Transoral surgery

经口手术
  • 文章类型: Case Reports
    Behçet病是一种难治性炎症性疾病,其特征是复发性口腔口疮溃疡。溃疡常见于口腔和咽部区域。在复发性咽部溃疡患者中,咽部狭窄可能发生并导致吞咽困难。在这里,我们报告一例由不完全性Behçet病引起的复发性溃疡引起的咽部狭窄。泼尼松龙,秋水仙碱,和英夫利西单抗治疗咽部溃疡,然而,吞咽困难持续存在。为了改善吞咽功能,进行了咽部扩张手术和经口视频喉镜手术,导致咽腔扩大.手术后的第二天开始口服水,六天后,患者能够正常饮食。手术后一年咽部狭窄没有复发,和正常的饮食继续没有任何饮食限制。因此,在严重口咽病变的情况下,耳鼻喉科医师的定期随访和手术干预是必要的.
    Behçet\'s disease is a refractory inflammatory disease characterized by recurrent oral aphthous ulcers. Ulcers are commonly seen in the oral cavity and the pharyngeal region. In patients with recurrent pharyngeal ulcers, pharyngeal stenosis may occur and leads to dysphagia. Herein, we report a case of pharyngeal stenosis caused by recurrent ulcers due to incomplete Behçet\'s disease. Prednisolone, colchicine, and infliximab were administered and resolved the pharyngeal ulcers, however, dysphagia persisted. To improve the swallowing function, a pharyngeal dilation surgery and transoral videolaryngoscopic surgery were performed, which resulted in an enlarged pharyngeal cavity. Oral intake of water was initiated the day after surgery, and after six days, the patient was able to take a normal diet. The pharyngeal stenosis had not recurred for one year after the surgery, and a normal diet continued without any dietary restrictions. Therefore, in a case of a severe oropharyngeal lesion, periodic follow-up and surgical interventions by an otolaryngologist are necessary.
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  • 文章类型: Review
    附件性腮腺肿瘤很少见,占腮腺肿瘤的不到10%。虽然类似的肿瘤影响副腮腺和腮腺,副腮腺肿瘤与较高的恶性率相关。手术是一线管理。标准的手术管理涉及与浅表腮腺切除术类似的方法,尽管这些病变位于前方。这种方法需要广泛的皮下通路和面神经解剖,因此,构成重大风险。它也可能导致不良的美容效果,由于疤痕和弗雷综合征。相反,经口的方法来降低美容畸形的风险,减少恢复时间,不会增加面神经的风险。我们介绍了一系列副腮腺肿块患者,已成功经口切除,无需内镜辅助。
    Accessory parotid tumours are rare, accounting for less than 10% of parotid neoplasms. Although similar tumours affect both the accessory parotid and parotid, accessory parotid tumours are associated with higher rates of malignancy. Surgery is first line management. Standard surgical management involves a similar approach to superficial parotidectomy, despite the anterior location of these lesions. This approach requires extensive subcutaneous access and facial nerve dissection and therefore, poses significant risk. It can also result in poor cosmetic result due to scarring and Frey\'s Syndrome. On the contrary, a transoral approach to reduces the risk of cosmetic deformity, reduces recovery time and does not increase risk to the facial nerve. We present a case series of patients with accessory parotid masses, which have been successfully excised transoral and without endoscopic assistance.
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  • 文章类型: Journal Article
    只有0.3-1%的喉癌是非鳞状细胞肿瘤。其中,一种罕见的实体是炎性肌纤维母细胞瘤(IMT),其中经常表达间变性淋巴瘤激酶-1(ALK-1)。仅报告了50例IMT。因此,许多耳鼻喉科医师可能不熟悉这种类型的肿瘤,并且容易过度或不充分治疗。我们报告了一例ALK-1阴性IMT在手术后6个月接受经口内镜切除术和无病治疗。
    Only 0.3-1% of laryngeal cancer are non-squamous cell neoplasms. Of these, a rare entity is inflammatory myofibroblastic tumour (IMT), in which anaplastic lymphoma kinase-1 (ALK-1) is frequently expressed. Just 50 cases of IMT have been reported. Therefore, many otolaryngologists may be unfamiliar with this type of tumour and be prone to its over- or undertreatment.We report a case of ALK-1-negative IMT treated with transoral endoscopic excision and disease-free 6 months after surgery.
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  • 文章类型: Case Reports
    Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the United States. Postoperative migration of the stomach into the chest is a rare complication of this procedure. In this study, we present a compilation of acute and chronic intrathoracic sleeve migrations (ITSMs) after LSG and present possible underlying mechanisms of this complication, as described in the literature. Methods: We retrospectively reviewed the preoperative, intraoperative, and postoperative course of patients who had an ITSM after LSG between 2011 and 2019. Results: Two patients presented with this complication in the acute setting, whereas 3 patients developed ITSM as a chronic issue years after the primary procedure. All 5 were female patients, with a mean age and body mass index of 55.6 ± 9.5 (years) and 37.8 ± 2.9 kg/m2, respectively. None of the cases had a hiatal hernia repair during the initial operation. All cases were completed laparoscopically with reduction of the migrated sleeve into the abdomen and primary hiatal hernia repair. One case required a return to the operating room for an acute reherniation. Conclusion: In this article, we report a compilation of cases of ITSMs after LSG with distinct clinical features that highlight the diversity of possible reasons and risk factors for its development.
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  • 文章类型: Case Reports
    BACKGROUND: Complications of nonunited Type II odontoid fractures can range from neck pain to progressive neurological deficit from cervical myelopathy. Rarely, the hypertrophic nonunion requires both anterior transoral decompression and posterior decompression with instrumented fusion. We present a case and review literature around this entity.
    METHODS: A 68-year-old female presented with rapidly progressive cervical myelopathy (from normal to moderate myelopathy modified Japanese Orthopedic Association [mJOA] 13) over 3 months. Her history was positive for a Type II odontoid fracture managed conservatively and lost to follow-up for 25 years. Spinal imaging studies revealed hypertrophic nonunion and craniocervical kyphotic deformity with significant subaxial stenosis and segmental kyphosis. The patient underwent anterior transoral decompression, followed by posterior occipitothoracic decompression and instrumented fusion. At follow-up, the cervical myelopathy has improved to near normalcy (mJOA 17) with no evidence or implant-related complication.
    CONCLUSIONS: Rarely, nonunion of Type II odontoid fractures may be hypertrophic where both instability and compression cause neurological morbidity. Such cases require anterior transoral decompression, posterior cervical decompression, and instrumented fusions.
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  • 文章类型: Journal Article
    BACKGROUND: Transoral resection of pharyngeal tumors with acceptable oncological and functional results can be challenging due to their location in a narrow anatomic space.
    METHODS: In this case report, we demonstrate successful visualization and resection of a squamous cell carcinoma of the oropharynx using the novel Medrobotics(®) Flex(®) System. The Medrobotics(®) Flex(®) System (Medrobotics Corp., Raynham, MA, USA) is an operator controlled flexible endoscope system that includes a rigid endoscope and computer-assisted controllers, with two external channels for the use of compatible, 3.5mm flexible instruments.
    CONCLUSIONS: In a 74-year old female patient a T1 squamous cell carcinoma of the oropharynx was visualized and completely resected using this system. The Medrobotics(®) Flex(®) System is a promising device for transoral approaches in resection of tumors within the pharynx.
    CONCLUSIONS: Good visualization, access, and flexibility of the endoscope and instruments are hereby clear advantages of the system compared to commonly used systems.
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  • 文章类型: Journal Article
    This study was conducted to describe a retropharyngeal myxoma and discuss clinical concerns regarding this pathology and a retropharyngeal site of occurrence. We present a case report and review of literature. A 71-year-old woman presented with mild right neck pressure for 3 weeks. Imaging studies and head neck examination confirmed a 5.3 × 3.1 × 1.0 cm retropharyngeal mass with no communication to the vertebral column but was intimately involved with the pharyngeal mucosa. A transoral fine needle aspiration biopsy suggested a possible spindle cell neoplasm. A presurgical swallowing consultation was obtained. A transoral excision of the tumor was possible with no intraoperative complications. Histopathology was a cellular myxoma. Postoperative dysphagia required swallowing therapy and nasogastric tube feeding for 2 weeks before oral intake was possible. The patient has no evidence of clinical or radiological recurrence more than 1 year after surgical intervention. We present the second case of a myxoma in the retropharynx reported in English literature. Transoral excision was safe, feasible, and cosmetically appealing option in our patient. Additional clinical data are required to valid its safety and utility as an approach to tumors in the retropharynx. Postoperative dysphagia can be significant and consequently we recommend preoperative swallowing evaluation and counseling.
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