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Sample records for superior laryngeal nerve-intact

  1. [The superior laryngeal nerve and the superior laryngeal artery].

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    Lang, J; Nachbaur, S; Fischer, K; Vogel, E

    1987-01-01

    Length, diameter and anastomoses of the nervus vagus and its ganglion inferius were measured 44 halved heads. On the average, 8.65 fiber bundles of the vagus nerve leave the retro-olivary area. In the area of the jugular foramen is the near superior ganglion of the 10th cranial nerve. In this area were found 1.48 (mean value) anastomoses with the 9th cranial nerve. 11.34 mm below the margo terminalis sigmoidea branches off the ramus internus of the accessory nerve which has a length of 9.75 mm. Further anastomoses with the 10th cranial nerve were found. The inferior ganglion of the 10th nerve had a length of 25.47 mm and a diameter of 3.46 mm. Five mm below the ganglion the 10th nerve had a width of 2.9 and a thickness of 1.5 mm. The mean length of the superior sympathetic ganglion was 26.6 mm, its width 7.2 and its thickness 3.4 mm. In nearly all specimens anastomoses of the superior sympathetic ganglion with the ansa cervicalis profunda and the inferior ganglion of the 10th cranial nerve were found. The superior laryngeal nerve branches off about 36 mm below the margo terminalis sigmoidea. The width of this nerve was 1.9 mm, its thickness 0.8 mm on the right and 1.0 mm on the left side. The division in the internal and external rami was found about 21 mm below its origin. Between the n. vagus and thyreohyoid membrane the ramus internus had a length of 64 mm, the length of external ramus between the vagal nerve and the inferior pharyngeal constrictor muscle was 89 mm. Its mean length below the thyreopharyngeal part was 10.7 mm, 8.6 branchlets to the cricothyroid muscle were counted. The superior laryngeal artery had its origin in 80% of cases in the superior thyroideal artery, in 6.8% this vessel was a branch of the external carotid artery. Its average outer diameter was 1.23 mm on the right side and 1.39 mm on the left. The length of this vessel between its origin and the thyreohyoid membrane was 34 mm. In 7% on the right side and in 13% on the left, the superior

  2. Voice range in superior laryngeal nerve paresis and paralysis.

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    Eckley, C A; Sataloff, R T; Hawkshaw, M; Spiegel, J R; Mandel, S

    1998-09-01

    Evaluation of Physiologic Frequency Range (PFR) and Musical Frequency Range (MRP) of Phonation was performed on 56 adults (singers and nonsingers) presenting with superior laryngeal nerve (SLN) paresis or paralysis confirmed by laryngeal electromyography. The most common etiology was neuritis (69.7%), followed by iatrogenic and unknown causes,each accounting for 10.2% of cases, and finally trauma (8.9%). Both female and male singers with SLN paresis or paralysis had significantly higher PFR and MPR than nonsingers. Female classical singers presented PFR and MPR of up to 10 semitones (ST) higher than nonclassical singers and nonsingers. The lowest PFR and musical ranges were found in patients with SLN paresis associated with recurrent laryngeal nerve paresis or paralysis. The authors suggest that voice range measurement is a useful parameter for analyzing the effects of SLN paresis or paralysis on voice and that it may also assist in measuring outcome following voice therapy.

  3. Superior parathyroid gland approach to the recurrent laryngeal nerve.

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    Elsheikh, Ezzeddin

    2017-07-01

    The superior parathyroid gland is known to be almost constant in its location under the false thyroid capsule. Could it be a landmark to point to the site of incision of the false thyroid capsule and find the plane of the recurrent laryngeal nerve (RLN) during thyroidectomy? The study included 48 patients with benign goiter scheduled for hemithyroidectomy or total thyroidectomy; there were 16 cases of solitary thyroid nodules, 27 cases of multinodular goiter, and 5 cases of toxic goiter. This study included 80 lobectomies. All patients showed no evidence of postoperative RLN palsy, bleeding, or hypoparathyroidism. The superior parathyroid gland was consistently found within the false capsule in all cases, whereas the inferior parathyroid was found within the same layer in 64 sides (80%). The described approach can accurately guide dissection between true and false capsules of the thyroid to reach and preserve both the RLN and the superior parathyroid gland. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1287-1290, 2017. © 2017 Wiley Periodicals, Inc.

  4. The role of the superior laryngeal nerve in esophageal reflexes.

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    Lang, I M; Medda, B K; Jadcherla, S; Shaker, R

    2012-06-15

    The aim of this study was to determine the role of the superior laryngeal nerve (SLN) in the following esophageal reflexes: esophago-upper esophageal sphincter (UES) contractile reflex (EUCR), esophago-lower esophageal sphincter (LES) relaxation reflex (ELIR), secondary peristalsis, pharyngeal swallowing, and belch. Cats (N = 43) were decerebrated and instrumented to record EMG of the cricopharyngeus, thyrohyoideus, geniohyoideus, and cricothyroideus; esophageal pressure; and motility of LES. Reflexes were activated by stimulation of the esophagus via slow balloon or rapid air distension at 1 to 16 cm distal to the UES. Slow balloon distension consistently activated EUCR and ELIR from all areas of the esophagus, but the distal esophagus was more sensitive than the proximal esophagus. Transection of SLN or proximal recurrent laryngeal nerves (RLN) blocked EUCR and ELIR generated from the cervical esophagus. Distal RLN transection blocked EUCR from the distal cervical esophagus. Slow distension of all areas of the esophagus except the most proximal few centimeters activated secondary peristalsis, and SLN transection had no effect on secondary peristalsis. Slow distension of all areas of the esophagus inconsistently activated pharyngeal swallows, and SLN transection blocked generation of pharyngeal swallows from all levels of the esophagus. Slow distension of the esophagus inconsistently activated belching, but rapid air distension consistently activated belching from all areas of the esophagus. SLN transection did not block initiation of belch but blocked one aspect of belch, i.e., inhibition of cricopharyngeus EMG. Vagotomy blocked all aspects of belch generated from all areas of esophagus and blocked all responses of all reflexes not blocked by SLN or RLN transection. In conclusion, the SLN mediates all aspects of the pharyngeal swallow, no portion of the secondary peristalsis, and the EUCR and ELIR generated from the proximal esophagus. Considering that SLN is not

  5. Relationship of the recurrent laryngeal nerve to the superior parathyroid gland during thyroidectomy.

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    Persky, Michael; Fang, Y; Myssiorek, D

    2014-03-25

    Design: The relationship of the recurrent laryngeal nerve to the superior parathyroid gland during consecutive thyroidectomies was prospectively evaluated. When one structure was noted, careful dissection was performed to locate the other structure, to preserve their natural anatomical relationship. Patients: In total, 103 consecutive thyroid lobectomies were performed on 73 patients. The distance from the superior parathyroid gland to the recurrent laryngeal nerve was recorded. Results: In 88 cases (88.9 per cent), the superior parathyroid gland was identified within 5 mm of the recurrent laryngeal nerve. In 62 cases (62.6 per cent), the gland was within 1 mm of the recurrent laryngeal nerve. The height of the thyroid lobe was positively associated with the distance between the two structures (p = 0.001), as was the incidence of cancer (p = 0.033). The incidence of recurrent laryngeal nerve paresis was less than 4 per cent. Conclusion: In most cases, the recurrent laryngeal nerve was found in close proximity to the superior parathyroid gland. In a thyroid gland with a large height, or in a cancerous lobe, this relationship is less reliable.

  6. Laryngeal

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    Brahim Bouaity

    2014-11-01

    Conclusion: Laryngeal amyloidosis is essentially a local clinical form whose main symptom is dysphonia. The treatment is usually based on local endoscopic procedures but may require a laryngectomy in advanced forms, associated with colchicine. The prognosis is much better than systemic forms.

  7. Surgical anatomy of the internal branch of the superior laryngeal nerve

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    Naderi, Sait; Ergur, Ipek; Korman, Esin

    2006-01-01

    The internal branch of the superior laryngeal nerve (ibSLN) may be injured during anterior approaches to the cervical spine, resulting in loss of laryngeal cough reflex, and, in turn, the risk of aspiration pneumonia. Such a risk dictates the knowledge regarding anatomical details of this nerve. In this study, 24 ibSLN of 12 formaldehyde fixed adult male cadavers were used. Linear and angular parameters were measured using a Vernier caliper, with a sensitivity of 0.1 mm, and a 1° goniometer. The diameter and the length of the ibSLN were measured as 2.1±0.2 mm and 57.2±7.7 mm, respectively. The ibSLN originates from the vagus nerve at the C1 level in 5 cases (20.83%), at the C2 level in 14 cases (58.34%), and at the C2–3 intervertebral disc level in 5 cases (20.83%) of the specimens. The distance between the origin of ibSLN and the bifurcation of carotid artery was 35.2±12.9 mm. The distance between the ibSLN and midline was 24.2±3.3 mm, 20.2±3.6 mm, and 15.9±4.3 mm at the level of C2–3, C3–4, and at the C4–5 intervertebral disc level, respectively. The angles of ibSLN were mean 19.6±2.6° medially with sagittal plane, and 23.6±2.6° anteriorly with coronal plane. At the area between the thyroid cartilage and the hyoid bone the ibSLN is the only nerve which traverses lateral to medial. It is accompanied by the superior laryngeal artery, a branch of the superior thyroid artery. The ibSLN is under the risk of injury as a result of cutting or compression of the blades of the retractor at this level. The morphometric data regarding the ibSLN, information regarding the distances between the nerve, and the other consistent structures may help us identify this nerve, and to avoid the nerve injury. PMID:16402208

  8. Surgical treatment of superior laryngeal neuralgia: A case report and review of the literature.

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    Salzman, Richard; Gabrhelík, Tomáš; Stárek, Ivo

    2016-03-01

    Superior laryngeal (SL) neuralgia is paroxysmal pain above the thyrohyoid membrane. We present a case of SL neuralgia that was resistant to conservative treatment and eventually required surgical intervention. The patient was a 39-year-old woman with a 5-year history of debilitating pain above the thyroid cartilage. After having undergone different imaging scans with negative results, she tried various treatments (e.g., antibiotics, analgesics, stellate ganglion block, radiofrequency SL neurotomy, and stereotactic radiosurgery), all of which were ineffective. Finally, she underwent bilateral surgical SL neurotomy. Postoperatively, she immediately noticed a significant alleviation of her pain. Her postoperative course was completely uneventful, as she experienced no dysphagia or dysphonia, even transiently. One month later, she no longer required regular painkillers, and at 14 months, she remained essentially pain-free. While medical management remains the treatment of choice for SL neuralgia, we recommend that refractory cases be treated initially with a neural block with local anesthesia. Patients who do not respond are candidates for surgery. We consider selective peripheral SL neurotomy to be safe and effective when performed by experienced hands. We also discuss the difficulties of managing SL neuralgia.

  9. The superior laryngeal nerve: its projection to the dorsal motor nucleus of the vagus in the guinea pig.

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    Basterra, J; Chumbley, C C; Dilly, P N

    1988-01-01

    The distribution of neurons in the dorsal motor nucleus of the vagus nerve (DMNV) that innervate the supraglottic and glottic areas of the larynx of the guinea pig have been studied using the horseradish peroxidase (HRP) technique. Following soaking of the superior laryngeal nerve in a solution of HRP, labeled neurons were always located ipsilaterally, at levels between the estria acustica and the caudal end of the inferior olivary nucleus. Characteristically, the neurons were small or medium in size.

  10. 甲状腺手术中喉返神经和喉上神经的保护%Protection of recurrent laryngeal nerve and superior laryngeal nerve in thyroid surgery

    Institute of Scientific and Technical Information of China (English)

    段李东

    2016-01-01

    目的:探讨喉上神经与喉返神经损伤在甲状腺手术中的保护对策。方法:收治甲状腺手术患者77例,回顾性分析其临床资料。结果:所有患者都没有出现喉上神经受损。1例(1.30%)二次残留腺体的切除与中央区淋巴结清扫术患者,出现短暂喉返神经功能性损伤,手术完成后出现声音嘶哑,术后21 d完全恢复。结论:对甲状腺手术中喉返神经与喉上神经进行有效的保护,必须对喉上神经与喉返神经的解剖进行充分了解,手术技术十分精巧。%Objective:To explore the protection countermeasures of recurrent laryngeal nerve and superior laryngeal nerve in thyroid surgery.Methods:77 patients with thyroid surgery were selected.The clinical data were retrospectively analyzed. Results:None of the patients had superior laryngeal nerve injury.Transient recurrent laryngeal nerve injury occurred in 1 patient(1.30%) with two times residual gland resection and central lymph node dissection.After surgery,the patient developed hoarse voice.21 days after the operation,the patient was completely recovered.Conclusion:We must fully understand the anatomy of the superior laryngeal nerve and the recurrent laryngeal nerve,in order to provide effective protection for recurrent laryngeal nerve and superior laryngeal nerve in thyroid surgery,the operation was very delicate.

  11. Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.

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    Rahman Md Mostafeezur

    Full Text Available Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1 and 2 (CB2. The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN, with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67 or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid neurons in the central pattern generator for swallowing.

  12. Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans.

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    Jafari, Samah; Prince, Rebecca A; Kim, Daniel Y; Paydarfar, David

    2003-07-01

    During swallowing, the airway is protected from aspiration of ingested material by brief closure of the larynx and cessation of breathing. Mechanoreceptors innervated by the internal branch of the superior laryngeal nerve (ISLN) are activated by swallowing, and connect to central neurones that generate swallowing, laryngeal closure and respiratory rhythm. This study was designed to evaluate the hypothesis that the ISLN afferent signal is necessary for normal deglutition and airway protection in humans. In 21 healthy adults, we recorded submental electromyograms, videofluoroscopic images of the upper airway, oronasal airflow and respiratory inductance plethysmography. In six subjects we also recorded pressures in the hypopharynx and upper oesophagus. We analysed swallows that followed a brief infusion (4-5 ml) of liquid barium onto the tongue, or a sip (1-18 ml) from a cup. In 16 subjects, the ISLN was anaesthetised by transcutaneous injection of bupivacaine into the paraglottic compartment. Saline injections using the identical procedure were performed in six subjects. Endoscopy was used to evaluate upper airway anatomy, to confirm ISLN anaesthesia, and to visualise vocal cord movement and laryngeal closure. Comparisons of swallowing and breathing were made within subjects (anaesthetic or saline injection vs. control, i.e. no injection) and between subjects (anaesthetic injection vs. saline injection). In the non-anaesthetised condition (saline injection, 174 swallows in six subjects; no injection, 522 swallows in 20 subjects), laryngeal penetration during swallowing was rare (1.4 %) and tracheal aspiration was never observed. During ISLN anaesthesia (16 subjects, 396 swallows), all subjects experienced effortful swallowing and an illusory globus sensation in the throat, and 15 subjects exhibited penetration of fluid into the larynx during swallowing. The incidence of laryngeal penetration in the anaesthetised condition was 43 % (P swallow cycle to evaluate the

  13. Intraoperative neuromonitoring of the external branch of the superior laryngeal nerve during robotic thyroid surgery: a preliminary prospective study

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    Kim, Su-jin; Oh, Byung-Mo; Oh, Eun Mee; Bae, Dong Sik; Choi, June Young; Myong, Jun Pyo; Youn, Yeo-Kyu

    2015-01-01

    Purpose The aim of this study was to evaluate the feasibility of monitoring external branch of the superior laryngeal nerve (EBSLN) during robotic thyroid surgery. Methods A total of 10 patients undergoing bilateral axillo-breast approach (BABA) robotic thyroid surgery were enrolled. The nerve integrity monitor (NIM Response 2.0 System) was used for EBSLN monitoring. We performed voice assessments preoperatively and at 1 and 3 months postoperatively using Voice Handicap Index-10 (VHI-10), maximal phonation time (MPT), phonation efficient index (PEI), and laryngeal electromyography (EMG). Results A total of 19 EBSLNs were at risk and 14 EBSLNs (73.7%) were identified using neuromonitoring. VHI-10 showed a change of voice over time (0.1 vs. 3.6 vs. 1.3); however, this was not statistically significant. VHI-10 scores normalized at 3 months postoperatively compared to the preoperative scores. MPT (a) (16.0 vs. 15.6 vs. 15.4), and MPT (e) (20.1 vs. 15.4 vs. 18.5) showed no significant differences preoperatively compared to the values obtained 1 and 3 months postoperatively. There was a significant change of PEI over time (4.8 vs. 1.1 vs. 4.6) (P = 0.036); however, the values normalized at 3 months postoperatively. Laryngeal EMG results showed 4 cases (21.2%) of neuropathy of EBSLNs at 1 month postoperatively, and electrodiagnostic studies revealed nearly complete recovery of the function of EBSLNs in 4 patients at 3 months postoperatively Conclusion It is suggested that neuromonitoring of EBSLNs during BABA robotic thyroid surgery is feasible and might be helpful to preserve voice quality. PMID:26576402

  14. Role of the Internal Superior Laryngeal Nerve in the Motor Responses of Vocal Cords and the Related Voice Acoustic Changes

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    Sadegh Seifpanahi

    2016-09-01

    Full Text Available Background: Repeated efforts by researchers to impose voice changes by laryngeal surface electrical stimulation (SES have come to no avail. This present pre-experimental study employed a novel method for SES application so as to evoke the motor potential of the internal superior laryngeal nerve (ISLN and create voice changes. Methods: Thirty-two normal individuals (22 females and 10 males participated in this study. The subjects were selected from the students of Iran University of Medical Sciences in 2014. Two monopolar active electrodes were placed on the thyrohyoid space at the location of the ISLN entrance to the larynx and 1 dispersive electrode was positioned on the back of the neck. A current with special programmed parameters was applied to stimulate the ISLN via the active electrodes and simultaneously the resultant acoustic changes were evaluated. All the means of the acoustic parameters during SES and rest periods were compared using the paired t-test. Results: The findings indicated significant changes (P=0.00 in most of the acoustic parameters during SES presentation compared to them at rest. The mean of fundamental frequency standard deviation (SD F0 at rest was 1.54 (SD=0.55 versus 4.15 (SD=3.00 for the SES period. The other investigated parameters comprised fundamental frequency (F0, minimum F0, jitter, shimmer, harmonic-to-noise ratio (HNR, mean intensity, and minimum intensity. Conclusion: These findings demonstrated significant changes in most of the important acoustic features, suggesting that the stimulation of the ISLN via SES could induce motor changes in the vocal folds. The clinical applicability of the method utilized in the current study in patients with vocal fold paralysis requires further research.

  15. Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

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    Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

    2013-01-01

    We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

  16. Central orexin inhibits reflex swallowing elicited by the superior laryngeal nerve via caudal brainstem in the rat.

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    Kobashi, Motoi; Mizutani, Satoshi; Fujita, Masako; Mitoh, Yoshihiro; Shimatani, Yuichi; Matsuo, Ryuji

    2014-05-10

    We examined the effects of orexins on the reflex swallowing using anesthetized rats. Orexins were administered into the fourth ventricle. Swallowing was induced by repeated electrical stimulation of the central cut end of the superior laryngeal nerve (SLN) and was identified by the electromyogram lead penetrated the mylohyoid muscle through bipolar electrodes. The frequency of swallowing during the electrical stimulation of the SLN decreased after the administration of orexin-A in a dose-dependent manner. The latency of the first swallowing tended to be extended after the administration of orexin-A. The administration of orexin-B did not affect swallowing frequency. Pre-administration of SB334867, an orexin-1 receptor antagonist, attenuated the degree of inhibition of swallowing frequency induced by the administration of orexin-A. To identify the effective site of orexin-A, the effect of a microinjection of orexin-A into the dorsal vagal complex (DVC) was evaluated. Orexin-A was injected into one of the lateral DVC, the intermediate DVC, or the medial DVC. Microinjection of orexin-A into the medial DVC but not the other two sites decreased swallowing frequency. Pre-injection of SB334867 into the medial DVC disrupted the inhibitory response induced by fourth ventricular administration of orexin-A. The electrical lesion of the commissural part of the NTS, but not ablation of the AP, abolished the inhibition of reflex swallowing induced by fourth ventricular administration of orexin-A. These results suggest that orexin-A inhibits reflex swallowing via orexin-1 receptors situated in the commissural part of the NTS and/or its vicinity.

  17. Intraoperative neuromonitoring of the external branch of the superior laryngeal nerve during thyroidectomy: the need for evidence-based data and perioperative technical/technological standardization.

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    Mangano, Alberto; Lianos, Georgios D; Boni, Luigi; Kim, Hoon Yub; Roukos, Dimitrios H; Dionigi, Gianlorenzo

    2014-01-01

    The external branch of the superior laryngeal nerve (EBSLN) is surgically relevant since its close anatomical proximity to the superior thyroid vessels. There is heterogeneity in the EBSLN anatomy and EBSLN damage produces changes in voice that are very heterogenous and difficult to diagnose. The reported prevalence of EBSLN injury widely ranges. EBSLN iatrogenic injury is considered the most commonly underestimated complication in endocrine surgery because vocal assessment underestimates such event and laryngoscopic postsurgical evaluation does not show standardized findings. In order to decrease the risk for EBSLN injury, multiple surgical approaches have been described so far. IONM provides multiple advantages in the EBSLN surgical approach. In this review, we discuss the current state of the art of the monitored approach to the EBSLN. In particular, we summarize, providing our additional remarks, the most relevant aspects of the standardized technique brilliantly described by the INMSG (International Neuromonitoring Study Group). In conclusion, in our opinion, there is currently the need for more prospective randomized trials investigating the electrophysiological and pathological aspects of the EBSLN for a better understanding of the role of IONM in the EBSLN surgery.

  18. Intraoperative Neuromonitoring of the External Branch of the Superior Laryngeal Nerve during Thyroidectomy: The Need for Evidence-Based Data and Perioperative Technical/Technological Standardization

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    Alberto Mangano

    2014-01-01

    Full Text Available The external branch of the superior laryngeal nerve (EBSLN is surgically relevant since its close anatomical proximity to the superior thyroid vessels. There is heterogeneity in the EBSLN anatomy and EBSLN damage produces changes in voice that are very heterogenous and difficult to diagnose. The reported prevalence of EBSLN injury widely ranges. EBSLN iatrogenic injury is considered the most commonly underestimated complication in endocrine surgery because vocal assessment underestimates such event and laryngoscopic postsurgical evaluation does not show standardized findings. In order to decrease the risk for EBSLN injury, multiple surgical approaches have been described so far. IONM provides multiple advantages in the EBSLN surgical approach. In this review, we discuss the current state of the art of the monitored approach to the EBSLN. In particular, we summarize, providing our additional remarks, the most relevant aspects of the standardized technique brilliantly described by the INMSG (International Neuromonitoring Study Group. In conclusion, in our opinion, there is currently the need for more prospective randomized trials investigating the electrophysiological and pathological aspects of the EBSLN for a better understanding of the role of IONM in the EBSLN surgery.

  19. Is a line the same as a box? Speech assessment by VAS is not superior to Likert scales in laryngeal cancer patients.

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    Johansson, Mia; Finizia, Caterina; Innocenti, Alessio Degl; Ryden, Anna

    2007-11-01

    The primary purpose was to assess if VAS or Likert was relatively more suitable when assessing self-ratings of voice and speech in patients treated for laryngeal cancer. An additional purpose was to investigate whether the scales differed in measuring change after treatment. Using both VAS and Likert, 71 patients answered three questions at baseline and 12 months after treatment began. For test-retest analyses, additional data were used from 21 subjects. Non-parametric statistical methods suitable for comparing scales with different numbers of response alternatives were applied. Test-retest reliability was strongest for the Likert scale. From baseline to follow-up, both scales detected significant improvements. However, for some Likert scores the associated VAS values varied across a wide range, and this was true for assessments at baseline, at follow-up, and for score changes. At baseline the inter-scale concordance showed a greater number of disordered pairs than at follow-up and on both occasions the older group produced a greater number of disordered pairs. No support for the superiority of VAS over Likert was found. However, VAS may produce instability in response patterns. When using self-ratings of voice and speech to identify a need of further rehabilitation, Likert scales seem better suited.

  20. Guided insertion of the ProSeal laryngeal mask airway is superior to conventional tracheal intubation by first-month anesthesia residents after brief manikin-only training.

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    Hohlrieder, Matthias; Brimacombe, Joseph; von Goedecke, Achim; Keller, Christian

    2006-08-01

    In the following pilot study, we compared conventional laryngoscope-guided tracheal intubation (tracheal intubation) and laryngoscope-guided, gum elastic bougie-guided ProSeal laryngeal mask airway insertion (guided ProSeal) for airway management by first-month anesthesia residents after brief manikin-only training. Five first-month residents with no practical experience of airway management were observed performing these techniques in 200 ASA I-II anesthetized, paralyzed adults. Each resident managed 40 patients, 20 in each group, in random order. The number of insertion attempts, effective airway time, ventilatory capability during pressure-controlled ventilation set at 15 cm H2O, airway trauma, and skill acquisition were studied. Data were collected by unblinded observers. Insertion was more frequently successful (100% versus 65%) and effective airway time was shorter (41 +/- 24 s versus 89 +/- 62 s) in the guided ProSeal group (both P mask airway is superior to conventional laryngoscope-guided tracheal intubation for airway management in terms of insertion success, expired tidal volume, and airway trauma by first-month anesthesia residents after brief manikin-only training. The guided ProSeal technique has potential for cardiopulmonary resuscitation by novices when conventional intubation fails.

  1. Protection of the recurrent laryngeal nerve and the superior laryngeal nerve in the thyroidectomy%甲状腺手术中对喉返神经和喉上神经保护的临床研究

    Institute of Scientific and Technical Information of China (English)

    张海东; 龚单春; 刘亚群; 张庆翔; 何双八; 于振坤

    2016-01-01

    目的:探讨甲状腺手术中喉返神经(RLN)、喉上神经(SLN)的保护方法,以避免或减少术后永久性神经损伤的发生率。方法对东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科,2013年6月—2014年11月行甲状腺精细化操作手术治疗141例患者的临床资料进行回顾性分析。其中男37例、女104例,年龄9~78岁。行甲状腺全切54例,甲状腺腺叶切除58例,甲状腺腺叶切除+对侧部分切除29例;其中二次手术者10例,行Ⅵ区清扫者18例。术中 RLN 显露者121例,未显露者20例。结果本组141例均顺利完成手术。术后并发 RLN 暂时性损伤5侧,占2.56%(5/195),给予激素、神经营养药物治疗,并配合发音训练,3个月内神经功能均恢复正常;其中 RLN 显露组占2.5%(3/121),未显露组占5%(1/20),组间比较差异无统计学意义(χ2=0.396, P >0.05)。无一例并发 RLN 永久性损伤和 SLN 损伤。结论熟悉 RLN、SLN 与甲状腺的正常解剖与变异情况,应用被膜解剖技术精细操作,术后可以避免神经的永久性损伤。一旦发生神经损伤,及时给予对症处理,提高患者的生活质量。%Objective To investigate how to correctly protect the recurrent laryngeal nerve (RLN) and the superior laryngeal nerve( SLN) in the thyroidectomy, to avoid and reduce permanent neurologic injury postoperation. Methods One hundred and forty-one cases who underwent thyroidectomy (37 male, 104 female, aged 9 - 78) were retrospectively analyzed from June 2013 to Nov. 2014 in Nanjing Tongren Hospital, including total thyroidwctomy (54 patiens), lobectomy (58 patiens), thyroid lobectomy with contralateral partial thyroidectomy (29 patiens), among them, 10 cases of secondary surgery, and Ⅵ area lymph nodes cleaning 18 patiens. Intraoperative RLN revealed 121 patiens, 20 patients did not show. Results All 141 patients were successfully completed surgery. The RLN transitory injury was occurred in 5 sides (2. 56% , 5

  2. The Effect of Bilateral Superior Laryngeal Nerve Lesion on Swallowing – A Novel Method to Quantitate Aspirated Volume and Pharyngeal Threshold in Videofluoroscopy

    Science.gov (United States)

    DING, Peng; FUNG, George Shiu-Kai; LIN, Ming De; HOLMAN, Shaina D.; GERMAN, Rebecca Z.

    2015-01-01

    Purpose To determine the effect of bilateral superior laryngeal nerve (SLN) lesion on swallowing threshold volume and the occurrence of aspiration, using a novel measurement technique for videofluorscopic swallowing studies (VFSS). Methods and Materials We used a novel radiographic phantom to assess volume of the milk containing barium from fluoroscopy. The custom made phantom was firstly calibrated by comparing image intensity of the phantom with known cylinder depths. Secondly, known volume pouches of milk in a pig cadaver were compared to volumes calculated with the phantom. Using these standards, we calculated the volume of milk in the valleculae, esophagus and larynx, for 205 feeding sequences from four infant pigs feeding before and after had bilateral SLN lesions. Swallow safety was assessed using the IMPAS scale. Results The log-linear correlation between image intensity values from the phantom filled with barium milk and the known phantom cylinder depths was strong (R2>0.95), as was the calculated volumes of the barium milk pouches. The threshold volume of bolus in the valleculae during feeding was significantly larger after bilateral SLN lesion than in control swallows (p<0.001). The IMPAS score increased in the lesioned swallows relative to the controls (p<0.001). Conclusion Bilateral SLN lesion dramatically increased the aspiration incidence and the threshold volume of bolus in valleculae. The use of this phantom permits quantification of the aspirated volume of fluid. The custom made phantom and calibration allow for more accurate 3D volume estimation from 2D x-ray in VFSS. PMID:25270532

  3. Terminal Branch of Recurrent Human Laryngeal Nerve

    Directory of Open Access Journals (Sweden)

    Andréa Aparecida Ferreira Pascoal

    2014-01-01

    Full Text Available The importance of the recurrent laryngeal nerve in surgery on the anterior region of the neck has motivated many published papers on critical points of its pathway, relationship with the inferior thyroid artery, penetration in the larynx, division outside the larynx, and branches communicating with the internal branch of the superior laryngeal nerve. We analyze the terminal branches of the recurrent laryngeal nerve and their distribution through the laryngeal muscles. 44 laryngeal nerves had been dissected. Most frequently, the recurrent laryngeal nerve presents a division below or at the level of the lower margin of the cricoid cartilage (outside the larynx. One of these branches forms the communication with the internal branch of the superior laryngeal nerve, and the other penetrates the laryngeal space. Above the lower margin of the cricoid cartilage, the inferior laryngeal nerve issues a variable number of branches to muscles (3 to 7: to the posterior cricoarytenoid muscle; to the oblique and transversal arytenoid muscles; and to the lateral cricoarytenoid muscle and the thyroarytenoid muscle.

  4. Laryngeal Leishmaniasis

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    Moraes, Bruno Teixeira de

    2012-01-01

    Full Text Available Introduction: Leishmaniasis is classified into three clinical presentations: visceral, coetaneous and mucocutaneous. The latter is usually secondary to hematogenous spread after months or years of skin infection and can manifest as infiltrative lesions, ulcerated or vegetating in nose, pharynx, larynx and mouth, associated or not with ganglionics infarction. Laryngeal involvement is part of the differential diagnosis of lesions in this topography as nonspecific chronic laryngitis, granulomatosis and even tumors of the upper aerodigestive tract presenting atypical evolution. Sometimes it is difficult for the correct diagnosis of Leishmaniasis, with description of cases in the literature were conducted improperly. Objective: The objective of this study is to report a case of laryngeal Leishmaniasis addressing the difficulty of diagnosis, complications and treatment applied. Case Report: A patient with pain throat, dysphagia, odynophagia, dysphonia and weight loss, with no improvement with symptomatic medication. At telelaringoscopy, infiltrative lesion showed nodular supraglottis. He underwent a tracheotomy for airway obstruction and biopsy with immunohistochemical study for a definitive diagnosis of laryngeal Leishmaniasis. The patient was referred to the infectious diseases that initiated treatment with N-methylglucamine antimoniate with satisfactory response to therapy. Final Comments: Faced with a clinical suspicion of granulomatous diseases, it is essential to follow protocol laboratory evaluation associated with histological injury, to get a precise definition etiological without prolonging the time of diagnosis. Medical treatment for mucosal Leishmaniasis, recommended by the World Health Organization, was adequate in the case of laryngeal disorders, with complete resolution of symptoms.

  5. Laryngeal histoplasmosis.

    Science.gov (United States)

    Ansari, Hina A; Saeed, Noora; Khan, Nazoora; Hasan, Naba

    2016-08-17

    Histoplasmosis is a fungal infection, having interesting synonyms such as Cave disease, Darling's disease, Ohio Valley disease, reticuloendotheliosis, Spelunker's lung and Caver's disease. The aetiological agent is a dimorphic fungus, Histoplasma capsulatum, causing chronic granulomatous disease. The route of transmission is by inhalation of dust particles from soil contaminated by excrement of birds or bats, harbouring the small spores or microconidia, which is considered the infectious form of fungus. The spectrum of illness ranges from subclinical infection of the lung to progressive disseminated disease. The major bulk of histoplasmosis infections are asymptomatic or present with mild influenza like illness and involve immunocompetent individuals. However, the immunocompromised or immunodeficient cases have disseminated/haematogenous infections with multiple organs involved and are usually fatal unless treated immediately. Laryngeal involvement is associated with the disseminated form of the disease. Histoplasmosis of larynx is a rare entity and poses diagnostic difficulty to otolaryngologists because clinically it may be mistaken for malignancy. We report an unusual case of laryngeal histoplasmosis in a man aged 60 years who presented with provisional diagnosis of tuberculosis/malignancy.

  6. Using Laryngeal Electromyography to Differentiate Presbylarynges from Paresis

    Science.gov (United States)

    Stager, Sheila V.; Bielamowicz, Steven A.

    2010-01-01

    Purpose: Differential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from…

  7. Identificação do ramo externo do nervo laríngeo superior na tireoidectomia minimamente invasivo vídeo-assistida Identification of the external branch of the superior laryngeal nerve during minimally invasive video-assisted thyroidectomy

    Directory of Open Access Journals (Sweden)

    Rogério A. Dedivitis

    2005-06-01

    Full Text Available A tireoidectomia minimamente invasiva vídeo-assistida (TIMIVA sem infusão de gás é considerada segura com vantagem estética em relação ao procedimento convencional. OBJETIVO: Apresentar os achados de identificação do ramo externo do nervo laríngeo superior (RELS durante a TIMIVA. FORMA DE ESTUDO: Estudo de coorte transversal. CASUÍSTICA E MÉTODO: Doze pacientes foram submetidos à hemitireoidectomia por doença nodular tireoidiana. Dissecamos o pedículo vascular tireoidiano superior com o auxílio de endoscópio de cinco milímetros de zero grau visando à identificação do RELS em todos os casos. RESULTADOS: Dos 12 casos, identificamos o RELS em 10 (83,3%, sendo que o trajeto era medial aos ramos da artéria tireoidiana superior em 8 (80% e cruzava anteriormente tais ramos em 2 (20%. CONCLUSÕES: Identificamos o RELS em 83,3% dos casos, com trajeto medial aos ramos da artéria tireoidiana superior em 80% e cruzando anteriormente tais ramos em 20%. A ligadura do pedículo superior da tireóide pode ser feita com o RELS sob visão direta.The minimally invasive video-assisted thyroidectomy (MIVAT without gas infusion is considered safe and has advantages in terms of cosmetic results compared to the conventional approach. AIM: to present our findings regarding the identification of the external branch of the superior laryngeal nerve (EBSLN during MIVAT. STUDY DESIGN: Transversal cohort study. MATERIAL AND METHOD: twelve patients underwent hemithyroidectomy for thyroid nodular disease through MIVAT method. The upper pedicle of the thyroid was dissected under the magnified view at 0-degree five-millimeter endoscope in order to achieve the identification of EBSLN in all cases. RESULTS: We identified 10 (83.3% EBSLN out of 12 cases. The nerve ran medially to the branches of the superior thyroid artery in 8 cases (80% and crossed anteriorly in 2 (20%. CONCLUSIONS: We identified the EBSLN in 83.3% of the cases, whose course was medial to

  8. Laryngeal (Voice Box) Cancer

    Science.gov (United States)

    ... requests or policy questions to our media and public relations staff at newsroom@entnet.org . Laryngeal cancer is ... A and beta-carotene may play a protective role. Signs and Symptoms of Laryngeal Cancer Signs and ...

  9. Comparative a numble of monitoring indicator, explore the superiority about Supreme dual-chamber laryngeal mask used for cesarean section anesthesia%Supreme双腔喉罩在剖宫产孕妇全身麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    房小斌; 姚伟瑜; 李师阳

    2013-01-01

    目的 探讨Supreme双腔喉罩用于剖宫产全身麻醉(全麻)的可行性和优越性.方法 对2011年3月至2012年3月在泉州儿童医院麻醉科实施麻醉的300例美国麻醉师协会(ASA)分级Ⅰ或Ⅱ级,择期剖宫产的足月初产妇,经医院伦理委员会批准,采用随机数字表法随机分为3组,双腔喉罩组(A组100例)、气管插管组(B组100例)和腰麻组(C组100例),在不同时段观察产妇心电图,脉搏氧饱和度(Sp02),平均动脉压(MAP)、心率、Narcotrend数值及Apgar评分.结果 喉罩组插喉罩前后心率,MAP无明显改变,Narcotrend数值维持在麻醉水平,插管组插管前后心率[(100±5)次/min比(131 ±9)次/min]、MAP[(77 ±4) mm Hg比(111±8) mmHg]有明显升高,Narcotrend数值明显升高[(29±4)比(60±5)],二者相比差异有统计学意义(P<0.05).喉罩组插喉罩所需时间显著短于气管插管组插管所需时间(P<0.01),两组患者气道密封压,通气指标相比差异无明显统计学意义(P>0.05).3组患者给药至胎儿娩出的时间均在5-10 min.3组新生儿Apgar评分相似,差异无统计学意义(P>0.05).结论 双腔喉罩用于剖宫产全麻对胎儿Apgar评分无影响,具有可行性,其操作简单方便,可进行有效通气,对比气管插管有明显优越性.%Objective Explore the feasibility and superiority about Supreme double-lumen laryngeal mask airway for cesarean section anesthesia.Methods From March 2011 to March 2012,a total of 300 patients with American Society of Anesthesiologists (ASA) Ⅰ or Ⅱ foot of cesarean section in full-term pregnant women for the first time production of Quanzhou Women's and Children's Hospital were recruited,authenticated by Hospital Ethics Committee,they were randomly divided into three groups (Random number table),dual-chamber in the LMA group (A group of 100 cases),tracheal intubation group (B group of 100 cases) and spinal anesthesia group (C group of 100 cases).ECG,SpO2,MAP,heart rate

  10. Supraglottic paraganglioma originated from superior laryngeal nerve

    Directory of Open Access Journals (Sweden)

    Ali Akbar Beigi

    2014-01-01

    Full Text Available Neurogenic tumors, especially paraganglioma of larynx, are rare. In this article, we present a 64-year-old woman who complained of intermittent dysphagia to solid foods. Further evaluation revealed a supraglottic paraganglioma and she was treated successfully by total excision of tumor.

  11. Laryngeal tuberculosis clinically similar to laryngeal cancer

    OpenAIRE

    Verma S; Verma Sanjay; Sanjay

    2007-01-01

    Laryngeal tuberculosis is a rare disease. The presenting features are usually hoarse-ness or dysphagia with other vague and nonspecific symptoms. Laryngoscopic fea-tures mimic malignancy in many cases. There are no noninvasive tests which can confirm a diagnosis of laryngeal tuberculosis. Biopsy of the primary growth itself is diagnostic and may show caseating granulomatous inflammation. Microbiologi-cal confirmation, though desirable, may not always be possible. The response to antitubercula...

  12. Superior laryngeal nerve anatomy in corpses not preserved in formaldehyde: contribution to the operative technique Anatomia do nervo laríngeo superior em cadáver não formalizado: contribuição para a técnica operatória

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    Ludércio Rocha de Oliveira

    2007-06-01

    Full Text Available PURPOSE: To carry out an anatomic study of superior laryngeal nerve in not preserved in formaldehyde and not frozen corpses. METHODS: Thirty-eight male corpses from the Minas Gerais Medico-legal Institute (IML were studied. In 18 corpses dissection was performed bilaterally and in 20 only on the left side, total number 56 nerves dissected. Their descriptive segments measurements and the anatomic relations with the cervical structures of the region were described. This nerve was statistically analyzed; the variables were corpse side (Friedman´s test (pOBJETIVO: Realizar um estudo anatômico do nervo laríngeo superior através da dissecção em cadáver não formolizado e não congelado. MÉTODOS: 38 cadáveres do sexo masculino, provenientes do Instituto Médico-Legal de Minas Gerais (IML, foram estudados. Em 18 cadáveres a dissecção foi realizada bilateralmente e em 20 somente do lado esquerdo, totalizando 56 nervos. Foram registradas as medidas descritivas dos seus segmentos e as relações anatômicas com as estruturas cervicais da região. Este nervo foi analisado sob o ponto de vista estatístico, com as variáveis: lado (teste de Friedman p<0,05, altura e idade (Pearson e etnia (Kruskal-Wallis. RESULTADOS: O nervo laríngeo superior apresentou uma disposição anatômica definida em todos os 56 nervos estudados, emergindo do gânglio inferior do nervo vago. O tronco do nervo laríngeo superior foi em média mais longo nos cadáveres acima de 25 anos de idade (p<0,05. Foram observadas diferenças significativas (p<0,05 entre as medidas do ramo interno e do ramo externo em todos os grupos étnicos, sendo que a média do ramo interno foi inferior à média do ramo externo. As medidas pareadas dos lados direito e esquerdo não apresentaram diferenças significativas nos 18 cadáveres estudados. CONCLUSÕES: A disposição dos 56 nervos laríngeos superiores mostrou um padrão anatômico definido, quanto à emergência, ao tronco,

  13. The neuromonitoring of the external branch of the superior laryngeal nerve in Micooli's endoscopic thyroidectomy%喉上神经监测在腔镜辅助小切口甲状腺手术中的应用

    Institute of Scientific and Technical Information of China (English)

    邹汉青; 邢春根; 金涛; 朱旬

    2012-01-01

    目的 探讨在腔镜辅助小切口甲状腺手术中,应用神经监测技术避免喉上神经外支损伤的可行性.方法 2011年2-9月间36例腔镜辅助小切口甲状腺手术患者,术中以电流刺激下环甲肌收缩活动作为阳性反应,定位喉上神经外支的走行,远离神经处理上极血管.手术前后VHI-10评分评价声音质量变化、喉镜检查观察声带活动情况.结果 手术共定位56侧喉上神经外支(100%),神经与甲状腺上动脉的交叉点距离甲状腺上极>1 cm者26侧(46.4%),<1 cm者30侧(53.6%),而在甲状腺上下径>5 cm患者中,则73%患者此距离<1.0 cm,P=0.006,手术前后VHI-10评分差异无统计学意义(P>0.05).结论 腔镜辅助小切口甲状腺手术中喉上神经监测可定位喉上神经外支走行,有利于预防喉上神经外支损伤.%Objective To evaluate the intraoperative neuromonitoring of the external branch of the superior laryngeal nerve (EBSLN) during Micooli's endoscopic thyroidectomy in order to avoid nerve injury.Methods In this study,36 patients with 56 nerves at risk were enrolled from February 2011 to September 2011.A positive signal is determined by observing contractions of the cricothyroid muscle to locate the EBSLN.The relationship between EBSLN and the upper pole of the thyroid or the inferior constrictor muscle was studied.The VHI-10 table was used for evaluation pre- and postoperatively. Results All 56 nerves were located successfully,26 nerves(46.4% ) crossed the superior thyroid artery more than 1 cm apart from the upper pole of the thyroid gland,while the other 30 nerves(53.6% ) did less than 1 cm.In cases where the diameter was longer than 5 cm,the nerves crossed the artery at less than 1.0 cm from the upper pole in 73% cases(P =0.006).There was no significant difference between VHI-10 results before and after surgery (P > 0.05). Conclusions Intraoperative neuromonitoring is useful and helpful in avoiding nerve injury by

  14. Laryngeal tuberculosis clinically similar to laryngeal cancer

    Directory of Open Access Journals (Sweden)

    Verma S

    2007-01-01

    Full Text Available Laryngeal tuberculosis is a rare disease. The presenting features are usually hoarse-ness or dysphagia with other vague and nonspecific symptoms. Laryngoscopic fea-tures mimic malignancy in many cases. There are no noninvasive tests which can confirm a diagnosis of laryngeal tuberculosis. Biopsy of the primary growth itself is diagnostic and may show caseating granulomatous inflammation. Microbiologi-cal confirmation, though desirable, may not always be possible. The response to antitubercular treatment is good. We report a 52 year old man who presented to us with hoarseness of voice, haemoptysis and a proliferative growth in the epiglottis and was diagnosed to have laryngeal tuberculosis on histopathology. He had an excellent response to antituberculosis therapy and is now asymptomatic.

  15. Laryngeal Elevation Velocity and Aspiration in Acute Ischemic Stroke Patients

    Science.gov (United States)

    Zhang, Jing; Zhou, Yun; Wei, Na; Yang, Bo; Wang, Anxin; Zhou, Hai; Zhao, Xingquan; Wang, Yongjun; Liu, Liping; Ouyoung, Melody; Villegas, Brenda; Groher, Michael

    2016-01-01

    Objectives Aspiration after stroke has been associated with aspiration pneumonia, which contributes to increased mortality of stroke. Laryngeal elevation is a core mechanism for protection from aspiration. Few studies have explored the predictive value of laryngeal elevation velocity for aspiration after stroke. This study aimed to explore the ability of laryngeal elevation velocity to predict aspiration in patients with acute ischemic stroke. Methods This was a prospective cohort study that included consecutive acute ischemic stroke patients treated at a teaching hospital during a 10-month period. Patients underwent magnetic resonance imaging (MRI) to confirm the diagnosis of acute ischemic stroke. Patients who were at risk of aspiration and could swallow 5 ml of diluted barium (40%, w/v) for a videofluoroscopic swallowing (VFS) study were included. The association between abnormal indices in the oral and pharyngeal phase of the VFS study and aspiration was examined using univariate analyses. These indices included the lip closure, tongue movement and control, laryngeal elevation velocity and range, the latency of pharyngeal swallowing, pharyngeal transit time (PTT), abnormal epiglottis tilt, residual barium in the pharynx, and the duration of upper esophageal sphincter (UES) opening. The laryngeal elevation velocity (%/s) was calculated as the range of laryngeal elevation (%) from the resting position to the maximum superior position or to the position where the laryngeal vestibule is fully closed divided by the corresponding duration of laryngeal elevation. The range of laryngeal elevation (%) was the percentage calculated as the distance between the resting laryngeal position and the maximum superior excursion position or position where the laryngeal vestibule is fully closed divided by the distance between the resting laryngeal position and the lowest edge of the mandible. A logistic regression analysis was used to determine the predictive value for aspiration

  16. [Laryngitis in childhood].

    Science.gov (United States)

    Korppi, Matti; Tapiainen, Terhi

    2015-01-01

    The most common causative agents of laryngitis are parainfluenza viruses. The diagnosis of laryngitis in children is a clinical one, typical symptoms including dry, often barking cough and inspiratory difficulty and wheezing. Typical age of occurrence is 0.5 to 3 years. In children under one year of age the structural and functional anomalies causing symptoms resembling laryngitis in connection with an infection should not be disregarded. Most patients can be nursed at home. An orally administered glucocorticoid and inhaled racemic adrenalin are effective drugs in emergency service.

  17. Laryngitis (For Kids)

    Science.gov (United States)

    ... heard. Even a lot of loud singing can irritate your vocal cords and cause laryngitis. Although it ... back up your swallowing tube. The acid can irritate your vocal cords. Allergies or smoking can also ...

  18. Imaging in laryngeal cancers

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    Varsha M Joshi

    2012-01-01

    Full Text Available Imaging plays an important complementary role to clinical examination and endoscopic biopsy in the evaluation of laryngeal cancers. A vast majority of these cancers are squamous cell carcinomas (SCC. Cross-sectional imaging with contrast-enhanced computed tomography (CT and magnetic resonance (MR imaging allows excellent depiction of the intricate anatomy of the larynx and the characteristic patterns of submucosal tumor extension. CT, MRI and more recently PET-CT, also provide vital information about the status of cervical nodal disease, systemic metastases and any synchronous malignancies. Additionally, certain imaging-based parameters like tumor volume and cartilaginous abnormalities have been used to predict the success of primary radiotherapy or surgery in these patients. Integration of radiological findings with endoscopic evaluation greatly improves the pretherapeutic staging accuracy of laryngeal cancers, and significantly impacts the choice of management strategies in these patients. Imaging studies also help in the post-therapeutic surveillance and follow-up of patients with laryngeal cancers. In this article, we review the currently used laryngeal imaging techniques and protocols, the key anatomic structures relevant to tumor spread and the characteristic patterns of submucosal extension and invasion of laryngeal cancer. The role of CT, MRI and PET-CT in the evaluation of patients with laryngeal SCC and the impact of imaging findings on prognosis and clinical management is also discussed.

  19. Imaging of laryngeal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Minerva, E-mail: Minerva.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Leuchter, Igor, E-mail: Igor.Leuchter@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Platon, Alexandra, E-mail: Alexandra.Platon@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Becker, Christoph D., E-mail: Christoph.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Dulguerov, Pavel, E-mail: Pavel.Dulguerov@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Varoquaux, Arthur, E-mail: Arthur.Varoquaux@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland)

    2014-01-15

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed.

  20. Imaging of laryngeal trauma.

    Science.gov (United States)

    Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  1. A fine-cut technique for permanent laryngeal sectioning.

    Science.gov (United States)

    Roy, S; Lundy, D S; Marcillo, A S; Casiano, R R

    2001-01-01

    A new technique for permanent sectioning of the human spinal cord has provided superior images over those produced with traditional methods. Application of this technique for sections of the human larynx may yield cost-effective, efficient, and accurate laryngeal anatomic dissections. This study was designed to evaluate this technique for dissections of the human larynx. Laryngeal sections from cadavers were submerged in a celloidin solution, a derivative of wallpaper plaster, and frozen to -15 degrees C. After preparation, axial and coronal cuts of 100 microm were made with a Macrocut Tome sectioning system. Sections were completed in approximately 30 hours. Digitized photographs of the laryngeal sections provide detailed images of precise anatomic relationships. Celloidin-based sectioning of the human larynx yields precise anatomic information beyond standard radiographic imagining and previous permanent laryngeal sectioning techniques in a cost-efficient and timely manner. Black and white fine-section photographs are provided.

  2. Primary laryngeal cryptococcosis resembling laryngeal carcinoma.

    Science.gov (United States)

    Tamagawa, Shunji; Hotomi, Muneki; Yuasa, Jun; Tuchihashi, Shigeki; Yamauchi, Kazuma; Togawa, Akihisa; Yamanaka, Noboru

    2015-08-01

    A case of an 82-year-old female with primary laryngeal cryptococcosis who had undergone long-term corticosteroid therapy for chronic obstructive pulmonary disease and rheumatoid arthritis is reported. She complained hoarseness with swallowing pain and irritability of the larynx for over a month. Endoscopic examination revealed a white, exudative irregular region on right arytenoid that mimicked a laryngeal carcinoma. Histological examination showed pseudoepitheliomatous hyperplasia and severe submucosal inflammation with ovoid budding yeasts by Grocott's stain. A serological study indicated a high titer of cryptococcal antigen. After treating with oral fluconazole for 3 months, her primary lesion of larynx turned to be clear. We implicate a long-term use of steroids as the significant risk factor in developing cryptococcosis of the larynx.

  3. Laryngeal cleft type 1

    Directory of Open Access Journals (Sweden)

    Danilo de Assis Pereira

    2015-06-01

    Full Text Available The clinical itinerary and the institution of conservative therapy in a case of laryngeal cleft type 1 refers to a child born by cesarean section, Apgar 9 and 10, a history of placental nd abruption in the 2 month of pregnancy, with respiratory nd distress on the 2 day of life and difficulty in breast feeding mothers. Presented evidence of aspiration pneumonia. The videodeglutogram showed aspiration of large amounts of material contrasted during swallowing. In bronchoscopy was visualized formation of threadlike small slit making the diagnosis of laryngeal cleft. We then decided, by institution of conservative treatment with enteral nutrition training and thickened with swallowing.

  4. Congenital laryngeal anomalies,

    Directory of Open Access Journals (Sweden)

    Michael J. Rutter

    2014-12-01

    Full Text Available Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the main aspects concerning airway management of infants will be analyzed. Conclusions: It is critical for clinicians to understand issues relevant to the airway management of infants.

  5. Laryngeal leishmaniasis in Malta.

    Science.gov (United States)

    Fsadni, C; Fsadni, P; Piscopo, T; Mallia Azzopardi, C

    2007-02-01

    The localization of Leishmania spp. in the larynx is rare especially when not associated with immunosuppression or with visceral or cutaneous leishmaniasis. We present a case of isolated laryngeal leishmaniasis, the first of its kind documented in Malta and infrequently reported from the Mediterranean basin.

  6. Inducible laryngeal obstruction

    DEFF Research Database (Denmark)

    Halvorsen, Thomas; Walsted, Emil Schwarz; Bucca, Caterina

    2017-01-01

    Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenc...

  7. Benign anatomical mistakes: the correct anatomical term for the recurrent laryngeal nerve.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2002-01-01

    The term recurrent laryngeal nerve has been adopted by Nomina Anatomica (1989) and Terminologia Anatomica (1998) to describe this vagus branch from its origin, its turn dorsally around the subclavian artery and the aortic arch, and its cranial pathway until it reaches its terminal organs in the neck. However, there is still much confusion, and either the terms inferior and recurrent laryngeal nerve are used interchangeably or inferior laryngeal nerve is considered the terminal branch of the recurrent laryngeal nerve. We hereby feel that it is necessary to reassess the term and we propose the term inferior laryngeal nerve for the entire nerve under consideration, from its origin from the vagus nerve to its destinations, including tracheal, esophageal, and pharyngeal branches. If the term superior laryngeal nerve is a given, standard and accepted term in the anatomical terminology, then logically the term inferior laryngeal nerve should also be accepted, as opposed to it. Of course the upward travel of the inferior laryngeal nerve is "recurrent". When nonrecurrence is encountered together with an arteria lusoria, a retroesophageal right subclavian artery or a right aortic arch, we consider that the term nonrecurrent inferior laryngeal nerve should be used to describe the deviation from the normal.

  8. Laryngeal hypersensitivity in chronic cough.

    Science.gov (United States)

    Hull, J H; Menon, A

    2015-12-01

    Patients with chronic cough often report symptoms arising in the throat, in response to non-specific stimuli. Accordingly, the concept of a 'hypersensitivity' of the larynx in chronic cough has evolved over the past ten years. Patients with cough and laryngeal hypersensitivity frequently report features that overlap other laryngeal dysfunction syndromes, including a tendency for the vocal cords to inappropriately adduct. The mechanisms underlying laryngeal hypersensitivity in chronic cough are currently unclear, however recent studies provide new clinical and physiological techniques to aid detection and monitoring of laryngeal hypersensitivity. This review provides an overview of the current state of knowledge in this field.

  9. Clinically isolated laryngeal sarcoidosis

    DEFF Research Database (Denmark)

    Plaschke, Christina Caroline; Owen, Hanne Hoejris; Rasmussen, Niels

    2011-01-01

    Laryngeal sarcoidosis is rare (0.5% of patients with sarcoidosis), the pathogenesis is unknown and the optimal treatment remains a matter of debate. We undertook this study to elucidate possible pathogenic factors in clinically isolated laryngeal sarcoidosis and to describe results...... of supraglottoplastic surgery. From 1995 to 2009, we identified six patients with histologically proven sarcoidosis of the larynx treated at Rigshospitalet. All patients were subjected to a panel of blood tests and MR scan of the head and neck. All patients had dyspnoea at admission, and five were subjected...... successful to maintain normal breathing. None of the many parameters examined--some previously having been found to be abnormal in sarcoidosis--were abnormal in the present cohort. We are therefore unable to elucidate the pathogenesis. The combined surgical approach re-established normal airway function...

  10. Solitary Polypoid Laryngeal Xanthoma

    Directory of Open Access Journals (Sweden)

    Francisco Vera-Sempere

    2013-01-01

    Full Text Available We report the case of a 51-year-old male smoker with diabetes mellitus and hyperlipidaemia and a long history of human immunodeficiency virus (HIV/hepatitis C virus (HCV infection treated with various antiretroviral regimes, who was referred to the otolaryngology department with progressive dysphonia. Fibre-optic laryngoscopy showed a solitary, yellowish-white pedunculated polyp on the anterior third of the left cord, with no other abnormality. Pathological analysis revealed a polypoid laryngeal xanthoma that was immunoreactive against CD68, perilipin, and adipophilin. This unusual laryngeal lesion in the clinical context of our patient suggests a possible role of antiretroviral treatment in the pathogenesis of these xanthomas.

  11. A metrical study of laryngeal cartilages and their ossification.

    Science.gov (United States)

    Ajmani, M L; Jain, S P; Saxena, S K

    1980-01-01

    This study was carried out on the laryngeal cartilages of 150 postmortem/dissection room specimens of adult age groups, ranging from 16 to 55 years in both the sexes. The age, height, sex and profession (in known postmortem cases) were noted. Various measurements of the laryngeal cartilages were taken from the inner surface. From the present study we can conclude that the various measurements in the laryngeal cartilages were more marked in male than the female except of the thyroid angle and the length of the superior horn. The thyroid angle on an average in male was 78 degrees +/- 10 degrees and in female 106 degrees +/- 14 degrees. There was no correlation with total body height. The presence of cuneiform cartilage, cartilago-triticea and corniculate cartilage is not constant, they were seen more commonly in females than in males.

  12. Laryngeal tuberculosis: A case of a non-healing laryngeal lesion

    Directory of Open Access Journals (Sweden)

    HK Chen and P Thornley

    2012-03-01

    Full Text Available We report a case of laryngeal tuberculosis in a 47-year-old Korean man. Laryngeal tuberculosis is rare and currently accounts for less than 1% of all cases of tuberculosis. Clinical features of laryngeal tuberculosis include hoarseness, odynophagia and dyspnoea. Macroscopically, laryngeal tuberculosis may mimic laryngeal carcinoma, chronic laryngitis or laryngeal candidiasis. The diagnosis is often delayed due to a low index of clinical suspicion and hence may pose a significant public health risk. Laryngeal tuberculosis should be considered in the differential diagnosis of patients who present with any form of laryngeal lesion.

  13. Laryngeal Manifestations of Neurofibromatosis.

    Science.gov (United States)

    Naunheim, Matthew R; Plotkin, Scott R; Franco, Ramon A; Song, Phillip C

    2016-03-01

    To describe the range of findings in patients with neurofibromatosis (NF) presenting to a laryngology clinic and to analyze the etiologic factors of vocal fold dysfunction in this cohort. Case series with chart review. Tertiary laryngology practice. All cases of NF presenting to an academic laryngology practice were retrospectively reviewed (August 2005 to May 2014), with a total of 34 cases. Demographic data, symptoms, and endoscopic examination findings were reviewed. Etiologic factors of laryngeal complaints were analyzed with reference to NF-associated pathologies and surgical history. Thirty-four patients with NF-1 or NF-2 were evaluated, and 28 of these patients (6 NF-1 and 22 NF-2) had laryngeal pathology. The most common presenting symptoms were vocal weakness (n = 21), dysphagia (n = 5), and globus (n = 4). Three patients had NF-related vocal fold masses on examination, including 2 neurofibromas and 1 schwannoma. Unilateral vocal cord paralysis was seen in 17 patients; bilateral paralysis was observed in 5 patients. Of patients with unilateral or bilateral paralysis, 20 had intracranial masses (vestibular schwannoma, meningioma, or skull base tumors), and 16 had previously undergone surgery for these lesions. Of the patients with NF-associated intracranial tumors, 87.0% presented with vocal cord paralysis, whereas only 40.0% of those without intracranial masses had paralysis (P = .0560). Seven patients underwent medialization procedures. Neurofibromatosis patients may present to laryngology clinic with primary laryngeal tumors or, more commonly, unilateral or bilateral paralysis. Otolaryngologists should be keenly aware of vocal fold paralysis caused by the NF-associated tumors, with particular attention to bilateral paralysis in NF-2. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Histoplasmosis laryngeal: report first case in Colombia.

    Science.gov (United States)

    Moriones Robayo, Carlos Alberto; Guerra Ortiz, Claudia Patricia

    2014-01-01

    Laryngeal histoplasmosis is a fungal infection that is frequent in Colombia. Laryngeal histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from the lungs to other organs. Histoplasmosis isolated laryngeal (primary) is rare. If a patient presents with a history of immunosuppression by renal transplant, primary laryngeal histoplasmosis with supraglottic granulomatous inflammation that was treated with amphotericin B and Itraconazole, with complete resolution of laryngeal lesions.

  15. Laryngeal Histoplasmosis: report first case in Colombia

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Moriones Robayo

    2015-01-01

    Full Text Available Laryngeal histoplasmosis is a fungal infection that is frequent in Colombia. Laryngeal histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from the lungs to other organs. Histoplasmosis isolated laryngeal (primary is rare. If a patient presents with a history of immunosuppression by renal transplant, primary laryngeal histoplasmosis with supraglottic granulomatous inflammation that was treated with amphotericin B and Itraconazole, with complete resolution of laryngeal lesions.

  16. [The laryngeal mask].

    Science.gov (United States)

    Poltroniéri, J

    1990-01-01

    A new type of airway has been widely used for two years, throughout hospitals in the United Kingdom. Designed and created since 1983 by Dr AIJ Brain, the Laryngeal Mask Airway (LMA) is a compromise between the endotracheal tube and the face-mask. Blindly inserted in an anaesthetized patient, without either a laryngoscope or neuromuscular blockade, it provides a good airway in almost all cases. It is often able to offer an effective alternative to difficult intubation. The LMA can be used with either spontaneous or positive pressure ventilation. Because it doesn't provide a reliable protection of the airway from aspiration, it should never be used in the patient with a full stomach. The spontaneously breathing patient, undergoing elective surgery for 15 to 60 minutes, in supine position, who would ordinarily be managed with a face-mask is the more likely candidate for the LMA. But, longer procedures, in lateral or prone position, with controlled ventilation can usually be carried out using the Brain's device. More effective and less demanding than the facial-mask, much less hurtful than the endotracheal tube, the Laryngeal Mask is potentially an important and valuable addition to anaesthetic care.

  17. Laryngeal cancer stem cells

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    Antonio Greco

    2016-03-01

    Full Text Available Laryngeal squamous cell carcinoma (LSCC is one of the most commonly diagnosed malignancies in the head and neck region with an increased incidence rate worldwide. Cancer stem cells (CSCs are a group of cells with eternal life or infinite self-renewal ability, which have high migrating, infiltrative, and metastatic abilities. Though CSCs only account for a small proportion in tumors, the high resistance to traditional therapy exempts them from therapy killing and thus they can reconstruct tumors. Our current knowledge, about CSCs in the LSCC, largely depends on head and neck studies with a lack of systematic data about the evidences of CSCs in tumorigenesis of LSCC. Certainly, the combination of therapies aimed at debulking the tumour (e.g. surgery, conventional chemotherapy, radiotherapy together with targeted therapies aimed at the elimination of the CSCs might have a positive impact on the long-term outcome of patients with laryngeal cancer (LC in the future and may cast a new light on the cancer treatment.

  18. Physiological Variability in the Deglutition Literature: Hyoid and Laryngeal Kinematics

    OpenAIRE

    Molfenter, Sonja M.; Catriona M. Steele

    2010-01-01

    A literature review was conducted on hyoid and/or laryngeal displacement during swallowing in healthy populations according to several inclusion criteria. Anterior and superior displacement measures of both structures from previously-published studies were compiled for meta-analysis. Results showed a large degree of variability across studies for each structure and plane of movement. Potential sources of variation were identified including statistical, methodological, stimulus-related and par...

  19. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  20. Section four: laryngitis and dysphonia.

    Science.gov (United States)

    Hueston, William J; Kaur, Dipinpreet

    2013-12-01

    Acute laryngitis is most often caused by viral illnesses through direct inflammation of the vocal cords or from irritation due to postnasal drainage. Bacterial infections, such as acute epiglottitis, also can cause dysphonia but typically have other systemic symptoms as well as respiratory distress. Chronic laryngitis is characterized by symptoms lasting more than 3 weeks. Chronic vocal cord issues can be related to overuse or stress on the vocal cords resulting in nodules or polyps. Individuals in certain occupations, such as singers, school teachers, and chemical workers, are at greater risk of chronic laryngitis. The diagnostic approach to chronic laryngitis should include visualization of the vocal cords to rule out potential malignant lesions. For acute and chronic overuse symptoms, the best treatment is vocal rest. The use of antibiotics or decongestants should be discouraged.

  1. [Open and closed laryngeal injuries].

    Science.gov (United States)

    Bartnik, Władysław; Bartnik-Krystalska, Alicja

    2003-01-01

    Treatment and results of 13 laryngeal and trachea traumas have been presented. All patients were operated in 24 hours after the injury. We had good results, only two patients had vocal chord paralysis. After phoniatric rehabilitation they regained good voice.

  2. Laryngeal metastasis from lung cancer

    OpenAIRE

    Umasankar Kalai; Karan Madan; Deepali Jain; Anant Mohan; Randeep Guleria

    2015-01-01

    Metastatic tumors of the larynx are rare. The most common tumors metastasizing to the larynx are melanoma and renal cell carcinoma. Bronchogenic carcinoma metastasizing to the larynx has been rarely described. Herein, we report the case of a 49-year-old, chronic smoker, who incidentally had a laryngeal growth detected during flexible bronchoscopy examination for evaluation of suspected lung cancer. Histopathological examination of the laryngeal nodule and the biopsy obtained from the main bro...

  3. An Unusual Laryngeal Injury

    Directory of Open Access Journals (Sweden)

    A Kohli

    2007-01-01

    Full Text Available Blunt injuries to the anterior neck are most commonly due to road traffic accidents but the incidence of such types of injuries are decreasing probably due to stricter laws pertaining to seat belts and drunken driving. Experience in managing such injuries is limited due to their rarity. The mainstay of management revolves around establishing and maintaining a patent airway and integrity of the spine. Here we document a case of a 25 year old male who met with a Road traffic accident while driving a motorbike and sustained a clear cut linear wound on the right side of the neck with minimal airleak due to the helmet clip. On exploration, he was found to have massive epiglottic edema, mucosal abrasions, lacerations and a thyroid cartilage fracture. The mechanism of injury was probably a combination of penetrating and blunt trauma neck. This case highlights the mechanism of laryngeal injury, its presentation and management

  4. Laryngeal Verrucous Carcinoma.

    Science.gov (United States)

    Echanique, Kristen A; Desai, Stuti V; Marchiano, Emily; Spinazzi, Eleonora F; Strojan, Primož; Baredes, Soly; Eloy, Jean Anderson

    2017-01-01

    Objective Laryngeal verrucous carcinoma (LVC) is a rare, locally invasive neoplasm comprising 1% to 3.4% of laryngeal carcinomas. Management strategies are a topic of ongoing conversation, and no definitive treatment protocol based on T stage and presentation exists. This review examines characteristics, treatment modalities, and patient outcomes of LVC. Data Sources PubMed, MEDLINE, EMBASE, and Web of Science. Methods Databases were searched through October 29, 2015, for literature detailing individual patient cases of LVC. Variables analyzed included patient demographics, tumor characteristics, tumor size, treatment, and outcomes. Results Thirty-seven articles with 369 cases were included. LVC was found more commonly in males (13.8:1), at an average age of 58.7 years, and located in the glottis (74.0%). Most patients had local disease at presentation (94.9%). The most common presenting symptom was hoarseness (92.3%). The most common primary treatment was surgery alone (72.3%), with local excision as the most common technique (56.8%). In patients with data available on both surgical modality and T stage, most patients who presented as T1 and were managed surgically underwent local excision (79.2%). Surgical treatment alone led to high rates of disease-free survival at follow-up (86.8%). A large number of patients presenting with T1 disease were disease free at follow-up (88.6%). Overall survival was 80.3%. Conclusion LVC is most often managed surgically. The extent of surgical resection may be guided by T stage, with smaller tumors resected via local excision and larger tumors via partial or total laryngectomy. Regardless of T stage or therapy, LVC has a good posttreatment prognosis.

  5. Relationship between reflux and laryngeal cancer

    NARCIS (Netherlands)

    Coca-Pelaz, A.; Rodrigo, J.P.; Takes, R.P.; Silver, C.E.; Paccagnella, D.; Rinaldo, A.; Hinni, M.L.; Ferlito, A.

    2013-01-01

    Gastroesophageal reflux disease (GERD), or its variation known as laryngopharyngeal reflux (LPR), has been recognized as a potential cause of several laryngeal disorders. Patients with laryngeal cancer have lifestyle risk factors, especially tobacco and alcohol consumption, that play an etiological

  6. CT for laryngeal and hypopharyngeal diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ohata, Takeo (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1982-10-01

    In 12 cases of laryngeal cancer and 3 of hypopharyngeal cancer, CT findings were compared with endoscopic and laryngographic findings. CT revealed tumor invasion into the piriform sinus, vallecula, cricoarytenoid articulate and laryngeal cartilage, while the other two methods did not. Cases were presented and CT findings of laryngeal and hypopharyngeal cancers were summarized.

  7. Laryngeal Involvement of Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Ariel B. Grobman

    2012-01-01

    Full Text Available The objectives of this paper are to discuss a rare cause of laryngeal multiple myeloma, to review unique pathologic findings associated with plasma cell neoplasms, to discuss epidemiology, differential diagnosis, and treatment options for plasma cell neoplasms of the larynx. Laryngeal multiple myeloma, also noted in the literature as “metastatic” multiple myeloma, presenting as a de novo laryngeal mass is extremely rare with few reported cases. Laryngeal involvement of extramedullary tumors is reported to be between 6% and 18% with the epiglottis, glottis, false vocal folds, aryepiglottic folds, and subglottis involved in decreasing the order of frequency. We present the case of a 58-year-old male with a history of IgA smoldering myeloma who presented to a tertiary care laryngological practice with a two-month history of dysphonia, which was found to be laryngeal involvement of multiple myeloma. We review the classification of and differentiation between different plasma cell neoplasms, disease workups, pathologic findings, and treatment options.

  8. Intralaryngeal neuroanatomy of the recurrent laryngeal nerve of the rabbit.

    Science.gov (United States)

    Ryan, Stephen; McNicholas, Walter T; O'Regan, Ronan G; Nolan, Philip

    2003-05-01

    We undertook this study to determine the detailed neuroanatomy of the terminal branches of the recurrent laryngeal nerve (RLN) in the rabbit to facilitate future neurophysiological recordings from identified branches of this nerve. The whole larynx was isolated post mortem in 17 adult New Zealand White rabbits and prepared using a modified Sihler's technique, which stains axons and renders other tissues transparent so that nerve branches can be seen in whole mount preparations. Of the 34 hemi-laryngeal preparations processed, 28 stained well and these were dissected and used to characterize the neuroanatomy of the RLN. In most cases (23/28) the posterior cricoarytenoid muscle (PCA) was supplied by a single branch arising from the RLN, though in five PCA specimens there were two or three separate branches to the PCA. The interarytenoid muscle (IA) was supplied by two parallel filaments arising from the main trunk of the RLN rostral to the branch(es) to the PCA. The lateral cricoarytenoid muscle (LCA) commonly received innervation from two fine twigs branching from the RLN main trunk and travelling laterally towards the LCA. The remaining fibres of the RLN innervated the thyroarytenoid muscle (TA) and comprised two distinct branches, one supplying the pars vocalis and the other branching extensively to supply the remainder of the TA. No communicating anastomosis between the RLN and superior laryngeal nerve within the larynx was found. Our results suggest it is feasible to make electrophysiological recordings from identified terminal branches of the RLN supplying laryngeal adductor muscles separate from the branch or branches to the PCA. However, the very small size of the motor nerves to the IA and LCA suggests that it would be very difficult to record selectively from the nerve supply to individual laryngeal adductor muscles.

  9. Current perspectives on reflux laryngitis.

    Science.gov (United States)

    Asaoka, Daisuke; Nagahara, Akihito; Matsumoto, Kenshi; Hojo, Mariko; Watanabe, Sumio

    2014-12-01

    Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease (GERD). With the increase of GERD patients, the importance of LPR is acknowledged widely. However, the pathophysiology of LPR is not understood completely and the diagnostic criteria for LPR remain controversial. Unfortunately, a gold standard diagnostic test for reflux laryngitis is not available. Recently, an experimental animal model for reflux laryngitis was developed to investigate the pathophysiology of reflux laryngitis. An empirical trial of lifestyle modification and proton pump inhibitor therapy is a reasonable approach for LPR symptoms. Alternatives after failure with aggressive medical treatment are limited and multichannel intraluminal impedance and pH monitoring is currently the best alternative to detect nonacid reflux. Additional prospective and evidence-based research is anticipated.

  10. Fungal laryngitis in immunocompetent patients.

    Science.gov (United States)

    Ravikumar, A; Prasanna Kumar, S; Somu, L; Sudhir, B

    2014-01-01

    The diagnosis of fungal laryngitis is often overlooked in immunocompetent patients because it is commonly considered a disease of the immunocompromised. Further confusion is caused by clinical and histological similarity to more common conditions like Leukoplakia. Demonstration of hyperkeratosis particularly if associated with intraepithelial neutrophils on biopsy should trigger a search for fungus using specialized stains. These patients usually present with hoarseness of voice. Pain is present inconsistently along with dysphagia and odynophagia. We present three cases of fungal laryngitis in immunocompetent patients out of which one underwent microlaryngeal surgery with excision biopsy. All these patients responded well with oral antifungal therapy.

  11. ‘ SILENT’ LARYNGEAL FOREIGN BODY

    Directory of Open Access Journals (Sweden)

    Chandrasekhar

    2015-06-01

    Full Text Available Laryngeal foreign bodies in adults are rare. The foreign bodies accidentally entering the larynx are symptomatic in the form of choking , stridor or even death. We are presenting a rare case of foreign body in the larynx in a 42 year old male who was symptom free except for dysphonia. The foreign body was removed successfully under local anesthesia.

  12. Menthol suppresses laryngeal C-fiber hypersensitivity to cigarette smoke in a rat model of gastroesophageal reflux disease: the role of TRPM8.

    Science.gov (United States)

    Liu, Bi-Yu; Lin, Yu-Jung; Lee, Hung-Fu; Ho, Ching-Yin; Ruan, Ting; Kou, Yu Ru

    2015-03-01

    Patients with gastroesophageal reflux disease (GERD) display enhanced laryngeal reflex reactivity to stimuli that may be due to sensitization of the laryngeal C-fibers by acid and pepsin. Menthol, a ligand of transient receptor potential melastatin-8 (TRPM8), relieves throat irritation. However, the possibility that GERD induces laryngeal C-fiber hypersensitivity to cigarette smoke (CS) and that menthol suppresses this event has not been investigated. We delivered CS into functionally isolated larynxes of 160 anesthetized rats. Laryngeal pH 5-pepsin treatment, but not pH 5-denatured pepsin, augmented the apneic response to CS, which was blocked by denervation or perineural capsaicin treatment (a procedure that blocks the conduction of C fibers) of the superior laryngeal nerves. This augmented apnea was partially attenuated by capsazepine [an transient receptor potential vanilloid 1 (TRPV1) antagonist], SB-366791 (a TRPV1 antagonist), and HC030031 [a transient receptor potential ankyrin 1 (TRPA1) antagonist] and was completely prevented by a combination of TRPV1 and TRPA1 antagonists. Local application of menthol significantly suppressed the augmented apnea and this effect was reversed by pretreatment with AMTB (a TRPM8 antagonist). Our electrophysiological studies consistently revealed that laryngeal pH 5-pepsin treatment increased the sensitivity of laryngeal C-fibers to CS. Likewise, menthol suppressed this laryngeal C-fiber hypersensitivity and its effect could be reversed by pretreatment with AMTB. Our results suggest that laryngeal pH 5-pepsin treatment increases sensitivity to CS of both TRPV1 and TRPA1, which are presumably located at the terminals of laryngeal C-fibers. This sensory sensitization leads to enhanced laryngeal reflex reactivity and augmentation of the laryngeal C-fiber responses to CS, which can be suppressed by menthol acting via TRPM8.

  13. A study of laryngeal gestures in Mandarin citation tones using simultaneous laryngoscopy and laryngeal ultrasound (SLLUS)

    OpenAIRE

    Moisik, S.; Lin, H.; Esling, J.

    2014-01-01

    In this work, Mandarin tone production is examined using simultaneous laryngoscopy and laryngeal ultrasound (SLLUS). Laryngoscopy is used to obtain information about laryngeal state, and laryngeal ultrasound is used to quantify changes in larynx height. With this methodology, several observations are made concerning the production of Mandarin tone in citation form. Two production strategies are attested for low tone production: (i) larynx lowering and (ii) larynx raising with laryngeal constr...

  14. Laryngeal resistance before and after minor surgery: endotracheal tube versus Laryngeal Mask Airway.

    Science.gov (United States)

    Tanaka, Atsuko; Isono, Shiroh; Ishikawa, Teruhiko; Sato, Jiro; Nishino, Takashi

    2003-08-01

    The placement of an endotracheal tube (ETT) may promote laryngeal swelling, which is an important cause of upper airway obstruction after extubation. The authors hypothesized that laryngeal swelling after ETT placement increases laryngeal resistance and tested that hypothesis by comparing postoperative laryngeal patency between patients with ETT placement and those with a Laryngeal Mask Airway trade mark (LMA). Fourteen adult patients who underwent elective minor surgeries were randomly allocated to two groups whose airway would be managed through ETTs (the ETT group) or LMAs (the LMA group) during the surgery. While maintaining at sevoflurane 1 minimum alveolar concentration, the authors measured laryngeal resistance before and after surgery, during both spontaneous breathing and mechanical ventilation under complete paralysis. In addition, they endoscopically measured the vocal cord angle under complete paralysis. In association with marked swelling of the vocal cords, the vocal cord angle significantly decreased after surgery in the ETT group, whereas the angle did not change in the LMA group. Laryngeal resistance during mechanical ventilation significantly increased only in the ETT group. Laryngeal resistance during spontaneous breathing significantly increased after surgeries in both groups. Postoperative laryngeal resistance increases at least in part because of laryngeal swelling in patients with ETT placement, whereas alteration of laryngeal neural control mechanisms has been also indicated. The use of the LMA trade mark has an advantage over ETT placement in order to avoid postoperative laryngeal swelling.

  15. Laryngeal lipoma: a rare cause of dysphonia.

    Science.gov (United States)

    Nada, Garrouche; Omezzine, Jerbi Saida; Maher, Dhifallah; Nouha, Ben Hamida; Hssine, Hamza

    2017-01-01

    Lipomas are the most common mesenchymal tumors. Laryngeal lipomas represent 1% of all lipomas but unlike other locations may cause life-threatening symptoms by obstruction of the respiratory tract. In this study, the case of a 32-year old woman with laryngeal lipoma is discussed. The lesion was detected on the left aryepiglottic fold, presented as a stalked and dynamic mass of 2 centimeters diameter. The imaging aspects of laryngeal lipoma cases, clinical evaluation, and approaches to treatment will be discussed.

  16. Laryngeal morbidity after tracheal intubation

    DEFF Research Database (Denmark)

    Sørensen, M K; Rasmussen, N; Kristensen, M S

    2013-01-01

    BACKGROUND: Tracheal intubation may cause vocal fold damage. The trial was designed to assess laryngeal morbidity comparing the Endoflex(®) tube with a conventional endotracheal tube with stylet. We hypothesised that laryngeal morbidity within the first 24 h after extubation would be lower...... with the Endoflex tube than with the conventional endotracheal tube with stylet because of less rigidity. METHODS: This randomised trial included 130 elective surgical patients scheduled for general anaesthesia with endotracheal intubation. Pre- and post-operative assessment of hoarseness, vocal fold pathology......, and voice analysis using the Multidimensional Voice Program was performed. Induction of anaesthesia was standardised. After complete neuromuscular paralysis, intubation was done with an Endoflex tube or a conventional endotracheal tube with stylet. RESULTS: Post-operative hoarseness was found in 45...

  17. Laryngeal histoplasmosis: an occupational hazard.

    Science.gov (United States)

    Teoh, Jian Woei; Hassan, Faridah; Mohamad Yunus, Mohd Razif

    2013-10-01

    Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.

  18. The epidemiology of laryngeal cancer in Brazil

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    Victor Wünsch

    Full Text Available The city of São Paulo exhibits one of the highest incidences of laryngeal cancer in world and Brazil presents remarkable occurrence, compared with other Latin American countries. Around 8,000 new cases and 3,000 deaths by laryngeal cancer occur annually in the Brazilian population. In the city of São Paulo, incidence rates for laryngeal cancer among males have been decreasing since the late 1980s while, among females, the rates have shown a stable trend. This phenomenon is probably the expression of changes in gender behavior related to tobacco smoking. Several risk factors are involved in the genesis of laryngeal cancer. The most important are tobacco smoking and alcohol intake, but occupational hazards have also been associated with the disease, such as asbestos, strong inorganic acids, cement dust and free crystalline silica. Additionally, salted meat and total fat intake have been linked to elevated risk of laryngeal cancer. Conversely, several studies have confirmed that fruits, raw leaf vegetables and legumes protect against this cancer. Some researchers have postulated a possible association between laryngeal squamous cell carcinoma and human papilloma virus (HPV, but this is not universally accepted. Gastroesophageal reflux disease is weakly, but consistently correlated with laryngeal cancer. Familial cancer clusters, particularly of head and neck tumors, seem to increase the risk of laryngeal cancer. Some genetic polymorphisms, such as of genes that code for xenobiotic-metabolizing enzymes, have shown elevated risk for laryngeal cancer according to recent studies. Public health policies regarding the control of tobacco smoking and alcohol consumption, and also surveillance of carcinogen exposure in occupational settings, could have an impact on laryngeal cancer. No proposals for screening have been recommended for laryngeal cancer, but one diagnostic goal should be to avoid treatment delay when suspected symptoms have been observed.

  19. Inflammation laryngeal changes in common cold children

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    E. P. Selkova

    2014-01-01

    Full Text Available This article is dedicated to the connection between laryngealinflammatory pathology and influenza/common cold.The purpose is to study the frequency of different form of laryngitis in children with common cold/ influenza, influenced of carried laryngitis within common cold on laryngeal structures and also the effectiveness of preventive measures against acute respiratory infections.Material and methods are the results of the examination (including laryngeal endoscopy and analysis of medical files of 3169 patients and also the data of the annual report of one Moscow semi-clinic.Results. Inflammation laryngeal pathology was revealed in 152 (4,79% cases, in 129 (84,9% – non-obstructive. 91 patient (59,8% belonged to category “frequently and often sick”. The recurrent episodes were seen in patients with both forms of laryngitis. Different laryngeal pathology (laryngitis, vocal nodules was seen after common cold treatment with 43,5% obstructive and 18,63% non-obstructive laryngitis patient as well as dysphonia in 3-14% getting worse with the following common cold episodes. The preventative measures carried among patients with laryngitis allowed to decrease spreading of this pathology notwithstanding the fact of annual growth of common cold in children.Conclusion. Thus taking to account the high circulation of respiratory viruses the absence of specific preventative measures and the especial role of viruses in development all forms of laryngitis it is recommended to include special drugs in preventative techniques of laryngitis prophylactics. Different methods of non-specific prophylactic are effective in decreasing the amount of common cold episodes, decrease the frequency and severity all forms of laryngitis in children and also tend to stabilize/normalize the voice quality in different laryngeal pathology children.

  20. [Laryngeal and larynx-associated reflexes].

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    Ptok, M; Kühn, D; Miller, S; Jungheim, M; Schroeter, S

    2016-06-01

    The laryngeal adductor reflex and the pharyngoglottal closure reflex protect the trachea and lower respiratory tract against the entrance of foreign material. The laryngeal expiration reflex and the cough reflex serve to propel foreign material, which has penetrated in the cranial direction. The inspiration reflex, the sniff reflex, and the swallowing reflex are further larynx-associated reflexes. In patients with dysphagia the laryngeal adductor reflex can be clinically tested with air pulses. The water swallow test serves to show the integrity of the cough reflex. The sniff reflex is useful to test the abduction function of the vocal folds. Future studies should address laryngeal reflexes more specifically, both for a better understanding of these life-supporting mechanisms and to improve diagnostic procedures in patients with impaired laryngeal function.

  1. Neurological complications in thyroid surgery: a surgical point of view on laryngeal nerves.

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    EMANUELA eVARALDO

    2014-07-01

    Full Text Available The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified,the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a

  2. Isolated laryngeal myasthenia gravis for 26 years.

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    Renard, Dimitri; Hedayat, Amir; Gagnard, Corinne

    2015-02-01

    Laryngeal myasthenia gravis is a relatively rare variant of myasthenia gravis. A vast portion of patients with initial laryngeal myasthenia gravis develop involvement of ocular and/or extra-ocular muscles during the years after symptom onset although a minority of laryngeal myasthenia gravis patients continues to have isolated laryngeal muscle involvement for several years. We present a 58-year-old woman with recurrent episodic isolated dysphonia (associated with diffuse bilateral vocal cord paresis on laryngoscopy) since the age of 32. Dysphonia became permanent since 6 months. A diagnosis of laryngeal myasthenia gravis was made based on abnormal single-fiber electromyography and spectacular response to pyridostigmine treatment. Repetitive nerve stimulation was normal and anti-acetylcholine receptor and anti-muscle specific tyrosine kinase antibodies were absent. This case shows that laryngeal myasthenia gravis can be isolated during 26 years of follow-up. We propose that even when myasthenia gravis seems unlikely as underlying mechanism of isolated dysphonia (because of lack of antibodies, normal repetitive nerve stimulation, and absence of extra-laryngeal involvement after years of follow-up), single-fiber electromyography should be performed and myasthenia gravis treatment should be tried.

  3. LARYNGEAL MALIGNANCY: A RETROSPECTIVE DESCRIPTIVE ANALYSIS

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    Vinod Kumar

    2016-06-01

    Full Text Available BACKGROUND Laryngeal cancer is the second most common head and neck cancer in India. The onset, rate of progression and duration of symptoms are variable for supraglottic, glottic and subglottic cancer. Smoking and alcohol are also most important risk factors for laryngeal cancer. Data regarding cases of laryngeal cancer in relation to age, sex, symptoms and signs, aetiological factors with special reference to smoking and alcohol, histopathological types, tumour staging, treatment and outcomes are important to assess changing trends in laryngeal cancer treatment. MATERIALS AND METHODS This study is about retrospective descriptive analysis of diagnosed and treated cases of laryngeal cancer in the Department of ENT from 2005 to 2008. Total fifty patients with laryngeal malignancy were seen from May 2005 to May 2008 with average 1 year of follow-up. Data regarding cases of laryngeal cancer in relation to age, sex, symptoms and signs, aetiological factors with special reference to smoking and alcohol, histopathological types, tumour staging, treatment and outcomes were analysed using SPSS software. All patients who were diagnosed to have laryngeal cancer and treated were included in the study. RESULTS In this descriptive analysis, 62% patients are between 51-70 years. Most of the patients had been symptomatic for 3-5 months; 58% patients presented with voice change followed by other complaints like throat pain, foreign body sensation, otalgia, breathing difficulty. Voice change was distinctly the most common symptom regardless of tumour site. It was more prevalent in glottis cases, but it was also the leading symptom in supraglottic tumours. Glottis tumours were more often found at an early stage and patients with a supraglottic tumour presented more often with neck node metastasis. CONCLUSION Laryngeal malignancy is one of the head and neck malignancies, which are more common in males. Tobacco is an important risk factor in causation of the

  4. Effects of dopamine D1 and D2 receptor antagonists on laryngeal neurophysiology in the rat.

    Science.gov (United States)

    Feng, Xin; Henriquez, Victor M; Walters, Judith R; Ludlow, Christy L

    2009-08-01

    Hypophonia is an early symptom in Parkinson's disease (PD) that involves an increase in laryngeal muscle activity, interfering with voice production. Our aim was to use an animal model to better understand the role of different dopamine receptor subtypes in the control of laryngeal neurophysiology. First, we evaluated the combined effects of SCH23390-a D(1) receptor antagonist with a D(2) receptor antagonist (eticlopride) on laryngeal neurophysiology, and then tested the separate effects of selective receptor antagonists. Thyroarytenoid (TA) and gastrocnemius (GN) muscle activity was measured at rest and while stimulating the internal branch of superior laryngeal nerve to elicit the laryngeal adductor response (LAR) in alpha-chloralose-anesthetized rats. Paired stimuli at different interstimulus intervals between 250 and 5,000 ms measured central conditioning of the LAR. Changes in resting muscle activity, response latency, amplitude, and LAR conditioning after each drug were compared with the saline control. SCH23390 alone increased the resting TA muscle activity (P < 0.05). With the combined SCH23390 + eticlopride or SCH23390 alone, response latency decreased (P < 0.01), amplitude increased (P < 0.01), and the test LAR was reduced at 2,000-ms ISI (P < 0.01). No LAR changes occurred when eticlopride was administered alone at a low dose and only a tendency to suppress responses was found at a high dose. No changes in GN muscle activity occurred in any of the groups. The results suggest that a loss of stimulation of D(1) receptors plays a significant role in laryngeal pathophysiology in PD.

  5. The application of anesthesia feasibility of superior laryngeal nerve block compound dexmedetomidine for the cleft lip in pediatric patients%喉上神经阻滞联合右美托咪定在婴儿唇腭裂手术中的应用

    Institute of Scientific and Technical Information of China (English)

    丛仔红

    2016-01-01

    Objective To investigate the anesthesia feasibility of superior laryngeal nerve block (SLNB) compound dexmedetomidine(DEX)for the cleft lip in pediatric patients .Methods Our hospital were identified as the cleft lip and palate operations for the children in the welfare .We will choose the volunteer with the examina‐tions results being satisfied 97 cases of children (of 39 cases of men ,women accounted for 58 cases) were random‐ly assigned to two groups (age 3 months to 1 year old;5‐12 kg weight) .Ninty‐seven pediatric patients with ASAⅠ‐Ⅱcleft lip were randomly selected into two groups :A group for SLNB compound DEX general anesthesia and B group for general anesthesia using muscle relaxant intubation .All the infants were forbidden to eat and drink as the operation routine .In order to decrease the effects of atropine on HR (heart rate) ,the infants were treated with the few atropine before the surgery .These two groups of infants by the anesthesia nurse pushed into the op‐erating room ,MAP (mean artery pressure) ,HR and SpO2 were observed .The monitoring indexes changes of in‐fants in two groups were investigated and compared at the time of before induction (T1 ) ,induction 5 min (T2 ) , induction 10 min (T3 ) ,induction 30 min (T4 ) ,after surgery 5 min (T5 ) during operation .The time of awareness disappearance ,recovery time of spontaneous breathing and the extrication time were recorded .The postoperative respiratory secretions ,restlessness ,nausea and vomiting were observed .Results There was no significant differ‐ent between groups in HR and MAP in the two groups ( P>0 .05) .The removal ,waking times and muscle re‐laxant in group A were significant shorter than that of group B ( P <0 .05) .The postoperative complications in group A was lower than that of group B ( P < 0 .05) .The symptoms of agitated in A group was few than B group .Conclusion The anesthesia effects of SLNB compound general anesthesia is safe and reasonable and has

  6. Comparison of classic laryngeal mask airway with Ambu laryngeal mask for tracheal tube exchange: A prospective randomized controlled study

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    Shruti Jain

    2013-01-01

    Full Text Available Background and Aim: Exchanging endotracheal tube (ETT with classic laryngeal mask airway TM (CLMA TM prior to emergence from anaesthesia is a safe technique to prevent the coughing and haemodynamic changes during extubation. We had compared CLMA TM and AMBU laryngeal mask TM (ALM TM during ETT/laryngeal mask (LM for haemodynamic changes and other parameters. Methods: A total of 100 American Society of Anesthesiologist Grade I and II adult female patients undergoing elective laparoscopic cholecystectomy under general anaesthesia were selected and randomly divided into two groups of 50 patients each. In Group I, CLMA TM and in Group II, ALM TM was placed prior to tracheal extubation. Haemodynamic parameters were recorded during ETT/LM exchange. Glottic view was seen through the LM using flexible fibrescope. Coughing/bucking during removal of LM, ease of placement and post-operative sore throat for both groups were graded and recorded. Statistical Analysis: Data within the groups was analysed using paired t-test while between the groups was analysed using unpaired t-test. Chi-square test was used to analyse grades of glottic view, coughing, and post-operative sore throat. Results: In Group I, there was a significant rise in systolic blood pressure and heart rate in contrast to insignificant rise in Group II. Glottis view was significantly better in Group II. Incidence of coughing, ease of placement and post-operative sore throat was identical between both groups. Conclusion: ALM TM is superior to CLMA TM for exchange of ETT before extubation due to greater haemodynamic stability during exchange phase and is better positioned.

  7. [Severe laryngitis associated to gastroesophageal reflux].

    Science.gov (United States)

    Botto, Hugo; Antonioli, Cintia; Nieto, Mary; Cocciaglia, Alejandro; Cuestas, Giselle; Roques Revol, Magdalena; López Marti, Jessica; Rodríguez, Hugo

    2014-02-01

    There is a strong association between gastroesophageal reflux and pharyngolaryngeal reflux as factors leading to respiratory disease, manifested as dysphonia, wheezing, coughing, recurrent laryngitis, bronchial obstruction, laryngospasm and apparent life-threatening events (ALTEs). These manifestations can be mild or severe and may sometimes put the patient's life at risk. We present two cases of patients with severe laryngitis who required endotracheal intubation, one of which underwent tracheostomy. The diagnostic methods and their limitations and the patients outcomes are described.

  8. [A rare case of laryngeal leiomyoma].

    Science.gov (United States)

    Burzej-Uchto, Małgorzata; Nowak-Makieła, Zuzanna; Lapińska-Skowron, Kalina; Kosowski, Bogdan

    2006-01-01

    To report a rare case of laryngeal leiomioma. Tumors of smooth muscle origin are rare in the upper aerodigestive tract, due to the paucity of smooth muscle in the area. A review of the literature confirm that this kind of neoplasm is extremely rare in the larynx and not so many cases were described in the literature so far. We described classification, treatment and clinical course of laryngeal leiomioma. We encountered such a tumor in a 68-year-old men who was admitted to our Hospital. Hoarseness since 2 years was a main symptom. The tumor was removed endoscopically and was located under left vocal cord. The patient recovered well but after 6 months was admitted again to our Hospital due to recurrence of ailments. Tracheotomy and enlarged chordectomy on the left side of larynx was performed under general anesthesia. The tumor was encapsulated and could be completely resected. No complications were observed in the postoperative course and patient was discharged from the hospital in 5th day after operation. There was no evidence of loco regional recurrence 4 years post surgery and laryngeal function was preserved. All histological pictures of the specimens from the first and second operation indicated tumor as a laryngeal leiomioma. Laryngeal leiomioma is a very infrequent neoplasm and to our knowledge, this is the 38th case of laryngeal smooth muscle tumor to be reported in the world literature.

  9. DNA ploidy of primary and recurrent irradiated laryngeal tumors

    NARCIS (Netherlands)

    Struikmans, H; Hordijk, GJ; Kal, HB

    2002-01-01

    Purpose: Radiosensitivity of diploid laryngeal cancers, as compared with that of aneuploid ones, appears to be increased. However, no conclusive data exist. If a causal relationship exists, then recurrent laryngeal cancer after irradiation should predominantly be characterized by aneuploidy. Patient

  10. Viscoelastic properties of laryngeal posturing muscles

    Science.gov (United States)

    Alipour, Fariborz; Hunter, Eric; Titze, Ingo

    2003-10-01

    Viscoelastic properties of canine laryngeal muscles were measured in a series of in vitro experiments. Laryngeal posturing that controls vocal fold length and adduction/abduction is an essential component of the voice production. The dynamics of posturing depends on the viscoelastic and physiological properties of the laryngeal muscles. The time-dependent and nonlinear behaviors of these tissues are also crucial in the voice production and pitch control theories. The lack of information on some of these muscles such as posterior cricoarytenoid muscle (PCA), lateral cricoarytenoid muscle (LCA), and intraarytenoid muscle (IA) was the major incentive for this study. Samples of PCA and LCA muscles were made from canine larynges and mounted on a dual-servo system (Ergometer) as described in our previous works. Two sets of experiments were conducted on each muscle, a 1-Hz stretch and release experiment that provides stress-strain data and a stress relaxation test. Data from these muscles were fitted to viscoelastic models and Young's modulus and viscoelastic constants are obtained for each muscle. Preliminary data indicates that elastics properties of these muscles are similar to those of thyroarytenoid and cricothyroid muscles. The relaxation response of these muscles also shows some similarity to other laryngeal muscles in terms of time constants.

  11. Blunt laryngeal trauma secondary to sporting injuries.

    Science.gov (United States)

    Mendis, D; Anderson, J A

    2017-08-01

    Laryngeal injury after blunt trauma is uncommon, but can cause catastrophic airway obstruction and significant morbidity in voice and airway function. This paper aims to discuss a case series of sports-related blunt laryngeal trauma patients and describe the results of a thorough literature review. Retrospective case-based analysis of laryngeal trauma referrals over six years to a tertiary laryngology centre. Twenty-eight patients were identified; 13 (46 per cent) sustained sports-related trauma. Most were young males, presenting with dysphonia, some with airway compromise (62 per cent). Nine patients were diagnosed with a laryngeal fracture. Four patients were managed conservatively and nine underwent surgery. Post-treatment, the majority of patients achieved good voice outcomes (83 per cent) and all had normal airway function. Sports-related neck trauma can cause significant injury to the laryngeal framework and endolaryngeal soft tissues, and most cases require surgical intervention. Clinical presentation may be subtle; a systematic approach along with a high index of suspicion is essential, as early diagnosis and treatment have been reported to improve airway and voice outcome.

  12. Tumor Volumes and Prognosis in Laryngeal Cancer

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    Mohamad R. Issa

    2015-11-01

    Full Text Available Tumor staging systems for laryngeal cancer (LC have been developed to assist in estimating prognosis after treatment and comparing treatment results across institutions. While the laryngeal TNM system has been shown to have prognostic information, varying cure rates in the literature have suggested concern about the accuracy and effectiveness of the T-classification in particular. To test the hypothesis that tumor volumes are more useful than T classification, we conducted a retrospective review of 78 patients with laryngeal cancer treated with radiation therapy at our institution. Using multivariable analysis, we demonstrate the significant prognostic value of anatomic volumes in patients with previously untreated laryngeal cancer. In this cohort, primary tumor volume (GTVP, composite nodal volumes (GTVN and composite total volume (GTVP + GTVN = GTVC had prognostic value in both univariate and multivariate cox model analysis. Interestingly, when anatomic volumes were measured from CT scans after a single cycle of induction chemotherapy, all significant prognosticating value for measured anatomic volumes was lost. Given the literature findings and the results of this study, the authors advocate the use of tumor anatomic volumes calculated from pretreatment scans to supplement the TNM staging system in subjects with untreated laryngeal cancer. The study found that tumor volume assessment after induction chemotherapy is not of prognostic significance.

  13. Tumor Volumes and Prognosis in Laryngeal Cancer

    Science.gov (United States)

    Issa, Mohamad R.; Samuels, Stuart E.; Bellile, Emily; Shalabi, Firas L.; Eisbruch, Avraham; Wolf, Gregory

    2015-01-01

    Tumor staging systems for laryngeal cancer (LC) have been developed to assist in estimating prognosis after treatment and comparing treatment results across institutions. While the laryngeal TNM system has been shown to have prognostic information, varying cure rates in the literature have suggested concern about the accuracy and effectiveness of the T-classification in particular. To test the hypothesis that tumor volumes are more useful than T classification, we conducted a retrospective review of 78 patients with laryngeal cancer treated with radiation therapy at our institution. Using multivariable analysis, we demonstrate the significant prognostic value of anatomic volumes in patients with previously untreated laryngeal cancer. In this cohort, primary tumor volume (GTVP), composite nodal volumes (GTVN) and composite total volume (GTVP + GTVN = GTVC) had prognostic value in both univariate and multivariate cox model analysis. Interestingly, when anatomic volumes were measured from CT scans after a single cycle of induction chemotherapy, all significant prognosticating value for measured anatomic volumes was lost. Given the literature findings and the results of this study, the authors advocate the use of tumor anatomic volumes calculated from pretreatment scans to supplement the TNM staging system in subjects with untreated laryngeal cancer. The study found that tumor volume assessment after induction chemotherapy is not of prognostic significance. PMID:26569309

  14. Comparison of Medical and Voice Therapy for reflux Laryngitis Based on Acoustic and Laryngeal Characteristics

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    Abbas Dehestani Ardakani

    2011-12-01

    Full Text Available Background and Aim: Reflux laryngitis is extremely common among patients with voice disorder. Medical therapy approaches are not efficient enough. The main goal of this study is to assess the acoustic and laryngeal characteristics of patients with dysphonia before and after medical or voice therapy, and to evaluate the effectiveness of each.Methods: In this retrospective study, 16 reflux laryngitis patients were assessed. Five received complete voice therapy, tow ceased voice therapy and nine received medication. Perceptual voice evaluation was performed by a speech-language pathologist, the severity of voice problem was calculated, based on the affected acoustic and laryngeal characteristics pre- and post-treatment.Results: Post-treatment evaluation in patients who received complete voice therapy indicates 80 percent improvement in the severity of disorder and 100 percent improvement in the perceptual voice evaluation. After medical therapy, we observed that voice disorder and perceptual voice evaluation are improved 44 and 66 percent respectively. The improvement was statistically significant in both treatment approaches: complete voice therapy (P=0.039 and medical therapy (p=0.017.Conclusion: In patients with reflux laryngitis, most acoustic and laryngeal characteristics were normal and satisfying after the treatment. It can be concluded that the proficiency of voice therapy in improving the acoustic and laryngeal characteristics is comparable to medical therapy

  15. Laryngeal electromyography in movement disorders: preliminary data

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    Kimaid Paulo A.T.

    2004-01-01

    Full Text Available This study describes preliminary laryngeal electromyography (LEMG data and botulinum toxin treatment in patients with dysphonia due to movement disorders. Twenty-five patients who had been clinically selected for botulinum toxin administration were examined, 19 with suspected laryngeal dystonia or spasmodic dysphonia (SD, 5 with vocal tremor, and 1 with Gilles de la Tourette syndrome (GTS. LEMG evaluations were performed before botulinum toxin administration using monopolar electrodes. Electromyography was consistent with dystonia in 14 patients and normal in 5, and differences in frequency suggesting essential tremor in 3 and Parkinson tremors in 2. The different LEMG patterns and significant improvement in our patients from botulinum toxin therapy has led us to perform laryngeal electromyography as a routine in UNICAMP movement disorders ambulatory.

  16. Methicillin-resistant Staphylococcus aureus laryngitis.

    Science.gov (United States)

    Liakos, Tracey; Kaye, Keith; Rubin, Adam D

    2010-09-01

    Infections due to methicillin-resistant Staphylococcus aureus (MRSA) have become more prevalent, in part because of the emergence and spread of community-acquired MRSA. This trend is particularly concerning because of the significant rates of morbidity and mortality associated with MRSA infections, and because MRSA strains are often resistant to many classes of antibiotics. Reports of infections of the head and neck, including wound infections, cellulitis, sinusitis, otitis media, and otitis externa, are well documented. However, to our knowledge, there have been no reports of bacterial laryngitis due to MRSA. We report the first published case of bacterial laryngitis caused by MRSA.

  17. Bronchial or Laryngeal Obstruction Induced by Exercise?

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    Ayoub Bey

    2017-06-01

    Full Text Available A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

  18. Bronchial or Laryngeal Obstruction Induced by Exercise?

    Science.gov (United States)

    Bey, Ayoub; Botti, Sophie; Coutier-Marie, Laurianne; Bonabel, Claude; Metche, Stéphanie; Demoulin-Alexikova, Silvia; Schweitzer, Cyril Etienne; Marchal, François; Coffinet, Laurent; Ioan, Iulia

    2017-01-01

    A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs) after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

  19. [Diagnosis and therapy of laryngitis gastrica].

    Science.gov (United States)

    Pahn, J; Schlottmann, A; Witt, G; Wilke, W

    2000-07-01

    We treated 64 patients with the diagnosis of laryngitis gastrica with Antra (Omeprazol) in doses of 10, 20, and 40 mg. To determine the success of the therapy, pH monitoring of the esophagus and hypopharynx, the voice status and measurement of vocal penetrating capacity were used. The results prove that a 20-mg dose of Antra is suitable for the therapy of laryngitis gastrica with a high rate of success. Problems which arose during the investigation, consequent changes of the original concept of the project as well as new aspects and questions which resulted from this are discussed with respect to further investigation.

  20. PREVALENCE OF LARYNGEAL CARTILAGE CALCIFICATIONS IN MANGALORE POPULATION; A RADIOGRAPHIC STUDY

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    Nandita Shenoy

    2014-10-01

    Full Text Available Soft tissue calcifications in the orofacial region are uncommon and are usually asymptomatic in nature. Some of the common calcifications found are Carotid artery calcifications (CAC, Triticeous cartilage, and Superior cornu of the thyroid cartilage, Tonsilloliths and lymph nodes calcifications. Disordered ossification or calcification of ligaments or cartilages may compress neurovascular structures, may be able to cause serious implications in any surgical intervention in the region, may lead to false neurological differential diagnosis or may be benign in nature without any clinical significance. Ossification and calcification of the laryngeal cartilages have been widely investigated since the original study by Chievitz in 1882 1 . The thyroid, cricoid, and greater part of the arytenoid cartilages consist of hyaline cartilage that undergoes calcification and ossification as part of the ageing process. The thyroid cartilage tends to be visible on the cephalometric and lateral neck radiograph when the ossification starts within the lamina or either of the cornua. The cricoids and arytenoid cartilages also become apparent when the ossification begins within their laminae. Radiographs of the head and neck are used to study the growth and development of skeletal structures can be used for identification of these calcifications 2 . A good understanding of the anatomy and the knowledge of variations in the laryngeal cartilage ossification is important for all clinicians especially while interpreting head and neck radiographs of patients who exhibit anatomical or functional deviations from the normal. The lateral cephalometric radiographs are advised more commonly by an orthodontist to look for occlusion and lateral profile of the patient pre and post orthodontic treatment. They also demonstrate the posterosuperior part of the lamina, and the superior cornu of the thyroid cartilage. Laryngeal and related cartilages like the cricoid and triticeal

  1. HUMAN PAPILLOMAVIRUS INFECTIONS IN LARYNGEAL CANCER

    NARCIS (Netherlands)

    Torrente, Mariela C.; Rodrigo, Juan P.; Haigentz, Missak; Dikkers, Frederik G.; Rinaldo, Alessandra; Takes, Robert P.; Olofsson, Jan; Ferlito, Alfio

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we revie

  2. Fibrous histiocytoma of the laryngeal glottis

    Institute of Scientific and Technical Information of China (English)

    GE Pingjiang; ZHANG Baoquan; GAO Zhiqiang; Wang Hui; CUI Quancai

    2005-01-01

    A case of a fibrous histiocytoma (FH) of the larynx in a 54-year-old male is reported. Laryngeal fibrous histiocytoma is uncommon. The case recurred several times over 4-year period. Its pathology is described including arguments on potential malignancy and the way of management.

  3. The laryngeal mask airway at altitude.

    Science.gov (United States)

    Wilson, Grant D; Sittig, Steven E; Schears, Gregory J

    2008-02-01

    The Laryngeal Mask Airway (LMA) is an accepted adjunct for airway management in emergency patients. There are a number of case reports describing its use in transport medicine for infant to adult patients, including during flight. Although studies of the effect altitude has on air-filled tracheal tubes exists, we were unable to find documentation of the effect of altitude on laryngeal mask airways. Our objective was to assess the effect of altitude on the LMA in both fixed wing and rotary wing models. We performed an in vitro study of the effect of altitude on the LMA cuff. Infant and adult airway trainer mannequins with properly sized and inserted LMA-Classic laryngeal mask airways were monitored for cuff pressure changes while flown at altitudes commonly encountered during air medical transport. Both models demonstrated that LMA cuff pressures may exceed manufacturer recommended levels for safe use even at the relatively low altitudes experienced during rotor wing flight. Properly inserted and inflated laryngeal mask airways at ground level may result in overinflated LMA cuffs when flown to altitudes commonly used for rotor and fixed wing medical transport unless monitored and corrected.

  4. [Multispiral computed tomographic semiotics of laryngeal cancer].

    Science.gov (United States)

    Vasil'ev, P V; Iudin, A L; Sdvizhkov, A M; Kozhanov, L G

    2007-01-01

    Multispiral computed tomography (MSCT) with intravenous bolus contrasting is a currently available method for radiodiagnosis of laryngeal cancer. MSCT is of much higher informative value in estimating the extent of a tumorous lesion than the traditional radiodiagnostic techniques: linear tomography, lateral X-ray study, roentgenoscopy and roentgenography of the laryngopharynx and esophagus with barium meal.

  5. Laryngeal sarkoidose hos 13-årig

    DEFF Research Database (Denmark)

    Herlow, Louise Buchreitz; Rasmussen, Niels

    2010-01-01

    Sarcoidosis is a chronic granulomatous disease of unknown pathogenesis. It can affect numerous organs but most commonly involves the respiratory tract. On rare occasions it only involves the larynx. We describe a case of isolated laryngeal sarcoidosis in a teenage girl with symptoms of hoarseness...

  6. Atraumatic laser treatment for laryngeal papillomatosis

    Science.gov (United States)

    McMillan, Kathleen; Pankratov, Michail M.; Wang, Zhi; Bottrill, Ian; Rebeiz, Elie E.; Shapshay, Stanley M.

    1994-09-01

    Ten to fifteen thousand new cases of recurrent respiratory papillomatosis (RRP) are diagnosed each year in the United States. RRP is caused by the human papillomavirus (HPV) and is characterized by recurrent, non-malignant, proliferative lesions of the larynx. Patients with RRP undergo numerous microsurgical procedures to remove laryngeal papilloma threatening airway patency and interfering with phonation. The standard surgical technique involves CO2 laser vaporization of laryngeal epithelium affected by the lesions, and requires general anesthesia. The pulsed dye laser operating at 585 nm has previously been demonstrated to be effective in clearing HPV lesions of the skin (verrucae). For treatment of RRP, the fiber- compatible pulsed dye laser radiation may be delivered under local anesthesia using a flexible intranasal laryngoscope. Potential advantages of the pulsed dye laser treatment over CO2 laser surgery include (1) reduced morbidity, especially a lower risk of laryngeal scarring; (2) lower cost; (3) reduced technical difficulty; and (4) reduced risk of viral dissemination or transmission. In vivo studies are underway to determine the effect of pulsed dye laser radiation on normal canine laryngeal tissue.

  7. Dysphagia Caused by Chronic Laryngeal Edema.

    Science.gov (United States)

    Delides, Alexander; Sakagiannis, George; Maragoudakis, Pavlos; Gouloumi, Αlina-Roxani; Katsimbri, Pelagia; Giotakis, Ioannis; Panayiotides, John G

    2015-10-01

    A rare case of a young female with chronic diffuse laryngeal edema causing severe swallowing difficulty is presented. The patient was previously treated with antibiotics and steroids with no improvement. Diagnosis was made with biopsy of the epiglottis under local anesthesia in the office.

  8. HUMAN PAPILLOMAVIRUS INFECTIONS IN LARYNGEAL CANCER

    NARCIS (Netherlands)

    Torrente, Mariela C.; Rodrigo, Juan P.; Haigentz, Missak; Dikkers, Frederik G.; Rinaldo, Alessandra; Takes, Robert P.; Olofsson, Jan; Ferlito, Alfio

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we revie

  9. Human papillomavirus infections in laryngeal cancer

    NARCIS (Netherlands)

    Torrente, M.C.; Rodrigo, J.P.; Haigentz Jr., M.; Dikkers, F.G.; Rinaldo, A.; Takes, R.P.; Olofsson, J.; Ferlito, A.

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we revie

  10. Laser Endoscopic Microsurgery of Laryngeal Cancers

    Directory of Open Access Journals (Sweden)

    Moustapha, Sereme

    2014-01-01

    Full Text Available Introduction The aim of our study is to present our experience in treating laryngeal cancers with endoscopic CO2 laser surgery. Materials and Methods This retrospective study was conducted from January 2008 to December 2012 at Antoine Lacassagne Center of Nice. The functional and oncologic results of this surgical technique were analyzed and discussed. Results The average length of hospital stay was 2.5 days. Phonatory results were considered excellent in 75% of our patients who maintained satisfactory phone communication skills after their interventions. Chronic hoarseness was the most common reason for bilateral or extended cordectomies. On the oncologic basis, histologic exam showed 90% of our margins were normal. The clinical control showed excellent laryngeal preservation in 94.23%. In 5 years, the overall survival was estimated at 96.15%. Conclusion This study shows the benefit of the laser endoscopic microsurgery for the preservation of laryngeal functions and the local histologic control, essentially for early stage laryngeal cancers.

  11. Human papillomavirus infections in laryngeal cancer

    NARCIS (Netherlands)

    Torrente, M.C.; Rodrigo, J.P.; Haigentz Jr., M.; Dikkers, F.G.; Rinaldo, A.; Takes, R.P.; Olofsson, J.; Ferlito, A.

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we

  12. HUMAN PAPILLOMAVIRUS INFECTIONS IN LARYNGEAL CANCER

    NARCIS (Netherlands)

    Torrente, Mariela C.; Rodrigo, Juan P.; Haigentz, Missak; Dikkers, Frederik G.; Rinaldo, Alessandra; Takes, Robert P.; Olofsson, Jan; Ferlito, Alfio

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we

  13. Postextubation laryngeal edema and stridor resulting in respiratory failure in critically ill adult patients : updated review

    NARCIS (Netherlands)

    Pluijms, Wouter A; van Mook, Walther Nka; Wittekamp, Bastiaan Hj; Bergmans, Dennis Cjj

    2015-01-01

    Endotracheal intubation is frequently complicated by laryngeal edema, which may present as postextubation stridor or respiratory difficulty or both. Ultimately, postextubation laryngeal edema may result in respiratory failure with subsequent reintubation. Risk factors for postextubation laryngeal ed

  14. Influences of laryngeal afferent inputs on intralaryngeal muscle activity during vocalization in the cat.

    Science.gov (United States)

    Shiba, K; Yoshida, K; Nakajima, Y; Konno, A

    1997-01-01

    The present study was undertaken to elucidate the possible role of the laryngeal afferent inputs in the regulation of intralaryngeal muscle activity during vocalization. We studied the influences of airflow and/or pressure applied to the larynx on intralaryngeal muscle activity during vocalization in ketamine-anesthetized cats. Vocalization was induced by airflow applied to the upper airway, which was isolated from the lower airway, during pontine call site stimulation. When the upper airway was open to the atmosphere through the nostrils and mouth, the airflow increased not only the vocal fold adductor and tensor activities but also the duration of these activities. The adductor and tensor activities were increased suddenly at a critical subglottic pressure level equivalent to the subglottic pressure threshold for vocalization. These effects were significantly reduced by sectioning of the internal branch of the superior laryngeal nerve or by lidocaine application to the laryngeal mucosa. Sustained pressure applied to the isolated upper airway, when the mouth and nostrils were occluded, did not affect adductor or tensor activities. These results indicate that the afferent inputs evoked by vocal fold stretching or vibration play an important role in the motor control of intralaryngeal and respiratory muscles during vocalization.

  15. Efficacy of oxygen-driven atomizing inhalation of budesonide in the treatment of acute laryngitis

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang

    2016-01-01

    Objective:To explore the clinical efficacy of oxygen-driven atomizing inhalation of budesonide in the treatment of acute laryngitis.Methods:Based on the routine treatment, the patients in the observation group were given oxygen-driven atomizing inhalation of budesonide, while the patients in the control group were given oxygen-driven atomizing inhalation of dexamethasone. The change of SpO2 before treatment and 30 min after treatment, the changes of serum IL-4 and IL-8 before treatment and 3 d after treatment, the clinical symptom disappearing time, hospitalization time, and clinical therapeutic effect after drug administration in the two groups were observed.Results: The improved degree of SpO2 30 min after treatment in the observation group was significantly superior to that in the control group. The decreased degree of IL-4 and IL-8 levels 3 d after treatment in the observation group was significantly superior to that in the control group. The clinical symptom disappearing time and hospitalization time in the observation group were significantly shorter than those in the control group. The total effective rate in the observation group (94.3%) was significantly superior to that in the control group (74.3%).Conclusions:Oxygen-driven atomizing inhalation of budesonide in the treatment of acute laryngitis can rapidly alleviate the local inflammatory reaction, improve the clinical symptoms, and enhance the safety of drug administration; therefore, it deserves to be widely recommended in the clinic.

  16. [The clinical application of data mining in laryngeal cancer].

    Science.gov (United States)

    Xu, Wen; Zhang, Rui; Qimin, E; Liu, Jialin; Laing, Chuanyu

    2015-07-01

    To provide a basis for the prediction and early diagnosis of laryngeal cancer through data mining and analysis. We constructed a laryngeal cancer data warehouse on Caché and combined IBM Cognos for on-line analytical processing. After building research data set, software Weka was used for feature selection and data mining. Data warehouse of laryngeal cancer was structured and Laryngeal cancer data were multidimensional presented. It is possible to find the high relevant and potential characteristics associated with laryngeal cancer by integration and 2-phase feature subset of data mining to extract the larynx. Application of data mining technology could help clinicians to find potential clinical knowledge and make early diagnosis of laryngeal cancer.

  17. A metrical study of the laryngeal skeleton in adult Nigerians.

    Science.gov (United States)

    Ajmani, M L

    1990-08-01

    Laryngeal cartilages were studied in 40 dissection room specimens of adult age groups ranging from 17 to 50 years in both the sexes. Various dimensions of the laryngeal skeleton were measured and statistical analysis of the data for male and female were evaluated separately. Conspicuous and highly significant differences of the dimensions between male and female laryngeal cartilages were observed. The incidence of the cuneiform cartilage and cartilago triticea was greater in the female than in the male.

  18. Laryngeal Reinnervation for Paralytic Dysphonia in Children Younger Than 10 Years

    National Research Council Canada - National Science Library

    Smith, Marshall E; Roy, Nelson; Houtz, Dan

    2012-01-01

    OBJECTIVE To study the effectiveness of ansa–recurrent laryngeal nerve laryngeal reinnervation to improve glottal incompetence causing dysphonia and dysphagia for children with unilateral vocal fold paralysis...

  19. Análise quantitativa das fibras mielínicas dos nervos laríngeos em humanos de acordo com a idade Quantitative analysis of myelinic fibers in human laryngeal nerves according to age

    Directory of Open Access Journals (Sweden)

    Romualdo Suzano Louzeiro Tiago

    2008-02-01

    Full Text Available INTRODUÇÃO E OBJETIVO: Realizar análise morfométrica das fibras mielínicas dos nervos laríngeos com a finalidade de verificar modificações quantitativas decorrentes do processo de envelhecimento. FORMA DE ESTUDO: Clínico e experimental. Material e Método: Foi coletado fragmento de 1cm dos nervos laríngeos superiores e nervos laríngeos recorrentes de 12 cadáveres do sexo masculino. A amostra foi dividida em dois grupos: idade inferior a 60 anos (Adulto e idade igual ou superior a 60 anos (Idoso. O material foi avaliado em microscópio de luz acoplado a sistema analisador de imagem. RESULTADOS: O número total de fibras mielínicas do nervo laríngeo superior foi semelhante nos dois grupos etários, mas com tendência para o maior número de fibras de 1µm no grupo adulto (p=0,0744. O grupo adulto apresentou maior número total de fibras mielínicas no nervo laríngeo recorrente (p=0,0006, e esta diferença ocorreu nas fibras com diâmetros de 1-3µm (pINTRODUCTION AND AIM: To carry out a morphometric analysis of myelinic fibers in laryngeal nerves aiming to identify quantitative changes as a result of aging. Study design: Clinical and experimental. MATERIAL AND METHOD: A 1cm fragment was collected from the superior laryngeal nerves and recurrent laryngeal nerves taken from twelve male cadavers. The sample was divided into two groups: those aged below 60 years (Adult and those aged 60 years or more (Elderly. The material was evaluated under light microscopy coupled with an image analysis system. RESULTS: The total number of myelinic fibers from the superior laryngeal nerve was similar in both age groups; there was, however, a trend for a higher number of 1μm fibers in the adult group (p=0.0744. The adult group had a higher total number of myelinic fibers in the recurrent laryngeal nerve (p=0.0006, and this difference was seen in fibers with diameters betwee 1-3μm (p<0.007. The adult group had a higher total number of myelinic fibers

  20. Laryngeal biomechanics of the singing voice.

    Science.gov (United States)

    Koufman, J A; Radomski, T A; Joharji, G M; Russell, G B; Pillsbury, D C

    1996-12-01

    By transnasal fiberoptic laryngoscopy, patients with functional voice often demonstrate abnormal laryngeal biomechanics, commonly supraglottic contraction. Appropriately, such conditions are sometimes termed muscle tension dysphonias. Singers working at the limits of their voice may also transiently demonstrate comparable tension patterns. However, the biomechanics of normal singing, particularly for different singing styles, have not been previously well characterized. We used transnasal fiberoptic laryngoscopy to study 100 healthy singers to assess patterns of laryngeal tension during normal singing and to determine whether factors such as sex, occupation, and style of singing influence laryngeal muscle tension. Thirty-nine male and 61 female singers were studied; 48 were professional singers, and 52 were amateurs. Examinations of study subjects performing standardized and nonstandardized singing tasks were recorded on a laser disk and subsequently analyzed in a frame-by-frame fashion by a blinded otolaryngologist. Each vocal task was graded for muscle tension by previously established criteria, and objective muscle tension scores were computed. The muscle tension score was expressed as a percentage of frames for each task with one of the laryngeal muscle tension patterns shown. The lowest muscle tension scores were seen in female professional singers, and the highest muscle tension scores were seen in amateur female singers. Male singers (professional and amateur) had intermediate muscle tension scores. Classical singers had lower muscle tension scores than nonclassical singers, with the lowest muscle tension scores being seen in those singing choral music (41%), art song (47%), and opera (57%), and the highest being seen in those singing jazz/pop (65%), musical theater (74%), bluegrass/country and western (86%), and rock/gospel (94%). Analyzed also were the influences of vocal nodules, prior vocal training, number of performance and practice hours per week

  1. Oral blastomycosis, laryngeal papillomatosis and esophageal tuberculosis

    OpenAIRE

    Montoya, Manuel; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. Médico infectólogo.; Chumbiraico, Robert; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. médico internista.; Ricalde, Melvin; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. médico neumólogo.; Cazorla, Ernesto; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. médico gastroenterólogo.; Hernández-Córdova, Gustavo; Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. Estudiante de medicina.

    2014-01-01

    Esophageal involvement is an extremely rare complication of tuberculosis even in countries with high prevalence of infection. We report the case of a 57 year-old hiv-seronegative patient with simultaneous diagnoses of oral blastomycosis and laryngeal papillomatosis. Both were confirmed by anatomopathological analysis. The esophageal biopsy revealed granulomatous esophagitis with necrosis and ziehl–neelsen stain showed acid-fast alcohol resistant bacilli suggestive of tuberculosis. The pat...

  2. EPIDEMIOLOGICAL FEATURES OF LARYNGEAL CANCER IN SLOVENIA

    Directory of Open Access Journals (Sweden)

    Vera Pompe-Kirn

    2002-12-01

    Full Text Available Background. In Slovenia laryngeal cancer incidence increased in men in the 50s, 60s and 70s and was rather stable afterwards, while in women the increase was more evident in the 80s and 90s. In order to better understand the trends in incidence in the 80s and 90s as well as the survival of laryngeal cancer patients, we analyzed the data by subsites (glottis and other parts of larynx, and considered the phenomenon of field cancerisation. In addition, projection of laryngeal cancer incidence till the year 2009 was calculated.Methods. The basic source of information was the data of the Cancer Registry of Slovenia. Standard and special methods of descriptive epidemiology were used (the APC model, the person-years approach, Hakulinen’s package for the survival analysis.Results. In the period 1980–1999, in men there was an increase of glottic carcinoma incidence during the whole 20 years, a decrease of supraglottic carcinoma in the period 1996– 1999, and no change in the incidence of not defined subsites. The ratio supraglottis vs. glottis has been changing in favor of glottis carcinoma. The percentage of localized diseases at diagnosis of all subsites is slightly improving. For patients with glottic carcinoma diagnosed in 1993–1997 the relative fiveyear survival was 87% while for patients with cancer of other defined subsites of the larynx (in 86% supraglottis, 4% subglottis and 10% overlapping lesions it was 41%.Conclusions. Our prediction till 2009 is a small increase of the incidence in laryngeal cancer in men as well as in women. But also a better survival of patients could be expected. Further efforts for a more efficient primary as well as secondary prevention are needed.

  3. Quantitative pathology of laryngeal epithelial hyperplastic lesions.

    Science.gov (United States)

    Cör, A; Gale, N; Kambic, V

    1997-01-01

    We studied 40 laryngeal biopsies samples in order to ascertain the reliability of light microscopical criteria for subdividing laryngeal epithelial hyperplastic lesions (EHL) and carcinoma in situ as well as to determine the relationship between proliferative activity of their epithelial cells and the histological grade. The biopsies were divided into four groups in accordance with the Kambic-Lenart classification: simple, abnormal and atypical hyperplasia and carcinoma in situ. 10 cases in each group were included. The morphometrical analysis was carried out by a semiautomatic image analysis system. The proliferative activity was determined by the high percentage of cell nuclear antigen (PCNA) and Ki-67 positive epithelial cells and with counting nucleolar organizer regions (Ag-NORs) per nucleus. Our results suggest that measuring the nuclear area of the basal cells. augmented with basaloid cells and carcinomatous cells, is the most useful morphometrical method of differentiating three types of laryngeal EHL and carcinoma in situ, while the proliferative activity progressively increased with the degree of epithelial hyperplasia. Morphometrical methods and proliferative activity should be regarded as useful in conjunction with the traditional histopathological methods allowing more of objective grading of EHL.

  4. [The use of eurespal for the treatment of chronic laryngitis].

    Science.gov (United States)

    Riabova, M A

    2011-01-01

    The author provides a rationale for the use of eurespal for the treatment of chronic laryngitis based on the pathogenetic concept of pathological condition. The results of a clinical study designed to evaluate the efficiency and safety of eurespal therapy in patients with chronic laryngitis are presented.

  5. Quantitative PCR Analysis of Laryngeal Muscle Fiber Types

    Science.gov (United States)

    Van Daele, Douglas J.

    2010-01-01

    Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses…

  6. Laryngeal structure and function in dogs with cough.

    Science.gov (United States)

    Johnson, Lynelle R

    2016-07-15

    OBJECTIVE To investigate the prevalence and type of laryngeal abnormalities in dogs examined because of cough that did not have signs of upper airway disease and to compare the prevalence of those abnormalities among dogs with various respiratory tract diseases. DESIGN Prospective study. ANIMALS 138 dogs with cough that did not have signs of upper airway disease. PROCEDURES The study was conducted between July 2001 and October 2014 and included dogs examined for cough that had laryngoscopic and bronchoscopic examinations performed by 1 examiner. Laryngeal hyperemia and swelling were recorded, and laryngeal function was assessed before and after doxapram stimulation when indicated. Results were compared among dogs on the basis of cough duration (acute [ 2 months]) and disease diagnosed (inflammatory airway disease, airway collapse, lower respiratory tract infection, and eosinophilic bronchopneumopathy). RESULTS Laryngeal hyperemia was detected in 73 of 134 (54%) dogs with cough of subacute or chronic duration, and its prevalence did not vary significantly among dogs with various diseases. Thirteen dogs had laryngeal paresis, and 13 dogs had laryngeal paralysis; dysphonia (n = 2) and stridor (1) were uncommon findings in those dogs. The prevalence of laryngeal dysfunction (paresis or paralysis) did not differ significantly among diseases. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that 26 of 138 (19%) dogs examined because of cough alone had laryngeal dysfunction, which suggested that a complete laryngoscopic examination should be included in the diagnostic evaluation of dogs with cough.

  7. Muscle Bioenergetic Considerations for Intrinsic Laryngeal Skeletal Muscle Physiology

    Science.gov (United States)

    Sandage, Mary J.; Smith, Audrey G.

    2017-01-01

    Purpose: Intrinsic laryngeal skeletal muscle bioenergetics, the means by which muscles produce fuel for muscle metabolism, is an understudied aspect of laryngeal physiology with direct implications for voice habilitation and rehabilitation. The purpose of this review is to describe bioenergetic pathways identified in limb skeletal muscle and…

  8. Quantitative PCR Analysis of Laryngeal Muscle Fiber Types

    Science.gov (United States)

    Van Daele, Douglas J.

    2010-01-01

    Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses…

  9. Fluorescence investigations to classify malignant laryngeal lesions in vivo

    DEFF Research Database (Denmark)

    Rydell, Roland; Eker, Charlotta; Andersson-Engels, Stefan;

    2008-01-01

    BACKGROUND: The extent of surgical resection for malignant laryngeal lesions influences voice quality. An instrument to estimate histopathologic grading of dysplasia in vivo may spare normal tissue without increasing the risk of local failure. METHODS: Laryngeal lesions (N = 39; 21 after...

  10. Causes of death of patients with laryngeal cancer.

    NARCIS (Netherlands)

    Ferlito, A.; Haigentz M, J.r.; Bradley, P.J.; Suarez, C.; Strojan, P.; Wolf, G.T.; Olsen, K.D.; Mendenhall, W.M.; Mondin, V.; Rodrigo, J.P.; Boedeker, C.C.; Hamoir, M.; Hartl, D.M.; Hunt, J.L.; Devaney, K.O.; Thompson, L.D.; Rinaldo, A.; Takes, R.P.

    2014-01-01

    Despite remarkable advances in the care of patients with laryngeal cancer over the past several decades, including a growing awareness of therapeutic complications and attention to quality of life, little is known about the causes of mortality in this population. In addition to the laryngeal

  11. Description of Laryngeal Pathologies in Children Evaluated by Otolaryngologists.

    Science.gov (United States)

    Dobres, Rachel; And Others

    1990-01-01

    Data were collected on 731 patients (age birth to 18) at a children's hospital otolaryngology clinic. Most frequent laryngeal pathologies were subglottic stenosis, vocal nodules, laryngomalacia, and vocal fold paralysis. Laryngeal pathologies were more common to males than females, were most common in the youngest patients, and were distributed…

  12. Laryngeal paralysis in dogs: An update on recent knowledge

    Directory of Open Access Journals (Sweden)

    Adriaan M. Kitshoff

    2013-04-01

    Full Text Available Laryngeal paralysis is the effect of an inability to abduct the arytenoid cartilages during inspiration, resulting in respiratory signs consistent with partial airway obstruction. The aetiology of the disease can be congenital (hereditary laryngeal paralysis or congenital polyneuropathy, or acquired (trauma, neoplasia, polyneuropathy, endocrinopathy. The most common form of acquired laryngeal paralysis (LP is typically seen in old, large breed dogs and is a clinical manifestation of a generalised peripheral polyneuropathy recently referred to as geriatric onset laryngeal paralysis polyneuropathy. Diagnosing LP based on clinical signs, breed and history has a very high sensitivity (90% and can be confirmed by laryngeal inspection. Prognosis after surgical correction depends on the aetiology: traumatic cases have a good prognosis, whereas tumour-induced or polyneuropathy-induced LP has a guarded prognosis. Acquired idiopathic LP is a slow progressive disease, with dogs reaching median survival times of 3–5 years after surgical correction.

  13. Laryngeal Dysfunction - Assessment and Management for the Clinician

    DEFF Research Database (Denmark)

    Hull, James H; Backer, Vibeke; Gibson, Peter G;

    2016-01-01

    . In some situations the larynx appears to adopt a functional state that could be considered maladaptive or 'dysfunctional'. This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute...... to the development of symptoms that appear 'refractory' to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g. inducible laryngeal obstruction), voice disturbance and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted...... treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward however and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some...

  14. Laryngeal melanosis: a case report and review of the literature.

    Science.gov (United States)

    Ayçiçek, Abdullah; Kenar, Fethullah; Tokyol, Ciğdem; Sargin, Ramazan; Yilmaz, Mustafa Deniz; Dereköy, F Sefa

    2008-10-01

    We present a case with laryngeal melanosis and discuss the clinical significance of this condition. A 58-year-old male patient was referred to the otolaryngology department with a 2-month history of hoarseness. He had a history of smoking 20 cigarettes a day for 40 years. Videolaryngosgopic examination showed chronic laryngitis findings with multifocal pigmented pachydermic areas. Multiple biopsies were performed by laryngomicrosurgery. Pathological examination revealed laryngeal melanosis. As the number is not much enough, the association of laryngeal melanosis and carcinogenesis seems to be controversial. In the point of management, we have to be aware of the risks of laryngeal melanosis, such as developing neoplasm, and monitor the patients closely by periodical examinations and biopsies and advise the patients to stop smoking.

  15. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Science.gov (United States)

    2010-01-01

    ... laryngeal muscle tissue. 310.15 Section 310.15 Animals and Animal Products FOOD SAFETY AND INSPECTION... of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human food. (b) Livestock thyroid glands and laryngeal muscle tissue may be...

  16. Laryngeal pathology at school age following very preterm birth.

    Science.gov (United States)

    Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel

    2015-03-01

    Intubation injury resulting in laryngeal pathology is recognised as a possible complication of preterm birth, yet few published studies have examined such pathology and its relation to voice outcomes. This study reports on the results of prospective laryngeal function examinations of a cohort of very preterm children, all of whom presented with significant dysphonia at school age. The laryngeal pathology of 20 very preterm children, born between 23 and 29 weeks gestation, was examined under halogen and stroboscopic conditions. Laryngeal structure and function were assessed using a rigid laryngoscope or a flexible nasendoscope. The approach was selected based on the age and/or likely compliance of the child. Nineteen children were found to have structural laryngeal pathology. Fourteen children presented with a chink to the posterior glottis and all demonstrated at least a mild degree of supraglottic hyperfunction. Other common findings were arytenoid prolapse and vocal fold immobility. More isolated findings included posterior scar band, vocal fold atrophy, arytenoid oedema and growth on the vocal folds. One child who presented with structural laryngeal pathology was never intubated. Supraglottic hyperfunction was common to all participants, regardless of the nature and extent of underlying structural laryngeal pathology. Posterior glottic chink was the most common pattern of incomplete vocal fold closure. These data support the hypothesis that very preterm children adopt supraglottic tightening to compensate for underlying laryngeal pathology. The mechanism underlying laryngeal damage in the child who was not intubated is unclear. Voice quality of very preterm children is affected by both laryngeal structure and function. A trial of behavioural voice treatment is recommended to evaluate any therapeutic response in this population. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Effects of simulated reflux laryngitis on laryngeal chemoreflexes in newborn lambs.

    Science.gov (United States)

    Carreau, Anne-Marie; Patural, Hugues; Samson, Nathalie; Doueik, Alexandre A; Hamon, Julie; Fortier, Pierre-Hugues; Praud, Jean-Paul

    2011-08-01

    It has been suggested that reflux laryngitis (RL) is involved in apneas-bradycardias of the newborn. The aim of the present study was to develop a unique RL model in newborn lambs to test the hypothesis that RL enhances the cardiorespiratory components of the laryngeal chemoreflexes (LCR) in the neonatal period. Gastric juice surrogate (2 ml of normal saline solution with HCl pH 2 + pepsin 300 U/ml) (RL group, n = 6) or normal saline (control group, n = 6) was repeatedly injected onto the posterior aspect of the larynx, 3 times a day for 6 consecutive days, via a retrograde catheter introduced into the cervical esophagus. Lambs instilled with gastric juice surrogate presented clinical signs of RL, as well as moderate laryngitis on histological observation. Laryngeal chemoreflexes were thereafter induced during sleep by injection of 0.5 ml of HCl (pH 2), ewe's milk, distilled water or saline into the laryngeal vestibule via a chronic, transcutaneous supraglottal catheter. Overall, RL led to a significantly greater respiratory inhibition compared with the control group during LCR, including longer apnea duration (P = 0.01), lower minimal respiratory rate (P = 0.002), and a more prominent decrease in arterial hemoglobin saturation (SpO(2)) (P = 0.03). No effects were observed on cardiac variables. In conclusion, 1) our unique neonatal ovine model presents clinical and histological characteristics of RL; and 2) the presence of RL in newborn lambs increases the respiratory inhibition observed with LCR, at times leading to severe apneas and desaturations.

  18. Unexpected radiation laryngeal necrosis after carbon ion therapy using conventional dose fractionation for laryngeal cancer.

    Science.gov (United States)

    Demizu, Yusuke; Fujii, Osamu; Nagano, Fumiko; Terashima, Kazuki; Jin, Dongcun; Mima, Masayuki; Oda, Naoharu; Takeuchi, Kaoru; Takeda, Makiko; Ito, Kazuyuki; Fuwa, Nobukazu; Okimoto, Tomoaki

    2015-11-01

    Carbon ion therapy is a type of radiotherapy that can deliver high-dose radiation to a tumor while minimizing the dose delivered to organs at risk. Moreover, carbon ions are classified as high linear energy transfer radiation and are expected to be effective for even photon-resistant tumors. A 73-year-old man with glottic squamous cell carcinoma, T3N0M0, refused laryngectomy and received carbon ion therapy of 70 Gy (relative biological effectiveness) in 35 fractions. Three months after the therapy, the patient had an upper airway inflammation, and then laryngeal edema and pain occurred. Five months after the therapy, the airway stenosis was severe and computed tomography showed lack of the left arytenoid cartilage and exacerbation of laryngeal necrosis. Despite the treatment, 5 and a half months after the therapy, the laryngeal edema and necrosis had become even worse and the surrounding mucosa was edematous and pale. Six months after the therapy, pharyngolaryngoesophagectomy and reconstruction with free jejunal autograft were performed. The surgical specimen pathologically showed massive necrosis and no residual tumor. Three years after the carbon ion therapy, he is alive without recurrence. The first reported laryngeal squamous cell carcinoma case treated with carbon ion therapy resulted in an unexpected radiation laryngeal necrosis. Tissue damage caused by carbon ion therapy may be difficult to repair even for radioresistant cartilage; therefore, hollow organs reinforced by cartilage, such as the larynx, may be vulnerable to carbon ion therapy. Caution should be exercised when treating tumors in or adjacent to such organs with carbon ion therapy.

  19. A robotic assistant for trans-oral surgery: the robotic endo-laryngeal flexible (Robo-ELF) scope.

    Science.gov (United States)

    Olds, Kevin; Hillel, Alexander; Kriss, Jonathan; Nair, Archana; Kim, Hongho; Cha, Elizabeth; Curry, Martin; Akst, Lee; Yung, Rex; Richmon, Jeremy; Taylor, Russell

    2012-03-01

    This paper describes the continued development of the Robotic EndoLaryngeal (Robo-ELF) Scope System, a simple clinically usable robot for manipulating flexible endoscopes, particularly in laryngeal surgery. The system includes a robot with three active and two passive degrees of freedom, a five degree of freedom passive positioning arm, a malleable scope shaft support, and a custom joystick controller. The Robo-ELF Scope allows a surgeon to control a flexible endoscope with only one hand and also to release the controls and perform bimanual surgery if desired. We have evaluated the Robo-ELF Scope system in both phantom and cadaver studies and found it superior to hand manipulation of flexible endoscopes and conventional rigid endoscopes.

  20. Correction: Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-11-30

    ABSTRACT: Following the publication of our article [Inferior alveolar nerve injury with laryngeal mask airway: a case report. Journal of Medical Case Reports 2011, 5:122] it was brought to our attention that we inadvertently used the registered trademark of the Laryngeal Mask Company Limited (LMA) as the abbreviation for laryngeal mask airway. A Portex(R) Soft Seal(R) Laryngeal Mask was used and not a device manufactured by the Laryngeal Mask Company.

  1. The human laryngeal microbiome: effects of cigarette smoke and reflux

    Science.gov (United States)

    Jetté, Marie E.; Dill-McFarland, Kimberly A.; Hanshew, Alissa S.; Suen, Garret; Thibeault, Susan L.

    2016-01-01

    Prolonged diffuse laryngeal inflammation from smoking and/or reflux is commonly diagnosed as chronic laryngitis and treated empirically with expensive drugs that have not proven effective. Shifts in microbiota have been associated with many inflammatory diseases, though little is known about how resident microbes may contribute to chronic laryngitis. We sought to characterize the core microbiota of disease-free human laryngeal tissue and to investigate shifts in microbial community membership associated with exposure to cigarette smoke and reflux. Using 454 pyrosequencing of the 16S rRNA gene, we compared bacterial communities of laryngeal tissue biopsies collected from 97 non-treatment-seeking volunteers based on reflux and smoking status. The core community was characterized by a highly abundant OTU within the family Comamonadaceae found in all laryngeal tissues. Smokers demonstrated less microbial diversity than nonsmokers, with differences in relative abundances of OTUs classified as Streptococcus, unclassified Comamonadaceae, Cloacibacterium, and Helicobacter. Reflux status did not affect microbial diversity nor community structure nor composition. Comparison of healthy laryngeal microbial communities to benign vocal fold disease samples revealed greater abundance of Streptococcus in benign vocal fold disease suggesting that mucosal dominance by Streptococcus may be a factor in disease etiology. PMID:27775059

  2. Downregulated Chibby in laryngeal squamous cell carcinoma with increased expression in laryngeal carcinoma Hep-2 cells.

    Science.gov (United States)

    Xu, Jue; Ren, Gang; Zhao, De-An; Li, Bo-An; Cai, Cheng-Fu; Zhou, Yi; Luo, Xian-Yang

    2014-11-01

    Chibby (Cby) inhibits Wnt/β-catenin-mediated transcriptional activation by competing with Lef-1 (the transcription factor and target of β-catenin) to bind to β-catenin. This suggests that Cby could be a tumor suppressor protein. In the present study, we examined Cby expression in laryngeal squamous cell carcinoma (LSCC) and its function and mechanism in laryngeal carcinoma cell lines. Cby expression levels were investigated by immunohistochemistry in a panel of 36 LSCC patient cases. The expression of β-catenin, c-myc and cyclin D1 in Hep-2 were determined through RT-PCR and western blot analysis. Activity of Wnt/β-catenin signaling pathway after overexpression of Cby was measured by TCF/LEF luciferase reporter gene assay. Proliferation, clone forming ability, cell cycle distribution and cell apoptosis of Hep-2 cells were detected by MTT assay, plate colony forming assay, flow cytometry and TUNEL assay, respectively. This study showed that expression of Cby protein was strongly downregulated in LSCC tumor tissues in comparison to normal laryngeal mucosa samples. No significant correlation was found between the expression of Cby in tumor tissue and gender, age, clinical stage and tumor differentiation of laryngeal cancer patients. When Cby was overexpressed in Hep-2 cells, the expression of cyclin D1 was reduced and β-catenin activity was inhibited. Proliferation and plate colony forming assays revealed a significant inhibitory effect of Cby on growth and colony formation ability of Hep-2 cells after Cby overexpression in comparison to control and mock-infected cells. In addition, we also found that upregulated expression of Cby resulted in accumulation of numbers of cells in G0/G1 phase with concomitant decrease in S phase by cell cycle assay. TUNEL staining demonstrated that, compared with the control group, the rate of apoptosis in the plv-cs2.0-Cby group was significantly increased. Taken together, downregulation of Cby was observed in LSCC, but with no

  3. Gastroesophageal reflux disease correlation with posterior laryngitis

    Directory of Open Access Journals (Sweden)

    Dimitrijević Milovan

    2009-01-01

    Full Text Available Background/Aim. Over the last years numerous studies have been performed dealing with mutual relations among gastroesophageal reflux disease (GERD and numerous diseases of the upper airways. The aim of the present study was to establish possible causal relationship between GERD and posterior laryngitis (PL. Methods. The study included 103 patients with gastrointestinal complaints. Diagnostic procedure included a medical history, gastroscopy and laryngeal directoscopy. The obtained data processed using classic methods of the descriptive statistics, as well as Pearson's chi-square test, Student's t test, rank sum test and Fisher's parametric analysis of variance. Results. Out of the total number of 103 examined patients, 33 (32% were diagnosed with PL, while GERD was diagnosed in five of the examined patients all belonging to the PL group (15% of the patients with PL. In the remaining patients, PL was caused by other factors. All the patients with GERD had PL and globus sensation while 80% of GERD patients had prominent symptom of pain. Conclusion. The results of the study are indicative of the causal relationship between GERD and PL.

  4. Association Between Laryngeal Cancer and Asbestos Exposure: A Systematic Review.

    Science.gov (United States)

    Ferster, Ashley P O'Connell; Schubart, Jane; Kim, Yesul; Goldenberg, David

    2017-04-01

    It has been debated whether a link exists between laryngeal cancer and asbestos exposure. Prior systematic reviews have been conducted on this topic, but no updates have been performed on the most recent literature since 2000. To provide an updated systematic review of the association between laryngeal cancer and asbestos exposure. A search of electronic databases, including PubMed and the Cochrane Library, was performed for articles published between January 1, 2000, and April 30, 2016. Search terms, including laryngeal cancer and asbestos, were used to identify publications reviewing the risk of laryngeal cancer in association with asbestos exposure. Studies analyzing this association that were published in any language and translated reliably were included. Two independent reviewers assessed articles based on predetermined eligibility criteria. Each study was reviewed for quality using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence and assessed for their findings of support for or against a correlation between asbestos exposure and laryngeal cancer. A total of 160 studies were retrieved from all databases, and 2 additional articles were identified by cross-references. Of the 162 articles screened, 15 articles comprising 438 376 study participants were included in this review. Of these 15 studies, 10 showed no correlation between asbestos exposure and laryngeal cancer. The remaining 5 studies claimed a correlation between asbestos exposure and incidence of laryngeal cancer, although only 1 accounted for smoking or alcohol exposure while 3 others did not, and 1 study included only 2 patients. Although asbestos is considered hazardous and carcinogenic, current evidence is lacking to support a correlation between asbestos exposure and laryngeal cancer. Few studies have been able to definitively conclude a causal association between asbestos exposure and laryngeal cancer, and those that found an association often did not account for the

  5. [Candida laryngitis and HIV infection: description of 4 cases].

    Science.gov (United States)

    Roig, P; Carrasco, R; Salavert, M; Navarro, V; Guix, J; Nieto, A; Bernacer, B

    1992-10-01

    Candidiasic laryngitis is a very rare Candida spp infection of mucosa, appearing typically in immunosuppressed patients, mainly in patients with neoplasia, and, recently, in patients with Human Immunodeficiency Virus (VIH) infection. We present four cases of candidiasic laryngitis and HIV infection, as well as the clinical description and evolution of said cases after treatment with fluconazole. We review, as well, the cases published on the scientific literature. We maintain that in each HIV infected patient, with or without oral candidiasis, who shows dysphonia, candidiasic laryngitis should be ruled out.

  6. Exercise-induced laryngeal obstructions objectively assessed using EILOMEA

    DEFF Research Database (Denmark)

    Christensen, Pernille; Thomsen, Simon Francis; Rasmussen, Niels;

    2010-01-01

    was found describing the degree of laryngeal obstruction by measuring cross-sectional areas of the inspiratory laryngeal images. A threshold value was set giving the diagnosis of EI-VCD, with a sensitivity of 0.65, a specificity of 0.96, a positive-predictive value of 0.79, and a negative-predictive value...... of 0.93. The threshold set for diagnosing EIL gave sensitivity, specificity, positive and negative-predictive value of 1.00. EIL and EI-VCD show different objective findings confirming that they are two separate conditions both causing laryngeal obstruction. The use of the CLE test is mandatory...

  7. Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis

    Directory of Open Access Journals (Sweden)

    Kerem Kökoğlu

    2014-01-01

    Full Text Available Laryngeal chondrosarcoma (CS is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature.

  8. [Simultaneous pulmonar, laryngeal and lingual affectation by Mycobacterium tuberculosis].

    Science.gov (United States)

    Díaz Manzano, J A; Castillo Romero, J L; Padilla Romero, M J; Sánchez Laínez, J J; Castillo Aguilar, C; Cegarra Navarro, M F

    2007-01-01

    The incidence of tuberculosis has lately increased in developed countries. The most frequent affectation is the pulmonar one and in the ORL area the laryngeal. The lingual affectation is exceptional. We present a case of a man 39 years old, with bilateral pulmonar, left vocal cord and mobile tongue affectation, negative Mantoux, positive spit culture and presence of acido-alcohol resistent bacillus in lingual and laryngeal biopsies. After antituberculosis treatment during 6 months the laryngeal and lingual lesions disappeared. We have only found two cases published of simultaneous tuberculosis in these three localisations in the last 30 years.

  9. ERp57 modulates STAT3 activity in radioresistant laryngeal cancer cells and serves as a prognostic marker for laryngeal cancer.

    Science.gov (United States)

    Choe, Min Ho; Min, Joong Won; Jeon, Hong Bae; Cho, Dong-Hyung; Oh, Jeong Su; Lee, Hyun Gyu; Hwang, Sang-Gu; An, Sungkwan; Han, Young-Hoon; Kim, Jae-Sung

    2015-02-20

    Although targeting radioresistant tumor cells is essential for enhancing the efficacy of radiotherapy, the signals activated in resistant tumors are still unclear. This study shows that ERp57 contributes to radioresistance of laryngeal cancer by activating STAT3. Increased ERp57 was associated with the radioresistant phenotype of laryngeal cancer cells. Interestingly, increased interaction between ERp57 and STAT3 was observed in radioresistant cells, compared to the control cells. This physical complex is required for the activation of STAT3 in the radioresistant cells. Among STAT3-regulatory genes, Mcl-1 was predominantly regulated by ERp57. Inhibition of STAT3 activity with a chemical inhibitor or siRNA-mediated depletion of Mcl-1 sensitized radioresistant cells to irradiation, suggesting that the ERp57-STAT3-Mcl-1 axis regulates radioresistance of laryngeal cancer cells. Furthermore, we observed a positive correlation between ERp57 and phosphorylated STAT3 or Mcl-1 and in vivo interactions between ERp57 and STAT3 in human laryngeal cancer. Importantly, we also found that increased ERp57-STAT3 complex was associated with poor prognosis in human laryngeal cancer, indicating the prognostic role of ERp57-STAT3 regulation. Overall, our data suggest that ERp57-STAT3 regulation functions in radioresistance of laryngeal cancer, and targeting the ERp57-STAT3 pathway might be important for enhancing the efficacy of radiotherapy in human laryngeal cancer.

  10. Reliable detection of human papillomavirus in recurrent laryngeal papillomatosis and associated carcinoma of archival tissue.

    Science.gov (United States)

    Weiss, Daniel; Heinkele, Thomas; Rudack, Claudia

    2015-05-01

    Recurrent laryngeal papillomatosis (RLP) is, although benign, a challenging disease for both, the patient and the treating physician. Maximum disease control with minimum intervention is considered to be the gold standard. However, patients have to undergo repeating surgical interventions. Human papillomavirus (HPV), mainly so called low risk types, are thought to be responsible for the development of RLP. But, there is still some controversy over the true prevalence of HPV and the virus-specific molecular diagnostic of choice. Therefore archival tissue samples from 44 patients with RLP at laryngeal site, out of which eight developed laryngeal cancer, was screened for presence of HPV through various molecular approaches. Results from these different methodologies were compared between each other and with patient's characteristics. The overall detection rates of HPV with the various methods used in this study were: HPV16 E6/E7 PCR: 0%; GP5+/6+ PCR: 4.5%; CDKN2A/p16 immunohistochemistry: 6.8%; in-situ hybridization for low and high risk HPV types: 52.3%; HPV6/11 L1 PCR: 72.7% and HPV6/11 E6 PCR: 79.5%. Disease progression showed no apparent dependence of the detected HPV type or clinical variables like age at diagnosis, sex, or additional drug application (Cidofovir and Bevacizumab). In conclusion, the broad-spectrum PCRs alone or in combination with immunohistochemistry of CDKN2A/p16 and in-situ hybridization are unsuitable for HPV detection in RLP. Based on the findings presented in this study the type specific PCRs targeting the E6 open reading frame are clearly superior in detection of HPV in this tumor entity.

  11. Reversing Age Related Changes of the Laryngeal Muscles by Chronic Electrostimulation of the Recurrent Laryngeal Nerve

    Science.gov (United States)

    Karbiener, Michael; Jarvis, Jonathan C.; Perkins, Justin D.; Lanmüller, Hermann; Schmoll, Martin; Rode, Hanna S.; Gerstenberger, Claus; Gugatschka, Markus

    2016-01-01

    Age related atrophy of the laryngeal muscles -mainly the thyroarytenoid muscle (TAM)- leads to a glottal gap and consequently to a hoarse and dysphonic voice that significantly affects quality of life. The aim of our study was to reverse this atrophy by inducing muscular hypertrophy by unilateral functional electrical stimulation (FES) of the recurrent laryngeal nerve (RLN) in a large animal model using aged sheep (n = 5). Suitable stimulation parameters were determined by fatiguing experiments of the thyroarytenoid muscle in an acute trial. For the chronic trial an electrode was placed around the right RLN and stimulation was delivered once daily for 29 days. We chose a very conservative stimulation pattern, total stimulation time was two minutes per day, or 0.14% of total time. Overall, the mean muscle fiber diameter of the stimulated right TAM was significantly larger than the non-stimulated left TAM (30μm±1.1μm vs. 28μm±1.1 μm, p<0.001). There was no significant shift in fiber type distribution as judged by immunohistochemistry. The changes of fiber diameter could not be observed in the posterior cricoarytenoid muscle (PCAM). FES is a possible new treatment option for reversing the effects of age related laryngeal muscle atrophy. PMID:27893858

  12. Laryngeal support device enhances the learning of laryngeal anatomy and voice physiology.

    Science.gov (United States)

    Curcio, Daniella Franco; Behlau, Mara; Barros, Mirna Duarte; Smith, Ricardo Luiz

    2012-01-01

    Multidisciplinary cooperation in health care requires a solid knowledge in the basic sciences for a common ground of communication. In speech pathology, these fundamentals improve the accuracy of descriptive diagnoses and support the development of new therapeutic techniques and strategies. The aim of this study is to briefly discuss the benefits of hands-on education on laryngeal anatomy and voice physiology in Brazilian graduate programs in speech pathology, as well as to describe a simple prototype that can be used as a useful educational tool for this purpose. The laryngeal anatomic support device was designed to provide a vertical frame to hold human or mammalian larynges with no preservation treatment, with the goal of allowing good visualization of the vocal folds during artificial phonation. The device was designed to provide the user the ability to manipulate the soft and cartilaginous structures of the larynx with near-natural biomechanical properties. The description of the project is detailed to allow the reproduction of this simple and inexpensive device. It may be used as an experimental feature in a variety of settings, from high-school programs to experimental research methods, and may suit a wide array of different educational models.

  13. Expression and significance of PTEN and PCNA in human laryngeal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    李长青; 文莲姬; 金春顺; 崔树勋

    2004-01-01

    Objective: To elucidate the expression and significance of PTEN and PCNA in human laryngeal squamous cell carcinoma. Methods: Immunochemical method was used to study 60 cases of laryngeal carcinoma, 20 cases of normal laryngeal tissues which were closely adjacent to carcinoma and 10 cases of normal laryngeal tissues. Results: It was showed that PTEN gene was expressed in 85 % laryngeal carcinoma tissues. The percentage of lymph node metastasis of laryngeal carcinoma which were negative or positive of PTEN protein was 77.8 % and 33.3 % respectively, and the difference was significance ( P < 0.05). Conclusion: Expression of PTEN in laryngeal carcinoma was different from that of normal laryngeal tissues. It may play a role but not important in the tumorigenesis and development of laryngeal carcinoma.

  14. Dietary consumption patterns and laryngeal cancer risk.

    Science.gov (United States)

    Vlastarakos, Petros V; Vassileiou, Andrianna; Delicha, Evie; Kikidis, Dimitrios; Protopapas, Dimosthenis; Nikolopoulos, Thomas P

    2016-06-01

    We conducted a case-control study to investigate the effect of diet on laryngeal carcinogenesis. Our study population was made up of 140 participants-70 patients with laryngeal cancer (LC) and 70 controls with a non-neoplastic condition that was unrelated to diet, smoking, or alcohol. A food-frequency questionnaire determined the mean consumption of 113 different items during the 3 years prior to symptom onset. Total energy intake and cooking mode were also noted. The relative risk, odds ratio (OR), and 95% confidence interval (CI) were estimated by multiple logistic regression analysis. We found that the total energy intake was significantly higher in the LC group (p consumption was higher in the LC group (p consumption of shrimp proving detrimental (p = 0.049; OR: 2.18). Finally, the intake of zinc was significantly higher in the LC group before and after logistic regression analysis (p = 0.034 and p = 0.011; OR: 30.15, respectively). Cereal consumption (including pastas) was also higher among the LC patients (p = 0.043), with logistic regression analysis showing that their negative effect was possibly associated with the sauces and dressings that traditionally accompany pasta dishes (p = 0.006; OR: 4.78). Conversely, a higher consumption of dairy products was found in controls (p consumption of fruits and vegetables between the LC patients and controls; however, the LC patients did have a greater consumption of cooked tomatoes and cooked root vegetables (p = 0.039 for both), and the controls had more consumption of leeks (p = 0.042) and, among controls younger than 65 years, cooked beans (p = 0.037). Lemon (p = 0.037), squeezed fruit juice (p = 0.032), and watermelon (p = 0.018) were also more frequently consumed by the controls. Other differences at the micronutrient level included greater consumption by the LC patients of retinol (p = 0.044), polyunsaturated fats (p = 0.041), and linoleic acid (p = 0.008); LC patients younger than 65 years also had greater

  15. Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury

    Institute of Scientific and Technical Information of China (English)

    Chenling Shen; Mingliang Xiang; Hao Wu; Yan Ma; Li Chen; Lan Cheng

    2013-01-01

    To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, we retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries. Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark. These findings indicate that anatomical variations of the recurrent laryngeal nerve are common, and that dissecting the recurrent laryngeal nerve during thyroid surgery is an effective means of preventing nerve injury.

  16. An Overview of Laryngeal Muscle Single Fiber Electromyography.

    Science.gov (United States)

    Bertorini, Tulio E; Sharaf, Aboubakar G

    2015-08-01

    Needle electromyography is an important tool in the diagnosis of neuromuscular diseases and has also been applied successfully in the evaluation of the vocal cord paralysis. Laryngeal electromyography, initially described by Weddell, is used to determine the cause of vocal cord paralysis and to differentiate organic from nonorganic causes of speech disorders. This test allows the diagnosis of lower motor neuron and nerve paralysis as well as myopathies. Laryngeal electromyography also helps to determine the prognosis of paralysis caused by traumatic injury of the laryngeal nerves and is used for guidance during botulinum toxin injection in spasmodic dysphonias. Single fiber electromyography is used to diagnose abnormalities of neuromuscular transmission and is applied in the study the architecture of the motor unit in muscles. This article reviews the techniques of laryngeal muscles single fiber electromyography, provides limited informative data, and discusses its potential value in the evaluation of patients with dysphonia.

  17. Laryngeal spasm after general anaesthesia due to Ascaris Lumbricoides

    OpenAIRE

    Finsnes, K D

    2013-01-01

    Postoperative upper airway obstruction during recovery from general anaesthesia may have several causes. This is a report of a young girl who developed laryngeal spasm as a result of an ectopic roundworm Ascaris lumbricoides.

  18. Laryngeal spasm after general anaesthesia due to Ascaris lumbricoides.

    Science.gov (United States)

    Finsnes, K D

    2013-08-01

    Postoperative upper airway obstruction during recovery from general anaesthesia may have several causes. This is a report of a young girl who developed laryngeal spasm as a result of an ectopic roundworm Ascaris lumbricoides.

  19. Risk factors for recurrent laryngeal nerve neuropraxia postthyroidectomy.

    LENUS (Irish Health Repository)

    Sheahan, Patrick

    2012-06-01

    Despite preservation of the recurrent laryngeal nerve (RLN), transient vocal cord paralysis (VCP) occurs after 1.2% to 10.9% of thyroidectomies. The objective of this study was to study risk factors for transient VCP after thyroidectomy.

  20. Chronic laryngitis as a result of gastro esophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Trajković Rada

    2014-01-01

    Full Text Available Reflux of gastric contents to the level of the pharynx and larynx is called laryngopharyngeal reflux, which can exist as such or laryngeal and pharyngeal reflux as separate entities, and in such form may lead to other diseases such as rhinitis, sinusitis, otitis media, and precancerous cancerous condition. To determine the relationship and impact of gastroesophageal reflux disease on the occurrence, frequency and duration of inflammatory processes and mucosal damage to the larynx. All patients were obtained anamnesticly, lab test done in all patients, indirect hipofaringo and laryngoscopy was performed in all patients. Based on the feedback reports gastroenterologists, we obtained data of gastroscopy. Results: 120 subjects were processed with dyspeptic symptoms. Based on history, all patients had some symptoms of upper respiratory tract disease.62 (51.66% male respondents and 58 (48.33% females. The average age of 54 years. In 82 (68.33% patients was increased salivation (one of the leading symptoms, of that number in 61 (74.39% participants laryngitis was present. In 68 (56.66% cases where the predominant symptom was cough, laryngitis was present in 26 (38.23%. In 70 (58.33% of patients with globus sensation, laryngitis was present in 38 (54.28% patients. Smoking has been represented with 65.83% (70 respondents, the percentage of patients with chronic laryngitis in this group was 69.62% (55 respondents. Been held after gastroscopy and otorinolaryngological examination in 62 (51.66% patients were diagnosed gastroesophageal reflux disease (GERD, of which, in 43 (69.35% patients laryngitis was present. After a three-month follow-up of patients with therapy (H2 blockers, proton pump inhibitors and antacids 28 (65.11% subjects (total treated, showed an improvement. The results of this study indicate a significant correlation between gastroesophageal reflux disease and chronic laryngitis, as well as the favorable impact and effect of antacid therapy

  1. Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

    OpenAIRE

    Paulauskienė Iveta; Mickevičienė Vaiva

    2016-01-01

    Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis) or functional (functio...

  2. Human laryngitis caused by Clinostomum complanatum.

    Science.gov (United States)

    Hara, Hirotaka; Miyauchi, Yuji; Tahara, Shinsaku; Yamashita, Hiroshi

    2014-02-01

    A 64-year-old Japanese man visited our outpatient department complaining of an irritable sensation in the throat, occurring two days after eating raw freshwater fish (carp sashimi) at a Japanese-style inn. During laryngeal endoscopy, a slow-moving worm (fluke) was found attached to the surface of the right aryepiglottic fold. After inhalation of 4% lidocaine, the fluke was removed using endoscopic forceps. Patient's throat symptoms immediately improved. The worm was microscopically identified as Clinostomum complanatum. C. complanatum is a digenetic trematode that usually infects fish-eating water birds. Clinostomum infections in humans are rare, and only 21 cases have been described in Japan and Korea. C. complanatum infection is known to occur after eating raw freshwater fish, which is a secondary intermediate host. In humans, the metacercariae are released into the stomach and migrate through the esophagus before lodging in the throat. Primary therapy involves endoscopic removal of the worm.

  3. Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

    Directory of Open Access Journals (Sweden)

    Paulauskienė Iveta

    2016-01-01

    Full Text Available Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis or functional (functional dysphonia, laryngeal conversion disorder, paradoxical vocal folds motion conditions. Rarely systemic diseases as amyloidosis, sarcoidosis, Wegener’s granulomatosis or tuberculosis can cause vocal dysfunction too. That is why laryngeal tuberculosis is often forgotten in case of persistent hoarseness. In this article, we present a case of a young previously healthy woman, complaining of persistent hoarseness with no other leading symptoms. Though endoscopic image suggested a malignancy, histology showed granulomatous lesion. Detailed examination revealed laryngeal and pulmonary tuberculosis resistant to rifampicin. Conclusion: Dysphonia can be the only one symptom of laryngeal tuberculosis. The disease should be taken into consideration when a patient complains of persistent hoarseness in order to avoid delays in treatment and spread of infection.

  4. Laryngeal Cancer: 12-Year Experience of a Single Center.

    Science.gov (United States)

    Calkovsky, V; Wallenfels, P; Calkovska, A; Hajtman, A

    2016-01-01

    Laryngeal cancer is about the twentieth most common cancer in the world and more than 150,000 new cases are diagnosed annually. The aim of the study was to evaluate the history, diagnostics, treatment outcomes, and prognosis in patients with laryngeal cancer in Northern Slovakia. We analyzed retrospectively 227 patients (207 males, 20 females) with laryngeal carcinoma treated in the period 2003-2014 at the Clinic of Otorhinolaryngology and Head and Neck Surgery of the Jessenius Faculty of Medicine and Martin University Hospital in Martin, Slovakia. The majority of patients were in the sixth (38.0 %) and seventh decade of life (30.8 %). Two hundred and seventeen patients (95.6 %) were smokers or ex-smokers. Sixty-six percent of patients were diagnosed with glottic or transglottic carcinoma, related probably to the anatomical structure of the larynx and exposure to inhalation pollutants. It is alarming that the majority of patients with malignant laryngeal disease were admitted to the hospital in advanced stages. In 151 (66.5 %) of patients, the extent of infiltration was T3 or T4, and 156 (68 %) patients were in disease stage III and IV. The incidence and mortality of laryngeal cancer suggest the need to intensify the prevention and to search for an early clinical stage of laryngeal cancer using a targeted screening.

  5. Laryngeal Dysfunction: Assessment and Management for the Clinician.

    Science.gov (United States)

    Hull, James H; Backer, Vibeke; Gibson, Peter G; Fowler, Stephen J

    2016-11-01

    The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation. In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute to the development of symptoms that appear "refractory" to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g., inducible laryngeal obstruction), voice disturbance, and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward, however, and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some time. This review provides an overview of the current state of knowledge in the field of laryngeal dysfunction, with a focus on pragmatic clinical assessment and management.

  6. Classification of laryngeal disorders based on shape and vascular defects of vocal folds.

    Science.gov (United States)

    Irem Turkmen, H; Elif Karsligil, M; Kocak, Ismail

    2015-07-01

    Vocal fold disorders such as laryngitis, vocal nodules, and vocal polyps may cause hoarseness, breathing and swallowing difficulties due to vocal fold malfunction. Despite the fact that state of the art medical imaging techniques help physicians to obtain more detailed information, difficulty in differentiating minor anomalies of vocal folds encourages physicians to research new strategies and technologies to aid the diagnostic process. Recent studies on vocal fold disorders note the potential role of the vascular structure of vocal folds in differential diagnosis of anomalies. However, standards of clinical usage of the blood vessels have not been well established yet due to the lack of objective and comprehensive evaluation of the vascular structure. In this paper, we present a novel approach that categorizes vocal folds into healthy, nodule, polyp, sulcus vocalis, and laryngitis classes exploiting visible blood vessels on the superior surface of vocal folds and shapes of vocal fold edges by using image processing techniques and machine learning methods. We first detected the vocal folds on videolaryngostroboscopy images by using Histogram of Oriented Gradients (HOG) descriptors. Then we examined the shape of vocal fold edges in order to provide features such as size and splay portion of mass lesions. We developed a new vessel centerline extraction procedure that is specialized to the vascular structure of vocal folds. Extracted vessel centerlines were evaluated in order to get vascular features of vocal folds, such as the amount of vessels in the longitudinal and transverse form. During the last step, categorization of vocal folds was performed by a novel binary decision tree architecture, which evaluates features of the vocal fold edge shape and vascular structure. The performance of the proposed system was evaluated by using laryngeal images of 70 patients. Sensitivity of 86%, 94%, 80%, 73%, and 76% were obtained for healthy, polyp, nodule, laryngitis, and

  7. Superior Hiking Trail

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  8. Bathymetry of Lake Superior

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Superior has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  9. Superior Hiking Trail Facilities

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  10. Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs.

    Science.gov (United States)

    Brisebois, Simon; Samson, Nathalie; Fortier, Pierre-Hugues; Doueik, Alexandre A; Carreau, Anne-Marie; Praud, Jean-Paul

    2014-08-15

    Reflux laryngitis in infants may be involved not only in laryngeal disorders, but also in disorders of cardiorespiratory control through its impact on laryngeal function. Our objective was to study the effect of reflux laryngitis on non-nutritive swallowing (NNS) and NNS-breathing coordination. Two groups of six newborn lambs, randomized into laryngitis and control groups, were surgically instrumented for recording states of alertness, swallowing and cardiorespiratory variables without sedation. A mild to moderate reflux laryngitis was induced in lambs from the experimental group. A significant decrease in the number of NNS bursts and apneas was observed in the laryngitis group in active sleep (p=0.03). In addition, lower heart and respiratory rates, as well as prolonged apnea duration (plaryngitis group. We conclude that a mild to moderate reflux laryngitis alters NNS burst frequency and autonomous control of cardiac activity and respiration in lambs.

  11. Laryngeal lymphoma: the high and low grades of rare lymphoma involvement sites.

    Science.gov (United States)

    Azzopardi, Charles Paul; Degaetano, James; Betts, Alexandra; Farrugia, Eric; Magri, Claude; Refalo, Nicholas; Gatt, Alexander; Camilleri, David J

    2014-01-01

    The larynx is an extremely rare site of involvement by lymphomatous disease. We present two cases of isolated laryngeal high-grade and another low-grade lymphoma, together with a literature review of laryngeal lymphoma management.

  12. Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

    OpenAIRE

    2012-01-01

    Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy. Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices. Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8±2.9 cmH20; P-LMA, 27.0±4.7 cmH20; p=0.42) and did not change...

  13. Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

    OpenAIRE

    2012-01-01

    Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy.Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices. Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8±2.9 cmH20; P-LMA, 27.0±4.7 cmH20; p=0.42) and did not change during the induction of and throughout pneumoperit...

  14. CYTOKINES AND C-REACTIVE PROTEIN CONTENT IN SERUM BLOOD OF PATIENTS WITH CHRONIC LARYNGITIS DISEASE

    OpenAIRE

    Zaiter Samir; Kulikova EA; Garyuk GI

    2013-01-01

    Some kinds of interleikines of patients with chronic laryngitis disease were investigated. There is “cytokines explosion” of the patients with chronic laryngitis with persistent herpes simplex virus. Comparative investigation cytokine profile in serum blood is demonstrated: balanced reaction cytokines profile of patients with chronic laryngitis without persistent herpes simplex virus and dysbalanced reaction of patients with laryngitis (hyperergation). Increased content IL-6 and low content g...

  15. Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

    The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.

  16. Discovery of laryngeal carcinoma by serum proteomic pattern analysis

    Institute of Scientific and Technical Information of China (English)

    XIAO; Xueyuan; ZHAO; Xiaodong; LIU; Jiankai; GUO; Fuzheng

    2004-01-01

    Laryngeal carcinoma is the most common malignancy among head and neck tumors. The purpose of this study is to find biomarkers for laryngeal carcinoma in patient blood serum using the Surface Enhanced Laser Desorption/Ionization (SELDI) technique. Serum samples from 33 laryngeal carcinoma (12 cases of glottis, 18 of supraglottis and 3 of subglottis) patients and 31 age- and sex-matched healthy people were analyzed by SELDI-TOF on a ProteinChip reader, PBSII-C. Protein profiles were generated using WCX2 protein chips. Protein peak clustering and classification analyses were performed utilizing the Biomarker Wizard and Biomarker Pattern software packages, respectively. The results showed that sixteen peaks had significant difference between laryngeal cancer patients and healthy group, eight of which were up-regulated in the patient samples, and the others were down-regulated. Two protein peaks 8153 Da and 2035 Da were automatically chosen for the system training and development of a classification tree. The analysis yielded a correct percentage of 96.9% for patients and 96.7% for control. The results suggest that serum is a useful resource for the detection of specific biomarkers for laryngeal carcinoma. Proteinchip Array System was a useful tool for a high throughput screening of large-sized serum samples to discover potential biomarkers for carcinoma.

  17. Prevalence of laryngeal alterations in patients with erosive esophagitis

    Directory of Open Access Journals (Sweden)

    Coelho, Marina Serrato

    2010-06-01

    Full Text Available Introduction: The association between gastroesophageal reflux disease (GERD and laryngeal disorders has been much debated in recent years. Recent studies suggest an association between laryngeal symptoms and pharyngeal symptoms extra-esophageal reflux, as atypical presentation of Gastroesophageal Reflux Disease. Objectives: To correlate the presence of laryngeal to the grades of erosive esophagitis. Methods: A prospective study. Patients with findings of esophagitis on endoscopy were categorized according to LosAngeles and submitted a questionnaire followed by laryngoscopy. The chi-square test was used for statistical analysis (p<0.05. Results: Patients with typical symptoms of gastroesophageal reflux disease accounted for 96.6%. Eighteen had changes consistent with class A (60%, class B with seven (7% and 5 with classes C + D (16.6%. The presence of laryngeal changes were more prevalent in more severe esophagitis (grades C and D Los Angeles when compared to milder forms (classes A and B, a statistically significant difference (p<0.05. Conclusion: The laryngeal disorders are frequent findings in patients with esophagitis, more frequent the greater the degree of esophageal injury.

  18. Prolonged ulcerative laryngitis: a new disease entity.

    Science.gov (United States)

    Hsiao, Tzu-Yu

    2011-03-01

    Over the last decade, a new disease entity, prolonged ulcerative laryngitis (PUL), with unique clinical presentation and prolonged disease course, has been recognized. Until now, very few studies dealing with this disease have been reported in the literature. From 1999 to 2008, we analyzed clinical data from a series of 39 PUL patients who were treated with an observational approach without implementing specific treatments. This disease affects adults, predominantly females. The age of patients in our series ranged from 26 to 76 years with a median of 49.5 years. This disease is characterized by ulcers and signs of acute inflammation on the membranous portion of the vocal folds with a prolonged clinical course. The recovery times of patients ranged from 4 to 20 weeks with an average of 9.4 weeks. The data in this study may reflect a natural history of this disease. PUL seems to be a self-limited disease, but the etiology of this disease is unknown. Specific infections or systemic inflammatory processes involving the larynx must be ruled out before diagnosis, and conservative treatments are suggested.

  19. Recurrent laryngeal nerve pathology in spasmodic dysphonia.

    Science.gov (United States)

    Bocchino, J V; Tucker, H M

    1978-08-01

    Since it was first described in 1871, spasmodic (spastic) dysphonia has been considered a disease of psychogenic origin. Unsupported theories of possible organic etiology have appeared sporadically in the literature. In 1976 sectioning of the recurrent laryngeal nerve for patients with this disease was reported with resultant improvement in voice production. This was attempted because the spasmodic dysphonic has, in effect, already compensated vocal cords bilaterally. It was reasoned, therefore, that if one of these was paralyzed the patient would immediately be converted to a state approximating that of well-compensated unilateral vocal cord paralysis which situation, as is well known, usually carries with it a fairly good voice. A controlled study to evaluate the efficacy of this surgical approach has been undertaken at the Cleveland Clinic during the past year. In an attempt to elucidate the possible organic etiology of spasmodic dysphonia, a section of nerve was removed in every case and examined by both light and electron microscopy. Special stains for myelin were also used on the light microscopy specimens. Demyelinization has been found in most of the cases examined by electron microscopy. Possible correlation between this disease entity and other cranial nerve syndromes of unknown etiology is noted. Such conditions as trigeminal neuralgia, glossopharyngeal neuralgia, belpharospasm, hemifacial spasm, and even possibly Bell's palsy may exhibit a similar etiology.

  20. A comparison of fiberoptical guided tracheal intubation via laryngeal mask and laryngeal tube

    Directory of Open Access Journals (Sweden)

    Thomas Metterlein

    2015-01-01

    Full Text Available Background: Fiberoptical assisted intubation via a placed laryngeal mask airway (LMA has been described as save and easy procedure to manage a difficult airway. The laryngeal tube (LT is a promising alternative to the LMA as supraglottic airway device. Fiberoptical assisted intubation via LT is possible, however considered more difficult. The aim of this study was to compare the fiberoptical assisted intubation via LT and LMA. Materials and Methods: A total of 22 anesthesiologists with different levels of experience participated in the study performed on an adult airway model. Primarily the supraglottic device was placed and correct position was confirmed by successful ventilation. A 5 mm internal diameter tracheal tube was loaded onto a flexible 3.6 mm fiberscope and the so prepared device was inserted into the proximal lumen of the LMA or the LT. The glottis was passed under visual control and the tube advanced into the trachea. After removal of the fiberscope, ventilation was examined clinically by inspection. Success rates, procedure time and observed complications of LMA versus LT were compared (U-test; P < 0.05. Results: Placement of the endotracheal tube was successful in all attempts using both the LMA and LT. There was no difference in the time needed for the placement procedure (33 [26-38] s LMA; 35 [32-38] s LT. Only minor technical complications were observed in both groups. Conclusion: A fiberoptical assisted intubation via LT can be considered as a relevant alternative in advanced airway management.

  1. Immunohistochemical analysis of laryngeal muscles in normal horses and horses with subclinical recurrent laryngeal neuropathy.

    Science.gov (United States)

    Rhee, Hannah S; Steel, Catherine M; Derksen, Frederik J; Robinson, N Edward; Hoh, Joseph F Y

    2009-08-01

    We used immunohistochemistry to examine myosin heavy-chain (MyHC)-based fiber-type profiles of the right and left cricoarytenoideus dorsalis (CAD) and arytenoideus transversus (TrA) muscles of six horses without laryngoscopic evidence of recurrent laryngeal neuropathy (RLN). Results showed that CAD and TrA muscles have the same slow, 2a, and 2x fibers as equine limb muscles, but not the faster contracting fibers expressing extraocular and 2B MyHCs found in laryngeal muscles of small mammals. Muscles from three horses showed fiber-type grouping bilaterally in the TrA muscles, but only in the left CAD. Fiber-type grouping suggests that denervation and reinnervation of fibers had occurred, and that these horses had subclinical RLN. There was a virtual elimination of 2x fibers in these muscles, accompanied by a significant increase in the percentage of 2a and slow fibers, and hypertrophy of these fiber types. The results suggest that multiple pathophysiological mechanisms are at work in early RLN, including selective denervation and reinnervation of 2x muscle fibers, corruption of neural impulse traffic that regulates 2x and slow muscle fiber types, and compensatory hypertrophy of remaining fibers. We conclude that horses afflicted with mild RLN are able to remain subclinical by compensatory hypertrophy of surviving muscle fibers.

  2. Successful training of HEMS personnel in laryngeal mask airway and intubating laryngeal mask airway placement.

    Science.gov (United States)

    Frascone, R J; Pippert, Greg; Heegaard, William; Molinari, Paul; Dries, David

    2008-01-01

    To evaluate laryngeal mask airway (LMA) and intubating laryngeal mask airway (ILMA) placement by helicopter emergency medical services (HEMS) personnel after a comprehensive training program. HEMS flight staff attended a didactic and manikin-based training session for both devices. After this training, they attempted LMA and ILMA placement in live, anesthetized patients in an operating room (OR). Outcome measures included placement success rates with the LMA, ILMA, and endotracheal intubation through the ILMA, time to ventilation, and time to intubation. Success rates and time to ventilation were compared using chi-squared and analysis of variance (ANOVA), respectively. Mean time to ventilation for the first and second placements of both devices was examined with repeated measures ANOVA. There was no difference in successful placement of the LMA compared with the ILMA (100% vs. 91%, P = .15). Ninety-five percent (19/20) of patients were successfully intubated through the ILMA. Time to intubation was 57.1 +/- 55 seconds (range, 20-240). Mean time to ventilation with either device did not differ significantly (36.8 +/- 17 vs. 38.05 +/- 20 seconds; P = .29). Mean time to ventilation for the first and second placement of either the LMA (P = .45) or the ILMA (P = .47) was not statistically different. Trained HEMS flight staff are capable of effectively placing the LMA and ILMA in the operating room after a comprehensive training protocol.

  3. PERSISTENT LEFT SUPERIOR VENACAVA

    Directory of Open Access Journals (Sweden)

    Devinder Singh

    2014-05-01

    Full Text Available A Persistent Left Superior Venacava (PLSVC is the most common variation of the thoracic venous system and rare congenital vascular anomaly and is prevalent in 0.3% of the population. It may be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. Incidental rotation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography. Condition is usually asymptomatic. Here we present a rare case of persistent left superior vena cava presented in OPD with dyspnoea & palpitations.

  4. [Cycloferon in complex therapy management of chronic laryngitis].

    Science.gov (United States)

    Demchenko, E V; Romantsov, M G; Grigorian, S S; Kovalenko, A L

    2013-01-01

    The clinical course of various forms of chronic laryngitis, including contact granulomas not only persistant and relapsing, but also inclined to oncologic pathology due to hyperplastic changes in the larynx resulting in malignization was described. Inhibition of the leukocyte interferon-synthesizing activity was observed in more than 88.1% of the subjects. Pathogenic viruses were isolated from 48.2% of the patients, EBV and mycoplasma prevailing. High direct correlation between chronic laryngitis and Herpes viruses was shown. The presence of three-component virus associations in the larynx mucosa was likely indicative of the bening process malignancy. The use of the interferon inductor cycloferon in the complex surgical and medicamentous management of chronic laryngitis was shown valid. The rate of the relapses lowered to 1.7 episodes a year.

  5. [Laryngeal amyloidosis: a clinical case and review of literature].

    Science.gov (United States)

    Fries, S; Pasche, P; Brunel, C; Schweizer, V

    2015-09-30

    Amyloidosis consists of different forms of systemic or isolated organ lesions characterised by fibrillary protein deposits in extra-cellular tissue. The isolated involvement of the larynx is the most frequent form in the ENT sphere. We present a clinical case of a 67 year-old woman addressed for a sub-acute laryngitis resistant to conservative treatment, and finally diagnosed with laryngeal amyloidosis. We reviewed its physiopathology, the scientific literature as well as the different possibilities of management. Laryngeal amyloidosis is rare. A thorough additional work-up for the research of multifocal or systemic forms is highly recommended. The treatment aims at a minimal invasive endoscopic surgery with functional organ preservation.

  6. Current evidence for the existence of laryngeal macrotremor and microtremor.

    Science.gov (United States)

    Shipp, T; Izdebski, K

    1981-07-01

    To test for the existence of laryngeal "microtremors" two experiments were conducted on humans. The first analyzed the acoustic characteristics of observable tremors (macrotremors) in the voice of singers using vocal vibrato and in pathologic subjects producing vocal tremor. In both of these groups acoustic oscillations between 4 and 8 Hz were found. The second study, using a normal subject, sampled electromyographic (EMG) activity from laryngeal and arm muscles during isometric contraction to determine if a periodic component (microtremor) was present in either muscle's contraction pattern. A 9-Hz signal was detected in limb muscle contraction, whereas no periodicity was found in signals from laryngeal muscles. The application of these findings to the theory behind voice "stress" analyzers is discussed

  7. OUR EXPERIENCES WITH INTUBATING LARYNGEAL MASK AIRWAY FOR ENDOTRACHEAL INTUBATION

    Directory of Open Access Journals (Sweden)

    Sandhya A.

    2015-06-01

    Full Text Available OBJECTIVE: A Prospective study was carried out to evaluate the clinical efficacy of ILMA for endotracheal intubation in patients with normal airway in terms of technical feasibility, problems encountered, hemodynamic responses and pharyngo - laryngeal complications and also to get acquainted with the technique. METHODS: Seventy patients of either sex, ASA grade 1 and 2, MPG grade I and II posted for various elective orthopedic, general surgical and ENT surgeries under general anesthesia were included in the study. Method used for insertion of ILMA and endotracheal intubation were as per the standard guidelines. RESULTS: The time required for insertion of ILMA and intubation, number of attempts required for successful insertion and intubation, manipulations required and success rate for ILMA insertion and intubation, along with hemodynamic changes and postoperative pharyngo - laryngeal complications were recorded. Conclusions: The ILMA can be used as a mean of endotracheal intubation with high success rate, good hemodynamic stability and minimal incidence of pharyngo - laryngeal complications.

  8. CORRELATION ANALYSIS BETWEEN STK15 GENE AND LARYNGEAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    赵旭; 李福才; 李英惠; 徐振明; 孙开来

    2004-01-01

    Objective: To explore the relationship between STK15 gene abnormal expression and laryngeal carcinoma. Methods: Tumor tissues and matched normal tissues were taken from 55 LSCC patients. Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect STK15 expression in 110 specimens. Results: In 38 of the 55 cases (69.1%), the STK15 expression at the mRNA levels was higher than that of the paired normal tissue. The ratio of ADV (average density value) of STK15 gene to ADV of β-actin gene was 1.22±0.49 in the cancer tissue, and 0.99±0.54 in the paired normal tissue with a significant difference (t=4.539, P<0.01). Conclusion: There was obvious association between the STK15 overexpression and laryngeal carcinoma. It may serve as an alternative mechanism of activating the pathogenesis of human laryngeal squamous cell carcinoma.

  9. The presence of Helicobacter pylori in laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Yilmaz, Ismail; Erkul, E; Berber, U; Kucukodaci, Z; Narli, G; Haholu, A; Demirel, D

    2016-03-01

    A definitive relationship between Helicobacter pylori (HP) and upper respiratory tract disorders has not been established. In this case-control study, we investigated the relationship between HP and laryngeal carcinoma by real-time PCR method in Turkey. 74 subjects were enrolled from patients who were admitted to the Otolaryngology Department. Formalin-fixed-paraffin-embedded tissue samples with laryngeal cancer were used and all samples were evaluated by real-time PCR method. Our study population included 72 males and 2 females with a mean age range of 62.7 years. Helicobacter Pylori was detected in only one case. The positive case was also investigated with histopathologic evaluation and HP immunohistochemistry. However, we could not detect HP in this case with both methods. This study revealed that HP might not contribute to the pathogenesis of laryngeal carcinoma. A definitive relationship between HP and upper respiratory tract disorders has not been established.

  10. Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis

    Science.gov (United States)

    Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria

    2016-01-01

    Introduction Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. Objective To identify factors associated with clinical and topographical features of LTB. Method a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Results Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Conclusions Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement. PMID:27077734

  11. CYTOKINES AND C-REACTIVE PROTEIN CONTENT IN SERUM BLOOD OF PATIENTS WITH CHRONIC LARYNGITIS DISEASE

    Directory of Open Access Journals (Sweden)

    Zaiter Samir

    2013-03-01

    Full Text Available Some kinds of interleikines of patients with chronic laryngitis disease were investigated. There is “cytokines explosion” of the patients with chronic laryngitis with persistent herpes simplex virus. Comparative investigation cytokine profile in serum blood is demonstrated: balanced reaction cytokines profile of patients with chronic laryngitis without persistent herpes simplex virus and dysbalanced reaction of patients with laryngitis (hyperergation. Increased content IL-6 and low content g-interferon and tumor necrosis factor (TNF-a are predisposition of chronisation inflammation processes in larynges. This situation needs sighting correction.

  12. Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy.

    Science.gov (United States)

    Silva, Carlos Eduardo Dilen da; Niedermeier, Bruno Taccola; Portinho, Fernando

    2015-07-01

    Introduction The indirect laryngoscopy has an important role in the characterization of reflux laryngitis. Although many findings are nonspecific, some strongly suggest that the inflammation is the cause of reflux. Objective The aim of this study was to evaluate the correlation between reflux symptoms and the findings of indirect laryngoscopy. Methods We evaluated 27 patients with symptoms of pharyngolaryngeal reflux disease. Results Laryngoscopy demonstrated in all patients the presence of hypertrophy of the posterior commissure and laryngeal edema. The most frequent symptoms were the presence of dry cough and foreign body sensation. Conclusion There was a correlation between the findings at laryngoscopy and symptoms of reflux.

  13. [Acute pseudo-membranous laryngitis in epidermolysis bullosa acquisita].

    Science.gov (United States)

    Lecomte, H; Folia, M; Muller, G; Gilbert, D; Tron, F; Besancenot, J-F; Romanet, P

    2010-05-01

    Epidermolysis bullosa acquisita is a rare entity belonging to the auto-immune cutaneous blistering disorders of the dermo-epidermal junction. Clinical manifestations are generally cutaneous including the development of sub-epidermal blisters. Mucosal manifestations should be systematically looking for, but laryngeal involvement remains uncommon. We report an 81-year-old woman who presented with dysphagia, dyspnea and dysphonia as the presenting features of laryngeal involvement of an epidermolysis bullosa acquisita. This is the tenth reported case in the literature. We describe our diagnostic approach and the therapeutic management, comparing them with the literature.

  14. Histoplasmosis Presenting as a Laryngeal Ulcer in an Immunocompetent Host.

    Science.gov (United States)

    John, Mary; Koshy, Jency Maria; Mohan, Sangeetha; Paul, Preethi

    2015-06-01

    Histoplasmosis is a granulomatous disease of worldwide distribution caused by a dimorphic fungus Histoplasma capsulatum. Majority of primary infections in immunocompetent hosts are asymptomatic or may present with flu-like illness. Histoplasmosis may occur in three forms: (i) Primary acute pulmonary form, (ii) chronic pulmonary and (iii) disseminated form. The manifestations of disseminated form of histoplasmosis are fever, weakness, weight loss, hepatosplenomegaly, and mucocutaneous lesions. The mucosal involvement could be oropharyngeal or laryngeal involvement. We report an unusual case of histoplasmosis presenting as a laryngeal ulcer in an immunocompetent host.

  15. Laryngeal carcinoma presenting as polymyositis: A paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Ritesh Sahu

    2016-01-01

    Full Text Available Laryngeal carcinoma is rarely associated with paraneoplastic syndrome. Inflammatory myopathy presenting as paraneoplastic event is commonly associated with carcinomas of ovary, lung, pancreas, stomach, colorectal, and non-Hodgkin′s lymphoma. We report a case of elderly male, who presented with proximal muscle weakness and found to be associated with laryngeal carcinoma. Diagnosis of polymyositis (PM was confirmed based on clinical features, laboratory test, and muscle biopsy. Exclusion of other commonly associated malignancies was done. This patient improved gradually after 6 months of immunosuppressive therapy and management of underlying cancer.

  16. Quantitative laryngeal electromyography: turns and amplitude analysis.

    Science.gov (United States)

    Statham, Melissa McCarty; Rosen, Clark A; Nandedkar, Sanjeev D; Munin, Michael C

    2010-10-01

    Laryngeal electromyography (LEMG) is primarily a qualitative examination, with no standardized approach to interpretation. The objectives of our study were to establish quantitative norms for motor unit recruitment in controls and to compare with interference pattern analysis in patients with unilateral vocal fold paralysis (VFP). Retrospective case-control study We performed LEMG of the thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) in 21 controls and 16 patients with unilateral VFP. Our standardized protocol used a concentric needle electrode with subjects performing variable force TA-LCA contraction. To quantify the interference pattern density, we measured turns and mean amplitude per turn for ≥10 epochs (each 500 milliseconds). Logarithmic regression analysis between amplitude and turns was used to calculate slope and intercept. Standard deviation was calculated to further define the confidence interval, enabling generation of a linear-scale graphical "cloud" of activity containing ≥90% of data points for controls and patients. Median age of controls and patients was similar (50.7 vs. 48.5 years). In controls, TA-LCA amplitude with variable contraction ranged from 145-1112 μV, and regression analysis comparing mean amplitude per turn to root-mean-square amplitude demonstrated high correlation (R = 0.82). In controls performing variable contraction, median turns per second was significantly higher compared to patients (450 vs. 290, P = .002). We first present interference pattern analysis in the TA-LCA in healthy adults and patients with unilateral VFP. Our findings indicate that motor unit recruitment can be quantitatively measured within the TA-LCA. Additionally, patients with unilateral VFP had significantly reduced turns when compared with controls.

  17. [Study on the correlation between EGFR-STAT3 signal pathway and laryngeal papilloma].

    Science.gov (United States)

    Wang, Xinhua; Sun, Jingwu

    2009-09-01

    To explore the relationship between the expression of EGFR and STAT3 in human laryngeal papilloma and its biological behavior. Reverse transcription polymerase chain reaction(RT-PCR), immunohistochemical staining and Western blot were used to evaluate the mRNA and protein expression of EGFR and STAT3 (p-STAT3) in 42 laryngeal papilloma tissues and 15 samples of normal laryngeal tissue, and the relationship between the protein expression of them and clinic pathological parameters was also analyzed. The mRNA expression levels of EGFR and STAT3 in laryngeal papilloma tissue were significantly higher than that in normal laryngeal tissue (P papilloma than normal laryngeal tissue by immunohistochemistry and western blot (P papilloma (P papilloma (P papilloma,, and the persistent activation of STAT3 gene plays an important role in the recurrence and canceration of laryngeal papilloma.

  18. Immunological responses against human papilloma virus and human papilloma virus induced laryngeal cancer.

    Science.gov (United States)

    Chitose, Shun-ichi; Sakazaki, T; Ono, T; Kurita, T; Mihashi, H; Nakashima, T

    2010-06-01

    This study aimed to clarify the local immune status in the larynx in the presence of infection or carcinogenesis associated with human papilloma virus. Cytological samples (for human papilloma virus detection) and laryngeal secretions (for immunoglobulin assessment) were obtained from 31 patients with laryngeal disease, during microscopic laryngeal surgery. On histological examination, 12 patients had squamous cell carcinoma, four had laryngeal papilloma and 15 had other benign laryngeal disease. Cytological samples were tested for human papilloma virus DNA using the Hybrid Capture 2 assay. High risk human papilloma virus DNA was detected in 25 per cent of patients (three of 12) with laryngeal cancer. Low risk human papilloma virus DNA was detected only in three laryngeal papilloma patients. The mean laryngeal secretion concentrations of immunoglobulins M, G and A and secretory immunoglobulin A in human papilloma virus DNA positive patients were more than twice those in human papilloma virus DNA negative patients. A statistically significant difference was observed between the secretory immunoglobulin A concentrations in the two groups. Patients with laryngeal cancer had higher laryngeal secretion concentrations of each immunoglobulin type, compared with patients with benign laryngeal disease. The study assessed the mean laryngeal secretion concentrations of each immunoglobulin type in the 12 laryngeal cancer patients, comparing human papilloma virus DNA positive patients (n = 3) and human papilloma virus DNA negative patients (n = 9); the mean concentrations of immunoglobulins M, G and A and secretory immunoglobulin A tended to be greater in human papilloma virus DNA positive cancer patients, compared with human papilloma virus DNA negative cancer patients. These results suggest that the local laryngeal immune response is activated by infection or carcinogenesis due to human papilloma virus. The findings strongly suggest that secretory IgA has inhibitory activity

  19. Air Superiority Fighter Characteristics.

    Science.gov (United States)

    1998-06-05

    many a dispute could have been deflated into a single paragraph if the disputants had just dared to define their terms.7 Aristotle ...meaningful. This section will expand on some key ideology concepts. The phrase "air superiority fighter" may bring to mind visions of fighter... biographies are useful in garnering airpower advocate theories as well as identifying key characteristics. Air campaign results, starting with World

  20. Serotonin in the solitary tract nucleus shortens the laryngeal chemoreflex in anaesthetized neonatal rats.

    Science.gov (United States)

    Donnelly, William T; Bartlett, Donald; Leiter, J C

    2016-07-01

    fibre afferents of the superior laryngeal nerve, and serotonergic shortening of the LCR may be mediated presynaptically by enhanced activation of inhibitory interneurons within the NTS.

  1. High Prevalence of Exercise-Induced Laryngeal Obstruction in Athletes

    DEFF Research Database (Denmark)

    Walsted Nielsen, Emil; Hull, James H; Backer, Vibeke

    2013-01-01

    INTRODUCTION: Unexplained respiratory symptoms reported by athletes are often incorrectly considered secondary to exercise-induced asthma. We hypothesised that this may be related to exercise induced laryngeal obstruction (EILO). This study evaluates the prevalence of EILO in an unselected cohort...

  2. A bony connection signals laryngeal echolocation in bats.

    Science.gov (United States)

    Veselka, Nina; McErlain, David D; Holdsworth, David W; Eger, Judith L; Chhem, Rethy K; Mason, Matthew J; Brain, Kirsty L; Faure, Paul A; Fenton, M Brock

    2010-02-18

    Echolocation is an active form of orientation in which animals emit sounds and then listen to reflected echoes of those sounds to form images of their surroundings in their brains. Although echolocation is usually associated with bats, it is not characteristic of all bats. Most echolocating bats produce signals in the larynx, but within one family of mainly non-echolocating species (Pteropodidae), a few species use echolocation sounds produced by tongue clicks. Here we demonstrate, using data obtained from micro-computed tomography scans of 26 species (n = 35 fluid-preserved bats), that proximal articulation of the stylohyal bone (part of the mammalian hyoid apparatus) with the tympanic bone always distinguishes laryngeally echolocating bats from all other bats (that is, non-echolocating pteropodids and those that echolocate with tongue clicks). In laryngeally echolocating bats, the proximal end of the stylohyal bone directly articulates with the tympanic bone and is often fused with it. Previous research on the morphology of the stylohyal bone in the oldest known fossil bat (Onychonycteris finneyi) suggested that it did not echolocate, but our findings suggest that O. finneyi may have used laryngeal echolocation because its stylohyal bones may have articulated with its tympanic bones. The present findings reopen basic questions about the timing and the origin of flight and echolocation in the early evolution of bats. Our data also provide an independent anatomical character by which to distinguish laryngeally echolocating bats from other bats.

  3. Probiotics reduce psychological stress in patients before laryngeal cancer surgery.

    Science.gov (United States)

    Yang, Hui; Zhao, Xiaoyun; Tang, Shan; Huang, Hua; Zhao, Xiulan; Ning, Zhuohui; Fu, Xiurong; Zhang, Caihong

    2016-03-01

    Laryngeal cancer is a common malignancy; surgery is the preferred treatment. Psychosocial stress is one of the negative impacts on patient recovery. This study aimed to elucidate the effect of probiotics on ameliorating anxiety, and on serum corticotropin-releasing factor (CRF) in laryngeal cancer patients before surgery. A total 30 patients with laryngeal cancer and 20 healthy volunteers were recruited. During the 2 weeks before surgery, 20 patients were randomly allocated to receive probiotics or placebo twice a day. Heart rate was recorded daily. The degree of anxiety was assessed by the Hamilton Anxiety Scale (HAMA). Serum CRF levels in laryngeal cancer patients increased significantly in approaching surgery. After ingestion of probiotics, serum levels of CRF and heart rate did not increase before surgery. In addition, taking probiotics relieved the degree of anxiety of the patients from HAMA 19.8 to 10.2. Probiotics can ameliorate the clinical anxiety and biochemical features of stress in patients scheduled for laryngectomy. © 2014 Wiley Publishing Asia Pty Ltd.

  4. Laryngeal Aerodynamics Associated with Oral Contraceptive Use: Preliminary Findings

    Science.gov (United States)

    Gorham-Rowan, Mary; Fowler, Linda

    2009-01-01

    The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p[subscript alpha] /repetitions were obtained using a…

  5. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... pulmonary air flow to the pharynx in the absence of the larynx, thereby permitting esophageal speech....

  6. Late endemic syphilis: case report of bejel with gummatous laryngitis.

    OpenAIRE

    Pace, J. L.; Csonka, G. W.

    1988-01-01

    An elderly Bedouin woman originally thought, on clinical and histological grounds, to have tuberculosis of the larynx was found to have gummatous laryngitis due to late endemic syphilis (bejel). This disease is highly prevalent in the Bedouin tribes of the Middle East. Doctors dealing with Arab patients, either in the Middle East or elsewhere, should be aware of this possibility.

  7. Prone surgery and laryngeal mask airways: an overview of recent ...

    African Journals Online (AJOL)

    2013-08-17

    Aug 17, 2013 ... muscular blocking drugs with their own risks and side- ... Clinicians tend to avoid the use of a laryngeal mask airway (LMA) in ... Patients are more haemodynamically stable if induced in the prone position .... be more pertinent in male patients.4 ... average body mass index (BMI) was 30.6 kg/m2 for females.

  8. Laryngeal Muscles Are Spared in the Dystrophin Deficient "mdx" Mouse

    Science.gov (United States)

    Thomas, Lisa B.; Joseph, Gayle L.; Adkins, Tracey D.; Andrade, Francisco H.; Stemple, Joseph C.

    2008-01-01

    Purpose: "Duchenne muscular dystrophy (DMD)" is caused by the loss of the cytoskeletal protein, dystrophin. The disease leads to severe and progressive skeletal muscle wasting. Interestingly, the disease spares some muscles. The purpose of the study was to determine the effects of dystrophin deficiency on 2 intrinsic laryngeal muscles, the…

  9. Endoscopic approach for a laryngeal neoplasm in a dog

    Directory of Open Access Journals (Sweden)

    Pedro Paulo Maia Teixeira

    2015-01-01

    Full Text Available Laryngeal and tracheal tumors are rare in pets; some piece of information on their disease behavior, therapy and evolution are limited. Neoplasms in this area are a diagnostic challenge. In many cases, they can be biopsied and excised using endoscopic instruments, but there is no report of this in canines. The goal of this study is to report a successful case of a laryngeal neoplasm removal through endoscopy. A head and neck radiogram revealed a mass in the laryngeal lumen protruding into the trachea. The patient then underwent an endoscopy to confirm the radiographic diagnosis and to surgically remove the tumor. The histopathological diagnosis was poorly differentiated carcinoma. The most appropriate treatment for laryngeal tumors is the resection of the submucosa or a partial laryngectomy however, partial and total laryngectomies are associated with many postoperative complications. In contrast, the endoscopic approach allows for highly magnified visualization of the lesion in situ, which facilitates the surgical removal of the mass through videosurgery. With little manipulation of the affected area, the chances of postoperative complications are reduced, leading to a more rapid recovery.

  10. Radiotherapeutical chromosomal aberrations in laryngeal cancer patients

    Directory of Open Access Journals (Sweden)

    Stošić-Divjak Svetlana L.

    2009-01-01

    Full Text Available Introduction. The authors present the results of cytogenetic analysis of 21 patients with laryngeal carcinomas diagnosed and treated in the period 1995-2000 at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia and Clinical Center of Novi Sad. Material and methods. The patients were specially monitored and the material was analyzed at the Institute of Human Genetics of the School of Medicine in Belgrade as well as in the Laboratory for Radiological Protection of the Institute of Occupational and Radiological Health 'Dr Dragomir Karajovic' in Belgrade. Results. The incidence of chromosomal aberrations and incidence of exchange of material between sister chromatids were observed in the preparation of the metaphasic lymphocyte chromosomes of the peripheral blood obtained in the culture. Structural aberrations were found on the chromosomes in the form of breakups, rings, translocations and dicentrics as early as after a single exposure of patients to tumor radiation dose of 2 Gy in the field sized 5x7. Out of the total number of 35 cultivated blood samples obtained from 13 patients, 21 were successfully cultivated and they were proved to contain chromosomal aberrations. Some of the peripheral blood samples failed to show cell growth in vitro due to the lethal cell damages in vivo. Discussion.. We have consluded that the number of structural aberrations cannot be used as a biological measure of the absorbed ionizing radiation dose. The presence of aberrations per se is indicative of the mutagenic effect of the ionizing radiation, which was also confirmed in our series on the original model by cultivation of the peripheral blood lymphocytes in the culture of the cells of the volunteer donors upon in vitro radiation. Using the method of bromdeoxyuridylreductase, the increased incidence of SCE as a mutagenic effect was registered. Conclusion. It has been concluded that the increase of absorbed radiation dose in

  11. Laryngeal findings and acoustic changes in hubble-bubble smokers.

    Science.gov (United States)

    Hamdan, Abdul-latif; Sibai, Abla; Oubari, Dima; Ashkar, Jihad; Fuleihan, Nabil

    2010-10-01

    The purpose of our investigation was to evaluate the laryngeal findings and acoustic changes in hubble-bubble smokers. A total of 42 subjects with history of hubble-bubble smoking were recruited for this study. A corresponding group with a history of cigarette smoking and controls were matched. All subjects underwent laryngeal video-endostroboscopic evaluation and acoustic analysis. In the hubble-bubble smoking group, 61.9% were males. The average age was 30.02 +/- 9.48 years and the average number of years of smoking was 8.09 +/- 6.45 years. Three subjects had dysphonia at the time of examination. The incidence of benign lesions of the vocal folds in the hubble-bubble group was 21.5%, with edema being the most common at 16.7% followed by cyst at 4.8%. The incidence of laryngeal findings was significantly higher in the hubble-bubble group compared to controls. In the cigarette-smoking group, the most common finding was vocal fold cyst in 14.8% followed by polyps in 7.4%, and edema, sulcus vocalis and granuloma. These findings were not significantly different from the hubble-bubble group except for the thick mucus, which was significantly higher in the latter. There were no significant changes in any of the acoustic parameters between hubble-bubble smokers and controls except for the VTI and MPT, which were significantly lower in the hubble-bubble group. In comparison with the cigarette-smoking group, hubble-bubble smokers had significantly higher Fundamental frequency and habitual pitch (p value 0.042 and 0.008, respectively). The laryngeal findings in hubble-bubble smokers are comparable to cigarette smokers. These laryngeal findings are not translated acoustically, as all the acoustic parameters are within normal range compared to controls.

  12. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids

    Science.gov (United States)

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-01-01

    Abstract The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No

  13. Role of surgery in modern treatment of laryngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Jović Rajko M.

    2013-01-01

    Full Text Available The strategy of organ preservation by applying chemoradiotherapy in the treatment of laryngeal carcinoma, which has been extensively used since 1990s, is now being reviewed regarding its further justification. Despite good results in other localization of head and neck cancer, it has not met the expectations in case of laryngeal cancer. One explanation is the lower participation of human papillomavirus type 16 in the etiology of laryngeal cancer. A lot of developing countries base their concept on primary surgery with subsequent radiotherapy, because the cost of operations for cancer of the larynx is much lower than in developed countries. Endoscopic surgery of T1 cancers is feasible in all environments using cold surgery thanks to modern management of anesthesia with the possibility of local application of adrenaline. Its price is € 481.46, and if it is performed through laryngofissure, the price is € 785.46. The introduction of lasers into the treatment would justify the initial investment and extend indications, and the surgery of T1 and T2 cancers with laser application should be the standard practice in all countries and regions dealing with laryngeal pathology. T2 and some T3 cancers can be treated by conservation surgery of the larynx. Most of T3 and T4 cancers are indications for total laryngectomy or near-total laryngectomy in selected cases. If it is the primary surgery, wound healing is good and complications are rare. This greatly reduces the cost of operation, which is €1910.15. Surgery after radiotherapy, particularly after chemoradiotherapy, may result in complications that significantly prolong the treatment and increase its costs. Thus, the biological nature of laryngeal cancer and its specificity make this approach to the treatment of cancer available in all regions of the world.

  14. Contabilidad Financiera Superior

    OpenAIRE

    Ipiñazar Petralanda, Izaskun

    2013-01-01

    Duración (en horas): De 31 a 40 horas. Destinatario: Estudiante y Docente A través de este material se presentan las pautas necesarias para implementar un aprendizaje basado en problemas en la asignatura de Contabilidad Financiera Superior dentro de los temas “Constitución de S.A. y S.R.L.” (Tema 2), “Ampliaciones de Capital” (Tema 3) y “Reducciones de Capital” (Tema 4). En primer lugar se presentan las guías generales de la asignatura, y a continuación, las diferentes activida...

  15. Contabilidad Financiera Superior

    OpenAIRE

    Ipiñazar Petralanda, Izaskun

    2013-01-01

    Duración (en horas): De 31 a 40 horas. Destinatario: Estudiante y Docente A través de este material se presentan las pautas necesarias para implementar un aprendizaje basado en problemas en la asignatura de Contabilidad Financiera Superior dentro de los temas “Constitución de S.A. y S.R.L.” (Tema 2), “Ampliaciones de Capital” (Tema 3) y “Reducciones de Capital” (Tema 4). En primer lugar se presentan las guías generales de la asignatura, y a continuación, las diferentes activida...

  16. UreA and cagA genes of Helicobacter pylori in Egyptian patients with laryngeal squamous cell carcinoma and benign laryngeal polyps: a cohort study.

    Science.gov (United States)

    Barakat, Ghada; Nabiel, Yasmin; Ali, Omima; El-Nady, Ghada; Musaad, Ahmed; El-Sharkawy, Asser

    2016-10-01

    This work aims to estimate the prevalence of Helicobacter pylori ureA gene and evaluate cagA gene-positive strains in both patients of laryngeal squamous cell carcinoma (LSCC) and those with benign laryngeal polyps. This study included 49 patients confirmed pathologically to have LSCC and 15 patients with benign laryngeal polyps over a period from June 2013 to March 2015. Samples of laryngeal tissue were collected during direct laryngoscope under general anesthesia to be pathologically evaluated followed by analysis for H. pylori detection. Each laryngeal tissue sample was divided into three parts; one for bacteriological examination, the second for pathological examination and the third for PCR to detect both ureA and cagA genes. Out of 49 LSCC samples, 31 (64.6 %) was positive for ureA by PCR. Out of them, 29 samples (93.5 %) were cagA positive. Only three cases (20 %) of the benign laryngeal polyp were ureA positive by PCR and one of them was cagA positive by PCR. By the bacteriological culture, only eight samples (25.8 %) gave growth. All of them were ureA positive and only seven of them were cagA positive. There was a significant association between presence of H. pylori and LSCC as compared to benign laryngeal polyp which may contribute in the pathogenesis of laryngeal carcinoma. These results should be confirmed by further studies over larger number of cases.

  17. Statistics of superior records

    Science.gov (United States)

    Ben-Naim, E.; Krapivsky, P. L.

    2013-08-01

    We study statistics of records in a sequence of random variables. These identical and independently distributed variables are drawn from the parent distribution ρ. The running record equals the maximum of all elements in the sequence up to a given point. We define a superior sequence as one where all running records are above the average record expected for the parent distribution ρ. We find that the fraction of superior sequences SN decays algebraically with sequence length N, SN˜N-β in the limit N→∞. Interestingly, the decay exponent β is nontrivial, being the root of an integral equation. For example, when ρ is a uniform distribution with compact support, we find β=0.450265. In general, the tail of the parent distribution governs the exponent β. We also consider the dual problem of inferior sequences, where all records are below average, and find that the fraction of inferior sequences IN decays algebraically, albeit with a different decay exponent, IN˜N-α. We use the above statistical measures to analyze earthquake data.

  18. Frenillo labial superior doble

    Directory of Open Access Journals (Sweden)

    Carlos Albornoz López del Castillo

    Full Text Available El frenillo labial superior doble no sindrómico es una anomalía del desarrollo que no hemos encontrado reportada en la revisión bibliográfica realizada. Se presenta una niña de 11 años de edad que fue remitida al servicio de Cirugía Maxilofacial del Hospital "Eduardo Agramonte Piña", de Camagüey, por presentar un frenillo labial superior doble de baja inserción. Se describen los síntomas clínicos asociados a esta anomalía y el tratamiento quirúrgico utilizado para su solución: una frenectomía y plastia sobre la banda muscular frénica anormal que provocaba exceso de tejido en la mucosa labial. Consideramos muy interesante la descripción de este caso, por no haber encontrado reporte similar en la literatura revisada.

  19. Reconstruction of laryngeal function in subtotal laryngectomy with preservation of monoarytenoid cartilage

    Institute of Scientific and Technical Information of China (English)

    RUAN Yan-yan; CHEN Wen-xian

    2002-01-01

    Objective:To evaluate subtotal laryngectomy with preservation of monoarytenoid cartilage to reconstruct laryngeal function in the treatment of advanced laryngeal cancer. Methods: We retrospectively reviewed 48 patients with advanced laryngeal cancer (T3 or T4 on the primary site) treated by subtotal laryngectomy with preservation of monoarytenoid cartilage to reconstruct laryngeal function. Eighteen of them underwent neck dissection. Ipsilateral recurrent laryngeal nerve was preserved during this surgery. The cricoid cartilage was anastomosed to hypopharynx accordingly. Results: The overall 3- and 5-year survival rates were 81.25%(39/45) and 66. 67 %(32/48 ), respectively. All patients had good phonation and swallowing function after surgery. Decannulation rate was 93. 75 %. Conclusion: Subtotal laryngectomy with preservation of monoarytenoid cartilage is satisfactory for treatment of elected advanced laryngeal cancers. The effect of this surgery is more satisfactory than that of the near-total laryngectomy (Pearson's technic).

  20. Stroboscopic findings in patients with benign laryngeal lesions: a brief report

    Directory of Open Access Journals (Sweden)

    S Azimian

    2012-11-01

    Full Text Available Background: Laryngeal videostroboscopy is an important noninvasive diagnostic tool in patients with dysphonia. More than 50% of patients with dysphonia have a benign laryngeal lesion on vocal fold examination. The aim of this study was to evaluate patients with benign laryngeal lesions by videostroboscopy.Methods: This cross-sectional study was done on 159 patients with dysphonia in Amiralam Hospital in Tehran, Iran during 2006-2007. All the patients underwent stroboscopic examination of the vocal folds, including their movement. We also evaluated the patients for mucosal status, mucosal wave and patterns of glottal closure.Results: Eighty-two patients participating in the study were female and 77 were male. Reflux laryngitis and muscle tension dysphonia were the most observed disorders in the patient population. Patients with sulcus vocalis and intracordal cysts had the worst mucosal wave patterns.Conclusion: Laryngeal videostroboscopy is a useful tool for the diagnosis and treatment planning in patients with benign laryngeal lesions.

  1. Cuff leak test and laryngeal survey for predicting post-extubation stridor

    OpenAIRE

    Patel, Anit B; Chizobam Ani; Colin Feeney

    2015-01-01

    Background and Aims: Evidence for the predictive value of the cuff leak test (CLT) for post-extubation stridor (PES) is conflicting. We evaluated the association and accuracy of CLT alone or combined with other laryngeal parameters with PES. Methods: Fifty-one mechanically ventilated adult patients in a medical-surgical intensive care unit were tested prior to extubation using; CLT, laryngeal ultrasound and indirect laryngoscopy. Biometric, laryngeal and endotracheal tube (ETT) parameters wer...

  2. ABO blood group is a predictor of survival in patients with laryngeal cancer

    OpenAIRE

    Jin, Ting; Li, Pei-Jing; Chen, Xiao-zhong; Hu, Wei-Han

    2016-01-01

    Background Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinicopathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis. Methods We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat-sen University Cancer Center ...

  3. Cuff leak test and laryngeal survey for predicting post-extubation stridor

    Directory of Open Access Journals (Sweden)

    Anit B Patel

    2015-01-01

    Full Text Available Background and Aims: Evidence for the predictive value of the cuff leak test (CLT for post-extubation stridor (PES is conflicting. We evaluated the association and accuracy of CLT alone or combined with other laryngeal parameters with PES. Methods: Fifty-one mechanically ventilated adult patients in a medical-surgical intensive care unit were tested prior to extubation using; CLT, laryngeal ultrasound and indirect laryngoscopy. Biometric, laryngeal and endotracheal tube (ETT parameters were recorded. Results: PES incidence was 4%. CLT demonstrated ′no leak′ in 20% of patients. Laryngeal oedema was present in 10% of the patients on indirect laryngoscopy, and 71% of the patients had a Grades 1-3 indirect laryngoscopic view. Mean air column width on laryngeal ultrasound was 0.66 ± 0.15 cm (cuff deflated, mean ratio of ETT to laryngeal diameter was 0.48 ± 0.07, and the calculated CLT and laryngeal survey composite was 0.86 ± 1.25 (range 0-5. CLT and the CLT and Laryngeal survey composite measure were not associated with or predict PES. Age, sex, peri-extubation steroid use, intubation duration and body mass index were not associated with PES. Conclusion: Even including ultrasonographic and indirect laryngoscopic examination of the airway, no single aspect of the CLT or combination with laryngeal parameters accurately predicts PES.

  4. Detection of helicobacter pylori in benign laryngeal lesions by polymerase chain reaction: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Izadi Farzad

    2012-04-01

    Full Text Available Abstract Background Although Helicobacter Pylori (HP was detected in some cases of chronic laryngitis, the results were not confirmed by polymerase chain reaction (PCR. By this time, it has not been found in laryngeal lesions by in house PCR, the most sensitive method for detecting the genome tracks. Regarding the previous results and also few numbers of studies about the presence of HP in benign laryngeal lesions, specifically by PCR, we aimed to investigate the presence of HP in benign laryngeal lesions by in-house PCR. Methods The samples were taken from 55 patients with benign laryngeal lesions and frozen in −20°C. One milliliter (ml of lysis buffer was added to 100 mg (mg of each sample and the tube was placed in 56°C overnight. Then DNA extraction was carried out. Results To find HP DNA, in-house PCR was performed that revealed 5 positive results among 55 patients with benign laryngeal lesions. Of them, 3 were polyp, 1 was nodule and 1 was papilloma. Conclusion Although the number of positive results was not a lot in this study, it was in contrast with previous studies which could not find any HP tracks in benign laryngeal lesions by other methods. More studies about the prevalence of HP in benign laryngeal lesions improve judging about the effect of this infection on benign laryngeal lesions.

  5. Self evaluation of communication experiences after laryngeal cancer – A longitudinal questionnaire study in patients with laryngeal cancer

    Directory of Open Access Journals (Sweden)

    Finizia Caterina

    2008-03-01

    Full Text Available Abstract Background Aim of this longitudinal study was to investigate the sensitivity to change of the Swedish Self Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (the S-SECEL, addressing communication dysfunction in patients treated for laryngeal cancer. Previous studies have highlighted the need for more specific questionnaires for this purpose. Methods 100 patients with Tis-T4 laryngeal cancer were included prior to treatment onset. Patients answered four questionnaires at six occasions during one year; the S-SECEL, the European Organisation for Research and Treatment of Cancer (EORTC Core Quality of Life Core Questionnaire (QLQ-C30 supplemented by the Head and Neck cancer module (QLQ-H&N35 and the Hospital Anxiety and Depression (HAD scale. In addition, performance status was assessed. Differences within groups were tested with the Wilcoxon paired signed ranks test and between-group analyses were carried out using the Mann-Whitney U test. Magnitude of group differences was analyzed by means of effect sizes. Results The S-SECEL was well accepted with a response rate of 76%. Communication dysfunction increased at 1 month, followed by a continuous decrease throughout the year. Changes were statistically significant at most measurement, demonstrating the sensitivity of the S-SECEL to changes in communication over time. The S-SECEL and the EORTC QLQ-C30 with the QLQ-H&N35 demonstrated similar results; however the S-SECEL was more sensitive regarding communication dysfunction. The largest changes were found in the most diagnose specific items concerning voice and speech. Conclusion The S-SECEL was investigated in the largest Scandinavian longitudinal study concerning health-related quality of life (HRQL in laryngeal cancer patients. The questionnaire was responsive to change and showed convergent results when compared to established HRQL questionnaires. Our findings also indicate that the S-SECEL could be a more

  6. VIDEOLARYNGOSCOPIC SURGEY IN BENIGN LARYNGEAL LESIONS-OUR EXPERIENCE

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    Satheesh

    2015-11-01

    Full Text Available : Benign laryngeal lesions are commonly encountered causes of dysphonia and are often surgically correctable. A prospective study on 62 cases selected for videolaryngoscopic surgery was undertaken in a single unit in the department of ENT, Medical College Hospital, Thiruvananthapuram. The male: female ratio was 1.8:1 and the most common affected age group was 35-45 yrs. The most common benign lesion was vocal polyp. Preoperative voice assessment and 70 degree endoscopy was done. Follow up visits were done at 1 week, 3 weeks and 6 weeks and voice assessment and laryngoscopic appearances were noted. 98% reported excellent improvement of voice. The varieties of benign lesions which cause hoarseness are sources of concern and worry as it can affect the self esteem of a person. Thus videolaryngoscopic surgery (VLS coupled with voice therapy offers cost effective and safe management in benign laryngeal lesions

  7. MICRO LARYNGEAL SURGERY: 25 CASES OF BENIGN LESIONS OF LARYNX

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    Shanta Nibedita

    2014-10-01

    Full Text Available : Micro Laryngeal Surgery (MLS is a procedure where the larynx is seen with the help of endoscope and the view is magnified by use of an operating microscope. This has numerous advantages in regard to delineating the extent of lesion and performing a satisfactory excision or biopsy. This is the procedure of choice in assessment as well as treatment of benign lesions of larynx. Patients who are voice users were benefited by the procedure by getting back their normal voice. Study group comprise of 25 patients with age group varying from 12-48 years. Various abnormalities were detected among these patients, vocal nodule being the commonest. Other pathologies were vocal cord polyp, Reinke’s Oedema, ventricular cyst, chronic laryngitis, tuberculosis and papilomatosis of larynx. MLS is safe, effective and smoothly performed procedure giving a person back his normal voice

  8. Co-existence of Pulmonary, Tonsillar and Laryngeal Tuberculosis

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    Erkan Ceylan

    2013-10-01

    Full Text Available    A 56-year old man applied to otorhinolaryngology clinic with sore throat, dysphagia. During direct examination, left palatine tonsil and tonsil plicas ulcerovegetative lesions were found. In the indirect laryngoscopy, in some regions of the larynx and epiglottis, ulcerovegetative lesions were observed too. Because of suspicion of laryngeal carcinoma and metastasis, punch biopsy of the left palatine tonsil was performed. Chest x-ray and computerized tomography of the thorax revealed two adjacent cavitations in the apicoposterior segment of the left upper lobe. In the histopathologic examination of biopsies, granulomatous structures that proved tuberculosis were observed. In the fiberoptic bronchoscopic analysis, endobronchial lesion was not detected. Acid-fast bacilli were determined in sputum and bronchial lavage in microscopy and culture. The case of this middle aged male patient with co-existence of tonsillar, laryngeal and pulmonary tuberculosis presents the clinical significance of upper airway tuberculosis in terms of its infectiousness and rare occurrence.

  9. Laryngeal schwannoma: a case report with emphasis on sonographic findings

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    Souza, Luis Ronan Marquez Ferreira de, E-mail: luisronan@gmail.com [Universidade Federal do Triangulo Mineiro (UFTM), Uberaba, MG (Brazil); De Nicola, Harley; Yamasaki, Rosiane; Pedroso, Jose Eduardo; Brasil, Osiris de Oliveira Campones do; Yamashita, Helio [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina

    2014-05-15

    Schwannomas are benign nerve sheath tumors composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral, cranial and autonomic nerves. Twenty-five to forty-five percent of all schwannomas occur in the head and neck region, but location of such tumors in the larynx is rarely observed. The present report is aimed at describing a clinical case of laryngeal schwannoma, with emphasis on sonographic findings. (author)

  10. Laryngeal mask airway protector™: Advanced uses for laparoscopic cholecystectomies

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    Leng Zoo Tan

    2017-01-01

    Full Text Available The laryngeal mask airway (LMA Protector™ is a second-generation perilaryngeal sealer type supraglottic airway device recently introduced into clinical practice. We describe our initial experiences with the use of the LMA Protector™ in three patients undergoing laparoscopic cholecystectomies. In all patients, we found the LMA Protector™ to have acceptable placements on the first attempt, adequate oropharyngeal leak pressures and ventilation adequacy.

  11. Reconstructive procedures for impaired upper airway function: laryngeal respiration

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    Müller, Andreas

    2005-09-01

    Full Text Available The larynx is the "bottleneck" of the human airway. For this reason, the effects of stenosing laryngeal pathologies on the vital factor respiratory gas exchange are particularly critical. Internal stabilization is a prerequisite for recovery of the laryngeal respiratory function in severe forms of inspiratory collapse (laryngomalacia. Effective laser surgery techniques have been developed to this end in recent years.Glottis-dilating surgery in cases of bilateral vocal cord motion impairment is now moving in the direction of endoscopic laser cordotomy or cordectomy, whereas arytenoidectomy and open surgical procedures are now used only rarely due to higher secondary morbidity rates. In individual cases, in particular if functional recovery is expected, temporary laterofixation of a vocal cord using an endoscopic suturing technique can be a helpful approach.Extensive laryngeal defects can be covered by means of composite grafts with mucosal lining, a supporting skeleton and their own vascularization. Autologous transplantation of the larynx, with its complex surgical and immunological problems, has become a manageable procedure. The problems of post-transplantation reinnervation and risk assessment of immunosuppression-induced recurrence of the tumor are still under consideration. Reanimation of the bilaterally paralyzed larynx by means of neurorrhaphy (neurosuture, neural grafting and, more recently, functional electrostimulation (pacemaker represents a challenge for the coming years. In most cases of paralysis of the recurrent laryngeal nerve, a part of the muscles is maintained by synkinetic reinnervation when therapy is carried out, which however also prevents effective vocal cord movement due to simultaneous activity of agonists and antagonists. Modulation of reinnervation by means of electrostimulation and modern genetic therapy approaches justify hopes of better outcomes in the future.

  12. Case Report: Acute tuberculous laryngitis presenting as acute epiglottitis

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    Ahmed H El Beltagi

    2011-01-01

    Full Text Available The incidence of laryngeal tuberculosis (TB, which had dropped dramatically after the institution of modern anti-TB chemotherapy, has shown recent reemergence. It is important to be aware of its possibility, especially as it can present with nonspecific upper airway symptoms and a frequent lack of constitutional manifestations. We report such a case presenting as acute epiglottitis, with diffuse involvement of the supraglottic larynx associated with reactivation lung TB.

  13. The diagnosis and treatment of the laryngeal chondrosarcoma

    Institute of Scientific and Technical Information of China (English)

    Wenwei Zhang; Jie Qiu; Xinyu Zhang

    2012-01-01

    Chondrosarcoma (CS) of larynx is uncommon and predominantly affects the cricoid cartilage. A 70% to 75% of these tumors arise on the endolaryngeal surface of the posterior lamina of the cricoid cartilage. The clinical presentation include hoarseness, stridor, dyspnea, or a neck mass etc. The diagnosis is suggested when calcification is identified in a laryngeal tumor. Computed tomography (CT) is the best noninvasive technique for imaging the lesion. Surgical extirpation is the standard therapy with no role for radiation therapy or chemotherapy.

  14. [Endotracheal tube for laryngeal CO2 laser microsurgery. 208 cases].

    Science.gov (United States)

    Brille, P; Milhaud, A; Starobinsky, E; Postel, J P; Buffet, J P; Vaquette, C; Boudin, G; Daelman, F; Lemoine, E

    1985-07-06

    To suppress the risk inherent in laryngeal microsurgery performed with a CO2 laser beam, the authors suggest to use a reinforced silicone endotracheal tube, the cuff of which is protected by a silicone plus aluminium powder shield. The resistance of silicone to fire is augmented during laser shots by a nitrogen flow on the upper side of the shield at the rates of 2 l/min in patients breathing air and 30 l/min in patients give oxygen.

  15. Laryngeal sensitivity in patients with amyotrophic lateral sclerosis

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    Giovanni Ruoppolo

    2016-11-01

    Full Text Available Recent studies have shown the involvement of the sensory nervous system in patients with amyotrophic lateral sclerosis (ALS. The aim of our study was to investigate the correlation between the laryngeal sensitivity deficit and the type of ALS onset (bulbar or spinal in a large series of 114 consecutive ALS patients. Participants were subdivided into two groups, bulbar and spinal ALS according to the clinical onset of disease, and submitted to a clinical and instrumental evaluation of swallowing, including a fibre-optic endoscopic evaluation of swallowing (FEES with sensory testing. Dysphagia severity was scored using the Penetration-Aspiration Scale (PAS and the Pooling score (P-score. In addition, three patients with laryngeal sensitivity deficit were submitted to a laryngeal biopsy to assess the status of the sensory innervation. All patients showed a normal glottal closure during phonation and volitional cough. Fifty-six subjects (49%, 14 spinal- and 42 bulbar-onset ALS, showed dysphagia at the first clinical observation (PAS score >1; P-score >5. Dysphagia resulted more frequently in bulbar-onset ALS (P < 0.01. Thirty-eight (33% patients had a sensory deficit of the larynx. The sensory deficit of the larynx was significantly more frequent in bulbar-onset ALS (P < 0.01. The sensory deficit of the larynx among dysphagic patients was also significantly more frequent in bulbar-onset ALS (P = 0.02. Several abnormalities were found in all three subjects who underwent a laryngeal biopsy: in one patient no intra-epidermal fibre was found; in the other two, the fibres showed morphological changes. Our observations are important to consider for assessment and management of dysphagia in patients with ALS.

  16. [Drugs for supplementation in cataract surgery with a laryngeal mask].

    Science.gov (United States)

    Becker, R; Schmidt, W; Viehl, H; Rupp, D

    2002-10-01

    We compared intraocular pressure (IOP), vitreous pressure and several anaesthesiological parameters for patients who underwent cataract surgery with propofol anaesthesia, laryngeal mask and different supplementations with reference to the effect of S-ketamin in particular. In 4 groups with 15 patients cataract surgery (phacoemulsification) was carried out using anaesthesia with propofol, laryngeal masks and spontaneous breathing if possible, supplementation with propofol (0.6 mg/kg, group 1), S-ketamin (0.3 mg/kg, group 2), ketamin (0.6 mg/kg, group 3) or fentanyl (0.5 microgram/kg, group 4); IOP measurement with tonopen XL and scoring vitreous pressure at different times during anaesthesia (score 0-3). For IOP and vitreous pressure, none of the different supplementations showed a significant difference. Insertion of the laryngeal mask did not cause a rise in intraocular pressure. The number of patients with spontaneous breathing during the operation in group 4 was significantly lower than in groups 1-3. No significant differences were observed between the different anaesthesiological parameters. S-Ketamin had no significant effect on IOP and vitreous pressure during phacoemulsification. It offers a safe "handling" of patients because of a high spontaneous breathing rate and lower concentration compared to Ketamin.

  17. Inhaled Mannitol as a Laryngeal and Bronchial Provocation Test.

    Science.gov (United States)

    Tay, Tunn Ren; Hoy, Ryan; Richards, Amanda L; Paddle, Paul; Hew, Mark

    2017-03-01

    Timely diagnosis of vocal cord dysfunction (VCD), more recently termed "inducible laryngeal obstruction," is important because VCD is often misdiagnosed as asthma, resulting in delayed diagnosis and inappropriate treatment. Visualization of paradoxical vocal cord movement on laryngoscopy is the gold standard for diagnosis, but is limited by poor test sensitivity. Provocation tests may improve the diagnosis of VCD, but the diagnostic performance of current tests is less than ideal. Alternative provocation tests are required. This pilot study demonstrates the feasibility of using inhaled mannitol for concurrent investigation of laryngeal and bronchial hyperresponsiveness. Consecutive patients with suspected VCD seen at our institution's asthma clinic underwent flexible laryngoscopy at baseline and following mannitol challenge. VCD was diagnosed on laryngoscopy based on inspiratory adduction, or >50% expiratory adduction of the vocal cords. Bronchial hyperresponsiveness after mannitol challenge was also assessed. We evaluated the interrater agreement of postmannitol laryngoscopy between respiratory specialists and laryngologists. Fourteen patients with suspected VCD in the context of asthma evaluation were included in the study. Mannitol provocation demonstrated VCD in three of the seven patients with normal baseline laryngoscopy (42.9%). Only two patients had bronchial hyperresponsiveness. There was substantial interrater agreement between respiratory specialists and laryngologists, kappa = 0.696 (95% confidence interval: 0.324-1) (P = 0.006). Inhaled mannitol can be used to induce VCD. It is well tolerated and can evaluate laryngeal and bronchial hyperresponsiveness at the same setting. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Laryngeal assessment by videolaryngostroboscopy in patients with rheumatoid arthritis.

    Science.gov (United States)

    Gómez-Puerta, José A; Cisternas, Ariel; Hernández, M Victoria; Ruiz-Esquide, Virginia; Vilaseca, Isabel; Sanmartí, Raimon

    2014-01-01

    To evaluate the larynx involvement in patients with rheumatoid arthritis (RA) in a clinical setting and correlate with the different clinical features related to more aggressive disease. Cross-sectional study including 36 consecutive patients with RA. Reflux symptoms were evaluated by the Reflux Symptom Index (RSI) and vocal cord impairment by the Voice Handicap Index-10 (VHI-10). Laryngeal involvement was done by videolaryngostroboscopy (VLS). The mean age was 56,3 ± 14 years with a mean disease duration of 2,6 ± 3,1 years (range 0-16 years). Voice use was considered as professional users in 33%. Twenty-four (67%) out of 36 patients had abnormal findings of VLS. One patient had larynx nodules (bamboo nodules). Eleven patients (31%) were diagnosed with muscle tension dysphonia, and there were symptoms and signs of pharyngeal-laryngeal reflux in 23 (64%) patients. No signs of cricoarytenoid joint impairment was found. Organic larynx involvement was uncommon in patients with RA. However symptoms and signs of pharyngeal-laryngeal reflux were seen in around 60% of patients. There was no correlation between the clinical phenotype, severity of disease, immunological profile or treatment with VLS findings. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  19. Sobredentadura total superior implantosoportada

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    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  20. Laryngeal carcinoma presented with thyroid mass symptoms: The importance of early onset hoarseness and absent of laryngeal crepitus

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    Chuen Shiun Chew

    2017-03-01

    Full Text Available Presentation of stridor with a marked anterior neck swelling is always presumed as thyroid mass compressing on the airway. However, a history of progressive hoarseness prior to the stridor should be taken into consideration as the airway obstruction might be due to intraluminal airway compression. We report an atypical presentation of laryngeal cancer with anterior neck swelling, which moved with swallowing, mimicking a thyroid tumour which cause delay of the management.

  1. Postoperative radiotherapy in N0 laryngeal cancer; Radiotherapie postoperatoire des cancers larynges classes N0

    Energy Technology Data Exchange (ETDEWEB)

    Maillard, S.; Cauchois, A.; Froissart, D.; Nguyen, T.D. [Institut Jean-Godinot, Service de radiotherapie, 51 - Reims (France); Jovenin, N. [Centre Hospitalier Universitaire, DIM, 51 - Reims (France); Merol, J.C.; Chays, A. [Centre Hospitalier Universitaire, Service d' otorhinolaryngologie, 51 - Reims (France)

    2005-09-15

    Purpose. - A retrospective study to re-assess the indications for postoperative radiation therapy in squamous cell carcinoma of the larynx staged N0 after gross resection. Patients and methods. - Between January 1975 and December 2000, 166 patients with squamous cell carcinoma of the larynx were treated by total laryngectomy with or without neck dissection. Surgery was completed by external radiotherapy delivering 45 to 65 Gy to the tumour bed and 45 to 50 Gy to cervical lymphatic chains. Minimal follow-up was 36 months and median follow-up was 98 months. Results. - The rate of nodal recurrence was 6% (median time for relapse was 9 months). The survival rates at 1. 2, 3 and 5 years were 93.5, 84, 80 and 69% respectively, with a 8 year 3 month median survival. The univariate analysis showed 4 parameters, which significantly increased the risk of local recurrence: the medical necessity for immediate tracheotomy, the sub-glottic involvement, the involvement of the whole larynx and the presence of lymphatic emboli in the neck dissection. There was no statistically significant difference between the patients with or without a neck dissection. Fifty-nine secondary cancers were observed, 15 of them occurring in the head and neck area. The Late complications consisted of cervical subcutaneous fibrosis (7%), oesophageal stricture (4%), oeso-tracheal fistula (1%). hypothyroidism (3%), bone necrosis (1%). Conclusion. - Prophylactic cervical radiotherapy in laryngeal cancers resulted in 6% cervical node recurrence rate. This value may resent the maximal rate to accept if one would favour new therapeutic strategies based on restricted indications for radiotherapy. (authors)

  2. CHARACTERISTICS OF TREATMENT OF PATIENTS WITH ACUTE AND CHRONIC LARYNGITIS DEPENDING ON RESULTS OF BACTERIOLOGICAL EXAMINATION OF LARYNX MICROFLORA

    OpenAIRE

    K. I. Chuikova; T. N. Zaripova; V. I. Mukhina

    2014-01-01

    This paper describes study of larynx microflora in patients with acute laryngtis and exacerbations of chronic laryngitis. Therapeutic algorithm based on bacteriologic examination data was developed reduce. New algorithm helps reduce sickness terms and to decrease prevalence of desease.123 patients of age from 18 to 60 were under observation: 43 patients with acute laryngitis and 80 patients with exacerbation of chronic laryngitis. 22 patients with acute laryngitis and 58 patients with exacerb...

  3. Computed tomography of pharyngo-laryngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Feuerbach, S.; Lotta, U.; Schmeisser, K.J.

    1982-05-01

    CT scans of 36 carcinomas of the laryngo-pharyngeal region were analysed retrospectively and the results compared with the endoscopic and operative findings. For the final tumour staging in 18 cases of carcinoma of the larynx equivalent results were obtained in 12 cases; CT scans offered a better evaluation in two cases and insufficient dates in four. Destruction of cartilagineous structures, submucosal tumour infiltration and the pre-epiglottic space are better shown on CT scans. Faulty evaluation of tumour presence of extent are due to superficial tumour growth or to motion artefacts. For the final staging of 18 carcinomas of the pharynx results of CT and clinical findings were comparable in nine cases. CT was less precise in five and superior to endoscopy in four. Evaluation of neoplastic infiltration of the parapharyngeal soft-tissue and of the skull base was the main advantage of CT scanning. Low grade tumours of the oro- and hypopharynx were not visible on CT and tumours of the base of the tongue were insufficiently displayed.

  4. Solitary Laryngeal Metastasis from Transitional Cell Carcinoma of the Kidney: Clinical Case and Review of the Literature

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    Tarek Assi

    2015-01-01

    Full Text Available The urogenital tract is a rare origin of laryngeal metastasis; transitional cell carcinoma with laryngeal metastases had never been reported previously. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of the first reported case of a laryngeal metastasis of a TCC followed by a brief review of the literature.

  5. Dynamic magnetic resonance imaging of swallowing and laryngeal motion using parallel imaging at 3 T.

    Science.gov (United States)

    Breyer, Tobias; Echternach, Matthias; Arndt, Susan; Richter, Bernhard; Speck, Oliver; Schumacher, Martin; Markl, Michael

    2009-01-01

    To evaluate the feasibility of an optimized MRI protocol based on high field imaging at 3 T in combination with accelerated data acquisition by parallel imaging for the analysis of oropharyngeal and laryngeal function. Fast 2D gradient echo (GRE) MRI with different spatial resolutions (1.7x2.7 and 1.1x1.5 mm2) and image update rates (4 and 10 frames per second) was employed to assess pharyngeal movements and visualize swallowing via tracking of an oral contrast bolus (blueberry juice). In a study with 10 normal volunteers, image quality was semi-quantitatively graded by three independent observers with respect to the delineation of anatomical detail and depiction of oropharynx and larynx function. Additionally, the feasibility of the technique for the visualization of pathological pre- and post-surgical oropharynx and larynx function was evaluated in a patient with inspiratory stridor. Image grading demonstrated the feasibility of dynamic MRI for the assessment of normal oropharynx and larynx anatomy and function. Superior image quality (Pswallowing. Results of the volunteer study demonstrated the feasibility of dynamic MRI at 3 T for the visualization of the oropharynx and larynx function during breathing, movements of the tongue and swallowing. Future studies are necessary to evaluate its clinical value compared to existing modalities based on endoscopy or radiographic techniques.

  6. "MUCOEPIDERMOID CARCINOMA OF THE LARYNX: REPORT OF A RARE LARYNGEAL TUMOR"

    Directory of Open Access Journals (Sweden)

    S. Z. Madani-Kermani

    2004-06-01

    Full Text Available Mucoepidermoid carcinoma is a neoplasm of salivary gland origin, and its laryngeal occurrence is extremely rare. This malignant tumor is composed of two distinct cell types, the epidermoid and mucus cells. Prognosis is largely dependent on the histologic pattern. In this report, an extremely rare laryngeal cancer and its clinicopathologic features are described.

  7. Laryngeal Aerodynamics in Healthy Older Adults and Adults with Parkinson's Disease

    Science.gov (United States)

    Matheron, Deborah; Stathopoulos, Elaine T.; Huber, Jessica E.; Sussman, Joan E.

    2017-01-01

    Purpose: The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method: Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and…

  8. Tea and coffee consumption and risk of laryngeal cancer: a systematic review meta-analysis.

    Science.gov (United States)

    Chen, Jiangbo; Long, Shuo

    2014-01-01

    Tea and coffee are the most commonly consumed beverages in the worldwide. The relationship between tea and coffee consumption on the risk of laryngeal cancer was still unclear. Relevant studies were identified by searching electronic database (Medline and EMBASE) and reviewing the reference lists of relevant articles until Oct. 2013. Observational studies that reported RRs and 95% CIs for the link of tea and coffee consumption on the risk of laryngeal cancer were eligible. A meta-analysis was obtained to combine study-specific RRs with a random-effects model. A total of 2,803 cases and 503,234 controls in 10 independent studies were identified. The overall analysis of all 10 studies, including the case-control and cohort studies, found that tea drinking was not associated with laryngeal carcinoma (RR = 1.03; 95% CI: 0.66-1.61). However, coffee consumption was significantly associated with the laryngeal carcinoma (RR = 1.47; 95% CI: 1.03-2.11). A dose-response relationship between coffee intake and laryngeal carcinoma was detected; however, no evidence of dose-response link between tea consumption and laryngeal carcinoma risk was detected. The results from this meta-analysis of observational studies demonstrate that coffee consumption would increase the laryngeal cancer risk, while tea intake was not associated with risk of laryngeal carcinoma.

  9. Changes in laryngeal sensation evaluated with a new method before and after radiotherapy.

    Science.gov (United States)

    Ozawa, Kikuko; Fujimoto, Yasushi; Nakashima, Tsutomu

    2010-05-01

    Radiotherapy of the laryngopharynx sometimes leads to functional disabilities including swallowing dysfunction. One of the reasons for these disabilities is a deterioration of laryngeal sensation. Laryngeal sensation is an important factor in swallowing, but quantitative evaluation of laryngeal sensation has been difficult. In this study, we evaluated changes in laryngeal sensation before and after radiotherapy for laryngeal and hypopharyngeal cancer, using a flexible laryngoscope and probes. This study was conducted in 12 patients, 8 with laryngeal cancer and 4 with hypopharyngeal cancer, who received radiotherapy alone or chemoradiotherapy at our medical centre. Measurements were performed using a 3.3-mm-diameter flexible laryngoscope with a probe port and four types of probes with 0.06-, 0.13-, 0.20-, and 0.30-mm nylon filaments attached to a wire tip. Sensation was evaluated at the tip of the epiglottis and the arytenoid region. Measurements were performed before radiotherapy, 1, 3 months, and 1 year after completion of radiotherapy. Sensation of the epiglottis and arytenoid deteriorated significantly 1 and 3 months after radiotherapy compared with before radiotherapy. Laryngeal sensation recovered in most cases within 1 year after radiotherapy. The present study clearly demonstrates the deterioration of laryngeal sensation with radiotherapy.

  10. SELECTIVE LARYNGEAL ABDUCTOR REINNERVATION IN CATS USING A PHRENIC-NERVE TRANSFER AND ORG-2766

    NARCIS (Netherlands)

    MAHIEU, HF; VANLITHBIJL, JT; GROENHOUT, C; TONNAER, JADM; DEWILDE, P

    1993-01-01

    Reinnervation of the recurrent laryngeal nerve following nerve injury often leads to laryngeal synkinesis. Selective reinnervation of adductor and abductor muscles might be able to avoid synkinesis. This study presents the results of selective abductor reinnervation in cats, using a phrenic nerve tr

  11. Promoter Hypermethylation of DNA Repair Gene MGMT in Laryngeal Squamous Cell Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The relationship between hypermethylation of CpG islands in the promoter regions of O6methylguanine DNA methyltransferase (MGMT)genes and laryngeal squamous cell carcinoma was explored. Methylation-specific PCR and semi-quantitative RT-PCR were used to study the promoter methylation and mRNA expression of the MGMT gene in laryngeal carcinoma tissues, t issues adjacent to the tumor and normal laryngeal tissues. Hypermethylation of MGMT gene was detected in 16 samples of 46 (34.8 %) laryngeal squamous cell carcinoma samples. However, the MGMT hypermethylation was not detected in all tissues adjacent to the tumors and normal tissues. No significant difference in MGMT gene hypermethylation was found in samples with different histological grades (x2= 3. 130, P=0. 077) or in samples from patients with different TNM status (x2=3. 957, P=0. 138). No expression of MGMT mRNA was detected in all hypermethylated laryngeal carcinoma tissues. The expression of MGMT mRNA was detected in all unmethylated laryngeal carcinoma tissues, tissues adjacent to the tumors and normal tissues. It suggests that MGMT gene promoter hypermethylation is associated with MGMT gene transcription loss in laryngeal carcinoma tissues and possibly plays an important role in carcinogenesis of laryngeal tissues.

  12. Endoscopic laryngeal patterns in vagus nerve stimulation therapy for drug-resistant epilepsy.

    Science.gov (United States)

    Felisati, Giovanni; Gardella, Elena; Schiavo, Paolo; Saibene, Alberto Maria; Pipolo, Carlotta; Bertazzoli, Manuela; Chiesa, Valentina; Maccari, Alberto; Franzini, Angelo; Canevini, Maria Paola

    2014-01-01

    In 30% of patients with epilepsy seizure control cannot be achieved with medications. When medical therapy is not effective, and epilepsy surgery cannot be performed, vagus nerve stimulator (VNS) implantation is a therapeutic option. Laryngeal patterns in vagus nerve stimulation have not been extensively studied yet. The objective was to evaluate laryngeal patterns in a cohort of patients affected by drug-resistant epilepsy after implantation and activation of a vagus nerve stimulation therapy device. 14 consecutive patients underwent a systematic otolaryngologic examination between 6 months and 5 years after implantation and activation of a vagus nerve stimulation therapy device. All patients underwent fiberoptic endoscopic evaluation, which was recorded on a portable device allowing a convenient slow-motion analysis of laryngeal patterns. All recordings were blindly evaluated by two of the authors. We observed three different laryngeal patterns. Four patients showed left vocal cord palsy at the baseline and during vagus nerve stimulation; seven showed left vocal cord palsy at the baseline and left vocal cord adduction during vagus nerve stimulation; and three patients showed a symmetric pattern at the baseline and constant left vocal cord adduction during vagus nerve stimulation. These laryngeal findings are here described for the first time in the literature and can be only partially explained by existing knowledge of laryngeal muscles and vagus nerve physiology. This might represent a new starting point for studies concerning laryngeal physiology and phonation, while the vagus nerve stimulation therapy could act as a new and ethical experimental model for human laryngeal physiology.

  13. Laryngeal amyloidosis : Localized versus systemic disease and update on diagnosis and therapy

    NARCIS (Netherlands)

    Bartels, H.; Dikkers, FG; Van der Wal, JE; Lokhorst, HM; Hazenberg, BPC

    2004-01-01

    The clinical and pathological characteristics, possibility of systemic disease, and effect of local therapy were studied in laryngeal amyloidosis. Records of all patients with localized laryngeal amyloidosis in a single tertiary referral center were examined retrospectively at diagnosis and after lo

  14. [The epiglottis, a glosso-laryngeal structure: an anatomic study of its innervation].

    Science.gov (United States)

    Touré, G; Vacher, C

    2005-09-01

    The epiglottis is known as a laryngeal structure. The authors studied the innervation of epiglottis using the Sihler method on six human epiglottises. Innervation of the epiglottis depended on the rami from the vagus, glossopharyngeal and hypoglossal nerves. By its innervation, epiglottis seems to be a glosso-laryngeal structure, as is confirmed by embryology, histology and clinical applications.

  15. F-18-FLT PET for visualization of laryngeal cancer : Comparison with F-18-FDG PET

    NARCIS (Netherlands)

    Cobben, DCP; van der Laan, BFAM; Maas, B; Vaalburg, W; Suurmeijer, AJH; Hoekstra, HJ; Jager, PL; Elsinga, PH

    The feasibility of F-18-3'-fluoro-3'-deoxy-L-thymidine PET (FLT PET) for detecting laryngeal cancer was investigated and compared with F-18-FDG PET. Methods: Eleven patients diagnosed with or strongly suspected of having recurrent laryngeal cancer and 10 patients with histologically proven primary

  16. Anatomical basis of the risk of injury to the right laryngeal recurrent nerve during thoracic surgery.

    Science.gov (United States)

    Benouaich, Vincent; Porterie, Jean; Bouali, Ourdia; Moscovici, Jacques; Lopez, Raphaël

    2012-08-01

    Despite the intrathoracic part being short, the right laryngeal recurrent nerve is often injured during thoracic surgery. The aim of this cadaver study was to understand the mechanisms of right laryngeal recurrent nerve injuries during thoracic surgery and to describe anatomical landmarks for its preservation. Dissections were performed on 10 fresh human cadavers. A right anterolateral thoracic wall segment was removed, preserving the first rib. Dissections were carried out to identify the following structures: first rib, esophagus, trachea, right main bronchus, right brachiocephalic and subclavian vessels, azygos vein, phrenic nerve, vagus nerve, and right laryngeal recurrent nerve. The distance between the origin of the right laryngeal recurrent nerve and its adjacent structures was assessed. Moderate traction of the thoracic part of the vagus nerve resulted in a downward translation of the right laryngeal recurrent nerve's origin. In such conditions, the right laryngeal recurrent nerve's origin was distant of 14.8 mm (±2.89 mm) from the subclavian artery. Intraoperative incidence of right laryngeal recurrent nerve direct injury could be decreased by understanding the detailed course of its intrathoracic part. Moreover, traction on the intrathoracic part of the right vagus nerve may result in indirect lesions of the right laryngeal recurrent nerve: stretch induced lesions and nerve vasculature's lesions.

  17. ANALYSIS OF C-HA-RAS GENE AMPLIFICATION AND MUTATION IN LARYNGEAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    刘世喜; 林代诚; 洪邦泰; 黄光琦

    1995-01-01

    In order to study the ahered molecular events during laryngeal carcinogenesis and elucidate the role of Ha-ras oncogene amplification and mutation, we have examined their profile by polymerase chain reaction (PCR) and selective oligonucleoride hybridization. We analyzed the mutational status of codon 12 of Ha-ras in 22 laryngeal carcinomas and 10 normal tissues, and found that 7 of 22 laryngeal carcinomas con-tained a Ha-ras mutation at codon 12. The frequency of mutation was 32%. None of the normal tissues re-vealed mutation. Moreover, no amplification was found in cancers when compared to the normal. Our findings indicated that the aefivmed Ha-ras gene existed in laryngeal carcinoma, and activation of the Ha-ras gene by mutation at codon 12 might play a key role in laryngeal carcinogenesis.

  18. Exercise induced laryngeal obstruction: a review of diagnosis and management.

    Science.gov (United States)

    Liyanagedara, Savinda; McLeod, Robert; Elhassan, Hassan A

    2017-04-01

    Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used. Primary searching found 469 records, 308 were excluded following screening of titles and citation. 100 were duplicates, a further 47 studies were excluded after applying inclusion and exclusion criteria. Two studies were identified following cross-referencing. A total of 15 studies were included. The last search date was 6/06/15. Average prevalence in the general adolescent population and athletes was 7.1 and 35.2 %, respectively. Dyspnoea was reported in 96.5, 99 and 100 % of three EILO patient cohorts. Two studies (n = 107) reported continuous laryngoscopy during exercise (CLE) testing could differentiate between patients and controls. In two studies (n = 33) the visual analogue scale (VAS) showed a beneficial effect of endoscopic supraglottoplasty (ES). Thirty-eight out of 43 patients who received two or more laryngeal control therapy sessions (LCT) had improvement or resolution of EILO symptoms. Exercise induced dyspnoea is the most common EILO symptom. EILO has a high occurrence in adolescents and athletes. The CLE test is the current gold standard for EILO diagnostics. Management of EILO includes both surgical and non-surgical interventions.

  19. Xanthohumol inhibits proliferation of laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Li, Yan; Wang, Kai; Yin, Shankai; Zheng, Hongliang; Min, Daliu

    2016-12-01

    Xanthohumol is a flavonoid compound that exhibits antioxidant and anticancer effects, and is used to treat atherosclerosis. The aim of the present study was to investigate the effect of xanthohumol on the cell proliferation of laryngeal squamous cell carcinoma and to understand the mechanism of its action. The effects of xanthohumol on the cell viability and apoptosis rate of laryngeal squamous cell carcinoma SCC4 cells were assessed by Annexin V-fluorescein isothiocyanate/propidium iodide staining. In addition, the expression levels of pro-apoptotic proteins, caspase-3, caspase-8, caspase-9, poly ADP ribose polymerase (PARP) p53 and apoptosis-inducing factor (AIF), as well as anti-apoptotic markers, B-cell lymphoma 2 (Bcl-2) and myeloid cell leukemia 1 (Mcl-1), were analyzed by western blotting. The results revealed that treatment with 40 µM xanthohumol significantly inhibited the proliferation of SCC4 cells. Furthermore, xanthohumol treatment (40 µM) induced SCC4 cell apoptosis, as indicated by the significant increase in activity and expression of caspase-3, caspase-8, caspase-9, PARP, p53 and AIF. By contrast, the protein expression of Bcl-2 and Mcl-1 was significantly decreased following treatment with 40 µM xanthohumol. Taken together, the results of the present study indicated that xanthohumol mediates growth suppression and apoptosis induction, which was mediated via the suppression of Bcl-2 and Mcl-1 and activation of PARP, p53 and AIF signaling pathways. Therefore, future studies that investigate xanthohumol as a potential therapeutic agent for laryngeal squamous cell carcinoma are required.

  20. Herpes zoster laryngitis accompanied by Ramsay Hunt syndrome.

    Science.gov (United States)

    Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Joo, Young Eun; Lim, Sang Chul

    2013-01-01

    The most common presentation of herpes zoster in the head and neck region is called Ramsay Hunt syndrome (RHS), which rarely accompanies multiple cranial neuropathy. Herpes zoster also involves the mucous membrane of the tongue, palate, pharynx, and larynx. Herpes zoster infection of the larynx accompanied by Ramsay Hunt syndrome with cranial polyneuropathy is extremely rare, with only few reported cases in the literature. At the time of this report, a review of the medical literature disclosed 4 reported cases of herpes zoster laryngitis accompanied by Ramsay Hunt syndrome. Herein, we present 2 additional cases and report the clinical outcome of cranial polyneuropathy with a review of the literature.

  1. Idiopathic ulcerative laryngitis causing midmembranous vocal fold granuloma.

    Science.gov (United States)

    Sinclair, Catherine F; Sulica, Lucian

    2013-02-01

    Idiopathic ulcerative laryngitis (IUL) is characterized by bilateral midmembranous vocal fold ulceration, which follows upper respiratory infection with cough. In contrast, granuloma of the membranous vocal fold can occur rarely following microlaryngoscopy, presumably secondary to surgical violation of deep tissue planes. We report a novel case of noniatrogenic membranous vocal fold granulation developing in a patient with IUL. Although the presence of granulation implied injury to the entire microstructure of the vibratory portion of the vocal fold, the lesion resolved with conservative management without adverse sequelae.

  2. Cryptococcal laryngitis: An uncommon presentation of a common pathogen.

    Science.gov (United States)

    Atiya, Y; Masege, S D

    2015-10-01

    Cryptococcus neoformans is an ubiquitous encapsulated yeast found worldwide, especially in areas with pigeons. The fungus thrives in pigeon droppings and is responsible for primary pulmonary infection, but may disseminate and cause infection of the central nervous system, skin and bone. Most cases are reported in immunocompromised hosts, most commonly those infected with HIV. However, infection has been reported in immunocompetent hosts. Primary infection of the larynx is uncommon, and to date only 12 cases have been reported. We present the first South African report of a young woman with HIV who presented with hoarseness of uncertain aetiology, which was later confirmed to be cryptococcal laryngitis.

  3. Acquired tracheoesophageal fistula status post laryngeal neoplasm resection

    Directory of Open Access Journals (Sweden)

    Sarah Luber

    2015-04-01

    Full Text Available A tracheoesophageal fistula (TEF, albeit rare, can be a life-threatening condition that requires prompt identification and treatment. Pulmonary contamination and restriction of proper nutrition are common, unfortunate consequences of untreated TEFs and are often the causes of mortality in this population. In our patient, a history of laryngeal malignancy along with symptoms of chest pain and cough with ingestion of liquids, even without evidence of aspiration pneumonia, appropriately prompted investigation for potential TEF. Initial imaging through barium swallow identified the TEF, and the patient underwent treatment with endoclips by endoscopy with bronchoscopic assistance.

  4. Intraoperative photodynamic therapy in laryngeal part of pharynx cancers

    Science.gov (United States)

    Loukatch, Erwin V.; Trojan, Vasily; Loukatch, Vjacheslav

    1996-12-01

    In clinic intraoperative photodynamic therapy (IPT) was done in patients with primal squamous cells cancer of the laryngeal part of the pharynx. The He-Ne laser and methylene blue as a photosensibilizator were used. Cobalt therapy in the postoperative period was done in dose 45 Gr. Patients of control groups (1-th group) with only laser and (2-th group) only methylene blue were controlled during three years with the main group. The statistics show certain differences of recidives in the main group compared to the control groups. These facts are allowing us to recommend the use of IPT as an additional method in ENT-oncology diseases treatment.

  5. [A case of industrial origin of laryngeal carcinoma (author's transl)].

    Science.gov (United States)

    Glasenapp, G B

    1975-07-01

    The Growing importance of industrial noxae for carcinogenesis will, in the course of further progressive mechanization and industrialization, suggest an increasing confrontation with this problem. The above mentioned case, a patient working with insulating materials on industrial heating systems, impressevely demonstrates the transformation of chronic laryngitis into a carcinoma in the course of years, brought about by industrial influences and thus proving the exogenous origin of this genesis. Dust as well as strong effects of heat under conditions of variable atmospheric humidily are concerned to be principal damaging factors.

  6. [Rare problem with the insertion of a Supreme™ laryngeal mask airway device. Case of the trimester].

    Science.gov (United States)

    2014-03-01

    A breast tumor was resected under general anesthesia. After induction, the airway was managed with a Supreme™ laryngeal mask airway device. The insertion of the laryngeal mask airway device, the insertion of the orogastric tube through the drain tube, as well as the mechanical ventilation, were very difficult from the beginning. On removing the laryngeal mask airway device to solve the problem, it was observed that the drain tube was broken, and the orogastric tube had passed into the anterior, laryngeal part of the device through the split. It was later found out that the laryngeal mask airway device, as well as the whole manufacturing batch, had suffered a design modification: the cuff was constructed with a softer material without reinforcement in the tip, and the drain tube had a heat-sealing defect that facilitated the break. The incident was reported to the local supplier and the manufacturer, and the defective batch of laryngeal mask airway devices was recalled. The incident was also reported to other hospitals via SENSAR, to warn other users of the potential dangers of the design modification in the Supreme™ laryngeal mask airway. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  7. [Fibre optic-assisted endotracheal intubation through the laryngeal mask in children].

    Science.gov (United States)

    Weiss, M; Mauch, J; Becke, K; Schmidt, J; Jöhr, M

    2009-07-01

    Fibre optic-assisted tracheal intubation through the laryngeal mask airway is a simple and safe procedure for securing the airway in the paediatric patient with unexpected and known difficult tracheal intubation. Therefore, fibre optic-assisted tracheal intubation through the laryngeal mask airway represents a standard airway technique and must be part of clinical education and also regular training. However, the removal of the laryngeal mask airway over the tracheal tube is impaired by the short length of the tracheal tube, easily resulting in tube dislocation from the trachea. Among several techniques to overcome this problem, the Cook airway exchange catheter offers a reliable method not only for safe removal of the laryngeal mask over the tracheal tube but also for insertion of an adequate tracheal tube, particularly in paediatric patients. This is particularly important for cuffed tubes as the pilot balloon of the cuffed tube is too large to pass through laryngeal mask airway tubes size 2.5 and smaller. This presentation demonstrates fibre optic-assisted tracheal intubation through the laryngeal mask airway in children step-by-step and discusses its clinical implications. A list with compatible sizes of laryngeal mask airways, tracheal tubes and airway exchange catheters is also provided.

  8. Prototype of a tool for analysing laryngeal cancer operations.

    Science.gov (United States)

    Dincer, Esra; Duru, Nevcihan

    2009-09-01

    In this study, a software tool was developed to analyse the medical data collected from laryngeal cancer operations by using two data mining techniques. The software, run on real-world medical data, is a tool that enables medical decisions to be reached by analysing past records from patients. The k-means algorithm, which is a clustering algorithm in data mining, was used to point out the intensities in the data set and to display two dimensions on the charts. The data of three screens that were named as selective clustering, different pre- and post-operation stages and clustering operations based on pre-operation T values, were processed using clustering with the k-means algorithm and one screen, which named relapse and survival percentages, was processed through classifying. It helps the future decision-making process by considering false estimates of pre-operation stages of the cases and by using the information gathered from past cases concerning tumour relapse and the survival percentage for prognostication. The characteristics of laryngeal cancer operations data, that involve causal links, were exposed by using two data mining techniques in this application.

  9. Microvessel and mast cell densities in malignant laryngeal neoplasm

    Directory of Open Access Journals (Sweden)

    Balica Nicolae Constantin

    2014-01-01

    Full Text Available Laryngeal neoplasm contributes to 30-40% of carcinomas of the head and neck. Mast cells are normal connective tissue residents, well represented in the respiratory tract. Experimental evidence suggests that the growth of a tumor beyond a certain size requires angiogenesis, which may also permit metastasis. The aim of this study was to evaluate the correlation between mast cell density, microvascular density, histopathological type and histological grade. Our study included 38 laryngeal carcinomas as follows: adenoid cystic carcinoma (2 cases, malignant papilloma (2 cases and squamous cell carcinoma (34 cases. The combined technique of CD 34-alcian blue safranin (ABS was used to identify microvessel and mast cell density, which was quantified by the hot spot method. A significant correlation was found between both mast cell and microvascular density, and G1/G2 histological grade (p=0.002 and p=0.004, respectively. Squamous cell carcinoma was significantly correlated with mast cell density (p=0.003, but not with microvascular density (p=0.454.

  10. Ultrastructure of the ganglion on human internal laryngeal nerve.

    Science.gov (United States)

    Ramaswamy, S; Shankar, S K; Manjunath, K Y; Devanathan, P H; Nityaseelan, N

    1994-01-01

    There is now definite evidence for the presence of a macroscopic ganglion on the human internal laryngeal nerve, with the distribution of its post-ganglionic fibres to the glands in the saccule and to the glands at the root of epiglottis in the vicinity of the opening of the saccule. This ganglion could be identified as early as 14 weeks in human foetal larynx, which contains immature neurons. Seven ganglia, dissected from human laryngectomy specimens and resected for carcinoma larynx, were studied by electron microscopy. Ultrastructurally, the neurons and the synaptic terminals had both small, round, luscent vesicles and dense core vesicles. Symmetrical, asymmetrical and electrical synaptic complexes were noted. A few neurons revealed degenerative changes suggestive of axotomy. The location of the ganglion on the internal laryngeal nerve, a branch of nervus vagus, and ultrastructural demonstration of large and small dense core vesicles and small luscent vesicles in the neurons of this ganglion, lead us to believe that the ganglion is parasympathetic in nature.

  11. Eucapnic voluntary hyperventilation in diagnosing exercise-induced laryngeal obstructions.

    Science.gov (United States)

    Christensen, Pernille M; Rasmussen, Niels

    2013-11-01

    Exercise-induced laryngeal obstructions (EILOs) cause exercise-related respiratory symptoms (ERRS) and are important differential diagnoses to exercise-induced asthma. The diagnostic method for EILOs includes provocation to induce the obstruction followed by a verification of the obstruction and the degree thereof. The objective of the present study was to examine if a eucapnic voluntary hyperventilation (EVH) test could induce laryngeal obstructions laryngoscopically identical in subtypes and development as seen during an exercise test. EVH and exercise testing with continuous laryngoscopy were performed during a screening of two national athletic teams (n = 67). The laryngoscopic recordings were examined for usability, abnormalities and maximal supraglottic and glottic obstruction using two currently available methods (Eilomea and CLE-score). The participants were asked questions on ERRS, and whether the symptoms experienced during each provocation matched those experienced during regular training. A total of 39 completed both tests. There were no significant differences in subtypes and development thereof, the experience of symptoms, and specificity and sensitivity between the methods. Significantly more recordings obtained during the exercise test were usable for evaluation primarily due to resilient mucus on the tip of the fiber-laryngoscope in the EVH test. Only recordings of six athletes from both provocation methods were usable for evaluation using the Eilomea method (high-quality demand). Amongst these, a linear correlation was found for the glottic obstruction. EVH tests can induce EILOs. However, the present test protocol needs adjustments to secure better visualisation of the larynx during provocation.

  12. Treatment of spastic dysphonia by recurrent laryngeal nerve section.

    Science.gov (United States)

    Barton, R T

    1979-02-01

    The problem of management of patients with spastic dysphonia has been complicated by a general resistance to speech therapy, psychotherapy, hypnotherapy, and drug therapy. Dedo introduced the concept of recurrent laryngeal nerve section in an attempt to eliminate the hyperfunction and excessive adduction of the vocal folds. Eleven patients were treated by RLN section with satisfactory results in 8 and some improvement in the other 3. The operation was found to be generally uncomplicated and required on average 4 days of hospitalization. Dedo's theory that spastic dysphonia is caused by a neurotropic viral-induced proprioceptive nerve deficit represents a new search for organic cause. His most recent report of finding unmyelinated fibres in one-third of the resected recurrent laryngeal nerves is of questionable significance. The evidence of deep emotional conflict and/or compulsive life-style is found in the majority of the patients, but the syndrome is not typical of an hysterical or conversion neurosis. Regardless of etiologic theory, RLN section is an effective treatment in selected, long-standing, and resistant instances of spastic dysphonia.

  13. Chemoresistance of CD133+ cancer stem cells in laryngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    YANG Jing-pu; LIU Yan; ZHONG Wei; YU Dan; WEN Lian-ji; JIN Chun-shun

    2011-01-01

    Background Mounting evidence suggests that tumors are histologically heterogeneous and are maintained by a small population of tumor cells termed cancer stem cells. CD133 has been identified as a candidate marker of cancer stem cells in laryngeal carcinoma. This study aimed to analyze the chemoresistance of CD133+ cancer stem cells.Methods The response of Hep-2 cells to different chemotherapeutic agents was investigated and the expression of CD133 was studied. Fluorescence-activated cell sorting analysis was used to identify CD133,and the CD133+ subset of cells was separated and analyzed in colony formation assays,cell invasion assays,chemotherapy resistance studies,and analyzed for the expression of the drug resistance gene ABCG2.Results About 1%-2% of Hep-2 cells were CD133+ cells,and the CD133+ proportion was enriched by chemotherapy.CD133+ cancer stem cells exhibited higher potential for clonogenicity and invasion,and were more resistant to chemotherapy. This resistance was correlated with higher expression of ABCG2.Conclusions This study suggested that CD133+ cancer stem cells are more resistant to chemotherapy. The expression of ABCG2 could be partially responsible for this. Targeting this small population of CD133+ cancer stem cells could be a strategy to develop more effective treatments for laryngeal carcinoma.

  14. Investigating the complexity of respiratory patterns during the laryngeal chemoreflex

    Directory of Open Access Journals (Sweden)

    Curran Aidan K

    2008-06-01

    Full Text Available Abstract Background The laryngeal chemoreflex exists in infants as a primary sensory mechanism for defending the airway from the aspiration of liquids. Previous studies have hypothesized that prolonged apnea associated with this reflex may be life threatening and might be a cause of sudden infant death syndrome. Methods In this study we quantified the output of the respiratory neural network, the diaphragm EMG signal, during the laryngeal chemoreflex and eupnea in early postnatal (3–10 days piglets. We tested the hypothesis that diaphragm EMG activity corresponding to reflex-related events involved in clearance (restorative mechanisms such as cough and swallow exhibit lower complexity, suggesting that a synchronized homogeneous group of neurons in the central respiratory network are active during these events. Nonlinear dynamic analysis was performed using the approximate entropy to asses the complexity of respiratory patterns. Results Diaphragm EMG, genioglossal activity EMG, as well as other physiological signals (tracheal pressure, blood pressure and respiratory volume were recorded from 5 unanesthetized chronically instrumented intact piglets. Approximate entropy values of the EMG during cough and swallow were found significantly (p p Conclusion Reduced complexity values of the respiratory neural network output corresponding to coughs and swallows suggest synchronous neural activity of a homogeneous group of neurons. The higher complexity values exhibited by eupneic respiratory activity are the result of a more random behaviour, which is the outcome of the integrated action of several groups of neurons involved in the respiratory neural network.

  15. Evaluation of voice disorders in patients with active laryngeal tuberculosis.

    Directory of Open Access Journals (Sweden)

    Marcia Mendonça Lucena

    Full Text Available Laryngeal tuberculosis (LTB is the most frequent larynx granulomatous disease. In general there is lung involvement, but in an important proportion of cases you can find LTB without pulmonary disease. The lesions observed in LTB, such as ulceration and fibrosis, can interfere in the process of voice production. The involvement of the mucous lining of the vocal folds can change their flexibility and, consequently, change voice quality, and the main symptom is dysphonia present in almost 90% of cases.To describe the anatomical characteristics and voice quality in LTB patients.A descriptive cross-sectional study was conducted with 24 patients.The most frequently affected sites were vocal folds in 87.5% patients, vestibular folds in 66.7%, epiglottis in 41.7%, arytenoid in 50%, aryepiglottic folds in 33.3%, and interarytenoid region in 33.3% patients. We found 95.8% cases of dysphonia. The voice acoustic analysis showed 58.3% cases of Jitter alterations, 83.3% of Shimmer and 70.8% of GNE.Voice disorders found in active laryngeal tuberculosis are similar to those reported after clinical healing of the disease, suggesting that sequelae and vocal adjustments may install during the active phase of the disease, negatively impacting the process of vocal quality reestablishment.

  16. Unilateral Laryngeal Pacing System and Its Functional Evaluation

    Directory of Open Access Journals (Sweden)

    Taiping Zeng

    2017-01-01

    Full Text Available Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG signals from cricothyroid (CT muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.

  17. Total thyroidectomy is safer with identification of recurrent laryngeal nerve

    Institute of Scientific and Technical Information of China (English)

    Hakan CANBAZ; Musa DIRLIK; Tahsin COLAK; Koray OCAL; Tamer AKCA; Oner BILGIN; Bahar TASDELEN; Suha AYDIN

    2008-01-01

    Objective: To investigate the effect of recurrent laryngeal nerve (RLN) identification on the complications after total thyroidectomy and lobectomy. Methods: Total 134 consecutive patients undergoing total thyroidectomy or thyroid lobectomy from January 2003 to November 2004 were investigated retrospectively. Patients were divided into two groups: RLN identified (Group A) or not (Group B). The two groups were compared for RLN injury and hypocalcaemia. Results: The numbers of patients and nerves at risk were 71 and 129 in Group A, and 63 and 121 in Group B, respectively. RLN injury in Group A (0) was significantly lower than that in Group B (5[7.9%]) patients, 7 [5.8%] nerves) for the numbers of patients (P=-0.016) and nerves at risk (P=0.006). Temporary hypocalcaemia was significantly higher in Group A than in Group B (14 [24.1%] vs 6 [10.3%], P=0.049).Permanent complications in Group B were significantly higher than those in Group A (13 [20.6%] vs 4 [5.6%], P=0.009). Conclusion: RLN injury was prevented and permanent complications were decreased by identifying the whole course and branches of the recurrent laryngeal nerve during total thyroidectomy.

  18. The time course of laryngeal coarticulation in children: First results

    Science.gov (United States)

    Koenig, Laura L.

    2004-05-01

    Previous work has suggested that the degree or extent of coarticulation is more extreme in young children than adults. Research in this area has focused primarily on supralaryngeal aspects of coarticulation, using spectral measures such as formant frequencies and fricative centroids. At the same time, studies of adults have found that laryngeal adjustments for voiceless consonants extend well into neighboring vowels, yielding higher values of open quotient and DC flow, and more symmetical pulse shapes, in vowels flanking voiceless as compared to voiced consonants. The current work investigates laryngeal coarticulation in normally developing, English-speaking 4- and 5-year olds. Inverse filtering of the oral airflow is used to approximate the glottal source signal in utterances containing /VpV, VhV, VbV/ sequences. The /VbV/ utterance, which does not require vocal-fold abduction, serves as a control condition to the voiceless consonants. Voice source (open quotient, speed quotient) and aerodynamic (AC and DC flow) quantities are measured over time, and compared between the children and adult females. Along with adding to our understanding of developmental changes in coarticulation, these data will contribute to the literature on differences in voice source properties between children and adults. [Work supported by NIH.

  19. Spontaneous pharyngo-laryngeal hematoma and anticoagulation. A case report

    Directory of Open Access Journals (Sweden)

    Marleny CASASOLA-GIRÓN

    2016-03-01

    Full Text Available Introduction and Objective: Spontaneous pharyngeal-laryngeal hematoma shows the importance of a complete ENT examination in the face of symptoms of banal appearance and a correct history that, in the case reported, unveiled the therapeutic use of anticoagulants. Case description: A 55 year old woman comes to emergency because of unexplained dysphagia. The inspection shows the presence of a hematoma in the pharyngeal-laryngeal region that, after the anticoagulant therapy was reversed, evolved favorably with conservative treatment. Discussion: In this case, apart from medical management performed by the hematology department, we focus our therapeutic approach in the protection of the airway and the prevention of a possible massive bleeding. Determining which patients require endotracheal intubation or tracheostomy and hemostatic surgery is the key to treatment. Conclusions: The anticoagulant therapy involves several complications that ENT specialists must consider in the face of clinical symptoms of dysphagia, dysphonia, dyspnea or signs of bleeding and they must know the possibilities of performance depending on the severity of each case.

  20. Podoplanin expression in the development and progression of laryngeal squamous cell carcinomas

    Directory of Open Access Journals (Sweden)

    Fresno Manuel F

    2010-03-01

    Full Text Available Abstract Background Podoplanin expression is attracting interest as a marker for cancer diagnosis and prognosis. We therefore investigated the expression pattern and clinical significance of podoplanin during the development and progression of laryngeal carcinomas. Results Podoplanin expression was determined by immunohistochemistry in paraffin-embedded tissue specimens from 84 patients with laryngeal premalignancies and 53 patients with laryngeal squamous cell carcinomas. We found podoplanin expression extending from the basal to the suprabasal layer of the epithelium in 37 (44% of 84 dysplastic lesions, whereas normal epithelium showed negligible expression. Patients carrying podoplanin-positive lesions had a higher laryngeal cancer incidence than those with negative expression reaching borderline statistical significance (51% versus 30%, P = 0.071. Podoplanin expression in laryngeal carcinomas exhibited two distinct patterns. 20 (38% cases showed diffuse expression in most tumour cells and 33 (62% focal expression at the proliferating periphery of tumour nests. High podoplanin expression was inversely correlated with T classification (P = 0.033, disease stage (P = 0.006, and pathological grade (P = 0.04. There was a trend, although not significant, towards reduced disease-specific survival for patients with low podoplanin levels (P = 0.31 and diffuse expression pattern (P = 0.08. Conclusions Podoplanin expression increases in the early stages of laryngeal tumourigenesis and it seems to be associated with a higher laryngeal cancer risk. Podoplanin expression in laryngeal squamous cell carcinomas, however, diminishes during tumour progression. Taken together, these data support a role for podoplanin expression in the initiation but not in the progression of laryngeal cancers.

  1. Evaluation of Fastrach Laryngeal Mask Airway as an Alternative to Fiberoptic Bronchoscope to Manage Difficult Airway: A Comparative Study

    Science.gov (United States)

    Shyam, Radhey; Sachan, Pushplata; Singh, Prithvi Kumar; Singh, Gyan Prakash; Bhatia, Vinod Kumar; Chandra, Girish; Singh, Dinesh

    2017-01-01

    Introduction Awake intubation via Fiberoptic Bronchoscope (FB) is the gold standard for management of difficult airway but patients had to face problems like oxygen desaturation, tachycardia, hypertension and anxiety due to awake state. This study was conducted to assess feasibility of Fastrach Laryngeal Mask Airway (FLMA) to manage difficult airway as a conduit for intubation as well as for ventilation. Materials and Methods After ethical approval and informed consent, 60 patients with difficult airway were randomly enrolled in FB group and FLMA group. In FB group, patients were sedated with midazolam/fentanyl. Airway anaesthetization of oropharynx was done with xylocaine spray and viscous and larynx and trachea by superior laryngeal nerve block and transtracheal block respectively. In FLMA group, initially patients were induced with propofol for FLMA insertion then succinylcholine was given for Tracheal Intubation (TI). The first TI attempt was done blindly via the FLMA and all subsequent attempts were performed with fiberoptic guidance. Haemodynamic monitoring was done during induction, intubation, immediately post insertion and there after at five minutes interval for 30 minutes. Results All patients in the FLMA group were successfully ventilated (100%). In both the groups 28 (93.33%) patients were successfully intubated. However, first/second/third attempt intubation rate in FLMA vs FB group was 15 (50%) vs 13 (43.3%), 8 (26.66%) vs 10 (33.33%) and 5 (16.66%) in both groups respectively. Patients in the FLMA group were more satisfied with their method of TI and had lesser complications (pmanagement of patients with difficult airways.

  2. The prevalence of hypothyroidism after treatment for laryngeal and hypopharyngeal carcinomas : are autoantibodies of influence?

    NARCIS (Netherlands)

    Lo Galbo, Annalisa M.; De Bree, Remco; Kuik, Dirk J.; Lips, Paul Th. A. M.; Von Blomberg, B. Mary E.; Langendijk, Johannes A.; Leemans, C. Rene

    2007-01-01

    Conclusions. The incidence rate of hypothyroidism after treatment for laryngeal and hypopharyngeal cancer is high, especially after combination treatment. An association between hypothyroidism and autoantibodies was found. Objectives. The incidences of hypothyroidism and autoantibodies were assessed

  3. Kinematic analysis of laryngeal movements in patients with neurogenic dysphagia before and after swallowing rehabilitation.

    Science.gov (United States)

    Prosiegel, M; Heintze, M; Sonntag, E W; Schenk, T; Yassouridis, A

    2000-01-01

    To examine whether kinematic analysis of laryngeal movements (which are closely linked to pharyngeal swallowing) can differentiate between normal and disturbed swallowing, we used a three-dimensional ultrasound movement recording system to measure the movements of the larynx during swallowing in 32 patients with neurogenic dysphagia caused by central nervous system lesions and in 32 age- and sex-matched healthy individuals. At the beginning of an inpatient rehabilitation swallowing program, laryngeal movements in 24 patients were highly disturbed in terms of velocity curve irregularities. After rehabilitation, the majority of patients with hitherto irregular velocity profiles exhibited laryngeal kinematics that were indistinguishable from those of 32 healthy subjects. Kinematic analysis of laryngeal movements, therefore, is suitable for monitoring motor recovery of swallowing disturbances in patients with neurogenic dysphagia while undergoing swallowing rehabilitation.

  4. Laryngeal paralysis associated with a muscle pseudotumour in a young dog

    Directory of Open Access Journals (Sweden)

    Francesca Rizzo

    2017-08-01

    Full Text Available An 18-month-old male entire Bloodhound dog was presented with a six-week history of progressive inspiratory dyspnoea, stridor, dysphonia and exercise intolerance. CT scan performed elsewhere had revealed the presence of an unencapsulated nodular mass (3x1x5 cm dorsal to the larynx and first tracheal rings. Laryngoscopy demonstrated the presence of bilateral laryngeal paralysis and distorted laryngeal architecture suggestive of extraluminal compression. Histopathology results of incisional biopsies from the mass were suggestive of a benign non-neoplastic muscular lesion. Surgery was performed to manage laryngeal paralysis and attempt mass excision. A second histopathology examination confirmed an inflammatory and dysplastic lesion suggestive of a pseudotumour. All clinical signs resolved after surgery and at the 13 months follow-up the dog remains asymptomatic. To the authors’ knowledge, this is the first report of a case of laryngeal paralysis caused by a muscle pseudotumour in a young dog.

  5. Development of laryngeal video stroboscope with laser marking module for dynamic glottis measurement.

    Science.gov (United States)

    Kuo, Chung-Feng Jeffrey; Wang, Hsing-Won; Hsiao, Shang-Wun; Peng, Kai-Ching; Chou, Ying-Liang; Lai, Chun-Yu; Hsu, Chien-Tung Max

    2014-01-01

    Physicians clinically use laryngeal video stroboscope as an auxiliary instrument to test glottal diseases, and read vocal fold images and voice quality for diagnosis. As the position of vocal fold varies in each person, the proportion of the vocal fold size as presented in the vocal fold image is different, making it impossible to directly estimate relevant glottis physiological parameters, such as the length, area, perimeter, and opening angle of the glottis. Hence, this study designs an innovative laser projection marking module for the laryngeal video stroboscope to provide reference parameters for image scaling conversion. This innovative laser projection marking module to be installed on the laryngeal video stroboscope using laser beams to project onto the glottis plane, in order to provide reference parameters for scaling conversion of images of laryngeal video stroboscope.

  6. 75 FR 28542 - Superior Resource Advisory Committee

    Science.gov (United States)

    2010-05-21

    ... orient the new Superior Resource Advisory Committee members on their roles and responsibilities. DATES... of the roles and responsibilities of the Superior Resource Advisory Committee members; Election of... Forest Service Superior Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice...

  7. Applied anatomy of the cervical region of the recurrent laryngeal nerve

    Institute of Scientific and Technical Information of China (English)

    Changchu Wu; Xing Guo; Yanwei Li

    2008-01-01

    BACKGROUND AND OBJECTIVE: To avoid recurrent laryngeal nerve (RLN) injury during thyroid surgery, it is important to identify the nerve and to follow its projection carefully to discriminate it from the inferior thyroid artery. DESIGN, TIME AND SETTING: All studies were performed at the Anatomy Division of Shaoyang Medical College from May 2003 to May 2004 with repeated measurement design. MATERIALS: Fifty embalmed adult corpses, comprising 20 females and 30 males, were obtained by donation. METHODS AND MAIN OUTCOME MEASURES: The projection, branches, and the relationship of the RLN to the inferior thyroid artery were observed. RESULTS: The RLN in all cases ascended through the tracheoesophageal groove at the isthmus superior levels of the thyroid gland. However, the RLN in 14 cases were situated inferior to the isthmus of the thyroid gland; 11 cases were to the right side and 2 cases to the left side, projected in the tracheoesophageal groove, and ascended away from the groove after 4.5-6.5 mm. The RLN typically ramified at the thyroid isthmus plane (44 cases, 44% of all cases). The RLN branches were variable. Type 2 rami were most common in the RLN, accounting for 55%; the second most common was RLN branches with no rami. RLN braches with type 3 rami, 4 rami, and 5 rami were less common. Approximately 54% of nerves were situated behind the main branch artery. The nerves located adjacent to the arteries, and between the arterial branches, were similar; the former applied to 19 cases, accounting for 19%, whereas the latter applied to 18 cases, accounting for 18%. Left nerves behind the artery, and right nerves before the artery, were more common. There were significant differences between the left and right nerves (P<0.01). CONCLUSION: There was not a significant difference in the projection of the RLN, while a significant difference in the number of RLN branches existed. In addition, the anatomical relationship of the RLN and the inferior thyroid artery exhibited

  8. Air-Q intubating laryngeal airway: A study of the second generation supraglottic airway device

    Directory of Open Access Journals (Sweden)

    Viren Bhaskar Attarde

    2016-01-01

    Full Text Available Background and Aims: Air-Q intubating laryngeal mask airway (ILA is used as a supraglottic airway device and as a conduit for endotracheal intubation. This study aims to assess the efficacy of the Air-Q ILA regarding ease of insertion, adequacy of ventilation, rate of successful intubation, haemodynamic response and airway morbidity. Methods: Sixty patients presenting for elective surgery at our Medical College Hospital were selected. Following adequate premedication, baseline vital parameters, pulse rate and blood pressure were recorded. Air-Q size 3.5 for patients 50-70 kg and size 4.5 for 70-100 kg was selected. After achieving adequate intubating conditions, Air-Q ILA was introduced. Confirming adequate ventilation, appropriate sized endotracheal tube was advanced through the Air-Q blindly to intubate the trachea. Placement of the endotracheal tube in trachea was confirmed. Results: Air-Q ILA was successfully inserted in 88.3% of patients in first attempt and 11.7% patients in second attempt. Ventilation was adequate in 100% of patients. Intubation was successful in 76.7% of patients with Air-Q ILA. 23.3% of patients were intubated by direct laryngoscopy following failure with two attempts using Air-Q ILA. Post-intubation the change in heart rate was statistically significant (P < 0.0001. 10% of patients were noted to have a sore throat and 5% of patients had mild airway trauma. Conclusion: Air-Q ILA is a reliable device as a supraglottic airway ensuring adequate ventilation as well as a conduit for endotracheal intubation. It benefits the patient by avoiding the stress of direct laryngoscopy and is also superior alternative device for use in a difficult airway.

  9. Efficacy and tolerability of an ectoine mouth and throat spray compared with those of saline lozenges in the treatment of acute pharyngitis and/or laryngitis: a prospective, controlled, observational clinical trial.

    Science.gov (United States)

    Müller, Dörte; Lindemann, Torben; Shah-Hosseini, Kija; Scherner, Olaf; Knop, Markus; Bilstein, Andreas; Mösges, Ralph

    2016-09-01

    The aim of this observational trial was to evaluate the efficacy and tolerability of a mouth and throat spray containing ectoine in the treatment of acute pharyngitis and/or laryngitis. The outcome was compared with control treatment using saline lozenges. This study was designed as a prospective, controlled, non-randomized, observational multicenter clinical trial and was conducted in Germany. The study population consisted of 95 patients. The decision for treatment with either spray or lozenges was based on the patients' preference for pharyngeal or oral application. Investigators assessed symptoms specific to acute pharyngitis/laryngitis and determined the pharyngitis symptom score. Both patients and investigators evaluated the tolerability and efficacy of the treatment applied. Treatment with the spray showed higher efficacy, 1.95 ± 0.81 versus 1.68 ± 0.67 (investigators) and 1.97 ± 0.88 versus 1.57 ± 0.69 (patients, p ectoine-based spray showed superior efficacy in treating acute pharyngitis and/or laryngitis.

  10. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    OpenAIRE

    Seyyedeh Maryam Khoddami; Noureddin Nakhostin Ansari; Farzad Izadi; Saeed Talebian Moghadam

    2013-01-01

    The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physio...

  11. Laryngeal High-Speed Videoendoscopy: Sensitivity of Objective Parameters towards Recording Frame Rate

    OpenAIRE

    Anne Schützenberger; Melda Kunduk; Michael Döllinger; Christoph Alexiou; Denis Dubrovskiy; Marion Semmler; Anja Seger; Christopher Bohr

    2016-01-01

    The current use of laryngeal high-speed videoendoscopy in clinic settings involves subjective visual assessment of vocal fold vibratory characteristics. However, objective quantification of vocal fold vibrations for evidence-based diagnosis and therapy is desired, and objective parameters assessing laryngeal dynamics have therefore been suggested. This study investigated the sensitivity of the objective parameters and their dependence on recording frame rate. A total of 300 endoscopic high-sp...

  12. Laryngeal Langerhans Cell Histiocytosis Presenting with Neck Mass in an Adult Woman

    Directory of Open Access Journals (Sweden)

    Hesam Jahandideh

    2016-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a very rare condition that commonly affects the head and neck region. There are very few cases of isolated laryngeal involvement by LCH, mostly reported in pediatric patients. Here, we report a case of laryngeal LCH in a 62-year-old woman presenting with a neck mass several weeks ago. The clinical and histopathological findings are reported with a brief discussion about the disease.

  13. Laryngeal Langerhans Cell Histiocytosis Presenting with Neck Mass in an Adult Woman

    Science.gov (United States)

    Jahandideh, Hesam; Nasoori, Yasser; Rostami, Sara; Safdarian, Mahdi

    2016-01-01

    Langerhans cell histiocytosis (LCH) is a very rare condition that commonly affects the head and neck region. There are very few cases of isolated laryngeal involvement by LCH, mostly reported in pediatric patients. Here, we report a case of laryngeal LCH in a 62-year-old woman presenting with a neck mass several weeks ago. The clinical and histopathological findings are reported with a brief discussion about the disease. PMID:27127670

  14. Pulmonary involvement in juvenile laryngeal papillomatosis: radiological findings; Disseminacao pulmonar na laringopapilomatose juvenil

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Luciano Lerch; Eickhoff, Karin; Jungblut, Sandra; Furtado, Alvaro Porto Alegre [Hospital das Clinicas de Porto Alegre, RS (Brazil). Servico de Radiologia

    1999-08-01

    Papillomas are the most common laryngeal tumors in infancy and childhood, and spreads to involve the lung parenchyma and bronchi in less than 2% of cases. The authors report one case of pulmonary spread in laryngeal papillomatosis and describe radiographic and tomographic aspects of these lesions. It is discussed the clinical presentation of this disease, the diagnostic methods, histopathology and therapeutic approaches involving the clinical data related and a recent literature reviewed. (author)

  15. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

    OpenAIRE

    Mohammad Javad Saeedi Borujeni; Ebrahim Esfandiary; Mostafa Almasi- Dooghaee

    2017-01-01

    Introduction: Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Cas...

  16. Multiple cutaneous metastases in laryngeal carcinoma: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Kishore Das

    2014-01-01

    Full Text Available Metastasis to the skin in laryngeal squamous cell carcinoma is an extremely rare occurrence. We report a case of multiple cutaneous metastases in the follow-up of a 60-year-old male with squamous carcinoma of the vocal cords that were treated with surgery and radiotherapy. The patient presented with multiple painful skin nodules at 3 months following the completion of treatment. Clinically the skin nodules mimicked an inflammatory skin lesion. The diagnosis of metastatic skin lesions was made by cytological examination. Appearance of new painful skin lesions soon after the completion of treatment in patients treated for squamous carcinoma of the larynx should warrant a clinical suspicion of cutaneous metastases.

  17. Danish Stød: Laryngealization or Tone

    DEFF Research Database (Denmark)

    Grønnum, Nina; Vazquez-Larruacaín, Miguel; Basbøll, Hans

    2013-01-01

    In the light of previous acoustic analyses of Danish stød and Danish intonation, we discuss two different phonological theories. In one, stød is an autonomous laryngeal syllable prosody. In the other, stød is the phonetic manifestation of a HL tonal pattern compressed within one syllable. The tonal...... representation is found to be contradicted by the phonetic reality, and it cannot account for the structurally determined alternation between non-stød and stød in inflection and derivation, nor for latent stød or stød in compounds. Furthermore, stød patterns are largely constant across regional varieties...

  18. Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO)

    DEFF Research Database (Denmark)

    Mehlum, Camilla Slot; Walsted, Emil Schwarz; Godballe, Christian;

    2016-01-01

    Breathing difficulties during exertion may be caused by exercise-induced laryngeal obstruction (EILO). The diagnosis depends on visualization of the larynx during exercise, i.e. by continuous laryngoscopic exercise (CLE) test. In case of severe supraglottic collapse and pronounced symptoms during...... strenuous exertion, surgical treatment (supraglottoplasty) has been suggested. The aims of this study were to evaluate outcome and patient satisfaction after supraglottoplasty for EILO and to compare our results with previously reported data. During the period December 2010 to October 2013, 17 patients...... diagnosed with moderate to severe supraglottic EILO were treated by supraglottoplasty with microlaryngoscopic laser technique at our institutions. The severity of patients symptoms (VAS score) and CLE scores was evaluated pre- and postoperatively. We found a decrease in patients symptoms from median 80...

  19. Automatic segmentation of equine larynx for diagnosis of laryngeal hemiplegia

    Science.gov (United States)

    Salehin, Md. Musfequs; Zheng, Lihong; Gao, Junbin

    2013-10-01

    This paper presents an automatic segmentation method for delineation of the clinically significant contours of the equine larynx from an endoscopic image. These contours are used to diagnose the most common disease of horse larynx laryngeal hemiplegia. In this study, hierarchal structured contour map is obtained by the state-of-the-art segmentation algorithm, gPb-OWT-UCM. The conic-shaped outer boundary of equine larynx is extracted based on Pascal's theorem. Lastly, Hough Transformation method is applied to detect lines related to the edges of vocal folds. The experimental results show that the proposed approach has better performance in extracting the targeted contours of equine larynx than the results of using only the gPb-OWT-UCM method.

  20. Recurrent laryngeal nerve histopathology in spastic dysphonia: a preliminary study.

    Science.gov (United States)

    Dedo, H H; Izdebski, K; Townsend, J J

    1977-01-01

    Spastic dysphonia is a severe voice disorder ordinarily described as psychogenic. Organic-neurologic changes secondary to central or peripheral nervous system involvement have also been postulated and led recently to the surgical treatment of spastic dysphonia by unilateral section of the recurrent laryngeal nerve (RLN). This study reports the histologic findings from these resections of the RLN from patients with an average 9.5 years duration of spastic dysphonia. Thirty percent of the RLNs examined demonstrated significant abnormalities as compared to age-matched controls. Although no reactive changes were noted by light microscopy, groups of fibers which did not stain for myelin or axons were found in RLNs from patients with spastic dysphonia. A preliminary ultrastructural study of these areas in one RLN revealed sheets of unmyelinated axons. These findings suggest an organic basis for spastic dysphonia at least in some patients.

  1. Laryngeal mask airway (LMA) artefact resulting in MRI misdiagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Schieble, Thomas [University of Medicine and Dentistry of New Jersey, Department of Anesthesiology, New Jersey Medical School, Newark, NJ (United States); Maimonides Medical Center, Department of Anesthesiology, Brooklyn, NY (United States); Patel, Anuradha; Davidson, Melissa [University of Medicine and Dentistry of New Jersey, Department of Anesthesiology, New Jersey Medical School, Newark, NJ (United States)

    2008-03-15

    We report a 7-year-old child who underwent brain MRI for a known seizure disorder. The technique used for general anesthesia included inhalation induction followed by placement of a laryngeal mask airway (LMA) for airway maintenance. Because the reviewing radiologist was unfamiliar with the use of an LMA during anesthesia, and because the attending anesthesiologist did not communicate his technique to the radiologist, an MRI misdiagnosis was reported because of artefact created by the in situ LMA. As a result of this misdiagnosis the child was subjected to unnecessary subsequent testing to rule out a reported anatomic abnormality induced by the LMA. Our case illustrates the need for coordination of patient care among hospital services. (orig.)

  2. Significance of Parafibromin Expression in Laryngeal Squamous Cell Carcinomas

    Directory of Open Access Journals (Sweden)

    Inju Cho

    2016-07-01

    Full Text Available Background: Parafibromin is a product of the tumor suppressor gene that has been studied as a potential indicator of tumor aggressiveness in the parathyroid, breast, colorectum, and stomach. However, the clinical significance and potential function of parafibromin expression in head and neck squamous cell carcinomas remain largely unknown. The aim of this study was to evaluate the expression of parafibromin in laryngeal squamous cell carcinoma (LSCC and to verify its potential as a biomarker of tumor behavior. Methods: Parafibromin expression was evaluated in 30 cases of LSCC using immunohistochemistry. The correlations between parafibromin expression and clinicopathologic parameters were investigated. Results: Parafibromin expression was positive in 15 cases (50% and negative in 15 cases (50%. Tumor size and T stage showed a statistically significant inverse relationship with parafibromin expression (p=.028 and p.05. Conclusions: Our results indicate that the downregulation or loss of parafibromin expression can be employed as a novel marker of tumor progression or aggressiveness in LSCC.

  3. [Dysphonia in children due to congenital laryngeal web. Case series].

    Science.gov (United States)

    Rodríguez, Hugo; Cuestas, Giselle; Zanetta, Adrián

    2013-01-01

    Dysphonia is common in children. Its main cause is the abuse or misuse of the voice. Congenital, neoplastic, infectious, neurological or iatrogenic causes are less frequent. The laryngeal web is a rare congenital anomaly resulting from an incomplete recanalization of the primitive larynx. This condition should be suspected in any newborn with dysphonic cry with or without stridor and respiratory distress. The diagnosis is confirmed by endoscopic examination. Therapy depends on the extent and thickness of the membrane and the severity of the symptoms. We describe our experience with 8 patients suffering this condition, and we emphasize the need to recognize voice disorders and to evaluate the airway for accurate diagnosis and appropriate treatment in every newborn, infant or child with persistent dysphonia.

  4. Manikin training for neonatal resuscitation with the laryngeal mask airway.

    Science.gov (United States)

    Gandini, Donna; Brimacombe, Joseph

    2004-06-01

    We describe our experience of brief (training with the laryngeal mask airway (LMA) for neonatal resuscitation in 80 health care workers. Prior to training, 31% had not heard of the LMA, 57% did not know the LMA could be used for neonatal resuscitation and 88% thought it was a disposable device. The mean (SD) range time to insert the LMA after training was 5 (2, 5-16) s and there were no failed insertions. The preferred technique for neonatal resuscitation, before vs after training, changed from 72 to 14% for the face mask (P training was adequate and the LMA should be available on neonatal resuscitation carts. Confidence in using the LMA increased from 8 to 97% (P training.

  5. Evaluation of Semon's Law in Laryngeal Paralysis

    Directory of Open Access Journals (Sweden)

    J. Hedayaty

    1957-01-01

    Full Text Available We have discussed hi t . ] . IS orica and clinical aspects of Semon's L concernIng the hevaviOur of the vocal cords' aw net ve paralysis and the exist' diff In the recurrent laryngeal Althou h ' mg I erent theories for its explanation. g One may fwd certain truth in neverthless, it seemsfl' SOmeof the old theories, ar more ogical and satisfactor the explanation of th S 'L y to us to search e ernon s aw throu h the anatomy of the SU . I g Our new knowledge of penor aryngeal nerve in man d i which innervate the .t' an ItS motor fibers In erarytenOld muscle.

  6. ACCOMPANYING THERAPY IN PATIENTS AFTER ENDOSCOPIC LARYNGEAL SURGERY

    Directory of Open Access Journals (Sweden)

    E. N. Novozhilova

    2014-01-01

    Full Text Available The paper describes the experience with accompanying therapy in patients after endoscopic laryngeal surgery, which has been gained at the Unit of Head and Neck Tumors, Moscow City Cancer Hospital Sixty-Two. Endolaryngeal operations have been performed using robotic CO2 laser and alternative modes of mechanical ventilation. Methods for abolishing laser-induced reactive tissue changes with different groups of pharmaceuticals are considered. Both the possible side effects of some drugs and their potential interaction are taken into account. The high efficacy of current inhalation systems (PARI delivering the required doses of medicaments over a short period of time and with minimal losses and regulating their dispersion in relation to the drug used is noted.

  7. [Relationship between vasculogenic mimicry and clinic pathological features in laryngeal carcinoma].

    Science.gov (United States)

    Feng, Yan; Wang, Binquan; Liang, Gang; Wen, Shuxin; Sun, Ruifang

    2015-12-01

    To investigate the presence of vasculogenic mimicry in laryngeal squamous cell carcino- ma and explore its clinical significance. The presence of vasculogenic mimicry and expression of endotheli- um-dependent vessel in 138 laryngeal squamous cell carcinomas cases were detected by the immunohistochemistry and tissue microarray. Metlab software was used to evaluate the relationship among vasculogenic mimicry, mi- crovessel density and clinic pathological parameters in laryngeal carcinoma. We found vasculogenic mimicry in 32 (26.23%) of 122 laryngeal carcinoma samples. The mean of microvessel density is 12.61 per high-power field. The vasculogenic mimicry and expression of endothelium-dependent vessel were not significantly related to patient age or gender, tumor location, pathology grade, T stage or N stage (P > 0.05). However, the vasculo- genic mimicry and the mean of microvessel density were a little higher in patients older than 60, with poorly differ- entiated and patients with N₁₋₃ stage. Vasculogenic mimicry was positively correlatedwith microvessel density (r = 0.1927, P mimicry can occur in laryngeal carcinoma. Moreover, vasculogenic mimicry may be associated with recurrence and metastasis in laryngeal carcinoma.

  8. Effect of human papilloma virus expression on clinical course of laryngeal papilloma.

    Science.gov (United States)

    Kim, Kwang Moon; Cho, Nam Hoon; Choi, Hong Shik; Kim, Young Ho; Byeon, Hyung Kwon; Min, Hyun Jin; Kim, Se-Heon

    2008-10-01

    Our observations suggest that human papilloma virus (HPV) 6/11 is the main causative agent of laryngeal papilloma and that detection of active HPV DNA expression may be helpful in identifying patients with aggressive recurrent laryngeal papilloma. HPV is assumed to be the main causative agent of this disease. We investigated the expression of the entire genotype of HPV in cases of laryngeal papilloma and correlated their expression with the clinical course of the disease. Seventy cases of laryngeal papilloma were evaluated for the presence of the HPV genome by in situ hybridization (ISH) using wide-spectrum HPV DNA probe. Specific types of HPV infection were determined by DNA ISH using type-specific HPV DNA probes (HPV 6, 11, 16, 18, 31, 33). Separate analyses were conducted comparing viral types, frequency of recurrences and duration of disease-free periods. We detected HPV DNA in 40 of the 70 laryngeal papilloma cases (57%). In particular, HPV DNA was detected in 75% of the juvenile types. There were significant associations between HPV and laryngeal papilloma (p<0.01). Among the HPV-positive cases, major specific types were HPV 6/11 (97%). Significant associations were also noted between viral expression and clinical course.

  9. Laryngeal motility alteration: A missing link between sleep apnea and vagus nerve stimulation for epilepsy.

    Science.gov (United States)

    Zambrelli, Elena; Saibene, Alberto M; Furia, Francesca; Chiesa, Valentina; Vignoli, Aglaia; Pipolo, Carlotta; Felisati, Giovanni; Canevini, Maria Paola

    2016-01-01

    This study aimed to evaluate the prevalence and the relationship of sleep breathing disorders (SBDs) and laryngeal motility alterations in patients with drug-resistant epilepsy after vagus nerve stimulator (VNS) implantation. Twenty-three consecutive patients with medically refractory epilepsy underwent out-of-center sleep testing before and after VNS implantation. Eighteen eligible subjects underwent endoscopic laryngeal examination post-VNS implantation. Statistical analysis was carried out to assess an association between laryngeal motility alterations and the onset/worsening of SBDs. After VNS implantation, 11 patients showed a new-onset mild/moderate SBD. Half of the patients already affected by obstructive sleep apnea (OSA) showed worsening of SBD. All of the patients with a new-onset OSA had a laryngeal pattern with left vocal cord adduction (LVCA) during VNS stimulation. The association between VNS-induced LVCA and SBD was statistically significant. This study suggests an association between VNS and SBD, hinting to a pivotal role of laryngeal motility alterations. The relationship between SBD and VNS-induced LVCA supports the need to routinely investigate sleep respiratory and laryngeal motility patterns before and after VNS implantation.

  10. Intrinsic laryngeal muscles are spared from myonecrosis in the mdx mouse model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Marques, Maria Julia; Ferretti, Renato; Vomero, Viviane Urbini; Minatel, Elaine; Neto, Humberto Santo

    2007-03-01

    Intrinsic laryngeal muscles share many anatomical and physiological properties with extraocular muscles, which are unaffected in both Duchenne muscular dystrophy and mdx mice. We hypothesized that intrinsic laryngeal muscles are spared from myonecrosis in mdx mice and may serve as an additional tool to understand the mechanisms of muscle sparing in dystrophinopathy. Intrinsic laryngeal muscles and tibialis anterior (TA) muscle of adult and aged mdx and control C57Bl/10 mice were investigated. The percentage of central nucleated fibers, as a sign of muscle fibers that had undergone injury and regeneration, and myofiber labeling with Evans blue dye, as a marker of myofiber damage, were studied. Except for the cricothyroid muscle, none of the intrinsic laryngeal muscles from adult and old mdx mice showed signs of myofiber damage or Evans blue dye labeling, and all appeared to be normal. Central nucleation was readily visible in the TA of the same mdx mice. A significant increase in the percentage of central nucleated fibers was observed in adult cricothyroid muscle compared to the other intrinsic laryngeal muscles, which worsened with age. Thus, we have shown that the intrinsic laryngeal muscles are spared from the lack of dystrophin and may serve as a useful model to study the mechanisms of muscle sparing in dystrophinopathy.

  11. Enhancement of aging rat laryngeal muscles with endogenous growth factor treatment.

    Science.gov (United States)

    Stemple, Joseph C; Andreatta, Richard D; Seward, Tanya S; Angadi, Vrushali; Dietrich, Maria; McMullen, Colleen A

    2016-05-01

    Clinical evidence suggests that laryngeal muscle dysfunction is associated with human aging. Studies in animal models have reported morphological changes consistent with denervation in laryngeal muscles with age. Life-long laryngeal muscle activity relies on cytoskeletal integrity and nerve-muscle communication at the neuromuscular junction (NMJ). It is thought that neurotrophins enhance neuromuscular transmission by increasing neurotransmitter release. We hypothesized that treatment with neurotrophin 4 (NTF4) would modify the morphology and functional innervation of aging rat laryngeal muscles. Fifty-six Fischer 344xBrown Norway rats (6- and 30-mo age groups) were used to evaluate to determine if NTF4, given systemically (n = 32) or directly (n = 24), would improve the morphology and functional innervation of aging rat thyroarytenoid muscles. Results demonstrate the ability of rat laryngeal muscles to remodel in response to neurotrophin application. Changes were demonstrated in fiber size, glycolytic capacity, mitochondrial, tyrosine kinase receptors (Trk), NMJ content, and denervation in aging rat thyroarytenoid muscles. This study suggests that growth factors may have therapeutic potential to ameliorate aging-related laryngeal muscle dysfunction.

  12. What are Millian Qualitative Superiorities?

    Directory of Open Access Journals (Sweden)

    Jonathan Riley

    2008-04-01

    Full Text Available In an article published in Prolegomena 2006, Christoph Schmidt-Petri has defended his interpretation and attacked mine of Mill’s idea that higher kinds of pleasure are superior in quality to lower kinds, regardless of quantity. Millian qualitative superiorities as I understand them are infinite superiorities. In this paper, I clarify my interpretation and show how Schmidt-Petri has misrepresented it and ignored the obvious textual support for it. As a result, he fails to understand how genuine Millian qualitative superiorities determine the novel structure of Mill’s pluralistic utilitarianism, in which a social code of justice that distributes equal rights and duties takes absolute priority over competing considerations. Schmidt-Petri’s own interpretation is a non-starter, because it does noteven recognize that Mill is talking about different kinds of pleasant feelings, such that the higher kinds are intrinsically more valuable than the lower. I conclude by outlining why my interpretation is free of any metaphysical commitment to the “essence” of pleasure.

  13. Isolated superior mesenteric artery dissection

    Directory of Open Access Journals (Sweden)

    Lalitha Palle

    2010-01-01

    Full Text Available Isolated superior mesenteric artery (SMA dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.

  14. A escrita no Ensino Superior

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    Maria Conceição Pillon Christofoli

    2013-01-01

    Full Text Available http://dx.doi.org/10.5902/198464445865 O presente artigo trata de apresentar resultados oriundos de pesquisa realizada no Ensino Superior, enfocando a escrita em contextos universitários. Depoimentos por parte dos acadêmicos evidenciam certa resistência ao ato de escrever, o que acaba muitas vezes distanciando o sujeito da produção de um texto. Assim sendo, mesmo que parciais, os resultados até então analisados dão conta de que: pressuposto 1 – há ruptura da ideia de coerência entre o que pensamos, o que conseguimos escrever, o que entende nosso interlocutor; pressuposto 2 – a autocorreção de textos como exercício de pesquisa é imprescindível para a qualificação da escrita; pressuposto 3 – os diários de aula representam rico instrumento para a qualificação da escrita no Ensino Superior; pressuposto 4 – há necessidade de que o aluno do Ensino Superior escreva variados tipos de escrita, ainda que a universidade cumpra com seu papel, enfatizando a escrita acadêmica; pressuposto 5 – o trabalho com a escrita no Ensino Superior deve enfatizar os componentes básicos da expressão escrita: o código escrito e a composição da escrita. Palavras-chave: Escrita; Ensino Superior; formação de professores.

  15. Value of Narrow Band Imaging (NBI) Endoscopy in the Early Diagnosis of Laryngeal Cancer and Precancerous Lesions

    Science.gov (United States)

    2016-09-07

    Chronic Inflammation of Hypopharynx; Hoarseness; Macroscopic Laryngeal Lesions; Histological Confirmation of Dysplasia; Carcinoma in Situ; Invasive Carcinoma of Larynx; Invasive Carcinoma of Hypo Pharynx; Recurrent Respiratory Papillomatosis

  16. Pensamiento Superior y Desarrollo Territorial

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    Víctor Manuel Racancoj Alonzo

    2015-04-01

    Full Text Available Esta reflexión pretende explicar el papel, fundamental, que juega el pensamiento superior, en la formulación y la práctica de modelos de desarrollo territorial local; para que contribuyan de forma sustantiva, en la transformación de las condiciones socioeconómicas adversas que hoy viven comunidades indígenas y rurales de muchos países, como Guatemala, situación que puede resumirse en altos índices de pobreza y desnutrición. Pero, el pensamiento superior, debe ser competencia de la población con pertenencia a lo local, pues si y solo si esta condición existe, se dará validez y viabilidad al desarrollo territorial. Para alcanzar competencias de pensamiento superior, en los espacios locales, se tiene que superar obstáculos en el modelo de universidad, que hoy estamos familiarizados a ver y pensar; modelos que tienen las características de: herencia colonial, disfunción con la problemática económica, cultural, social y política de la sociedad y la negación de los saberes ancestrales.

  17. Superior sulcus tumors (Pancoast tumors).

    Science.gov (United States)

    Marulli, Giuseppe; Battistella, Lucia; Mammana, Marco; Calabrese, Francesca; Rea, Federico

    2016-06-01

    Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner's syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach.

  18. GROWTH INHIBITION OF HUMAN LARYNGEAL CANCER CELL WITH THE ADENOVIRUS-MEDIATED p53 GENE

    Institute of Scientific and Technical Information of China (English)

    WANG Qi; HAN De-min; WANG Wen-ge; WU Zu-ze; ZHANG Wei

    1999-01-01

    Objective: In most laryngeal cancers, the function of p53 gene is down regulated. To explore the potential use of p53 in gene therapy of laryngeal cancer, by introducing wild-type p53 into laryngeal cancer cell line via a recombinant adenoviral vector, Ad5CMV-p53 and analyzing its effects on cell and tumor growth. Methods: A human laryngeal cancer cell line Hep-2 was used.Recombinant cytomegalovirus-promoted adenoviruses containing human wild-type p53 cDNA was transiently introduced into Hep-2 line. The growth suppression of the Hep-2 cells and established s.c. squamous carcinoma model was examined. The p53 protein expression was detected using immunohistochemical analysis. Results: The transduction efficiencies of Hep-2 cell line were 100% at a multiplicity of 100 or greater. The p53 protein expression peaked on day 2 after infection and lasted far 5 days. In vitro growth assays revealed cell death following Ad5CMV-p53 infected. In vivo studies, Ad5CMV-p53 inhibited the tumorigenicity of Hep-2 cell, and in nude mice with established s.c. squamous carcinoma nodules showed that tumor volumes were significantly reduced in mice that received peritumoral infiltration of Ad5CMV-p53. Conclusion: Adenovirus-mediated antitumor therapy carrying the p53 gene is an efficient method to inhibit laryngeal cancer growth. Transfection of laryngeal cancer cells with the wild-type p53 gene via Ad5CMV-p53 is a potential novel approach to the therapy of laryngeal cancer.

  19. Pretherapeutic and posttherapeutic laryngeal imaging; Prae- und posttherapeutische Larynxbildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Becker, M.; Burkhardt, K.; Allal, A.S.; Dulguerov, P.; Ratib, O.; Becker, C.D. [Hopitaux Universitaires de Geneve, Abteilung fuer Hals-Nasen-Ohren-Radiologie, Geneve (Switzerland)

    2009-01-15

    Cross-sectional imaging with CT, MRI and more recently PET CT plays an indispensable complementary role to endoscopy in the pretherapeutic diagnostic and staging of laryngeal neoplasms and in the evaluation of the operated or irradiated larynx. Adequate interpretation of the CT, PET CT and MR images requires a thorough knowledge of the patterns of submucosal spread and familiarity with the diagnostic signs of neoplastic invasion as seen with each modality. In addition, one should be aware of the implications of imaging for staging and treatment. Both CT and MR imaging are highly sensitive for the detection of neoplastic invasion of the preepiglottic and paraglottic spaces, subglottic region and cartilage. The high negative predictive value of both CT and MRI allows a relatively reliable exclusion of neoplasm cartilage invasion. The specificity of both CT and MRI is, however, moderately high and both methods may, therefore, overestimate the extent of tumor spread. However, recent investigations have shown that the specificity of MRI may be significantly improved by using new diagnostic criteria which allow differentiation of tumor from peritumoral inflammation in many instances. Both cross-sectional imaging methods also significantly improve the pretherapeutic staging accuracy of laryngeal tumors if used in addition to clinical examination and endoscopic biopsy. In the presence of a submucosal mass, CT and MRI play a key role for the diagnosis, as they may characterize the lesion, reliably depict its submucosal extent and guide the endoscopist to perform deep biopsies which allow the definitive histological diagnosis. Cross-sectional imaging also plays a key role in the evaluation of laryngoceles, recurrent laryngeal nerve paralysis and fractures. (orig.) [German] Sowohl CT als auch MRT und neuerdings die PET-CT sind unentbehrliche Zusatzuntersuchungen zur Diagnostik und Stadieneinteilung von Tumoren des Larynx. Sie sind der klinischen Untersuchung (einschliesslich

  20. Brush Cytology with Immunocytochemical Evaluation of VEGF Expression versus Biopsy in Clinically Precancerous Laryngeal Lesions: Can We Diagnose Laryngeal Cancer Only with Brush Cytology?

    Science.gov (United States)

    Chatziavramidis, Angelos; Tsinaslanidou, Zinovia; Valeri, Rozalia; Konstantinidis, Iordanis; Constantinidis, Jannis

    2015-01-01

    Introduction. Laryngeal squamous cell carcinoma (LSCC) is the most common SCC of the head and neck. The high incidence of this malignancy and the low survival rate necessitate the development of novel diagnostic approaches. Aim of this study is to compare the diagnostic value of laryngeal brush cytology combined with VEGF immunocytochemistry versus histopathology of clinically precancerous lesions of the larynx. Material and Methods. Thirty patients with precancerous or suspected malignant laryngeal lesions underwent microlaryngoscopy, during which samples were taken for cytological, immunocytochemical, and histological analysis. Cytology and histology results were classified as follows: benign lesions, atypia/moderate dysplasia, and malignancy, whereas the expression of VEGF was evaluated as strong, moderate, weak, and zero expression, based on the percentage of cells stained. Results. The cytology results were in accordance with the histology results in 86.7% of the patients. The exfoliative cytology's sensitivity was estimated at 85% and its specificity at 90%. Its positive prognostic value was 94%, while its negative prognostic value was 75%. The additional immunocytochemical evaluation of VEGF expression increased all the noted parameters. Discussion. Exfoliative cytology of laryngeal lesions is a minimal-invasive, easily applicable procedure during microlaryngoscopy and reliable in terms of diagnostic value. Under certain conditions it could be held also in local anesthesia. Concurrent immunocytochemical analysis of VEGF expression further enhances its diagnostic value. PMID:26457244

  1. Brush Cytology with Immunocytochemical Evaluation of VEGF Expression versus Biopsy in Clinically Precancerous Laryngeal Lesions: Can We Diagnose Laryngeal Cancer Only with Brush Cytology?

    Directory of Open Access Journals (Sweden)

    Angelos Chatziavramidis

    2015-01-01

    Full Text Available Introduction. Laryngeal squamous cell carcinoma (LSCC is the most common SCC of the head and neck. The high incidence of this malignancy and the low survival rate necessitate the development of novel diagnostic approaches. Aim of this study is to compare the diagnostic value of laryngeal brush cytology combined with VEGF immunocytochemistry versus histopathology of clinically precancerous lesions of the larynx. Material and Methods. Thirty patients with precancerous or suspected malignant laryngeal lesions underwent microlaryngoscopy, during which samples were taken for cytological, immunocytochemical, and histological analysis. Cytology and histology results were classified as follows: benign lesions, atypia/moderate dysplasia, and malignancy, whereas the expression of VEGF was evaluated as strong, moderate, weak, and zero expression, based on the percentage of cells stained. Results. The cytology results were in accordance with the histology results in 86.7% of the patients. The exfoliative cytology’s sensitivity was estimated at 85% and its specificity at 90%. Its positive prognostic value was 94%, while its negative prognostic value was 75%. The additional immunocytochemical evaluation of VEGF expression increased all the noted parameters. Discussion. Exfoliative cytology of laryngeal lesions is a minimal-invasive, easily applicable procedure during microlaryngoscopy and reliable in terms of diagnostic value. Under certain conditions it could be held also in local anesthesia. Concurrent immunocytochemical analysis of VEGF expression further enhances its diagnostic value.

  2. A randomised crossover trial comparing a single-use polyvinyl chloride laryngeal mask airway with a single-use silicone laryngeal mask airway.

    Science.gov (United States)

    Bell, S F; Morris, N G; Rao, A; Wilkes, A R; Goodwin, N

    2012-12-01

    We compared insertion rates of single-use polyvinyl chloride laryngeal mask airways (LMAs) vs single-use silicone LMAs in 72 anaesthetised patients. Both airways were produced by Flexicare Medical. Laryngeal mask airway insertion was successful on the first attempt in 68/72 (94%) polyvinyl chloride LMAs vs 64/72 (89%) silicone LMAs (p = 0.39). Overall insertion rates were 72/72 (100%) for the polyvinyl chloride LMAs and 71/72 (99%) for the silicone LMAs (p = 1.0). Mean (SD) insertion times were similar for polyvinyl chloride and silicone LMAs: 24.3 (5.1)s vs 24.8 (7.8)s (p = 0.64). Laryngeal mask airway position, as assessed using a fibrescope, was not different (p = 0.077). The median (IQR [range]) leak pressure was 16 (12-20 [6-30]) cmH(2) O for the polyvinyl LMA and 18 (13-22 [6-30]) cmH(2) O or the silicone LMA (p = 0.037). In conclusion, we did not find any important differences between polyvinyl chloride and silicone laryngeal mask airways.

  3. Using endografts from superelastic titanium-nickelid-based alloy singular tissue plural tissues in organ-preserving surgery of laryngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kulbakin, D. E., E-mail: kulbakin-d@mail.ru [Tomsk Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634050 (Russian Federation); Tomsk State University, 36, Lenin Avenue, Tomsk, 634050 (Russian Federation); Mukhamedov, M. R., E-mail: muhamedov@oncology.tomsk.ru [Tomsk Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634050 (Russian Federation); Siberian State Medical University, 2, Moscow Highway, Tomsk, 634050 (Russian Federation); Choynzonov, E. L., E-mail: choynzonov@gmail.com [Tomsk Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634050 (Russian Federation); Siberian State Medical University, 2, Moscow Highway, Tomsk, 634050 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Gynter, V. E., E-mail: tc77@rec.tsu.ru [Tomsk State University, 36, Lenin Avenue, Tomsk, 634050 (Russian Federation); Research Institute of Medical Materials, 17, 19 Gv. Divizii, Tomsk, 634034 (Russian Federation)

    2015-11-17

    Our study has demonstrated feasibility of performing larynx preservation surgeries in patients with recurrent laryngeal cancer after failure of radiotherapy. The technique of combined laryngeal reconstruction with endografts from superelastic titanium-nickelid-based alloy Singular tissue Plural tissues results in improvement of life quality by preserving laryngeal functions.

  4. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  5. Comparative evaluation of intraocular pressure changes subsequent to insertion of laryngeal mask airway and endotracheal tube.

    Directory of Open Access Journals (Sweden)

    Ghai B

    2001-07-01

    Full Text Available AIMS: To evaluate the intraocular pressure and haemodynamic changes subsequent to insertion of laryngeal mask airway and endotracheal tube. SUBJECTS AND METHODS: The study was conducted in 50 adult patients. A standard general anaesthesia was administered to all the patients. After 3 minutes of induction of anaesthesia baseline measurements of heart rate, non-invasive blood pressure and intraocular pressure were taken following which patients were divided into two groups: laryngeal mask airway was inserted in group 1 and tracheal tube in group 2. These measurements were repeated at 15-30 second, every minute thereafter up to 5 minutes after airway instrumentation. RESULTS: A statistically significant rise in heart rate, systolic blood pressure, diastolic blood pressure and intraocular pressure was seen in both the groups subsequent to insertion of laryngeal mask airway or endotracheal tube. Mean maximum increase was statistically more after endotracheal intubation than after laryngeal mask airway insertion. The duration of statistically significant pressure responses was also longer after endotracheal intubation. CONCLUSION: Laryngeal mask airway is an acceptable alternative technique for ocular surgeries, offering advantages in terms of intraocular pressure and cardiovascular stability compared to tracheal intubation.

  6. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Saeedi Borujeni

    2017-01-01

    Full Text Available Introduction:Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Case Report:In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy.  Conclusion:In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child.

  7. Vocal cord mucosal flap for the treatment of acquired anterior laryngeal web

    Institute of Scientific and Technical Information of China (English)

    Xiao Yang; Wang Jun; Han Demin; Ma Lijing; Ye Jingying; Xu Wen

    2014-01-01

    Background Anterior glottic web is one type of laryngeal stenosis.Previous surgical methods had some drawbacks,such as large surgical trauma,long postoperative recovery time,and multiple-stage surgery.This study aimed to explore better treatment to repair anterior glottis web.Methods We performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs.All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.Results All 32 patients completed surgery in one stage,without postoperative laryngeal edema,difficulty in breathing,or other complications.After the surgery,the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however,in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords,accompanied by scar appearance of bilateral vocal cords.The GRB score,voice handicap index scores,and maximum phonation time score significantly improved in all patients after the surgery.There was no evidence of recurrent laryngeal webbing in the 6-rnonth follow-up.Conclusion Vocal cords mucosal flap repair surgery has the advantages of less trauma,quick recovery,and significant improvement of the voice in the treatment of laryngeal webs.

  8. The relationship between prognostic parameters and tumor associated tissue eosinophilia in supraglottic laryngeal tumors

    Directory of Open Access Journals (Sweden)

    Ali Süner

    2013-03-01

    Full Text Available Objective: Tumor-associated tissue eosinophilia (TATEhas been noted in human cancers, sometimes with differentresults regarding their association with clinical outcome.In this study, the association between TATE andprognostic parameters of supraglottic laryngeal cancerwas analyzed.Materials and methods: Sixty-two patients with diagnosisof supraglottic laryngeal squamous cell carcinoma andwho treated surgically in our center were evaluated. Thecases were divided into 3 categories according to the averagenumber of eosinophils per high-power field (400x:0 (negative, 1-5 (grade 1+, more than 5 (grade 2+.Results: We found 24 TATE-negative (38.7% and 38TATE-positive (61.3% cases. There was not any statisticallysignificant correlation between TATE and tumor differentiation,vascular invasion, perineural invasion, lymphnode metastasis, patients’ ages, T stages (p>0.05. Asexpected, vascular invasion correlated with lymph nodemetastasis (p=0.001.Conclusion: The results of this study showed that TATEhas no correlation with prognostic parameters such ashistologic differentiation, vascular invasion, perineuralinvasion, lymph node metastasis, patients’ ages and Tstages in supraglottic laryngeal squamous cell carcinoma.The data suggest that stromal eosinophilic infiltrationis not useful for determining biological aggressiveness insupraglottic laryngeal cancer.Key words: laryngeal carcinoma, supraglottic, eosinophilia,prognostic parameters

  9. Increased Expression of MuRF1 Is Associated with Radiation-induced Laryngeal Muscle Atrophy.

    Science.gov (United States)

    Han, Xiaochen; Pires, Leonardo; Browne, J Dale; Sullivan, Christopher A; Zhao, Weiling; Feng, Xin

    2015-11-01

    Laryngeal muscles play an important role in breathing, sound production and trachea protection against food. Laryngeal dysfunctions during radiotherapy for head and neck cancers are common. In the present study, we aimed to investigate the early effect of radiation on the laryngeal muscles in vivo and possible mechanisms involved in this process. Eight-week-old female C57bl/ mice received neck irradiation with a single dose of 25 Gy and bilateral thyroarytenoid (TA) muscles of mice were collected at day 3, 7 and 10 post-irradiation for evaluating muscle size, myosins, myosin heavy chain (MyHC) composition and MuRF1 protein levels. A significant reduction in the size of muscle fibers and myosins in the TA muscles were observed at days 3, 7, 10 after radiation (pmuscle fiber atrophy and myosin loss in the intrinsic laryngeal muscles. MuRF1 may play an important role in the radiation-induced protein degradation in the laryngeal muscles and warrants further investigation. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  10. Short, sharp shock public health campaign had limited impact on raising awareness of laryngeal cancer.

    Science.gov (United States)

    Sethi, Neeraj; Rafferty, Amy; Rawnsley, Trisha; Jose, Jemy

    2016-09-01

    Laryngeal cancer has poorer outcomes if diagnosed at a later stage. Improving awareness could encourage earlier presentation and improve outcomes. This study aimed to evaluate a public engagement campaign targeted at raising awareness of laryngeal cancer. An epidemiological study identified high-risk populations in the region. A target population as well as a matched control population was selected. A cancer awareness survey combined with focus groups guided the design of a 3-month multimedia campaign. The survey was repeated post-campaign to evaluate the campaign effectiveness. The study identified populations with the highest rates of laryngeal cancer and late stage disease at presentation. The surveys performed revealed a limited effect of the multimedia campaign in raising awareness of the signs and symptoms of laryngeal cancer. Recall of the campaign also faded rapidly. This is the first public awareness campaign aimed at laryngeal cancer carried out in the UK. The results suggest that short-term campaigns have a limited effect and a more prolonged approach should be considered.

  11. Impact of laryngeal mask airway cuff pressures on the incidence of sore throat in children.

    Science.gov (United States)

    Wong, Justin Gin Leong; Heaney, Mairead; Chambers, Neil A; Erb, Thomas O; von Ungern-Sternberg, Britta S

    2009-05-01

    Hyperinflation of laryngeal mask airway cuffs can cause harm to the upper airway mainly by exerting high pressures on pharyngeal and laryngeal structures thus impairing mucosal perfusion. Although cuff manometers can be used to guide the monitoring of cuff pressures, their use is not routine in many institutions. In a prospective audit, we assessed the incidence of sore throat following day-case-surgery in relation to the intracuff pressure within the laryngeal mask airway. Four hundred children (3-21 years) were consecutively included in this study. The laryngeal mask airway was inflated as deemed necessary by the attending anesthetist. Cuff pressures were measured using a calibrated cuff manometer (Portex Limited, Hythe, Kent, UK, 0-120 cm H2O, pressures exceeding the measurement range were set at 140 cm H2O for statistical purposes) at induction of anesthesia. Forty-five children (11.25%) developed sore throat, 32 (8%) sore neck and 17 (4.25%) sore jaw. Of those that developed sore throat, 56.5% had cuff pressures exceeding >100 cm H2O. In contrast, when cuff pressures were sore throat, whilst there was only a 4.6% occurrence of sore throat if cuff pressures were between 40-60 cm H2O. We have demonstrated that intra cuff pressure in laryngeal mask airways is closely related to the development of sore throat with higher pressures increasing its likelihood. Hence, cuff pressures should be measured routinely using a manometer to minimize the incidence of sore throat.

  12. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

    Science.gov (United States)

    Saeedi Borujeni, Mohammad Javad; Esfandiary, Ebrahim; Almasi-Dooghaee, Mostafa

    2017-01-01

    Introduction: Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Case Report: In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy. Conclusion: In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child. PMID:28229063

  13. [The ProSeal-LM, a new variant of the laryngeal mask: description and first clinical results].

    Science.gov (United States)

    Füllekrug, B; Reissmann, H; Pothmann, W; Masch, T; Schulte am Esch, J

    2001-04-01

    The ProSeal-LMA is a modification of the laryngeal mask airway (LMA) invented by AIJ Brain. It differs from the known models in three major respects: An additional lumen extending into the tip of the cuff allows insertion of a gastric tube. A pocket immediately behind the cuff accommodates a finger or a siliconated metal introducer and thus facilitates insertion. An additional cuff at the dorsal aspect of the mask pushes the mask into a ventral direction and thus improves the seal around the glottic opening. Our experience after 8 months of clinical use and first data from an international multi-center-study (24 ProSeal-LMA/24 Standard-LMA) are reported. With a ProSeal-LMA insertion of a gastric tube is much easier and more reliable than with a Standard-LMA (24/24 patients vs. 2/24 patients). Judged from visibility of the oesophagus during fibre-endoscopy the position of the ProSeal-LMA is superior to that of the Standard-LMA. Both are equally well tolerated and handled. Most remarkable is a better seal for the ProSeal-LMA (pressure for a leak of 3 L/min: 31 mbar compared to 20 mbar (mean) for the Standard-LMA). Therefore the ProSeal-LMA seems suitable for anaesthesia procedures with IPPV, which up to now are a domain of endotracheal intubation.

  14. A COMPARATIVE STUDY OF IN HALATION AL SEVOFLURANE VERSUS INTRAVENOUS PROPOFOL FOR INSERTION OF LARYNGEAL MASK AIRWAY IN ADULTS

    Directory of Open Access Journals (Sweden)

    Kailash

    2015-10-01

    Full Text Available BACKGROUND: Inhalational sevoflurane and intravenous propofol have been widely used for anesthesia induction. This study compared the efficacies of inhalational sevoflurane and intravenous propofol inductions for laryngeal mask airway (LMA insertion for minor surgical procedures. METHODS: Fifty adult patients of ASA I and II between the ages 18 - 60 years of either sex posted for elective, minor surgeries in general surgery, obstetric, gynecological, urologic and orthopedic surgeries, received anesthesia induction with inhalational sevoflurane and intravenous propofol. Induction time, quality and ease of LMA insertion, hemodynamic changes and complications were observed . RESUL TS: LMA was inserted most rapidly with intravenous propofol (100.8 ± 14.48 s and less rapidly with inhalational sevoflurane (122 ± 15.6 s. Anesthesia induction with intravenous propofol produced statistically significant difference with mean arterial pressur e and heart rate at one minute, when compared with inhalational sevoflurane. The LMA insertion was excellent with intravenous propofol than inhalational sevoflurane. CONCLUSION: Inhalational sevoflurane provides a smoother induction with a stable hemodynam ic profile, but requiring a longer time for LMA insertion in premedicated patients. The quality of anesthesia provided with intravenous propofol is superior. Thus inhalational sevoflurane is an acceptable alternative to intravenous propofol for LMA inserti on in adults

  15. Entidades fiscalizadoras superiores y accountability

    OpenAIRE

    Estela Moreno, María

    2016-01-01

    OBJETIVOS DE LA TESIS: El objetivo general del trabajo es establecer el nivel de eficacia de las Entidades Fiscalizadoras Superiores (EFS) como agencia asignada y herramienta de accountability horizontal, a través de la valoración de su diseño institucional y de la calidad de sus productos finales, los informes de auditoría, estableciéndose los siguientes objetivos específicos: 1. Relevar las nociones de accountability, actualizando el Estado del Arte de la cuestión. 2. Analizar la ...

  16. HISTOGENESIS AND MORPHOGENESIS OF HUMAN LARYNGEAL EPITHELIUM: A PRENATAL STUDY

    Directory of Open Access Journals (Sweden)

    Rachna

    2015-04-01

    Full Text Available The anatomy of epithelium of human foetal larynx has not been fully described . In the present study we observed the development of epithelium of human larynx , in 40 fetuses with gestational ages ranging from 75mm C . R . L . ( crown rump length to 220mm C . R . L . ( C rown rump length . Tissues were prepared for microtomy by paraffin wax embedding method . Step sections ( every fifth were fixed and stained by Hematoxylin and Eosin ( H&E and Masson’s Trichrome method . In the present study , the entire laryngeal cavity is lined uniformily by respiratory epithelium initially , i . e ., ciliated pseudostratified columnar type . Later on the epithelium over the true vocal cords and dorsal surface of the epiglottis changes into stratified squamous type . Besides , there is flattenin g of epithelium , over the true vocal cords as a result of desquamation . Larynx , though is a common organ to reptiles , amphibians and mamm a ls with function of breathing , sound production and preventing food particles going into the trachea but the advancement of human has make it a very important organ for physicians , paediatricians , otorhinolaryngologists etc . So the knowle d ge of anatomy of fetal airway and its development is important for the diagnosis and treatment of various diseases . Our aim wa s to study the type of epithelium during different stages of development of human fetal larynx

  17. Laryngeal imaging with polarization-sensitive optical coherence tomography

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    Burns, James A.; Kim, Ki Hean; Anderson, R. Rox

    2011-03-01

    Objectives/Hypothesis: Optical coherence tomography (OCT), an imaging technology that provides crosssectional subsurface tissue structure images using backscattered light, is a promising noninvasive, imaging modality for in-vivo assessment of vocal fold layered microstructure. Polarization-sensitive OCT (PS-OCT) augments conventional OCT by detecting changes in the polarization state of reflected light. This study imaged various benign laryngeal pathologies in patients undergoing direct laryngoscopy under general anesthesia to determine whether PS-OCT would provide useful additional information about vocal fold microstructure and glottic surface pathology. Study Design:Prospective clinical trial. Methods: Eighteen patients who were undergoing microlaryngoscopy under general anesthesia for benign glottic disease were imaged bilaterally with OCT and PS-OCT (N=34 vocal folds). Intraoperative microphotography guided placement of the imaging probe. Normalappearing glottic tissue was also imaged if present. When clinically indicated, biopsy or complete removal of the lesion established histologic confirmation. Results: PS-OCT provided high quality, vertical, cross-sectional images up to 1.2mm deep that complemented microlaryngoscopy, and conventional OCT for vocal fold pathologies. Scar tissue was visualized by PS-OCT, characterized by a birefringence pattern more intense than that of normal glottic tissue. Conclusions: Combining PS-OCT with OCT during human vocal cord imaging provides useful information in characterizing vocal cord lesions, particularly scar tissue.

  18. Simultaneous Laryngeal Squamous Cell Carcinoma and Papillary Thyroid Carcinoma

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    Bighan Khademi

    2011-04-01

    Full Text Available The association of squamous cell carcinoma of the larynx with thyroid papillary carcinoma is an unusual finding. From 2004 to 2011, approximately 250 patients underwent laryngectomies due to squamous cell carcinoma of the larynx at the Otolaryngology Department of Khalili Hospital, affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In three patients, synchronous occurrence of squamous cell carcinoma and thyroid papillary carcinoma was found. Histopathologic study of the lymph nodes revealed metastatic papillary thyroid carcinoma in one case. We report three cases of thyroid papillary carcinoma incidentally found on histological examinations of resected thyroid lobes, as a procedure required for treatment of head and neck squamous cell carcinoma. In comparison, laryngeal squamous cell carcinoma needs more aggressive treatment than well-differentiated thyroid carcinoma. The prevalence of thyroid papillary carcinoma, as an incidental finding in our study was 0.01%. Therefore, preoperative evaluation of the thyroid gland by ultrasonography and fine needle aspiration biopsy of suspicious lesions is recommended in patients who are candidates for open laryngectomy.

  19. Neural correlates of abnormal sensory discrimination in laryngeal dystonia

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    Pichet Termsarasab

    2016-01-01

    Full Text Available Aberrant sensory processing plays a fundamental role in the pathophysiology of dystonia; however, its underpinning neural mechanisms in relation to dystonia phenotype and genotype remain unclear. We examined temporal and spatial discrimination thresholds in patients with isolated laryngeal form of dystonia (LD, who exhibited different clinical phenotypes (adductor vs. abductor forms and potentially different genotypes (sporadic vs. familial forms. We correlated our behavioral findings with the brain gray matter volume and functional activity during resting and symptomatic speech production. We found that temporal but not spatial discrimination was significantly altered across all forms of LD, with higher frequency of abnormalities seen in familial than sporadic patients. Common neural correlates of abnormal temporal discrimination across all forms were found with structural and functional changes in the middle frontal and primary somatosensory cortices. In addition, patients with familial LD had greater cerebellar involvement in processing of altered temporal discrimination, whereas sporadic LD patients had greater recruitment of the putamen and sensorimotor cortex. Based on the clinical phenotype, adductor form-specific correlations between abnormal discrimination and brain changes were found in the frontal cortex, whereas abductor form-specific correlations were observed in the cerebellum and putamen. Our behavioral and neuroimaging findings outline the relationship of abnormal sensory discrimination with the phenotype and genotype of isolated LD, suggesting the presence of potentially divergent pathophysiological pathways underlying different manifestations of this disorder.

  20. Long-distance communication between laryngeal carcinoma cells.

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    Ieva Antanavičiūtė

    Full Text Available Tunneling nanotubes and epithelial bridges are recently discovered new forms of intercellular communication between remote cells allowing their electrical synchronization, transfer of second messengers and even membrane vesicles and organelles. In the present study, we demonstrate for the first time in primary cell cultures prepared from human laryngeal squamous cell carcinoma (LSCC samples that these cells communicate with each other over long distances (up to 1 mm through membranous tunneling tubes (TTs, which can be open-ended or contain functional gap junctions formed of connexin 43. We found two types of TTs, containing F-actin alone or F-actin and α-tubulin. In the LSCC cell culture, we identified 5 modes of TT formation and performed quantitative assessment of their electrical properties and permeability to fluorescent dyes of different molecular weight and charge. We show that TTs, containing F-actin and α-tubulin, transport mitochondria and accommodate small DAPI-positive vesicles suggesting possible transfer of genetic material through TTs. We confirmed this possibility by demonstrating that even TTs, containing gap junctions, were capable of transmitting double-stranded small interfering RNA. To support the idea that the phenomenon of TTs is not only typical of cell cultures, we have examined microsections of samples obtained from human LSCC tissues and identified intercellular structures similar to those found in the primary LSCC cell culture.

  1. Laryngeal sequelae due to accidental inhalation of anhydrous ammonia

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    Cruz, Walter Paiva

    2009-03-01

    Full Text Available Introduction: Anhydrous Ammonia (AA is a caustic compound commonly used in the industry that can cause burns, even with brief contact. As with other alkali burns, the early washing to remove the AA from burnt areas is crucial to limit tissue damage. The concentration of toxic agent and duration of its contact determine the degree of skin and mucosa destruction. A tanker truck carrying AA (NH3 fell off a highway, and released a dense cloud of AA gas. Fifty-four people inhaled the gas and after ninety days, three people were still experiencing hoarseness and were examined. Case Report: We assessed three patients with laryngeal sequelae due to AA inhalation burn. We found a case of hyperemia and edema, one case of granuloma of the posterior third portion of the left vocal cord, and one case of vocal cord adhesion. Necropsy findings are commented both macroscopically and microscopically. The sequelae and the best treatments for them are discussed herein.

  2. Role of laryngeal mask airway in laparoscopic cholecystectomy

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    José; M; Bele?a; Ernesto; Josué; Ochoa; Mónica; Nú?ez; Carlos; Gilsanz; Alfonso; Vidal

    2015-01-01

    Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway(LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway during general anesthesia. Use of LMA has some advantages when compared to endotracheal intubation, such as quick and ease of placement, a lesser requirement for neuromuscular blockade and a lower incidence of postoperative morbididy. However, the use of the LMA in laparoscopy is controversial, based on a concern about increased risk of regurgitation and pulmonary aspiration. The ability of these devices to provide optimal ventilation during laparoscopic procedures has been also questioned. The most important parameter to secure an adequate ventilation and oxygenation for the LMA under pneumoperitoneum condition is its seal pressure of airway. A good sealing pressure, not only state correct patient ventilation, but it reduces the potential risk of aspiration due to the better seal of airway. In addition, the LMAs incorporating a gastric access, permitting a safe anesthesia based on these commented points. We did a literature search to clarify if the use of LMA in preference to intubation provides inadequate ventilation or increase the risk of aspiration in patients undergoing laparoscopic cholecystectomy. We found evidence stating that LMA with drain channel achieves adequate ventilation for these procedures. Limited evidence was found to consider these devices completely safe against aspiration. However, we observed that the incidence of regurgitation and aspiration associated with the use of the LMA in laparoscopic surgery is very low.

  3. [Diode laser surgery in the endoscopic treatment of laryngeal paralysis].

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    Ferri, E; García Purriños, F J

    2006-01-01

    Several surgical procedures have been proposed for the treatment of respiratory distress secondary to bilateral vocal cord paralysis. The aim of all surgical techniques used is to restore a glottic lumen sufficient to guarantee adequate breathing through the natural airway, without tracheotomy and preserving an acceptable phonatory quality. In this study we present our experience from 1998 to 2004 concerning the use of the diode contact laser for a modified Dennis-Kashima posterior endoscopic cordectomy (extended to the false homolateral chord in 3 cases and to the homolateral arytenoid vocal process in 6 cases). 18 patients (15 male, 3 female) were treated; the age range was 35-84 years. The etiology of paralysis varied: iatrogenic post-thyroidectomy and post-thoracic surgery in 5 cases (28%), post-traumatic in 2 cases (11%), secondary to a central lesion in 11 (61%). The operation was carried out with a diode contact laser (60W; 810 nm). Follow-up was 20 months. Dyspnea improved in all patients; the 9 tracheostomized patients were decannulated within 2 months after surgery. Final voice quality was subjectively good in 16 patients (88%). None of patients had any complications after surgery. In conclusion, the endoscopic posterior cordectomy performed by contact diode laser is an effective and reliable method for the treatment of dyspnea secondary to bilateral laryngeal paralysis, guaranteing a sufficient airway without impairing swallowing and maintaining acceptable voice quality.

  4. The indirect measurement of laryngeal and tracheal resistance.

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    Schumann, K; Beck, C; Mann, W

    1979-06-01

    We used a body-plethysmograph to determine air-way resistances in 485 cases of laryngeal and tracheal stenoses. We decided in 143 cases to intervene after observing resistance exceeding 60 mm H2O/l and sec. A vocal chord was lateral fixated in 49 patients suffering bilateral recurrent paralysis. Optimal results were obtained at a postoperative resistance level of 30 mm H2O/l and sec (standard value: 14.77+/-6.53--n = 387). The patients could carry out work of medium intensity and had a steady voice. We performed tracheal interventions in 94 cases of tracheal stenoses. A mean, post-operative resistance of 29.9 mm H2O/l and sec, with a tracheal diameter of 7--8 mm was attained. In practice, only a few patients found the remaining obstruction a hindrance during work of maximal intensity. No recurrences were observed after treatment. Airway resistances exceeding 150 mm H2O/l and sec were found in 13 new admissions and 73 times in those undergoing therapy. In these cases asphyxiation threatens. These patients have to be tracheotomized or intubated immediately.

  5. TLR receptors in laryngeal carcinoma - immunophenotypic, molecular and functional studies.

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    Mirosław Szczepański

    2011-04-01

    Full Text Available Toll-like receptors (TLRs have been shown to play crucial role in the recognition of unicellular pathogens. We have shown the expression of three TLRs on tumor cells of human laryngeal carcinoma by means of immunohistochemistry. In the current study we searched presence of TLR1-10 on protein and molecular level in larynx carcinoma cell lines and the impact of respective TLR ligands on TLR expression. Larynx carcinoma cell lines have been used. Cell were subjected to immunocytochemistry. RNA isolated from the cells was tested by RT-PCR. Cells were cultured in the presence of respective TLR ligands. Cells than were harvested and subjected to flow cytometry, using anti TLR1-10 Moabs. The cells were evaluated of membrane and cytoplasmic cell staining. TLR reactivity varied in individual cell lines. RT-PCR allowed to show mRNA for all TLRs tested. After short-term cell culture each cell line exhibited distinct pattern of expression of TLRs following interaction with respective ligand. Cytoplasmic TLR staining had usually higher MFI value than membrane one, but after culture with ligand it became reversed. TLRs 7 and 9 showed highest expression in the majority of tumor cells tested. In conclusion, larynx carcinoma cell lines exhibit rather universal expression of TLRs, both on protein and molecular level. Culture of TLR expressing tumor cells with ligands points out for potential reactivity of tumor cells with TLR agonists, what may have therapeutic implications.

  6. Safety And Efficacy Of Proseal Laryngeal Mask Airway Versus Classic Laryngeal Mask Airway And Endo Tracheal Tube During Elective surgery

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    Soad A. Mansour , Wafaa G.Ahmed , Kawthar A. Azzam ,Tarek M. EL said

    2005-12-01

    Full Text Available The present study was performed to compare safety , efficacy of Proseal Laryngeal Mask Airway (PLMA, classic Laryngeal mask airway (LMA and cuffed Endo Tracheal Tube (ETT as a ventilatory device during controlled positive pressure ventilation and airway management , Haemodynamic response to insertion and removal, gastric tube insertion through either device, air leak detection and assessment of position by fiberoptic bronchoscope . Forty five ASA I or II patients aged between 18-55 years old , were divided equally into three groups of fifteen patients each , and airway management either through PLMA(groupI,classic LMA (groupIIand ETT (group III . All patients were premedicated by zantac hydrochloride 150 mg orally at mid night and two hours before the operation ­ Anaesthesia was induced with fentanyl 2 ug/kg and propofol 2.5 mg /kg and maintenance was with a mixture of 50% N2O , 50% O2 and isoflurane 1 - 1.5 % and rocuronium 0.5 mg /kg followed by continous infusion of rocuronium 0.3-0.6 mg/kg/hr A proper size PLMA , classic LMA or ETT was selected oxygenation and ventilation were optimal in 100% in group I and III while in group II 80% optimal and suboptimal in 13.3% and failed in 6.7 % . Haemodynamic parameters showed that significantly increase in HR and MAP in the three studied groups especially at insertion and removal of the airway device with statisticaly significant difference between group I,II in comparison to group III, comparison of gastric tube insertion showed that positive insertion was 86.7% in group I and in 46.7% in group II, while in group III positive insertion was 100% air leak was detected by epigastric auscultation which signified lower leakage in PLMA group than LMA group . Position assessment by fiberoptic bronchoscope in PLMA group was grade 4 in 5 patients , grade 3 in 5 patients , grade2 in 4 patients and grade 1 in 1 patient while in LMA group it was grade 4 in 7 patients , grade 3 in 6 patients , grade 2 in 2

  7. Relationship between the Expression of CD44v6 and Development, Progress, Invasion and Metastasis of Laryngeal Carcinoma

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    LIU Banghua; KONG Weijia; GONG Shusheng; YANG Chengzhang; WANG Guangping; ZHU Lixin

    2005-01-01

    Summary: The expression of CD44v6 and its relationship with the development, progress, invasion and metastasis of laryngeal carcinoma was investigated. The expression and content of CD44v6 mRNA in tissuess were detected by both RT-PCR and FCM which were respectively extracted from normal laryngeal mucosa, leukoplakia of larynx, laryngeal papilloma, polyp of vocal cord, tissues of laryngeal carcinoma, metastatic and nonmetastatic lymph nodes of neck, and tissues close to carcinoma. The outcome of RT-PCR indicated that the expression rate of CD44v6 mRNA involved in tissues of laryngeal carcinoma and metastatic lymph nodes of neck was the highest (90 %-100 %) compared with that of leukoplakia of larynx, laryngeal papilloma, tissues close to carcinoma by 0.5 cm (55.56 %-60.00 %) and that of normal laryngeal mucosa, polyp of vocal cord, nonmetastatic lymph nodes and tissues close to carcinoma by 1.0 cm was the lowest ( 13.33 %-20 %). The result from FCM was highly consistent with that from RT-PCR. It was suggested that CD44v6 was closely related with the development, progress, invasion and metastasis of laryngeal carcinoma. The outcome from the tissues close to carcinoma by different distance could do help to the determination of incisal edge in surgery abstractly.

  8. Acoustic Correlates of Fatigue in Laryngeal Muscles: Findings for a Criterion-Based Prevention of Acquired Voice Pathologies

    Science.gov (United States)

    Boucher, Victor J.

    2008-01-01

    Purpose: The objective was to identify acoustic correlates of laryngeal muscle fatigue in conditions of vocal effort. Method: In a previous study, a technique of electromyography (EMG) served to define physiological signs of "voice fatigue" in laryngeal muscles involved in voicing. These signs correspond to spectral changes in contraction…

  9. The sentence superiority effect revisited.

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    Snell, Joshua; Grainger, Jonathan

    2017-11-01

    A sentence superiority effect was investigated using post-cued word-in-sequence identification with the rapid parallel visual presentation (RPVP) of four horizontally aligned words. The four words were presented for 200ms followed by a post-mask and cue for partial report. They could form a grammatically correct sentence or were formed of the same words in a scrambled agrammatical sequence. Word identification was higher in the syntactically correct sequences, and crucially, this sentence superiority effect did not vary as a function of the target's position in the sequence. Cloze probability measures for words at the final, arguably most predictable position, revealed overall low values that did not interact with the effects of sentence context, suggesting that these effects were not driven by word predictability. The results point to a level of parallel processing across multiple words that enables rapid extraction of their syntactic categories. These generate a sentence-level representation that constrains the recognition process for individual words, thus facilitating parallel word processing when the sequence is grammatically sound. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Current understanding of the tumor microenvironment of laryngeal dysplasia and progression to invasive cancer

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    Trivedi, Sumita; Rosen, Clark A.; Ferris, Robert L.

    2017-01-01

    Purpose of review This review examines the historical tumor progression genetic model of laryngeal carcinomas, from dysplasia to invasive carcinoma and the role of infiltrating immune and inflammatory cells as contributors to this process. Recent findings Classically, the genetic model of carcinogenesis describes overexpression of oncogenes and/or silencing of tumor suppressor genes which, when combined with exposure to environmental carcinogens over the course of time, results in damage to cellular DNA. Increasing evidence indicates that innate and adaptive immune mediators also play an important role in tumor progression of laryngeal carcinomas. Cellular mediators of immune suppression are often over represented in the tumor microenvironment and these cells release cytokines, which perpetuate immune suppression allowing for tumor immune evasion. Summary Future therapies targeting laryngeal malignancies should focus on a combined approach which targets both genetic variations and immune mediators. PMID:26963671

  11. A case of laryngeal radionecrosis treated with a prostacyclin (PGI{sub 2}) analogue

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    Matsubara, Naoko; Umezaki, Toshiro; Adachi, Kazuo; Koike, Kouji; Hirakawa, Naoya; Komiyama, Sohtaro [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    2002-11-01

    Laryngeal necrosis occurs rarely after radiation therapy for laryngeal cancer. We performed radiation therapy with a total dose of 68.2 Gy on a 61-year-old man, whose larynx revealed partial necrosis two months later. Thyroid cartilage was exposed from the inside of the larynx and a piece of cartilage was also destroyed. We performed laryngomicrosurgery to remove the necrotic tissue and to confirm that there was no residual cancer. We administered clarithromycin and beraprost sodium for 102 days. Beraprost sodium is the first orally active prostacyclin analogue, and it has various biological activities including a vasodilation effect and a cytoprotective effect on endothelial cells. As a result, the inside of the larynx was covered by a healthy mucosa six months after radiation therapy. We cured the laryngeal necrosis without using steroids and thus were able to successfully preserve the function of the larynx. (author)

  12. Recurrent laryngeal nerve palsy complicating subclavian line insertion: a case report

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    Fishman Jonathan M

    2009-09-01

    Full Text Available Abstract Introduction Although recurrent laryngeal nerve injury has been described following central venous access via the jugular route, it has not previously been reported following access via the subclavian route. Case presentation A 63-year-old man presented with acute dysphonia immediately after insertion of a Hickman line via the subclavian route. Flexible laryngoscopy revealed a left vocal fold palsy. A computed tomography scan from the skull base to the thoracic inlet showed no obvious abnormality other than an abducted left vocal cord. The timing of the events and the computed tomography scan results strongly support the conclusion that the left recurrent laryngeal nerve was injured during insertion of the Hickman line, resulting in a left adductor vocal cord palsy. Conclusion This case illustrates an unusual example of iatrogenic injury to the recurrent laryngeal nerve. It is important to recognize the possibility that such injuries may occur in order to prevent them.

  13. Association of history of allergies and influenza-like infections with laryngeal cancer in a case-control study.

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    Filippidis, Filippos T; Schwartz, Stephen M; Becker, Nikolaus; Dyckhoff, Gerhard; Kirschfink, Michael; Dietz, Andreas; Becher, Heiko; Ramroth, Heribert

    2015-08-01

    Prior studies suggest that history of allergy and infections early in life might be inversely associated with cancer. We explored the association between allergies, recent influenza infections and laryngeal cancer risk. We used data from a case-control study which included 229 cases of laryngeal cancer and 769 population controls matched for age and sex. History of a physician-diagnosed allergy, influenza-like infections in the past 5 years, smoking, alcohol consumption and occupational exposure to carcinogens were self-reported. Allergies were classified into two groups (Type I and Type IV), according to the underlying immunologic mechanism. Conditional logistic regression models were fitted using laryngeal cancer as the outcome, adjusting for smoking, alcohol consumption and occupational exposure and stratified for age and sex. Having any allergy was not associated significantly with laryngeal cancer. Although Type I and Type IV allergies were non-significantly associated with laryngeal cancer, Type IV allergies showed a strong inverse association after adjusting for smoking and alcohol (OR 0.50, 95 % CI 0.22-1.2). Participants who reported at least one influenza-like infection during the past 5 years were significantly less likely to have laryngeal cancer (OR 0.57, 95 % CI 0.39-0.81). After considering fever (≥38.5 °C) as a criterion for influenza infection, the association between influenza infection and laryngeal cancer was even stronger (OR 0.29, 95 % CI 0.13-0.63). We found no significant association between any allergy and laryngeal cancer, some indication of an inverse association between Type IV allergy and laryngeal cancer, whereas recent influenza infections were inversely associated with laryngeal cancer risk.

  14. A CLINICAL ASSESSMENT OF MACINTOSH BLADE, MILLER BLADE AND KING VISIONTM VIDEOLARYNGOSCOPE FOR LARYNGEAL EXPOSURE AND DIFFICULTY IN ENDOTRACHEAL INTUBATION

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    Apoorva Mahendera

    2016-03-01

    Full Text Available CONTEXT Previous studies suggest glottic view is better achieved with straight blades while tracheal intubation is easier with curved blades and videolaryngoscope is better than conventional laryngoscope. AIMS Comparison of conventional laryngoscope (Macintosh blade and Miller blade with channelled videolaryngoscope (King Vision TM with respect to laryngeal visualisation and difficulty in endotracheal intubation. SETTINGS AND DESIGN This prospective randomised comparative study was conducted at a tertiary care hospital (in ASA I and ASA II patients after approval from the Institutional Ethics Committee. METHODS We compared Macintosh, Miller, and the King VisionTM videolaryngoscope for glottic visualisation and ease of tracheal intubation. Patients undergoing elective surgeries under general anaesthesia requiring endotracheal intubation were randomly divided into three groups (N=180. After induction of anaesthesia, laryngoscopy was performed and trachea intubated. We recorded visualisation of glottis (Cormack-Lehane grade-CL, ease of intubation, number of attempts, need to change blade, and need for external laryngeal manipulation. STATISTICAL ANALYSIS Demographic data, Mandibular length, Mallampati classification were compared using ANOVA, Chi-square test, Kruskal-Wallis Test, where P value <0.005 is statically significant. RESULTS CL grade 1 was most often observed in King Vision -TM VL group (90% which is followed by Miller (28.33%, and Macintosh group (15%. We found intubation was to be easier (grade 1 with King Vision -TM VL group (73.33%, followed by Macintosh (38.33%, and Miller group (1.67%. External manipulation (BURP was needed more frequently in patients in Miller group (71.67%, followed by Macintosh (28.33% and in King Vision -TM VL group (6.67%. All (100% patients were intubated in the 1 st attempt with King Vision -TM VL group, followed by Macintosh group (90% and Miller group (58.33%. CONCLUSIONS In patients with normal airway

  15. Clinical and laboratory evaluation of thyroid function following total laryngectomy in laryngeal cancer

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    Motasaddi Zarandy M

    2007-07-01

    Full Text Available Background: Hypothyroidism is a well-documented complication after treatment of laryngeal cancer and is particularly significant among patients undergoing laryngectomy. We investigated the frequency of hypothyroidism in patients treated with total laryngectomy for laryngeal cancer. We also evaluated the effect of neck radiotherapy on thyroid function after total laryngectomy for laryngeal cancer. Methods: In a cross-sectional study, we evaluated 31 patients with laryngeal squamous cell carcinoma (mean age 53.6 years. Among these patients, 14 were treated with surgery only and 17 were treated with surgery plus radiotherapy. Laboratory evaluation included levels of thyroid stimulating hormone (TSH, free T4, free T3, and antithyroid antibodies both preoperatively and postoperatively at the first day, as well as one and six months after surgery. Results: All patients had normal thyroid function before treatment; however, after 6 months, five patients (16.1% were hypothyroid. Of these, three patients (9.6% had subclinical symptoms, including elevated thyroid-stimulating hormone with normal free T4, and two patients (6.5% showed clinical symptoms of hypothyroidism. Radiotherapy and neck dissection were significantly associated with higher incidences of hypothyroidism. Conclusion: Our data suggest that hypothyroidism occurs in a substantial proportion of patients undergoing surgery for laryngeal cancer. The results indicate that thyroid function studies should be routinely performed in the follow-up care of laryngeal cancer patients, especially if radiotherapy and neck dissection were part of the treatment. We suggest that this approach will improve the patient's quality of life and diminish the co-morbidity associated with this kind of surgery.

  16. Effects of Voice Rehabilitation After Radiation Therapy for Laryngeal Cancer: A Randomized Controlled Study

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    Tuomi, Lisa, E-mail: lisa.tuomi@vgregion.se [Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Andréll, Paulin [Department of Molecular and Clinical Medicine/Multidisciplinary Pain Center, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Finizia, Caterina [Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden)

    2014-08-01

    Background: Patients treated with radiation therapy for laryngeal cancer often experience voice problems. The aim of this randomized controlled trial was to assess the efficacy of voice rehabilitation for laryngeal cancer patients after having undergone radiation therapy and to investigate whether differences between different tumor localizations with regard to rehabilitation outcomes exist. Methods and Materials: Sixty-nine male patients irradiated for laryngeal cancer participated. Voice recordings and self-assessments of communicative dysfunction were performed 1 and 6 months after radiation therapy. Thirty-three patients were randomized to structured voice rehabilitation with a speech-language pathologist and 36 to a control group. Furthermore, comparisons with 23 healthy control individuals were made. Acoustic analyses were performed for all patients, including the healthy control individuals. The Swedish version of the Self Evaluation of Communication Experiences after Laryngeal Cancer and self-ratings of voice function were used to assess vocal and communicative function. Results: The patients who received vocal rehabilitation experienced improved self-rated vocal function after rehabilitation. Patients with supraglottic tumors who received voice rehabilitation had statistically significant improvements in voice quality and self-rated vocal function, whereas the control group did not. Conclusion: Voice rehabilitation for male patients with laryngeal cancer is efficacious regarding patient-reported outcome measurements. The patients experienced better voice function after rehabilitation. Patients with supraglottic tumors also showed an improvement in terms of acoustic voice outcomes. Rehabilitation with a speech-language pathologist is recommended for laryngeal cancer patients after radiation therapy, particularly for patients with supraglottic tumors.

  17. Posterior laryngitis: a study of persisting symptoms and health-related quality of life.

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    Pendleton, Hillevi; Ahlner-Elmqvist, Marianne; Jannert, Magnus; Ohlsson, Bodil

    2013-01-01

    Posterior laryngitis is a common cause of chronic cough, hoarseness, voice fatigue and throat pain. The aim of the present study was to examine how patients with posterior laryngitis have been examined, treated and followed up, and to assess their present health-related quality of life (HRQOL). Patients treated for posterior laryngitis at consultation at the ear-, nose- and throat clinic during 2000-2008 were contacted by mail. The letter contained questionnaires addressing the current symptoms and medication, and the HRQOL 36-item short-form questionnaire (SF-36). Medical records were scrutinized. One hundred and twenty-two patients with verified signs and symptoms of posterior laryngitis were included. Forty percent of the patients had been treated for acid-related symptoms prior to consultation. The most common symptoms at the time of consultation were the sensation of hoarseness (women 40 %, men 37 %), globus (women 35 %, men 33 %) and cough (women 33 %, men 26 %). The most frequent diagnosis was gastro-oesophageal reflux disease. Ninety percent of the women and 92 % of the men were treated with proton pump inhibitors (PPIs). At the time of study, 63 % of the patients still had symptoms. The results of the SF-36 questionnaire showed significantly lower HRQOL for women. Patients with posterior laryngitis present varying symptoms, and are often not adequately treated or followed up. When PPI treatment fails, other aetiologies of their complaints, such as visceral hypersensitivity, weakly gaseous acid reflux or non-acid reflux are not considered. Symptoms from posterior laryngitis have a negative impact on the HRQOL for women.

  18. Laryngoscopic and spectral analysis of laryngeal and pharyngeal configuration in non-classical singing styles.

    Science.gov (United States)

    Guzman, Marco; Lanas, Andres; Olavarria, Christian; Azocar, Maria Josefina; Muñoz, Daniel; Madrid, Sofia; Monsalve, Sebastian; Martinez, Francisca; Vargas, Sindy; Cortez, Pedro; Mayerhoff, Ross M

    2015-01-01

    The present study aimed to assess three different singing styles (pop, rock, and jazz) with laryngoscopic, acoustic, and perceptual analysis in healthy singers at different loudness levels. Special emphasis was given to the degree of anterior-posterior (A-P) laryngeal compression, medial laryngeal compression, vertical laryngeal position (VLP), and pharyngeal compression. Prospective study. Twelve female trained singers with at least 5 years of voice training and absence of any voice pathology were included. Flexible and rigid laryngeal endoscopic examinations were performed. Voice recording was also carried out. Four blinded judges were asked to assess laryngoscopic and auditory perceptual variables using a visual analog scale. All laryngoscopic parameters showed significant differences for all singing styles. Rock showed the greatest degree for all of them. Overall A-P laryngeal compression scores demonstrated significantly higher values than overall medial compression and VLP. High loudness level produced the highest degree of A-P compression, medial compression, pharyngeal compression, and the lowest VLP for all singing styles. Additionally, rock demonstrated the highest values for alpha ratio (less steep spectral slope), L1-L0 ratio (more glottal adduction), and Leq (more vocal intensity). Statistically significant differences between the three loudness levels were also found for these acoustic parameters. Rock singing seems to be the style with the highest degree of both laryngeal and pharyngeal activity in healthy singers. Although, supraglottic activity during singing could be labeled as hyperfunctional vocal behavior, it may not necessarily be harmful, but a strategy to avoid vocal fold damage. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Peptide GE11-Polyethylene Glycol-Polyethylenimine for targeted gene delivery in laryngeal cancer.

    Science.gov (United States)

    Ren, Henglei; Zhou, Liang; Liu, Min; Lu, Weiyue; Gao, Chunli

    2015-07-01

    The objective of this study was to evaluate the possibility of using GE11-polyethylene glycol-polyethylenimine (GE11-PEG-PEI) for targeted gene delivery to treat epidermal growth factor receptor (EGFR)-overexpressing laryngeal cancer. This study described the design, characterization, and in vitro and in vivo study of the nanocarrier GE11-PEG-PEI for gene delivery to treat laryngeal cancer. Analysis of the sizes and zeta potentials indicated that the formation of PEGylated complexes was dependent on the N/P ratio, and these complexes were capable of binding plasmid DNA and condensing DNA into small positively charged nanoparticles. The results also revealed that GE11-PEG-PEI had a weaker effect on cell survival in vitro. Gene transfection was performed on human laryngeal cancer Hep-2 cells in vitro and in vivo. Both the in vitro and in vivo results demonstrated that GE11-PEG-PEI had greater transfection efficiency than mPEG-PEI. Compared with mPEG-PEI/pORF-hTRAIL and saline, GE11-PEG-PEI/pORFh-TRAIL significantly (p < 0.05) reduced tumor growth in nude mice with laryngeal cancer. Moreover, the GE11-PEG-PEI/pORF-hTRAIL-treated groups showed more apoptosis than the mPEG-PEI/pORF-hTRAIL-treated groups. Therefore, our results showed that the peptide GE11 conjugated to PEG-PEI delivered significantly more genes to EGFR-overexpressing laryngeal cancer cells in vivo, indicating that GE11-PEG-PEI may be a suitable gene vector for treating EGFR-overexpressing laryngeal cancer.

  20. Effect of adenoid hypertrophy on the voice and laryngeal mucosa in children.

    Science.gov (United States)

    Gomaa, Mohammed A; Mohammed, Haitham M; Abdalla, Adel A; Nasr, Dalia M

    2013-12-01

    The adenoids, or pharyngeal tonsils, are lymphatic tissue localized at the mucous layer of the roof and posterior wall of nasopharynx. Dysphonia defined as perceptual audible change of a patient's habitual voice as self judged or judged by his or her listeners. The diagnosis of dysphonia relies on clinical judgment based on phoniatric symptoms, auditory perceptual assessment of voice (APA) and full laryngeal examination. Our study was conducted to evaluate the effect of adenoid hypertrophy on voice and laryngeal mucosa. The study sample composed of sixty children, forty of them had adenoid hypertrophy (patient's group) and twenty healthy children (control group). Patient's group composed of 17 boys (42.5%) and 23 girls (57.5%), while control group consists of 8 males (40%) and 12 females (60%). All patients and control group subjected to history taking, clinical examination, lateral soft tissue X-ray on the nasopharynx, APA based on the modified GRBAS scale and full laryngeal examination. The data are collected and analyzed statistically by using software SPSS. Our results showed that there is a significant association between adenoid hypertrophy and, degree of dysphonia, leaky voice, pitch of voice and laryngeal lesion. Adenoid hypertrophy did not associate with loudness of voice, as well as character (irregular, breathy and strained). Laryngeal lesions were detected in thirteen children from patient group (32.5%): nodules (n = 6), thickening (n = 5), congestion (n = 2), while one child only out of 20 children of the control group had congestion (5.0%). Our results showed the importance of the assessment of voice and laryngeal examination in patients with adenoid hypertrophy, also treating the minimal mucosal lesions that results from adenoid hypertrophy should be taken in consideration. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Surgical Management of Supraglottic Laryngeal Carcinoma in Patients with Special Emphasis on Functional Preservation

    Institute of Scientific and Technical Information of China (English)

    LiqiangZhang; XinyongLuan; XinliangPan; GuangXie; FengleiXu; DayuLiu; DapengLei

    2004-01-01

    OBJECTIVE To explore the surgical methods and evaluate the long-term results of laryngectomy in patients with supraglottic laryngeal cancer.METHODS A total of 182 patients with supraglottic laryngeal carcinoma underwent an operation from 1979 to 1999. These cases comprised 11 in stage Ⅰ , 45 in stage Ⅱ , 49 in stage Ⅲ and 77 in stage Ⅳ. The choice of surgical procedure was decided based on the condition of the diseasedl arynx. The surgical procedures proposed by TD Wang were adhered to as follows: minor partial laryngectomy 36, major partial laryngectomy 85,subtotal partial laryngectomy with laryngoplasty 22 and total larygectomy 39.RESULTS The final rate of larynx preservation was 78.6% (143/182) and 69.8% (88/126) in patients with stage III and IV diseases. The extubation rate was 81.8% in cases with preservation of laryngeal function. The overall 3-and 5-year survival rates were 82.9% and 67.3%, with 76.88% and 57.4% in the advanced (stage III and IV) cases who survived with preserved laryngeal function, and 82.5% and 67.0% in similar advanced cases who were treated by total laryngectomy. The difference in the survival rates between these 2 groups was not statistically significant.CONCLUSION It is suggested that preservation of the laryngeal function is possible for advanced supraglottic laryngeal carcinoma without compromising the long-term survival rate. To improve the rate of larynx preservation, one should follow the surgical methods suggested.

  2. MDCT in the assessment of laryngeal trauma: value of 2D multiplanar and 3D reconstructions.

    Science.gov (United States)

    Becker, Minerva; Duboé, Pier-Olivier; Platon, Alexandra; Kohler, Romain; Tasu, Jean-Pierre; Becker, Christoph D; Poletti, Pierre-Alexandre

    2013-10-01

    The purpose of this study was to analyze fracture patterns and related effects of laryngeal trauma and to assess the value of 2D multiplanar reformation (MPR) and 3D reconstruction. Among 4222 consecutively registered trauma patients who underwent emergency MDCT, 38 patients had presented with laryngeal trauma. Axial, 2D MPR, 3D volume-rendered, and virtual endoscopic images were analyzed retrospectively by two blinded observers according to predefined criteria. Laryngeal fractures, soft-tissue injuries, and airway compromise were evaluated and correlated with clinical, endoscopic, surgical, and follow-up findings. Fifty-nine fractures (37 thyroid, 13 cricoid, nine arytenoid) were present in 38 patients. They were isolated in 21 (55%) patients. The other 17 (45%) patients had additional injuries to the neck, face, brain, chest, or abdomen. Laryngeal fractures were bilateral in 31 (82%) patients and were associated with hyoid bone fractures in nine (24%) patients. Arytenoid luxation was present in eight cartilages. Axial imaging missed 7 of 59 (12%) laryngeal fractures, six of eight (75%) arytenoid luxations, and four of nine (44%) hyoid bone fractures. Additional 2D MPR imaging missed 5 of 59 (8%) laryngeal fractures, five of eight (62.5%) arytenoid luxations, and two of nine (22%) hyoid bone fractures, whereas 3D volume-rendered images depicted them all. Virtual endoscopy and 3D volume rendering added diagnostic accuracy with respect to the length, width, shape, and spatial orientation of fractures in 22 of 38 (58%) patients; arytenoid luxation in six of eight (75%) luxations; and the evaluation of airway narrowing in 19 of 38 (50%) patients. Three-dimensional volume rendering was not of additional value in evaluation of the cricoid cartilage. The use of 2D MPR and 3D volume rendering with or without virtual endoscopy improved assessment of thyroid and hyoid bone fractures, arytenoid luxations, and laryngotracheal narrowing, providing helpful data for optimal

  3. Upper Airway Obstruction Requiring Emergent Tracheostomy Secondary to Laryngeal Sarcoidosis: A Case Report

    Science.gov (United States)

    Ryu, Changwan; Herzog, Erica L.; Pan, Hongyi; Homer, Robert; Gulati, Mridu

    2017-01-01

    Patient: Female, 35 Final Diagnosis: Laryngeal sarcoidosis Symptoms: Hoarseness • stridor Medication: — Clinical Procedure: Tracheostomy Specialty: Otolaryngology Objective: Rare disease Background: Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33–2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. Case Report: A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea. Laryngeal sarcoidosis was diagnosed three years previously, and she remained stable on low-dose prednisone until six months prior to admission, at which time she self-discontinued her prednisone for the homeopathic treatment Nopalea cactus juice. Her physical examination was concerning for impending respiratory failure as she presented with inspiratory stridor and hoarseness. Laryngoscopy showed a retroflexed epiglottis obstructing the glottis with edematous arytenoids and aryepiglottic folds. Otolaryngology performed an emergent tracheostomy to secure her airway and obtained epiglottic biopsies, which were consistent with sarcoidosis. She was eventually discharged home on prednisone 60 mg daily. Following months of corticosteroids, a laryngoscopy showed the epiglottis continuing to obstruct the glottis. The addition of methotrexate to a tapered dosage of prednisone 10 mg daily was unsuccessful, and she remains on prednisone 20 mg daily for disease control. Conclusions: Laryngeal sarcoidosis, a rare extrapulmonary manifestation of sarcoidosis, uncommonly presents as the life-threatening complication of complete upper airway obstruction. As such, laryngeal sarcoidosis is associated with significant morbidity and mortality, requiring a high index

  4. A comparison of GlideScope videolaryngoscope with Macintosh laryngoscope for laryngeal views

    Institute of Scientific and Technical Information of China (English)

    LI Jin-bao; DENG Xiao-ming; WANG Xiao-lin; XIONG Yuan-chang; FAN Xiao-hua; LIU Yi; XU Hua; MA Yu; DU Jian-er; ZHAI Rong

    2007-01-01

    Objective: To describe the use of the GlideScope in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation. Methods: Two hundred patients, ASA Ⅰ-Ⅱ scheduled for elective surgery under general anesthesia requiring orotracheal intubation were selected. Information was collected identifying the patient demographics and airway assessment features (Mallampati oropharyngeal scale, thyromenta distance and mouth opening). In a random crossover design, after induction of anesthesia and neuromuscular block, the laryngoscopes were inserted in turn, and the views of the glottis at laryngoscopy (Cormack and Lehane scores) were compared. The tracchea was intubated using either the standard Macintosh laryngoscope or GlideScope after the second grading at laryngoscopy was done. Complications associated with intubating were recorded. Results: There were 200 patients including 107 males and 93 females, with mean age being 52±13 years, height 164. 8±11.3 cm, weight 64.0±11.5 kg, thyromental distance 6.9±1.1 cm, and mouth opening 5.7±0.5 cm. There was a significant association between the preoperative view of the oropharynx (Mallampati score) and the view of the glottis at laryngoscopy for both the direct Macintosh laryngoscope (P<0.001) and the GlideScope (P<0.001). Among 200 patients, 106 patients had the same C&L grade, 91 of remaining patients showed improvement in the C&L grade (P<0.001) obtained with GlideScope compared with the direct Macintosh laryngoscope.3 of remaining patients showed better view of the glottis(C&L grade) with the direct Macintosh laryngoscope (grade 1) than with GlideScope (grade 2). There were no cases of failure to be intubated. There were no cases of dental or mucosal injury in all patients. Conclusion: GlideScope videolaryngoscope yielded comparable or superior laryngeal view compared with Macintosh laryngoscope. The new type of laryngoscope may have potential advantages for managing the difficult

  5. Effectiveness of Two Training Methods for Avoiding Excessive Inflation of Laryngeal Mask Airway Supreme.

    Science.gov (United States)

    Ya-Hong, Gong; Si, Chen; Zhi-Yong, Zhang; Yu-Guang, Huang

    2015-06-01

    To evaluate the effectiveness of two training methods for avoiding excessive inflation of laryngeal mask airway(LMA)Supreme. Totally 41 anesthesiologists were randomly divided into hand touch group(H group,n=20)and short-term pressure gauge training group(G group,n=21). Before training,subjects were asked to inflate the cuff of LMA Supreme to two target pressures,30 cmH(2)O and 60 cmH(2)O, according to their own experiences. The actual cuff pressures were recorded as baseline pressures. Subjects in H group then received the training of hand touch:touch the vermilion of the lip and apex nasi with the left ring finger and feel the hardness. A cuff pressure with hardness similar to the vermilion of the lip was defined as 30 cmH(2)O, and similar to the apex nasi as 60 cmH(2)O. Subjects in G group were asked to inflate the cuff with a pressure gauge and feel the hardness of the cuff when the pressure reached 30 cmH(2)O and 60 cmH(2)O. After one-week training,two groups of subjects repeated the cuff inflation test. Actual cuff pressures after training were also recorded and compared with the baseline pressures. Results Actual cuff pressures after training[Group H:(39.7±15.7) cmH(2)O(P=0.00);Group G:(26.2±13.2) cmH(2)O(P=0.03)]were significantly lower than baseline pressures in both groups when the target cuff pressure was 30 cmH(2)O, and the differences were not statistically significant between these two groups(P=0.06). When the target pressure was 60 cmH(2)O,the actual cuff pressure of H group [(91.1±24.3)cmH(2)O] was significantly higher than that of G group [(58.1±15.4) cmH(2)O (P=0.01)]. However,the actual cuff pressure of G group was similar to the target pressure. The two training methods are equally effective when the target pressure is 30 cmH(2)O, while short-term pressure gauge training method is superior when the target pressure is 60 cmH(2)O.

  6. 78 FR 21116 - Superior Supplier Incentive Program

    Science.gov (United States)

    2013-04-09

    ... Department of the Navy Superior Supplier Incentive Program AGENCY: Department of the Navy, DoD. ACTION... policy that will establish a Superior Supplier Incentive Program (SSIP). Under the SSIP, contractors that..., performance, quality, and business relations would be granted Superior Supplier Status (SSS). Contractors...

  7. Ramsay Hunt syndrome and zoster laryngitis with multiple cranial nerve involvement.

    Science.gov (United States)

    Shinha, Takashi; Krishna, Pasala

    2015-01-01

    Ramsay Hunt syndrome is characterized by varicella zoster virus infection affecting the geniculate ganglion of the facial nerve. It typically presents with vesicles in the external auditory canal associated with auricular pain and peripheral facial nerve paralysis. Although vestibulocochlear nerve is frequently co-involved during the course of Ramsay Hunt syndrome, multiple lower cranial nerve involvement has rarely been described in the literature. In addition, laryngitis due to varicella zoster virus is a diagnostic challenge due to its unfamiliarity among clinicians. We report a case of Ramsay Hunt syndrome with laryngitis involving multiple lower cranial nerves.

  8. [Cycloferon in therapy of hyperplastic laryngitis for decrease of the number of relapses].

    Science.gov (United States)

    Grigorian, S S; Romantsov, M G; Demchenko, E V; Kovalenko, A L

    2013-01-01

    The article describes the clinical forms of chronic hyperplastic laryngitis, characterized by persistent and recurrent course, a tendency to the formation of oncological pathology, at the expense of hyperplastic changes in the larynx, leading to a malignancy of the inflammatory process. It was demonstrated the bacterization of larynx by Epstein-Barr virus (EBV) and Mycoplasma in imbalance of system of interferon. Clinical recovery, depending on the clinical form of the disease, using cycloferon, was observed in 57.4% of patients. The inclusion in the complex of the medical support of chronic hyperplastic laryngitis inducer of interferon - cycloferon, provided the reduction of the number of relapses.

  9. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    Directory of Open Access Journals (Sweden)

    Seyyedeh Maryam Khoddami

    2013-01-01

    Full Text Available The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD. The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

  10. The assessment methods of laryngeal muscle activity in muscle tension dysphonia: a review.

    Science.gov (United States)

    Khoddami, Seyyedeh Maryam; Nakhostin Ansari, Noureddin; Izadi, Farzad; Talebian Moghadam, Saeed

    2013-11-04

    The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

  11. Prenatal Diagnosis and Pathology of Laryngeal Atresia in Congenital High Airway Obstruction Syndrome

    Directory of Open Access Journals (Sweden)

    Piya Chaemsaithong

    2012-01-01

    Full Text Available Congenital high airway obstruction syndrome is a rare but life-threatening condition. Therefore, prenatal diagnosis is important. The obstruction can be due to laryngeal/tracheal atresia or external compression. While a differential diagnosis with congenital cystic adenomatoid malformation (CCAM type III may be difficult, it is still possible with ultrasonography. In this study, we report a case of bilateral echogenic lungs with hydrops fetalis. After the prenatal diagnosis of laryngeal atresia, the couple opted to have an elective termination of pregnancy performed at 20 weeks of gestation. The diagnosis was confirmed by a complete pathological examination.

  12. Ramsay Hunt syndrome and zoster laryngitis with multiple cranial nerve involvement

    Directory of Open Access Journals (Sweden)

    Takashi Shinha

    2015-01-01

    Full Text Available Ramsay Hunt syndrome is characterized by varicella zoster virus infection affecting the geniculate ganglion of the facial nerve. It typically presents with vesicles in the external auditory canal associated with auricular pain and peripheral facial nerve paralysis. Although vestibulocochlear nerve is frequently co-involved during the course of Ramsay Hunt syndrome, multiple lower cranial nerve involvement has rarely been described in the literature. In addition, laryngitis due to varicella zoster virus is a diagnostic challenge due to its unfamiliarity among clinicians. We report a case of Ramsay Hunt syndrome with laryngitis involving multiple lower cranial nerves.

  13. Laparoscopic instrument use in laryngeal surgery: transoral resection of a supraglottic haemangioma.

    Science.gov (United States)

    Bannon, R; Gohil, R; Manickavasagam, J

    2017-09-01

    Adult laryngeal haemangiomas are rare vascular tumours that have been managed by a variety of surgical techniques. This paper describes a case of near-fatal acute airway obstruction secondary to such a lesion, followed by our approach to surgical resection using a laparoscopic bipolar tissue-sealing device. This technique resulted in successful excision of the lesion, with no evidence of recurrence at one year of follow up. Laparoscopic bipolar instruments can be used for the resection of moderate to large laryngeal haemangiomas as an alternative to laser excision.

  14. superior en México

    Directory of Open Access Journals (Sweden)

    César Mureddu Torres

    2008-01-01

    Full Text Available El presente artículo desarrolla algunos de los retos que ha traído consigo el acceso a la información existente en la red de Internet y lo que ello supone. Se abordan principalmente las consecuencias de la presencia actual de una sociedad llamada del conocimiento, si se mantiene la confusión entre conocimiento e información. Por ello, la sola gestión de la información no puede ser tomada como definitoria respecto a la función de educación superior confiada a las universidades. Hacerlo sería cometer un error aún más grave que la confusión teórica entre los términos mencionados.

  15. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias

    Science.gov (United States)

    Waugh, Jeff L.; Kuster, John K.; Levenstein, Jacob M.; Makris, Nikos; Multhaupt-Buell, Trisha J.; Sudarsky, Lewis R.; Breiter, Hans C.; Sharma, Nutan; Blood, Anne J.

    2016-01-01

    Background Dystonia, a debilitating movement disorder characterized by abnormal fixed positions and/or twisting postures, is associated with dysfunction of motor control networks. While gross brain lesions can produce secondary dystonias, advanced neuroimaging techniques have been required to identify network abnormalities in primary dystonias. Prior neuroimaging studies have provided valuable insights into the pathophysiology of dystonia, but few directly assessed the gross volume of motor control regions, and to our knowledge, none identified abnormalities common to multiple types of idiopathic focal dystonia. Methods We used two gross volumetric segmentation techniques and one voxelwise volumetric technique (voxel based morphometry, VBM) to compare regional volume between matched healthy controls and patients with idiopathic primary focal dystonia (cervical, n = 17, laryngeal, n = 7). We used (1) automated gross volume measures of eight motor control regions using the FreeSurfer analysis package; (2) blinded, anatomist-supervised manual segmentation of the whole thalamus (also gross volume); and (3) voxel based morphometry, which measures local T1-weighted signal intensity and estimates gray matter density or volume at the level of single voxels, for both whole-brain and thalamus. Results Using both automated and manual gross volumetry, we found a significant volume decrease only in the thalamus in two focal dystonias. Decreases in whole-thalamic volume were independent of head and brain size, laterality of symptoms, and duration. VBM measures did not differ between dystonia and control groups in any motor control region. Conclusions Reduced thalamic gross volume, detected in two independent analyses, suggests a common anatomical abnormality in cervical dystonia and spasmodic dysphonia. Defining the structural underpinnings of dystonia may require such complementary approaches. PMID:27171035

  16. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias.

    Directory of Open Access Journals (Sweden)

    Jeff L Waugh

    Full Text Available Dystonia, a debilitating movement disorder characterized by abnormal fixed positions and/or twisting postures, is associated with dysfunction of motor control networks. While gross brain lesions can produce secondary dystonias, advanced neuroimaging techniques have been required to identify network abnormalities in primary dystonias. Prior neuroimaging studies have provided valuable insights into the pathophysiology of dystonia, but few directly assessed the gross volume of motor control regions, and to our knowledge, none identified abnormalities common to multiple types of idiopathic focal dystonia.We used two gross volumetric segmentation techniques and one voxelwise volumetric technique (voxel based morphometry, VBM to compare regional volume between matched healthy controls and patients with idiopathic primary focal dystonia (cervical, n = 17, laryngeal, n = 7. We used (1 automated gross volume measures of eight motor control regions using the FreeSurfer analysis package; (2 blinded, anatomist-supervised manual segmentation of the whole thalamus (also gross volume; and (3 voxel based morphometry, which measures local T1-weighted signal intensity and estimates gray matter density or volume at the level of single voxels, for both whole-brain and thalamus.Using both automated and manual gross volumetry, we found a significant volume decrease only in the thalamus in two focal dystonias. Decreases in whole-thalamic volume were independent of head and brain size, laterality of symptoms, and duration. VBM measures did not differ between dystonia and control groups in any motor control region.Reduced thalamic gross volume, detected in two independent analyses, suggests a common anatomical abnormality in cervical dystonia and spasmodic dysphonia. Defining the structural underpinnings of dystonia may require such complementary approaches.

  17. Laryngeal Verrucous Carcinoma: A Population-Based Analysis.

    Science.gov (United States)

    Dubal, Pariket M; Svider, Peter F; Kam, David; Dutta, Rahul; Baredes, Soly; Eloy, Jean Anderson

    2015-11-01

    Verrucous carcinoma of the larynx (VCL) is a rare entity with reportedly favorable prognosis. Current analyses are limited primarily to case reports and case series, thus making a population-based analysis useful in characterizing frequency, incidence, and survival trends to guide clinical diagnosis and decision making. Analysis of the National Cancer Institute's SEER (Surveillance, Epidemiology, and End Results) database. Cases of VCL diagnosed between 1973 and 2011 were searched in the SEER database. Analysis was carried out with respect to patient demographics, tumor characteristics, incidence, treatment modality, and survival. In sum, 516 patients with VCL were identified. Males composed 88.4% of cases. Whites accounted for 88.4% of cases, with 8.1% of cases occurring in black patients. Most cases (79.7%) arose in the glottis, a statistically significant predilection when compared with other laryngeal malignancies (P < .0001). Incidence of VCL decreased from 2000 to 2011, with an annual percent change of -5.4%. Overall 1-, 5-, and 10-year disease-specific survival for VCL was 97.5%, 88.0%, and 77.4%, while 1-, 5-, and 10-year relative survival was 98.1%, 85.5%, and 74.2%, respectively. Surgery seemed to confer better prognosis when compared with other treatment modalities. This large population-based analysis of VCL demonstrates that this entity has a good prognosis, arises in the glottis, and is decreasing in incidence. Five-year survival seems highest when surgery is utilized. However, this finding may be subject to selection bias in high-stage lesions. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  18. Escuela Superior de Palos Verdes

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    Neutra, Richard J.

    1965-02-01

    Full Text Available Before initiating the building operations for the «Palos Verdes» School, the site was divided into two large horizontal surfaces, at different levels. The lower one served to accommodate the playing fields, a car park, the physical training building, and shop and ancillary buildings. On the higher of these two surfaces, and to the West of the access road, there is a car park and also the building and plot of ground devoted to agricultural technology, as well as the literary studies and general purpose buildings. As a complement to these, there is a series of blocks, arranged in parallel rows, which house the administrative offices, the art school, the craft's school, the general classrooms, and those devoted to higher education. The fascinating aspect of this school is the outstanding penetration of the architect's mind into the essential function of the project. Its most evident merit is the sense of comradeship and harmony that permeates the whole architectural manifold.Antes de construir el complejo escolar «Palos Verdes» se comenzó por crear, en el terreno, dos grandes mesetas a niveles diferentes. Sobre el inferior se organizaron: los campos de juegos, de deportes, un aparcamiento, el edificio para educación física y los destinados a tiendas y servicios. Sobre la meseta superior, al oeste de la vía de acceso, se dispuso un aparcamiento y el edificio y campo para adiestramiento agrícola; al este, otro aparcamiento, el edificio dedicado a materias literarias, y el destinado a usos múltiples. Completan las instalaciones de la escuela una serie de bloques paralelos: la administración, la escuela de arte, las clases de trabajos manuales, las aulas de enseñanzas generales, y las de los cursos superiores. Lo fascinante de este complejo escolar es la perfecta y magistral compenetración del arquitecto con el tema proyectado, y su mayor mérito, la sensación de cordialidad y armonía con el ambiente.

  19. A RANDOMIZED CROSSOVER COMPARISON OF THE LARYNGEAL MASK AIRWAY PROSEAL AND LARYNGEAL MASK AIRWAY SUPREME IN ANESTHETIZED ADULT PATIENTS

    Directory of Open Access Journals (Sweden)

    Vinayaka

    2015-10-01

    Full Text Available BACKGROUND : Newer supraglottic airway devices have been recently introduced, motivated by the need for a single use equivalent to the reusable LMA Proseal. LMA Supreme is a new single use laryngeal mask airway with gastric access providing an easy, reliable airway and good airway seal. The objectives of the present study were to compare LMA Proseal and LMA Supreme for ease of insertion, oropharyn geal leak pressure and fibre - optic position in anesthetized adult patients. MATERIAL AND METHODS : We conducted a prospective randomized study in 60 ASA grade I and II adult patients posted for elective surgeries under general anesthesia. Both devices were inserted into each patient in random order. Two attempts were allowed. Digital insertion was used for the first attempt and guided insertion for the second attempt. The ease of insertion, oropharyngeal leak pressure and fibre - optic position were determined . RESULTS : First attempt and overall success of insertion were similar (LMA Proseal 93.33% and 100%; LMA Supreme 96.66% and 100%. Guided insertion was always successful following failed digital insertion. There was no difference in the mean duration of insertion for both the devices (23.92±1.44 vs 23.44±1.72seconds. The mean oropharyngeal leak pressure was significantly higher for the LMA Proseal than the LMA Supreme (23.24 vs 19.37cm of H 2 O (p<0.05. The fibre - optic view of the glottis was similar for both the devices. CONCLUSION : In this study, the ease of insertion and fibre - optic position were similar for the LMA Proseal and LMA Supreme, but oropharyngeal leak pressure is higher for the LMA Proseal. The LMA Proseal provides a more effective seal tha n LMA Supreme for positive pressure ventilation.

  20. Family history of cancer and the risk of laryngeal cancer: a case-control study from Italy and Switzerland.

    Science.gov (United States)

    Garavello, Werner; Turati, Federica; Bosetti, Cristina; Talamini, Renato; Levi, Fabio; Lucenteforte, Ersilia; Chiesa, Fausto; Franceschi, Silvia; La Vecchia, Carlo; Negri, Eva

    2012-02-01

    Only limited data is available on the relationship between family history of laryngeal and other neoplasms and laryngeal cancer risk. We investigated the issue using data from a multicentre case-control study conducted in Italy and Switzerland between 1992 and 2009 including 852 cases with histologically confirmed laryngeal cancer and 1970 controls admitted to hospital for acute, non neoplastic conditions. Unconditional logistic regression models adjusted for age, sex, study center, education, tobacco smoking, alcohol drinking and number of siblings were used to estimate the odds ratios (ORs) of laryngeal cancer. The multivariate OR was 2.8 (95% confidence interval [CI], 1.5-5.3) in subjects reporting a first-degree relative with laryngeal cancer, as compared to subjects with no family history. The OR was higher when the relative was diagnosed before 60 years of age (OR = 3.5, 95% CI 1.4-8.8). As compared to subjects without family history, non-smokers, and moderate drinkers, the OR was 37.1 (95% CI 9.9-139.4) for current smokers, heavy drinkers, with family history of laryngeal cancer. Family history of colorectal (OR = 1.5, 95% CI 1.0-2.3) and kidney (OR = 3.8, 95% CI 1.2-12.1) cancer were also associated to an increased risk of laryngeal cancer, while no significant increase in risk was found for family history of cancer at all sites, excluding the larynx (OR = 1.1).

  1. EXPRESSION OF mRNA FOR MEMBRANE-TYPE 1, 2, AND 3 MATRIX METALLOPROTEINASES IN HUMAN LARYNGEAL CANCER

    Institute of Scientific and Technical Information of China (English)

    Ya-nan Sun; Yuan Li

    2004-01-01

    Objective To investigate correlation of expressions of membrane-type 1, 2, and 3 matrix metalloproteinases (MT1, MT2,and MT3-MMP) to the invasion and metastases in laryngeal cancer.Methods Reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the mRNA level of MT1,MT2, and MT3-MMP in 24 patients with laryngeal cancer. The relationships of these three MT-MMP expressions to clinicopathology were analyzed by statistics.Results The expressions of MT1, MT2, and MT3-MMP were significantly higher in laryngeal cancer tissues than those in para-tumorous tissues (P < 0.01) and had a close relationship with invasive depth (P < 0.05). But no significantly different expressions of these three MT-MMPs were found in different primary location and different histological grade of laryngeal cancer (P > 0.05). The expression of MT1-MMP was obviously higher in patients with metastatic lymph nodes than that in patients without metastatic lymph nodes (P < 0.05).Conclusion MT1, MT2, and MT3-MMP play an important role in the progression of laryngeal cancer, and MT1-MMP may serve as a reliable marker in estimating invasive and metastatic potency of laryngeal cancer. Suppressing expressions of MT 1, MT2, and MT3-MMP early may inhibit the invasion and metastases of laryngeal cancer.

  2. Association between Obesity and Chronic Laryngitis in Women - Data from the Korea National Health and Nutrition Examination Survey

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    Young-Hoon Joo

    2015-07-01

    Full Text Available Background: This study aimed to investigate the relationship between obesity and chronic laryngitis in South Korea using data from the Korea National Health and Nutrition Examination Surveys (KNHANES collected during 2008-2010. Methods: KNHANES was a cross-sectional survey of the civilian, non-institutionalized population of South Korea (n = 13,819. Obesity status was measured by using BMI and waist circumference. Results: Among the population over 19 years of age, the prevalence of chronic laryngitis was 4.0 ± 0.4%. Chronic laryngitis was significantly associated with age, BMI, waist circumference, fat proportion, both systolic and diastolic blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein cholesterol in women. Old age and current smoking were significantly associated with chronic laryngitis in men. Obese women were at a higher risk for chronic laryngitis than women without obesity (odds ratio (OR 2.022, 95% confidence interval (95% CI 1.412-2.895 after further adjustment for confounders. Women with abdominal obesity were also at higher risk for chronic laryngitis (OR 1.475, 95% CI 1.024-2.126. Conclusion: Obese women in Korea have an elevated risk for developing chronic laryngitis. Further epidemiological and experimental studies are necessary to clarify the impact of obesity on this condition.

  3. The Composition of Microbiome in Larynx and the Throat Biodiversity between Laryngeal Squamous Cell Carcinoma Patients and Control Population.

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    Hong-Li Gong

    Full Text Available The throat is an ecological assemblage involved human cells and microbiota, and the colonizing bacteria are important factors in balancing this environment. However, this bacterial community profile has thus been poorly investigated. The purpose of this study was to investigate the microbial biology of the larynx and to analyze the throat biodiversity in laryngeal carcinoma patients compared to a control population in a case-control study. Barcoded pyrosequencing analysis of the 16S rRNA gene was used. We collected tissue samples from 29 patients with laryngeal carcinoma and 31 control patients with vocal cord polyps. The findings of high-quality sequence datasets revealed 218 genera from 13 phyla in the laryngeal mucosa. The predominant communities of phyla in the larynx were Firmicutes (54%, Fusobacteria (17%, Bacteroidetes (15%, Proteobacteria (11%, and Actinobacteria (3%. The leading genera were Streptococcus (36%, Fusobacterium (15%, Prevotella (12%, Neisseria (6%, and Gemella (4%. The throat bacterial compositions were highly different between laryngeal carcinoma subjects and control population (p = 0.006. The abundance of the 26 genera was significantly different between the laryngeal cancer and control groups by metastats analysis (p<0.05. Fifteen genera may be associated with laryngeal carcinoma by partial least squares discriminant analysis (p<0.001. In summary, this study revealed the microbiota profiles in laryngeal mucosa from tissue specimens. The compositions of bacteria community in throat were different between laryngeal cancer patients and controls, and probably were related with this carcinoma. The disruption of this bio-ecological niche might be a risk factor for laryngeal carcinoma.

  4. Factors confusing the diagnosis of laryngopharyngeal reflux: the role of allergic rhinitis and inter-rater variability of laryngeal findings.

    Science.gov (United States)

    Eren, Erdem; Arslanoğlu, Seçil; Aktaş, Ayşe; Kopar, Aylin; Ciğer, Ejder; Önal, Kazım; Katılmiş, Hüseyin

    2014-04-01

    The objective of the study was to determine the inter-rater variability in assessment of laryngeal findings and whether diagnosing laryngopharyngeal reflux based on the laryngeal findings and history alone without considering allergic rhinitis leads to the overdiagnosis and overtreatment of laryngopharyngeal reflux. Patients with positive and negative skin prick tests were recruited from an allergy clinic in a tertiary teaching university hospital. All subjects completed the Reflux Symptom Index (RSI) and underwent laryngeal examinations by three physicians blinded to the skin prick test results and the Reflux Finding Score (RFS) was determined. RFS >7 or RSI >13 was considered reflux positive. Fleiss' kappa (κ) was used to measure inter-rater agreement. The inter-rater agreement was low for pseudosulcus vocalis (κ = 0.078), ventricular obliteration (κ = 0.206), diffuse laryngeal edema (κ = 0.204), and posterior laryngeal hypertrophy (κ = 0.27), intermediate for laryngeal erythema/hyperemia (κ = 0.42) and vocal fold edema (κ = 0.42), and high for thick endolaryngeal mucus (κ = 0.61). Although the frequency of allergy was high, there was no significant difference between allergy-positive and laryngopharyngeal reflux-positive patients. On logistic regression analysis, thick endolaryngeal mucus was a significant predictor of allergy (p = 0.012, odds ratio 0.264, 95 % confidence interval 0.093-0.74). The laryngeal examination for reflux is subject to marked inter-rater variability and allergic laryngitis was not misdiagnosed as laryngopharyngeal reflux. The presence of thick endolaryngeal mucus should alert physicians to the possibility of allergic rhinitis/laryngitis.

  5. CHARACTERISTICS OF TREATMENT OF PATIENTS WITH ACUTE AND CHRONIC LARYNGITIS DEPENDING ON RESULTS OF BACTERIOLOGICAL EXAMINATION OF LARYNX MICROFLORA

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    K. I. Chuikova

    2014-01-01

    Full Text Available This paper describes study of larynx microflora in patients with acute laryngtis and exacerbations of chronic laryngitis. Therapeutic algorithm based on bacteriologic examination data was developed reduce. New algorithm helps reduce sickness terms and to decrease prevalence of desease.123 patients of age from 18 to 60 were under observation: 43 patients with acute laryngitis and 80 patients with exacerbation of chronic laryngitis. 22 patients with acute laryngitis and 58 patients with exacerbation of chronic laryngitis underwent etiotropic treatment with antibiotics. The group of comparison with acute laryngitis (21 patients and chronic laryngitis (22 patients received treatment according to the conventional scheme.Bacteriologic examination of larynx mucous, clinical study and functional voice test (time of maximum vowels phonation before and after treatment were carried out.As a result of the research it was established that the most common causative agent of acute and chronic inflammatory larynx diseases is S. aureus as a mono culture or combined with other bacterial associations (S. аnhemolyticus, Str. viridans etc..After the end of antibacterial therapy we found symptoms as hoarseness, irritation, dry laryngopharynx, hyperemia and swelling of larynx mucous reduced eather in new treatment group than controlled group. Time of maximum vowels phonation (in seconds also increased significantly.Sickness terms after prescription of new treatment was shorter than in comparison groups: (10.9 ± 7.9 days for acute laryngitis and (12.6 ± 7.3 days for chronic laryngitis respectively. Health index was 20.8 and 19.5% respectively.

  6. Eletromiografia laríngea em pacientes com disfonia e fechamento glótico incompleto Laryngeal electromyography in dysphonic patients with incomplete glottic closure

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    Noemi Grigoletto De Biase

    2012-12-01

    Full Text Available O diagnóstico de comprometimento do nervo laríngeo superior e de ramos do laríngeo recorrente demanda eletromiografia, pois as alterações à laringoscopia são inespecíficas. OBJETIVO: Avaliar eletrofisiologicamente a função dos nervos laríngeo superior e inferior por meio da atividade elétrica dos músculos por eles inervados, em pacientes com disfonia com coaptação incompleta das pregas vocais à fonação. MÉTODO: Estudo prospectivo; 39 indivíduos com disfonia e fechamento glótico incompleto foram submetidos à eletromiografia dos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente. Foram avaliadas atividade de inserção, no repouso (fibrilação, onda positiva e fasciculação e durante contração voluntária dos músculos (recrutamento, amplitude e duração do potencial e latência entre início da atividade elétrica e a sonorização. RESULTADOS: Não observamos alteração na atividade de inserção e no repouso. Nenhum paciente apresentou recrutamento alterado. A média da amplitude dos potenciais elétricos esteve compatível com a normalidade nos músculos testados, assim como a duração do potencial e o tempo de latência entre o início da atividade elétrica e a sonorização. CONCLUSÃO: Não observamos sinais de desnervação nos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente nos pacientes estudados.The lack of specificity in laryngoscopical examination requires that the diagnosis of superior laryngeal and recurrent laryngeal nerve involvement be carried out with the aid of electromyography. OBJECTIVE: This study aims to assess the electrophysiological function of the superior and inferior laryngeal nerves by measuring the electrical activity of the muscles they innervate in dysphonic patients with incomplete closure of the vocal folds during phonation. METHOD: Thirty-nine patients with incomplete glottic closure were enrolled in a

  7. Transforming growth factor alpha and epidermal growth factor in laryngeal carcinomas demonstrated by immunohistochemistry

    DEFF Research Database (Denmark)

    Christensen, M E; Therkildsen, M H; Poulsen, Steen Seier

    1993-01-01

    Fifteen laryngeal squamous cell carcinomas were investigated for the presence of transforming growth factor alpha (TGF-alpha) and epidermal growth factor (EGF) using immunohistochemical methods. In a recent study the same material was characterized for epidermal growth factor receptors (EGF recep...

  8. Progress against laryngeal cancer in The Netherlands between 1989 and 2010

    NARCIS (Netherlands)

    van Dijk, Boukje A. C.; Karim-Kos, Henrike E.; Coebergh, Jan Willem; Marres, Henri A. M.; de Vries, Esther

    2014-01-01

    Cancer of the larynx is a frequently occurring head and neck cancer in The Netherlands. The main risk factors are smoking and excessive alcohol consumption. The aim of our study was to evaluate the progress against laryngeal cancer by studying trends in incidence, mortality and survival in The Nethe

  9. Low Phosphorylated AKT Expression in Laryngeal Cancer: Indications for a Higher Metastatic Risk

    Energy Technology Data Exchange (ETDEWEB)

    Nijkamp, Monique M.; Span, Paul N.; Stegeman, Hanneke [Department of Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Grénman, Reidar [Departments of Otorhinolaryngology-Head-and-Neck-Surgery and Medical Biochemistry, Turku University Hospital and University of Turku, Turku (Finland); Kaanders, Johannes H.A.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Bussink, Johan, E-mail: j.bussink@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands)

    2013-10-01

    Purpose: To validate the association of phosphorylated (p)AKT with lymph node metastasis in an independent, homogeneous cohort of patients with larynx cancer. Methods and Materials: Seventy-eight patients with laryngeal cancer were included. Epidermal growth factor receptor, pAKT, vimentin, E-cadherin, hypoxia, and blood vessels were visualized in biopsy material using immunohistochemistry. Positive tumor areas and spatial relationships between markers were assessed by automated image analysis. In 6 laryngeal cancer cell lines, E-cadherin and vimentin messenger RNA was quantified by real-time polymerase chain reaction and by immunohistochemistry before and after treatment with the pAKT inhibitor MK-2206. Results: A significant correlation was found between low pAKT in the primary tumor and positive lymph node status (P=.0005). Tumors with lymph node metastases had an approximately 10-fold lower median pAKT value compared with tumors without lymph node metastases, albeit with large intertumor variations, validating our previous results. After inhibition of pAKT in laryngeal cancer cells with MK-2206, up-regulation of vimentin and a downregulation of E-cadherin occurred, consistent with epithelial–mesenchymal transition. Conclusion: Low pAKT expression in larynx tumors is associated with lymph node metastases. Further, inhibition of pAKT in laryngeal cancer induces epithelial–mesenchymal transition, predisposing for an increased metastatic risk.

  10. ED50 of desflurane for laryngeal mask airway removal in anaesthetised adults.

    Science.gov (United States)

    Makkar, J K; Arora, S; Jain, K; Wig, J

    2011-09-01

    Previous estimates for the end-tidal concentration of desflurane that allows removal of the laryngeal mask airway in 50% of anaesthetised adults (ED50) have ranged from 2.1% to 5.3%. To assess which value is correct, we studied 32 female patients (aged 30-50 years) undergoing intracavity caesium implants for cervical carcinoma under general anaesthesia. Anaesthesia was induced with propofol 2-3 mg.kg(-1) and maintained with desflurane in a 50% nitrous oxide-oxygen mixture. At the end of surgery, a predetermined target end-tidal desflurane concentration (starting at 4%) was maintained for 10 min using Dixon's up-down method and the laryngeal mask airway was removed. The target end-tidal concentration in the next patient was increased or decreased by 0.5% depending upon the response of the previous patient. Removal of the laryngeal mask airway without coughing, clenching, biting, movement or any adverse airway event during or within 1 min after removal was considered to be successful. We found that the laryngeal mask airway can be successfully removed in 50% (ED50) and 95% (ED95) of the anaesthetised adults at end-tidal desflurane concentrations of 2.4% (95% CI 1.3-2.9) and 3.8% (3.1-9.6), respectively.

  11. Nuclear BMI-1 expression in laryngeal carcinoma correlates with lymph node pathological status

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    Allegra Eugenia

    2012-10-01

    Full Text Available Abstract Background The main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes. The current clinical staging criteria fail to differentiate patients with occult metastasis from patients without metastasis. Identifying molecular markers of the disease might improve our understanding of the molecular mechanisms underlying the pathogenesis and development of laryngeal carcinoma and may help improve clinical staging and treatment. Methods Sixty-four previously untreated patients who underwent surgical excision of laryngeal squamous cell carcinoma with neck dissection were included in this study. The expression of B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1 was examined immunohistochemically on formalin-fixed paraffin-embedded primary tissue specimens. Results Nuclear expression of BMI-1 (nBMI-1 was detected in 32 of the 64 tumors (50%, cytoplasmic expression of BMI-1 (cBMI-1 was detected in 22 (34.4%, and 10 tumors (15.6% showed no BMI-1 immunoreactivity. High nBMI-1 expression levels (≥10 were detected in 28 of the 32 (87.5% nBMI-1-positive patients. Multivariate analysis including age at diagnosis, grade, tumor location, TNM status, and nBMI-1 expression showed that a high nBMI-1 expression level was an independent prognostic factor for lymph node metastasis. Conclusion The expression of BMI-1 in patients with laryngeal carcinoma seems to correlate with lymph node metastasis.

  12. Visualization of small glottic laryngeal cancer using methyl-labeled C-11-methionine positron emission tomography

    NARCIS (Netherlands)

    Wedman, Jan; Pruim, J.; Langendijk, J. A.; van der Laan, B. F. A. M.

    2009-01-01

    Despite abundant literature on the use of PET in head and neck cancer, a little is known about the visualization of small laryngeal cancer. Moreover, most literature deals with the radiopharmaceutical F-18-fludeoxyglucose (FDG), whereas only a few papers address the use of C-11 labeled amino acids.

  13. Enhanced recovery program (ERP) in major laryngeal surgery: building a protocol and testing its feasibility.

    Science.gov (United States)

    Gemma, M; Toma, S; Lira Luce, F; Beretta, L; Braga, M; Bussi, M

    2017-05-22

    Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®. Twenty-four patients undergoing major laryngeal surgery (total and partial laryngectomies or surgical removal of oropharyngeal tumour with muscle flap reconstruction) were treated according to such an ERP protocol, which differed under several respects from our previous standard practice (described in 70 consecutive patients who underwent major laryngeal surgery before ERP implementation. The adherence rate to the different ERP items is reported. Adherence to ERP items was high. Nutritional assessment, antibiotic prophylaxis, postoperative nausea and vomit (PONV) prophylaxis and postoperative speech therapy targets were applied as required in 100% of cases. Some ERP items (antibiotic prophylaxis, intraoperative infusion rate, and postoperative speech therapy) were already frequently implemented before ERP adoption. Postoperative medical complications occurred in 8.3% of patients. Our expert-opinion-based ERP protocol for major laryngeal surgery proved feasible. The degree of benefit deriving from its implementation has yet to be assessed. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  14. The Phonetics and Phonology of Laryngeal Features in Native American Languages

    NARCIS (Netherlands)

    Coler, Matthew; Avelino, Herbierto; Wetzels, Leo

    2016-01-01

    This book presents unique insights into laryngeal features, one of the most intriguing topics of contemporary phonetics and phonology. It investigates in detail properties such as tone, non-modal phonation, non-pulmonic production mechanisms (as in ejectives or implosives), stress, and prosody. What

  15. Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer

    NARCIS (Netherlands)

    Langius, Jacqueline A. E.; Doornaert, Patricia; Spreeuwenberg, Marieke D.; Langendijk, Johannes A.; Leemans, C. Rene; van Bokhorst-de van der Schueren, Marian A. E.

    2010-01-01

    Background and purpose: Although patients with early stage (T1/T2) laryngeal cancer (LC) are thought to have a low incidence of malnutrition, severe weight loss is observed in a subgroup of these patients during radiotherapy (RI). The objective of this study was to evaluate weight loss and nutrition

  16. Ortner's Syndrome: Secondary Laryngeal Paralysis Caused by a Great Thoracic Aorta Aneurysm

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    Zangirolami, Ana Claudia Alves

    2015-01-01

    Full Text Available Introduction Recurrent laryngeal nerve injury caused by cardiovascular disease is a rare condition, and often it is the only prominent sign of an imminent break of an aortic artery aneurysm. Objective To report left laryngeal paralysis caused by a great aortic arch aneurysm and to highlight the importance of an otorhinolaryngologic evaluation along with a thoracic radiologic study. Resumed Report A 42-year-old man complained of thickness of his voice and dysphagia for 3 months, but no thoracic pain or other relevant complaints. Video laryngoscopy revealed immobility of his left vocal fold in the paramedian position. Imaging was obtained for investigation, including magnetic resonance imaging of his thorax, which showed a fusiform aneurysm in the aortic arch, leading to recurrent compression of the left laryngeal nerve. The patient was successfully treated with endovascular repair of the aneurysm. At 2-month follow-up, there was still no recovery of the laryngeal mobility. Conclusion An aortic artery aneurysm can suddenly break, requiring emergency heart surgery, and the results can be fatal in many cases. We suggest routine exam of the vocal folds in all patients with a heart condition, and we review the literature and suggest the use of imaging to reduce the number of emergency procedures.

  17. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available BACKGROUND: Swallowing dysfunction (also known as dysphagia, which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. METHODS: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. RESULTS: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. CONCLUSIONS: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

  18. Laryngeal choking on food and acute ethanol intoxication in adults--An autopsy study.

    Science.gov (United States)

    Nikolić, Slobodan; Zivković, Vladimir; Dragan, Babic; Juković, Fehim

    2011-01-01

    The retrospective autopsy study included 98 adults who died because of laryngeal choking on a bolus of food: 67 men and 31 women (χ(2)=6.843, pintoxicated (z=-7.126, pintoxication in individuals without mental disorders, were the most important risk factors for bolus death.

  19. Visualization of small glottic laryngeal cancer using methyl-labeled C-11-methionine positron emission tomography

    NARCIS (Netherlands)

    Wedman, Jan; Pruim, J.; Langendijk, J. A.; van der Laan, B. F. A. M.

    2009-01-01

    Despite abundant literature on the use of PET in head and neck cancer, a little is known about the visualization of small laryngeal cancer. Moreover, most literature deals with the radiopharmaceutical F-18-fludeoxyglucose (FDG), whereas only a few papers address the use of C-11 labeled amino acids.

  20. Routine follow-up after laryngeal cancer treatment : the assessment of pre-symptomatic recurrence detection

    NARCIS (Netherlands)

    Ritoe, Savitri Christine

    2007-01-01

    The principal goal of the follow-up program as formulated for patients with laryngeal carcinoma is the pre-symptomatic detection of local and regional recurrences. Different studies were conducted to evaluate the effectiviness of this follow-up protocol. The first study comprised 402 patients with s

  1. Analogy between Laryngeal Gesture in Mongolian "Long Song" and Supracricoid Partial Laryngectomy

    Science.gov (United States)

    Crevier-Buchman, Lise; Pillot-Loiseau, Claire; Rialland, Annie; Narantuya; Vincent, Coralie; Desjacques, Alain

    2012-01-01

    This article reports the results of a multiparametrical analysis of "Mongolian Long Song," characterised by multiple ornamentation and shows the similarities between the laryngeal behaviour observed during these ornamentations and the compensatory gesture produced by patients after supracricoid partial laryngectomy. This study includes…

  2. Balloon Dilatation of Pediatric Subglottic Laryngeal Stenosis during the Artificial Apneic Pause: Experience in 5 Children

    Directory of Open Access Journals (Sweden)

    J. Lisý

    2014-01-01

    Full Text Available Introduction. Balloon dilatation is a method of choice for treatment of laryngeal stenosis in children. The aim of procedure in apneic pause is to avoid new insertion of tracheostomy cannula. Patients and Methods. The authors performed balloon dilatation of subglottic laryngeal strictures (SGS in 5 children (3 girls and 2 boys without tracheotomy. Two of them with traumatic and inflammatory SGS had a tracheal cannula removed in the past. The other 3 children with postintubation SGS had never had a tracheostomy before. The need for tracheostomy due to worsening stridor was imminent for all of them. Results. The total of seven laryngeal dilatations by balloon esophagoplasty catheter in apneic pause was performed in the 5 children. The procedure averted the need for tracheostomy placement in 4 of them (80%. Failure of dilatation in girl with traumatic stenosis and concomitant severe obstructive lung disease led to repeated tracheostomy. Conclusion. Balloon dilatation of laryngeal stricture could be done in the absence of tracheostomy in apneic pause. Dilatation averted threatening tracheostomy in all except one case. Early complication after the procedure seems to be a negative prognostic factor for the outcome of balloon dilatation.

  3. Laryngeal High-Speed Videoendoscopy: Rationale and Recommendation for Accurate and Consistent Terminology

    Science.gov (United States)

    Deliyski, Dimitar D.; Hillman, Robert E.; Mehta, Daryush D.

    2015-01-01

    Purpose: The authors discuss the rationale behind the term "laryngeal high-speed videoendoscopy" to describe the application of high-speed endoscopic imaging techniques to the visualization of vocal fold vibration. Method: Commentary on the advantages of using accurate and consistent terminology in the field of voice research is…

  4. Adenovirus with p16 gene exerts antitumor effect on laryngeal carcinoma Hep2 cells.

    Science.gov (United States)

    Yang, Zhengang; Hu, Jingxia; Li, Dajun; Pan, Xinliang

    2016-08-01

    Laryngeal cancer is an uncommon form of cancer. The tumor suppressor P16, known to be mutated or deleted in various types of human tumor, including laryngeal carcinoma, is involved in the formation and development of laryngeal carcinoma. It has been previously reported that the inactivation or loss of P16 is associated with the acquisition of malignant characteristics. The current study hypothesized that restoring wild‑type P16 activity into P16‑null malignant Hep2 cells may exert an antitumor effect. A recombinant adenovirus carrying the P16 gene (Ad‑P16) was used to infect and express high levels of P16 protein in P16‑null Hep2 cells. Cell proliferation and invasion assays and polymerase chain reaction were performed to evaluate the effects of the P16 gene on cell proliferation and the antitumor effect on Hep2 cells. The results demonstrated that the Hep2 cells infected with Ad‑P16 exhibited significantly reduced cell proliferation, invasion and tumor volume compared with untreated or control adenovirus cells. Furthermore, the expression of laryngeal carcinoma‑associated genes, EGFR, survivin and cyclin D1, were measured in Ad‑P16‑infected cells and were significantly reduced compared with control groups. The results of the current study demonstrate that restoring wild‑type P16 activity into P16-null Hep2 cells exerts an antitumor effect.

  5. Leishmaniasis isoleret til larynx som årsag til kronisk laryngitis

    DEFF Research Database (Denmark)

    Kaltoft, Mikkel; Munch-Petersen, Helga Richert; Møller, Henrik

    2010-01-01

    Mucosal leishmaniasis is uncommon outside Central and South America, where it is commonly caused by Leishmania (L.) braziliensis. We present a case of isolated laryngeal leishmaniasis detected in a 78-year-old male, who presented with chronic hoarseness. Histologic examination of biopsies taken...

  6. A Preclinical Study of Laryngeal Motor-Evoked Potentials as a Marker Vagus Nerve Activation.

    Science.gov (United States)

    Grimonprez, Annelies; Raedt, Robrecht; De Taeye, Leen; Larsen, Lars Emil; Delbeke, Jean; Boon, Paul; Vonck, Kristl

    2015-12-01

    Vagus nerve stimulation (VNS) is a treatment for refractory epilepsy and depression. Previous studies using invasive recording electrodes showed that VNS induces laryngeal motor-evoked potentials (LMEPs) through the co-activation of the recurrent laryngeal nerve and subsequent contractions of the laryngeal muscles. The present study investigates the feasibility of recording LMEPs in chronically VNS-implanted rats, using a minimally-invasive technique, to assess effective current delivery to the nerve and to determine optimal VNS output currents for vagal fiber activation. Three weeks after VNS electrode implantation, signals were recorded using an electromyography (EMG) electrode in the proximity of the laryngeal muscles and a reference electrode on the skull. The VNS output current was gradually ramped up from 0.1 to 1.0 mA in 0.1 mA steps. In 13/27 rats, typical LMEPs were recorded at low VNS output currents (median 0.3 mA, IQR 0.2-0.3 mA). In 11/27 rats, significantly higher output currents were required to evoke electrophysiological responses (median 0.7 mA, IQR 0.5-0.7 mA, p vagus nerve. Furthermore, our results suggest that low output currents are sufficient to activate vagal fibers.

  7. Dysphonia as a sign of HPV laryngeal infection: a case report.

    Science.gov (United States)

    Longubuco, Carlos Eduardo Gama; dos Reis, Helena Lucia Barroso; Cavalcante, Fernanda Sampaio; de Pinho, Carla Renata Petillo; Oliveira, Nathalia Silva; Nicol, Alcina Frederica; Zamolyi, Renata Quintella; Ferreira, Dennis de Carvalho

    2014-12-11

    Voice dysfunction or dysphonia may be associated with several clinical conditions. Among these, laryngeal human papillomavirus (HPV)-induced lesions should be considered as a possible causative factor. We report a case of dysphonia in a patient presenting with an HPV laryngeal lesion. We also discuss the clinical features of the disease, its histopathological findings, and treatment and rigorous follow-up. We report a case of laryngeal papilloma in a 29-year-old, Afro-descendant, male patient with dysphonia. He was a non-smoker and was not a drug user. Videolaryngostroboscopy revealed signs suggestive of pharyngolaryngeal reflux. The right vocal fold presented with a papillomatous aspect in the posterior third, which underwent excision. Histopathological examination showed a nodular lesion of the right vocal fold, conclusive of squamous papilloma with absence of malignancy. Patients presenting with persistent voice dysfunction or dysphonia should be investigated for possible laryngeal HPV infection. Diagnostic confirmation by HPV genotyping is important for follow-up of potential recurrence.

  8. Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study.

    Science.gov (United States)

    Cohn, Jason E; Touati, Andrew; Lentner, Mark; Weitzel, Mark; Fisher, Casey; Sataloff, Robert T

    2017-07-01

    The purpose of this study is to identify laryngeal symptoms and injuries in self-extubated patients. A retrospective chart review was conducted to identify symptoms and clinical findings associated with self-extubation. A novel scoring system was developed and used to quantify these findings. Symptom score included all symptoms that patients reported after self-extubation. Clinical score consisted of laryngeal findings visualized on nasopharyngeal laryngoscopy. Finally, a total self-extubation score was calculated as the sum of the symptom and clinical scores. Additionally, duration of intubation and endotracheal tube size were correlated with these scores. Sixty (n = 60) patients who self-extubated in our institution's intensive care unit were identified. Average calculated symptom, clinical, and total self-extubation scores were 0.92, 1.43, and 2.35, respectively. The most common symptom observed was hoarseness (62%), while the most common clinical finding was posterior laryngeal edema (58%). A significant positive correlation was found between duration of intubation and both symptom score and total self-extubation score (r = 0.314, P = .008 and r = 0.223, P = .05, respectively). Symptom score predicted clinical score with a significant positive correlation present (r = 0.278, P = .02). This study demonstrates that the majority of self-extubated patients have laryngeal symptoms and clinical findings. A comprehensive, multidisciplinary evaluation is warranted for self-extubations.

  9. Effect of Dystrophin Deficiency on Selected Intrinsic Laryngeal Muscles of the "mdx" Mouse

    Science.gov (United States)

    Fry, Lisa T.; Stemple, Joseph C.; Andreatta, Richard D.; Harrison, Anne L.; Andrade, Francisco H.

    2010-01-01

    Background: Intrinsic laryngeal muscles (ILM) show biological differences from the broader class of skeletal muscles. Yet most research regarding ILM specialization has been completed on a few muscles, most notably the thyroarytenoid and posterior cricoarytenoid. Little information exists regarding the biology of other ILM. Early evidence suggests…

  10. Patient-reported symptom questionnaires in laryngeal cancer: Voice, speech and swallowing

    NARCIS (Netherlands)

    Rinkel, R.N.P.M.; Verdonck-de Leeuw, I.M.; van den Brakel, N.; de Bree, R.; Eerenstein, S.E.J.; Aaronson, N.K.; Leemans, C.R.

    2014-01-01

    Objectives: To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. Materials and methods

  11. Pre- and post-radiotherapy MRI results as a predictive model for response in laryngeal carcinoma

    NARCIS (Netherlands)

    Ljumanovic, Redina; Langendijk, Johannes A.; Hoekstra, Otto S.; Knol, Dirk L.; Leemans, C. Rene; Castelijns, Jonas A.

    2008-01-01

    The purpose was to determine if pre-radiotherapy (RT) and/or post-radiotherapy magnetic resonance (MR) imaging can predict response in patients with laryngeal carcinoma treated with RT. Pre- and post-RT MR examinations of 80 patients were retrospectively reviewed and associated with regard to local

  12. Screening for second primary lung cancer after treatment of laryngeal cancer.

    NARCIS (Netherlands)

    Ritoe, S.C.; Krabbe, P.F.M.; Janssen, M.L.H.; Festen, J.; Joosten, F.B.M.; Kaanders, J.H.A.M.; Hoogen, F.J.A. van den; Verbeek, A.L.M.; Marres, H.A.M.

    2002-01-01

    OBJECTIVES/HYPOTHESIS: As a result of smoking, patients who have received curative treatment for laryngeal cancer run a high risk of developing lung cancer. Therefore, these patients enter a screening program that aims to detect lung cancer at an asymptomatic stage. The study evaluated whether

  13. Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil

    NARCIS (Netherlands)

    Lee, MC; Absalom, AR; Menon, DK; Smith, HL

    2006-01-01

    We assessed the use of intravenous remifentanil for the insertion of the laryngeal mask airway in 10 healthy awake volunteers, a technique primarily developed to facilitate functional magnetic resonance imaging studies of anaesthesia. Each volunteer received 200 mu g glycopyrronium intravenously. To

  14. Treatment of Laryngeal Radionecrosis with Hyperbaric Oxygen Therapy: A Case Report

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    Ying-Che Hsu

    2005-02-01

    Full Text Available An 81-year-old male with early-stage laryngeal carcinoma had been treated with 60 Gy curative radiotherapy. He complained of a sore throat, foul odor in the mouth, progressive dyspnea, and fever 2 months after the completion of radiotherapy. Direct laryngoscopy revealed narrowing of the glottis with diffuse ulcerative necrotic tissue. Biopsies at multiple sites and pathology revealed intense coagulation necrosis with complete denudation of covering epithelium without any malignancy. Since laryngeal radionecrosis was suspected, the patient received hyperbaric oxygen (HBO therapy 40 times for 1 hour of 100% O2 at 2 atm absolute pressure. His clinical symptoms gradually improved and repeated endolaryngeal biopsies were undertaken near the end of HBO therapy and again 6 months later. The patient's larynx healed completely with diffuse fibrosis and no malignant cells were found on pathology. Radionecrosis must be differentiated from cancer recurrence following curative radiotherapy for early laryngeal cancer. HBO therapy could be a useful treatment adjunct for laryngeal radionecrosis.

  15. Development of a System to Monitor Laryngeal Movement during Swallowing Using a Bend Sensor

    Science.gov (United States)

    Li, Qiang; Hori, Kazuhiro; Minagi, Yoshitomo; Ono, Takahiro; Chen, Yong-jin; Kondo, Jyugo; Fujiwara, Shigehiro; Tamine, Kenichi; Hayashi, Hirokazu; Inoue, Makoto; Maeda, Yoshinobu

    2013-01-01

    Background Swallowing dysfunction (also known as dysphagia), which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF) examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. Methods Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. Results Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. Conclusions The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement. PMID:23940652

  16. Effects of Masking Noise on Laryngeal Resistance for Breathy, Normal, and Pressed Voice

    Science.gov (United States)

    Grillo, Elizabeth U.; Abbott, Katherine Verdolini; Lee, Timothy D.

    2010-01-01

    Purpose: The purpose of the present study was to explore the effects of masking noise on laryngeal resistance for breathy, normal, and pressed voice in vocally trained women. Method: Eighteen vocally trained women produced breathy, normal, and pressed voice across 7 fundamental frequencies during a repeated CV utterance of /pi/ under normal and…

  17. Clinical aspects of type 1 posterior laryngeal clefts: literature review and a report of 31 patients.

    NARCIS (Netherlands)

    Doef, H.P. van der; Yntema, J.L.; Hoogen, F.J.A. van den; Marres, H.A.M.

    2007-01-01

    OBJECTIVES: The clinical relevance of posterior laryngeal clefts (PLCs) of type 1 has only recently been highlighted in the medical literature. We present a review of the literature and a report of a contributive series of 31 type 1 PLC patients. STUDY DESIGN AND METHODS: We performed a MEDLINE

  18. SU-E-T-809: Volumetric Modulated Arc Radiotherapy Vs. Intensity-Modulated Radiotherapy for Locally Advanced Laryngeal Carcinoma: A Dosimetric Study

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    Lu, J-Y; Huang, B-T; Zhang, W-Z; Yan, L-J [Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China)

    2015-06-15

    Purpose: To compare volumetric modulated arc radiotherapy (VMAT) technique with fixed-gantry intensity-modulated radiotherapy (IMRT) technique for locally advanced laryngeal carcinoma. Methods: CT datasets of eleven patients were included. Dual-arc VMAT and 7-field IMRT plans, which were created based on the Eclipse treatment planning system, were compared in terms of dose-volume parameters, conformity index (CI) and homogeneity index (HI) of planning target volume (PTV), as well as organ-at-risk (OAR) sparing, planning time, monitor units (MUs) and delivery time. Results: Compared with the IMRT plans, the VMAT plans provided lower D2% and better CI/HI for the high-risk PTV (PTV1), and provided better CI and comparable HI for the low-risk PTV (PTV2). Concerning the OAR sparing, the VMAT plans demonstrated significantly lower Dmax of the spinal cord (planning OAR volume, PRV) and brainstem (PRV), as well as lower Dmean and V30Gy of the right parotid. No significant differences were observed between the two plans concerning the doses delivered to the thyroid, carotid, oral cavity and left parotid. Moreover, the VMAT planning (147 ± 18 min) consumed 213% more time than the IMRT planning (48 ± 10 min). The MUs of the VMAT plans (556 ± 52) were 64% less than those of the IMRT plans (1684 ± 409), and the average delivery time (2.1 ± 0.1 min) was 66% less than that of the IMRT plans (6.3 ± 0.7 min). Conclusion: Compared with the IMRT technique, the VMAT technique can achieve superior target dose distribution and better sparing of the spinal cord, brainstem and right parotid, with less MUs and less delivery time. It is recommended for the radiotherapy of locally advanced laryngeal carcinoma.

  19. Assessment of human papilloma virus infection in adult laryngeal papilloma using a screening test.

    Science.gov (United States)

    Makiyama, Kiyoshi; Hirai, Ryoji; Matsuzaki, Hiroumi; Ikeda, Minoru

    2013-03-01

    Human papilloma virus (HPV) infection is involved in both juvenile and adult laryngeal papilloma. We wished to determine which types of adult laryngeal papilloma were clinically related to HPV infection. We hypothesized that multiple-site and recurrent papillomas would have a strong relationship to HPV and conducted the present study to test this hypothesis. Thirteen male patients with adult laryngeal papilloma who underwent resection of papilloma between August 2006 and September 2009 were studied. We examined the relationships between whether the tumor was solitary or multiple, presence or absence of recurrence after surgery, and HPV infection. High-risk HPV types (HPV-DNA types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) and low-risk HPV types (6, 11, 42, 43, and 44) were tested by a liquid-phase hybridization method. In addition, HPV typing was performed for patients positive for low-risk HPV types. Twenty patients with laryngeal carcinoma or laryngeal leukoplakia were enrolled as the control group. In the laryngeal papilloma group, all patients tested were negative for high-risk HPV and 69.2% were positive for low-risk HPV. Typing performed for seven of the patients who tested positive for low-risk HPV showed that one patient was positive for HPV-11, whereas the remaining six patients were positive for HPV-6. All patients with recurrent laryngeal papillomatosis (RLP) were positive for low-risk HPV. All patients who were positive for low-risk HPV had RLP. Tumor samples from repeat operations were positive for low-risk HPV in all patients tested. HPV was not detected in the control group. The relationship between RLP and low-risk HPV was strong, with all cases that were positive for low-risk HPV showing recurrence. Tumor tissue resected at the time of repeat surgery was positive for low-risk HPV in all cases tested. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  20. Fetal development of the human epiglottis revisited: appearance of GFAP-positive mesenchymal cells and fibrous connections with other laryngeal and lingual structures.

    Science.gov (United States)

    Katori, Yukio; Takeuchi, Hiromi; Rodríguez-Vázquez, Jose Francisco; Kitano, Hiroya; Murakami, Gen; Kawase, Tetsuaki

    2011-03-01

    The fetal anatomy of the human epiglottis has not yet been fully described. We investigated the histology (paraffin-embedding) of 18 mid-term fetuses at 7-25 weeks of gestation (three fetuses each at 7, 9, 12, 15, 20 and 25 weeks). A mesenchymal condensation of the epiglottic cartilage appears posterior and somewhat superior to the hyoid body at 9 weeks, but at 12 and 15 weeks, the root or inferior part descends to the level of the thyroid cartilage. The covering epithelium stains much darker with hematoxylin than other pharyngeal epithelia. After 20 weeks, the epiglottis again protrudes superiorly beyond the hyoid body. In contrast to other laryngeal cartilage anlagen, the mesenchymal condensation of the epiglottis begins to express glial fibrillary acidic protein (GFAP) at 15 weeks. At the same stage, mucosal glands begin invading into the epiglottic mesenchyme. The developing cartilage becomes penetrated and fragmented by abundant mucosal glands up until 25 weeks. The thyro-epiglottic ligament seems to develop from the GFAP-positive mesenchymal condensation, whereas the hyo-epiglottic ligament is likely to originate from the fasciae of lingual muscles. Epithelial-mesenchymal interaction is strongly suggested in the development of the epiglottic cartilage and concomitant glands.

  1. Diagnosis and management of type I posterior laryngeal clefts.

    Science.gov (United States)

    Bakthavachalam, Sivi; Schroeder, James W; Holinger, Lauren D

    2010-04-01

    We review the diagnosis and management of type I posterior laryngeal clefts (PLCs). We performed a retrospective study at a tertiary-care children's hospital of children who were diagnosed with a PLC between January 2003 and August 2008. We studied concurrent airway anomalies, comorbidities, presenting symptoms, age at the time of aspiration resolution, and rate of aspiration resolution. Sixty-seven children with PLCs were identified (41 boys and 26 girls). Fifty-nine had type I clefts, 6 had type II, and 2 had type III. Of the 59 type I cases, 15 (25.4%) were surgically repaired by endoscopy. Eleven of these 15 children (73.3%) have had symptomatic improvement since the surgery, and 7 of those 11 (63.6%) are tolerating thin liquids by mouth. Two of the 15 (13.3%) displayed no improvement with surgery, and 2 of the 15 (13.3%) were lost to follow-up. Forty-four of the 59 type I clefts (74.6%) were managed nonsurgically. Twenty of these 44 children (45.5%) did not present with aspiration. Twenty-four of the 44 (54.5%) presented with aspiration, and 16 of the 24 (66.7%) are now tolerating thin liquids by mouth. Seven of these 24 patients (29.2%) are still aspirating, and 1 has died. The average time to resolution of aspiration was 7.8 months for the surgical group and 13.6 months for the nonsurgical group (p = 0.19). In the surgical group, the average age at resolution of aspiration for patients who received their diagnosis at 0 to 6 months of age was 21.5 months; that for those with a diagnosis at 6 to 12 months was 27.3 months; and that for those with a diagnosis at older than 12 months was 27.3 months (p = 0.31). In the nonsurgical group, the average age at resolution of aspiration for patients who received their diagnosis at 0 to 12 months of age was 15.8 months; that for those with a diagnosis at 12 to 24 months was 27.3 months; and that for those with a diagnosis at older than 24 months was 77.3 months (p = 0.0015). We found that (1) the reported incidence of

  2. Sobredentadura total superior implantosoportada Superior total overdenture on implants

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    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  3. Upper Airway Obstruction Requiring Emergent Tracheostomy Secondary to Laryngeal Sarcoidosis: A Case Report.

    Science.gov (United States)

    Ryu, Changwan; Herzog, Erica L; Pan, Hongyi; Homer, Robert; Gulati, Mridu

    2017-02-13

    BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea. Laryngeal sarcoidosis was diagnosed three years previously, and she remained stable on low-dose prednisone until six months prior to admission, at which time she self-discontinued her prednisone for the homeopathic treatment Nopalea cactus juice. Her physical examination was concerning for impending respiratory failure as she presented with inspiratory stridor and hoarseness. Laryngoscopy showed a retroflexed epiglottis obstructing the glottis with edematous arytenoids and aryepiglottic folds. Otolaryngology performed an emergent tracheostomy to secure her airway and obtained epiglottic biopsies, which were consistent with sarcoidosis. She was eventually discharged home on prednisone 60 mg daily. Following months of corticosteroids, a laryngoscopy showed the epiglottis continuing to obstruct the glottis. The addition of methotrexate to a tapered dosage of prednisone 10 mg daily was unsuccessful, and she remains on prednisone 20 mg daily for disease control. CONCLUSIONS Laryngeal sarcoidosis, a rare extrapulmonary manifestation of sarcoidosis, uncommonly presents as the life-threatening complication of complete upper airway obstruction. As such, laryngeal sarcoidosis is associated with significant morbidity and mortality, requiring a high index of suspicion for timely diagnosis and treatment.

  4. Laryngeal reinnervation for paralytic dysphonia in children younger than 10 years.

    Science.gov (United States)

    Smith, Marshall E; Roy, Nelson; Houtz, Dan

    2012-12-01

    To study the effectiveness of ansa-recurrent laryngeal nerve laryngeal reinnervation to improve glottal incompetence causing dysphonia and dysphagia for children with unilateral vocal fold paralysis. DESIGN We reviewed a series of consecutive cases treated from January 1, 2006, through December 31, 2011. Otolaryngology division of a children's hospital. PATIENTS Thirteen children with unilateral vocal fold paralysis. Surgical complications, parent surrogate quality-of-life measures, global overall assessment of improvement, and auditory perceptual assessment. Thirteen children underwent laryngeal reinnervation. Ages ranged from 2.2 to 8.8 years (mean [SD] age, 5.3 [2.6] years). No major complications were identified. Nine children had preoperative and 6- to 12-month postoperative data on voice and swallowing. Mean parental global voice rating (0 indicates no voice; 100%, normal voice) changed from 43% (range, 20%-65%) preoperatively to 79% (range, 50%-100%) postoperatively. Regarding perceptual assessment, the mean GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) Rating Scale sum score (0 indicates normal voice; 15, profoundly abnormal voice) improved from 6.3 to 2.9. Parental assessment of dysphagia with liquids also improved for all children with preoperative symptoms and worsened for none. Our early experience suggests that ansa-recurrent laryngeal nerve laryngeal reinnervation is a safe and effective treatment for unilateral vocal fold paralysis with symptomatic dysphonia and dysphagia in young children. The procedure has advantages compared with other treatments. This option should be discussed with parents when the paralysis is identified. The child should be observed for several years in the event that voice and swallowing symptoms from glottal incompetence do not improve.

  5. Quality of life of patients with laryngeal cancer treated with radiotherapy

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    Ikeda, Hajime; Sawai, Yuka; Inoue, Toshihiko [Osaka Univ. (Japan). Biomedical Research Center; Matayoshi, Yoshinobu; Murayama, Shigeyuki; Kozuka, Takahiro

    1995-09-01

    Radiotherapy (RT) is considered as the best treatment for early laryngeal cancer in terms of survival and preservation of voice. Quality of life (QOL) must also be assessed after new treatments, such as laser treatment or laryngomicrosurgery. The QOL after RT was assessed in 61 patients (57 men and 4 women) with histologically proven laryngeal or hypopharyngeal cancer (glottis T1-2, 48 : supraglottis 11 : hypopharynx, 2). Cobalt-60 gamma rays were emitted via lateral opposed portals that included the glottis/larynx area. The delivered dose was 53 to 70 Gy/23 to 35 Fr (median, 60 Gy/30 Fr). Assessment was done by interview of physicians at periodic follow-up examinations of patients. The census period was June to December 1990. Patients` ages ranged from 37 to 82 years (median, 62 years) at treatment and 38 to 88 years (median, 68 years) at QOL assessment. Most patients enjoyed the similar daily activities and job status as before. Thirty-seven of 61 patients felt occasional hoarseness after RT, and 21 refrained from loud speech. All patients could use the telephone easily, except for one patient who had severe hearing loss. Many patients stopped smoking cigarettes, but most drank as before RT. There were no significant differences in lifestyle quality between less than and more than 5 years after RT. This QOL assessment is applicable to patients with laryngeal cancer. One half of patients treated by RT have symptoms compatible with chronic laryngitis. This study confirms that RT yields good QOL and voice quality for patients with laryngeal cancer. (author).

  6. Angled telescopic surgery, an approach for laryngeal diagnosis and surgery without suspension

    Directory of Open Access Journals (Sweden)

    Plínio Ferreira Morgado

    1999-09-01

    Full Text Available CONTEXT: Many methods have been used successfully for the diagnosis and treatment of laryngeal diseases. Microscopic and, recently, telescopic surgery represent the state of the art in endoscopic laryngeal surgery but drawbacks are possible during their application. To keep the suspension apparatus adequately positioned, excessive force is sometimes placed on the upper teeth and tongue with the laryngoscope tube causing damage. Complications in relation to the pharynx, larynx and cardiovascular system have also been reported. OBJECTIVE: In order to reduce complications resulting from the manipulation or stimulation of the upper aerodigestive tract and from torque forces on the upper teeth. We present a method of larynx surgery in which laryngeal suspension is not required. DESIGN: Technical report. TECHNIQUES: We have devised a fiber-optic telescope with its 40mm distal portion deviated 60 degrees from the direction of the proximal portion. This angle was taken by measuring patients immediately before standard microlaryngeal surgery was performed. The surgical instruments have the same angle as the telescope, in order to work on the larynx. This technique provides an image that is not limited by the distal aperture of the laryngoscope and has an advantage in that magnification and illumination may be provided by changing the distance of the lesion from the tip of the instrument. we have operated on four patients with laryngeal diseases and have had no complications as a result of this approach. We feel that this technique gives us the freedom to view the lesions better and helps to minimize the drawbacks caused by laryngeal suspension.

  7. ABO blood group is a predictor of survival in patients with laryngeal cancer.

    Science.gov (United States)

    Jin, Ting; Li, Pei-Jing; Chen, Xiao-Zhong; Hu, Wei-Han

    2016-10-13

    Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinicopathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis. We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat-sen University Cancer Center between January 1993 and December 2009. The Chi-square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan-Meier method was used to estimate 3-, 5-, and 10-year overall survival (OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS. No significant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3-, 5-, and 10-year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had significant effects on prognosis in patients with laryngeal cancer. The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had significantly shorter OS than patients with other ABO blood groups.

  8. Coblation plus photodynamic therapy (PDT) for the treatment of juvenile onset laryngeal papillomatosis: case reports.

    Science.gov (United States)

    Zhou, Chengyong; Sun, Baochun; Wang, Feng; Dai, Zhiyao; Han, Zeli; Han, Jiahong; Chen, Maomao; Shen, Yao

    2014-08-29

    In treating juvenile-onset laryngeal papillomatosis, the most difficult aspect is preventing recurrence. After a single treatment, recurrence can begin after as soon as 20 days and the recurrent rate can be higher than 90%. The causes of recurrence include the presence of mucosal cells infected with papilloma virus, which are undetectable with the naked eyes, and surgery-induced infection. Photodynamic therapy (PDT) could effectively solve this problem. Virus-infected cells have a very high metabolic energy for capturing and internalizing the photosensitizer, which, after light stimulation, subsequently induces active oxygen species inside the nucleus, which kill infected cells. The second generation of photosensitizer agents (PA) are locally applied to avoid the intravenous systemic damage caused by first-generation PAs, and this method is widely used for the treatment of genital warts to very good effect. We used the photodynamic method to treat laryngeal papillomatosis in children and obtained significant efficacy. We followed three juvenile subjects with recurrent laryngeal papillomatosis through a course of treatment (each course includes three PDT sessions), with a follow-up after 6 months. The characteristic procedures involve exposing the larynx with a laryngoscope and using low-temperature plasma technology to visualize the tumor resection, as the effects of plasma technology can reduce postoperative laryngeal edema and reduce intraoperative metastasis. PDT was performed during the first surgery, 20 days after and 30 days after surgery. At the 6-month follow-ups, there was no recurrence. This was the world's first successful reported case of the use of PDT treatment for juvenile laryngeal papillomatosis.

  9. Vocal power and pressure-flow relationships in excised tiger larynges.

    Science.gov (United States)

    Titze, Ingo R; Fitch, W Tecumseh; Hunter, Eric J; Alipour, Fariborz; Montequin, Douglas; Armstrong, Douglas L; McGee, Joann; Walsh, Edward J

    2010-11-15

    Despite the functional importance of loud, low-pitched vocalizations in big cats of the genus Panthera, little is known about the physics and physiology of the mechanisms producing such calls. We investigated laryngeal sound production in the laboratory using an excised-larynx setup combined with sound-level measurements and pressure-flow instrumentation. The larynges of five tigers (three Siberian or Amur, one generic non-pedigreed tiger with Bengal ancestry and one Sumatran), which had died of natural causes, were provided by Omaha's Henry Doorly Zoo over a five-year period. Anatomical investigation indicated the presence of both a rigid cartilaginous plate in the arytenoid portion of the glottis, and a vocal fold fused with a ventricular fold. Both of these features have been confusingly termed 'vocal pads' in the previous literature. We successfully induced phonation in all of these larynges. Our results showed that aerodynamic power in the glottis was of the order of 1.0 W for all specimens, acoustic power radiated (without a vocal tract) was of the order of 0.1 mW, and fundamental frequency ranged between 20 and 100 Hz when a lung pressure in the range of 0-2.0 kPa was applied. The mean glottal airflow increased to the order of 1.0 l s(-1) per 1.0 kPa of pressure, which is predictable from scaling human and canine larynges by glottal length and vibrational amplitude. Phonation threshold pressure was remarkably low, on the order of 0.3 kPa, which is lower than for human and canine larynges phonated without a vocal tract. Our results indicate that a vocal fold length approximately three times greater than that of humans is predictive of the low fundamental frequency, and the extraordinarily flat and broad medial surface of the vocal folds is predictive of the low phonation threshold pressure.

  10. Parathyroid gland autotransplantation after total thyroidectomy in surgical management of hypopharyngeal and laryngeal carcinomas: A case series

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    Abd Elmaksoud M. Abd Elmaksoud

    2015-06-01

    Conclusions: Parathyroid gland autotranplantation is a simple safe technique with high success rate in preventing persistent hypoparathyroidism after total thyroidectomy in surgical management of advanced hypopharyngeal and laryngeal carcinomas.

  11. Application of primary cell cultures of laryngeal carcinoma and laser scanning cytometry in the evaluation of tumor reactivity to cisplatinum.

    Directory of Open Access Journals (Sweden)

    Krzysztof Kupisz

    2008-06-01

    Full Text Available Unsatisfactory effects of treatment of laryngeal carcinoma patients stimulate the clinicians as well as researchers to develop new more effective treatment models and to find new reliable prognostic factors. The aim of the present study was the evaluation of the use of primary cell cultures of the laryngeal carcinoma and laser scanning cytometry (LSC in the assessment of tumor reactivity to cisplatinum. Nineteen primary cultures of laryngeal carcinoma cells established from fragments of laryngeal carcinoma infiltrations were cultured with or without cisplatin, stained with monoclonal antibodies against P53 and BCL-2 proteins and analyzed by LSC. Cisplatin added to the culture medium leads to the significant increase of P53 expression and decrease of BCL-2 expression. Moreover, changes of P53 and BCL-2 expressions were significantly correlated. Our findings of apoptosis regulatory mechanisms could be useful in patient qualification for the chemotherapeutic follow-up treatment.

  12. Identification of radioresistance-related molecules in laryngeal cancer cells using proteomic and EST data mining approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Sung; Hong, Eun Hee; Yoon, Hong Sik; Yang, Kyung Mi; Hwang, Sang Gu [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2009-05-15

    Laryngeal cancer is the largest subgroup of head and neck cancer which is the sixth most prevalent cancer in the world. Radiotherapy is known as a major treatment modality of laryngeal caner in conjunction with surgery and chemotherapy. Clinical radiotherapy is generally based on the treatment of fractionated radiation (commonly 2 Gy daily to total 60-70 Gy) to the cancer. This chronic treatment can trigger tumor-adaptive radioresistance contributing cancer recurrence following radiotherapy. Unfortunately, approximately 15 % of laryngeal cancers after radiotherapy acquire radioresistance. However, little is known about the molecular markers and mechanisms underlying tumor-adaptive radioresistance. In the present study, we established the radioresistant model system using HEp-2 cell line and identified radioresistance-related molecules by using the analysis of laryngeal cancer expressed sequence tag (EST) data bases and two-dimensional polyacrylamide gel electrophoresis (2D-PAGE)

  13. Occupational asbestos exposure and risk of pleural mesothelioma, lung cancer, and laryngeal cancer in the prospective netherlands cohort study

    NARCIS (Netherlands)

    Offermans, N.S.M.; Vermeulen, R.; Burdorf, A.; Goldbohm, R.A.; Kauppinen, T.; Kromhout, H.; Brandt, P.A. van den

    2014-01-01

    OBJECTIVE:: To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and smoking.

  14. Occupational asbestos exposure and risk of pleural mesothelioma, lung cancer, and laryngeal cancer in the prospective Netherlands cohort study

    NARCIS (Netherlands)

    Offermans, Nadine S M; Vermeulen, Roel|info:eu-repo/dai/nl/216532620; Burdorf, Alex; Goldbohm, R Alexandra; Kauppinen, Timo; Kromhout, Hans|info:eu-repo/dai/nl/074385224; van den Brandt, Piet a

    2014-01-01

    OBJECTIVE: To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and

  15. Occupational asbestos exposure and risk of pleural mesothelioma, lung cancer, and laryngeal cancer in the prospective netherlands cohort study

    NARCIS (Netherlands)

    Offermans, N.S.M.; Vermeulen, R.; Burdorf, A.; Goldbohm, R.A.; Kauppinen, T.; Kromhout, H.; Brandt, P.A. van den

    2014-01-01

    OBJECTIVE:: To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and smoking.

  16. 改良Proseal喉罩与改良普通喉罩在无痛纤维支气管镜检查中的气道管理%Comparison of modified Proseal laryngeal mask and three-way laryngeal mask airway for painless fiberoptic bronchoscopy in airway management in effect

    Institute of Scientific and Technical Information of China (English)

    王绍林; 张进; 张鹏; 殷骏; 俞蕾; 何磊; 程庆余; 刘小彬

    2012-01-01

    Objective To compare the effects of airway management with modified Proseal laryngeal mask airway and modified laryngeal mask airway in painless fiberoptic bronchoscopy. Methods Forty patients who scheduled for painless fiheroptic bronechscopy were randomly divided into two groups (n = 20): Modified Proseal laryngeal mask airway group (group P) and modified laryngeal mask airway group (group L). After induction of general anesthesia were inserted with hands. BP, HR and SpO2 were measured respectively before anesthesia laryngeal mask airway (To), immediately after inserting laryngeal mask airway (T1 ) and 3 min (T2). The laryngeal mask airway insertion time, complications, the ventilated assessment, fiberoptic bronchoscopy assessed and airway sealing pressure were also simultaneously recorded. Results There was no significant difference in laryngeal mask airway insertion time, BP. HR and SpO2 at each point Airway sealing pressure in group P was significantly higher than that in group L (P<0. 01). The excellent rates of ventilated assessment and fiberoptic bronchoscopy scores were both 100% in group P, and were much higher than those in group L (85%, 80% respectively F<0. 01). Blood staining in group P was less than that in group L (1 vs. 7 cases, respectively P<0. 05). Conclusion The modified Proseal laryngeal mask is better than modified laryngeal mask airway at the aspects of gas-tightness, assessment of ventilation and fiberoptic bronchoscopy. but no effects on hemodynamics in two groups.Objective To compare the effects of airway management with modified Proseal laryngeal mask airway and modified laryngeal mask airway in painless fiberoptic bronchoscopy. Methods Forty patients who scheduled for painless fiheroptic bronechscopy were randomly divided into two groups (n = 20): Modified Proseal laryngeal mask airway group (group P) and modified laryngeal mask airway group (group L). After induction of general anesthesia were inserted with hands. BP, HR and SpO2 were

  17. Paso superior en una ladera

    Directory of Open Access Journals (Sweden)

    Bender, O.

    1965-07-01

    Full Text Available The Redwood highway, through the Californian forest, runs on a viaduct, as it crosses a mountain slope of about 45° inclination. The firm ground is fairly deep, and as an additional constructional difficulty, it was necessary to respect the natural beauty of the countryside. A structure of portal frames were built, forming a number of short spans. These spans were bridged with metal girders, on which a 19 m wide deck was placed. The columns are hollow and have a transversal cross beam, to join each pair. There was difficulty in excavating the foundations for the columns, as it was necessary to dig through the soft top soil, and also prevent this soil from hurting the trunks of the forest trees. Another significant difficulty in the construction of this viaduct was the access to the working site, since there were no suitable platforms from which to operate the appropriate machinery. This made it necessary to do a lot of the work by manual operation. As one of the edges of the deck is very close to the mountain side, a supporting beam was erected on this side. It was made of concrete, on metal piles. The formwork for the deck structure was placed on the concrete stems of the supporting piles.La autopista denominada Redwood (California salva, con un paso superior, la ladera de un bosque cuya pendiente es del 1/1. El terreno firme se halla a bastante profundidad, añadiéndose, a los naturales problemas de la construcción, el imperativo de respetar la belleza agreste del paraje. La solución adoptada consiste en una estructura porticada, con varios tramos de pequeñas luces, salvados con vigas metálicas, sobre los que se coloca la losa del tablero, de 19 m de anchura total. Los soportes están constituidos por pórticos de dos montantes huecos (con bases de hormigón en masa por debajo del suelo, hasta el firme coronados por un cabezal. La perforación de pozos para el hormigonado de los montantes presentaba la dificultad de atravesar el terreno

  18. Potential anti-inflammatory effect of low-level laser therapy on the experimental reflux laryngitis: a preliminary study.

    Science.gov (United States)

    Marinho, Renata R; Matos, Renata M; Santos, Jandson S; Ribeiro, Maria A G; Ribeiro, Ronaldo A; Lima, Roberto C P; Albuquerque, Ricardo L C; Thomazzi, Sara M

    2014-01-01

    The most common cause of laryngitis is the laryngopharyngeal reflux disease. The symptoms of laryngitis can be hoarseness, globus, chronic cough, voice fatigue, throat pain, and dysphagia. Low-level laser therapy (LLLT) is beneficial to reduce the pain and inflammatory response without side effects. Therefore, LLLT may be a useful tool for the treatment of laryngitis. This study proposes to analyze the effect of laser therapy in a model of reflux-induced laryngitis. The animals were randomly put into three groups: control--non-intubated; nasogastric intubation--intubated; and nasogastric intubation with laser therapy-intubated treated with 105-J/cm(2) laser irradiation. For the induction of laryngitis, the animals were anesthetized and a nasogastric tube was inserted through the nasopharynx until it reached the stomach, for 1 week. Thereafter, measurement of myeloperoxidase activity and the histopathological procedures were performed. In conclusion, we observed in this study that 105-J/cm(2) infrared laser reduced the influx of neutrophils in rats, and it improved the reparative collagenization of the laryngeal tissues.

  19. DETECTION OF HUMAN PAPILLOMAVIRUS L1 -16 AND -18 DNA AND EPSTEIN-BARR VIRUS DNA IN LARYNGEAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    LIU Bao-guo; Wang Jian-jun; Ke Yang; Lu Zhe-ming; Li Yong; Jiang Hai-rong; Liao Fei; Peng Fang-yi; Rao Xiao-song; Chen Rong-rui; ZHANG Nai-song

    2005-01-01

    Objective: To look for the further evidence for HPV L1 HPV16 E6, HPV 18 E6 and EBV as carcinogenic factors in laryngeal carcinoma. Method: we examined representative numbers of specimens from laryngeal cancer with highly sensitive PCR technique for the presence of HPV L1 and high-risk types HPV16 E6, HPV18 E6 and EBV LMP1. Results: Using PCR detection, 7.3% samples were HPV L1 positive, 52.03% were HPV16 E6 positive, 30.89% were HPV18 E6 positive and 9.13% were EBV LMP1 positive. The low incidence of HPV L1 and high incidence of HPV-16 E6 and HPV18 E6 genes suggest that HPV might be integrated into tumor cells. Our results support a role of HPV-16 and HPV-18 infection in the pathogenesis of laryngeal carcinoma in China. Conclusion: Integration of E6 into host genome and stable expression of these genes may be associated with the carcinogenesis of laryngeal carcinoma. HPV-16 and HPV-18 may synergistically function on the pathogenesis of laryngeal carcinoma. Our results suggest an association of laryngeal carcinogenesis and infection with the high-risk HPV types 16, HPV 18 and EBV.

  20. Pseudodisplacements of superior vena cava catheter in the persistent left superior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Jantsch, H.; Draxler, V.; Muhar, U.; Schlemmer, M.; Waneck, R.

    1983-01-01

    Pseudodisplacement of a left sided superior vena cava catheter in a persistent superior vena cava may be expected in adults in 0,37% and in a group of children with congenital heart disease in 2,5%. Embryology, anatomy and clinical implications is discussed on the basis of our own cases. The vena cava superior sinistra persitents is depending on a sufficient calibre a suitable vessel for a superior cava catheter.

  1. Clinical analysis on emergent laryngeal reconstruction surgery for cases with open laryngeal trauma%开放性喉外伤急诊喉重建手术及临床分析

    Institute of Scientific and Technical Information of China (English)

    石达; 王虎; 江月成; 罗将

    2016-01-01

    Objective To investigate the better procedures for definite diagnosis and emergent treatment by laryngeal reconstruction surgery for cases with open laryngeal trauma based on a clinical trial. Methods A retrospective study was made among 17 cases with open laryngeal trauma, treated by emergency laryngeal reconstruction surgery in our Hospital. Carefully analyzed were their clinical data to sum up clinical features of such a condition and our experience with definite diagnosis and emergent treatment for it. Results All these 17 cases received emergent laryngeal reconstruction operation. During the following up period, it was found that 12 cases had their pronunciation function recovered to normal status. There were 2 cases presented with pharyngeal fistula, 1 case with tracheoesophageal fistula and 1 with laryngeal stenosis. Followed appropriate treatment for such conditions, fistula was healed, with no hoarse left, and laryngeal stenosis cured by reoperation, but still showing some degree of hoarse postoperatively. However, there was one case died of severe condition of laryngeal injury in this group of cases. Conclusion During the period of emergency for cases with open laryngeal trauma, one of the most important things is to reserve, or recover, patient's laryngeal function as maximized as possible and to prevent complications from occurring.%目的:探讨开放性喉外伤的准确诊断与急诊处理方法。方法回顾性分析开放性喉外伤急诊患者17例的临床诊疗资料,总结其临床特点及诊疗经验。结果17例患者均采用了急诊重建手术。术后12例发音恢复正常;2例发生术后咽瘘,1例发生术后气管食管瘘,经进一步处理后瘘道均愈合,无声音嘶哑;1例术后发生喉狭窄,再次手术后喉狭窄治愈,单遗留术后声音嘶哑;1例患者因伤势过重而死亡。结论在开放性喉外伤的急诊期即应尽抢救,最大限度保留或恢复喉功能,防止并发症。

  2. The primary growth of laryngeal squamous cell carcinoma cells in vitro is effectively supported by paired cancer-associated fibroblasts alone.

    Science.gov (United States)

    Wang, Mei; Wu, Chunping; Guo, Yu; Cao, Xiaojuan; Zheng, Wenwei; Fan, Guo-Kang

    2017-05-01

    Most primarily cultured laryngeal squamous cell carcinoma cells are difficult to propagate in vitro and have a low survival rate. However, in our previous work to establish a laryngeal squamous cell carcinoma cell line, we found that laryngeal cancer-associated fibroblasts appeared to strongly inhibit the apoptosis of primarily cultured laryngeal squamous cell carcinoma cells in vitro. In this study, we investigated whether paired laryngeal cancer-associated fibroblasts alone can effectively support the growth of primarily cultured laryngeal squamous cell carcinoma cells in vitro. In all, 29 laryngeal squamous cell carcinoma specimens were collected and primarily cultured. The laryngeal squamous cell carcinoma cells were separated from cancer-associated fibroblasts by differential trypsinization and continuously subcultured. Morphological changes of the cultured laryngeal squamous cell carcinoma cells were observed. Immunocytofluorescence was used to authenticate the identity of the cancer-associated fibroblasts and laryngeal squamous cell carcinoma cells. Flow cytometry was used to quantify the proportion of apoptotic cells. Western blot was used to detect the protein levels of caspase-3. Enzyme-linked immunosorbent assay was used to detect the levels of chemokine (C-X-C motif) ligand 12, chemokine (C-X-C motif) ligand 7, hepatocyte growth factor, and fibroblast growth factor 1 in the supernatants of the laryngeal squamous cell carcinoma and control cells. AMD3100 (a chemokine (C-X-C motif) receptor 4 antagonist) and an anti-chemokine (C-X-C motif) ligand 7 antibody were used to block the tumor-supporting capacity of cancer-associated fibroblasts. Significant apoptotic changes were detected in the morphology of laryngeal squamous cell carcinoma cells detached from cancer-associated fibroblasts. The percentage of apoptotic laryngeal squamous cell carcinoma cells and the protein levels of caspase-3 increased gradually in subsequent subcultures. In contrast, no

  3. Apropos of a case of cutaneous metastasis from laryngeal cancer with review of literature

    Directory of Open Access Journals (Sweden)

    Romeeta Trehan

    2015-01-01

    Full Text Available Cutaneous metastasis from laryngeal carcinoma is a rare occurrence. A 55-year-old male patient with supraglottic cancer was treated with concurrent chemoradiation. Eighteen months later, he presented with ulceroproliferative growth on dorsum of the right hand. Biopsy revealed metastatic squamous cell carcinoma. Further investigations revealed underlying bone destruction with lung metastasis. In view of poor general condition and widespread dissemination of disease, palliative radiotherapy was delivered to the hand of the patient. He achieved satisfactory palliation in form of pain relief, control of bleeding, and discharge. The present report serves to emphasize the importance of properly diagnosing metastatic spread to unusual sites. Such metastasis is rare and is associated with a poor prognosis. Treatment is usually aimed at providing pain relief in these patients with limited life expectancy. Hence, we present a case of extensive cutaneous metastasis from laryngeal carcinoma with review of the literature.

  4. Experience of monitoring the recurrent laryngeal nerve in thyroid surgery with endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Liang Feng

    2017-01-01

    Full Text Available Purpose:To analysis clinical experience of applying recurrent laryngeal monitoring endotracheal tube (NIM EMG Endotracheal Tube in the surgery of thyroid. Method: A retrospective analysis of 84 patients who underwent endotracheal intubation laryngeal nerve monitoring by thyroid surgery in the Chinese-Japanese Friendship Hospital of Jilin University from March to December in 2015. To summarize the experience of intubation with NIM EMG Endotracheal Tube. Result 77 (91.7%had initial intubation achievement in the 84 patients.FROM the 77 cases we had gotten s atisfactory nerve monitoring signal.Whereas there are 7 cases (8.3% appear abnormal EMG or signal missing, in the 7 cases there is one which being intubated too deep, 3 cases which being intubated too shallow and 3 cases with malrotation intubation.Conclusion: We got the satisfactory signals after adjust1ing the tube by using the visual laryngoscope.

  5. [Intelligent system to perform a diagnostic protocol for lymphatic invasion in laryngeal cancer].

    Science.gov (United States)

    Zapater, E; Moreno, S; Armengot, M; Campos, A; Taleb, C; Alba, J R; Basterra, J

    2002-11-01

    Laryngeal carcinoma is the most frequent malignant tumour in head and neck. Node invasion is known to be one of the most important prognostic factors. The aim of this study has been to design an intelligent system to perform a diagnostic algorithm of metastasic neck nodes. 122 clinical reports of patients diagnosed of laryngeal carcinoma in our department have been reviewed. The compiled data have been: tumor site, T stage, N stage (clinical, after CT scan and post-surgery). The method used to design the intelligent system has been the ID3, which is able to generate a minimal decision tree. Palpation has been the variable that has given more information about node invasion. CT has proved to be more efficient in supraglottic tumours. ID3 method has shown to be useful in performing diagnostic algorithms, specially when the number of cases and diagnostic tests are high.

  6. [Laryngitis epidemic (893 cases of acute laryngotracheitis and spastic croup). II. Clinical, diagnostic and therapeutic aspects].

    Science.gov (United States)

    González de Dios, J; Ramos Lizana, J; López López, C

    1990-05-01

    We retrospectively review 893 cases of children, occurred in epidemic bout in September-October 1987, in order to study the usual management of his pathology in our hospital. In most cases (82.3%) diagnose was laryngitis or acute laryngitis without specification acute laryngotracheitis or spasmodic group. Epiglottitis was no detected in any case. Complementary tests were performed only in 5% of the patients, but they were of little help for the diagnose. Treatment applied was ambiental hummidiffication (95.5%), followed by water and alcohol impregned neck collar (87.2%), rectal magnesium-sulfate + papaverine (67.5%), epinephrine nebulization (63%), antibiotics (44.3%), steroids (9%), bronchodilatadors (4.8%). This therapeutic approach is discussed.

  7. Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods: Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0.75% pure bupivacaine (8-12 mg) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results: The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ. Obturator nerve reflex was observed in 15 (50.0%) patients in Group Ⅰ, but none (0%) in Group Ⅱ (P<0.01). Conclusion: Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

  8. Cortactin is associated with perineural invasion in the deep invasive front area of laryngeal carcinomas

    DEFF Research Database (Denmark)

    Ambrosio, Eliane Papa; Rosa, Fabíola Encinas; Domingues, Maria Aparecida Custódio;

    2011-01-01

    . The transcript expression levels were evaluated in a subset of cases. Overexpression of CTTN cytoplasmatic protein (80% of cases in both the deep invasive front and superficial areas) and transcript (30% of samples) was detected in a significant number of cases. In more than 20% of cases, observation verified...... of CTTN in the deep invasive front showed good prognosis parameters, and a second group with moderate to strong expression of CTTN were associated with an unfavorable prognosis, suggesting an association with worse outcome. Taken together, these results suggest that the deep invasive front might...... be considered a grading system in laryngeal carcinomas and that cortactin is a putative marker of worse outcome in the deep invasive front of laryngeal carcinomas....

  9. PCNA--a cell proliferation marker in vocal chord cancer. Part I: Premalignant laryngeal lesions.

    Science.gov (United States)

    Pignataro, L D; Broich, G; Lavezzi, A M; Biondo, B; Ottaviani, F

    1995-01-01

    Laryngeal hyperkeratotic lesions can progress to fully developed malignant carcinoma in some cases. These premalignant lesions are proliferative disorders whose potential for further tumour progression is perhaps difficult to assess by mere histology. Immunostaining with PCNA, a protein correlated with cell proliferation, has been used to study tissue behavior in 30 cases of premalignant laryngeal vocal chord lesions treated by epithelial stripping in microlaryngoscopy, 15 of whom had no progression and 15 had recurrence and final development of full malignancy. The results showed a statistically significantly higher PCNA-index in the cases which underwent further tumour progression towards malignancy. PCNA testing may thus be suggested as a marker for tumour progression potential and help in determining clinical treatment choices.

  10. Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma.

    Science.gov (United States)

    Arslanoğlu, Seçil; Eren, Erdem; Özkul, Yılmaz; Ciğer, Ejder; Kopar, Aylin; Önal, Kazım; Etit, Demet; Tütüncü, G Yazgı

    2016-02-01

    The objective of this study was to determine the incidence of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma; and the association between clinicopathological parameters and thyroid gland invasion. Medical records of 75 patients with laryngeal and hypopharyngeal squamous cell carcinoma who underwent total laryngectomy with thyroidectomy were reviewed, retrospectively. Preoperative computed tomography scans, clinical and operative findings, and histopathological data of the specimens were evaluated. There were 73 male and two female patients with an age range of 41-88 years (mean 60.4 years). Hemithyroidectomy was performed in 62 (82.7 %) and total thyroidectomy was performed in 13 patients (17.3 %). Four patients had histopathologically proven thyroid gland invasion (5.3 %). In three patients, thyroid gland involvement was by means of direct invasion. Thyroid gland invasion was significantly correlated with thyroid cartilage invasion. Therefore, prophylactic thyroidectomy should not be a part of the treatment policy for these tumors.

  11. Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

    Science.gov (United States)

    Wellenstein, David J; Schutte, Henrieke W; Takes, Robert P; Honings, Jimmie; Marres, Henri A M; Burns, James A; van den Broek, Guido B

    2017-09-18

    Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. Review of literature on office-based procedures in laryngology and head and neck oncology. Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process. Copyright © 2017 The Voice Foundation. All rights reserved.

  12. [Diagnosis and management of laryngeal verrucous carcinoma (case report in one patient and literature review)].

    Science.gov (United States)

    Lv, Dan; Yang, Hui; Zhu, Yuanzhi; Liu, Shixi

    2013-05-01

    To investigate the clinical, pathological character and differential diagnosis of laryngeal verrucous carcinoma. Clinical data of one case with laryngeal verrucous carcinoma in our hospital were retrospectively analyzed. The diagnosis of verrucous carcinoma was difficult and depend on repeated biopsy. Verrucous carcinoma of larynx is a highly differentiated variant of squamous carcinoma that has peculiar clinical and morphological features. The basement membrane is not invaded. It is prone to distant metastasis, than to local recurrence. The case underwent the partial laryngectomy, and was followed up for more than 4 years with no recurrence. Verrucous carcinoma of the larynx is a special pattern of the well-differentiated squamous cancer. A correct diagnosis requires close cooperation between the laryngologist and the pathologist. The main treatment of verrucous carcinoma is complete surgical excision to reserve larynx function as far as possible and improve the quality of life.

  13. Basaloid Squamous Cell Carcinoma: An Unusual Ball-Valve Laryngeal Obstruction

    Directory of Open Access Journals (Sweden)

    Sien Hui Tan

    2015-05-01

    Full Text Available Introduction: A rare case of basaloid squamous cell carcinoma (BSCC of the larynx, which has not been previously reported, is described. Case Report: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords.   Conclusion:  Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

  14. Superiority in value and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    James Griffin has considered a weak form of superiority in value a possible remedy to the Repugnant Conclusion. In this paper, I demonstrate that, in a context where value is additive, this weaker form collapses into a stronger form of superiority. And in a context where value is non-additive, weak...... superiority does not amount to a radical value difference at all. I then spell out the consequences of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest....

  15. Progress of laryngeal cartilage dysplasia%喉软骨发育不良的研究进展

    Institute of Scientific and Technical Information of China (English)

    庞爽; 李娜(综述); 穆亚平(审校)

    2015-01-01

    喉软骨发育不良又称先天性喉软骨软化症或先天性喉喘鸣,是临床比较常见的婴幼儿喉部疾病,常表现为由于喉或气管发生阻塞,患者用力呼吸时,气流通过喉或气管狭窄处发出特殊声音,即喉喘鸣。阻塞的原因可以是气道管腔内,也可以是外压性。气道阻塞部位可位于鼻、咽、喉及气管。临床上多种疾病可引起喉喘鸣,如先天性喉喘鸣、急性喉炎或急性喉气管支气管炎、呼吸道异物、先天性喉狭窄及喉蹼等。该文就喉软骨发育不良的病因、病理、临床表现、诊断及治疗等进行综述。%Laryngeal cartilage dysplasia,also known as congenital laryngeal cartilage softening or con-genital laryngeal stridor,a clinical common laryngeal disease in infant. It is often shown as airflow makes special sound through larynx or tracheal stenosis,also known as laryngeal stridor. Obstruction can be caused by airway lumen or external pressure. Airway obstruction position can be located in the nose,pharynx and larynx and tra-chea. Laryngeal stridor can be caused by many diseases,such as congenital laryngeal stridor,acute laryngeal,or acute laryngotracheobronchitis,respiratory tract foreign bodies,congenital laryngeal stenosis and laryngeal web, etc. The pathogenesis,pathology,clinical manifestation,diagnosis and treatment are reviewed.

  16. Leishmaniosis laríngea recidivante: un caso inusual en un paciente inmunocompetente tratado con corticoides Recidivant laryngeal leishmaniosis: an unusual case in an immunocompetent patient treated with corticosteroids

    Directory of Open Access Journals (Sweden)

    R. Casero

    2010-06-01

    Full Text Available La leishmaniosis es una parasitosis de evolución crónica; en Argentina, sus agentes etiológicos principales pertenecen al complejo Leishmania (Viannia braziliensis, habitualmente asociado a lesiones cutáneas y mucocutáneas. Informamos en este trabajo un caso de leishmaniosis laríngea en un hombre de 29 años procedente de Jujuy, quien a raíz de múltiples subdiagnósticos portaba esta parasitosis desde hacía 20 años. En el año 2008 este paciente consulta por disfonía crónica y trastornos en las vías aéreas superiores, refiere que fue sometido a terapias con tuberculostáticos, antifúngicos y corticoides desde 2002. Diferentes biopsias y fibroscopías revelaron los siguientes diagnósticos: laringitis granulomatosa inespecífica, laringitis compatible con tuberculosis, laringitis compatible con histoplasmosis, linfoma Natural Killer extraganglionar a células pequeñas. Finalmente, estudios realizados en nuestro hospital demostraron la presencia de una laringe granulomatosa en toda su extensión, amastigotes intra y extracelulares de Leishmania spp., ausencia de formas compatibles con Micobacterias e Histoplasma, y laringitis crónica vinculable a Leishmania spp. El paciente realizó tratamiento con antimoniato de N-metil-glucamina y demostró una muy buena evolución clínica tras ser examinado 2 meses después. Si bien la leishmaniosis laríngea como lesión única no es la presentación prevalente de esta zoonosis, su estudio amerita especial atención en pacientes tratados con corticoides, pues esto evitará un diagnóstico tardío y las mayores consecuencias asociadas a la morbimortalidad propia de esta parasitosis.Leishmaniosis is a chronic parasitic disease, which in Argentina is mainly caused by protozoa belonging to the Leishmania (Viannia braziliensis complex, leading to cutaneous and mucosal pathologies. We report a rare case of laryngeal leishmaniosis in a 29 year-old man from Jujuy province, Argentina, who had been

  17. Prognostic role of tumor volume for radiotherapy outcome in patient with T2 laryngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rutkowski, T.; Wygoda, A.; Skladowski, K.; Rutkowski, R.; Maciejewski, B. [Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice (Poland). Dept. of Radiation Oncology; Hejduk, B. [Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice (Poland). Dept. of Radiodiagnostic; Kolosza, Z. [Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice (Poland). Dept. of Epidemiology

    2013-10-15

    Background and purpose: Tumor volume (TV) is recognized as a prognostic factor of treatment outcome for head and neck tumors but is not routinely included in the treatment decision-making process. The purpose of the study was to define its prognostic role for patients with T2 laryngeal cancer. Material and methods: TV of 160 patients who underwent RT between 2002 and 2006 for T2 laryngeal squamous cell carcinoma were reviewed. The tumor was located in the glottis and epiglottis in 82 (51 %) and 78 (49 %) patients, respectively. TV was manually contoured on pretreatment, planning, contrast-enhanced CT scans and the volumetric measurement (cm{sup 3}) was calculated by the volume algorithm. Results: The median TV value was 2.01 cm{sup 3} (range 0.15-21.68 cm{sup 3}). The median TV was significantly lower in patients with glottic tumors (p < 0.0001), N0 (p < 0.001), or well histopatologically differentiated tumors (p = 0.01). A significant correlation between TV, hemoglobin concentration (p < 0.01), and total dose (TD; p < 0.001) was observed. On univariate analyses, TV influenced local control (LC; p = 0.02) and overall survival (OS, p < 0.001). On multivariate analysis, both age (HR 1.038, p = 0.03) and TV (HR = 1.075, p = 0.01) remained significantly related to LC and OS (age: HR 1.038, p = 0.005; TV: HR 1.097, p = 0.0001). Conclusion: Large TV worsen prognosis of patients with T2 laryngeal cancer. A large TV is more common for supraglottic, poorly differentiated tumors and may suggest higher risk of nodal spread. The routine estimation of TV prior to therapy may be essential in order to select the best treatment option for patients with T2 laryngeal cancer. (orig.)

  18. Atraumatic intubation: experience using a 5.0 endotracheal tube without a stylet for laryngeal surgery.

    Science.gov (United States)

    Moore, Jaime E; Hu, Amanda; Rutt, Amy; Green, Parmis; Hawkshaw, Mary; Sataloff, Robert T

    2015-02-01

    Vocal fold injury is a well-know complication of intubation, with rates reported as high as 69%. Laryngology textbooks recommend the use of a small endotracheal tube (ETT) to help avoid these complications and optimize visualization. Case reports have suggested that the rigid stylet can lead to laryngeal injury. Given the additional risks, intubation without the stylet is our preferred practice. There is limited documentation in the literature regarding this viewpoint. Our study investigated the feasibility of and potential barriers to intubation using 5.0 ETT without a stylet. Prospective study. Consecutive adult patients undergoing laryngeal surgery were recruited for intubation with a 5.0 ETT without a stylet. Demographic data, specialty and training level of the intubator, and factors that would predict a difficult intubation were recorded. Descriptive statistical analysis was performed. Findings of the participants (n = 67) included average American Society of Anesthesiologists (ASA) physical status classification (2.2), average Mallampati score (1.7), average Cormack-Lehane grade (1.5), and average body mass index (28.0). Five patients (7.4%) required intubation using a stylet, and one of these five participants was intubated initially with a stylet. Of these five participants, 80% required use of a GlideScope (P intubation attempts (P = .042). One patient sustained an oropharyngeal injury during intubation with a stylet. No participants had laryngeal injury. Most patients can be intubated successfully using a 5.0 ETT without a stylet. There were no cases of laryngeal trauma with this technique. 2b. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Laryngo-tracheal ultrasonography to confirm correct endotracheal tube and laryngeal mask airway placement

    OpenAIRE

    Wojtczak, Jacek A.; Davide Cattano

    2014-01-01

    Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions. Real-time upper airway (laryngo-tracheal) ultrasonography to confirm correct endotracheal tube placement was sh...

  20. Episodic Laryngeal Breathing Disorders: Literature Review and Proposal of Preliminary Theoretical Framework.

    Science.gov (United States)

    Shembel, Adrianna C; Sandage, Mary J; Verdolini Abbott, Katherine

    2017-01-01

    The purposes of this literature review were (1) to identify and assess frameworks for clinical characterization of episodic laryngeal breathing disorders (ELBD) and their subtypes, (2) to integrate concepts from these frameworks into a novel theoretical paradigm, and (3) to provide a preliminary algorithm to classify clinical features of ELBD for future study of its clinical manifestations and underlying pathophysiological mechanisms. This is a literature review. Peer-reviewed literature from 1983 to 2015 pertaining to models for ELBD was searched using Pubmed, Ovid, Proquest, Cochrane Database of Systematic Reviews, and Google Scholar. Theoretical models for ELBD were identified, evaluated, and integrated into a novel comprehensive framework. Consensus across three salient models provided a working definition and inclusionary criteria for ELBD within the new framework. Inconsistencies and discrepancies within the models provided an analytic platform for future research. Comparison among three conceptual models-(1) Irritable larynx syndrome, (2) Dichotomous triggers, and (3) Periodic occurrence of laryngeal obstruction-showed that the models uniformly consider ELBD to involve episodic laryngeal obstruction causing dyspnea. The models differed in their description of source of dyspnea, in their inclusion of corollary behaviors, in their inclusion of other laryngeal-based behaviors (eg, cough), and types of triggers. The proposed integrated theoretical framework for ELBD provides a preliminary systematic platform for the identification of key clinical feature patterns indicative of ELBD and associated clinical subgroups. This algorithmic paradigm should evolve with better understanding of this spectrum of disorders and its underlying pathophysiological mechanisms. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Prehospital Use of the Intubating Laryngeal Mask Airway in Patients with Severe Polytrauma: A Case Series

    Directory of Open Access Journals (Sweden)

    Andrew M. Mason

    2009-01-01

    Full Text Available A case series of five patients is described demonstrating the utility of the intubating laryngeal mask airway in the prehospital setting, both as a primary airway rescue device and as a bridge to tracheal intubation. All patients were hypoxaemic, had sustained severe polytrauma and were trapped in their vehicles following road traffic collisions. A probability of survival study showed better-than-predicted outcomes for the group as a whole.

  2. Laryngeal response patterns influence the efficacy of mechanical assisted cough in amyotrophic lateral sclerosis

    Science.gov (United States)

    Andersen, Tiina; Sandnes, Astrid; Brekka, Anne Kristine; Hilland, Magnus; Clemm, Hege; Fondenes, Ove; Tysnes, Ole-Bjørn; Heimdal, John-Helge; Halvorsen, Thomas; Vollsæter, Maria; Røksund, Ola Drange

    2017-01-01

    Background Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation–exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. Methods We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched volunteers. We used video-recorded flexible transnasal fibre-optic laryngoscopy during MI-E undertaken according to a standardised protocol, applying pressures of ±20 to ±50 cm H2O. Laryngeal movements were assessed from video files. ALS type and characteristics of upper and lower motor neuron symptoms were determined. Results At the supraglottic level, all patients with ALS and bulbar symptoms (n=14) adducted their laryngeal structures during insufflation. At the glottic level, initial abduction followed by subsequent adduction was observed in all patients with ALS during insufflation and exsufflation. Hypopharyngeal constriction during exsufflation was observed in all subjects, most prominently in patients with ALS and bulbar symptoms. Healthy subjects and patients with ALS and no bulbar symptoms (n=6) coordinated their cough well during MI-E. Conclusions Laryngoscopy during ongoing MI-E in patients with ALS and bulbar symptoms revealed laryngeal adduction especially during insufflation but also during exsufflation, thereby severely compromising the size of the laryngeal inlet in some patients. Individually customised settings can prevent this and thereby improve and extend the use of non-invasive MI-E. PMID:27174631

  3. Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

    Science.gov (United States)

    Jung, Soo Yeon; Park, Hae Sang; Bae, Hasuk; Yoo, Jeong Hyun; Park, Hyung Jun; Park, Kee Duk; Kim, Han Su; Chung, Sung Min

    2017-04-01

    To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment. A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded. Among them, patients with normal EMG findings were included in this study. The patients who reported voice symptom improvement after LEMG without further treatment were placed in laryngeal MPS (LMPS) group and the other patients were placed in non-laryngeal MPS (non-MPS) group. Predisposing factors, voice symptom, symptom-duration, and stroboscopic findings of these patients were reviewed. Among the 16 patients, LEMG findings were normal, five (31%) were included in the LMPS group and the other 11 patients (69%) were included in the non-MPS group. All LMPS group patients had a history of voice abuse and reported odynophonia. The Korean Voice Handicap Index-10 score decreased significantly after US-guided LEMG without additional treatment in the LMPS group. The stroboscopic findings revealed that vocal fold hypomobility was the most common finding in the LMPS group, and two patients showed a muscle tension dysphonia pattern. The LMPS groups showed improvement of vocal fold mobility on 1-week stroboscopic evaluation. LMPS is a potential diagnosis for patients with vocal fold hypomobility finding on stroboscopic findings but with normal EMG results. Diagnosis of LMPS could be considered in patients who showed symptom and vocal fold movement improvement after LEMG. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. [Usefulness of the aspiration-coagulation clip in laryngeal microsurgery using the CO2 laser].

    Science.gov (United States)

    Remacle, M

    1991-01-01

    The coming-out of the "super-pulse" and the "micro-spot" induced us to design a forcep for laryngeal microsurgery, also usable for smoke succion and coagulation. Two forms are available: one with fine and striated bit and one with wide heart-shaped bit. The problem of lesions manipulation at the same time as smoke succion is resolved in this way.

  5. Use of a laryngeal mask airway in a brachycephalic dog with masticatory myositis and trismus.

    Science.gov (United States)

    Reed, Frances; Iff, Isabelle

    2012-03-01

    An 8-month old, male, neutered bulldog was presented for investigation of a 2-day history of trismus. Endotracheal intubation was impossible as the dog was only able to open his mouth approximately 2 cm. A laryngeal mask airway was blindly inserted after induction of general anesthesia to maintain the patient on inhalational anesthesia and improve respiration for computed tomography and muscle biopsy. The dog recovered from anesthesia uneventfully.

  6. Recovery of laryngeal nerve function with sugammadex after rocuronium-induced profound neuromuscular block.

    Science.gov (United States)

    Pavoni, Vittorio; Gianesello, Lara; Martinelli, Cristiana; Horton, Andrew; Nella, Alessandra; Gori, Gabriele; Simonelli, Martina; De Scisciolo, Giuseppe

    2016-09-01

    The aim of this study was to evaluate the efficacy of sugammadex in reversing profound rocuronium-induced neuromuscular block at the laryngeal adductor muscles using motor-evoked potentials (mMEPs). A prospective observational study. University surgical center. Twenty patients with American Society of Anesthesiologists physical class I-II status who underwent propofol-remifentanil anesthesia for the surgery of the thyroid gland. Patients were enrolled for reversal of profound neuromuscular block (sugammadex 16 mg/kg, 3 minutes after rocuronium 1.2 mg/kg). To prevent laryngeal nerve injury during the surgical procedures, all patients underwent neurophysiologic monitoring using mMEPs from vocal muscles. At the same time, the registration of TOF-Watch acceleromyograph at the adductor pollicis muscle response to ulnar nerve stimulation was performed; recovery was defined as a train-of-four (TOF) ratio ≥0.9. After injection of 16 mg/kg of sugammadex, the mean time to recovery of the basal mMEPs response at the laryngeal adductor muscles was 70 ± 18.2 seconds. The mean time to recovery of the TOF ratio to 0.9 was 118 ± 80 seconds. In the postoperative period, 12 patients received follow-up evaluation of the vocal cords and no lesions caused by the surface laryngeal electrode during electrophysiological monitoring were noted. Recovery from profound rocuronium-induced block on the larynx is fast and complete with sugammadex. In urgent scenarios, "early" extubation can be performed, even with a TOF ratio ≤0.9. However, all procedures to prevent postoperative residual curarization should still be immediately undertaken. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The effects of physiological adjustments on the perceptual and acoustical characteristics of simulated laryngeal vocal tremor

    OpenAIRE

    Rosemary A Lester; Story, Brad H.

    2015-01-01

    The purpose of this study was to determine if adjustments to the voice source [i.e., fundamental frequency (F0), degree of vocal fold adduction] or vocal tract filter (i.e., vocal tract shape for vowels) reduce the perception of simulated laryngeal vocal tremor and to determine if listener perception could be explained by characteristics of the acoustical modulations. This research was carried out using a computational model of speech production that allowed for precise control and manipulati...

  8. Airflow study of pathologic larynges using a constant temperature anemometer: further experience.

    Science.gov (United States)

    Kitajima, K; Fujita, F

    1992-08-01

    Phonatory airflow was recorded in 361 laryngeal disease patients and 59 normal subjects by using a constant temperature anemometer to measure Isshiki's proposed parameter, the AC/DC percentage. The pathologic groups displayed AC/DC percentage values smaller than those of the normal group. The value differentials observed among the various diseases suggest that the AC/DC percentage may reflect the vibrational capacity of the vocal cords.

  9. Comparison of surgical techniques in the treatment of laryngeal polypoid degeneration.

    Science.gov (United States)

    Lumpkin, S M; Bishop, S G; Bennett, S

    1987-01-01

    Surgical excision has been the accepted treatment of laryngeal polypoid degeneration, or chronic polypoid corditis. We report on 29 women with polypoid degeneration who received one of three surgical treatments: vocal fold stripping, carbon dioxide laser obliteration, or the Hirano technique. The duration of postoperative dysphonia was longest with the laser removal and shortest with the Hirano technique. A combination of vocal hygiene management and the Hirano technique of removal provided the most efficacious treatment.

  10. Parapharyngeal abscess following use of a laryngeal mask airway during open revision septorhinoplasty

    Directory of Open Access Journals (Sweden)

    Benjamin van der Woerd

    2015-01-01

    Conclusion: Laryngeal mask airways have a high rate of success and low rate of complications. In this reported case, pressure necrosis from over-inflation of the LMA is thought to have perforated the right pyriform fossa. The perforation created a communication into the parapharyngeal space causing infection. We report this case to highlight the importance of identifying possible complications associated with a routine method of airway management during shared airway surgeries.

  11. Recurrent laryngeal nerve regeneration using an oriented collagen scaffold containing Schwann cells.

    Science.gov (United States)

    Chitose, Shun-Ichi; Sato, Kiminori; Fukahori, Mioko; Sueyoshi, Shintaro; Kurita, Takashi; Umeno, Hirohito

    2017-07-01

    Regeneration of the recurrent laryngeal nerve (RLN), which innervates the intrinsic laryngeal muscles such that they can perform complex functions, is particularly difficult to achieve. Synkinesis after RLN neogenesis leads to uncoordinated movement of laryngeal muscles. Recently, some basic research studies have used cultured Schwann cells (SCs) to repair peripheral nerve injuries. This study aimed to regenerate the RLN using an oriented collagen scaffold containing cultured SCs. Preliminary animal experiment. A 10-mm-long autologous canine cervical ansa was harvested. The nerve tissue was scattered and subcultured on oriented collagen sheets in reduced serum medium. After verifying that the smaller cultivated cells with high nucleus-cytoplasm ratios were SCs, collagen sheets with longitudinally oriented cells were rolled and inserted into a 20-mm collagen conduit. The fabricated scaffolds containing SCs were autotransplanted to a 20-mm deficient RLN, and vocal fold movements and histological characteristics were observed. Scaffolds containing cultured SCs were successfully fabricated. Immunocytochemical examination revealed that these isolated and cultured cells, identified as SCs, expressed S-100 protein and GFAP but not vimentin. The orientation of SCs matched that of the oriented collagen sheet. Two months after successful transplantation, laryngeal endoscopy revealed coordinated movement of the bilateral vocal folds by external stimulation under light general anesthesia. Hematoxylin and eosin staining showed that the regenerated RLN lacked epineurium surrounding the nerve fibers and was interspersed with collagen fibers. Myelin protein zero was expressed around many axons. Partial regeneration of RLN was achieved through the use of oriented collagen scaffolding. NA Laryngoscope, 127:1622-1627, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Exercise-induced laryngeal obstructions: prevalence and symptoms in the general public

    DEFF Research Database (Denmark)

    Christensen, Pernille Melia; Thomsen, S F; Rasmussen, N

    2011-01-01

    Respiratory difficulties caused by exercise-induced laryngeal obstructions (EILOs) are reported with increasing frequency. The aim of this study was to assess the prevalence and symptoms of EILOs and their relation to airway hyperresponsiveness (AHR). In total, 556 randomly selected youths......). No symptoms were found specific for either AHR or EILOs. The minimum prevalence of EILOs in this cohort was 7.5%. EILOs were verified in 26.1% of participants with AHR. Questionnaires could not differentiate between AHR and EILOs....

  13. Partial Recurrent Laryngeal Nerve Paralysis or Paresis? In Search for the Accurate Diagnosis

    Directory of Open Access Journals (Sweden)

    Alexander Delides

    2015-01-01

    Full Text Available “Partial paralysis” of the larynx is a term often used to describe a hypomobile vocal fold as is the term “paresis.” We present a case of a dysphonic patient with a mobility disorder of the vocal fold, for whom idiopathic “partial paralysis” was the diagnosis made after laryngeal electromyography, and discuss a proposition for a different implementation of the term.

  14. Value of computed tomography for evaluating the sub glottis in laryngeal and hypopharyngeal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Barros, Nestor de; Paes Junior, Ademar Jose de Oliveira; Tornin, Olger de Souza; Rapoport, Abrao; Cerri, Giovanni Guido [Hospital Heliopolis, Sao Paulo, SP (Brazil). Dept. de Cirurgia de Cabeca e Pescoco, Otorrinolaringologia e Imagem]. E-mail: ricapires@ig.com.br; olger1@uol.com.br

    2007-03-15

    Context And Objective: Sub glottic involvement in squamous cell carcinoma is a determining factor for contraindicating conservative partial surgery. The subglottis is easily identified by axial computed tomography sections. The present study aimed to evaluate the occurrence of false-negative and false-positive results, and the overall accuracy of staging by computed tomography, in order to detect the involvement of the subglottic laryngeal compartment, in cases of laryngeal and hypopharyngeal squamous cell carcinoma. Design And Setting: Retrospective, non-randomized study of patients treated at Hospital Heliopolis, Sao Paulo, Brazil. Methods: Computed tomography scans were performed on third-generation equipment with 5-mm slice thickness. Afterwards, all patients underwent surgical and anatomopathological examinations as the gold standard procedures. Results: Among 60 patients, 14 were diagnosed with subglottic extension by surgical and histopathological examination. There were three false-negative and no false-positive results from computed tomography scans. The sensitivity and negative predictive value were 100.0%. Accuracy was 95.0%, specificity was 93.5% and positive predictive value was 82.4%. Conclusions: Computed tomography could serve as a powerful auxiliary method for staging laryngeal and hypopharyngeal cancer. However, precautions should be taken in analyzing computed tomography scan data, because vegetating lesions may also be projected into the subglottic compartment, without real involvement of the subglottis, which may cause a false-positive result. (author)

  15. [The clinical characters and surgical managements of congenital laryngeal cysts in infants].

    Science.gov (United States)

    Zhang, Yamin; Wang, Zhinan; Xu, Zhongqiang

    2014-05-01

    To classify congenital laryngeal cysts in 62 newborn or infants, and to discuss the characteristics of different operation mode. The clinical data of 62 infants with laryngeal cysts treated were reviewed retrospectively. After the examination of neck palpation, laryngoscope and imaging (CT or MRI), all patients were under general anesthesia of laryngeal cyst excision. we select operation mode according to the classification. Classification include: 61 cases of cysts were confined to the larynx, 1 case was beyond the larynx. Surgical managements include: an excision through external carotid approach in 1 case beyond the larynx, 61 cases had endoscopic excision under general anesthesia (12 cases with traditional bite exception, 12 cases with powered system and 37 cases with low-temperature radiofrequency ablation). The operations was successful. No recurrence was found after 0.5 to 7 years follow-up. To chose surgical management after classification and preoperative assessment, which could avoid unnecessary opening surgical approaches, reducing the recurrence, and preventing repeated endoscopic treatment or tracheotomy. The low-temperature radiofrequency ablation had the advantages of short operation time, less bleeding, little injury, low recurrence rate and light postoperative reaction. It is worthy of clinical promotion.

  16. Regional and gender differences in laryngeal cancer mortality: trends and predictions until 2030 in Brazil.

    Science.gov (United States)

    Dantas de Oliveira, Nayara Priscila; Barbosa, Isabelle Ribeiro; Vieria Paulino, Jéssica Nayara; de Camargo Cancela, Marianna; Bezerra de Souza, Dyego Leandro

    2016-11-01

    Analysis of laryngeal cancer mortality trends in Brazil and its geographic regions for the period 1996-2010 and calculation of mortality predictions for the period 2011-2030. An epidemiologic, ecologic, demographic-based study, which utilized information from the Mortality Information System on all cancer-related deaths in Brazil, is presented here. Mortality trends were analyzed by Joinpoint regression, and Nordpred was utilized for the calculation of predictions. When comparing the last observed period and the last predicted period for men, an increase of 10,588 deaths is expected, representing an increase of 69%. For women, the expected increase in the number of deaths will be 2217, representing an increase of 104%. Laryngeal cancer mortality rates will increase in the North and Northeast regions for men and in the Northeast and Southeast regions for women. Despite the current high mortality for laryngeal cancer, rates will continue to increase until 2030 in Brazil. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. [Vasculogenic mimicry in laryngeal squamous cell carcinoma and its clinicopathological significance].

    Science.gov (United States)

    Wu, Shiwu; Yu, Lan; Zhou, Lei; Cheng, Zenong; Wang, Danna

    2014-08-01

    The present paper aims to investigate whether or not vasculogenic mimicry (VM) exists in laryngeal squamous cell carcinoma (LSCC), and to elucidate its relationship to microvessel density (MVD), galectin-3 (Gal-3) expressionb and clinicopathological factors of patients with LSCC. VM, score of MVD and expression of Gal-3 protein were detected by immunohistochemistry and histochemistry in 83 specimens of LSCC tissue and 20 specimens of nor- mal laryngeal tissue. The positive rate of VM in normal laryngeal tissues was 0%, and was 33.7% in LSCC tissues. There was a significant difference between the two groups (Page, gender and tumor site (P>0. 05). And there was a positive correlation between every two of VM, score of MVD, and Gal-3 protein (P< 0. 05). The results suggest that expression of Gal-3 protein may be related to the initiation, angiogenesis and VM formation in LSCC; And VM, angiogenesis and Gal-3 protein may be involved in the development, invasion and metastasis of LSCC.

  18. Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need

    DEFF Research Database (Denmark)

    Rokamp, K.Z.; Secher, N.H.; Møller, Ann;

    2010-01-01

    ABSTRACT: BACKGROUND: To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. METHOD: In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without...... the use of nitrous oxide) were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. RESULTS: In the 119 patients provided with a tracheal tube, the median cuff pressure was 30 (range 8 - 100) cm H2O and the pressure exceeded 30 cm H2O (upper recommended level) for 54...... patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121) cm H2O and above 60 cm H2O (upper recommended level) for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H2O). There was no association between cuff pressure...

  19. Short- and long-term effects of irradiation on laryngeal mucosa of the rat

    Energy Technology Data Exchange (ETDEWEB)

    Lidegran, M. [Karolinska Inst., Stockholm (Sweden). Dept. of Otorhinolaryngology; Forsgren, S. [Umeaa Univ. (Sweden). Dept. of Anatomy; Dahlqvist, Aa. [Umeaa Univ. (Sweden). Dept. of Otorhinolaryngology; Franzen, L. [Umeaa Univ. (Sweden). Dept. of Oncology; Domeij, S. [Umeaa Univ. (Sweden). Dept. of Histology and Cell Biology

    1999-07-01

    Although radiotherapy is often used to treat laryngeal carcinoma, there is little information on the effects of this treatment on laryngeal structures. Rats were irradiated to the head and neck region and the larynges were studied by light- and electron-microscopy and immunohistochemistry. Ten days after irradiation, a change in the ultrastructural appearance of the granules of the subglottic glands was observed. Substance P-, bombesin- and enkephalin-like immunoreactivity was increased in local ganglionic cells and glandular nerve fibres. The mast cells were reduced in number. At examination 4-6 months after irradiation, there were no obvious differences compared with controls concerning mast-cell numbers and neuropeptide expression. The ultrastructural changes seen in the subglottic glands remained to some extent. The results show that structural changes in the subglottic glands occur concomitantly with an increased expression of certain neuropeptides in the innervation of these glands, which implies a relationship between these two parameters. The mast cells respond drastically to irradiation, but in the long run, regeneration of these cells occurs. (orig.)

  20. Laryngeal and pharyngeal dysfunction in horses homozygous for hyperkalemic periodic paralysis.

    Science.gov (United States)

    Carr, E A; Spier, S J; Kortz, G D; Hoffman, E P

    1996-08-15

    Evaluate histories, clinical signs, and laboratory data of 69 horses homozygous by DNA testing for hyperkalemic periodic paralysis (HPP). Cohort study. 69 of 189 horses testing homozygous for HPP between October 1992 and November 1994. Questionnaires addressing signalment, training regimes, medical history, and current status of affected horses were sent to owners, trainers, or attending veterinarians. Data from completed questionnaires were tabulated and evaluated, using descriptive statistics. Sixty-nine (37%) of 189 questionnaires were completed and returned. Clinical episodes of muscle weakness or paralysis varied in severity and frequency from mild muscle fasciculations to recumbency and death. Sixty-three of 68 HPP-affected horses were reported to have had stridor associated with exercise, excitement, stress, or episodes of muscle paralysis. Common endoscopic findings in affected horses included pharyngeal collapse, pharyngeal edema, laryngopalatal dislocation, and laryngeal paralysis. Twelve of 27 horses receiving acetazolamide had decreases in stridor while receiving medication. Most horses testing homozygous for HPP had clinical signs associated with pharyngeal and laryngeal dysfunction. Hyperkalemic periodic paralysis should be included on a differential list for horses examined for signs of laryngeal or pharyngeal dysfunction or stridor. Treatment with acetazolamide may help to control respiratory tract signs associated with this disease.

  1. Readability and quality assessment of internet-based patient education materials related to laryngeal cancer.

    Science.gov (United States)

    Narwani, Vishal; Nalamada, Keerthana; Lee, Michael; Kothari, Prasad; Lakhani, Raj

    2016-04-01

    Patients are increasingly using the internet to access health-related information. The purpose of this study was to assess the readability and quality of laryngeal cancer-related websites. Patient education materials were identified by performing an internet search using 3 search engines. Readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI). The DISCERN instrument was utilized to assess quality of health information. A total of 54 websites were included in the analysis. The mean readability scores were as follows: FRES, 48.2 (95% confidence interval [CI] = 44.8-51.6); FKGL, 10.9 (95% CI = 10.3-11.5); and GFI, 13.8 (95% CI = 11.3-16.3). These scores suggest that, on average, online information about patients with laryngeal cancer is written at an advanced level. The mean DISCERN score was 49.8 (95% CI = 45.4-54.2), suggesting that online information is of variable quality. Our study suggests much of the laryngeal cancer information available online is of suboptimal quality and written at a level too difficult for the average adult to read comfortably. © 2015 Wiley Periodicals, Inc.

  2. Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need

    Directory of Open Access Journals (Sweden)

    Møller Ann M

    2010-12-01

    Full Text Available Abstract Background To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. Method In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without the use of nitrous oxide were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. Results In the 119 patients provided with a tracheal tube, the median cuff pressure was 30 (range 8 - 100 cm H2O and the pressure exceeded 30 cm H2O (upper recommended level for 54 patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121 cm H2O and above 60 cm H2O (upper recommended level for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H2O. There was no association between cuff pressure and age, body mass index, type of surgery, or time from induction of anaesthesia to the time the cuff pressure was measured. Conclusion For maintenance of epithelia flow and nerve function and at the same time secure air sealing, this evaluation indicates that the cuff pressure needs to be checked as part of the procedures involved in induction of anaesthesia and eventually checked during surgery.

  3. Glottal open quotient in singing: Measurements and correlation with laryngeal mechanisms, vocal intensity, and fundamental frequency

    Science.gov (United States)

    Henrich, Nathalie; D'Alessandro, Christophe; Doval, Boris; Castellengo, Michèle

    2005-03-01

    This article presents the results of glottal open-quotient measurements in the case of singing voice production. It explores the relationship between open quotient and laryngeal mechanisms, vocal intensity, and fundamental frequency. The audio and electroglottographic signals of 18 classically trained male and female singers were recorded and analyzed with regard to vocal intensity, fundamental frequency, and open quotient. Fundamental frequency and open quotient are derived from the differentiated electroglottographic signal, using the DECOM (DEgg Correlation-based Open quotient Measurement) method. As male and female phonation may differ in respect to vocal-fold vibratory properties, a distinction is made between two different glottal configurations, which are called laryngeal mechanisms: mechanism 1 (related to chest, modal, and male head register) and mechanism 2 (related to falsetto for male and head register for female). The results show that open quotient depends on the laryngeal mechanisms. It ranges from 0.3 to 0.8 in mechanism 1 and from 0.5 to 0.95 in mechanism 2. The open quotient is strongly related to vocal intensity in mechanism 1 and to fundamental frequency in mechanism 2. .

  4. Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Eliandra da Silveira de Lima

    Full Text Available ABSTRACT INTRODUCTION: Acute laryngeal lesions after intubation appear to be precursors of chronic lesions. OBJECTIVE: To describe the incidence and type of acute laryngeal lesions after extubation in a pediatric intensive care unit (PICU. METHODS: A cohort study involving children from birth to <5 years, submitted to intubation for more than 24 h in the PICU of an university hospital. In the first eight hours after extubation, a flexible fiberoptic laryngoscopy (FFL was performed at the bedside. Those with moderate to severe abnormalities underwent a second examination seven to ten days later. RESULTS: 177 patients were included, with a median age of 2.46 months. The mean intubation time was 8.19 days. Seventy-three (41.2% patients had moderate or severe alterations at the FFL, with the remaining showing only minor alterations or normal results. During follow-up, 16 children from the group with moderate to severe lesions developed subglottic stenosis. One patient from the normal FFL group had subglottic stenosis, resulting in an incidence of 9.6% of chronic lesions. CONCLUSION: Most children in the study developed mild acute laryngeal lesions caused by endotracheal intubation, which improved in a few days after extubation.

  5. [Effect of microRNA-205 on proliferation of laryngeal carcinoma cell line Hep-2].

    Science.gov (United States)

    Li, Xiaotian; Li, Wei; Jiang, Xuejun

    2015-05-01

    To study the effect of microRNA-205 (miRNA-205) on proliferation of laryngeal carcinoma cell line Hep-2. The expressions of miRNA-205 in 27 cases laryngeal carcinoma tissues and adjacent normal tissues were detected by Real-time quantitative PCR, the expression of PTEN protein was detected by Western blot. The expressions of PTEN were detected by Western blot after miRNA-205 inhibitor or miRNA-205 mimics was transfected into Hep-2 cells and Hep-2 cells proliferation was measured by CCK-8 kit. The expression level of miRNA-205 was significantly higher in laryngeal carcinoma tissues than in adjacent normal tissues (P Hep-2 cells was decreased significantly and the expression of PTEN protein in Hep-2 cells was increased significantly after miRNA-205 inhibitor was transfected into (P Hep-2 cells was increased significantly and the expression of PTEN protein in Hep-2 cells was decreased significantly after miRNA-205 mimics was transfected into (P Hep-2 cells by regulating the expression of PTEN.

  6. Bakumondo-to appears to alleviate radiation-induced mucositis in early laryngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kanaya, Koichiro [Saiseikai Yamaguchi General Hospital (Japan); Imate, Yuji; Takemoto, Tsuyoshi; Hasuike, Koji; Watanuki, Koichi; Moriya, Keiji

    2002-02-01

    Tsumura Co.'s Bakumondo-to (TJ-29) is a Chinese herb medicine prescribed widely in Japan for bronchitis and laryngitis. It is well known that TJ-29 not only has a variety of effects including anti-inflammatory and antitussive properties, but also is capable of increasing salivary secretions. The purpose of this study is to examine whether TJ-29 can reduce mucosal toxicity caused by radiotherapy in patients with early laryngeal carcinoma. Between 1993 and 1999, 20 patients with primary early laryngeal carcinoma were treated by radiotherapy at Nagato General Hospital. All patients were treated with 2 Gy per fraction daily, 5 days a week. Eight patients formed the control group (no TJ-29) and 12 patients received TJ-29 throughout the radiation therapy. The severity of daily subjective symptoms such as hoarseness, xerostomia or pharyngoxerosis, cough, and sore throat were graded 0 to 3 according to descriptions on the clinical charts. No statistically significant between-group differences were seen in subjective hoarseness, xerostomia or pharyngoxerosis, and cough. However the mean final grade of subjective sore throat was less severe in the TJ-29 group (p=0.0023). Despite the limited number of patients, this study suggests that TJ-29 was able to reduce the severity of mucositis induced by radiotherapy. Further intensive research is needed. (author)

  7. Alternative treatment option for hypopharyngeal cancer: clinical outcomes after conservative laryngeal surgery with partial pharyngectomy.

    Science.gov (United States)

    Chung, Eun-Jae; Lee, Jong-Joo; Kim, Hyun-Sung; Lee, Dong-Jin; Jung, Chul-Hoon; Chang, Yong-Joon; Rho, Young-Soo

    2013-08-01

    The oncological and functional outcomes of hypopharyngeal cancer after conservative laryngeal surgery are fairly acceptable, making this a reasonable initial treatment option for selected patients. The purpose of this study was to assess the clinical outcomes of patients with hypopharyngeal squamous cell carcinoma (SCC) treated with conservative laryngeal surgery with partial pharyngectomy. Fifty-eight patients with hypopharyngeal SCC who underwent laryngeal preservation surgery were enrolled. The tumors were classified as cT1 in 5 (8.6%) patients, cT2 in 35 (60.3%), cT3 in 14 (24.1%), and cT4a in 4 (6.9%) patients. Surgical outcomes: 5-year overall and disease-specific survival rates were 78% and 77.6%. Recurrent disease developed in 13 patients (22.4%). Multivariate analysis revealed that level VI metastasis confirmed by histopathological analysis, close (alimentation was achieved within a mean of 26.1 days after surgery. Fifty-one patients (87.9%) could be decannulated after a mean of 43.8 days postoperatively.

  8. Laryngeal High-Speed Videoendoscopy: Sensitivity of Objective Parameters towards Recording Frame Rate

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    Anne Schützenberger

    2016-01-01

    Full Text Available The current use of laryngeal high-speed videoendoscopy in clinic settings involves subjective visual assessment of vocal fold vibratory characteristics. However, objective quantification of vocal fold vibrations for evidence-based diagnosis and therapy is desired, and objective parameters assessing laryngeal dynamics have therefore been suggested. This study investigated the sensitivity of the objective parameters and their dependence on recording frame rate. A total of 300 endoscopic high-speed videos with recording frame rates between 1000 and 15 000 fps were analyzed for a vocally healthy female subject during sustained phonation. Twenty parameters, representing laryngeal dynamics, were computed. Four different parameter characteristics were found: parameters showing no change with increasing frame rate; parameters changing up to a certain frame rate, but then remaining constant; parameters remaining constant within a particular range of recording frame rates; and parameters changing with nearly every frame rate. The results suggest that (1 parameter values are influenced by recording frame rates and different parameters have varying sensitivities to recording frame rate; (2 normative values should be determined based on recording frame rates; and (3 the typically used recording frame rate of 4000 fps seems to be too low to distinguish accurately certain characteristics of the human phonation process in detail.

  9. Laryngeal Squamous Intraepithelial Lesions: An Updated Review on Etiology, Classification, Molecular Changes, and Treatment.

    Science.gov (United States)

    Gale, Nina; Gnepp, Douglas R; Poljak, Mario; Strojan, Primož; Cardesa, Antonio; Helliwell, Tim; Šifrer, Robert; Volavšek, Metka; Sandison, Ann; Zidar, Nina

    2016-03-01

    Laryngeal carcinogenesis is a multistep process, characterized by an accumulation of genetic changes associated with architectural and cytologic alterations, ranging from squamous hyperplasia to carcinoma in situ and encompassed by the terminology of squamous intraepithelial lesions (SILs). The etiology, classification, genetic changes, and malignant progression of these lesions are reviewed. Tobacco remains the principal etiological factor with gastroesophageal reflux disease recently considered as a possible factor. In contrast, there is little evidence that microbiological agents, especially human papillomavirus infection, are frequently involved in laryngeal carcinogenesis and probably treatment. The currently used classifications, the dysplasia system, squamous intraepithelial neoplasia, and the Ljubljana classification, reflect different standpoints on this important topic. The modified Ljubljana classification, with good interobserver agreement, could be considered as a proposal for a unified classification of laryngeal SILs. This review also briefly discusses recently discovered genetic changes, such as CDKN2A and CTNNB1 genes, and chromosome instability of chromosomes 1 and 7; however, none of these can at present improve histologic diagnosis. Malignant progression of precursor lesions varies from 2% to 74%, according to different studies. Cold-steel microinstruments, CO2 laser, and radiotherapy are used to treat the different grades of precursor lesions. There is as yet no worldwide agreement on the treatment of high-grade lesions and carcinoma in situ.

  10. Non-recurrent inferior laryngeal nerve: case report and review of the literature.

    Science.gov (United States)

    Iorgulescu, R; Bistriceanu, I; Badanoiu, D; Calin, C; Capatana, C; Iordache, N

    2014-01-01

    Total thyroidectomy is nowadays the operation of choice in the majority of endocrine surgery centers, whether the pathology is benign or malignant. To obtain good results, a thorough knowledge of local anatomy and a profound respect for hemostasis are necessary. Routine, at least visual, identification of the inferior laryngeal nerve (ILN) is considered gold standard and is strongly recommended. Surgeons are generally aware of the variations the nerve can have, especially on the right side. Although very rare, one such variation, with possible great impact on outcomes, is the non-recurrent route of the nerve. We present the case of a middle-aged woman with a multinodular goiter scheduled for elective surgery. During total thyroidectomy, on the right side, we were not able to find the inferior laryngeal nerve in its usual position, using the customary anatomical landmarks. Instead, we encountered it emerging directly from the right vagus nerve, at a rather right angle and entering the larynx as a unique non-bifurcating nerve. Thus, it could be spared from any injury and protected, although it could have been easily confounded with a vascular structure, given its transverse course.We think it is never overmuch to repeat that the routine identification and exposure of the inferior laryngeal nerve is a must for the thyroid surgeon in order to safely preserve its integrity.

  11. A influência da angulação na posição do telescópio na videoquimografia laríngea The influence of the position of the laryngeal endoscope laryngeal on videokymography

    Directory of Open Access Journals (Sweden)

    Paulo Augusto de Lima Pontes

    2005-12-01

    Full Text Available A videoquimografia é considerada a mais recente tecnologia na semiologia avançada da laringe. A videoquimografia utiliza-se de tecnologia digital para a análise ultra-rápida da vibração das pregas vocais. A imagem apresentada é a referência de uma única linha, representando um estreito segmento horizontal da imagem laríngea. A videoquimografia avalia todos os tipos de irregularidades de vibração, identifica pequenas assimetrias esquerda-direita, diferenças no quociente de abertura ao longo das pregas vocais, propagação lateral da onda mucosa e movimentação das margens superior e inferior da onda de mucosa das pregas vocais. O objetivo do presente estudo foi verificar a correspondência das imagens obtidas na videoquimografia, com variação do ângulo de exposição da laringe em relação ao telescópio. Foram analisados três indivíduos do sexo feminino, sem queixa vocal. As imagens videoquimográficas foram registradas com o telescópio laríngeo de 90o posicionado na linha média, perpendicular à glote - zero grau, durante a emissão de uma vogal sustentada "é", em freqüência e intensidade habituais. O procedimento foi repetido mais duas vezes, porém com rotação de quinze graus do telescópio, no sentido horário, deslocando-se o laringoscópio à direita da linha média do paciente e, no sentido anti-horário, à esquerda. Os resultados obtidos indicaram diferenças evidentes nas imagens obtidas, o que demanda uma padronização da exposição laríngea para a interpretação da videoquimografia.Videokymography is a new high-speed imaging technique to investigate vocal fold vibration. The system has been considered useful in the analysis of irregular signals, making it possible to observe left-right asymmetries, open quotient, propagation of mucosal waves, and movement of the upper and lower margins. The aim of the present study was to verify the correspondence of the videokymographic images with larynx exposition

  12. Millian superiorities and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2008-01-01

    James Griffin has considered a form of superiority in value that is weaker than lexical priority as a possible remedy to the Repugnant Conclusion. In this article, I demonstrate that, in a context where value is additive, this weaker form collapses into the stronger form of superiority. And in a ......James Griffin has considered a form of superiority in value that is weaker than lexical priority as a possible remedy to the Repugnant Conclusion. In this article, I demonstrate that, in a context where value is additive, this weaker form collapses into the stronger form of superiority...... of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest....

  13. Measuring Financial Gains from Genetically Superior Trees

    Science.gov (United States)

    George Dutrow; Clark Row

    1976-01-01

    Planting genetically superior loblolly pines will probably yield high profits.Forest economists have made computer simulations that predict financial gains expected from a tree improvement program under actual field conditions.

  14. Superior mesenteric artery syndrome causing growth retardation

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    Halil İbrahim Taşcı

    2013-03-01

    Full Text Available Superior mesenteric artery syndrome is a rare and lifethreateningclinical condition caused by the compressionof the third portion of the duodenum between the aortaand the superior mesenteric artery’s proximal part. Thiscompression may lead to chronic intermittent, acute totalor partial obstruction. Sudden weight-loss and the relateddecrease in the fat tissue are considered to be the etiologicalreason of acute stenosis. Weight-loss accompaniedby nausea, vomiting, anorexia, epigastric pain, andbloating are the leading complaints. Barium radiographs,computerized tomography, conventional angiography,tomographic and magnetic resonance angiography areused in the diagnosis. There are medical and surgical approachesto treatment. We hereby present the case ofa patient with superior mesenteric artery syndrome withdelayed diagnosis.Key words: superior mesenteric artery syndrome, nausea-vomiting, anorexia

  15. Leiomyosarcoma of the superior vena cava.

    Science.gov (United States)

    de Chaumont, Arthus; Pierret, Charles; de Kerangal, Xavier; Le Moulec, Sylvestre; Laborde, François

    2014-08-01

    Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts.

  16. Superior mesenteric artery compression syndrome - case report

    OpenAIRE

    Paulo Rocha França Neto; Rodrigo de Almeida Paiva; Antônio Lacerda Filho; Fábio Lopes de Queiroz; Teon Noronha

    2011-01-01

    Superior mesenteric artery syndrome is an entity generally caused by the loss of the intervening mesenteric fat pad, resulting in compression of the third portion of the duodenum by the superior mesenteric artery. This article reports the case of a patient with irremovable metastatic adenocarcinoma in the sigmoid colon, that evolved with intense vomiting. Intestinal transit was carried out, which showed important gastric dilation extended until the third portion of the duodenum, compatible wi...

  17. Basic life support trained nurses ventilate more efficiently with laryngeal mask supreme than with facemask or laryngeal tube suction-disposable--a prospective, randomized clinical trial.

    Science.gov (United States)

    Gruber, Elisabeth; Oberhammer, Rosmarie; Balkenhol, Karla; Strapazzon, Giacomo; Procter, Emily; Brugger, Hermann; Falk, Markus; Paal, Peter

    2014-04-01

    In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel, especially in rural areas where arrival of advanced life support teams can be delayed. The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel, but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation. In this prospective, randomized clinical single-centre trial we compared airway management and ventilation performed by nurses using facemask, laryngeal mask Supreme (LMA-S) and laryngeal tube suction-disposable (LTS-D). Basic life support trained nurses (n=20) received one-hour practical training with each device. ASA 1-2 patients scheduled for elective surgery were included (n=150). After induction of anaesthesia and neuromuscular block nurses had two 90-second attempts to manage the airway and ventilate the patient with volume-controlled ventilation. Ventilation failed in 34% of patients with facemask, 2% with LMA-S and 22% with LTS-D (Ptraining, nurses were able to use LMA-S more effectively than facemask and LTS-D. High ventilation failure rates with facemask and LTS-D may indicate that additional training is required to perform airway management adequately with these devices. High-level trials are needed to confirm these results in cardiac arrest patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. 喉外伤18例临床分析%Clinical Analysis of 18 Patients with Laryngeal Trauma

    Institute of Scientific and Technical Information of China (English)

    郑云开; 钟朝官; 范敏芳

    2014-01-01

    Objective:To summarize the treatment measures of patient with laryngeal trauma to improve the clinical effect. Methods: The clinical data of 18 patients with laryngeal trauma were analyzed retrospectively from Jan 2003 to Dec 2013. Results: 15 patients with open laryngeal trauma were underwent neck exploration and laryngeal reconstruction and low tracheotomy. In 3 patients with closed laryngeal trauma , 2 cases were underwent tracheotomy. Among 17 cases underwent tracheotomy , 16 cases were received tracheal extubation successfully and 1 case needed to wear tracheal tube for a long term. Conclusion: The principle in the treatment of laryngeal trauma are saving the patient's life, retaining the laryngeal function and preventing complications as soon as possible.%目的:总结喉外伤的救治方法以提高其疗效。方法:回顾性分析2003年1月-2013年12月收治的喉外伤患者18例的临床资料。结果:15例开放性喉外伤均行颈部探查术,并行喉整复术及低位气管切开术;3例闭合性喉外伤中2例行气管切开术。17例接受气管切开的患者中16例成功拔管,1例术后拔管困难。结论:在喉外伤的综合救治中,应以抢救患者生命为原则,并尽可能保留、恢复喉功能和防止并发症。

  19. The relationship between Interleukin 18 expression in laryngeal squamous cell carcinoma and clinical pathology as well as the effect of cetuximab on its expression

    Institute of Scientific and Technical Information of China (English)

    Xiu-Ping Liao; Nian Lyu; Sen-Lan Long

    2015-01-01

    Objective:To explore the relationship between Interleukin 18 (IL-18) expression in laryngeal squamous cell carcinoma and clinical pathology as well as the effect of cetuximab on its expression.Methods:40 cases of patients with laryngeal squamous cell carcinoma from January 2010 to June 2014 were chosen as the research group; 40 cases of patients with vocal cord polyp and 40 healthy volunteers were chosen as the control group. Statistical analysis was carried out on clinical pathology of laryngeal squamous cell carcinoma. IL-18, IFN-γ, TNF-αand IL-6 levels in peripheral blood mononuclear cells before and after cetuximab application were detected.Results:Detected IL-18 values of laryngeal squamous cell carcinoma group were higher than those of adjacent cancer tissue and vocal cord polyps; IL-18 positive rate (75.0%) of laryngeal squamous cell carcinoma group was higher than that of adjacent cancer tissue (47.5%) and polyp tissue (37.5%); IL-18 expressions of laryngeal squamous cell carcinoma group were related to primary lesion staging, differentiation degree and lymph node metastasis; before cetuximab application, IL-18 levels were significantly higher than those of the control group, and after cetuximab application, IL-18 levels significantly decreased than before. Differences were statistically significant; after cetuximab application, IFN-γ, TNF-αand IL-6 levels in PBMCs supernatant of patients with laryngeal squamous cell carcinoma were significantly lower than before. Differences were statistically significant.Conclusion:IL-18 can be highly expressed in laryngeal squamous cell carcinoma; IL-18 expression is involved in the occurrence and progress of laryngeal squamous cell carcinoma; IL-18 is possible to be involved in the occurrence and progress of laryngeal squamous cell carcinoma through regulating expressions of IFN-γ, TNF-α and IL-6, etc; IL-18 can be used as a target of laryngeal squamous cell carcinoma treatment, and cetuximab can inhibit IL-18

  20. Differentiating laryngeal carcinomas from precursor lesions by diffusion-weighted magnetic resonance imaging at 3.0 T: a preliminary study.

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    De-Sheng Shang

    Full Text Available BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI has been introduced in head and neck cancers. Due to limitations in the performance of laryngeal DWI, including the complex anatomical structure of the larynx leading to susceptibility effects, the value of DWI in differentiating benign from malignant laryngeal lesions has largely been ignored. We assessed whether a threshold for the apparent diffusion coefficient (ADC was useful in differentiating preoperative laryngeal carcinomas from precursor lesions by turbo spin-echo (TSE DWI and 3.0-T magnetic resonance. METHODS: We evaluated DWI and the ADC value in 33 pathologically proven laryngeal carcinomas and 17 precancerous lesions. RESULTS: The sensitivity, specificity, and accuracy were 81.8%, 64.7%, 76.0% by laryngostroboscopy, respectively. The sensitivity, specificity, and accuracy of conventional magnetic resonance imaging were 90.9%, 76.5%, 86.0%, respectively. Qualitative DWI analysis produced sensitivity, specificity, and accuracy values of 100.0, 88.2, and 96.0%, respectively. The ADC values were lower for patients with laryngeal carcinoma (mean 1.195±0.32×10(-3 mm(2/s versus those with laryngeal precancerous lesions (mean 1.780±0.32×10(-3 mm(2/s; P<0.001. ROC analysis showed that the area under the curve was 0.956 and the optimum threshold for the ADC was 1.455×10(-3 mm(2/s, resulting in a sensitivity of 94.1%, a specificity of 90.9%, and an accuracy of 92.9%. CONCLUSIONS: Despite some limitations, including the small number of laryngeal carcinomas included, DWI may detect changes in tumor size and shape before they are visible by laryngostroboscopy. The ADC values were lower for patients with laryngeal carcinoma than for those with laryngeal precancerous lesions. The proposed cutoff for the ADC may help distinguish laryngeal carcinomas from laryngeal precancerous lesions.