Low-temperature Plasma Radiofrequency Ablation Research Articles

Low-Temperature Plasma Radiofrequency Ablation for Congenital Epiglottic Cysts.

Objectives: Congenital epiglottic cysts are rare disorders of the larynx with symptoms such as laryngeal stridor and inspiratory dyspnea and are life-threatening in severe cases. This study aimed to investigate the usefulness of low-temperature plasma radiofrequency ablation for congenital epiglottic cysts and provide a reference for clinicians to develop treatment options. Methods: The clinical data of children (n = 7, 4 males and 3 females) with congenital epiglottic cysts, who were admitted to the Second Affiliated Hospital of Wenzhou Medical University and Yuying Children's Hospital from March 2018 to March 2023, were analyzed retrospectively. Following preoperative examinations, all patients underwent low-temperature plasma radiofrequency ablation under general anesthesia, and the curative effect was evaluated. Following surgery, regular patient follow-up examinations were conducted to monitor recurrence. Results: The age at the time of operation ranged from 1 day to 99 days, with an average of 37.57 ± 35.01 days. The surgical procedure was successfully completed in all the children; dyspnea disappeared and no surgical complications were observed. In addition, during the postoperative follow-up period of 6 months to 5 years, recurrence was not observed. Conclusions: Low-temperature plasma radiofrequency ablation is a safe and effective procedure for treating congenital epiglottic cysts and deserves clinical application and promotion.

Comparison of the Efficacy of Different Radiofrequency Techniques for the Treatment of Lumbar Facet Joint Pain: Combined with Anatomy.

Lumbar facet pain is generally considered to be one of the major causes of chronic low back pain. Each lumbar facet joint is innervated by the medial branch of the posterior spinal nerve from its own level and above. Radiofrequency (RF) of the medial branch of the posterior branch of the spinal nerve is an effective method for the treatment of lumbar facet pain. RF technology is diverse, including traditional radiofrequency (TRF), pulsed radiofrequency (PRF), cooled radiofrequency (CRF), low-temperature plasma radiofrequency ablation (CA), and other treatment methods. The purpose of this paper is to compare the efficacy of different radiofrequency techniques and to analyze the reasons for this in the context of anatomy. There have been studies confirming the differences in efficacy of different RF techniques. However, most of the studies only compared two RF techniques, not four techniques, TRF, CRF, PRF, and CA, and did not analyze the reasons for the differences in efficacy. This article reviews the differences in the efficacy of the above four RF techniques, clarifies that the differences are mainly due to the inability to precisely localize the medial branch of the posterior branch of the spinal nerve, analyzes the reasons for the inability to precisely localize the posterior branch of the spinal nerve in conjunction with anatomy, and proposes that the development of RF technology for lumbar facet pain requires more in-depth anatomical, imaging, and clinical studies.

Retracted: Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function

Retracted: Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function

A novel endoscopic nasopharyngectomy by low-temperature plasma radiofrequency ablation in localized recurrent nasopharyngeal carcinoma.

Endoscopic nasopharyngectomy (ENPG) with en bloc resection has been well accepted in resectable localized recurrent nasopharyngeal carcinoma (rNPC), but it is a difficult technique to master for most otorhinolaryngology head and neck surgeons. Ablation surgery is a new and simplified method to remove tumors. We designed a novel method using low-temperature plasma radiofrequency ablation (LPRA) and evaluated the survival benefit. A total of 56 localized rNPC patients were explained in detail and retrospectively analyzed. The surgery method was ablated from the resection margin to the center of the tumor. The postmetastatic overall survival (OS), local relapse-free survival (LRFS) rate, progression-free survival (PFS) and distant metastasis-free survival (DMFS) were analyzed using the Kaplan-Meier method and compared by the log-rank test. All surgeries were successfully performed without any severe postoperative complications or deaths. The median operation time of ablation and harvested NSFF respectively were 29 min (range, 15-100 min) and 101 min (range, 30-180 min). The average number of hospital days postoperation was 3 days (range, 2-5 days). All cases (100.0%) had radical ablation with negative resection margins. The nasopharyngeal defects were completely re-epithelialized in 54 (96.4%) patients. As of the data cutoff (September 3, 2023), the median follow-up time was 44.3 months (range, 17.1-52.7 months, 95% CI: 40.4-48.2). The 3-year OS, LRFS, PFS and DMFS of the entire cohort were 92.9% (95% CI: 0.862-0.996), 89.3% (95% CI: 0.813-0.973), 87.5% (95% CI: 0.789-0.961), and 92.9% (95% CI: 0.862-0.996), respectively. Cycles of radiotherapy were independent risk factors for OS (p = 0.003; HR, 32.041; 95% CI: 3.365-305.064), LRFS (p = 0.002; HR, 10.762; 95% CI: 2.440-47.459), PFS (p = 0.004; HR, 7.457; 95% CI: 1.925-28.877), and DMFS (p = 0.002; HR, 34.776; 95% CI: 3.806-317.799). Radical endoscopic nasopharyngectomy by using low-temperature plasma radiofrequency ablation is a novel, safe and simplified method to master and disseminate for treating resectable rNPC. However, further data and longer follow-up time are needed to prove its efficacy.

Impacts of Postoperative Enteral Nutrition and Rosiglitazone on Quality of Life Together with Prognosis of Patients with Early-Stage Glottic Laryngeal Carcinoma

We aimed to clarify the influence of postoperative enteral nutrition and rosiglitazone on the quality of life and prognosis of patients with early stage glottic laryngeal carcinoma. Low-temperature plasma radiofrequency ablation was performed in the control group, while the observation group additionally received rosiglitazone and postoperative enteral nutrition. After therapy, the observation group had lower fundamental frequency perturbation and amplitude perturbation and higher harmonic-to-noise ratio and effective rate than the control group. One month after treatment, the serum levels of albumin, prealbumin, and hemoglobin in the observation group were higher than those in the control group. Moreover, peripheral blood immune markers, CD3+, CD4+, and CD4+/CD8+ levels were higher in the observation group, while CD8+ levels were lower. The incidence rate of adverse reactions was lower in the observation group than in the control group. The five-year survival rates were 77.14% (27/35) and 54.29 % (19/35) in the observation and control groups, respectively. Postoperative enteral nutrition and rosiglitazone can prolong survival, improve immune function and quality of life in patients with early-stage glottic laryngeal carcinoma, and reduce adverse reactions during treatment, which is an ideal treatment plan.

Case Reports of Low-Temperature Plasma Radiofrequency Treatment for Congenital Epiglottic Cysts in Neonates and Infants.

An uncommon benign condition in neonates, known as congenital epiglottic cyst, can lead to symptoms such as neonatal dyspnea, laryngeal stridor, and, in severe cases, even pose a potential threat of asphyxia-related mortality. A congenital epiglottic cyst is one of the neonatal emergencies. Fibrolaryngoscopy is the predominant method of diagnosis, and early identification, diagnosis, as well as treatment are the key points. Successful endoscopic ablation of congenital epiglottic cysts in 3 newborns was achieved through the utilization of a low-temperature plasma radiofrequency ablation system. Consequently, the purpose of this case report is to assist pediatric emergency physicians in the timely identification of congenital epiglottic cysts with the potential risk of mortality and to provide additional experience in clinical management.

Clinical manifestation and treatment strategy of intervertebral space infection after radiofrequency ablation of lumbar nucleus pulposus

To study the clinical manifestations and treatment of intervertebral space infection after percutaneous lumbar radiofrequency ablation of nucleus pulposus. A retrospective analysis was performed of 496 patients who underwent percutaneous lumbar disc decompression using low-temperature plasma radiofrequency ablation nucleus pulposus from June 2009 to June 2019. Six patients had lumbar infection, and the infection rate was 1.21%. All patients were male, ranging in age from 20 to 61 years old. Three patients underwent single segment radiofrequency ablation, two patients underwent dual segments ablation;and one patient underwent three segment ablation, totaling 10 intervertebral discs. One patient was complicated with type 2 diabetes before operation. The interval between infection occurrence ranged from 21 to 65 days. All 6 patients were followed up, and the duration ranged from 18 to 40 months, with an average of 24 months. Among them, 2 patients presented with symptoms of low back pain accompanied by fever, and imaging examination showed intervertebral space infection accompanied by abscess. In addition, 4 patients experienced low back pain but no fever, and MRI showed abnormal signals of the infected intervertebral endplate or vertebral body. One patient showed staphylococcus aureus in blood culture, while the remaining 5 patients showed negative bacterial culture. All the patients were treated with antibiotics after diagnosis. Four patients were treated with conservative management to control infection;1 patient was treated with debridement of posterior lumbar infection focus, and 1 patient was treated with debridement of posterior lumbar infection focus combined with interbody fusion and internal fixation. The occurrence of intervertebral space infection during lumbar radiofrequency ablation nucleoplasty should be given sufficient attention. Strict aseptic technique, avoiding repeated multi segment puncture, realizing early detection and treatment, and selecting appropriate treatment methods according to the severity of infection is the guarantee of achieving curative effect.

Evaluation of the efficacy and safety of day surgery for cervical disc herniation treated with low temperature plasma radiofrequency ablation.

The purpose of this study was to evaluate and compare the clinical efficacy of patients with cervical disc herniation (CDH) treated by low-temperature plasma radiofrequency ablation (LTP-RFA) as day surgery with traditional inpatients. According to the selection criteria, single-segment mild to moderate CDH patients who received LTP-RFA from January 2020 to December 2021 were divided into day surgery procedure (DSP) group anda traditional inpatient procedure (TIP) group. The visual analogue score (VAS) and modified Japanese Orthopedic Association score (mJOA) of neurological function of patients in the two groups were recorded at the time of preoperative, and one day, three months, six months after surgery and the last follow-up respectively. The gender, age, responsible segment, surgical complications, hospitalization time, hospitalization expenses, and patient satisfaction were recorded and analyzed for both groups. The modified Macnab standard was used to evaluate the postoperative efficacy at one month and six months after operation. A total of 127 patients (75 in DSP;52 in TIP) with complete data were enrolled and completed sixmonth follow-up. There were no statistically significant pre-treatment VAS scores and mJOA scores in the two groups (P>0.05). The postoperative VAS and mJOA scores in both groups were improved after surgery (P<0.05). However, there was no significant difference in VAS scores and mJOA scores between the two groups in the same postoperative period (all P > 0.05). The efficacy of MacNab was similar one month and sixmonths after operation (P > 0.05). The hospitalization time and hospitalization cost were significantly lower in DSP group (all P<0.05). As the treatment effects were comparable, patients in both groups were similarly satisfied at discharge. LTP-RFA is an effective method for the treatment of mild to moderate CDH. We suggest that the application of LTP-RFA in DSP for mild to moderate CDH is worthy of wide application.

Clinical efficacy of low-temperature plasma radiofrequency ablation in children with pyriform fossa fistula

ObjectiveTo evaluate clinical efficacy of low-temperature plasma radiofrequency ablation in children with pyriform fossa fistula. MethodsFrom June 2015 to August 2021, 80 children with pyriform fossa fistula who underwent low-temperature plasma radiofrequency ablation to occlude internal fistula in our hospital were included in this retrospective study. Antibiotics were routinely used for 3–5 days after operation. Indwelling gastric tube was given for 5–7 days, and nasal feeding was given. The curative effect, recurrence rate and incidence of postoperative complications were observed. ResultsThere were 67 cases of left pyriform fossa fistula and 13 cases of right pyriform fossa fistula. The average follow-up time was 16 months. During postoperative follow-up, 2 cases recurred, and the recurrence rate was 2.5%. The recurrence time was 10–21 months after operation. Temporary hoarseness occurred in 7 children after operation and recovered within 3 months after discharge. Children developed one or several clinical symptoms, such as choking cough, dysphagia, infection and esophageal injury. ConclusionLow-temperature plasma radiofrequency ablation has the advantages of low recurrence rate and incidence of postoperative complication rate for internal fistula closure in children with pyriform fossa fistula. It is a safe and effective treatment for children without surgical contraindications.

A clinical study of C arm-guided selective spinal nerve block combined with low-temperature plasma radiofrequency ablation of dorsal root ganglion in the treatment of zoster-related neuralgia.

This study evaluated the analgesic efficacy and psychological response of low-temperature plasma ablation of dorsal root ganglion (DRG) combined with selective spinal nerve block in patients with acute or subacute zoster-related neuralgia (ZRN). Totally 90 ZRN patients were randomly and evenly divided into three groups. Treatment was given to Group A using C arm-guided selective spinal nerve block (C-SSVB), Group B using C-SSVB and pulsed radiofrequency (PRF), and Group C using C-SSVB and low-temperature plasma ablation of the DRG. The outcomes were examined using the Visual Analog Scale (VAS). Anxiety and depression of patients were evaluated using the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Quality of life was assessed using the Pittsburgh Sleep Quality Index (PSQI) and postoperative Satisfaction scale. In addition, data on adverse events and medication usage rates were collected. The 90 patients were eligible for this study. The three treatments reduced VAS scores with no significant difference between groups A and B at the same time points; however, group B tended to have numerically lower VAS scores. Comparatively, group C had significantly reduced VAS scores on day 1 and 1 month after treatment compared with the other two groups. In terms of the decreasing SAS, SDS and PSQI scores, all the three treatments improved the anxiety, depression and sleep quality of the patients. In addition, significant alleviation in anxiety was found in group C compared with group A at all- time points. However, there was no statistically significant difference among the three groups in treatment-related adverse events that mainly focused on puncture pain at the surgical-site, skin numbness and medication usage rates. C-SSVB and LTPRA of DRG will be considered as a promising treatment option for ZRN patients if those results can be confirmed after further validation.

Therapeutic effects of low-temperature plasma radiofrequency ablation and partial laryngectomy for glottis cancer: A comparative study.

To compare the therapeutic effects of low-temperature plasma radiofrequency ablation and partial laryngectomy in the treatment of early glottis carcinoma. Clinical data of 80 patients with early glottis carcinoma treated in our hospital from June 2019 to January 2021 were analyzed. Patients were retrospectively divided into two groups based on the type of intervention. Forty patients received partial laryngectomy (Control group) and 40 patients received low-temperature plasma radiofrequency ablation (Observation group). Surgical indexes, length of hospital stay, postoperative complications, and visual analog scale (VAS) score of postoperative pain of patients in the two groups were compared. Postoperative stress response indexes, clinical efficacy, and postoperative recovery in two groups were compared and analyzed. The operation time, hospital stay, intraoperative bleeding, and the incidence of postoperative complications in the observation group were significantly lower than those in the Control group (P<0.05). The postoperative pain VAS scores, Levels of malondialdehyde (MDA) and glutathione (GSH) in the observation group were significantly lower than those in the control group (P<0.05), while the level of nitro tyrosine (3-NT) and superoxide dismutase (SOD) were significantly higher than that in the control group (P<0.05). After a one-year follow-up, the excellent and good rate of pronunciation function in the observation group (95%) was significantly higher than control group (75%) (P<0.05). Low-temperature plasma radiofrequency ablation in the treatment of early glottis carcinoma is associated with less trauma, short operation time, less bleeding, short hospital stay and low postoperative stress reaction rate. Compared with partial laryngectomy, it has higher safety and better postoperative vocal cord function recovery.

Clinical Diagnosis and Treatment of Primary Laryngeal Neuroendocrine Carcinoma.

This study aims to investigate the clinical diagnosis and treatment characteristics of primary laryngeal neuroendocrine carcinoma. A retrospective analysis was performed for the data of 6 patients with primary laryngeal neuroendocrine carcinoma admitted to the Department of Otorhinolaryngology of Dalian Central Hospital from September 2015 to January 2022, all of whom were male patients. And laryngoscopy showed that 4 had a similar appearance to hemangioma, 1 had nodular hyperplasia, and 1 was papilloma-like. The site of onset was located on the laryngeal surface of the epiglottis in 3 cases, situated in the aryepiglottic fold in 2 cases, and the posterior ventricular zone in 1 case. Five patients underwent surgery, including 4 by transoral endoscopic cryogenic plasma radiofrequency mass resection; one underwent a cervical lymph node dissection and supraglottic horizontal hemilaryngectomy. The remaining 1 case was treated in another hospital after the pathological diagnosis was confirmed by biopsy. All patients had no cervical lymph node metastases and were not supplemented with chemoradiotherapy. The postoperative pathological diagnosis of all 5 patients was neuroendocrine carcinoma. No cancer cells were seen at the margins and base. One patient was lost to follow-up after treatment in another hospitals and the rest were followed up for 6months to 6years. One patient had removed laryngeal tumor and epiglottis by a low-temperature plasma radiofrequency ablation, recurrence 1year after surgery, and no recurrence for 5years after supraglottic horizontal hemilaryngectomy combined with prophylactic cervical lymph node dissection, no recurrence for the other 4patients after 6months to 4years of follow-up. The common sites of laryngeal neuroendocrine carcinoma are the laryngeal surface of the epiglottis and the aryepiglottic fold. The appearance of the tumor is mainly similar to that of hemangioma. Moreover, a common pathological classification is atypical carcinoid tumors, where early detection and surgical treatment can achieve a good therapeutic effect.

Low-temperature plasma radiofrequency ablation tuboplasty and myringotomy: A preliminary report

ObjectiveTo evaluate the efficacy of Low-temperature plasma radiofrequency ablation (RF) tuboplasty and myringotomy for treating chronic otitis media with effusion (COME) with chronic obstructive eustachian tube dysfunction (COETD) involving hypertrophic tissue of the ET orifice. Methods and materialsThis was a prospective study of 43 ears with COME and COETD who underwent RF tuboplasty. Outcomes included the ability to perform a Valsalva maneuver, tympanometry results, and TM status. Success was defined by an improvement in tympanogram type and Valsalva maneuver. Follow-up ranged from 4 weeks to 12 months. ResultsA total of 43 ears (43 patients) were included in the study. Mucosal hypertrophy of the ET orifice was seen in 35 (81.4 %) patients, while polypoid tissue was observed in 8 (18.6 %) patients. All patients completed the 12-month follow-up, the success rate was 95.3 % (41/43) at postoperative 3 months, 39/43 (90.4 %) at postoperative 6 months, and 37/43 (86.0 %) at postoperative 12 months. No procedure-related serious adverse events were reported for any patient, and there were no cases of patulous ET. Stenosis/scar of anterior-post wall in the ET orifice occurred in two patients at 6 months postoperatively and in one patient at 12 months postoperatively, which the Valsalva maneuver was positive. Thus, no further treatment was applied for the ET orifice in 3 patients. The risk of stenosis of the ET orifice was 3/47 (6.4 %). ConclusionsRF eustachian tuboplasty may be an effective treatment for patients with COME, COETD and hypertrophic mucosa in the ET orifice, particularly as an adjunct to balloon tuboplasty.

Effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma

ObjectiveTo explore the effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma. Methods70 patients with early glottic laryngeal carcinoma were enrolled in this retrospective study. The patients (40 cases) in the control group were treated by CO2 laser. The patients in the combination group (30 cases) were treated by CO2 laser combined with low-temperature plasma radiofrequency ablation. ResultsThe postoperative recurrence rate in the combination group was notably decreased than the control group (P < 0.05). There were 2 patients with postoperative bleeding, 3 with vocal cord adhesion, and one with dyspnea in the combination group. Similarly, there were 3 patients with postoperative bleeding, 5 with vocal cord adhesion, and 1 with dyspnea in the control group. ConclusionCO2 laser combined with low-temperature plasma radiofrequency ablation has a low postoperative recurrence rate in the treatment of the early glottic laryngeal carcinoma.

Dynamic Incision under Nasal Endoscope and Low-Temperature Plasma Radiofrequency Ablation for Nasal Inverted Papilloma: An Analysis of Differences in Efficacy and the Destructive Effect on Immune Function.

Methods NIP patients (n = 106) admitted between January 2020 and March 2021 were selected and grouped as follows according to the random number table method: a dissection group treated with dynamical-system surgery under nasal endoscope and an ablation group treated with LTPRA. The clinical curative effects of the two procedures were compared, and the related indexes (operation time (OT), intraoperative blood loss (IBL), and length of stay (LOS)) and postoperative adverse reactions (ARs) were counted. In addition, fasting venous blood samples were collected before treatment (T0), as well as 3 (T1) and 7 days after treatment (T2) to detect inflammatory factors (IFs; C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)) and T lymphocyte subsets (CD3+, CD4+, and CD8+). Finally, all patients received a one-year follow-up to compare the differences in prognostic survival rate and disease recurrence rate between groups. Results The ablation group has a similar LOS to the dissection group (P > 0.05), but lower OT and IBL. No marked difference was observed between groups in terms of the total effective rate (P > 0.05), but the adverse reaction rate was higher in the dissection group compared with the ablation group (P < 0.05). Compared with T0, elevated CRP, IL-6, TNF-α, and CD3+ were observed in both cohorts at T1, with lower levels in the ablation group as compared to the dissection group, while CD4+ and CD8+ decreased in both cohorts and were higher in the ablation group (P < 0.05). Meanwhile, the levels of CRP, IL-6, TNF-α, and CD3+ in both groups were lower at T2 compared to T1, whereas those of CD4+ and CD8+ in both groups were higher at T2 compared to T1 (P < 0.05). As indicated by the statistics on prognostic follow-up, the two cohorts of patients showed no evident difference in the 1-year survival rate and disease recurrence rate (P > 0.05). Conclusions Both dynamical-system surgery under nasal endoscope and LTPRA have good therapeutic effects on NIP, but the latter is safer and can effectively reduce the postoperative inflammatory reaction of patients and maintain the stability of immune function, which has higher clinical application value.

Meta-Analysis of Low Temperature Plasma Radiofrequency Ablation and CO2 Laser Surgery on Early Glottic Laryngeal Carcinoma.

Objective Meta-analysis is used to analyze the treatment of early glottic laryngeal carcinoma by cryogenic plasma radiofrequency ablation combined with CO2 laser surgery. Methods Retrieval of PubMed, Embase, Medline, VIP, Wanfang, and CNKI databases using a computer. The retrieval period is from the creation of the database until August 31, 2021. References to the included literature were also searched at the same time. According to the inclusion and exclusion criteria, literatures are screened independently, relevant data were extracted, and meta-analysis was conducted. Results Recurrence rates are reported in seven literatures. In interstudy heterogeneity test: P = 0.624, I2 = 0%, fixed effect model analysis shows that there is no significant difference in recurrence rate between low temperature plasma radiofrequency ablation and CO2 laser ablation (OR = 0.80, 95% CI (0.35, 1.29), P = 0.371). Intraoperative blood loss is reported in 5 literatures, and heterogeneity test of each study is as follows: P = 0.03, I2 = 67%. Low temperature plasma radiofrequency ablation results in more intraoperative blood loss than CO2 laser ablation (SMD = −0.71, 95% CI (0.08, 0.82), P = 0.01). There are five reports on postoperative pain in two treatments: P = 0.04, I2 = 64%. There is no significant difference in postoperative pain between low temperature plasma radiofrequency ablation and CO2 laser ablation (SMD = −0.21, 95% CI (-0.44, 0.10), P = 0.134). Operative time is reported in nine articles: P < 0.01, I2 = 95%. The operative time of low temperature plasma radiofrequency ablation is significantly shorter than CO2 laser ablation (SMD = −2.38, 95% CI (-3.91, -1.62), P < 0.01). There are two reports on postoperative mucosal recovery: P = 0.328, I2 = 2%. Low temperature plasma radiofrequency ablation was significantly better than CO2 laser ablation in postoperative mucosal recovery (OR = 5.49, 95% CI (2.36, 10.18), P < 0.01). Conclusion Low temperature plasma radiofrequency ablation is superior to CO2 laser surgery in the treatment of early glottic laryngeal carcinoma in terms of operative time and postoperative mucosal recovery. Low-temperature plasma radiofrequency ablation, on the other hand, results in higher intraoperative blood loss, with no discernible difference in recurrence rate or postoperative pain severity between the two treatments.

Preliminary dynamic observation of wound healing after low-temperature plasma radiofrequency ablation for laryngeal leukoplakia

Background Low-temperature plasma ablation (LTPA) is an emerging technique for laryngeal leukoplakia (LL). Objective To initially observe the healing process of trauma after LTPA for LL. Materials and methods Seventeen patients who underwent LTPA for LL were collected, and the degrees of wound healing were analyzed. Results Only 1 patient in who dysbiosis of the pharyngeal flora was induced by self-administered hormone nebulization treatment during the follow-up period. In the remaining patients, the wound healing was characterized by a crater-shaped defect on the vocal folds surface with pseudo-membranes, congestion, and mild edema on postoperative day 1. These symptoms became worse on postoperative day 7. On postoperative day 15, the pseudo-membrane was fully formed and some patients had granulomatous swelling of the vocal cords. These symptoms became better and better on postoperative day 30 and day 45. On postoperative day 60, the mucosa of the vocal folds had essentially returned to normal. On postoperative day 90, the vocal folds morphology and function had recovered well. Conclusion It takes 2–3 months for the wound to heal completely after LTPA for LL. Significance A proper understanding of the wound healing process can reduce unnecessary surgical and pharmacologic interventions and avoid excessive treatment.

Clinical and Radiological Comparisons of Percutaneous Low-Power Laser Discectomy and Low-Temperature Plasma Radiofrequency Ablation for Cervical Radiculopathy: A Prospective, Multicenter, Cohort Study

BackgroundMinimally invasive techniques, such as percutaneous low-power laser discectomy (PLLD) and low-temperature plasma radiofrequency ablation (coblation) can be applied to treat degenerative cervical radiculopathy. However, less evidence supports the superiority of distinct minimally-invasive therapy. Our study aimed to evaluate the clinical and radiological characteristics of the PLLD and coblation for cervical radiculopathy.MethodsThis was a prospective, multicenter, cohort study (ChiCTR-ONC-17010356). The modified Macnab criteria was performed to assess the clinical improvement pre- and post-surgery. To evaluate the radiological effect, the Pfirrmann grading system and disk herniation index were applied with MRI.ResultsIn this study, 28 patients were enrolled in the coblation group and 30 patients in the PLLD group. The mean good-excellent rate at 3-month follow-up was 82.1% for PLLD group, and 66.7% for coblation group, respectively (p = 0.179). The PLLD group achieved higher good-excellent rate 6 and 12 months after discharge (92.9 vs. 70.0%, p = 0.026). Radiological data revealed that PLLD but not coblation treatment achieved significant reduction of disk herniation index (p < 0.0001). Coblation treatment did not change the Pfirrmann grades of cervical radiculopathy patients (n = 18), and 7 out of 17 (41.2%) patients achieved improvement after PLLD therapy. None obvious adverse event was observed in this study.ConclusionBoth PLLD and coblation are effective and safe option for patients with cervical radiculopathy. Better long-term clinical outcomes may be potentially associated with the improvement of disk degeneration after PLLD treatment.

Clinical Application of Low-Temperature Plasma Radiofrequency in the Treatment of Hemangioma in Nasal Cavity, Pharynx and Larynx.

Hemangioma is a common benign tumor in the head and neck. The therapeutic effect by conventional treatment was not very satisfactory. The purpose of this study is to explore the surgical strategy of low-temperature plasma radiofrequency in the treatment of hemangioma located in the nasal cavity, pharynx, and larynx. The clinical data of 29 cases with hemangioma in nasal cavity, pharynx, and larynx treated by low-temperature plasma radiofrequency ablation were retrospectively analyzed. The strategy of ablation before resection was performed for 16 cases of nasal capillary hemangioma. The other 13 cases of cavernous hemangioma in the pharynx and larynx were treated by the strategy of direct ablation. All 29 patients underwent a successful operation with minimal intraoperative bleeding and no postoperative bleeding complications. There was no nasal septum perforation, dyspnea, dysphagia, dysphonia, or other complications. The patients were followed up for more than 3 years without recurrence. Low-temperature plasma radiofrequency is a practical, minimally invasive, and accurate method for treating hemangiomas in the nasal cavity, pharynx, and larynx. For capillary hemangiomas, the strategy of ablation before resection may be an effective way to reduce bleeding, and for cavernous hemangiomas, the strategy of direct ablation is a simple and efficient method.

Analysis of related factors of postoperative complications of Juvenile-onset recurrent respiratory papillomatosis

Objective:To analyze the causes and related factors of postoperative complications of Juvenile-onset recurrent respiratory papillomatosis（JORRP）. Methods:One hundred and seventy cases of JORRP who underwent surgical treatment in Beijing Tongren Hospital of Capital Medical University from 2017 to 2019 were followed up, and the types of complications, age of first operation, number and frequency of operations, and underwent tracheotomy or not were reviewed. According to the presence or absence of postoperative complications, the patients were divided into a complication group and a control group, and the differences between the two groups and related factors causing postoperative complications were compared. Results:In the 170 cases, 75（44.12%） had postoperative complications, including 52（69.33%） cases of vocal cord adhesion, 37（49.33%） cases of lower airway diffusion, and 25（33.33%） cases of laryngeal stenosis in the complication group. The age of first operation was among 0.3-14 years old, and the total number of surgeries was 14.52（1-54） for each patient during the observation period, with an average annual number of 2.93（0.04-18.39）. Compared with the control group, the complication group had 19.07±13.12 total surgeries, the control group had 10.97±9.41 surgeries（P<0.01）, annual surgeries ≥4 times（P=0.034）, postoperative complications after tracheotomy（P=0.007）, and underwent low temperature plasma radiofrequency ablation and photodynamic therapy were more likely to occur than those treated with CO2laser only（P<0.01）. Conclusion:The postoperative complications of JORRP include vocal cord adhesion, laryngotracheal stenosis, lower airway dissemination, etc. Multiple and frequent operations, tracheotomy, and different surgical methods are closely related to postoperative complications. The risk of postoperative complications may be increased when children are younger in age of initial operation and with more frequency of surgeries.