OBJECTIVE To explore the clinical and therapeutic effects of cervical plexus reinnervation for infiltrated or injured unilateral recurrent laryngeal nerve （URLN）. METHODS Functional neck dissection for removal of di...OBJECTIVE To explore the clinical and therapeutic effects of cervical plexus reinnervation for infiltrated or injured unilateral recurrent laryngeal nerve （URLN）. METHODS Functional neck dissection for removal of differentiated thyroid carcinoma （DTC） in patients was performed, in which cervical plexus reinnervation was adopted for patients with stage I disease and URLN with injury or with tumor invasion. Outcomes of surgery were evaluated by examination under fibrolaryngoscope, and the patients＇ voices were evaluated before and after surgery. RESULTS All cases were followed up for 3 mon-2 years （average 8 mon）. Abductory motion of the vocal cords of 15 patients was completely or partly restored, but 3 patients＇ vocal cords were immovable. The recovery rate of abductory motion of the paralyzed vocal cords was 83.33% （15/18）. The function of phonation in the 16 patients was restored to normal or near normal limits, and their hoarseness was improved significantly. CONCLUSION Cervical plexus-URLN reinnervation should be considered when treating patients with unilateral vocal cord paralysis. Removing the tumor simultaneously with cervical plexus reinnervation during surgery for repair of unilateral recurrent laryngeal nerve injury was convenient and easy to perform with less functional damage compared with other methods of reinnervation. The abductory motion of vocal cord could be satisfactorily restored by this reinnervation. Surgical performance skills and application of neurotrophic drugs were important for the success of the surgery.展开更多
With the increase of elderly population, more and more implant operations need to be performed in osteoporotic bone, while different forms of microdamage will be produced in peri-implant bone intraoperatively, includi...With the increase of elderly population, more and more implant operations need to be performed in osteoporotic bone, while different forms of microdamage will be produced in peri-implant bone intraoperatively, including high- and low-density diffuse damages, as well as linear cracks. The length and location of the microcracks are the main factors in affecting the biomechanical performance of bone. Suppression of bone remodeling by bisphosphonates may lead to microdamage accumulation, which is often accompanied with the decrease of bonestrength and the increase of bone fragility. Microdamage can be repaired by bone remodeling or mineralization to maintain the strength and structural integrity. Both remodeling and mineralization can affect the bone quality and long-term implant stability, In this paper, we make a brief summary of some important issues and research progresses in this field.展开更多
文摘OBJECTIVE To explore the clinical and therapeutic effects of cervical plexus reinnervation for infiltrated or injured unilateral recurrent laryngeal nerve （URLN）. METHODS Functional neck dissection for removal of differentiated thyroid carcinoma （DTC） in patients was performed, in which cervical plexus reinnervation was adopted for patients with stage I disease and URLN with injury or with tumor invasion. Outcomes of surgery were evaluated by examination under fibrolaryngoscope, and the patients＇ voices were evaluated before and after surgery. RESULTS All cases were followed up for 3 mon-2 years （average 8 mon）. Abductory motion of the vocal cords of 15 patients was completely or partly restored, but 3 patients＇ vocal cords were immovable. The recovery rate of abductory motion of the paralyzed vocal cords was 83.33% （15/18）. The function of phonation in the 16 patients was restored to normal or near normal limits, and their hoarseness was improved significantly. CONCLUSION Cervical plexus-URLN reinnervation should be considered when treating patients with unilateral vocal cord paralysis. Removing the tumor simultaneously with cervical plexus reinnervation during surgery for repair of unilateral recurrent laryngeal nerve injury was convenient and easy to perform with less functional damage compared with other methods of reinnervation. The abductory motion of vocal cord could be satisfactorily restored by this reinnervation. Surgical performance skills and application of neurotrophic drugs were important for the success of the surgery.
基金This research was supported by grants from National Natural Science Foundation for the Youth （No. 11002090）, Shanghai Natural Science Foundation （No. 10ZR1417900） and the Program for Key Disciplines of the Shanghai Mu- nicipal Education Commission （No. J50206）.
文摘With the increase of elderly population, more and more implant operations need to be performed in osteoporotic bone, while different forms of microdamage will be produced in peri-implant bone intraoperatively, including high- and low-density diffuse damages, as well as linear cracks. The length and location of the microcracks are the main factors in affecting the biomechanical performance of bone. Suppression of bone remodeling by bisphosphonates may lead to microdamage accumulation, which is often accompanied with the decrease of bonestrength and the increase of bone fragility. Microdamage can be repaired by bone remodeling or mineralization to maintain the strength and structural integrity. Both remodeling and mineralization can affect the bone quality and long-term implant stability, In this paper, we make a brief summary of some important issues and research progresses in this field.
