Papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) are generally characterized as less invasive forms of thyroid cancer with favorable prognosis. However, once lateral cervical lymph node metastasis takes place, the prognosis may be significantly impacted. The purpose of this study was to evaluate whether there is a difference in the pattern of lateral lymph node metastasis between PTC and PTMC. A retrospective analysis was performed for PTC and PTMC patients that underwent central area dissection and unilateral lateral neck lymph node dissection (II–V area) between January 2020 and December 2021. Compared with PTMC group, the PTC group exhibited higher incidence of capsule invasion, extrathyroid invasion and lymphatic vessel invasion. Both the number and rate of central lymph nodes metastasis were elevated in the PTC group. While the number of lateral cervical lymph node metastasis was higher, the metastasis rate did not demonstrate significant difference. No significant differences were identified in the lymph node metastasis patterns between the 2 groups. The determination of the extent of lateral neck lymph node dissection solely based on the tumor size may be unreliable, as PTC and PTMC showed no difference in the number and pattern of lateral neck metastasis. Additional clinical data are warranted to reinforce this conclusion. For patients categorized as unilateral, bilateral, or contralateral cervical lymph node metastasis (including level I, II, III, IV, or V) or retropharyngeal lymph node metastasis who require unilateral lateral neck dissection, the size of the primary tumor may not need to be a central consideration when assessing and deciding the extent of lateral neck dissection.

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) and Obesity Hypoventilation Syndrome (OHS) are core components of the obesity-related respiratory disease spectrum, and their comorbidity has become a major challenge in the global public health field. This review systematically summarizes the epidemiological characteristics, pathophysiological mechanisms, diagnostic criteria, diagnostic technologies and treatment strategies of OSAHS-OHS comorbidity, with a focus on the cutting-edge progress of digital therapeutics and metabolic intervention, as well as the historical evolution and current status of clinical management. We also conduct an in-depth analysis of the unresolved controversies and practical challenges in the current clinical management of this comorbidity. OSAHS-OHS comorbid patients have a significantly higher risk of cardiovascular complications than those with a single disease, and chronic intermittent hypoxia (CIH) forms a vicious cycle with obesity through multiple pathophysiological pathways. The combination of multi-dimensional assessment tools and portable monitoring devices has improved the screening efficiency of OSAHS-OHS comorbidity, and the selection of respiratory support therapies such as continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) depends on patient phenotypes. Digital therapeutics and novel metabolic intervention drugs have shown promising clinical value in the management of this comorbidity. The multidisciplinary collaboration model is the key to improving the prognosis of comorbid patients, while current clinical management is still faced with challenges such as policy lag, ethical controversies and uneven resource allocation. Future research should focus on individualized therapeutic targets, the integration of digital technologies and the optimization of health policies to achieve precise and efficient management of OSAHS-OHS comorbidity.