OBJECTIVE To study the therapeutic effect of arytenoid within-shift combining with recurrentlaryngeal nerve (RLN) anastomosis to ansa cervicalis for patients with long-term unilateral vocal cord paralysis (UVCP) . METHODS Twelve patients with traumatic RLNs paralysis were studied. The courses of injury varied from 3 to 22 years. RLN was anastomosed to ansa cervicalis and arytenoid was within-shifted on ipsilateral side in all patients. Therapeutic efficacy was evaluated by laryngoscope, strobe-laryngoscope, voice evaluation, voice acoustics parameter analysis, and laryngeal electromyography (LEMG) . RESULTS The voice was improved in all cases after arytenoid within-shift immediately. The mean values of voice acoustics parameters (jitter, shimmer, NNE) were significantly smaller and maximum phonation time (MPT) were significantly longer after operation compared with those of before treatment. Laryngoscope showed that arytenoid was significantly within-shifted. The glottic posterior chink vanished in 9 cases and reduced in 3 cases. The voice resumed normal, obviously improved, improved and no improved were found in 9、 3、0、0 cases respectively 12 months after operation. The mass and tension of all treated vocal cords may become the same as the contralateral normal vocal cords, thus resuming symmetric vibration of the vocal cords. The reinnervation of the RLNs were approved by LEMG in these patients whose RLNs were restored. CONCLUSION Arytenoid within-shift combining with RLN anastomosis to ansa cervical can restored normal voice in patients with long-term UVCP.
Objective To study the damaged extent of efferent fibres across the Corti′s tunnel in guinea pigs after intensive impulse noise exposure.Methods The cochlear AchE(acetylcholinesterase)decoration and a computer assistant quantitative observation of the efferent fibres across the Corti′s tunnel were carried out in three groups of guinea pigs.The guinea pigs of group 3 d and 21 d were fed 3 days and 21 days after exposure of intensive impulse noise,while the normal control group did not receive noise.Results The noise damaged efferent fibres across the Corti′s tunnel mainly took place in the first turn and the second turn of the cochlear.The quantity of the efferent fibres across the Corti′s tunnel in every 0.24 mm length in the first turn and the second turn of the cochlear were(9.6±4.2),(8.8± 3.4) in 3 days group;(11.4±3.2),(10.6±2.5)in 21 days group and(23.2±3.2),(20.7±2.9)in normal control group separately.There were significant statistic difference( P 0 01)between 3 days group and 21 days group with the normal control group.Conclusions The intensive impulse noise could damage efferent fibre across the Corti′s tunnel severely.
Objective To investigate the relationship between the thickness of vocal cords with the depth of early glottic carcinoma infiltrating.Methods Included in this study were 10 samples of vocal cord and 20 ones of early glottic carcinoma taken from operation respectively.The samples of vocal cord were embedded in paraffin for sections making and those of early glottic carcinoma were made sections by both paraffin embedding and frozen preparing procedures respectively.Then,exact measurement was undertaken to determine the thickness of vocal cords and the depth of early glottic carcinoma infiltration in the vocal tissues respectively under micrometer microscope,and followed was a correlation analysis on the collected data in a comparative way.Results The thickness of vocal cords was 5.32±0.84mm,while the infiltrating depth of early glottic carcinoma in vocal tissues were basically depended upon either the clinical staging of lesion or the section preparing procedures,with the infiltrating depth of T1 lesion being 1.62±0.51mm and 1.32±0.49mm and that of T2 lesion being 2.89±0.68mm and 2.58±0.67mm in frozen sections and in paraffin ones respectively.Conclusion Quantitative analysis on the thickness of vocal cords and the depth of earlyglottic carcinoma infiltr ating is very valuable for minimal invasive surgery performed on this kind of laryngeal lesion in clinic.
In order to investigate the changes in cellular distribution of the glycocalyces in nasal inverted papilloma, formalin-fixed, paraffin-embedded biopsy specimens of inverted papilloma were analyzed by the avidin-biotin-peroxidase complex technique for the demonstration of peanut agglutinin (PNA) receptors, concanavalin A (Canavalia ensiformis agglutinin; ConA) receptors, carcinoembryonic antigen (CEA), and keratin, and compared with normal nasal mucosa, nasal polyps, and papillary adenocarcinoma. The inverted papillomas were positive for PNA and CEA, to the same degree as papillary adenocarcinoma. Their PNA binding was related to the degree of dysplasia. The ConA reaction was intermediate between that of normal mucosa and adenocarcinoma. The results suggest that the alteration of cellular glycoprotein structure in inverted papilloma is associated with its biologic characterization.
Eight patients underwent ansa cervicalis anastomosis to the adductor branch of the recurrent laryngeal nerve for unilateral vocal cord paralysis. They were followed long enough (at least 1 year) to determine if the procedure was successful. All cases have been subjected to preoperative and postoperative voice recording, acoustic analysis, and videolaryngoscopy. Some of them have been subjected to stroboscopy and electromyography (EMG). Data from these cases indicate that satisfactory phonatory quality may be achieved after the procedure. The reinnervated vocal cord neither abducted nor adducted, but it presented itself in midline for precise apposition with the normal cord. Synchronous mucosal waves in both vocal cords could be observed. EMG showed that the procedure produced satisfactory reinnervation of the adductory muscles. Therefore, the authors believe that the procedure could be proposed as an alternative to Teflon injection or thyroplasty in selected cases.
To investigate the efficacy and safety of Mizolastine in the treatment of perennial allergic rhinitis.Multicentric random Double-blind parallel-controlled study was adopted, and compared with placebo and Cetirizine. Patients (n = 177) were grouped, seventy-two in Mizolastine group, sixty-nine in Cetirizine and thirty-six in placebo group.In the seventh curative day symptomatic and sign marks in Mizolastine group and Cetirizine group were lower, but the mark in Mizolastine group reduced more than in Cetirizine group and placebo group. Mizolastine group is better than Cetirizine group in improvement of nasal obstruction and itching with Visual analogue scale. In the twenty first curative day reduction of symptomatic and sign marks in Mizolastine group was lower than Cetirizine group, but no statistic difference. There were 27 adverse events, no serious adverse events in 177 patients during experimental period. Most adverse events were headache and dryness in mouth and eyes. There were 10 cases adverse events in Mizolastine group, one case was related with experiment and four cases might be related with experiment. There were 14 cases adverse events in Cetirizine group, one case was related with experiment and four cases might be related with experiment. There were three cases adverse events in placebo group.Generally speaking the efficacy of Mizolastine in treatment of perennial allergic rhinitis is better than Cetirizine, Bad events are less. It is safe.
To determine the comprehensive prognostic value of spontaneous and evoked electromyography (EMG) in laryngeal paralysis.The characteristics of laryngeal EMG of 91 cases with unilateral vocal cord paralysis (VCP) after thyroid surgery were assessed. All cases were divided into four groups according to the interval of laryngeal EMG after onset, which were group one (2 months shorter, n = 13), group two (2 to 4 months, n = 23), group three (4 to 6 months, n = 36), group four (6 months longer, n = 19). The waveform morphology and the amplitude of laryngeal EMG and the highest evoked compound muscular active potential (CMAP) of thyroarytenoid muscles were examined and analyzed during voluntary tasks. The potential amplitude was showed by the percentage of that of the healthy lateral. The criterion of evaluation on evoked potential was attained by calculating statistical confidence interval.The highest evoked CMAP in group one was significantly lower than that of the others (P < 0.05), but no significant difference was observed between group two and group three (P > 0.05), so group two and group three were analyzed together. There were 2 recovered cases and 11 unrecovered cases in group one. On the basis of this criterion that a positive prognosis for laryngeal recovery was indicated when the evoked CMAP presented and there was no misdirect generated potential, correct prognostic rate was 92% (12/13). There were 11 recovered cases and 48 unrecovered cases in group two and three. The highest evoked CMAP was much higher in the recovered than in the unrecovered, significant difference was observed between them (P < 0.001). On the basis of the criterion that a positive prognosis for laryngeal recovery was indicated when the highest evoked CMAP was higher than 26. 4%, correct prognostic rate was 90% (53/59). On the basis of the criterion that a positive prognosis for laryngeal recovery was indicated when there was no misdirect generated potential and the highest evoked CMAP was higher than 26.4%, correct prognostic rate was 93% (55/59). When the interval from onset to laryngeal EMG recovering was longer than 6 months, none of these patients had return of vocal cord mobility whatever were the outcomes of laryngeal EMG.Correct prognostic rate can be improved if the prognosis of VCP in different courses is judged respectively by analyzing comprehensively spontaneous and evoked EMG.
To investigate the effect on cilia movement of experimental maxillary sinusitis in rabbits with different dispose to ostia and mucosa.Forty New Zealand White rabbits which had been induced experimental sinusitis were divided into 3 groups according to mucosa dispose during operation. The another two groups were divided according to different dispose ostia of maxillary sinus. Activated charcoal powder was used to test mucociliary transport (MCT) of maxillary sinus.All data had be processed statistically. MCT of rabbits before operation were faster than that after operation and both of them were faster than the sinusitis group(P < 0.01). The difference of MCT in different propose of ostia groups was not significant(P > 0.05).It's a effective method to estimate the function of cilia using activated charcoal powder to test MCT of maxillary sinus. The function of regenerate mucosa after operation is lower than normal mucosa. The difference of MCT between ostia enlarged operation and ostia patent surgery is not significant.
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