BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of sali...BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.展开更多
BACKGROUND Cardiac myxoma is a benign neoplasm and one of the most common types of primary cardiac tumors.Synchronous cardiac myxoma and other malignancies are extremely rare,and only limited cases have been reported....BACKGROUND Cardiac myxoma is a benign neoplasm and one of the most common types of primary cardiac tumors.Synchronous cardiac myxoma and other malignancies are extremely rare,and only limited cases have been reported.CASE SUMMARY We describe a young patient with newly diagnosed locally advanced laryngeal cancer,with a synchronous cardiac tumor detected on staging scans.An echocar-diogram showed the typical appearance of myxoma in the left atrium.Early cardiac surgery was performed in view of its obstructive features and post cardiac surgery recovery was uneventful.The patient was scheduled for subsequent oncological treatment for the laryngeal cancer.However,due to rapid progression of the advanced laryngeal malignancy,he was placed on supportive care.CONCLUSION To our knowledge,this is the first reported case of synchronous cardiac myxoma with laryngeal malignancy.Individualized treatment strategy should be adopted to manage synchronous tumors in a multidisciplinary approach.The most life-threatening condition needs be treated first.Single resection,staged operations or simultaneous resection of both tumors have been reported with good outcomes.展开更多
The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses...The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses a large series of minimally invasive LMEP recordings in 46 female Lewis rats,implanted with a custom-made VNS electrode around the left cervical vagus nerve.After a 3-week recovery,LMEPs were recorded twice in each animal,with swapping the anode and cathode positions of the VNS electrode(polarity inversion).A VNS-induced LMEP was identified as the initial negative peak wave post-stimulation artifact,consistently recorded in all sweeps at a given stimulation output current.Latency was defined as the time from stimulation onset to this negative peak,and stimulation threshold as the lowest current showing a clear and reproducible LMEP.An LMEP response was shown by 37/46 animals(80.4%),with stimulation intensity threshold of 0.37±0.27 mA and latency of 2.39±0.45 ms.Administering the cathodic pulse phase first at the caudal electrode contact resulted in the shortest LMEP latencies(MWU:p=0.049.2.36±0.43 ms vs.2.41±0.47 ms).Minimally invasive LMEP recording provides a feasible and reliable means for checking electrode functioning and correct implantation.展开更多
Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare...Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare.^([1]) HAE symptoms include recurrent episodes of skin and mucosal edema that can occur anywhere in the body.^([1-4]) Laryngeal edema is life-threatening,as it can lead to airway obstruction and potentially fatal suffocation.^([1-3])Edema of the gastrointestinal mucosa may cause abdominal pain,vomiting,and symptoms that are often misdiagnosed as acute abdomen.^([1-4]) This study included four patients,including one with HAE-nC1-INH (genetic testing revealed a heterozygous mutation in the KNG1 gene (c.1404G>C:p.Q468H)) and three with HAE due to C1 inhibitor deficiency (HAE-C1-INH).This case series aims to increase knowledge of HAE by illustrating its diverse clinical presentations and emphasizing features that may prompt clinical suspicion and facilitate timely diagnosis.展开更多
文摘BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.
文摘BACKGROUND Cardiac myxoma is a benign neoplasm and one of the most common types of primary cardiac tumors.Synchronous cardiac myxoma and other malignancies are extremely rare,and only limited cases have been reported.CASE SUMMARY We describe a young patient with newly diagnosed locally advanced laryngeal cancer,with a synchronous cardiac tumor detected on staging scans.An echocar-diogram showed the typical appearance of myxoma in the left atrium.Early cardiac surgery was performed in view of its obstructive features and post cardiac surgery recovery was uneventful.The patient was scheduled for subsequent oncological treatment for the laryngeal cancer.However,due to rapid progression of the advanced laryngeal malignancy,he was placed on supportive care.CONCLUSION To our knowledge,this is the first reported case of synchronous cardiac myxoma with laryngeal malignancy.Individualized treatment strategy should be adopted to manage synchronous tumors in a multidisciplinary approach.The most life-threatening condition needs be treated first.Single resection,staged operations or simultaneous resection of both tumors have been reported with good outcomes.
基金The Research Foundation Flanders(FWO),Grant/Award Number:1S25620NThe Charcot Research Fund。
文摘The laryngeal muscle evoked potential(LMEP)is a neurophysiological outcome parameter that guarantees integrity of the nerve-electrode interface during experiments with vagus nerve stimulation(VNS).This paper discusses a large series of minimally invasive LMEP recordings in 46 female Lewis rats,implanted with a custom-made VNS electrode around the left cervical vagus nerve.After a 3-week recovery,LMEPs were recorded twice in each animal,with swapping the anode and cathode positions of the VNS electrode(polarity inversion).A VNS-induced LMEP was identified as the initial negative peak wave post-stimulation artifact,consistently recorded in all sweeps at a given stimulation output current.Latency was defined as the time from stimulation onset to this negative peak,and stimulation threshold as the lowest current showing a clear and reproducible LMEP.An LMEP response was shown by 37/46 animals(80.4%),with stimulation intensity threshold of 0.37±0.27 mA and latency of 2.39±0.45 ms.Administering the cathodic pulse phase first at the caudal electrode contact resulted in the shortest LMEP latencies(MWU:p=0.049.2.36±0.43 ms vs.2.41±0.47 ms).Minimally invasive LMEP recording provides a feasible and reliable means for checking electrode functioning and correct implantation.
基金supported by the National Social Science Fund of China (19VJX168)。
文摘Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare.^([1]) HAE symptoms include recurrent episodes of skin and mucosal edema that can occur anywhere in the body.^([1-4]) Laryngeal edema is life-threatening,as it can lead to airway obstruction and potentially fatal suffocation.^([1-3])Edema of the gastrointestinal mucosa may cause abdominal pain,vomiting,and symptoms that are often misdiagnosed as acute abdomen.^([1-4]) This study included four patients,including one with HAE-nC1-INH (genetic testing revealed a heterozygous mutation in the KNG1 gene (c.1404G>C:p.Q468H)) and three with HAE due to C1 inhibitor deficiency (HAE-C1-INH).This case series aims to increase knowledge of HAE by illustrating its diverse clinical presentations and emphasizing features that may prompt clinical suspicion and facilitate timely diagnosis.
