Superior laryngeal nerve block for treatment of throat pain and cough following laryngeal herpes zoster:A case report

BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior laryngeal nerve,which leads to several complications such as throat pain,and cough.CASE SUMMARY Patient concerns:A 52-year old woman presented with a 70 d history of throat pain and a 67 d history of non-productive cough.Three days after onset of pain,she was diagnosed with laryngeal herpes zoster.Flexible nasolaryngoscopy revealed multiple white ulcerated lesions on the left hemi epiglottis and the left supraglottic area.She was prescribed with 750 mg famciclovir a day for 7 d,and 150 mg pregabalin,100 mg tramadol and 10 mg nortriptyline a day for 67 d.However,despite of these medications,she complained of pain and persistent cough.Therefore,superior laryngeal nerve block under ultrasound guidance was performed.Three days after the intervention,the throat pain and cough disappeared.The patient remained symptom-free at 3 mo follow-up.CONCLUSION A superior laryngeal nerve block can be an effective option for treatment of pain and cough following laryngeal herpes zoster.

Novel defined N7-methylguanosine modification-related lncRNAs for predicting the prognosis of laryngeal squamous cell carcinoma

Objective:Through integrated bioinformatics analysis,the goal of this work was to find new,characterised N7-methylguanosine modification-related long non-coding RNAs(m7G-lncRNAs)that might be used to predict the prognosis of laryngeal squamous cell carcinoma(LSCC).Methods:The clinical data and LSCC gene expression data for the current investigation were initially retrieved from the TCGA database&sanitised.Then,using co-expression analysis of m7G-associated mRNAs&lncRNAs&differential expression analysis(DEA)among LSCC&normal sample categories,we discovered lncRNAs that were connected to m7G.The prognosis prediction model was built for the training category using univariate&multivariate COX regression&LASSO regression analyses,&the model’s efficacy was checked against the test category data.In addition,we conducted DEA of prognostic m7G-lncRNAs among LSCC&normal sample categories&compiled a list of co-expression networks&the structure of prognosis m7G-lncRNAs.To compare the prognoses for individuals with LSCC in the high-&low-risk categories in the prognosis prediction model,survival and risk assessments were also carried out.Finally,we created a nomogram to accurately forecast the outcomes of LSCC patients&created receiver operating characteristic(ROC)curves to assess the prognosis prediction model’s predictive capability.Results:Using co-expression network analysis&differential expression analysis,we discovered 774 m7G-lncRNAs and 551 DEm7G-lncRNAs,respectively.We then constructed a prognosis prediction model for six m7G-lncRNAs(FLG−AS1,RHOA−IT1,AC020913.3,AC027307.2,AC010973.2 and AC010789.1),identified 32 DEPm7G-lncRNAs,analyzed the correlation between 32 DEPm7G-lncRNAs and 13 DEPm7G-mRNAs,and performed survival analyses and risk analyses of the prognosis prediction model to assess the prognostic performance of LSCC patients.By displaying ROC curves and a nomogram,we finally checked the prognosis prediction model's accuracy.Conclusion:By creating novel predictive lncRNA signatures for clinical diagnosis&therapy,our findings will contribute to understanding the pathogenetic process of LSCC.

Effect of Individualized Nutrition Intervention Care Combined with Swallowing Training on Postoperative Nutritional Status in Patients with Laryngeal Cancer

Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.

Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients (60.97%). Histologically, it was a squamous cell carcinoma in 205 patients (95.34%). The most site invaded by the tumor was cricoid cartilage.T4 type was most found (45 patients or 40.90%) followed by the T3 type with 34.55%. There was no lymphadenopathy invasion (Type N0) in 74 patients (67.27%), capsular rupture was reported in five patients (6.77%), no evaluable metastasis in 110 patients (97.27%), and stage IVA predominated in 66 patients (60%). Conclusion: laryngeal cancer is a reality in our contexts, however, its incidence is poorly understood in Senegal. The main risk factors remain tobacco and alcohol. Histology confirms the diagnosis. Its management is multidisciplinary and must be early.

Laryngeal Tuberculosis and Laryngeal Cancer: Two Similar Diagnoses in an Elderly Person in Tuberculosis-Endemic Area

Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report the case of a 77-year-old woman, with no reported pathological history. She also has no alcohol or tobacco intoxication, who presented with chronic dysphonia evolving for 2 months, associated with an altered general condition. The examination of the larynx by direct laryngoscopy and anatomical pathology study of the biopsies led to the diagnosis of laryngeal tuberculosis. A search for secondary sites revealed a concomitant pulmonary infection. The evolution was favorable under standard anti-tuberculosis treatment, with complete voice recovery and improved performance status. Laryngeal tuberculosis should be suspected in patients living in endemic areas and suffering from chronic dysphonia, even if they are not alcoholics or smokers.

Circulating immune parameters-based nomogram for predicting malignancy in laryngeal neoplasm

BACKGROUND Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm.AIM To evaluate the circulating immune population and develop a nomogram for prediction of malignancy in patients with laryngeal neoplasm.METHODS A primary cohort of 156 patients was divided into laryngeal benign lesion,premalignant lesion and malignant lesion groups.Peripheral blood from patients was measured by blood routine test and flow cytometry.A nomogram was developed and applied to a validation cohort containing 55 consecutive patients.RESULTS Age,gender and seven circulating immune parameters exhibited significant differences between laryngeal benign lesion and premalignant lesion.The nomogram incorporated predictors,including gender,age,smoke index,proportions of monocytes,CD8+T cells,CD4+T cells,B cells and CD4/CD8+T cell ratio.It showed good discrimination between laryngeal premalignant lesion and malignant lesion,with a C-index of 0.844 for the primary cohort.Application of this nomogram in the validation cohort(C-index,0.804)still had good discrimination and good calibration.Decision curve analysis revealed that the nomogram was clinically useful.CONCLUSION This novel nomogram,incorporating both clinical risk factors and circulating immune parameters,could be appropriately applied in preoperative individualized prediction of malignancy in patients with laryngeal neoplasm.

Coblation: An Alternative to CO2 Laser and Microdebrider for Laryngeal Papillomatosis

Objective: To assess the efficacy of coblation in treating laryngeal papillomatosis and its effect on post operative voice outcome. Study Design: This is a retrospective study. Setting: Tertiary referral centre. Subjects and Methods: All the patients diagnosed with laryngeal papillomatosis between January 2013 to December 2016 were included in this study. Preoperative assessment was done with rigid and flexible laryngoscopy. PRAAT software was used for voice analysis. All patients underwent coblation assisted microlaryngeal surgery. Post operatively patients were followed up at 1 week, 15 days, 1 month, 3 months and 6 months with rigid laryngoscopy. Voice analysis was repeated after 3 months to assess the improvement in voice. Results: Coblation was found to be effective in treating laryngeal papillomatosis. In our series of seven patients, three patients underwent repeat procedure with coblation for recurrence. But longterm follow up these patients did not reveal any recurrence of laryngeal papillomatosis. Voice analysis revealed a significant improvement in measures of perturbation and maximum phonation time. Conclusion: Coblation is a promising alternative to the conventional methods for the treatment of laryngeal papillomas as it can achieve satisfactory disease clearance with good voice quality.

Incidence and mortality of laryngeal cancer in China, 2011

Objective： Laryngeal cancer is the common cancer of the upper aerodigestive tract. We aimed to use the national cancer registration data in 2011 to estimate the incidence and mortality of laryngeal cancer within China. Methods： Comparable, high-quality data from 177 population-based cancer registries were qualified for analysis. The pooled data were stratified by area, sex and age group. National new cases and deaths of laryngeal cancer were estimated using age-specific rates and national population in 2010. All incidence and death rates were age-standardized to the 2000 Chinese standard population and Segi＇s population, which were expressed per 100,000 populations. Results： All 177 cancer registries covered a total of 175,310,169 population （98,341,507 in urban and 76,968,662 in rural areas）, accounting for 13.01% of the national population. The data quality indicators of proportion of morphological verification （MV%）, percentage of cancer cases identified with death certification only （DCO%） and mortality to incidence ratio （Mr/） were 77.98%, 2.62% and 0.55, respectively. Estimated 20,875 new cases of laryngeal cancer were diagnosed and 11,488 deaths from laryngeal cancer occurred in China in 2011. The crude incidence rate of laryngeal cancer was 1.55/100,000 （2.69/100,000 in males and 0.35/100,000 in females）. Age-standardized incidence rates by Chinese standard population （ASIRC） and by world standard population （ASIRW） were 1.13/100,000 and 1.14/100,000, respectively. Laryngeal cancer is much rarer in females than in males. The incidence rate was higher in urban areas than that in rural areas. The crude mortality rate of laryngeal cancer was 0.85/100,000 （1.42/100,000 in males and 0.25/100,000 in females）. Age-standardized mortality rates by Chinese standard population （ASMRC） and by world standard population （ASMRW） were both 0.61/100,000. The mortality rate in males was much higher than that in females. There was no definite difference in mortality rates of laryngeal cancer between urban and rural areas. Conclusions： Larynx is a specialized area and cancer of larynx significantly affects the quality of life for the patients. Comprehensive measures should be carried out to prevent the ascent of laryngeal cancer.

Incidence and mortality of laryngeal cancer in China, 2015

Objective: Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015.Methods: Data submitted from 501 cancer registries were checked and evaluated according to the criteria of data quality control and 368 registries’ data were qualified for the final analysis. Data were stratified by area(urban/rural), sex, age group and combined with national population data to estimate laryngeal cancer incidence and mortality in China, 2015. China population census in 2000 and Segi’s population were used for agestandardized.Results: The percentage of cases morphological verified(MV%) of laryngeal cancer was 74.18%. The percentage of death certificate-only cases(DCO%) was 2.10%. And the mortality to incidence(M/I) ratio was 0.55.About 25,300 new cases of laryngeal cancer were diagnosed in 2015 and 13,700 deaths were reported. The crude rate of laryngeal cancer was 1.84 per 100,000(males and females were 3.20 and 0.42 per 100,000, respectively).Age-standardized incidence rates by Chinese standard population(ASIRC) and by world standard population(ASIRW) were 1.18 and 1.19 per 100,000, respectively. The cumulative incidence rate(0-74 years old) was 0.15%.The crude mortality rate was 1.00 per 100,000. Age-standardized mortality rates by Chinese standard population(ASMRC) and by world standard population(ASMRW) were 0.61 and 0.61 per 100,000, respectively, with the cumulative rate(0-74 years old) was 0.07%. Incidence and mortality of laryngeal cancer in males were higher than those in females. And the rates in urban areas were higher than those in rural areas.Conclusions: The incidence and mortality of laryngeal cancer in China were low. And the rates were significantly higher in males than in females. Risk factor control and targeted prevention should be strengthened.

Incidence and mortality of laryngeal cancer in China,2008–2012

Objective：To analyze the incidence and mortality rates of laryngeal cancer in China from 2008 to 2012.Methods：Incident and death cases of laryngeal cancer were retrieved from the National Central Cancer Registry（NCCR）database collecting from 135 cancer registries in China during 2008–2012.The crude incidence and mortality rates of laryngeal cancer were calculated by area（urban/rural）,region（eastern,middle,western）,gender and age group（0,1–4,5–9,…,85＋）.China census in 2000 and Segi’s world population were applied for age standardized rates.Join Point（Version 4.5.0.1）model was used for time trend analysis.Results：The crude incidence rate of laryngeal cancer was 1.86/100,000 ranked the 21st in overall cancers.The age-standardized incidence rates by China population（ASIRC）and by World population（ASIRW）were1.22/100,000 and 1.23/100,000,respectively.The crude mortality of laryngeal cancer in China was 1.01/100,000and it was the 21st cause of cancer-related death in overall cancers.Both the age-standardized mortality rates by Chinese standard population（ASMRC）and by world standard population（ASMRW）were 0.63/100,000.Incidence and mortality rates of laryngeal cancer were higher in males than in females and higher in urban areas than in rural areas.Middle areas had the highest incidence and mortality rates followed by eastern and western areas.Incidence and mortality rates of laryngeal cancer retained low level before age of 40 years old but increased greatly after and peaked in age group of 75.Incidence showed significant down trends in recent 10 years by 1.27%annually[95%confidence interval（95%CI）：–2.2%,–0.3%].Mortality declined in females sharply by 5.18%per year although stable in males and both sexes combined.Conclusions：Appropriate targeted prevention,early detection and treatment programs should be carried out to control the local burden of laryngeal cancer.

Correlation of survivin,p53 and Ki-67 in laryngeal cancer Hep-2 cell proliferation and invasion

Objective: To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion. Methods: Laryngeal squamous cell carcinoma and paracancerous normal tissues were collected, total RNA was extracted from tissues, survivin, p53 and Ki-67 gene m RNA expression levels in laryngeal cancer and the adjacent tissues were detected by Real-time PCR. Human laryngeal cancer Hep-2 epithelial cells were selected, survivin gene was overexpressed, and cell proliferation was detected by MTT. p53 and Ki-67 gene expression changes in overexpressed survivin gene were detected by Western blot. Changes in Hep-2 cell invasive ability were studied when survivin was overexpressed as detected by Transwell invasion assay. Results: In the adjacent tissues, survivin, p53 and Ki-67 gene relative expression levels were 1.72 ± 0.9, 13.7 ± 5.7 and 5.7 ± 1.3, respectively; while in cancer tissues, gene relative expression levels were 53.7 ± 8.3, 66.7 ± 5.2 and 61.0 ± 3.1, respectively, which was significantly increased. As detected by MTT, relative cell survival rate within 12 h of survivin overexpression were: load control group,(88.5±1.6)%; overexpressed group,(90.3±1.9)%. Transwell invasion assay results indicated that overexpressed survivin could significantly increase the relative survival rate of cells. Conclusions: Expressions of p53, Ki67 and survivin are increased in cancer; and there is a positive correlation between survivin, p53 and Ki67 expressions in laryngeal carcinoma.

Expression of Hypoxia Inducible Factor-1α and Its Relationship to Apoptosis and Proliferation in Human Laryngeal Squamous Cell Carcinoma

Summary: To investigate the expression of hypoxia inducible factor-1 alpha (HIF-1α) and its relationship to apoptosis and proliferation in laryngeal squamous cell carcinoma (LSCC), immunohistochemical method was used to detect the expression of HIF-1α and PCNA. Tunnel technique was used to detect in situ cell apoptosis in LSCC. Our results showed that the expression of HIF-1α was related to the clinical stages of cancer and lymph node metastasis (P<0.05). The relationship between HIF-1α and PCNA was statistically significant (P<0.05) and no relationship was found between HIF-1α and apoptosis (P>0.05) It is concluded that HIF-1α plays a role in the carcinogenesis of laryngeal carcinoma and is correlated with proliferation, but bears no relationship with the apoptosis of tumor cells in LSCC.

Effect and mechanism of miR-34a on proliferation, apoptosis and invasion of laryngeal carcinoma cells

Objective: To discuss the effect and mechanism of miR-34 a on the proliferation, apoptosis and invasion of laryngeal carcinoma cells. Methods: The laryngeal squamous carcinoma Hep2 cells were transiently transfected with miR-34 a mimics and miR-34 a NC. The MTT, colony-forming assay, Hoechst staining and Annexin V-PI double staining flow cytometry were employed to detect the effect of miR-34 a on the viability and apoptosis of laryngeal squamous carcinoma Hep2 cells; Transwell assay to defect the effect of miR-34 a on the migration and invasion of laryngeal squamous carcinoma Hep2 cells; western blot and RTPCR assay to defect the effect of miR-34 a mimics on the expression of survivin and Ki-67 m RNA in laryngeal squamous carcinoma Hep2 cells. Results: Compared with miR-34 a NC group, the cell viability in miR-34 mimics group was significantly decreased(P<0.01), the cell apoptosis rate was significantly increased(P<0.01), the abilities of cell migration and invasion were significantly reduced(P<0.01) and the expression of survivin and Ki-67 m RNA was significantly decreased(P<0.01). Conclusions: The increased expression of miR-34 a can induce the apoptosis of Hep2 laryngeal carcinoma cells and inhibit the cell proliferation and invasion, which is related to the down-regulated expression of survivin and Ki-67.

Adipose-derived mesenchymal stem cells accelerate nerve regeneration and functional recovery in a rat model of recurrent laryngeal nerve injury

Medialization thyroplasty or injection laryngoplasty for unilateral vocal fold paralysis cannot restore mobility of the vocal fold. Recent studies have shown that transplantation of mesenchymal stem cells is effective in the repair of nerve injuries. This study investigated wheth- er adipose-derived stem celt transplantation could repair recurrent laryngeal nerve injury. Rat models of recurrent laryngeal nerve injury were established by crushing with micro forceps. Adipose-derived mesenchymal stem cells （ADSCs; 8 ×105） or differentiated Schwann-like adipose-derived mesenchymal stem cells （dADSCs; 8×105） or extracellular matrix were injected at the site of injury. At 2, 4 and 6 weeks post-surgery, a higher density of myelinated nerve fiber, thicker myelin sheath, improved vocal fold movement, better recovery of nerve conduction capacity and reduced thyroarytenoid muscle atrophy were found in ADSCs and dADSCs groups compared with the extracellu- lar matrix group. The effects were more pronounced in the ADSCs group than in the dADSCs group. These experimental results indicated that ADSCs transplantation could be an early interventional strategy to promote regeneration after recurrent laryngeal nerve injury.

Role of laryngeal mask airway in laparoscopic cholecystectomy

Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway(LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway during general anesthesia. Use of LMA has some advantages when compared to endotracheal intubation, such as quick and ease of placement, a lesser requirement for neuromuscular blockade and a lower incidence of postoperative morbididy. However, the use of the LMA in laparoscopy is controversial, based on a concern about increased risk of regurgitation and pulmonary aspiration. The ability of these devices to provide optimal ventilation during laparoscopic procedures has been also questioned. The most important parameter to secure an adequate ventilation and oxygenation for the LMA under pneumoperitoneum condition is its seal pressure of airway. A good sealing pressure, not only state correct patient ventilation, but it reduces the potential risk of aspiration due to the better seal of airway. In addition, the LMAs incorporating a gastric access, permitting a safe anesthesia based on these commented points. We did a literature search to clarify if the use of LMA in preference to intubation provides inadequate ventilation or increase the risk of aspiration in patients undergoing laparoscopic cholecystectomy. We found evidence stating that LMA with drain channel achieves adequate ventilation for these procedures. Limited evidence was found to consider these devices completely safe against aspiration. However, we observed that the incidence of regurgitation and aspiration associated with the use of the LMA in laparoscopic surgery is very low.

Novel technique for lymphadenectomy along left recurrent laryngeal nerve during thoracoscopic esophagectomy

BACKGROUND In esophageal squamous carcinoma,lymphadenectomy along the left recurrent laryngeal nerve(RLN)is recommended owing to its highly metastatic potential.However,this procedure is difficult due to limited working space in the left upper mediastinum,and increases postoperative complications.AIM To present a novel method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the semi-prone position.METHODS The fundamental concept of this novel method is to exfoliate a bilateral pedicled nerve flap,which is a two-dimensional membrane,which includes the left RLN,lymph nodes(LNs)along the left RLN,and tracheoesophageal vessels,by suspending the esophagus to the dorsal side and pushing the trachea to the ventral side(named“bilateral exposure method”).Then,the hollow-out method is performed to transform the two-dimensional membrane to a three-dimensional structure,in which the left RLN and tracheoesophageal vessels are easily distinguished and preserved during lymphadenectomy along the left RLN.This novel method was retrospectively evaluated in 116 consecutive patients with esophageal squamous carcinoma from August 2016 to February 2018.RESULTS There were 58 patients in each group.No significant difference was found between the two groups in terms of age,gender,postoperative pneumonia,anastomotic fistula,and postoperative hospitalization.However,the number of dissected LNs along the left RLN in this novel method was significantly higher than that in the conventional method(4.17±0.359 vs 2.93±0.463,P=0.0447).Moreover,the operative time and the rate of postoperative hoarseness in the novel method were significantly lower than those in the conventional method(306.0±6.774 vs 335.2±7.750,P=0.0054;4/58 vs 12/58,P=0.0312).CONCLUSION This novel method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the semi-prone position is much safer and more effective.

Schwannoma originating from the recurrent laryngeal nerve in a thyroid cancer patient: A case report and review of the literature

BACKGROUND Schwannoma rarely originates from the recurrent laryngeal nerve, and there are few reports on schwannoma originating from the recurrent nerve in the mediastinum. Herein, we present an extremely rare case of schwannoma originating from the recurrent laryngeal nerve in the neck.CASE SUMMARY This is a case report of one patient diagnosed with thyroid cancer with schwannoma originating from the recurrent laryngeal nerve in the neck, which was incidentally found during a thyroidectomy, and a review of the literature.CONCLUSION Preoperative diagnostic examinations are of less use for detecting schwannoma originating from a recurrent laryngeal nerve in the neck in such small size, which may only incidentally be found during a thyroidectomy. Surgical excision with opening the capsule and shelling out the tumor is the treatment of choice. If the nerve is unable to be preserved, end-to-end recurrent laryngeal nerve anastomosis may be a simple and minimally invasive reconstruction procedure to improve phonation.

Expression of Vascular Endothelial Growth Factor and Cyclooxygenase-2 in Laryngeal Squamous Cell Carcinoma and Its significance

n order to study the expressions of vascular endothelial growth factor （VEGF） and cyclooxygenase-2 （COX-2） in human laryngeal squamous cell carcinoma （LSCC） and its significance, the expression of VEGF mRNA and COX-2 mRNA in 62 cases of LSCC and 54 adjacent noncancerous laryngeal tissues and 9 normal human laryngeal mucous tissues was detected by using techniques of semi-quantitative RT-PCR. It was found that the expression level of VEGF and COX-2 mRNA was significantly increased in LSCC as compared with that in the normal human laryngeal mucous tissues （both P〈0. 01）, and the expression level of VEGF and COX-2 mRNA were significantly increased in stage Ⅲ＋ Ⅳtissues of LSCC as compared with the stage Ⅰ ＋ Ⅱ tissues of LSCC （P 〈0.01）. There was a high positive correlation between VEGF and COX-2 expression in LSCC （r= 0. 756,P〈0.01）. These data raise the possibility that VEGF and COX-2 may play key roles in the growth, invasion and metastasis of LSCC.

ABO blood group is a predictor of survival in patients with laryngeal cancer

Background: Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinico?pathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis.Methods: We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat?sen University Cancer Center between January 1993 and December 2009. The Chi?square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3?, 5?, and 10?year overall survival(OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS.Results: No signiicant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3?, 5?, and 10?year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had signiicant efects on prognosis in patients with laryngeal cancer.Conclusions: The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had signiicantly shorter OS than patients with other ABO blood groups.

Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: A review

Recurrent laryngeal nerve(RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring(IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes "high risk". There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency.