Biomedical subjects
G F Tucker
Publications and source records attributed to G F Tucker.
Pharyngolaryngeal web. Report of a new anomaly.
Within the last several months we have seen two patients with pharyngolaryngeal webs. The webs extend from the lateral borders of the epiglottis to the lateral and posterior pharyngeal walls framing the glottis with a "keyhole" type of effect. No web of this kind has ever been documented in the literature to our knowledge. These children suffer from intermittent airway obstruction, probably secondary to tethering of the epiglottis. These webs are very difficult to identify without the panoramic view of the hypopharynx which is afforded by the fiber-illuminated endoscopic telescopes. We recommend that endoscopy of neonates include observation of the hypopharynx with the endoscopic telescope as well as with the open laryngoscope.
Limitations of bronchoscopic carbon dioxide laser surgery.
Laser technology has provided new options in the endoscopic management of patients with selected diseases of the tracheobronchial tree. At present, bronchoscopic laser surgery is performed using either the carbon dioxide laser or the neodymium:yttrium aluminum garnet (Nd:YAG) laser. Strong and his colleagues first performed bronchoscopic laser surgery over 10 years ago when they successfully coupled the CO2 laser to a rigid ventilating bronchoscope. Since that time, the indications for bronchoscopic laser surgery have expanded and the instruments used have become both safer and more "user friendly." Despite these advances in CO2 laser technology, certain limitations are associated with its use for the endoscopic management of patients with tracheobronchial lesions. This paper discusses these limitations, places this technology in perspective, and reviews recent publications which have suggested that the Nd:YAG laser may be more efficacious than the CO2 laser for the treatment of the same group of patients.
Paraglottic laryngitis in association with epiglottitis.
Infection of the supraglottic larynx is a well-recognized clinical entity in both adults and children. The anatomical relationships of the various components of the larynx have been studied extensively, especially as they relate to the spread of malignant disease. However, the relationship of these spaces and compartments in inflammatory disease has not been heretofore appreciated. This report describes for the first time histologic evidence that infection of the supraglottic larynx may spread to the paraglottic space, thus causing compromise of the glottic region. This potential carries significant implications for planning the appropriate therapeutic measures.
Cleft larynx with airway obstruction.
Cleft larynx is a rare congenital anomaly becoming recognized and reported with increasing frequency. While it is most commonly associated with aspiration in newborns, airway obstruction can occur. We report two cases of upper airway obstruction due to a soft tissue mass related to the cleft. Since endoscopic findings of cleft larynx are subtle and easily overlooked, the technique of direct laryngoscopy is extremely important. In addition to recognition of the condition, embryology and treatment are also discussed.
Congenital laryngeal anomalies associated with tracheal agenesis.
Forty-eight cases of tracheal agenesis have been reported to date. Previous authors have studied gross postmortem laryngeal specimens. Of 37 cases wherein laryngeal findings were mentioned, only 14 were reported to be abnormal. This report details two more cases of tracheal agenesis and includes a detailed histopathologic study of the laryngeal anomalies by serial horizontal section. Although one of these specimens appeared normal at autopsy, both were found to have several abnormalities when studied microscopically in horizontal section. Both have an elliptical cricoid cartilage, an abnormality originally discovered by one of us (G.F.T.) using the same technique.
Carcinoma of the larynx in an 11-year-old boy with late cervical metastasis: report of a case with a ten-year follow-up.
An 11-year-old boy with laryngeal carcinoma underwent a partial laryngectomy. Subsequently, a cervical metastatic node developed eight months following a tonsillectomy; a radical neck dissection was performed. The patient has remained free of disease over a ten-year follow-up period. In our review of the English literature, no similar case report was found. The potential relationship of tonsillectomy to alterations in local T cell-mediated immune response is discussed.
Survey of the development of laryngeal epithelium.
An overview of the developing laryngeal epithelium has been presented to establish the norm. The sequential relationships of the formation of the protective laryngeal covering, cellular and glandular, have been reviewed. The topographical distribution of the epithelial elements in the human larynx are illustrated in the adult and contrasted in the child. Unique and previously undescribed cellular ultrastructure and transition areas have been identified. Biological integrationof form and function is again well illustrated in the epithelium of the human larynx.