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The evaluation model of lymph node metastasis in rⅥb region was established based on the above three correlative features of color doppler ultrasound. The ROC curve analysis showed that the model had high application value . ConclusionThe tumor size, multiple foci and capsule invasion are risk factors for lymph node metastasis in rⅥb region of thyroid micropapillary carcinoma.ObjectiveTo analyze the clinical features and discuss the treatment of ossifying fibroma in the nasal cavity and sinuses. MethodThe patients were performed surgical treatment after admission. 6 cases were treated by endoscopic transnasal approach with image guidance system to resect the mass, 8 cases were operated by simple endoscopic approach, tumor resection was performed via endoscopic surgery with external approach in 2 cases, and endoscopic surgery combined with modified Caldwell-Luc procedure in 1 case. 1 patient was operated through labiolingual groove approach. ResultThe intraoperative blood loss of ossified fibroma patients was large, with an average blood loss of 550ml. DMH1 All the patients were followed up for 6 months to 8 years, 15 patients with complete resection had no recurrence after surgery, and 3 patients with partial resection survived with tumor. ConclusionOssifying fibroma in the nasal cavity and sinuses can be completely resected by nasal endoscopic surgery with less trauma and good effect. Transnasal endoscopic surgery assisted by image navigation system can protect important structures in lesions involving orbital cardboard and anterior skull base. Nasal endoscopic surgery combined with small eyebrow incision approach is feasible for ossifying fibroma invading frontal sinus. Ossifying fibroma, which requires adequate preoperative evaluation and blood preparation is prone to bleeding, and lesions with rich blood supply need preoperative interventional therapy.ObjectiveTo analyze the distribution of comorbid psychiatric disorders in patients with chronic otitis media associated tinnitus. MethodThe data of patients with chronic otitis media associated tinnitus who accepted surgical treatments from July 2017 to September 2018 were retrospectively analyzed. All patients accepted pure tone audiometry and acoustic conductance examination and were requested to fill the tinnitus history questionnaire, THI, TEQ, SAS, SDS and PSQI scales before operation. When the SAS or/and SDS score ≥50 the patient was judged as having comorbid psychiatric disorders. When the PSQI score>6 the patient was judged as having comorbid sleep disorder, and then all the results were analyzed. ResultSixty-two patients were included in the study, 43 cases were diagnosed as chronic suppurative otitis media, and 19 cases were diagnosed as middle ear cholesteatoma. The average course of chronic otitis media or middle ear cholesteatoma was（14.38±14.06） years, while the average course of tinnitus was（8.owed up for 0.5 to 1.8 years after operation, and in 43 cases the tinnitus was reduced or disappeared after operation（the effective rate was 81.13%）. There were no significant difference between patients in tinnitus relief group and those in tinnitus without relief group in age, sex, course of the disease, type of the disease, with or without comorbid psychiatric disorders and/or sleep disorder, postoperative hearing improvement. ConclusionComorbid psychiatric disorders are common in patients with chronic otitis media associated tinnitus and the tinnitus in patients with comorbid psychiatric disorders is significantly more serious than that those without. For the treatment of chronic otitis media associated tinnitus, besides surgery, the complications such as psychiatric and sleep disorders and so on should be evaluated and treated accordingly.ObjectiveTo compare the consistency of RSI and RFS, pepsin detection and 24 h Dx-pH monitoring in the diagnosis of laryngopharyngeal reflux （LPR） in children. MethodA retrospective analysis was made of 76 children with suspicious LPR. A total of 65 children with suspicious LPR were finally diagnosed. RSI and RFS scales, pepsin detection and Dx-pH monitoring were performed simultaneously. The diagnostic consistency of the three methods was tested, and the sensitivity and specificity were calculated. ResultThe sensitivity of pepsin detection, 24 h Dx-pH monitoring, RSI and RFS in the diagnosis of LPR in 76 suspected LPR patients were 95.31%, 66.15% and 84.62%, and the specificity were 100%, 81.82% and 72.73%. The pepsin detection was well consistent with the scale（Kappa>0.75）, pepsin detection and 24 h Dx-pH monitoring were in medium consistency（Kappa=0.467）, and 24 h Dx-pH monitoring and scale were in medium consistency（Kappa=0.446）. link2 ConclusionPepsin detection can be used as a reliable index for the diagnosis of LPR in children. It is objective, economical, non-invasive, comfortable and easy to spread.ObjectiveTo investigate the influence of conventional STI and endoscopic STI on clinical effects and safety of patients with chronic dacryocystitis. MethodOne hundred and ten patients with chronic dacryocystitis were chosen in the period in our hospital and randomly divided into two groups including conventional group（55 patients） with conventional STI and endoscopy group（55 patients） with endoscopic STI. The improvement rate of epiphora symptoms, ocular surface symptoms score before and after treatment, operation time, intraoperative VAS score and postoperative complication rate of both groups were compared. ResultThere was no significant difference in the improvement rate of epiphora symptoms between two groups（P>0.05）. The ocular surface symptoms score after treatment of endoscopy group were significantly less than conventional group（P0.05）. The operation time and intraoperative VAS score of endoscopy group were significantly less than conventional group（P less then 0.05）. The postoperative complication rate of endoscopy group were significantly lower than conventional group（P less then 0.05）. ConclusionConventional STI and endoscopic STI in the treatment of patients with chronic dacryocystitis possess the same clinical effects; but endoscopic STI application can efficiently reduce operation difficulty, relieve intraoperative pain and prevent postoperative complications.ObjectiveTo investigate the long-term efficacy of semicircular canal occlusion in the treatment of refractory Meniere’s disease. link3 MethodFifteen patients with Meniere’s disease who underwent semicircular canal occlusion were reviewed. The preoperative and postoperative frequency of vertigo ,quality of life, hearing and tinnitus level were compared. All patients were followed for more than 24 months. ResultPostoperatively, vertigo was controlled effectively in all 15 cases, and the control rate was 100%, of which 11 cases were completely controlled（Grade A） and 4 cases were basically controlled（Grade B）. The improvement rate of quality of life was 100%. The hearing worse in 4 cases（26.7%） and stabilized in 11 cases（73.3%）. The tinnitus was relieved in 7 cases（46.7%）, unchanged in 7 cases（46.7%） and aggravated in 1 case（6.7%）. ConclusionSemicircular canal occlusion can effectively control the vertigo symptoms of refractory Meniere’s disease and improve the quality of life. The long-term efficacy of semicircular canal occlusion is definite, but there is a risk of hearing loss.ObjectiveTo evaluate the therapeutic outcome and complication of grommet insertion for cancer patients in head and neck suffering from otitis media with effusion following radiotherapy. MethodRetrospectively analyze the clinical data of grommet insertion in patients with head and neck cancer suffering from otitis media with effusion following radiotherapy. ResultFifty-five ears in 33 cases of cancer patients in head and neck with otitis media with effusion following radiotherapy had been performed grommet insertion. All patients were revisited seven days after operation, the phonetic frequency hearing in 55 ears had been improved in various degrees, and on average, it was increased 20.79 dB compared to that prior to the procedure. Sensation of the ear fullness had been disappeared in all the ears; the symptoms of tinnitus and headache were relieved in 80% of the patients. However, postoperative complications occurred in 67.3%（37/55） of the ears, including ventilation tube falling out in 11（20%） ears, all of which had been re-catheterized; otorrhea in 10（18.2%） ears, which were healed after antibiotic treatment; Ventilation tube occlusion in 9（16.4%） ears, and they were recanalized after 5% sodium bicarbonate ear drops treatment; tympanic membrane retraction in 4（7.3%） ears, which were restored after eustachian tube blowing; eardrum perforation in 2（3.6%） ears without further treatment; the ventilation tube sliding into the tympanic cavity in 1（1.8%） ear, which was removed by surgery. The grommet was inserted more than twice in 31（56.4%） ears because of complications or recurrence of symptoms after grommet was removed. ConclusionThe grommet insertion is used for the treatment of radiotherapy-induced otitis media with effusion, which can improve the hearing and relieve the discomfort symptoms in ear in such patients. However, the incidence of postoperative complications is high and should be actively prevented to improve the therapeutic effect.ObjectiveTo compare the effect of closure of pharyngeal cavity with linear stapler and manual suture in total laryngectomy. MethodA retrospective study was conducted on 32 patients who underwent total laryngectomy with linear stapler to close the pharyngeal from December 2014 to March 2019. Among them, 25 patients used closed technique and 7 patients used open technique. At the same time, 23 patients who underwent total laryngectomy with manual suture the pharyngeal by the same operator from January 2010 to December 2014 were collected. The clinical parameters of the two groups were compared and analyzed. ResultCompared with the control group, the closed technical group had no significant difference in terms of gender, diabetes mellitus, second surgery, T stage, and surgical method（P> 0.05）. While the age （63.60 ± 9.46） years and （54.35 ± 11.13） years , operation time （239.67 ± 88.43） min and （474.35 ± 140.16） min , oral feeding time （12.84 ± 3.65） min and （17.3 ± 9.71）min , hospitalization days after operation （ 15.48 ± 3.78） d and （20.22 ± 10.14） d, incidence of Pharygocutaneous fistula 4.0% （1/25） and 26.1% （6/23）, had significant statistical differences （P 0.05），while there was a statistically significant difference in diabetes mellitus, second surgery, and operation time （P less then 0.05）. ConclusionThe linear stapler closed closure technique can reduce the incidence of Pharygocutaneous fistula, shorten the operation time and oral feeding time, and reduce the length of hospital stay.ObjectiveThe aim of this study is to investigate the effect of modified uvulopalatopharyngoplasty （UPPP） combined with endoscopic hypothermic Plasma glossectomy （Eco-TBR） on the severe Obstructive sleep apnea syndrome. MethodSixty patients with severe OSAHS were diagnosed by polysomnography, and their obstructive plane located in the oropharynx and tongue base. Patients were divided into the control group （30 cases of simple H-UPPP） and the experimental group （30 cases of H-UPPP combined with Eco-TBR） according to their random hospital sequence. SPSS 20.0 software package was used to analyze the preoperative and postoperative data of the two groups. ResultFifty-seven OSAHS patients had full data and a minimum 6 month follow up to assess the efficacy. The total effective rate in the control group was 41.38% lower than that in the experimental group 67.85%, and the difference was statistically significant （χ²=4.03, P0.05）. ConclusionThe effect of H-UPPP combined with Eco-TBR on severe OSAHS patients with obstructive plane of oropharynx and tongue root is definite.