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PubMed2000

PH20: a novel tumor marker for laryngeal cancer.

OBJECTIVE: To determine whether levels of PH-20, a hyaluronidase similar to that found in human sperm, are elevated in laryngeal cancer tissue. DESIGN: In this case-control study. reverse transcription polymerase chain reaction was used to measure levels of PH-20 messenger RNA in tissue taken from laryngectomy specimens. SETTING: A university medical center. PATIENTS: We compared tissue samples taken from 11 patients with laryngeal cancer, and from 2 metastatic lymph nodes, with samples of normal, healthy laryngeal tissue and prostate cancer tissue (positive control). MAIN OUTCOME MEASURE: PH-20 complementary DNA expression as quantified by densitometric analysis. RESULTS: Expression of PH-20 was significantly higher in nonirradiated laryngeal cancer specimens than in normal laryngeal tissue (P<.01). Metastatic lymph nodes also had higher levels of PH-20 expression than did primary laryngeal cancer tissue (P = .11) and normal laryngeal tissue (P<.01). Irradiated laryngeal cancer specimens had PH-20 levels comparable to normal. CONCLUSIONS: We report the first data on PH-20 expression in laryngeal cancer tissue. PH-20 expression is significantly elevated in primary laryngeal cancer tissue and seems to be even higher in metastatic lesions compared with normal laryngeal tissue. PH-20 may be a useful tumor marker and prognostic tool for laryngeal cancer.

Biomarkers, Tumor↗
PubMed1996

Effect of omeprazole on the course of associated esophagitis and laryngitis.

Esophagitis has increasingly been implicated as a cause of chronic laryngitis and there is some evidence that gastro-esophageal reflux disease (GERD) is more common in patients with laryngitis. The aim of this study was to evaluate whether patients with esophagitis and laryngitis responded to treatment with omeprazole. Of 74 consecutive patients with endoscopically proven GERD, 21 had laryngitis. These 21 patients with associated esophagitis and chronic laryngitis were treated for 4 weeks with omeprazole 40 mg per day. After 2 weeks of treatment and at the conclusion of the study, 2 weeks later, esophagoscopy and laryngoscopy were performed and the patients responded to a questionnaire on their symptoms. The follow-up period was 1 year. Twenty-one of the 74 patients (28.4%) had esophagitis (grade I, n = 12; grade II, n = 9) and associated laryngitis (grade I, n = 14; grade II, n = 7). The severity of the esophagitis accorded with the severity of the laryngitis. After 2 weeks' treatment with omeprazole, both the esophageal and the laryngeal symptoms had improved in all 21 patients. Endoscopically, the healing rates were 62% for esophagitis and 33.3% for laryngitis. At the end of the study period, at 4 weeks, all patients were symptom-free and the esophagitis and laryngitis had healed completely. No patient suffered from drug-induced side effects. Patients with associated laryngitis and esophagitis should be given adequate anti-reflux therapy. Both the laryngeal and esophageal symptoms improved with the omeprazole treatment, suggesting that reflux was the underlying etiology.

Adult↗
PubMed2007

PC cell-derived growth factor overexpression promotes proliferation and survival of laryngeal carcinoma.

PC cell-derived growth factor is a novel growth factor for tumor formation and progression. No comprehensive literature concerning PC cell-derived growth factor expression status and its biological function in squamous cell carcinoma, especially in the larynx, is, however, available. The target of this study is to evaluate the clinical significance of PC cell-derived growth factor and the potential of small interfering RNA-induced genetic silencing of PC cell-derived growth factor as a supplementary therapeutic way for laryngeal squamous cell carcinoma. A total of 146 primary laryngeal cancer, 108 adult laryngeal papilloma and 41 laryngeal leukoplakia samples, as well as 10 normal larynx tissues were investigated. The PC cell-derived growth factor mRNA level was examined by real-time polymerase chain reaction and protein localization by immunohistochemistry. The biological function of PC cell-derived growth factor was assessed by transfection of small interfering RNA PC cell-derived growth factor construction. The PC cell-derived growth factor protein levels and mRNA levels of the laryngeal squamous cell carcinomas were significantly higher than those of normal laryngeal tissues (P<0.001). Simultaneously, the difference in the levels of mRNA and protein between those of laryngeal precancerous lesions (papilloma/leukoplakia) and those of normal tissues was significant (P<0.05, P<0.05), whereas those of laryngeal precancerous lesions (papilloma/leukoplakia) were significantly lower than those of laryngeal squamous cell carcinomas (P<0.05, P<0.05). Strong PC cell-derived growth factor expression was associated with lymph node metastases in laryngeal squamous cell carcinoma (P<0.05). Functional studies on Hep-2 cell lines demonstrated that the attenuation of PC cell-derived growth factor expression levels led to diminished cell proliferation rates (P<0.001), anchorage-independent growth in vitro (P<0.001), tumor forming in vivo (P<0.01) and resistance to apoptosis (P<0.001). PC cell-derived growth factor is a pivotal autocrine growth factor in the tumorigenesis of laryngeal squamous cell carcinoma. Our findings also indicate that PC cell-derived growth factor is a logical and potential target for early diagnosis, specific therapy and prognosis of laryngeal squamous cell carcinoma.

Aged↗
PubMed2006

[Diagnosis and treatment of laryngeal web in infants].

OBJECTIVE: To summarize the clinical manifestation, operative method and therapeutic effect of various type of laryngeal web in infants. METHODS: The clinical data of 12 cases were analyzed, 5 cases of which were congenital laryngeal web (4 cases, glottic type; 1 case, subglottic type), 7 cases of which were secondary laryngeal web (1 case, tuberculous laryngeal web; 6 cases, traumatic laryngeal web). Diagnosis was mainly depended on history and clinical manifestation. Final diagnosis was depended on fibrolaryngoscope and pathological report. Microlaryngoscopic surgery was the main operative method. However, specific infection should be cured before operation. RESULTS: During 3-18 months follow-up, 4 glottic laryngeal webs were cured. One subglottic laryngeal web case well recovered and secondary surgery is not needed at least recently. One tuberculous laryngeal web was followed up for 6 months, no vocal adhesion was observed. During 3-6 months follow-up, 1 traumatic laryngeal web was cred, while the other 6 cases need secondary surgery. CONCLUSIONS: Final diagnosis of congenital laryngeal web is mainly depended on fibrolaryngoscope. And prognosis of it is well. Laryngeal web induced by specific infection should be cured specific infection before operation. The prevention is the key for traumatic laryngeal web because the surgery outcome is not satisfactory.

Child↗
PubMedDate not supplied

An in vitro comparison of cordopexy, cordopexy and laryngoplasty, and laryngoplasty for treatment of equine laryngeal hemiplegia.

OBJECTIVE: To examine the effect of cordopexy, laryngoplasty, and cordopexy combined with a modified laryngoplasty on airway mechanics. STUDY DESIGN: Experimental airway mechanics were determined by subjecting equine cadaveric larynges to airflows similar to inspiratory airflow of exercising horses. ANIMALS OR SAMPLE POPULATION: Twenty equine larynges. METHODS: Using cadaveric larynges, we developed and tested a new technique of arytenoid cartilage abduction. All larynges had the right arytenoid cartilage abducted to mimic the degree of arytenoid abduction that occurs at maximal exertion in live horses. Three surgical techniques were used to stabilize the left arytenoid cartilage of treated larynges; the left arytenoid cartilage was not stabilized in control larynges. Technique 1: Cordopexy--a suture was placed between the vocal ligament and the lamina of the thyroid cartilage. Technique 2: Standard laryngoplasty--a suture was placed between the muscular process of the arytenoid cartilage and the caudomedial aspect of the cricoid cartilage. Technique 3: Cordopexy plus modified laryngoplasty--the cordopexy suture was placed with a second suture between the horizontal ridge rostral to the muscular process of the left arytenoid cartilage and the lamina of the thyroid cartilage. Translaryngeal impedances (TI) were determined for each surgical technique by subjecting the larynges to increasing airflows and measuring the translaryngeal pressure differences. The arytenoid right to left angle quotient (RLQ) and the glottic cross-sectional area (CSA) were also measured. RESULTS: At maximal airflow, the adjusted means for the arytenoid RLQ and the TI for the cordopexy plus modified laryngoplasty (1.48 +/- 0.04, 0.69 +/- 0.05 cm H2O/L/s) and the standard laryngoplasty (1.39 +/- 0.04, 0.78 cm H2O/L/s) were different (P < .05) from values obtained after cordopexy alone (2.74 +/- 0.37, 1.76 +/- 0.48 cm H2O/L/s) or in control larynges (3.66 +/- 0.54, 4.16 +/- 0.96 cm H2O/L/s). Overall, a cordopexy plus modified laryngoplasty (9.69 cm2), a standard laryngoplasty (9.34 cm2), and a cordopexy alone (9 cm2) resulted in an increased glottic CSA greater than that for control larynges (6.94 cm2; P = .0001). CONCLUSIONS: Cordopexy alone did not improve airflow in a left laryngeal hemiplegic model. Cordopexy plus modified laryngoplasty was as efficacious as the standard laryngoplasty in alleviating the effects of left laryngeal hemiplegia on TI, glottic CSA, and arytenoid RLQ. CLINICAL RELEVANCE: Fixation of the vocal cord (cordopexy) in addition to a laryngoplasty procedure may prove useful in the surgical treatment of equine laryngeal hemiplegia.

Animals↗
PubMed2003

Is the external laryngeal nerve an exclusively motor nerve? The cricothyroid connection branch.

OBJECTIVES: To obtain an accurate morphological description of the nerve that provides communication between the external laryngeal nerve and the recurrent laryngeal nerve in a large sample of human larynges. STUDY DESIGN: Morphological study of human larynges. METHODS: Microdissection of 103 human larynges obtained from necropsies was performed. Both the external laryngeal nerve and the recurrent laryngeal nerve were identified and dissected. The existence of a communication between the two nerves was evaluated. RESULTS: A neural communication between the external laryngeal nerve and the recurrent laryngeal nerve was found in 85% of the larynges studied (bilaterally in 44% and unilaterally in 41%). Two patterns of communication (with single or double branches) were found. The communication between the nerves can appear at different levels, giving off collateral branches to the cricothyroid muscle (23%), the cricothyroid joint capsule (49%), and the subglottic mucosa (50%). CONCLUSIONS: The nerve supply of the human larynx is more complex than classically considered. Our study does not support the classic neuroanatomical belief that the external laryngeal nerve is purely a motor nerve to the cricothyroid muscle. Our results reveal that it carries sensory and motor fibers on to other muscles (thyroarytenoid) or regions (subglottis mucosa and cricothyroid joint), as has been demonstrated in experimental studies in cats and dogs.

Adult↗
PubMed2005

Variability in nerve patterns of the adductor muscle group supplied by the recurrent laryngeal nerve.

INTRODUCTION: Accurate knowledge of the nerve supply of each individual muscle is needed to achieve a successful selective reinnervation of the larynx. The aim of the present work was to study the nerve supply of the adductor laryngeal muscles supplied by the recurrent laryngeal nerve. STUDY DESIGN: Morphologic study of human larynges. METHODS: The muscular nerve supply was studied in a total sample of 75 human larynges obtained from necropsies (47 males and 28 females, age range from 41-95 years) and examined by careful dissection using a surgical microscope. RESULTS: The arytenoid muscle received one branch from each recurrent nerve. In 88% of cases, this branch arose in a common trunk with the upper branch of the posterior cricoarytenoid muscle. In 8% of cases, the nerve for the arytenoid muscle also had a branch going to the lateral cricoarytenoid muscle. The arytenoid muscle also received from one to three pairs of branches from the posterior division of the internal laryngeal nerve; these were interconnected ipsi- and contralaterally and were also connected to the two branches coming from the recurrent laryngeal nerve. The lateral cricoarytenoid muscle received from one to six branches from the recurrent nerve, but in 5.8% of cases, it also received a twig from a connecting branch between the recurrent nerve and the external (5.6%) or the internal laryngeal nerves (0.2%). The thyroarytenoid muscle received from one to four branches from the recurrent nerve, but in 5.6% of cases, it also received a twig from a connecting branch between the recurrent nerve with the external (4.6%) or the internal (1%) laryngeal nerves. CONCLUSION: No abductor or adductor division of the recurrent laryngeal nerve was found in the present study. In 88% of cases, the nerve supply to the arytenoid muscle (adductor) and the posterior cricoarytenoid muscle (abductor) arose from a common trunk, which in 8% of cases, also had a branch to the lateral cricoarytenoid muscle. Furthermore, the high incidence of branches innervating the adductor muscles from connections between the recurrent laryngeal nerve and the internal and external laryngeal nerves led us to reconsider the contribution of these nerves in the supply to this muscle group.

Adult↗
PubMed1993

ras gene mutations and HPV infection are common in human laryngeal carcinoma.

To evaluate the role of ras activation and human papillomavirus (HPV) infection in laryngeal carcinoma, we analyzed tumor DNA from 43 cases, including 25 primary laryngeal tumors, 12 lymph-node and one skin metastases, and 5 recurrent laryngeal carcinomas. Thirteen normal laryngeal tissues and 7 benign laryngeal nodule biopsy specimens along with normal tissue surrounding laryngeal carcinoma in 2 cases were also included. The polymerase-chain-reaction technique was used to amplify DNA fragments containing codon 12 and 61 of H-, K- and N-ras, also HPV 16, 18 and 33 DNA, subsequently hybridized with sequence-specific oligonucleotides. DNA samples from 22 patients with laryngeal carcinoma revealed ras mutations (18 in N-ras codon 12, 6 in H-ras codon 61, and 3 in K-ras codon 61). Likewise, HPV DNA was found in 16 cases (HPV 16, 18 and 33 in 3 cases, 14 cases and 1 case respectively). ras mutations were significantly higher in metastatic tumors (10 of 13 cases) than in primary (11 of 25 cases) and recurrent laryngeal carcinomas (1 of 5 cases). HPV DNA was detected in 60% of recurrent, 44% of primary and 15% of metastatic tumors. Only 2 of the 13 normal laryngeal tissues and 1 out of 7 laryngeal nodule specimens were found to contain HPV DNA. These results suggest that ras activation, especially in N-ras codon 12.1 (GGT-->AGT) and HPV infection are 2 important factors in (multistage) laryngeal carcinogenesis. The ras mutation may be associated with metastatic ability of the tumor.

Adult↗
PubMed2006

Superior approach to the inferior laryngeal nerve in thyroid surgery: anatomy, surgical technique and indications.

GOALS OF THE STUDY: To describe the anatomical bases of the surgical access to the higher part of the thyroid lobe, with first location of the inferior laryngeal nerve at its laryngeal penetration, to discuss the advantages and disadvantages of this surgical technique and to determine the operational indications. POPULATION AND METHOD: A prospective study of surgical anatomy performed over a period of 18 months was conducted. A total of 25 (22 women and 3 men) patients with cervicothoracic goitre underwent total thyroidectomy. Thyroid lobectomies were performed using the technique of "capsular thyroidectomy", with first location and complete dissection of the inferior laryngeal nerve. A neurostimulator was systematically used for the location of the inferior laryngeal nerve and also the external laryngeal nerve. RESULTS: The first detection of the inferior laryngeal nerve at the top of the thyroid lobe was positive in 49/50 cases. A superior parathyroid gland was found in 75% of cases and an inferior parathyroid gland in 37.5% of cases. The external laryngeal nerve was stimulated and respected in 12,5% of cases. No voice trouble, no laryngeal palsy and no definitive hypoparathyroidism occurred after surgery. CONCLUSION: Safeguarding of the inferior laryngeal nerve is the principal and obligatory stake in thyroid surgery. Locating the inferior laryngeal nerve at the level of its laryngeal penetration at the superior pole of the thyroid region is necessary in cases of particular situations: huge cervicothoracic goitres, re-operative procedures and various anatomical variations. The use of a neurostimulator secures this technique.

Adult↗
PubMed2006

Accuracy of laryngeal examination during upper gastrointestinal endoscopy for premalignancy screening: prospective study in patients with and without reflux symptoms.

BACKGROUND AND STUDY AIMS: Gastroesophageal reflux disease may be associated with laryngeal damage caused by reflux material. The aim of this study was to investigate the accuracy of laryngeal examinations during routine upper gastrointestinal endoscopy as a method of screening for major laryngeal injury in a series of patients with reflux symptoms. PATIENTS AND METHODS: A total of 100 consecutive patients with reflux symptoms and 100 control individuals underwent upper gastrointestinal endoscopy with standard or high-resolution magnifying video endoscopes. Any laryngeal abnormalities were initially identified by the gastroenterologist before the scope was inserted into the esophagus. All of the examinations were recorded on video and subsequently reevaluated by an otorhinolaryngologist. All of the patients underwent standard laryngoscopy as a reference procedure. RESULTS: All of the patients completed the study. The sensitivity, specificity, negative predictive value, and positive predictive value of the preliminary laryngeal exploration for detecting laryngeal abnormalities (such as laryngitis and vocal leukoplakia) were 90%, 90%, 92%, and 89%, respectively. High-resolution magnifying endoscopy had a higher sensitivity and specificity than standard endoscopy for detecting laryngeal pathology. Two patients were found to have laryngeal leukoplakia. CONCLUSIONS: This study shows that preliminary diagnosis of laryngeal disorders can be accurately carried out by the gastroenterologist when patients are undergoing upper endoscopy for reflux symptoms. This approach could also be helpful for the timely diagnosis of major reflux-related laryngeal disease.

Adult↗
PubMed2002

Laryngeal mask airway--a novel method of airway protection during ERCP: comparison with endotracheal intubation.

BACKGROUND: ERCP sometimes requires deep sedation and rarely general anesthesia with airway protection. The laryngeal mask airway device is placed perorally to create a seal over the larynx. Unlike endotracheal intubation, no tube traverses the vocal cords, thus reducing airway stimulation and obviating the need to administer muscle relaxants. The feasibility of using the laryngeal mask airway during ERCP was evaluated and recovery times compared for patients undergoing ERCP with the laryngeal mask airway versus endotracheal intubation. METHODS: In this retrospective cohort study, anesthesia records were reviewed for anesthesiologist-assisted ERCP procedures performed during a 30-month period. Demographics, procedure duration, and time from endoscope removal to extubation were abstracted. Either propofol or inhalation agents were used for anesthesia in all patients. OBSERVATIONS: Anesthesiologists administered sedation for 41 ERCPs. The airway was managed in 12 patients with endotracheal intubation and the laryngeal mask airway in 20 patients. Six patients underwent laryngeal mask airway insertion and removal while prone. A therapeutic duodenoscope was passed beyond the laryngeal mask airway with little or no resistance in all cases. Repositioning the laryngeal mask airway during the procedure was required in 1 case. Laryngeal mask airway use was associated with shorter extubation time compared with endotracheal intubation (7.2 vs. 12 min.; p = 0.004). There were no airway complications. CONCLUSION: ERCP can be performed while using the laryngeal mask airway for airway protection. The laryngeal mask airway can be placed with the patient prone, obviating the need to change position. Laryngeal mask airway shortens extubation time compared with endotracheal intubation.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1993

Pathways and mechanisms involved in neural control of laryngeal submucosal gland secretion.

The purpose of this study was to define the pathways and mechanisms involved in the neural regulation of laryngeal mucosal gland functions. In anesthetized, paralyzed, and artificially ventilated dogs, the responses of laryngeal submucosal glands to stimulation of laryngeal mechanoreceptors and peripheral chemoreceptors were examined by measuring the number of hillocks and volume of secreted fluid before and after activation of sensory nerve endings. Compared with a control period, the number of hillocks and volume of secreted fluid significantly increased (P < 0.05) with mechanical stimulation of the vocal folds (n = 13) and with chemical activation of peripheral chemoreceptors by systemic administration of sodium cyanide (100 micrograms/kg; n = 11). The reflex responses induced by vocal fold stimulation and activation of peripheral chemoreceptors were slightly decreased by interrupting transmission in the recurrent laryngeal nerves (P > 0.05) and were abolished by subsequent sectioning of superior laryngeal nerves or prior intravenous administration of atropine methylnitrate (P < 0.05). In denervated animals, topical application of nicotine on laryngeal epithelium caused significant activation of submucosal glands (P < 0.05). We conclude that laryngeal secretion can be significantly altered reflexly by stimulation of laryngeal sensory nerve endings and peripheral chemoreceptors, that both superior and recurrent laryngeal nerves convey cholinergic outflow to laryngeal submucosal glands, and that nicotine acting locally activates laryngeal submucosal glands.

Animals↗
PubMed2004

The epidemiology of laryngeal cancer in Brazil.

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.

Adult↗
PubMed2002

Evaluation of airway leakage using reinforced laryngeal mask during dental anesthesia with spontaneous breathing.

BACKGROUND: The purpose of this study was to evaluate whether manipulation or position change of the head during dental procedures for handicapped patients (mentally retarded) using a reinforced laryngeal mask airway for ventilation would lead to air leak. METHODS: All patients had a reinforced laryngeal mask airway inserted after induction of anesthesia; anesthesia was maintained with sevoflurane. Normal saline stained with methylene blue was instilled into the oral cavity of the patient. Then, the patient's laryngeal region was checked for blue staining with a fiberoptic bronchoscope. After dental treatment, the laryngeal region was checked again under fiberoptic bronchoscopy. The staining results were recorded and analyzed. RESULTS: In one of 51 patients (1.96%), the laryngeal region was stained blue after the flexible laryngeal mask airway was inserted. In ten of 51 (19.6%) patients, the laryngeal area was stained blue after the dental procedure. One of the ten patients who had a leak because the laryngeal mask was pulled out during the dental procedure. And in another one patient endotracheal tube was placed in lieu of laryngeal mask due to severe leakage. No oxygen desaturation below 90% occurred in all patients. No major complications such as fever or aspiration pneumonia were reported. CONCLUSIONS: The use of a reinforced laryngeal mask airway eliminates the complications due to endotracheal intubation and enhances the progress of the dental procedure. Although leakage may happen during dental manipulation, it usually does not raise serious problem. No serious complications such as aspiration were found in our cases. So a reinforced laryngeal mask airway may be considered to be another safe choice for maintenance of a patent airway in handicapped patients during dental procedures.

Adolescent↗
PubMed2004

[Reconstructing or pulling down tongue-base in surgical treatment of laryngeal cancer].

BACKGROUND & OBJECTIVE: The surgical treatment of laryngeal cancer, especially for the supraglottic cancer, usually involve the management of tongue-base, which is important in the rebuilding laryngeal function. There was no simple and effective method to repair tongue-base previously, which was removed for the greater part when invaded by advanced laryngeal cancer. As a result, many cases could not regain the satisfactory laryngeal function. And only several published reports focused on the efficacy of rebuilding laryngeal function by means of tongue-base flap. In order to develop a simple and reliable method to rebuild the laryngeal function, the management of tongue base in surgical treatment of laryngeal cancer was explored. METHODS: After the laryngeal carcinoma or the involved tongue-base was removed, according to the extent of surgical defect, sternohyoid myofascial flap was used to reconstruct the tongue-base, or the tongue-base was selected to rebuild the laryngeal function when greater part of it was preserved. RESULTS: Out of the 32 cases with partial laryngectomy, 26 cases were decannulated with a decannulation rate of 81.3%, all the cases regained speaking functions except 4 cases undergone total laryngectomy. All the cases resumed normal diet, none presented complication of accidental aspiration. The 3-year and 5-year survival rates were 81.3% and 65.6%, respectively. CONCLUSION: Reconstructing or pulling down the tongue-base is highly effective in rebuilding satisfactory laryngeal function, which is easily and simply performed with less damage and complications, appropriate for surgical treatment of laryngeal cancer.

Adult↗
PubMed2005

[Expression of chemokine receptor CXCR4 and CCR7 in laryngeal carcinoma].

OBJECTIVE: This study was designed to observe the expression of CXCR4 and CCR7 in laryngeal carcinoma tissues in order to primitively clarify the relationship between Chemokine Receptor CCR7 and CXCR4 and the malignity of laryngeal carcinoma. It would be helpful to cure laryngeal carcinoma. METHOD: We examined the expression of Chemokine Receptor CXCR4 and CCR7 in 30 cases laryngeal carcinoma tissues (experiment group) and 18 cases normal laryngeal tissues (control group)with immunohistochemistry. And qualitative analysis of light microscopy with computer-assisted image system was employed. Then our conclusion was drawn from statistical analysis. RESULT: (1) Chemokine Receptor CXCR4 and CCR7 were positively expressed in laryngeal carcinoma tissues while they were negative in the control group. Their expressions were significantly higher than those of control group (P < 0.01).; (2) Chemokine Receptor CXCR4 and CCR7 expression in laryngeal carcinoma declined with the rise of the differentiation grade of laryngeal carcinoma (P < 0.05). The expression of CXCR4 and CCR7 were significantly higher in the group with lymph node metastasis than those without lymph node metastasis (P < 0.01). And the same results appeared between laryngeal carcinoma groups with different clinical stages (P < 0.01). CONCLUSION: Chemokine Receptor CXCR4 and CCR7 are highly expressed in laryngeal carcinoma, and their expression were associated with differentiation grade of laryngeal carcinoma, clinical stage and neck lymph node metastasis.

Adult↗
PubMed1986

[Laryngeal nerves. A histomorphometric and cartographic study].

Major difficulties in laryngeal reconstruction are due to laryngeal nerves. A study was conducted of 100 larynges from fresh subjects after vascular injection. Vascularization of superior laryngeal nerves is derived essentially from superior laryngeal and ascending pharyngeal arteries. Inferior laryngeal nerves obtain their vascular supply from inferior thyroid and main carotid arteries. Histomorphometric study of laryngeal nerves used semi-automatic techniques: microscope, numerical table, computer, printer. The number of fibers per nerve varied between 511 and 2.244, the number of nerve fasculi between 3 and 14, and the diameter of myelinated fibers between 2 and 12 micron. Fibers of left inferior laryngeal nerve had a mean diameter (8.9 to 10.2) greater than those of right inferior laryngeal nerve (5.1 to 5.2 micron). Nerve tissue represented 60% to 66% of total. The left recurrent was longer than right nerve but had larger fibers providing more rapid conduction. Cartography of laryngeal nerves from 2 mm serial sections confirmed their plexis structure, this study providing new and objective precisions on laryngeal nerve structure.

Histological Techniques↗
PubMed1993

The roles of sex, innervation, and androgen in laryngeal muscle of Xenopus laevis.

The relative contributions of innervation and androgen to three muscle fiber properties--twitch type, size, and number--were examined in the sexually dimorphic, androgen-sensitive laryngeal muscle of Xenopus laevis. In adults, the muscle contains all fast-twitch fibers in males and fast- and slow-twitch fibers in females; laryngeal muscle fibers are larger and more numerous in males than in females. Juvenile larynges are female-like in both sexes; male laryngeal muscle is subsequently masculinized by androgen secretion during postmetamorphic development. Because both laryngeal motor neurons and muscle fibers are androgen sensitive during masculinization, we examined the role of the nerve in androgen-regulated muscle fiber development. Laryngeal muscle of male and female juvenile frogs was unilaterally denervated, and effects on muscle fiber type, size, and number were examined 4 weeks later. Half of the frogs received a dihydrotestosterone pellet at the time of denervation. Androgen treatment converts laryngeal muscle from mixed slow and fast to all fast twitch in both innervated and denervated muscle. Thus, the nerve is not required for androgen-regulated fiber type expression in either sex. Denervation produces muscle fiber atrophy and androgen treatment induces muscle fiber hypertrophy in male and female larynx. Nerve and hormone effects are independent and additive; fiber size in androgen-treated denervated muscle is greater than in untreated innervated muscle, and fiber size in androgen-treated denervated muscle is smaller than in androgen-treated innervated muscle. There is no sex difference in the effects of innervation or androgen on fiber size. Denervation causes laryngeal muscle fiber loss in males but not in females. Androgen treatment protects male laryngeal muscle from denervation-induced fiber loss and causes fiber addition in innervated female laryngeal muscle. We conclude that there is a sexually dimorphic interaction between innervation and androgen in control of laryngeal muscle fiber number.

Androgens↗