Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Sev...Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Methods: Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. Results: The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. Conclusion: The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy.展开更多
<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><spa...<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">T</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">objective</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> determine whether there are differences in the position of the hyoid bone at rest in natural head position in subjects with mandibular hyperdivergence</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">to evaluate whether there are differences in hyoid position and antegonial notch depth in mandibular hyperdivergent males and females. </span><b><span style="font-family:Verdana;">Methods and Materials: </span></b><span style="font-family:Verdana;">This is a retrospective cohort study involving a review of lateral cephalometric radiographs of 45 adult men and women with mandibular hyperdivergency. Hyperdivergency was determined by cephalometric ranges of: SN-GoGn as least +2 SD from normal, Y-axis, PP-GoGN, and gonial angle greater than +1SD from normal. A group of 45 normodivergent adults served as a control, with cephalometric ranges of: SN-GoGn within </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;">1 SD of normal, with only one measurement of the other three between +1 and +1.5 standard deviations. A custom digital cephalometric analysis, the Hyoid Analysis, was designed, to measure the vertical and horizontal position and inclination of the hyoid and the antegonial notch depth. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In hyperdivergent subjects, the posterior aspect of the hyoid is located lower and more posterior, compared to the control group, while there is no difference in position of the anterior surface of the hyoid and the antegonial notch is 0.6</span></span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm deeper. In males, the posterior aspect of hyoid is lower by 8.5</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm, while the anterior surface is located 9.0</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm lower. In males, the hyoid is inclined more steeply than in females by 4.4 degrees and the antegonial notch is deeper than in females by 0.6</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There are differences in hyoid bone position and mandibular morphology in hyperdivergent subjects compared to normodivergent subjects and in males compared to females.展开更多
BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE ...BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE SUMMARY A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat.18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid,and computed tomography(CT)revealed osteolytic lesions.Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells.Systemic work-up ruled out the possibility of POEMS syndrome,lymphoma,and multiple myeloma,leading to a final diagnosis of solitary hyoid plasmacytoma with UCD.The patient underwent partial hyoid resection and selective neck dissection,followed by intensity-modulated radiotherapy.99mTc-MDP singlephoton emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up.CONCLUSION The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.展开更多
基金supported by the Natural Science Foundation of Guangdong Province, China (Grant No. 303041353002)
文摘Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Methods: Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. Results: The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. Conclusion: The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy.
文摘<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">T</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">objective</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> determine whether there are differences in the position of the hyoid bone at rest in natural head position in subjects with mandibular hyperdivergence</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">to evaluate whether there are differences in hyoid position and antegonial notch depth in mandibular hyperdivergent males and females. </span><b><span style="font-family:Verdana;">Methods and Materials: </span></b><span style="font-family:Verdana;">This is a retrospective cohort study involving a review of lateral cephalometric radiographs of 45 adult men and women with mandibular hyperdivergency. Hyperdivergency was determined by cephalometric ranges of: SN-GoGn as least +2 SD from normal, Y-axis, PP-GoGN, and gonial angle greater than +1SD from normal. A group of 45 normodivergent adults served as a control, with cephalometric ranges of: SN-GoGn within </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;">1 SD of normal, with only one measurement of the other three between +1 and +1.5 standard deviations. A custom digital cephalometric analysis, the Hyoid Analysis, was designed, to measure the vertical and horizontal position and inclination of the hyoid and the antegonial notch depth. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In hyperdivergent subjects, the posterior aspect of the hyoid is located lower and more posterior, compared to the control group, while there is no difference in position of the anterior surface of the hyoid and the antegonial notch is 0.6</span></span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm deeper. In males, the posterior aspect of hyoid is lower by 8.5</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm, while the anterior surface is located 9.0</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm lower. In males, the hyoid is inclined more steeply than in females by 4.4 degrees and the antegonial notch is deeper than in females by 0.6</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There are differences in hyoid bone position and mandibular morphology in hyperdivergent subjects compared to normodivergent subjects and in males compared to females.
基金Supported by Key Program of the Medical Engineering Cross Research Fund of Shanghai Jiao Tong University,No.YG2019QNA55Tou-Yan Innovation Team Program of Heilongjiang Province,No.2019-15。
文摘BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE SUMMARY A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat.18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid,and computed tomography(CT)revealed osteolytic lesions.Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells.Systemic work-up ruled out the possibility of POEMS syndrome,lymphoma,and multiple myeloma,leading to a final diagnosis of solitary hyoid plasmacytoma with UCD.The patient underwent partial hyoid resection and selective neck dissection,followed by intensity-modulated radiotherapy.99mTc-MDP singlephoton emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up.CONCLUSION The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.
