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Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The traditional transcervical approach is frequently applied but limited in handling the tumors in parapharyngeal space. Objectives: We explore a new transcervical endoscopic approach with more direct visualization, less complications, and better outcomes. Material and methods: Eight cadaver heads (sixteen sides) were prepared for endoscopic dissection. Clinical cases were carefully selected, and thirty patients accepted the transcervical endoscopic surgery. Results: The transcervical approach with an endoscopic video system clearly exposed the detailed structures in the parapharyngeal space. The stylopharyngeus, styloglossus muscles, and styloid process were critical landmarks in this approach. During the thirty cases of clinical surgeries, internal carotid arteries and cranial nerves could be effectively exposed and protected with the endoscopic video system. Accurate hemostasis could be achieved under endoscopic transcervical approach with a mean amount between 30 to 100 ml of hemorrhaging. There was no postoperative hemorrhages and emergency tracheotomies. The follow up led to promising results. Conclusions and significance: The transcervical endoscopic approach provides a wide corridor for surgery in the parapharyngeal space. With accurate hemostasis, this approach can be applied as the first-line strategy for parapharyngeal surgeries in selected patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the capability of indirect computed tomography and magnetic resonance lymphography (CT/MR-LG) with gadolinium-loaded, polyethylenimine-entrapped gold nanoprobes (Gd-Au PENPs) for assessing lingual sentinel lymph node (SLN) metastasis in a tongue VX2 carcinoma model. Materials and methods: Seventeen rabbits were used to establish a metastatic cervical lymph node model by implanting VX2 carcinoma suspension into the ventral tongue muscle. CT and MR images were acquired one hour after Gd-Au PENPs injection into the tongue submucosa bilaterally, on 1w (n = 4), 2w (n = 6) and 3w (n = 7) tumour-bearing rabbits after carcinoma transplantation. Then, the filling defects and enhancement features of the lingual SLN on indirect CT/MR-LG were assessed. Results: The enhanced lingual SLNs were observed bilaterally in all rabbits using indirect CT/MR-LG. In total, 15 enhanced SLNs displayed oval or round shape with uniform density and no filling defects or only local small filling defects, and all nodes were metastasis-negative, while 19 enhanced SLNs demonstrated irregular morphologies with filling defects, non-uniform densities and unclear borders, of which 14 nodes were metastatic. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value when using SLN enhancement with irregular morphology, filling defects, non-uniform density and unclear border as diagnostic criteria for metastasis were 100%, 75.0%, 85.3%, 73.7% and 100%, respectively. Conclusions: Indirect CT/MR-LG with Gd-Au PENPs can be used for the metastatic diagnosis of lingual SLN in tongue cancer. [ABSTRACT FROM AUTHOR]

Conclusions: Most neoplasms of the parapharyngeal space are benign. The transcervical surgical approach is the preferred procedure in most cases. Intra-operative endoscopic exploration offers a new surgical management technique to reduce operative complications and post-operative recurrence rates. Objectives: To present the authors' experience in the treatment of primary parapharyngeal space tumors with emphasis on surgical approaches and employment of endoscopy to detect residual tumors through conventional approaches. Method: One hundred and sixty-seven patients treated surgically over a 10-year period were retrospectively reviewed. A comparison of the surgical approaches in a relevant case series was also conducted. Results: All of the patients underwent pre-operative imaging before surgery, and intra-operative endoscopic detection was selectively used for large, deep tumors. Complete resection of the tumor was used in 158 patients (95%), with a transcervical surgical approach applied in 144 cases (84%). Of 167 tumors, 150 (90%) were benign and 17 (10%) were malignant, with neurilemmoma/schwannoma as the most frequent pathology (42%). Surgical complications were reported in 26 patients (15%), most commonly unilateral paralysis of the vocal cords (6%). Two patients (1%) presented with recurrence, on average 2.5 years (range = 1–4 years) after initial excision, and the mean follow-up time was 3.8 years (range = 10 months–10 years). [ABSTRACT FROM AUTHOR]

Conclusions:The rabbit lingual sentinel lymph node (SLN) could be long-term visualized by indirect lymphography using gadolinium-loaded polyethylenimine-entrapped gold nanoparticles (Gd-Au PENPs) as CT/MR dual-modal contrast agent. Objective:To investigate duration and intensity of rabbit lingual SLN enhancement using Gd-Au PENPs as a CT/MR dual-modal contrast agent. Methods:Twelve rabbits were randomly divided into indirect CT lymphography (CT-LG) and MR lymphography (MR-LG) groups. In each group, two rabbits received unilateral injection and four received bilateral injection of Gd-Au PENPs in the sub-mucosa of the tongue. Then the enhancement characteristics of SLN were investigated. Results:The enhanced SLNs were observed in 100% in all rabbits by indirect CT-LG and MR-LG simultaneously at 1 min after injection. Then SLN enhancement was improved rapidly and the first peaks were observed at 25 min for CT-LG and 1 h for MR-LG, respectively, then SLN enhancement decreased gradually to a minimum at 2 h for CT-LG and 3 h for MR-LG. Afterwards, the enhancement intensity increased again and second peaks were observed at 24 h for both CT-LG and MR-LG. Hereafter, the intensity dropped slowly and weak enhancement was also observed at the 40th week for CT-LG and 31st day for MR-LG. Black-stained SLNs were visualized in 100% at autopsy in all rabbits. [ABSTRACT FROM PUBLISHER]

Conclusions: Indirect computed tomography lymphography (CT-LG) combined with blue dye injection can locate the sentinel lymph node (SLN) in tongue carcinoma. Objective: To localize the SLN in tongue VX2 carcinoma using indirect CT-LG combined with methylene blue injection. Methods: Eighteen rabbits were placed into three groups: metastasis, hyperplasia, and control. Indirect CT-LG was performed with an iohexol injection into the tongue submucosa. CT images were acquired at 1, 5, and 15 min after injection. Methylene blue was injected into the same area 24 h after indirect CT-LG, followed by SLN identification and histopathological examination. Results: SLNs were visualized with an identification rate of 100%. SLN location identified using CT lymphography was confirmed by methylene blue dye. Control and hyperplastic enhanced SLNs were round or oval without any filling defects. Control rabbits had enhanced SLN attenuation values of 689.2 ± 55.4 HU, 278.4 ± 33.5 HU, and 71.7 ± 9.2 HU at 1, 5, and 15 min after injection, respectively. Hyperplastic rabbits had values of 877.4 ± 69.4 HU, 352.5 ± 43.3 HU, and 80.2 ± 11.5 HU. Filling defects were only observed in the ipsilateral metastatic SLNs of the metastasis group. CT attenuation values of the metastatic SLNs were 687.4 ± 55.6 HU, 535.1 ± 86.6 HU, and 282.3 ± 19.4 HU at 1, 5, and 15 min, respectively, after iohexol injection. Metastatic lymph node attenuation values were significantly greater than those of the control or hyperplastic nodes at 5 ( p < 0.001) and 15 min ( p < 0.001) after injection. [ABSTRACT FROM AUTHOR]