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At least 217 records · Page 12Linked to original sources
PubMed1998

Computerized tomography of the glottis after intracordal autologous fat injection.

According to the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery, various surgical methods such as laryngeal framework surgery, laryngeal re-innervation, and injection laryngoplasty might be used to palliate inferior laryngeal nerve paralysis. In the present case report we document the survival and exact location of the boluses of autologous fat in one patient in whom this material was used for injection laryngoplasty.

Adipose Tissue↗
PubMed1996

[Endolaryngeal surgical procedures in glottis expansion in bilateral recurrent nerve paralysis].

OBJECTIVE: Subtotal cordectomy and posterior cordectomy have repeatedly been recommended as surgical interventions restoring the airway, for the treatment of bilateral vocal cord paralysis. The objective of this study was to assess the effectiveness of transoral laser cordectomy and posterior cordectomy as compared to laser arytenoidectomy and to compare the respiratory and phonatory results of these minimally invasive procedures. MATERIAL AND METHODS: Forty patients with bilateral vocal cord paralysis were included in a prospective study and operated upon to improve their laryngeal airways. Twenty-two patients had cordectomy, 13 had arytenoidectomy, and 5 had posterior cordectomy. Lung function tests and voice analysis were obtained preoperatively and postoperatively. Subclinical aspiration was determined by endoscopic evaluation of the larynx during deglutition. The results were compared to determine the relative effectiveness of the three surgical methods. RESULTS: Flow volume spirograms documented equally improved flow rates in both groups. Final voice evaluation revealed maximum phonation time. Peak sound pressure levels and frequency range were reduced in all 28 patients, but phonatory results varied considerably in each group. Subclinical aspiration was noticed in 5 out of 10 patients after arytenoidectomy, but in none of 18 patients after cordectomy. Four previously tracheotomised patients were decannulated within 2 weeks after surgery, while the other 24 patients had no perioperative tracheotomies. CONCLUSION: Transoral laser cordectomy and arytenoidectomy are equally effective and reliable in the management of the restricted airway. Cordectomy and posterior cordectomy offer the advantage of uncompromised deglutition after surgery. Although no clinically relevant aspiration occurred in any of the patients, cordectomy should be considered as the method of choice in patients for whom subclinical aspiration could be potentially harmful due to coexisting pulmonary or cardiac disease. Phonatory outcome is not predictable with both surgical procedures. Subtotal cordectomy and posterior cordectomy are easier and faster to perform, and subclinical aspiration is not encountered with these procedures.

Airway Resistance↗
PubMed1991

[Laser surgical microlaryngoscopic glottis dilatation in the treatment of recurrent bilateral nerve paralysis. Surgical technique and results].

In addition to conventional endoscopic operation procedures for vocal fold lateralisation, laser surgery has been used to perform endolaryngeal arytenoidectomy by individual laryngologists during the past few years. With respect to a regular swallowing function, the endoscopic technique presented in this paper preserves the arytenoid cartilage. Instead, a submucosal cordectomy is performed and the mucosal flap is glued onto the endolaryngeal wound. Tracheostomy is usually not required with this technique. 15 own cases are described, 14 of whom showed a sufficient respiratory result. Indications for endoscopic laser surgery in the treatment of bilateral vocal cord paralysis are discussed.

Adult↗
PubMed1990

[Considerations and studies of the classification of glottis cancers].

Since 1972, the principles of the T classification of glottic carcinomas have remained unchanged. Nevertheless, discrepancies between T-classification and post-therapeutic pT classification are reported repeatedly and doubts have been expressed about the reliability of this system. Our T classification is based on pathohistological investigations performed 20 years ago. Therefore, the origin of the above-mentioned discrepancies must be sought in the definition and the clinical diagnostics. First, problems of the T classification of glottic cancer are analyzed and discussed on the basis of conditions which must be fulfilled by each classification: (1) clearly defined boundaries of the anatomical regions; (2) clearly defined rules for classification; (3) practicability for the clinician as well for the pathologist and comparability for both, and (4) prognostic relevance. Second, a new definition of the glottic region is proposed. It should be confined to the extension of the vocal ligaments, their anterior commissure and the medial surface of the arytenoid cartilages, including Reinke's space and the epithelial layer covering all the described areas. This is because the glottic region is confined to anatomical areas with reduced lymphatic drainage and a connective tissue barrier. The proposal is based on an anatomical and morphometric investigation of 154 larynx specimens. Third, 403 glottic carcinomas, treated between 1970 and 1984 were classified by the current T classification and histologically by pT classification (UICC 1987). By comparing these two classifications it was established that the early carcinomas had been overestimated and the advanced carcinomas underestimated.(ABSTRACT TRUNCATED AT 250 WORDS)

Follow-Up Studies↗
PubMed2003

[CO2-laser decortication: an efficient alternative to radiotherapy in the treatment of T1a carcinomas of the glottis].

OBJECTIVE: Given that CO2-laser decortication and radiotherapy are equally effective in the treatment of T1a glottic carcinomas, to determine which of the two is most efficient with respect to treatment costs. DESIGN: Retrospective analysis. METHOD: The costs of both treatment modalities from the first visit to the Free University Medical Centre, Amsterdam, the Netherlands, until two years after the start of the treatment were calculated, based on the medical consumption of 89 patients who were treated with curative intent for a T1a glottic carcinoma in the years 1995-1999. RESULTS: The total costs from diagnosis until two years after the start of treatment were [symbol: see text] 7,253,- for radiotherapy and [symbol: see text] 3,864,- for CO2-laser decortication. These amounts included the costs of diagnosis and treatment of any recurrence or benign laryngeal disorders occurring within the two-year interval. The difference was statistically significant. CONCLUSION: Radiotherapy was significantly more expensive than CO2-laser decortication. Therefore CO2-laser decortication is an efficient alternative to radiotherapy in the treatment of eligible patients with T1a glottic carcinoma.

Aged↗
PubMedDate not supplied

Salvage chemotherapy and surgery for radio recurrent carcinoma glottis.

Chemoradiotherapy is increasingly used in advanced laryngeal cancers. Failures are generally managed by surgery. They include histologically confirmed recurrent or residual disease or a symptomatic life threatening treatment sequelae. Tumour recurrence or residivism can be managed by chemotherapy when radical surgery is either refused by the patient or if the general condition of the patient do not permit it. However surgery becomes inevitable when life threatening treatment sequelae like absolute pharyngo-oesophageal stricture and aspiration sets in.

Antineoplastic Agents↗
PubMed2006

[Glottis morphology after supracricoid laryngectomy with CHP or CHEP--protetective and respiratory function assessement].

The aim of this study was to evaluate morphology and assess of the protective and respiratory function of larynx after cricohyopexis (CHP) and cricohyoepiglottopexis (CHEP). The examined group consisted of 58 patients (49 males and 9 female) operated between 1984-2002. An average age 54 (min. 36, max. 67). 32 patients underwent CHP and 26 had CHEP. CHP was performed in following modes: a) 1 aryteroid cartilage left in 17 (43,75%) cases, b) 2 aryteroid cartilages left in 14 (43,75%) cases and c) 1 aryteroid cartilage left and second resected with subsequent reconstruction in 1 (3,31%) case. In CHEP patients the operations were a) 17 (65,38%), b) 4 (15,38%) and c) 5 (19,23%) respectively. The aryteroid cartilage was reconstructed in 19 cases (8 after CHP and 11 after CHEP). In the reconstruction of aryteroid cartilage vascularized thyroid lobe was used in 8 cases (6 after CHP and 2 after CHEP), cuneiform or corniculate cartilage was used in 4 patients (1 CHP and 3 CHEP) and mucous membrane in 7 cases (1 CHP and 6 CHEP). To determine morphology of larynx, videolaryngoscopy was done. Thus examination distinguished 5 neoglottis shapes: oval (62,1%), longitudinal (13,8), triangle (8,6%), irregular (6,9%). In 8,6% cases the neoglottis was invisible. Decaniulation was possible in 66% patients, 24 (75%) after CHP and 14 (54%) after CHEP. In the group with both aryteroid cartilages left, 16 (89%) patients were decannulated. 31 (54%) patients complained about occasional liquid aspiration. To evaluate dysphagia, subjective complaints between 6-12, 12-18 and >18 months after surgery were analyzed. The swallowing was improving in the course of time. Between 6 and 12 months after surgery 31 (54%) subjects developed dysphagia, but after 18 months only 3 (5,1%) complained about swallowing impairment. Patients without aryteroid cartilage reconstruction or decanulated had more efficient swallowing.

Adult↗
PubMed1990

[Local and lymph node recurrence of epitheliomas starting in the glottis, treated by partial laryngeal surgery: apropos of 432 patients].

Four hundred and thirty-two patients with a carcinoma of the true vocal cord, treated with a partial laryngectomy from 1972 through 1984, were retrospectively analyzed. All patients were staged as NO, MO. Survival and death rates were not presented. A three-year minimum follow-up was achieved in 97% of the cases. Local and cervical recurrences were presented and analyzed. Factors such as local tumor extent, impaired mobility of the true vocal cord, invasion of conus elasticus or thyroid cartilage, and positive margins of resection enhance the outcome of local and cervical recurrences. This present report underscores that thyrotomies, hemilaryngectomies, and cricohyoidoepiglottopexies should be adapted to the exact tumor location and the laryngeal mobilities. Cervical lymph node recurrence is less likely to happen if local control is achieved. The role and rationale for an associated elective ipsilateral cervical and paratracheal lymph chain dissection are presented and advocated.

Adult↗