Chinese journal of otorhinolaryngology head and neck surgery最新文献

{"title":"[Risk factors for contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma].","authors":"J H Wang, Z H Wang, Y B Chen, Y X Sun","doi":"10.3760/cma.j.cn115330-20250127-00079","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250127-00079","url":null,"abstract":"<p><p><b>Objective:</b> To explore the risk factors for contralateral central lymph nodes (Cont-CLNs) metastasis of unilateral papillary thyroid carcinoma (PTC) and to guide the decision-making of clinical surgical scope. <b>Methods:</b> The data of 362 patients who underwent total thyroidectomy and bilateral central lymph node dissection at the Sichuan Cancer Hospital from September 2020 to April 2022 and were confirmed as unilateral PTC by postoperative pathology were retrospectively analyzed. Among them, 87 were male and 275 were female, aged from 11 to 76 years. According to whether presence of Cont-CLNs metastasis, they were divided into the metastasis group (115 cases) and the non-metastasis group (247 cases). The relationship between the demographic characteristics, clinicopathological characteristics and other indicators of the two groups of patients and their metastases of Cont-CLNs was analyzed. Univariate analysis, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to screen the risk factors for Cont-CLNs metastasis. Postoperative follow up was performed in the patients. <b>Results:</b> Univariate analysis showed that age, gender, combined Hashimoto's thyroiditis, extranodal invasion, pretracheal and prelaryngeal lymph node metastasis, ipsilateral central lymph nodes (Ipsi-CLNs) metastasis on the affected side, lateral cervical lymph node metastasis on the affected side, lesion location, and tumor diameter were associated with Cont-CLNs metastasis (all <i>P</i> values<0.05). Multivariate revealed that: each of male gender, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph node metastasis, cancer focus location in the isthmus, and unilateral glandular lobe combined with isthmus was an independent risk factor for Cont-CLNs metastasis. For predicting the metastasis risk of Cont-CLNs, the optimal critical value of the number of metastasized Ipsi-CLNs was 2.5, and the area under the ROC curve (AUC) was 0.700; the optimal cut-off value of the number of metastasized pretracheal and prelaryngeal lymph nodes was 1, with an AUC of 0.681. The AUC of gender was 0.630, and the AUC of the cancer lesion location was 0.545. Multivariate ROC curve analysis for Cont-CLNs metastasis based on gender, the number of metastasized Ipsi-CLNs, the number of metastasized pretracheal and prelaryngeal lymph nodes, and the location of cancer foci showed an AUC of 0.794. The patients were followed up until January 2025. Excluding 3 cases with hoarseness caused by recurrent laryngeal nerve invasion before the operation and 3 cases with resection and reconstruction of invaded recurrent laryngeal nerves discovered during the operation, there were no patients with permanent recurrent laryngeal nerve palsy after the operation. There were 3 cases with postoperative permanent hypoparathyroidism. There no patients with postoperative recurrence. <b>Conclusion:</b> Risk factors for Cont-CLNs metastasis include","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"505-510"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tornwaldt cysts in a child: a case report].","authors":"A Y Zhang, M Xu, X Wen, J Q Geng, Q Sun, Y F Wang, L Cui, L J Zuo","doi":"10.3760/cma.j.cn115330-20241105-00618","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20241105-00618","url":null,"abstract":"","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"539-540"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in research on function of <i>LHFPL</i>5 Gene in inner ear and the mechanisms of hearing loss caused by <i>LHFPL</i>5 Mutations].","authors":"L Y Qi, X L Ma, J Ma","doi":"10.3760/cma.j.cn115330-20240530-00325","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240530-00325","url":null,"abstract":"","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"552-557"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in the management of cervical lymph node metastasis from head and neck squamous cell carcinoma].","authors":"G H Hu, C Liu","doi":"10.3760/cma.j.cn115330-20250304-00126","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250304-00126","url":null,"abstract":"","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"485-489"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Accuracy evaluation of airborne pollen concentrations monitored by a new volumetric suction pollen monitor].","authors":"Y H Ouyang, J Yang, J X Zhang, Y Yan, L Zhang","doi":"10.3760/cma.j.cn115330-20240501-00257","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240501-00257","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the accuracy of airborne pollen concentrations monitored by a novel volumetric suction pollen monitor. <b>Methods:</b> During the peak period of autumn pollen concentration in Beijing from September 1st to 27th, the pollen concentration was collected using gravitational and volumetric pollen monitor, and the correlation of pollen concentration between two kind of pollen monitor was analyzed. The effects of daily mean temperature, relative humidity and wind speed on the real-time pollen concentration of the volumetric suction pollen monitor were also analyzed. SPSS 25.0 software was used for statistical analysis. <b>Results:</b> There was significant correlation between the pollen concentration obtained by the two collectors (<i>r_s</i> value was 0.85 and 0.86, respectively, both <i>P</i><0.001). Using a volumetric suction monitor, the pollen concentration in the horizontal 3 lines of the pollen sample (12.5%) under a 200×microscope was significantly correlated with the pollen concentration in the whole sample (<i>r_s</i>=0.97, <i>P</i><0.001). The real-time pollen concentration collected by the volumetric suction monitor within 24 hours was greatly affected by the daily average temperature (all <i>P</i><0.05), and the pollen concentration increased with the daytime temperature, which was not affected by the relative humidity and the average wind speed (all <i>P</i>>0.05). <b>Conclusion:</b> The airborne pollen concentration monitored by new volumetric pollen monitor has high accuracy and can accurately achieve real-time.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"527-531"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application and efficacy of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery].","authors":"Z H Sun, W Meng, G Y Sun, W J Wang, M Yan, H Xiao, S B He","doi":"10.3760/cma.j.cn115330-20240816-00478","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240816-00478","url":null,"abstract":"<p><p><b>Objective:</b> To explore the the application and outcomes of microscopic vocal cord shortening with retrodisplacement of anterior commissure in voice feminization surgery. <b>Methods:</b> We conducted a retrospective analysis of 296 patients(including 3 cases of pseudohermaphroditism and 293 transgender women)who underwent this procedure at the Voice Center of Nanjing Tongren Hospital of Otolaryngology-Head and Neck Surgery between November 2014 and August 2023. The patients, aged 18-50 years (mean age of 28.3±14.5) underwent feminizing laryngoplasty via transoral microsurgery, involving resection of the superficial lamina propria of the anterior vocal cords and subglottic tissues of the anterior commissure, followed by vocal ligament plication to achieve vocal cords shortening and anterior commissure retrodisplacement. Patients adhered to a1-month voice rest postoperatively and subsequently underwent speech rehabilitation training. Subjective/objective voice analyses, aerodynamic evaluations, and stroboscopic examinations were performed at 3, 6, and 12 months postoperatively to assess the effectiveness of voice feminization. <b>Results:</b> All surgeries were performed successfully and 94.3% (279/296) of the patients reported satisfaction at the end of the one-year follow-up. For effective cases, fundamental frequency (F₀) increased by 57.42±16.72 Hz compared to baseline. Postoperative acoustic/aerodynamic parameters and stroboscopic findings of vocal cord mucosal wave motion remained within normal ranges. These results indicated that this voice feminization surgery combined with postoperative pronunciation training achieved natural and feminine vocal characteristics. <b>Conclusion:</b> The combination of vocal cord shortening and anterior commissure retrodisplacement, along with postoperative pronunciation training, represents an effective surgical strategy for achieving a natural feminine voice.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"520-526"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Conventional ultrasound and contrast-enhanced ultrasound for predicting cervical lymph node metastasis in head and neck squamous cell carcinoma].","authors":"C Liu, W Ma, X W Chen, L Chen, M Pan, Y S Li, X L Liu, G H Hu","doi":"10.3760/cma.j.cn115330-20240921-00538","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240921-00538","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the diagnostic efficacy of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) for detecting cervical lymph node metastasis in head and neck squamous cell carcinoma (HNSCC). &lt;b&gt;Methods:&lt;/b&gt; This retrospective case control study included 259 patients (249 males and 10 females,aged 40-88 years with a median age of 63 years) who were pathologically diagnosed with HNSCC at the First Affiliated Hospital of Chongqing Medical University from April 2022 to August 2024. A total of 259 lymph nodes were assessed(78 pathologically positive nodes and 181 pathologically negative ones). Receiver operating characteristic (ROC) curves were plotted to compare the diagnostic efficacies of conventional ultrasound combined with CEUS and CT, MRI, or conventional ultrasound for cervical lymph node metastasis. Patients were randomly assigned to a training group (&lt;i&gt;n&lt;/i&gt;=208) and a validation group (&lt;i&gt;n&lt;/i&gt;=51) (8∶2). Univariate and multivariate Logistic regression were used to analyze the independent risk factors for lymph node metastasis prediction. A nomogram model was constructed based on independent risk factors. The model predictive efficacy was assessed by ROC curve, and model's fit was evaluated by &lt;i&gt;Hosmer-Lemeshow&lt;/i&gt; test. &lt;b&gt;Results:&lt;/b&gt; The area under the curve (AUC) for conventional ultrasound combined with CEUS in predicting cervical lymph node metastasis in HNSCC was 0.923 (95%&lt;i&gt;CI&lt;/i&gt;: 0.880-0.965), which was significantly higher than those for enhanced CT, cervical enhanced MRI, and conventional ultrasound [AUC were 0.820 (95%&lt;i&gt;CI&lt;/i&gt;: 0.753-0.886), 0.802 (95%&lt;i&gt;CI&lt;/i&gt;: 0.737-0.866), and0.836 (95%&lt;i&gt;CI&lt;/i&gt;: 0.774-0.899), respectively].There were no statistically significant differences in clinical data between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Univariate Logistic regression analysis showed that, among contrast-enhanced ultrasound features, the centripetal perfusion pattern, irregular perfusion defect type, and uneven distribution of contrast agent were significantly associated with cervical lymph node metastasis (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Among conventional ultrasound features, L/S ratio≤1.5, heterogeneous internal echoes, uneven cortex thickening, blurred corticomedullary boundary, loss of lymphatic gate structure, and peripheral or mixed type on color Doppler flow imaging were significantly associated with cervical lymph node metastasis (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Multivariate Logistic regression analysis indicated that the centripetal perfusion pattern, heterogeneous internal echoes, and uneven cortical thickening were independent risk factors for cervical lymph node metastasis (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). A nomogram model was constructed based on the above independent risk factors, and offered an AUC of 0.933 (95%&lt;i&gt;CI&lt;/i&gt;:0.890-0.976) in the training group, which was significantly higher than that for enhanced CT, enhanced MRI, conventional ultrasound, and conventional ultrasound combined with CEUS [AUC w","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"496-504"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on surgical treatment of chronic sinusitis in children].","authors":"L Shen, Q Luo, J Ye","doi":"10.3760/cma.j.cn115330-20240531-00329","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240531-00329","url":null,"abstract":"","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"566-571"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminary evaluation of the protective effects of semicircular canal occlusion under continuous irrigating mode of endoscopic ear surgery on hearing function].","authors":"H Liao, W J Wang, L Wang, Y Xu, X L Yang, J Ren, Z J Zhang","doi":"10.3760/cma.j.cn115330-20240913-00529","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240913-00529","url":null,"abstract":"<p><p><b>Objective:</b> To introduce a new technique of precise exposure and preservation of membranous semicircular canal under endoscope, and to evaluate the protective effect of this method on hearing preservation of semicircular canal occlusion. <b>Methods:</b> The study included three patients with unilateral refractory Meniere's disease, including 1 male and 2 females, with hearing stage 4 in 2 cases and stage 3 in 1 case, the average hearing thresholds were 72.5, 82.5 and 48.8 dBHL, respectively. All of them were treated with triple semicircular canal occlusion under continuous irrigating mode of endoscopic ear surgery (CIM-EES) in RenMin Hospital of WuHan University. The surgical procedure involved the following key steps: the bony walls of the three semicircular canals near the ampullae were gradually thinned to expose the blue line. The endoscope was positioned as close as possible to the operating area to obtain a clear, magnified view. A micro hook needle was used to create a window on the bony semicircular canals. The hook needle progressively removed the bony material while preserving the membranous canals, which were clearly visible during the procedure. The bone dust was removed out of the surgical area by the continuous exchanged insuline without the help of suction that can avoid the damage of the membranous semicircular canals caused by aspiration and the open bony canals were precisely filled with bone wax and covered with bone powder to ensure complete occlusion of the three semicircular canals. Postoperative follow-up included regular assessments of vertigo control and hearing preservation. <b>Results:</b> All the 3 patients obtained complete hearing preservation at 6 months after surgery, and the hearing preservation rate was 100%. The average hearing thresholds at 6 months postoperatively were 66.3, 81.3, and 50.0 dBHL, respectively. Postoperatively, all patients experienced horizontal spontaneous nystagmus toward the healthy side on the day of surgery and the first day after surgery. One patient reported complete disappearance of tinnitus, while the other two patients showed no change in tinnitus severity. Postoperative MRI revealed complete occlusion of the three semicircular canals with normal vestibular imaging. At 6 months postoperatively, none of the patients experienced any vertigo attacks, suggesting effective control of vertigo symptoms. <b>Conclusions:</b> Precise Semicircular canal occlusion under CIM-EES is a promising technique for the treatment of intractable vertigo in patients with refractory Meniere's disease. This method provides clear visualization of the membranous canals, reducing the risk of inner ear damage and preserving hearing function of the patients.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"532-536"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The computer-aided diagnosis model of middle ear cholesteatoma based on integrated convolutional neural networks].","authors":"Y T Zhao, R X Ma, H L Ren, N Y Feng, N Zhang, L Wang, Y C Li, X L Shen, J He","doi":"10.3760/cma.j.cn115330-20240515-00282","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240515-00282","url":null,"abstract":"<p><p><b>Objective:</b> Middle ear cholesteatoma is a common otolaryngological disease, and traditional diagnostic methods have certain limitations. This study aims to construct a computer-aided diagnosis model for middle ear cholesteatoma based on integrated convolutional neural networks (CNNs) to improve diagnostic accuracy and efficiency. <b>Methods:</b> Firstly, Data were collected from patients who visited the Department of Otorhinolaryngology Head and Neck Surgery at the First People's Hospital of Yinchuan between January 2020 and December 2021. 8 000 temporal bone CT images were collected, including 5 000 images diagnosed pathologically as middle ear cholesteatoma and 3 000 normal images. A five-fold cross-validation method was used to divide the dataset into training and testing sets. Next, a transfer learning approach was used to initialize model parameters, and the AlexNet, GoogleNet, and ResNet networks were pre-trained to extract deep features from the images. Then, the Softmax classification algorithm was applied to classify the features, resulting in three independent classifiers. These classifiers were combined using an ensemble learning method with a weighted voting approach to obtain the final diagnostic results. Finally, the model was evaluated by comparing the ensemble classifier with individual classifiers to assess its accuracy, precision, sensitivity, specificity, and diagnostic time, and a comparison with low-mid-and high-experience physician groups was conducted to comprehensively evaluate the model's diagnostic performance. <b>Results:</b> The experimental results showed that the model achieved an accuracy of 88.8%(178/200), precision of 92.9%,(112/120) sensitivity of 89.8%(108/120), and specificity of 88.1%(70/80). The average diagnostic time for individual patient temporal bone CT images was reduced to 2-3 seconds. Compared to the diagnostic results from low-mid-and high-experience physician groups, the model demonstrated significant advantages and effectively assisted clinicians in making rapid and accurate middle ear cholesteatoma diagnoses. <b>Conclusion:</b> The proposed middle ear cholesteatoma diagnostic model based on integrated convolutional neural networks exhibits high recognition accuracy and rapid diagnostic speed, significantly improving clinical diagnostic efficiency, especially in early screening and auxiliary diagnosis, making it of considerable value in clinical practice.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 5","pages":"511-519"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}