To investigate time of delayed reinnervated laryngeal muscle, 15 dogs were divided into two groups. The right recurrent laryngeal nerves of 10 dogs in experimental group were cut, and repaired at 4, 6, 8, 10 and 12 months intervals by transposition of the phrenic nerve to the recurrent laryngeal nerve after cutting and suturing the adductor branch to the main branch of ansa cervicalis. The right recurrent laryngeal nerves of 5 dogs in control group were cut, but did not repair. Laryngoscope, electromyography, contractile tension of laryngeal muscle and histologic studies were performed at six months postoperatively. The results showed that fair recovery of adduction and abduction was noted within ten months interval, and the effect of adduction was better than that of abduction. The effect decreased gradually with the denervated time increased. The conclusion demonstrated that delayed reinnervation of laryngeal muscle should be performed within ten months.
目的：观察古方止嗽散加味治疗喉源性咳嗽的疗效。方法：采用加味止嗽散治疗喉源性咳嗽116例，并设西药对照组113例。结果：治疗组有效率87.3%，对照组有效率68.2%，两组比较有显著差异(Plt;0.01)。治疗组不良反应例数为零；对照组不良反应例数约占10.2%。结论：加味止嗽散具有疏风宣肺、清热解毒、利咽祛痰、益气养阴、扶正祛邪、抗病毒、抗菌、抗炎和增强免疫功能等功效，为治疗喉源性咳嗽的有效方药。
Reports 3 cases of transplantation ofmicrovaseular jejunal segments to reconstracthypopharynx and cervical esophagus. Threewere survived. The major advantages of thistechnique include the fat that it is a one staseprocedure, thereby allowing early rehabilita -tion , and that the complication rate is low.
Objective To explore anatomical features and variation of non-recurrent laryngeal nerve and to summarize identification method, operation skill, and damage treatment experience of it. Method The clinical data of 15 patients with non-recurrent laryngeal nerve in 4 054 patients who underwent thyroidectomy from our division by the same medical group from January 2006 to January 2016 were retrospectively analyzed. Results A total of 6 626 recurrent laryngeal nerve (left side 3 248, right side 3 378) were exposed in 4 054 cases. Fifteen patients with non-recurrent laryngeal nerve were detected with an incidence of 0.23% (15/6 626), all located on the right side. There were 3 males and 12 females. There were 3 cases of type Ⅰ, 10 cases of type Ⅱa, 2 cases of type Ⅱb. And 2 patients with non-recurrent laryngeal nerve were injured. Conclusions Incidence of non-recurrent laryngeal nerve is lower, most of which occur on right side of neck, there is a high injury rate for its special anatomical location. It’s key to prevent nerve injury for careful interpreting preoperative auxiliary examination results and improving awareness of non-recurrent laryngeal nerve, fining dissection, conventional exposuring recurrent laryngeal nerve, and accurate using nerve monitor during operation.
ObjectiveTo master the morphological characteristics of the recurrent laryngeal nerve (RLN) and extra-laryngeal branching (ELB) in dogs, and to provide an anatomical basis for the establishment of an animal model of injury to the ELB in dogs as well as for functional studies. MethodsSix adult healthy Beagles were selected, completely dissected the thyroid gland, the full length of the cervical segment of the RLN and the ELB. Then, the location, size and morphology of the thyroid gland and the morphological features of the RLN and ELB were observed. The length of the RLN and its ELB were measured. The incidence and number of ELB and their relationship with trachea, esophagus and peripheral blood vessels were recorded. ResultsSix Beagles (12 sides) all had ELB. In 9 sides the main trunk of the RLN divided into internal and external branches on its way up into the larynx and converged before them entering the larynx. The total number of ELB was 48, and the number of branches on each side were ranging from 1 to 7. There were 38 ELB were located below the lowest level of the thyroid gland. ConclusionsThe Beagles included in this study all have ELB. The ELB were widely distributed in the cervical trachea and esophagus after branching from the internal branch of RLN. It is speculated that the ELB may be involved in the function of the cervical esophagus and trachea. In thyroid surgery, the tracheal branch and esophageal branch of the ELB should be preserved as much as possible.
ObjectiveTo investigate the predictive value of recurrent laryngeal nerve lymph nodes (RLN) status for supraclavicular lymph node (SLN) metastasis in esophageal squamous cell carcinoma.MethodsWe retrospectively analyzed the clinical data of 83 patients with esophageal squamous cell carcinoma who underwent McKeown three-field lymphadenectomy from January 2017 to April 2018 in our hospital, including 53 males and 30 females with an average age of 64.07±7.05 years.ResultsThe SLN metastasis rate of the patients was 24.1%. The rate in the thoracic and abdominal metastases positive (N1-3) group and negative (N0) group was 37.8% and 13.0%, respectively, with a statistical difference (P<0.05). The rate of SLN metastasis was significantly different between the RLN metastasis positive (RLN+) and negative (RLN–) groups (39.1% vs. 18.3%, P<0.05). One side of RLN metastasis could lead to SLN metastasis on the opposite side. No correlation between the SLN metastasis and age, gender, location, differentiation degree, maximum tumor diameter, T-staging or histologic type was observed (P>0.05). Multivariate analysis showed that lymph node metastasis in chest or abdomen was an independent predictor of SLN metastasis.ConclusionRLN+ is not the independent predictor for SLN metastasis. SLN should be dissected in N1-3 patients with esophageal squamous cell carcinoma without considering tumor location and T-staging. Bilateral SLN dissection should be recommended even if RLN metastasis is only unilateral.
Objective To compare the difference of preparing the acellular larynx scaffold between perfusion method and immersion method, and find better way to make acellular larynx scaffold for tissue engineering. Methods Twenty 6-month-old male New Zealand rabbits, weighing 2.0-2.5 kg, were divided into perfusion group (n=10) and immersion group (n=10) at random. All the larynxes were excised in a sterile fashion. The acellular larynx scaffold was obtained by perfusionmethod and immersion method respectively, and then comparative examinations were performed by the macroscopicview, histological view, scanning electron microscope (SEM), cartilage vital ity assay and toluidine blue staining. ResultsMacroscopic view showed that the larynxes perfused by sodium dodecyl sulphate (SDS) became transparent after 2 hoursof perfusion, but the larynxes immersed by SDS over 16 hours still appeared pink-white. Histology and SEM indicated thatcompared with immersion group, perfusion group showed better acellular effect, more ventages and collagen fibers wereretained, no intact cell or nuclei remained in acellular matrix and chondrocytes were still survival. The porosity was 85.39% ± 3.16% in perfusion group and 34.72% ± 4.51% in immersion group, showing significant difference (P lt; 0.01). The chondrocyte vital ity rate of perfusion group (86.93% ± 1.52%) was higher than that of immersion group (77.73% ± 1.66%), showing significant difference (P lt; 0.01). Toluidine blue staining showed that the chondrocyte heterochromaty was ber in perfusion group than that in immersion group. Conclusion Compared with immersion method, perfusion method is a better way to construct acellular larynx scaffold because it can achieve better acellular effect and retain chondrocyte vital ity at the greatest extent in the acellular larynx scaffold.