BackgroundIn treating juvenile-onset laryngeal papillomatosis, the most difficult aspect is preventing recurrence. After a single treatment, recurrence can begin after as soon as 20 days and the recurrent rate can be higher than 90%. The causes of recurrence include the presence of mucosal cells infected with papilloma virus, which are undetectable with the naked eyes, and surgery-induced infection. Photodynamic therapy (PDT) could effectively solve this problem. Virus-infected cells have a very high metabolic energy for capturing and internalizing the photosensitizer, which, after light stimulation, subsequently induces active oxygen species inside the nucleus, which kill infected cells. The second generation of photosensitizer agents (PA) are locally applied to avoid the intravenous systemic damage caused by first-generation PAs, and this method is widely used for the treatment of genital warts to very good effect.MethodsWe used the photodynamic method to treat laryngeal papillomatosis in children and obtained significant efficacy. We followed three juvenile subjects with recurrent laryngeal papillomatosis through a course of treatment (each course includes three PDT sessions), with a follow-up after 6 months.ResultsThe characteristic procedures involve exposing the larynx with a laryngoscope and using low-temperature plasma technology to visualize the tumor resection, as the effects of plasma technology can reduce postoperative laryngeal edema and reduce intraoperative metastasis. PDT was performed during the first surgery, 20 days after and 30 days after surgery. At the 6-month follow-ups, there was no recurrence.ConclusionThis was the world's first successful reported case of the use of PDT treatment for juvenile laryngeal papillomatosis.

BackgroundNoise induced injury of the cochlea causes shifts in activation thresholds and changes of frequency response in the inferior colliculus (IC). Noise overexposure also induces pathological changes in the cochlea, and is highly correlated to hearing loss. However, the underlying mechanism has not been fully elucidated. In this study, we hypothesized that overexposure to noise induces substantial electrophysiological changes in the IC of guinea pigs.ResultsDuring the noise exposure experiment, the animals were undergoing a bilateral exposure to noise. Additionally, various techniques were employed including confocal microscopy for the detection of cochlea hair cells and single neuron recording for spontaneous firing activity measurement. There were alterations among three types of frequency response area (FRA) from sound pressure levels, including V-, M-, and N-types. Our results indicate that overexposure to noise generates different patterns in the FRAs. Following a short recovery (one day after the noise treatment), the percentage of V-type FRAs considerably decreased, whereas the percentage of M-types increased. This was often caused by a notch in the frequency response that occurred at 4 kHz (noise frequency). Following a long recovery from noise exposure (11–21 days), the percentage of V-types resumed to a normal level, but the portion of M-types remained high. Interestingly, the spontaneous firing in the IC was enhanced in both short and long recovery groups.ConclusionOur data suggest that noise overexposure changes the pattern of the FRAs and stimulates spontaneous firing in the IC in a unique way, which may likely relate to the mechanism of tinnitus.

This simple technique is feasible and minimally invasive, and may be particularly beneficial to patients with a deviated septum who seek to improve both their aesthetic appearance and nasal functionality. However, this method is not appropriate for those with a crooked nose caused by nasal bone deformity, lateral cartilages, and severe septal deformity.

Background The keystone region is an important anatomical structure to consider in rhinoseptoplasty, because there are few published data regarding the keystone region in Chinese noses. Objectives The authors sought to describe the anatomy of the Chinese nasal keystone region and provide useful knowledge for rhinoseptoplasty. Methods Sixteen cadaveric heads (11 males, 5 females) were dissected, measured, and then compared with previously published data. Results Both the nasal bone caudal margin and nasal bone-upper lateral cartilage overlapping area displayed 5 distinct shapes, and the upper lateral cartilage showed 4 distinct shapes. The nasal bone-upper lateral cartilage overlap was 6.47 mm ± 2.50 in the midline, 3.53 mm ± 2.23 on the left, and 3.81 mm ± 2.56 on the right. The length of the whole quadrangular cartilage was 25.63 mm ± 4.27; 25% ± 8% was overlapped by the nasal bone. The height of the caudal quadrangular cartilage was 18.14 mm ± 3.44, and the width of the nasal bone-upper lateral cartilage articulation was 23.56 mm ± 8.30. The upper lateral cartilage-quadrangular cartilage complex stayed in position on the maxillary crest and nasal spine, even after being dissected from the nasal bone, perpendicular plate of the ethmoid bone, and vomer. Bilateral perichondrial-periosteal mucosa detached from the nasal septum. Conclusions We report various anatomical and structural features of the Chinese keystone region, which will be valuable for rhinoseptoplasty planning in Chinese patients.

This study aims to explore the effects and advantages of coblation combined with microscopy to treat epiglottis cysts. Ninety patients with epiglottis cysts were randomly assigned to three groups: the first group: marsupialisation + electric coagulation group, n = 30; the second group: marsupialisation + coblation, n = 30; and the third group: marsupialisation + coblation + microsurgery, n = 30. To compare the cure rate, intraoperative bleeding volume, postoperative pain, operation time and postoperative complications were investigated among these three groups. The comparison among three procedures showed a significant difference for intraoperative bleeding volume, operation time and postoperative pain (P < 0.05), whereas no significant difference was observed for cure rate (P > 0.05). These three procedures are effective in treating epiglottis cysts. Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, less pain and few complications. Thus, microscopic surgery is worthy of clinical application.