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Background and purpose: There are many anastomoses between stomach and esophagus in esophageal cancer surgery, each of which has its own advantages and disadvantages. The aim of this study was to investigate the safety and feasibility of end-to-end double-layer esophagogastric anastomosis and gastric fundus embedding during minimally invasive esophagectomy for esophageal cancer. Methods: The clinicopathological data of 129 patients who underwent minimally invasive esophagectomy from April 2019 to April 2021 in Zigong Fourth People’s Hospital were retrospectively reviewed. All patients were treated with thoracoscopy and laparoscopy combined with minimally invasive cervicothoracic and abdominal tri-incision (McKeown procedure) esophageal cancer resection. The thoracic procedure was performed with thoracoscopy, and the abdominal procedure with laparoscopy. The patients were divided into end-to-end double-layer esophagogastric anastomosis and gastric fundus embedding group (87 cases) and end-to-side anastomosis group (42 cases). Patients were followed up for evaluation of associated complications, of which anastomotic leakage, anastomotic stenosis and gastroesophageal reflux were the primary objectives of this study. Results: All the 129 patients underwent esophagectomy. Neoadjuvant therapy was more common in the end-to-end doubled anastomosis group (12.0% vs 2.3%, P = 0.037). There was no statistically significant difference in other basic clinical data between the two groups (P>0.05). There was no significant difference in the mean operation time between the two groups. The anastomosis time was less in end-to-side stapling group than in end-to-end stapling group[(32.0±6.8) min vs (15.0±5.4) min, P = 0.021]. The differences in the incidences of anastomotic leakage (1.1% vs 11.9%, P = 0.023), gastroesophageal reflux (9.1% vs 26.1%, P = 0.012), pneumonia (12.6% vs 30.9%, P = 0.023) and arrhythmia (10.3% vs 26.1.%, P = 0.020) were statistically significant between the two groups. Conclusion: The method of end-to-end double-layer anastomosis and gastric fundus embedding is safe and stable in esophagectomy. It can effectively prevent anastomotic leakage and gastroesophageal reflux.

In order to seal the hydraulic oil in the transmission, a piston ring with C-type cut was designed. To provide a guide for dimension design, a dynamic stress analysis was simulated for the designed piston ring by the ABAQUS software. Meanwhile, a metal gauges with groove was designed to help the measurement of the size of piston ring. Finally, a practical test was carried out for the piston ring by customers. The test results indicated that the piston ring designed by this work could meet the requirements for transmission sealing. On the other hand, this test also confirmed that the analysis software used in this work could well serve for the design of sealing rings. [ABSTRACT FROM AUTHOR]

The pediatric total facial management refers to a series of diagnosis and treatment processes to achieve the healthy development of the face through reasonable medical intervention. The main reason for the poor treatment effect is that the first contact doctor is limited to his own disciplinary analysis and treatment. The importance of multidisciplinary cooperation in the diagnosis and treatment of facial dysplasia in children has become increasingly prominent. it is necessary to comprehensively analyze and find the pathogenic factors of patients and formulate a comprehensive treatment plan to restore normal upper airway structure and nasal breathing, and then reshape the healthy craniomaxillofacial tissue structure, and the monitoring of the results of medical intervention should accompany the whole process of children's growth and development. This paper summarizes the current situation of the treatment of children with facial dysplasia and puts forward the concept of orderly individualized multi-disciplinary diagnosis and treatment of pediatric oral maxillofacial management., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

With the enhancement of aesthetic awareness of children's oral maxillofacial development, multi-disciplinary doctors pay attention to children's oral maxillofacial management. Artificial intelligence (AI) technology has been gradually applied to all fields of children's oral maxillofacial management because of its outstanding advantages in medical screening and auxiliary decision-making. This article reviews the application of AI technology in the screening, diagnosis, treatment and follow-up of oral maxillofacial management in children., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To discuss the application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid. Methods: The clinical data of 97 children with adenoid hypertrophy admitted to Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University General Hospital from July 2022 to December 2022 were collected. The virtual endoscopic reconstruction of the nasopharynx was performed by cone beam computed tomography. The results of virtual endoscopic adenoid size measurement were compared with the results of nasopharyngeal CT median sagittal position and nasopharyngeal endoscopy. Virtual endoscopic classification of adenoid based on the size of the adenoids and their relationship with the torus tubarius. Results: The t -test results of the size of adenoids measured by virtual endoscopy and nasopharyngeal CT were t =1.699 and P =0.093, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.921 and P <0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal CT was highly consistent. The t-test results of the size of adenoids measured virtual endoscopy and nasopharyngeal endoscopy were t =1.543 and P =0.15, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.900 and P <0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal endoscopy was highly consistent. Among the 97 children, the morphological classification results of adenoids were 48 cases of overall hypertrophy type, 47 cases of central bulge type, and 2 cases of flat thickening type. Conclusion: The diagnosis of adenoid hypertrophy by virtual endoscopy has high accuracy, which not only avoids the invasive operation of traditional nasopharyngeal endoscopy, but also can observe the adenoid condition and its relationship with the torus tubarius from multiple angles. And, the morphological classification of adenoids using virtual endoscopy has guiding significance for perioperative preparation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

The maxillofacial region has multiple functions such as breathing, language, and facial expressions. Children's maxillofacial development is a complex and long process, which is affected by many factors such as genetics, diseases, bad habits and trauma. Early detection, early diagnosis, and early treatment are important concepts in children's maxillofacial management. Digital technology medicine is an emerging technology based on medical imaging and anatomy that has emerged in recent years. The application of this technology in the field of clinical medicine will undoubtedly bring great benefits to children's maxillofacial management. This article summarizes the research on digital technology in children's maxillofacial management, and focuses on the research on children's malocclusion, children's OSA, cleft lip and palate and other related diseases., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods: From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results: For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（ P >0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（ P <0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion: The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy. Methods: Prospectively collected 60 children with obstructive sleep apnea （OSA） diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group （ n =30） underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group （ n =30） underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured. Results: The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery（ P <0.05）; The number of inflammatory attacks in the experimental group was （0.50±0.63） times/year, which was lower than that of （1.33±0.80） times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups. Conclusion: Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: Summarize the safety and feasibility of highly selective vidian neurectomy guided by the palatovaginal canal. Methods: Hypothermal plasma surgery was performed on 53 patients with perennial allergic rhinitis （PAR）. Remove the soft tissue covering the anterior wall of the sphenoid process of palatine bone using the Coblation system. Find the palatovaginal canal and cut off the neurovascular bundle in the palatovaginal canal. Expose the anterior orifice of the vidian canal and cut off the vidian nerve. Results: 53 PAR patients have conducted the novel vidian neurectomy without sphenopalatine artery trunk damage. No secondary hemorrhage and hard palate numbness happened. The symptoms of nasal obstruction, sneeze, nasal discharge, and rhinocnesmus were relieved significantly. Conclusion: The simple and safe approach of highly selective vidian neurectomy guided by the palatovaginal canal provides an alternative surgical option for clinicians., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyzed allergens and screen for common airborne allergens in patients with allergic rhinitis （AR） in Shenzhen, and identified the distribution pattern of allergens in this region. We aimed to provide scientific and feasible statistical and clinical basis for prevention and treatment of allergenic rhinitis. Methods: For 3351 suspected cases of allergenic rhinitis, 18 kinds of airborne allergen serum-specific IgE were determined using a detection system of BioSciTec GmbH company, and statistical analysis was carried out according to sex, age, severity and seasonal allergen. Results: A total of 3,351 cases with allergic rhinitis were positive for airborne allergens. The top five inhalation allergens were Blomia tropicalis （2231, 66.6%）, Dermatophagoides pterronyssinus （2212, 66.0%）, Dermatophagoides farinae （1986, 59.3%）, Cockroach （967, 28.9%）, and Short ragweed （844, 25.2%）. For the severity of the allergen, Dermatophagoides pterronyssinus ≥ level 3 accounted for 41.3% （1385/3351 cases） and Dermatophagoides farinae ≥level 3 accounted for 40.6% （1360/3351 cases）. Blomia tropicalis were classified as level 2, and other allergens were mainly classified as level 1 or 2. The detection rate among different age groups and gender is significantly different. Conclusion: The main airborne allergens in Shenzhen were Blomia tropicalis, Dermatophagoides pterronyssinus, Dermatophagoides farinae, Cockroach, as well as Short ragweed. The distribution of allergens was affected by sex, age and season., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Congenital posterior choanal atresia is a rare congenital deformity. Due to the influence of nose and face and intellectual development, its preferred surgical treatment. But surgical treatment methods and technology are in dispute. The using of high resolution display systems combine with micro tools can effectively reduce postoperative scarring and adhesion formation which is the key point to prevent restenosis. There is also the focus of controversy whether should place an expansive tube after operation. Currently nasal endoscopic approach has become the first choice for otolaryngologist treating congenital posterior choanal atresia.

Objective: To construct prokaryotic expression vector pET-28a(+)-human sucrase (hSUC) and express hSUC fusion protein in E.coli., Methods: The hSUC gene fragment was amplified by reverse transciption PCR (RT-PCR) and cloned into pET-28a(+) vector to construct the prokaryotic expression vector pET-28a(+)-hSUC. The recombinant plasmid was then transformed into E.coli BL21. Hisdidine (His)-tagged fusion proteins were induced by isopropyl-beta-D-thiogalactopyranoside (IPTG) and purified by nitrilotriacetic acid (Ni-NTA) agarose resin. The purified fusion proteins were identified by SDS-PAGE and Western blotting., Results: RT-PCR showed that sub-clone of hSUC was about 1482 bp. The recombinant plasmid was correctly constructed as demonstrated by sequencing and restriction enzyme analysis. The molecular mass of the fusion protein was about 61 240. Western blotting showed that the fusion proteins bound specifically to hSUC antibody., Conclusion: The hSUC protein has been successfully expressed and purified in E.coli.

A 56 years old female was admitted to our department with complaint of a painless cervical mass. Clinical feature:there was a painless mass above left lobe of thyroid gland, which was about 3.0 cm x 2.5 cm in size, and could move with swallowing action. B-mode ultrasound features: there was a solid mass in left lobe of thyroid gland, which was about 3.2 cm. Nodule was found in isthmus, accompanied with lymphadenovarix on the left neck possibly be MCA. fT3: 4.64 pmol/L, fT4:16.56 pmol/L,TSH:3.74 mIU/L, anti-TG:17.75 U/ml, anti-TPO:40.77 U/ml. Pathological result of the neoplasm: papillocarcinoma. Clinical diagnosis: papillary thyroid carcinoma.

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.

Objective: To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS., Method: One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed., Result: Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant., Conclusion: The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.

Objective: Observed the using of coblation during the maxillary sinus operation, to investigate the superiority of its clinical application., Method: Selecting 46 patients with the maxillary sinus lesions of sinusitis, nasal polyps and nasal inverted papilloma as research objects, the control group used high speed cutting drill, the research group used coblation separately for functional endoscopic sinus surgery. Six months postoperative follow-up, observeing the subjective symptoms and objective examination., Result: Subjective symptoms and objective examination scores of two groups of patients improved significantly. Compared with the control group, the operation time, bleeding volume and postoperative examination time are reduced in the study group of patients. Endoscopic examinations of the study group are better than the control group., Conclusion: Using coblation for the maxillary sinus operation, treatment are more thorough, more minimally invasive, shorten operation time, reduce bleeding and recheck time after surgery, is worthy of clinical use.

Objective: To observe and summarize the abnormal morphological appearance of nasal septum tail during adenoidectomies, and to have a preliminary study on its clinical significance., Method: One hundred and eighty-three children were shown with abnormality on nasal septum tail in 2892 cases with adenoid hypertrophy who received adenoidectomies in our department., Result: The abnormalities of nasal septum tail can be classified into two types: del tails and columnar ones. All children suffered from nasal septum tail received radiofrequency ablation and all had a good postoperative recovery., Conclusion: The presence of these two types of nasal septum tail may be related to adenoid hypertrophy, adenoiditis, sinusitis, and some congenital malformations.

Objective: To analyze the clinical feature of cervical metastatic carcinoma of unknown primary site (CCUP) for guiding clinical diagnosis and treatment., Method: Twenty-seven cases of CCUP during May 2007 to September 2013 in department were analyzed retrospectively. Kaplan-Meier method and Log-rank test were used for survival analysis, multivariate analysis using the Cox regression model., Result: There is no significant influence among gender, age and the mass position on the median survival time. Median survival time of patients with different pathological types was statistically significant (P < 0.05). Treatment affected the median surial significantly (P < 0.05) and also was the independent prognostic factors (P < 0.05)., Conclusion: The early establishment of pathological type and primary focal position can improve the prognosis. Taking treatment according to pathological types can increase the patient's survival rate. Combined treatment can prolong the patient's survival time.

Objective: To explore beryllium oxide induced oxidative lung injury and the protective effects of LBP., Methods: Intoxication of animals were induced by once intratracheal injection and LBP intervention by intragastric administration. The content of HIF-1, VEGF and HO-1 of lung tissues were measured by kits. The pathological changes of lung tissue were showed by pathological section. The changes of lung ultrastructure were observed by electron microscope., Results: Pathological changes of the lung tissue in beryllium oxide exposure group rats were in line with the characteristics of beryllium disease in human. Compared with the control group, HO-1 was increased in beryllium oxide exposure 40 d group and low doses of LBP group, compared with the control group, HO-1 was increased in beryllium oxide exposure 80d group and LBP treatment groups (P < 0.05 or P < 0.01). Compared with the control group, HIF-1 was increased in beryllium oxide exposure 40 d group, LBP treatment groups, beryllium oxide exposure 60 d and 80 d groups (P < 0.05 or P < 0.01). Compared with the control group, VEGF was increased of all phases, especially in beryllium oxide exposure 40d and 80 groups, LBP treatment groups and beryllium oxide exposure 60 d (P < 0.05 or P < 0.01). The content of HO-1 of beryllium oxide exposure group was higher than the LBP treatment for 40d group but below LBP treatment for 80 d group (P < 0.05). The content of HIF1 of beryllium oxide exposure group was higher than high dose of LBP treatment for 60d group and LBP treatment for 80 d group (P < 0.01). The content of VEGF of beryllium oxide exposure group was higher than LBP treatment for 40 d group and high dose of LBP treatment for 60 d (P < 0.05 or P < 0.01)., Conclusions: BeO can cause abnormal expression of related genes of lung tissue in rats, LBP has protective effects on BeO caused lung injury.

The patient was a 42 years old female. And the reason why she was addmited to the hospital was progressive bilateral nasal congestion for one year, and bilateral nasal bleeding for one day. Physical examination showed no surgical contraindication so the patient got the nasal endoscope by plasma radiofrequency ablation surgery with general anesthesia on 3rd Dec. 2013. And the result of potholegical examination was nasopharynx pleomorphic adenoma.

Objective: To investigate the therapeutic effects of coblation treatment via endoscopy in epiglottic benign tumors., Method: Retrospective analysis was carried out in 128 patients with epiglottic benign tumors who underwent coblation treatment via endoscopy. The complications and therapeutic effect were analyzed., Result: The effective rate of treatment was 100% in cyst of epiglottis and in papillary epithelioma, and was 96.36% in hypertrophy of lingual tonsils. The pseudomembrane 1 w after operation. Postoperative pain is slight. There were no complications such as dyspnea, bleeding and infection., Conclusion: Radio frequency coblation via endoscopy will be applicable in the therapy of epiglottic benign tumors.

Objective: To investigate the therapeutic effects of the image navigation system in nasal endoscopic surgery in treatment of basicranial tumor., Method: Retrospective analysis was carried out in 17 patients with basicranial tumor who underwent nasal endoscopic resection via image navigation system. The accuracy of image navigation system, operation procedure time, curative effect and complications were analyzed and summarized to evaluate the effect., Result: The image navigation system provided an accurate anatomical localization 0.5-2.0 mm localization error (mean 1.2 mm). The operation procedure time was 1.5-3.0 h. Postoperative complications occurred in 3 of 17 patients including cerebrospinal fluid rhinorrhea and injury of sieve plate. Two patients recrudesce within half a year., Conclusion: The image navigation system in combination with a nasal endoscope is helpful in the resection of basicranial tumor with minimal trauma, increasing the curative effect and avoiding complications.

Objective: To investigate the therapeutic effects of 894 coblation-assisted treatment in adult with obstructive sleep apnea-hypopnea syndrome., Method: A review of 894 coblation-assisted treatment in adult with obstructive sleep apnea-hypopnea syndrome was presented with respect to the sleep monitoring results, SF-36 health questionnaire survey, therapeutic effects and complications., Result: After operation for 6 months, the patients' sleep Monitoring results were improved remarkably (P<0. 01) and their symptoms of snore or choke got improved. SF-36 health questionnaire survey showed that social function, energy and mental health dimension scores were significantly higher than the preoperative (P<0. 05). There were 18 patients suffered Secondarily bleeding within 2 weeks and 23 patients recrudesced within 1 year., Conclusion: Radio frequency coblation is an applicable method of therapy for patients with obstructive sleep apnea-hypopnea. The treatments differ with the obstructive location and character of upper airway.

A 6 years old boy came to our department with a complaint of a growing goitre behind and below the right ear that started 4 years ago. Clinical features: there was a 2.0 cm x 1.5 cm nontender goitre behind and below the right ear, protruding from the skin with clear boundary. The temperature and color of the skin covered the goitre were normal. B-mode ultrasound features: there was a mass under the skin with the size of 2.0 cm x 0.8 cm showing strong echo. The borders of the mass were unclear, and no signal of blood flow was detected. Pathology diagnosis: pilomatricoma.

Objective: To evaluate the effect of the coblation under endoscopy on epiglottis cyst., Method: One hundred and ninety-three patients with epiglottis cyst were treated with coblation under endoscopy. Follow-up study was performed from 1 month to 6 months after treatments., Result: All 193 cases with epiglottis cyst were primary cured without serious complication and the cure rate was 100%. Moreover, the minor hemorrhage (1-5 ml) was observed., Conclusion: The coblation under endoscopy on epiglottis cyst was safe, effective and minimally invasive.

Objective: To investigate the therapeutic effects of 768 coblation treatment in children with obstructive sleep apnea-hypopnea syndrome., Method: A review of 768 coblation treatment in children with obstructive sleep apnea-hypopnea syndrome was presented with respect to the sleep monitoring results, therapeutic effects and complications., Result: The time of pseudomembrane ablate was 10-14 d after operation. There were 11 patients occurred Secondarily bleeding within 1 week and 21 patients lymphatic tissue hyperplasia compensatorily within half a year after operation. After operation 3 months, the sleep Monitoring results were improved remarkably (P < 0.01) and the symptoms of snore and choke improved., Conclusion: Coblation treatment in children with obstructive sleep apnea-hypopnea syndrome can reduce bleeding volume and improve obstruct syndrome apparently. The treatments of tonsils and adenoids differ with the characteristics of children and tympanotomy was fit for chil dren with secretory otitis media.

Objective: To assess the therapeutic effect and study the role of nasal mucosa epithelization after endoscopic surgery using the plasma radiofrequency ablation at low temperature in patients with nasal inverted papilloma., Method: The clinical data of 104 patients with nasal inverted papilloma underwent endoscopic surgery u sing the plasma radiofrequency ablation at low temperature from July, 2008 to July, 2012 were analyzed,and the recovery of mucosa was observed under nasal endoscope., Result: The mucosa recovery extent showed a decreasing trend from mucosa pattern degree I to III, where the difference was statistically significant by chi-square test between groups (P < 0.05). The average epithelialization time was 2.7 months. It showed a significantly decreasing trend among average epithelialization time of different degrees of mucosa (P < 0.05). The nasal mucosa of most patients completed epithelialization 2.9 months after surgery., Conclusion: It is safe and effective to treat nasal inverted papilloma with plasma radiofrequency ablation at low temperature. The patients should be followed up with regular reexamination for at least three months after surgery.

Objective: The aim of this study is to explore the applications of digital department in otolaryngology concern with the emergent and dangerous of otolaryngology diseases., Method: We have constructed digital otolaryngology head and neck surgery department on the basis of hospital information system, which is constructed under the guidance of the theories and methods of modern information integration technology, computer software technology, health informatics and network information technology., Result: The foundation of digital otolaryngology department can optimize digital workflow, improve work efficiency and eliminate the manual operation., Conclusion: Digital department in otolaryngology will promote the quality and upgrade the level of medical staff, it plays an important role in the hospital informationization.

A 5 years old boy was referred to our department with complaints of a painless midline neck swelling. Clinical feature: there was a painless swelling above the middle of thyroid cartilage, it was about 2.0 cm x 0.5 cm, and it was soft. And its boundary was clear. The skin temperature is normal. B-mode ultrasound features: there is a cystic mass in the front of the neck, it is about 2.3 cm x 1.0 cm, and be apart from the skin is 0.3 cm. It is showed that another cystic mass behind this one, is about 1.9 cm x 0.7 cm. The borders are clear, and no blood flow signal is detected. The thyroid was not abnormal. Pathology results showed the wall of cyst and there were pectin in the cyst. Diagnosis: thyroglossal cyst of double cyst.

Objective: To investigate the efficacy of Coblation-channelling for the tongue(CCT) treatment of tongue hypertrophy., Method: The 31 patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) combining tongue hypertrophy staged as Friedman ll or N were performed CCT after nasal septum surgery, coblation channelling of bilateral inferior turbinate and coblation-assisted UPPP. While the vertical channelling in the base and the body of the tongue, the tilted one parallel side edge and posterior to the tongue were combined. The intraoperative and postoperative complications such as bleeding were observed. The 12 months postoperative follow-up were done by MRI of the tongue., Result: The retrolingual space were expanded postoperatively. The 2 bleedings occurred immediately after channellings in the tongue body, and they were stopped by local compression. No postoperative tongue paralysis, no tongue hematoma and abscess happened. The tongue sizes changed from preoperative III or IV degree to postoperative I to II degrees. One case received three CCT sessions., Conclusion: CCT treatment tongue hypertrophy is a individually safe, effective and minimally invasive treatment.

Objective: To investigate the treatment for lingual thyroglossal duct cyst by low temperature coblation on endoscope., Method: Eleven cases of lingual thyroglossal duct cyst were treated by low temperature coblation on endoscope,to observe the curative effect and complication., Result: Eleven cases of lingual thyroglossal duct cyst were satisfied after operation, without serious complication. There were no recurrence during a followed up for 1-3 years after operation., Conclusion: The operation for lingual thyroglossal duct cyst by low temperature coblation on endoscope was easy,safe and effective.

Objective: To investigate the protein expression of OPN and C-met and their relationship with tumorigenesis, invasion and cancer metastasis in laryngeal squamous cell carcinoma (LSCC)., Method: The expression of OPN and C-met were detected immunohistochemical method(Elivision plus)in 52 laryngeal squamous carcinoma and 30 adjacent tissues, to analyse the relationship between their expression levels and clinical stages, differentiation grades and the metastasis of pelvic lymph nodes., Result: The expression of OPN and C-met in laryngeal squamous carcinoma and adjacent tissues were 71.2%, 6.7% and 63.5 %,16.7%, respectively. The positive rate of OPN and C-met with LSCC in stage I-II is 48.1% and 55.6%, and that in 25 cases of stage III-IV is 96.0% and 80.0%, with significant difference among them. The positive rate of OPN is significantly lower in the cases without-metastasis of lymph node (53.6%) than that in the ones with-metastasis of lymph node (91.7%). The positive rate of C-met in the metastasis cases is 83.3%, which is much higher than that in the cases without-metastasis (46.4%). The positive rate of OPN and C-met in squamous cell carcinoma with high, medium-grade differentiation is 65.7% and 54.3%, and that in 17 cases of in squamous cell carcinoma with low-grade differentiation is 82.4%. The OPN and C-met positive rate have negative correlations with differentiation grades., Conclusion: Expression of OPN and C-met were higher with advance of clinical stages, and it has relation to the metastasis of lymph, but it's difficult to say that there is regular relation between expression of OPN and C-met and differentiation grades. Expression of OPN and C-met have positive correlation in LSCC, and abnormal expression of OPN and C-met have some effect on tumor invasion and metastasis in LSCC patients.

The purpose is to report a case of chordoma, which orignated from sphenoid sinus and encroach on sella, metasella and clivus. We comprehensively analyzed the CT and MRI information and diffrentiated the illness from the commonly encountered diseases of sphenoid sinus and sellato improve the accuracy before surgery.

Objective: The aim of the present study was to evaluate the effects of radiofrequency coblation surgery for treatment of abnormal sensation of throat induced by the hypertrophy of lingual tonsil., Method: Three hundred and seven patients affected by abnormal sensation of throat induced by the hypertrophy of lingual tonsil were enrolled. Radiofrequency coblation was performed on all patients under nasal endoscopy. A comprehensive statistics were obtained from all the participants regarding the recovery of wound surface, postoperative pain, intra and postoperative bleeding and the effects of the procedure., Result: The VAS score of abnormal sensation of throat was reduced from (9.3 +/- 0.6) to (3.7 +/- 2.4) (P<0.05) after the operation. 84.4% of the abnormal sensation dis appeared, no recurrence within six month; 6.8% of the abnormal sensation largely reduced within six month; 4.6% of the abnormal sensation reduced within six month. There was no significant postoperative pain. 3.6% (11/307) of patients experienced postoperative hemorrhage. The follow-up period ranged from 6 to 36 months, there was no recurrence., Conclusion: Radiofrequency coblation is a useful surgical technique, as effective as,or even superior to,other surgical techniques when dealing with patients suffering from abnormal sensation of throat induced by the hypertrophy of lingual tonsil with potentially fewer adverse effects and subsequently improved quality of life for patients.

Objective: To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children., Method: The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared., Result: By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01)., Conclusion: Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.

Objective: To assess the effect of low-temperature radiofrequency coblation of tongue Channeling for supine position associated OSAHS., Method: One thousand and three hundred eighty one patients with OSAHS were examined and treated with radiofrequency coblation of tongue channeling. Polysomnography was performed before and one year after the surgery. Visual analogue scale was performed to assess the postoperative function of speech and swallowing, Scores of quality of life and sleepiness scale to evaluate the effectiveness of the surgery., Result: One year after the surgery, the patients were obviously relieved with sleep snoring, arousal and daytime sleepiness symptoms as swallowing and speech function was not affected. AHI with supine position was reduced by an average of 27.1 times/h and the minimum postoperative O2 saturation was significantly increased. SF-36 health questionnaire survey showed that social function and mental health dimension scores were significantly higher than the preoperative., Conclusion: Radiofrequency coblation of tongue channeling is an applicable method of therapy for patients who have sleep apnea that is more marked in the supine position.

Objective: To introduce a new surgical treatment for subglottic stenosis., Method: Six patients with subglottic stenosis were retrospectively studied. Four cases had history of intubation or tracheostomy. Two cases were because of B cell lymphoma and Wegener granulomatosis. All cases underwent endoscope assisted coblation surgery., Result: All of the patients were discharged from hospital with no tube in one week after surgery. In a follow-up of 3-21 months, stenosis in 2 cases of B cell lymphoma and Wegener granulomatosis recurred 3 months after operation. These 2 patients were operated by coblation again and are still followed-up by now., Conclusion: The endoscope assisted coblation surgery is a new minimally invasive method for treating subglottic stenosis. Further more,it can be reused to whom has a relapse.

Objective: To investigate the relationship between the protein expression of MDM2 and P16 in laryngeal squamous cell carcinoma (LSCC), and their relationship with clinic pathological feature., Method: The expression of MDM2 and P16 were detected by S-P immunohistochemical method with mouse monoclonal anti MDM2 antibody and anti P16 antibody in 35 LSCC specimens, 21 specimens of precancerous larynx, 20 normal laryngeal specimens., Result: Expression of MDM2 positive in normal laryngeal specimens, precancerous larynx and LSCC specimens were 10.0%, 38.1%, 54.3% respectively (P < 0.05), and in I - III pathological grade laryngeal carcinoma were 38.1%, 66.7%, 100.0% respectively (P < 0.05); Expression of P16 positive in normal laryngeal specimens, precancerous larynx and LSCC specimens were 85.1%, 52.4%, 34.3% respectively (P < 0.05), and in I - III pathological grade laryngeal carcinoma were 52.4%, 11.1%, 0% respectively (P < 0.05)., Conclusion: Expression of MDM2 positive were higher with lower differentiation, so it's maybe helpful to diagnose LSCC. Expression of P16 positive were lower with lower differentiation, and there's no expression in III pathological grade LSCC, so it has positive effect on malignancy determination. Abnormal expression of MDM2 and P16 have different effects on LSCC development. Expression of MDM2 and P16 have negative correlation in LSCC.

Objective: To compare the low-temperature plasma assisted way and the traditional method in surgery treating styloid process syndrome., Method: The clinical data from 23 patients who have a typical syndrome and need surgery treating, thirteen patients had been treated by low-temperature plasma way and the left cases by traditional one. Comparing operation time, amount of bleeding, degree of pain,time of the fake membrane falling and effort estimating., Result: The difference of operation time,amount of bleeding and degree of pain between low-temperature plasma and tradition in the two operation procedures is significant (P < 0.01). But time of the fake membrane falling and effort estimating of low-temperature plasma and traditional procedures are found to be similar (P > 0.05). And one patient who used the traditional operation bled when he was at home., Conclusion: The two operation procedures are both effective. The low-temperature plasma assisted via mouth for surgery treating elongated styloid process has a big advantage in operation time, amount of bleeding and degree of pain. For the more, it reserves the function and morphology of tonsil; which is more simple, convenient, safe and tiny wound.

Objective: To investigate the therapeutic efficacy of coblation-assisting uvulopalatopharyngoplasty (CAUPPP) combining with coblation-channeling of the tongue (CCT) for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS)., Method: A retrospective analysis was made on patients with severe OSAHS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apnea-hypopnea index (AHI) were beyond 40/h and lowest arterial oxygen saturation (LSaO2) were under or equal to 80%. Surgical approach: The UPPP was performed to decrease the size of soft palate with coblation and coblation-channeling in the soft palate and decrease the size of tongue by CCT. All patients were followed up for 6 to 12 months and underwent polysomnography (PSG)., Result: Subjective symptoms of patients improved more significantly than that of preoperation. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared with the preoperative data, AHI values were significantly decreased (P<0.01) and the lowest oxygen saturations increased significantly (P<0.01) and the effective rate was 91.7%., Conclusion: There are usually multiple obstruction levels in patients with severe OSAHS and the traditional surgical treatment is not ideal. This study demonstrated that with the assistance of coblation, combining CAUPPP with CCT for patients with severe OSAHS is an effective surgical method. It has less blood loss, minimally invasive, retained the normal function of the soft palate, etc., should be widely applied.

Objective: To explore the clinical efficacy of coblation-assisted FESS (CAFESS) by observing the patients intraoperatively and postoperatively., Method: Thirty patients with chronic sinusitis or/and with nasal polyps were selected. The subjective symptoms and objective changes were observed 6 to 9 months after CAFESS., Result: The sense of nasal congestion, headache and face pain, purulent rhinorrhea, postnasal drip, and other symptoms were relieved. The scores of SNOT-20 reduced from preoperative (22.53 +/- 6.26) to (7.80 +/- 3.63) 6 months postoperatively, and the difference was statistically significant (t = 16.741, P < 0.05). The scores of Lund-Kennedy decreased from (4.30 +/- 1.15) preoperatively to (1.17 +/- 0.83) 6 months postoperatively, and the difference was statistically significant (t = 19.947, P < 0.05). The observation under endoscope illustrated that epithelization commenced at 6w postoperatively and completed until 12 week after CAFESS., Conclusion: CAFESS is a new technique for treatment of chronic sinusitis and nasal polyps, and postoperative clinical results were satisfactory. It's a good method for the treatment of chronic sinusitis and nasal polyps.

Objective: To investigate the efficacy and feasibility of coblation treatment of partial tonsillectomy in children with obstructive sleep apnea-hypopnea syndrome (OSAHS)., Method: The clinical datum of 91 children with OSAHS were retrospective analysis during the period from January 2009 to November 2009. All subjects, the main obstructive lesions were hypertrophy of tonsils and adenoids ,and which without recurrent pharyngodynia and tonsillitis, were applied with coblation treatment of partial tonsillectomy and adenoid ablation., Result: Intraoperative blood loss was about 1-2 ml in all subjects,no primary and delayed hemorrhage happened and postoperative pain happened. All subjects were followed-up for 12 months to 22 months, symptoms of snoring and mouth breathing disappeared. No tonsil regeneration and repeated inflammatory episode was found., Conclusion: Coblation treatment of partial tonsillectomy in children with OSAHS is micro-invasive, safe and effective, which is suitable for children of different age groups with hypertrophy of tonsils.

Objective: To investigate the clinical characters and treatments of maxillofacial fractures., Method: A review of 101 maxillofacial fractures was presented with respect to age, sex, cause of fractures, pattern of fractures, treatments and therapeutic effect., Result: The majority of fractures were found in 20-to-50-year-old males. Most fractures happened in summer and the leading causes were traffic accidents. Mandible was the most part of fractures and associated combined injures were found in 31 cases. Rigid internal fixation was the primary treatment., Conclusion: Maxillofacial fractures mainly occurred in young adult males and traffic accidents were the main causes. Rigid internal fixation after exact replacement was the primary common treatment.