Clinical and functional characteristics of lung surgery-related vocal fold palsy

Interest of the Leicester Cough Questionnaire in predicting postoperatives complications after lung resection: LCQ-SURGE

Background

Postoperative complications may occur after major lung surgery for non-small cell lung cancer (NSCLC), with a high rate of morbidity and mortality. The main objective of this study was to assess the relevance of preoperative Leicester Cough Questionnaire (LCQ) to predict postoperative complications after major lung resection for any indication.

Methods

This was a retrospective cohort study conducted in the Thoracic Surgery Department of Rouen University Hospital from November 21st, 2022, to June 2nd, 2023. Patients aged ≥18 years who underwent major lung resection for any indications and filled an LCQ self-questionnaire were included.

Results

Seventy-one patients were eligible for our study. One patient was lost to follow-up upon hospital discharge. Nineteen (27.1%) postoperative complications of grade ≥2 according to the Clavien-Dindo classification were observed. The mean LCQ total score was 18.11±2.56. The area under the receiver operating characteristic (ROC) curve for the LCQ result to predict postoperative complications of grade ≥2 within 30 days following the surgical intervention was 0.60 [95% confidence interval (CI): 0.45, 0.75].

Conclusions

This study failed to demonstrate the relevance of a preoperative LCQ to predict postoperative complications after major lung surgery. However, the statistical precision of this study was insufficient to show a moderate predictive performance. Further studies conducted in larger populations are needed.

A self-fused hydrogel for the treatment of glottic insufficiency through outstanding durability, extracellular matrix-inducing bioactivity and function preservation

Injection laryngoplasty with biomaterials is an effective technique to treat glottic insufficiency. However, the inadequate durability, deficient pro-secretion of extracellular matrix (ECM) and poor functional preservation of current biomaterials have yielded an unsatisfactory therapeutic effect. Herein, a self-fusing bioactive hydrogel comprising modified carboxymethyl chitosan and sodium alginate is developed through a dual-crosslinking mechanism (photo-triggered and dynamic covalent bonds). Owing to its characteristic networks, the synergistic effect of the hydrogel for vocal folds (VFs) vibration and phonation is adequately demonstrated. Notably, owing to its inherent bioactivity of polysaccharides, the hydrogel could significantly enhance the secretion of major components (type I/III collagen and elastin) in the lamina propria of the VFs both in vivo and in vitro. In a rabbit model for glottic insufficiency, the optimized hydrogel (C₁A₁) has demonstrated a durability far superior to that of the commercially made hyaluronic acid (HA) Gel. More importantly, owing to the ECM-inducing bioactivity, the physiological functions of the VFs treated with the C₁A₁ hydrogel also outperformed that of the HA Gel, and were similar to those of the normal VFs. Taken together, through a simple-yet-effective strategy, the novel hydrogel has demonstrated outstanding durability, ECM-inducing bioactivity and physiological function preservation, therefore has an appealing clinical value for treating glottic insufficiency.

One day at a time

In this issue of Biomedical Journal we get to know measures to prevent a nosocomial COVID-19 outbreak, a compound that is able to stall SARS-CoV-2 replication, and the connection between air pollution and COVID-19 cases. Another article allows an insight into the potential of treating HIV combining a conventional drug and low level laser therapy. Furthermore, the advantages of awake craniotomy are presented, the efficacy of IRES is examined, and plant extracts are on the one hand explored as a nociceptive agent and on the other hand as therapeutic approach against breast cancer. We learn about drug resistance in liver cancer, a mutation involved in a rare inflammatory disorder, and lung surgery related unilateral vocal fold paralysis. Finally, the success of emergency endotracheal intubations across different hospital units is compared, the importance of monitoring cerebral blood flow in asphyxiated neonates is elucidated, and resistance variants in hepatitis C virus are examined. A study about the necessity to perform quantitative cardiac MRI in Asian population is presented, and an approach is shown on how to augment the effect of platelet-rich plasma injections in chronic knee osteoarthritis.