not resolve or improve within 4 weeks or of any duration if a serious underlying etiology is suspected. Management is directed at the underlying etiology. Empiric treatment with antibiotics, corticosteroids, and antireflux drugs should be avoided in the absence of a clear indication. In patients with a definitive diagnosis, management includes vocal hygiene, voice therapy, pharmacotherapy, and surgery.
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Affiliation(s)
- Robert L Gauer
- Uniformed Services University F Edward Hébert School of Medicine Department of Family Medicine, 4301 Jones Bridge Road A1038, Bethesda, MD 20814-4799
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28
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Park J, Alnouri G, Eichorn D, Sataloff RT. Correlation Between Presbylarynx and Laryngeal EMG. J Voice 2020; 36:413-416. [PMID: 32928604 DOI: 10.1016/j.jvoice.2020.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The normal aging process affects many human functions profoundly. The voice is no exception, and some aging effects on the voice are obvious including vocal fold atrophy, bowing, stiffness, more prominent vocal fold processes, and glottic insufficiency. The study's primary aim was to determine the correlation between presbylarynx and laryngeal electromyography (LEMG) results and to compare these electromyography (EMG) results with young and old voice patients without evidence of presbylarynx changes on strobovideolaryngoscopy. METHODS Medical records for voice patients seen in the senior author's (RTS) practice between 2015 and 2019 were reviewed retrospectively. Patients with presbylarynx confirmed by strobovideolaryngoscopy were identified and compared to two control groups. The first control group included patients with ages and American Society of Anesthesiologists scores similar to the experimental group but no presbylarynx. The second control group included younger patients (ages ranging between 18 and 35 years with mean age of 24.57 years) with vocal fold paresis. All groups had undergone LEMG because of suspected paresis clinically. Social and medical factors reviewed and compared between groups included smoking history, alcohol consumption, occupation (voice demanding versus not voice demanding occupation), Voice Handicap Index score at the initial office visit, medical comorbidities, medications, and LEMG results. RESULTS There was no significant difference in the recruitment results for three pairs of muscles (cricothyroid, thyroarytenoid and posterior cricoarytenoid) between the presbylarynx group and both control groups. Rate of asthma was higher in presbylarynx group compared with the first control group. Rates of corticosteroid inhaler use, thyroid medications, smoking, and Voice Handicap Index score were higher in presbylarynx group compared with the second control group. There was no significant difference in occupation type and alcohol consumption between groups. CONCLUSION There was no significant difference found in the neuromuscular function based on laryngeal EMG between presbylarynx patients and both old and young patients with vocal fold paresis but without presbylarynx. Corticosteroid inhaler is associated with atrophic changes seen in presbylarynx. There still could be differences in the neuromuscular function which weren't detected. More research is needed to confirm or refute these findings.
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Affiliation(s)
- Jin Park
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Ghiath Alnouri
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Daniel Eichorn
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Robert T Sataloff
- Professor and Chair, Department of Otolaryngology - Head and Neck Surgery, Senior Associate Dean for Clinical Academic Specialties, Drexel University College of Medicine, Director of Otolaryngology and Communication Sciences Research, Lankenau Institute for Medical Research, Philadelphia, Pennsylvania.
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29
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S A, R V, P C, V I. Reversible Cardiovocal (Ortner's) Syndrome in Dilated Cardiomyopathy - A Rare Presentation of a Common Disease. J Assoc Physicians India 2020; 68:65-66. [PMID: 32610886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ortners syndrome is a rare cause of recurrent laryngeal nerve palsy due to cardiac causes. After the description of this syndrome by Ortner in patients with mitral stenosis, it was described by many authors in multiple other cardiac conditions. Here we present a case of Ortner's syndrome in Dilated cardiomyopathy,which reverted completely after medical management of DCMP.
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Affiliation(s)
- Anbarasan S
- Assistant Professor, Sri Venkateswara Medical College and Research Institute- Pondicherry
| | - Vairakkani R
- Assistant Professor, Sri Venkateswara Medical College and Research Institute- Pondicherry
| | - Chinnaiyan P
- Professor and HOD, Sri Venkateswara Medical College and Research Institute- Pondicherry
| | - Indhumathi V
- Resident, Sri Venkateswara Medical College and Research Institute- Pondicherry
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30
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Lee JC, Maher DI, Goare S, Forrest E, Grodski S, Serpell JW. Response to Walgama et al. re: "Routine Preoperative Laryngoscopy for Thyroid Surgery Is Not Necessary Without Risk Factors" (Thyroid 2020;30:785-786. DOI: 10.1089/thy.2020.0042). Thyroid 2020; 30:786-787. [PMID: 32138616 DOI: 10.1089/thy.2020.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- James C Lee
- Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Dominic I Maher
- Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia
| | - Stephanie Goare
- Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia
| | - Edward Forrest
- Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia
| | - Simon Grodski
- Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Jonathan W Serpell
- Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
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31
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Walgama E, Sinclair C, Chen AY, Davies L, Noel JE, Orloff LA, Shindo M, Sigston E, Stack BC, Terris D, Randolph GW. Re: "Routine Preoperative Laryngoscopy for Thyroid Surgery Is Not Necessary Without Risk Factors" by Maher et al. (Thyroid 2019;29:1646-1652. DOI: 10.1089/thy.2019.0145). Thyroid 2020; 30:785-786. [PMID: 32228150 DOI: 10.1089/thy.2020.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Evan Walgama
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Catherine Sinclair
- Department of Ear, Nose, and Throat-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA
| | - Amy Y Chen
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Louise Davies
- Department of Surgery, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Julia E Noel
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Lisa A Orloff
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Maisie Shindo
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Elizabeth Sigston
- Department of Otorhinolaryngology, Head and Neck Surgery, Monash Health, Melbourne, Australia
| | - Brendan C Stack
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - David Terris
- Department of Otolaryngology, Augusta University, Augusta, Georgia, USA
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Wang H, Hou J, Li XP, Jiang J, Sun L, Zhou Q. [Application of ultrasonography in etiologic judgment of hoarseness after thyroidecomy]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:1173-1175. [PMID: 31914268 DOI: 10.13201/j.issn.1001-1781.2019.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Indexed: 06/10/2023]
Abstract
Objective:To explore the application value of ultrasound in etiologic judgement of hoarseness after thyroidecomy. Method:Sixty-three cases of hoarseness after thyroidecomy were examed by laryngeal ultrasonography. Vocal cord, arytenoid cartilage, pyriform fossa, thyroid operation area and recurrent laryngeal nerve pathway were evaluated. Regard electronic laryngoscope results as gold standard and compare the differences between the two methods. Result:Sixty-three patients were detected by ultrasound, then, 29 cases were diagnosed with left vocal cord paralysis, 24 cases with right vocal cord paralysis, 2 cases with bilateral vocal cord paralysis, 1 case with right vocal cord polyp, 3 cases with left vocal cord polyp, 1 case with renke layer edema, and 3 cases has normal laryngeal imaging. The accuracy of ultrasonography in determining the etiology of hoarseness after thyroidecomy is 92.1%, the sensitivity is 93.3%, and the specificity is 66.7%. Conclusion:The ultrasonography can not only show laryngeal structures, but also display thyroid operation area and recurrent laryngeal nerve pathway. Moreover, as an non-invasive method, ultrasonography has high accuracy in etiologic judgement of hoarseness after thyroidecomy and certain clinical application values.
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Affiliation(s)
- H Wang
- Department of Ultrosound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China
| | - J Hou
- Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University
| | - X P Li
- Department of Ultrosound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China
| | - J Jiang
- Department of Ultrosound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China
| | - L Sun
- Department of Ultrosound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China
| | - Q Zhou
- Department of Ultrosound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China
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33
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Hs S, Utpat K, Joshi JM. Pulmonary Vocal Syndrome. J Assoc Physicians India 2019; 67:91-92. [PMID: 31561700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Vocal cord paralysis is a common entity with diverse causes clinically manifesting as dysphonia. Vocal cord paralysis due to respiratory cause is due to involvement of left recurrent laryngeal nerve usually secondary to bronchogenic carcinoma. However, it can also be seen in association with other less well recognised causes such as pulmonary tuberculosis. We present to you a patient with hoarseness of voice due to left recurrent laryngeal nerve paralysis secondary to endobronchial tuberculosis.
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34
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Affiliation(s)
- Hui Sun
- Jilin Provincial Key Laboratory of Surgical Translational Medicine, China-Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun city, Jilin Province, China
| | - Gianlorenzo Dionigi
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Via C. Valeria 1, 98125, Messina, Italy.
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35
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Affiliation(s)
- Scott M Bradley
- Section of Pediatric Cardiac Surgery, Medical University of South Carolina, Charleston, SC.
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Na'ara S, Amit M, Billan S, Cohen J, Gil Z. [SURGICAL TREATMENT OF LOCALLY ADVANCED WELL DIFFERENTIATED THYROID CARCINOMA]. Harefuah 2017; 156:568-572. [PMID: 28971654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIMS We aimed to better define the most appropriate therapeutic protocol for this type of tumor. BACKGROUND The incidence of well-differentiated thyroid carcinoma is rising and the mortality from the disease remains low for patients with early disease. Nevertheless, the survival of patients with advanced disease has not improved during the last four decades and a controversy still exists in the literature regarding the optimal treatment in patients with locally advanced (T4) differentiated thyroid carcinoma. METHODS Meta-analysis of the literature and our institutional experience, in treating patients with advanced papillary/follicular thyroid carcinoma. The main outcome measures were overall survival (OS) and disease-specific survival (DSS). RESULTS The study group consisted of 38 patients with locally advanced thyroid carcinoma (T4). Regional spread to nodal metastases was present in 25 (65.7%) patients. Tracheal invasion was diagnosed in 29 (76.3%), of those 10 (26.3%) patients had airway obstruction. Recurrent laryngeal nerve (RLN) paralysis was revealed with clinical evidence during diagnosis in 23 (60.5%) patients. The 5-years OS was 66% and DSS was 87%. Multivariate analysis of outcome showed that undifferentiated carcinoma foci and vocal cord paralysis were associated with significantly reduced 5-years OS, and vocal cord paralysis was the only independent prognostic variable for DSS. Male gender and adjuvant radioactive iodine treatment were significant prognostic variables for disease free survival but not OS or DSS. CONCLUSIONS Surgical resection remains the mainstay of treatment for locally advanced differentiated thyroid cancers. Foci of poorly differentiated cells, vocal cord paralysis and male gender are associated with poor prognosis. Radioactive iodine treatment improved local control but did not not affect OS. These patients should be managed by a multidisciplinary team in university centers specializing in treating complicated cancer patients.
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Affiliation(s)
- Shorook Na'ara
- Otolaryngology, Head and Neck Surgery, Rambam Medical Campus, Haifa, Israel
- The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
| | - Moran Amit
- Otolaryngology, Head and Neck Surgery, Rambam Medical Campus, Haifa, Israel
- The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
| | - Salem Billan
- Oncology Department, Rambam Medical Campus, Haifa, Israel
| | - Jacob Cohen
- Otolaryngology, Head and Neck Surgery, Rambam Medical Campus, Haifa, Israel
| | - Ziv Gil
- Otolaryngology, Head and Neck Surgery, Rambam Medical Campus, Haifa, Israel
- The Laboratory for Applied Cancer Research, CRIR, Rambam Medical Campus, Haifa, Israel
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Sanabria Sanchinel AA, Navarro Pérez MP, Flores Robles BJ, Tejero Juste C. Tapia syndrome plus: A new entity or a variant of Tapia syndrome? Neurologia 2017; 34:348-349. [PMID: 28712836 DOI: 10.1016/j.nrl.2017.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 05/03/2017] [Accepted: 05/11/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- A A Sanabria Sanchinel
- Neuro-Clínica de Neurología, Ciudad de Guatemala, Guatemala; Sección de Neurología, CAMIP-Pamplona, Ciudad de Guatemala, Guatemala.
| | - M P Navarro Pérez
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - B J Flores Robles
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | - C Tejero Juste
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Henry BM, Sanna B, Vikse J, Graves MJ, Spulber A, Witkowski C, Tomaszewska IM, Tubbs RS, Tomaszewski KA. Zuckerkandl's tubercle and its relationship to the recurrent laryngeal nerve: A cadaveric dissection and meta-analysis. Auris Nasus Larynx 2017; 44:639-647. [PMID: 28377109 DOI: 10.1016/j.anl.2017.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/23/2017] [Accepted: 03/10/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Zuckerkandl's tubercle (ZT), when present, is an anatomical landmark by which surrounding structures such as the recurrent laryngeal nerve (RLN) can be identified intraoperatively. This study aimed to investigate the prevalence and anatomical characteristics of Zuckerkandl's tubercle by combining cadaveric dissection with a meta-analysis. METHODS Through October 2016, an extensive search of PubMed, CNKI, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science was completed. Extracted data, along with the findings from our cadaveric dissections, were pooled into a meta-analysis to assess the prevalence and size of ZT and its relationship to the RLN. RESULTS The pooled prevalence estimate of a ZT was 70.2% in the general population, 65.0% of which were considered Grade 0 tubercles (<1.0cm) and 35.0% Grade 1 (≥1.0cm). The RLN ran posteromedially to the ZT in 82.7% of cases, laterally to it in 8.7%, and on top of it in 8.6% of hemilarynges. CONCLUSION RLN palsy is a common postoperative complication and cause for litigation following neck surgery. The ZT is a common component of the thyroid gland and with proper knowledge, surgeons can use it to reliably and quickly identify the RLN during operative procedures.
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Affiliation(s)
- Brandon Michael Henry
- International Evidence-Based Anatomy Working Group, 12 Kopernika St, 31-034 Krakow, Poland; Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika St, 31-034 Krakow, Poland.
| | - Beatrice Sanna
- Faculty of Medicine and Surgery, University of Cagliari, S.S. 554, Bivio Sestu, 09042 Monserrato, CA, Sardinia, Italy
| | - Jens Vikse
- International Evidence-Based Anatomy Working Group, 12 Kopernika St, 31-034 Krakow, Poland; Division of Medicine, Stavanger University Hospital, Gerd-Ragna Bloch Thorsens gate 8, 4011 Stavanger, Norway
| | - Matthew J Graves
- International Evidence-Based Anatomy Working Group, 12 Kopernika St, 31-034 Krakow, Poland; Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika St, 31-034 Krakow, Poland
| | - Alexandru Spulber
- Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika St, 31-034 Krakow, Poland
| | - Cecylia Witkowski
- Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika St, 31-034 Krakow, Poland
| | - Iwona M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, 16 św. Łazarza Street, 31-530 Krakow, Poland
| | - R Shane Tubbs
- Seattle Science Foundation, 550 17th Ave, James Tower, Suite 600, Seattle, WA 28122, USA
| | - Krzysztof A Tomaszewski
- International Evidence-Based Anatomy Working Group, 12 Kopernika St, 31-034 Krakow, Poland; Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika St, 31-034 Krakow, Poland
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Zhang N, Zhang Q, She C. [Coblation treatment for laryngopharynx hemangioma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 29:1878-1880. [PMID: 26930910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effect and feasibility of coblation treatment for laryngopharynx hemangioma. METHOD Retrospectively analyzed 24 cases with coblation treatment for laryngopharynx hemangioma in recent years. RESULT Twenty-four patients were treated with coblation, follow-ups range 6 months to 24 months after surgry. Recurrence occurred in 2 months after surgry in one patient who was cured with coblation for second time. There was incomplete vocal cord paralysis in another patient because of wide range angeioma. CONCLUSION Coblation treatment for laryngopharynx hemangioma was an ideal way to less bleeding, less damage and more clearfield of vision.
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Gong S, Zhang H, Liu Y, Zhang Q, Yu Z. [Preliminary report on meticulous operation of thyroid lobectomy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 50:28-32. [PMID: 25764924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Thyroid lobectomy can be programmed to operate as "step by step". Each step must be performed meticulously with quality control, so as to minimize the complications of surgery. METHODS From May 2013 to Auguest 2014, the meticulous thyroid operation was conducted in 72 cases (144 lobectomies). Pre- and post-operative evaluations by strobe laryngoscopy, parathyroid hormone (PTH), and blood calcium examinations were conducted in all cases. RESULTS Four cases (5.6%) had transient recurrent laryngeal nerve paralysis after surgery, but no permanent recurrent laryngeal nerve paralysis. There was no transient or permanent superior laryngeal nerve paralysis. Transient hypoparathyroidism occurred in 10 cases, with no permanent hypoparathyroidism. No case presented with postoperative bleeding or infection. CONCLUSIONS "Meticulous operation of thyroid lobectomy" may minimize effectively the complication of surgery.
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Affiliation(s)
- Shanchun Gong
- Department of Otolaryngology Head and Neck Surgery, Southeast University Medical College, Affiliated Nanjing Tongren Hospital, Nanjing 211102, China
| | - Haidong Zhang
- Department of Otolaryngology Head and Neck Surgery, Southeast University Medical College, Affiliated Nanjing Tongren Hospital, Nanjing 211102, China
| | - Yaqun Liu
- Department of Otolaryngology Head and Neck Surgery, Southeast University Medical College, Affiliated Nanjing Tongren Hospital, Nanjing 211102, China
| | - Qingxiang Zhang
- Department of Otolaryngology Head and Neck Surgery, Southeast University Medical College, Affiliated Nanjing Tongren Hospital, Nanjing 211102, China
| | - Zhenkun Yu
- Department of Otolaryngology Head and Neck Surgery, Southeast University Medical College, Affiliated Nanjing Tongren Hospital, Nanjing 211102, China.
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Gao Q, Zhao D. [Clinical application of carbon nanoparticles labeled lymph node in cervical lymph node dissection with papillary thyroid cancer staged preoperatively as N0]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1938-1940. [PMID: 25895310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the clinical application of carbon nanoparticles staining in cervical lymph node dissection on clinical neck lymph nodes the negative (cN0 period) thyroid papillary thyroid carcinoma (PTC). METHOD This retrospective analysis comprised 100 papillary thyroid cancer patients who met inclusion criteria,and they were randomly divided into the nano-carbon group (50 cases) and control group (50 cases). They underwent lobectomy, subtotal thyroidectomy or total thyroidectomies and were given elective central compartment neck dissection (CCND). The number of detected lymph nodes in each group was summed, and pathological examination was conducted. The number of lymph nodes (dyedor not dyed) and the location of metastatic nodes were recorded separately. RESULT In the nano-carbon group the average number of eliminated lymph nodes is significantly more than that of the control group(P<0.05). The metastasis lymph nodes in the nano-carbon group was higher than that in the control group(P<0.01). Among 100 cases, 2% had temporary vocal cord palsy, and 8% had temporary hypoparat hyroidism. No case of permanent vocal cord palsy or permanent hypocalcemia was observed. CONCLUSION The dyed lymph nodes can be easily identified and can be used as a guide for lymphnodes dissection in papillary thyroid carcinoma operation.
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Dai H, Hua Q, Jiang Y, Sheng J. [Anatomy of recurrent laryngeal nerve during thyroid surgery]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1925-1930. [PMID: 25895306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study the anatomic characteristics of recurrent laryngeal nerve during thyroid surgery. METHOD A retrospective review of surgical data of 307 patients undertook thyroid surgery was conducted. RESULT Total 342 recurrent laryngeal nerves were identified during the surgery(184 on the right side, left 158). 215 (62.9%) nerves were deep to the inferior thyroid artery, 106(31.0%)were superficial to the artery, 21(7.5%) were between the arterial branches. A nerve bifurcation was found in 203(59.4%). None of nerve bifurcation was found in 136(39.8%). 3(0.9%)were confirmed to hold non-recurrent laryngeal nerves during operations. No patient showed permanent laryngeal recurrent nerve paralysis postoperatively. CONCLUSION The careful dissection and protection of the recurrent laryngeal nerve was an effective method to prevent its injury during thyroid surgery.
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