Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “GLOTTIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2002

A cadaver study to measure the adult glottis and subglottis: defining a problem associated with the use of double-lumen tubes.

OBJECTIVE: To test the hypothesis that the adult cricoid diameter is the same or less than that of the glottis. DESIGN: Prospective. SETTING: A city mortuary. PARTICIPANTS: Adult cadavers undergoing autopsy. INTERVENTIONS: After removal of the organs, the trachea was opened above the first ring to allow access to the cricoid from below, and the cricothyroid membrane was cut so that passage of measuring sounds through the vocal cords from above could be confirmed. MEASUREMENTS AND MAIN RESULTS: In 79 male and 55 female cadavers, the largest of a graduated series of cylindrical sounds that the cricoid ring would accommodate was noted. Then the biggest size possible that could pass through the glottis was measured. Height and weight were recorded. In 68% of males and 76% of females, glottic diameter was greater than subglottic; in all other cases, it was the same. In none was it smaller. Correlation between height and cricoid diameter was 0.24 for male cadavers and 0.21 for female cadavers. Regression analysis showed females to average a cricoid diameter 3.5 mm less than males of the same height. CONCLUSIONS: The ruling diameter of the adult larynx is not the glottis but the cricoid ring. Its correlation with height is extremely poor, and it averages 3.5 mm less in females than males of the same height. These findings are important for thoracic anesthesiologists.

Adult↗
PubMed1998

Characteristics of glottis-induced turbulence in oscillatory flow: an empirical investigation.

Turbulence inducement from the glottis was scrutinized by employing an idealized model of the larynx and trachea for oscillatory flow conditions. The characterization of turbulence was achieved with the two-component velocity measurements of split-film probe anemometry and with the flow visualization of a smoke-wire technique. The apertures of two different (triangular and circular) shapes were utilized in the airway model to address the distinct effects of the triangular-shaped glottal aperture on the generation, development, and decay of turbulence. One of the salient turbulence characteristics for the triangular aperture case was found to be the relatively high turbulence levels around the center region (2r/D approximately 0) in conjunction with the asymmetric mean axial velocity across the frontal-rear (A-O-P) plane of the trachea at one tracheal diameter (x/D = 1) downstream from the glottis. The detailed turbulence properties such as the Reynolds shear stresses and turbulence intensities for the triangular aperture case differed significantly from those for the circular aperture case within a few tracheal diameters (x/D < 7) downstream from the apertures. The glottis-induced turbulence was incipient during the acceleration phase of inspiration and convected downstream with the traits of decaying turbulence.

Acceleration↗
PubMed1996

Nasal two-level positive-pressure ventilation in normal subjects. Effects of the glottis and ventilation.

The purpose of this study was to examine the behavior of the glottis during intermittent positive-pressure ventilation (nIPPV) using a two-level positive-pressure ventilator and to compare the glottic adaptation to this ventilatory mode with the one observed using volumetric ventilators, recently reported by us. Six healthy subjects were studied during both wakefulness and sleep. Their glottis was continuously monitored through a fiberoptic bronchoscope. We measured breath by breath the widest inspiratory angle formed by the vocal cords at the anterior commissure, the corresponding tidal volume, and other indices. We used the controlled ventilatory mode. The expiratory pressure was kept at 4 cm H2O, and the inspiratory pressure was increased by steps from 10 to 15 to 20 cm H2O. Increases in inspiratory pressure did not always lead to increases in effective ventilation reaching the lungs. This was due to a significant narrowing of the glottis by adduction of the vocal cords in all subjects. Periodic breathing with or without apneas were common during wakefulness, but especially during sleep, representing 10.5 +/- 11% (SD) of total sleep time. We conclude that effective ventilation during nIPPV using a two-level positive-pressure ventilator in the controlled mode is less predictable and less stable than during nIPPV using volumetric ventilators.

Adaptation, Physiological↗
PubMed1988

[The effect of the configuration of the thyroid cartilage on the asymmetry of the dorsal glottis and its significance for vocal function].

We investigated the effect of thyroid cartilage asymmetry on the posterior glottis. 1. Patients with vocal disorders showing "crossing" of the arytenoid cartilages underwent phoniatric and logopedic investigation as well as CT scan of the larynx in the horizontal plane. The shape of the thyroid cartilage and its relation to the other laryngeal structures were measured and analysed quantitatively. 2. Laryngeal serial sections in the horizontal plane were made and analysed in the same way. 3. Experiments were done in which the configuration of the thyroid cartilage was varied and the muscular influences were stimulated to produce typical anomalies of the posterior glottis. These investigations showed that there is a correlation between the configuration of the supraglottic thyroid cartilage and anomalies of the posterior glottis. Irregular growth of the thyroid cartilage causes different positions of the aryepiglottic folds with different positions of the corniculate cartilage during phonation. The shape of the anomaly described by us correlated in all cases with reduced vocal ability. It can now be assessed by CT.

Adult↗
PubMed1999

A multimodal strategy for the treatment of patients with T2 invasive squamous cell carcinoma of the glottis.

BACKGROUND: The current conservative standard of care for T2 squamous cell carcinoma of the glottis is either partial laryngectomy or radiation therapy. METHODS: Based on an inception cohort of 100 patients with T2 squamous cell carcinoma of the glottis and a minimum of 3 years of follow-up, the present study documented the results achieved with a multimodal strategy using platinum-based induction chemotherapy and partial laryngeal surgery. Statistical analysis of survival and local control was based on the Kaplan-Meier actuarial life table method. Univariate analysis was performed to determine whether there was a correlation among various factors and toxicity, clinical response, histologic regression, local control, and survival. RESULTS: A complete clinical response and a partial response after induction chemotherapy was achieved in 24% and 58% of patients, respectively. Complete histologic regression was noted in 31%. A significant statistical relation (P < 0.0001) was noted between a complete clinical response after induction chemotherapy and a complete histologic regression. The 5-year actuarial survival estimate was 85.8%. The 5-year actuarial local control estimate was 95.7% (97.7% if the vocal cord was mobile and 93.8% if the motion of the vocal cord was impaired). Salvage treatment resulted in an overall 99% rate of local control and a 95% rate of laryngeal preservation. CONCLUSIONS: Because this represents a nonrandomized retrospective study, no definitive conclusions can be derived. However, when compared with the data reported in a large series using radiation therapy or partial laryngectomy alone, this 10-year experience suggests that, in patients with "early" invasive squamous cell carcinoma of the glottis, the use of platinum-based induction chemotherapy prior to a conventional conservative treatment modality should be investigated further.

Adult↗
PubMed2002

Comparison of endoscopic glottis-dilating operations.

Endoscopic glottis-dilating operations were first utilized in 1948 by Thornell, who performed an endolaryngeal arytenoidectomy. The real breakthrough in these operations was reported by Kleinsasser in 1968. There have been many modifications of the endoscopic glottis dilating operations by other authors over the past 30 years or more. These methods have brought great progress in relieving airway obstruction. However, some disadvantages have reduced the effectiveness of these operations. This study will compare the advantages and disadvantages of the previous methods and compare them to the methods based on the endo-extralaryngeal suture technique by Lichtenberger in the hope that some of the previous ineffectiveness of glottis-dilating operations can be eliminated. These recent endo-extralaryngeal suture techniques consist of two operations. The first operation performed on patients whose vocal cords were paralyzed is an irreversible operation. This was performed with and without arytenoidectomy. These operations were successful in 89 out of 94 patients. The second operation was reversible endo-extralaryngeal lateralization, which was carried out in 37 patients; of these operations, 35 were successful. The operation was performed, and, if the cords remained paralyzed, the suture was not removed. If there was evidence of a return of vocal cord function, the suture was removed, eliminating the need for further dilating operations. The author feels that these two operations are quite successful, because the medial mucous membrane of the vocal cord is preserved, and this avoids the scar and granuloma formation that are characteristic of most other glottic dilating operations.

Adult↗
PubMed2000

Treatment results of carcinoma in situ of the glottis: an analysis of 82 cases.

OBJECTIVES: To evaluate the results of different treatment modalities for carcinoma in situ of the glottis, and to identify important prognostic factors for outcome. DESIGN: Review of 82 cases treated definitively for glottic carcinoma in situ between 1958 and 1998. The median follow-up for all patients was 112 months, and 90% had more than 2 years of follow-up. SETTING: Academic tertiary care referral centers. INTERVENTION: Fifteen patients were treated with vocal cord stripping (group 1), 13 with more extensive surgery (group 2) including endoscopic laser resection (11 patients) and hemilaryngectomy (2 patients), and 54 with radiotherapy (group 3). Thirty patients had anterior commissure involvement and 9 had bilateral vocal cord involvement. Radiotherapy was delivered via opposed lateral fields at 1.5 to 2.4 Gy per fraction per day (median fraction size, 2 Gy), 5 days per week. The median total dose was 64 Gy, and the median overall time was 47 days. MAIN OUTCOME MEASURES: Initial locoregional control (LRC), ultimate LRC, and larynx preservation. RESULTS: The 10-year initial LRC rates were 56% for group 1, 71% for group 2, and 79% for group 3. Of those who failed, the median time to relapse was 11 months for group 1, 17 months for group 2, and 41 months for group 3. Univariate analysis showed that the difference in initial LRC rates between groups 1 and 3 was statistically significant (P =.02), although it was not statistically significant on multivariate analysis (P =.07). Anterior commissure involvement was an important prognostic factor for LRC on both univariate (P =.03) and multivariate (P =.04; hazard ratio, 1.6) analysis, and its influence appeared to be mainly confined to the surgically treated patients (groups 1 and 2). The 10-year larynx preservation rates were 92% for group 1, 70% for group 2, and 85% for group 3. Anterior commissure involvement was the only important prognostic factor for larynx preservation (P =. 01) on univariate analysis. All but 2 patients in whom treatment failed underwent successful salvage surgery. Voice quality was deemed good to excellent in 73% of the patients in group 1, 40% in group 2, and 68% in group 3. CONCLUSIONS: Treatment of carcinoma in situ of the glottis with vocal cord stripping or more extensive surgery or radiotherapy provided excellent ultimate LRC and comparable larynx preservation rates. Anterior commissure involvement was associated with poorer initial LRC and larynx preservation, particularly in the surgically treated patients. The choice of initial treatment should be individualized, depending on patient age, reliability, and tumor extent. Pretreatment and posttreatment objective evaluation of voice quality should be helpful in determining the best therapy for these patients.

Aged↗
PubMed1993

Prognostic factors for local control and survival in T1 squamous cell carcinoma of the glottis.

PURPOSE: To evaluate the effect of host, tumor, and treatment-related variables on local control and survival in patients with T1N0M0 squamous cell carcinoma of the glottis. MATERIALS AND METHODS: Ninety-one patients with T1N0M0 squamous cell carcinoma of the glottic larynx were analyzed. Median follow-up was 9 years (range 2-25). Patients were treated with daily fractions of 180 cGy to 220 cGy to doses of 5925-7000 cGy (median 6400). The following factors were analyzed: age, sex, histologic grade, disease extent, beam energy, field size, total dose, dose per fraction, and elapsed treatment days. RESULTS: The 5-year actuarial local control was 80%. On univariate analysis, only elapsed treatment days and dose per fraction were significant factors for local control. Local control was 100% if treatment was completed within 42 days, 91% for 43-46 days, 74% for 47-50 days, 65% for 51-54 days, and 50% for 55-66 days (p = 0.0001). In patients treated at < 200 cGy per fraction, local control was 62% as compared to 87% for > or = 200 cGy per fraction (p = 0.006). On multivariate analysis, only elapsed treatment days was a significant factor for local control (p = 0.0001). The 5-year actuarial survival for the whole group was 92%. Elapsed treatment days was the only variable affecting survival. Survival was 100% if treatment was delivered within 42 days, 96% for 43-46 days, 94% for 47-50 days, 91% for 51-54 days, and 67% for 55-66 days (p = 0.02). The 5-year actuarial disease-specific survival was 95%, with treatment duration again being the only significant prognostic factor. Disease-specific survival was 97% for treatment completed within 39-54 days versus 80% for 55-66 days (p = 0.02). Only three (3.3%) patients experienced moderate or severe complications. None of the evaluated parameters impacted significantly on complications. CONCLUSION: We conclude that elapsed days is the most prognostically significant factor for local control and survival in patients treated with radiotherapy for T1 squamous cell carcinoma of the glottis. We recommend that these patients be treated with 210 cGy daily fractions to 6300 cGy.

Carcinoma, Squamous Cell↗
PubMed2005

Glottis constriction response in healthy subjects.

The purpose of this study was to evaluate the glottis constriction response induced by a sudden and involuntary increase in gastric and oesophageal pressures by Tll-Ll intervertebral magnetic stimulation of the abdominal muscle roots in nine healthy subjects. Twitch flow, twitch gastric, and oesophageal pressures were measured after abdominal muscle root stimulation, which allowed pharyngo-laryngeal muscle activation to be characterized. Pharyngeal endoscopies were performed on five subjects to assess vocal cord movements. All stimulations induced positive gastric and oesophageal pressures and expiratory flow, which increased with stimulation intensity (flow: R=0.32; p<0.0001; oesophageal pressure: R=0.26; p=0.001; gastric pressure: R=0.37; p<0.0001). Twitch gastric pressure and twitch oesophageal pressure were negatively correlated with twitch flow (respectively, R=-0.183, p<0.05; R=-0.35, p<0.0001). Upper airway resistance was higher at peak oesophageal pressure than at peak flow (p<0.001). Peak twitch gastric and twitch oesophageal pressure latencies were similar (133+/-4ms and 122+/-4ms) but longer than peak twitch flow and EMG latencies (62+/-2ms and 73+/-4ms, p<0.0001). Glottis constriction following magnetic abdominal muscle root stimulation was seen in all subjects during endoscopy, with a latency estimated at between 80 and 100ms. This method could be a new, simple tool for assessing the upper airway constriction protective reflex.

Abdominal Muscles↗
PubMed1998

Effectiveness of classical chordectomy in the treatment of cancer of the glottis.

From 1980 to 1992, 85 patients diagnosed with tumour of the glottis, localized exclusively in the vocal cord area, had undergone surgery. A 90% 5-year survival rate without recurrences had been obtained. Taking into account the cases of life-saving surgery, the percentage of the 5-year survivals amounted to 94%. Considerably better results were obtained by the excision of the entire vocal cord and not just one of its sections (1/2, 2/3 etc.). The degree of deformation of the voice following chordectomy was assessed by means of acoustic and laryngographic methods (Laryngograph Processor PCLX). A 13% rate of irregularity in the functioning of the neoglottis, following surgery, was observed. The Jitter-Shimmer co-efficients were established. The results of the deformation of the voice following chordectomy were presented on the J-S scale and compared with other partial surgeries performed on patients with tumours of the glottis. All of the acoustic and laryngographic findings were presented in the from of mean values most representative of chordectomy.

Glottis↗
PubMed1999

Preservation of function and histologic appearance in the injured glottis with topical mitomycin-C.

OBJECTIVE: To evaluate the functional and histological effects of a single application of topical mitomycin-C after laser injury in the posterior canine glottis. STUDY DESIGN: A prospective, randomized study of 16 canines. METHODS: A supersaturated (1%) solution of topical mitomycin-C was applied to a unilateral, laser-induced injury near the cricoarytenoid joint in eight dogs. The mitomycin-soaked pledget was placed immediately after induction of the injury and was left in contact with exposed cartilage for 3 minutes. The opposite side was not injured to provide an internal control. In eight additional dogs, the same laser injury was allowed to heal untreated. After 6 weeks, the animals were sacrificed and their larynges harvested. Arytenoid adduction sutures were placed bilaterally, and the force required to bring the vocal folds to midline was measured for each side using tensiometry. Gross and microscopic histological analysis was performed. Statistical analysis was accomplished using a two-tailed Student t test of unpaired samples, and the Wilcoxon Signed Rank Test where appropriate. RESULTS: The mitomycin-C treated larynges demonstrated improved cricoarytenoid joint mobility (P = .007), decreased granulation tissue development (P = .03), and complete prevention of secondary "vocal granuloma" formation (P = .0004) when compared with eight dogs with identical laser injuries allowed to heal untreated. No complications were noted. CONCLUSIONS: This study demonstrates functional preservation and improved histological appearance of the injured glottis after a single treatment with topical mitomycin-C. Potential applications of these findings include prophylactic use of topical mitomycin-C on glottic insults that commonly progress from granulation tissue formation to scarring and decreased vocal fold function.

Administration, Topical↗
PubMedDate not supplied

Effect of the signal measured from the glottis on determination of the vocal tract shape.

All-pole and pole-zero models for the vocal tract are developed. First an impulse train, then the pressure signal measured from the glottis, is used as the input in the models. The models for eight Turkish vowels produced by one male subject are studied to determine the effects of the presumed impulse train and the pressure signal measured from the glottis on the estimation of the vocal tract shape. The motion of the tongue is also examined for a whole word.

Biomedical Engineering↗
PubMed2004

Sound generation by steady flow through glottis-shaped orifices.

Although the signature of human voice is mostly tonal, it also includes a significant broadband component. Quadrupolelike sources due to turbulence in the region downstream of the glottis, and dipolelike sources due to the force applied by the vocal folds onto the surrounding fluid are the two primary broadband sound generating mechanisms. In this study, experiments were conducted to characterize the broadband sound emissions of confined stationary jets through rubber orifices formed to imitate the approximate shape of the human glottis at different stages during one cycle of vocal fold vibrations. The radiated sound pressure spectra downstream of the orifices were measured for varying flow rates, orifice shapes, and gas mixtures. The nondimensional sound pressure spectra were decomposed into the product of three functions: a source function F, a radiation efficiency function M, and an acoustic response function G. The results show that, as for circular jets, the quadrupole source contributions dominated for straight and convergent orifices. For divergent jets, whistling tonal sounds were emitted at low flow rates. At high flow rates for the same geometry, dipole contributions dominated the sound radiated by free jets. However, possible source-load acoustic feedback may have hampered accurate source identification in confined flows.

Computer Simulation↗
PubMed1991

T1-T2 carcinoma of the glottis: relative hypofractionation.

Radiation therapy, the preferred primary treatment for early squamous cell carcinoma of the glottis, offers high local control rates with voice preservation; however, the optimal treatment schedule is subject to debate. Local control, with and without surgical salvage, and associated long-term effects and complications were retrospectively analyzed in 90 patients treated with definitive radiation therapy for T1-T2 squamous cell carcinoma of the glottis. Patients received three weekly fractions of 333 cGy to a total dose of 60 Gy in 6 weeks. Median follow-up was 51.5 months. With radiation therapy alone, local control was 92% for T1 disease and 88% for T2; with surgical salvage, the control rate was 99%. Long-term effects included moderate hoarseness (16% of patients) and moderate or severe laryngeal edema (10% of patients). In seven patients who underwent salvage surgery, the complication rate was 29%. Despite excellent local control, this regimen may produce more long-term effects and complications than conventional fractionation.

Carcinoma, Squamous Cell↗
PubMed1995

Effects of nasal positive-pressure hyperventilation on the glottis in normal awake subjects.

We have recently observed obstructive apneas during nasal intermittent positive-pressure ventilation (nIPPV) and suggested that they were due to hypocapnia-induced glottic closure. To confirm this hypothesis, we studied seven healthy subjects and submitted them to nIPPV while their glottis was continuously monitored through a fiber-optic bronchoscope. During wakefulness, we measured breath by breath the widest inspiratory angle formed by the vocal cords at the anterior commissure along with several other indexes. Mechanical ventilation was progressively increased up to 30 l/min. In the absence of diaphragmatic activity, increases in delivered minute ventilation resulted in progressive narrowing of the vocal cords, with an increase in inspiratory resistance and a progressive reduction in the percentage of the delivered tidal volume effectively reaching the lungs. Adding CO2 to the inspired gas led to partial widening of the glottis in two of three subjects. Moreover, activation of the diaphragmatic muscle was always associated with a significant inspiratory abduction of the vocal cords. Sporadically, complete adduction of the vocal cords was directly responsible for obstructive laryngeal apneas and cyclic changes in the glottic aperture resulted in waxing and waning of tidal volume. We conclude that in awake humans passive ventilation with nIPPV results in vocal cord adduction that depends partly on hypocapnia, but our results suggest that other factors may also influence glottic width.

Adult↗
PubMed1997

Barrier between the supraglottis and the glottis: myth or reality?

Controversial opinions on the existence of a "barrier" between the supraglottic and glottic regions of the larynx are reported. Even if the two areas have different embryological derivations, there is no anatomic evidence of a "barrier" that could prevent supraglottic cancer from extending downward to the glottis. Numerous adequate pathologic studies, including whole organ sections, confirm that for advanced cancers, anatomic compartments delimiting the spread of the neoplastic process from the supraglottis to the glottis do not exist. Therefore, supraglottic laryngectomy should be performed not on the basis of embryological considerations, but on the basis of the actual extension of the neoplastic lesion.

Glottis↗
PubMed2005

[Horizontal glottectomy--oncological and functional results. Part II. Morphology of the glottis and perceptive-acoustics characteristic of the voice and speech after horizontal glottectomy].

INTRODUCTION: The authors showed findings concerning glottis morphology and perceptual-acoustic characteristics of voice and speech after partial classical (PCGLg) and extended glottic partial laryngectomy (PEGLg). MATERIAL AND METHODS: 10 patients (9 M., 1 F. average age 56 (min. 47 max. 65) were examined. All patients were undergone glottic partial laryngectomy: a) classical (n = 5) b) extended of vocal process (n = 3) with (n = 2) or without (n = 1) the removal of the mucous false folds, c) extended of part of arytenoid cartilage with (n = 2) or without (n = 1) the removal of the mucous of the false folds. The following examinations were executed: phoniatric, videolaryngoscopic and perceptual-acoustic analysis. RESULTS: After PCGLg and one extended of vocal process, voice and speech has mostly characterized of features of hypofunction dysphonia. Hyperfunction was found in patients after removal of the mucous of the false folds due to leucoplakia. In case of removing of a part of arythenoid cartilage the notable or entire standstill or lack of full phonatory closure were found. The phonetical-acoustic analysis showed that in patients using melodious voice, the character of the source of actuating was periodically-noise, with the component of noise in all range of the course of the acoustic signal of voice. The parameters such as F0, jitter, shimmer does not make coherent conclusions and are less useful in the assessment of the quality of voice. CONCLUSIONS: In case of the resection of the part of the arythenoid cartilage during glottis laryngectomy, we take into account lack of full phonatory closure and using whisper by the patients. Obtaining the reliable conclusions needs continuations of the investigations and increasing number of patients. These researches are in progress.

Aged↗
PubMed1988

Carcinoma in situ and microinvasive squamous carcinoma of the laryngeal glottis.

Twenty-five patients with severe squamous intraepithelial neoplasia, grade 3 (SIN III) of the glottis were identified and followed up; three patients (12%) eventually developed invasive carcinoma and nine patients (36%) were noted to have coexisting microinvasive carcinoma. Two of the patients with microinvasive carcinoma were treated by hemilaryngectomy, three with stripping and radiation therapy, two with stripping alone, and two by radiation therapy. None of the patients developed recurrent disease after one to five years of follow-up. This observation supports the approach of treating "true" microinvasive carcinoma similar to carcinoma in situ. The 16 remaining patients were treated by stripping (ten patients), stripping and radiation therapy (four patients), and radiation therapy alone (two patients). Three patients progressed to invasive squamous carcinoma at 35, 39, and 84 months after the diagnosis of SIN III. Patients in this study displaying SIN III with or without microinvasive carcinoma were successfully treated by surgery or radiation therapy alone or by combined therapy. The finding of 12% progression to invasive carcinoma and coexisting microinvasive carcinoma in 36% confirms the preinvasive nature of SIN III of the laryngeal glottis.

Adult↗