The objective of the present study was to determine the effect of voice training on the vocal rehabilitation of patients with vocal cords polyps following phonomicrosurgery. A total of 60 cases of vocal cord polyps treated by laser phonomicrosurgery were randomly divided into training and control groups with 30 cases in each group. The patients were treated with laser phonomicrosurgery, routine postoperative treatment and nursing. The training group were additionally treated with vocal training, including relaxation training, breathing training, basic pronunciation training, chewing voice training and tone sandhi pronunciation training, and attention was paid to the training steps. Subjective and objective voice evaluations of the two groups were compared three months after the surgery and the differences between groups were statistically significant (P<0.05). Voice training may significantly improve the postoperative voice quality of patients with vocal cord polyps and support rehabilitation.

Objectives: The aim of this study was to describe common iatrogenic causes of anterior glottic stenosis and to investigate the surgical treatment outcomes of 3 different techniques aimed at repairing stenoses and preventing web reformation. Methods: Clinical information regarding patient demographics, presentation, etiology, treatment, and follow-up outcomes was obtained retrospectively through a review of patients’ records between April 2010 and April 2017. Voice quality was evaluated using grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores. Objective acoustic parameters were collected using the Kay Elemetrics Multi-Speech program. Results: Twenty patients were included in the study. Causes of glottic web formation included chemoradiation therapy and previous laryngeal surgery for polyps or malignant tumors at the anterior commissure. Web lysis with a CO ₂ laser, intralaryngeal suturing, and keel placement were used in surgical treatment. Satisfactory results were achieved in 19 patients, and 1 recurrence was observed. Grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores and objective voice variables for patients with Cohen type I or II webs improved significantly after the surgery. Conclusions: Treatment modalities for anterior glottic stenosis should be carefully chosen according to the etiology of the web, as well as the length and depth of the glottis involved.

Background and Aims: Duodenal perforation caused by foreign bodies (FBs) is very rare but is an urgent emergency that traditionally requires surgical intervention. Several case reports have reported the successful endoscopic removal of duodenal perforating FBs. Here we aimed to evaluate the safety and efficacy of endoscopic management of duodenal perforating FBs in adults.Methods: Between October 2004 and October 2022, 12,851 patients with endoscopically diagnosed gastrointestinal FBs from four tertiary hospitals in China were retrospectively reviewed. Patients were enrolled if they were endoscopically and/or radiographically diagnosed with duodenal perforating FBs.Results: The incidence of duodenal total FBs and perforating FBs was 1.9% and 0.3%, respectively. Thirty‐four patients were enrolled. Endoscopic removal was achieved in 25 patients (73.5%), and nine patients (26.5%) received surgery. For the endoscopic group, most perforating FBs were located in the duodenal bulb (36.0%) and descending part (28.0%). The adverse events included 3 mucosal injuries and 1 localized peritonitis. All patients were cured after conventional treatment. In the surgical group, most FBs were lodged in the descending part (55.6%). One patient developed localized peritonitis and one patient died of multiple organ failure. The significant features of FBs requiring surgery included FB over 10 cm, both sides perforation, multiple perforating FBs and massive pus overflow.Conclusion: Endoscopic removal of duodenal perforating FBs is safe and effective, and can be the first choice of treatment for experienced endoscopists. Surgical intervention may be required for patients with FBs over 10 cm, both sides perforation, multiple perforating FBs, or severe infections.

Objectives. The simulation of microlaryngeal skills is rarely seen in surgical training, but it is particularly important in phonomicrosurgery. This study described and validated the laryngeal surgical simulator through surgical training.Methods. A simple and low-cost simulator was developed for the fixation of the suspension laryngoscope and porcine larynges. Twenty participants with work skills and experience did preparation before training, and performed suture and carbon dioxide (CO2) laser cordectomy for simulator evaluation. The results were proposed by the aspects of time taken for each procedure, the global rating scale, a procedure-specific assessment, and a post-simulation questionnaire.Results. All participants completed the preparation within 9 minutes and reached the conclusion that the microlaryngeal surgical simulator was helpful in improving their surgical skills. The performance of experts was superior to that of novices in both suture and CO2 laser cordectomy.Conclusion. This simulator could be easily assembled and was successfully validated by microlaryngeal surgical training both subjectively and objectively. It may be helpful to clinicians in microlaryngeal skills.

Background: Neutrophilic chronic rhinosinusitis with nasal polyps (CRSwNP) occur predominantly in Asian subjects. Appropriate treatments for this endotype have not been elucidated. This study aimed to evaluate the efficacy of budesonide nasal spray on neutrophilic CRSwNP. Materials and Methods: Fifteen neutrophilic CRSwNP patients were included, and then they received budesonide nasal spray treatment for 3 months. Biopsies of nasal polyps (NPs) were obtained from these subjects. Their clinical indexes were scored using Visual Analog Scale (VAS), Sino-Nasal Outcome Test (SNOT)-22, and Endoscopic Appearances (EAs). Histological analyses were used to assess numbers of neutrophils, goblet cells, and submucosal gland cells in NPs. Percentages of CD8⁺ T cells and CD4⁺CD25⁺Foxp3⁺ regulatory T cells (Tregs) were evaluated using flow cytometry. Mucin 5AC (MUC5AC), MUC5B, myeloperoxidase (MPO), interferon (IFN)-γ, and interleukin (IL)-1β and their mRNAs were also examined. After that, we cultured NP tissues in vitro and evaluated the abovementioned inflammatory parameters before and after the administration of budesonide. Results: Budesonide nasal spray did not improve clinical evaluations including VAS, SNOT-22, and EA scores. Numbers of neutrophils and goblet cells, the score of submucosal gland cells, percentages of CD8⁺ T cells and Tregs, MUC5AC, MUC5B, MPO, IFN-γ, and IL-1β and their mRNAs were not decreased in NPs after the budesonide treatment. Furthermore, the administration of budesonide into NP cultures also did not reduce their levels in comparison with those before the treatment. Conclusion: These findings demonstrate that budesonide treatment may not alleviate the inflammatory condition in neutrophilic CRSwNP.