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PubMed1980

[Post-operative radiotherapy of supraglottic carcinoma: technique with three fields of 60Co (author's transl)].

Post-operative radiotherapy of supraglottic carcinoma, because of the high risk of lymph-nodal metastases, should include irradiation of the primary tumour as well as regional lymph-nodes (jugular chain, posterior cervical. supraclavicular, submental and submaxillary triangle nodes). Taking into account the anatomically complex region to be irradiated and the critical organs present within the areas involved, the authors present a treatment plan that provides the neck irradiation through three 60Co fields: Two posterior oblique and a posterior one with median lead block in correspondence to the spinal cord. The isodose curves (at jaw level, at the medium plane of the neck and at clavear level) show that the required dose distribution has been achieved by safeguarding of radiation tissue tolerance of medulla. The authors conclude that only the adoption of a "different" procedure, i.e. outwith of any reciprocal relation "portal-target", has permitted the overcoming of anatomo-clinical problems linked with the region to be irradiated. The authors believe that the adopted methodology, the only acceptable in case of irradiation of anatomically complex and articulate regions, can be also extended to simple cases where immediate and intuitive solution is not always the most appropriate, one.

Cobalt Radioisotopes↗
PubMed1995

[Detection of neck lymph node metastasis in the patients with supraglottic cancer].

Histo-pathologic materials from 115 cases of supraglottic squamous cell carcinoma were studied by retroSpective analysis. Each set of laryngeal specimens was reviewed with attention to the following factors: 1. Site of the primary lesion. 2. Size of the primary lesion. 3. Histologic grade of the primary tumor. 4. Histologic pattern at the tumor periphery. 5. Clinical and pathological stage. The features would reliably assist the laryngologist in identifying the laryngeal cancer with high probability of lymph node metastasis, so they can be used as the data for arranging the operation or treatment of the neck.

Adult↗
PubMed1995

A reappraisal of the radiologic findings of acute inflammation of the epiglottis and supraglottic structures in adults.

PURPOSE: To evaluate the radiologic characteristic of acute inflammation of the epiglottis and supraglottic structures in adults. METHODS: The clinical and radiographic findings in 27 adult patients with epiglottitis (average age, 43 years; range, 28 to 81 years) were compared with those of a control group of asymptomatic subjects (n = 15; average age, 48 years; range, 24 to 79 years). Unusual clinical aspects in the current series included two patients who were positive for human immunodeficiency virus, 1 with acquired immunodeficiency syndrome and Kaposi sarcoma, 3 with emphysematous epiglottitis, 1 with abscess formation, and 1 with laryngeal carcinoma. One patient required emergency tracheostomy. One patient died of pneumonia. RESULTS: The ratio of the soft-tissue parameters to the anteroposterior width of the C-4 vertebral body yielded three key parameters of high statistical significance in adult epiglottitis. The ratio of the width of the epiglottis to the anteroposterior width of C-4 should not be greater than 0.33 (sensitivity, 96%; specificity, 100%). The ratio of the prevertebral soft tissue to C-4 should not exceed 0.5 (sensitivity, 37%; specificity, 100%) and the ratio of the width of the hypopharyngeal airway to the width of C-4 should be less than 1.5 (sensitivity, 44%; specificity, 87%). The aryepiglottic folds were enlarged in 85%, and the arytenoids were swollen in 70% of the patient population (specificity, 100%). CONCLUSION: These defined radiologic parameters should aid in the diagnosis of acute epiglottitis in adults.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Supraglottic horizontal-vertical hemilaryngectomy].

During the years 1980 to 1989, 41 patients (36 men and 5 women) with squamous cell carcinoma of larynx had undergone the supraglottic horizontal-vertical hemilaryngectomy. The patients' age ranged from 43 to 67 years; 78% was aged from 50 to 59. Among 41 patients, 23 were at the Department of Head and Neck Surgery of Shanxi Tumor Hospital and the other 18 patients at the Department of ENT of Beijing Hospital. There were 70.7% (29 patients) in T3 and T4 and 43.9% (18 patients) in N1-3. The 3- and 5-year survival rates of the patients were 82.9% and 75.7% respectively. The 41 patients have acquired the function of speech and swallowing in different degree; 85.4% (35 patients) was extubated. In this article, the main procedure of the operation is described and the modified method during the operation dealing with the recurrence of the original carcinoma, the lymph node metastasis, aspiration of the food and raise the raising of of extubation.

Adult↗
PubMed1994

[Incidence and distribution of lymph node metastases in supraglottic squamous cell carcinoma: therapeutic implications].

This retrospective study was designed to establish some guidelines for the treatment of the neck in the case of supraglottic cancer. The patient population included a series of 264 patients, from 39 to 76 years old (mean age 58.3), who had undergone monolateral (76) or bilateral (188) neck dissection for a total of 452 neck dissections. The distribution of the patients, according to pT category, was the following: 17 T1 (6.4%), 88 T2 (33.3%), 107 T3 (40.5%) and 52 T4 (19.7%). In 121 patients the tumor was central (45.8%), whereas in 143 (54.2%) the neoplasm did not extend beyond the midline and was therefore defined as lateralized. The overall incidence of lymph node metastases was 43.4% (39 N1, 32 N2b, 28 N2c), and the rate of occult metastases was 24.7%. The distribution of metastases according to pT category was as follows: 6.2% T1, 30.7% T2, 38.3% T3 and 57.7% T4 (p < 0.001). Occult metastases distribution was: 0% T1, 19.6% T2, 26.7% T3 and 44.4% T4 (0.001 < p < 0.01). The incidence of bilateral metastases was significantly different (p < 0.001) in central (45.8%) and lateralized tumors (7.8%). The distribution of metastases according to level was 0.8% I, 82.4% II, 35.2% III, 13.6% IV and 0% V (p < 0.001). When level I or IV was involved, lymph node metastases were also present in level II and/or III. These results suggest that contralateral elective neck dissection is not required in lateralized tumors and elective neck dissection is not indicated in T1 lesions. Since no occult metastases were detected in level I or V, the management of choice for the clinically negative neck might well be a selective dissection limited to levels II, III and IV ("lateral neck dissection"). Levels I and V should be dissected only when metastatic nodes are found.

Adult↗
PubMedDate not supplied

HLA-ABC antigens in supraglottic cancer patients and their relationship with incidence and survival.

The frequency of HLA-ABC antigens in the total of 153 cases of supraglottic cancer of the larynx and in 118 and 37 patients from this group after 3 years and 5 or more years of survival respectively, was analysed. No significant differencies in the phenotype frequency class I HLA antigens in these patients were found, as compared with the frequency of of HLA, antigens in the healthy control population. The incidence of clinical stage I-III or IV did not affect the results, of the analysis. If the patients survived 5 or more years, the HLA-A31 antigen specificity was significantly more common at the beginning of the disease (Chi-square = 15,837; p < 0.005). A negative association for HLA-A11 in the patients with 3 years' survival was observed (Chi-square = 13,355; p < 0.025).

Female↗
PubMed1993

[Role of upper jugular node dissection in the management of supraglottic cancer of N0 category].

The results of management of neck nodes in 295 cases with supraglottic laryngeal carcinoma were reviewed. Different approaches had been adopted. For N1-N3 cases RND was instituted routinely; for N0 cases, RND, which has been advocated by many authors, seems to be an overtreatment. We prefer upper jugular node dissection for pathologic evaluation. Out of 86 N0 cases, only 6 were proved to be positive for metastases. The 3 and 5 year survival rates for this series were 89.5% and 75.3% respectively which were comparable with those reported to have RND.

Adult↗
PubMed1996

[Exclusive radiotherapy in 250 cases of stage I-II cancers of the supraglottic larynx].

Two-hundred and fifty patients presenting with a stage I-II cancer of the supraglottic larynx were definitively treated with irradiation. The 5-year disease-free survival rate is 76%. Multivariate analysis reveals that the only statistically significant prognostic parameters are clinical stage (I versus II), and tumour site (epilarynx versus supraglottis).

Adult↗
PubMed1997

Supraglottic laryngectomy--series report and analysis of results.

Between October 1987 and October 1993, 92 patients with squamous cell carcinoma of the supraglottis were treated by supraglottic laryngectomy and neck dissection in our department. There were 33 T1, 46 T2, six T3 and seven T4 cases. All patients with N+ necks and T3 or T4 tumours received post-operative radiotherapy (5,000-6,500 cGy). The patients were followed for a minimum of 36 months or until death. The incidence of local recurrence was 7.6 per cent. Neck recurrence was observed in 13 per cent of patients. Decannulation was achieved in 93.4 per cent of the cases with three patients undergoing gastrostomy because of aspiration. The average hospital stay was 26 days. The overall three-year survival was 83.6 per cent, with eight patients dying of unrelated causes. There was a significant difference in recurrence rate between patients in the N0 and the N+ stage.

Aged↗
PubMed1997

Supraglottic and subglottic airway injury due to deployment and rupture of an automobile airbag.

A 46-year-old white female with underlying interstitial lung disease and asthma was driving a pickup truck when it was struck broadside. The airbag inflated and then ruptured, forcing inhalation of its contents. This produced facial desquamation, productive cough, wheezing, and headache. Chest radiograph showed bilateral interstitial fibrosis. Pulmonary function tests demonstrated small airway obstruction, hyperinflation, and impaired diffusion. Computerized tomography showed extensive sinusitis. She improved following treatment with inhaled steroids, bronchodilators, and oral antibiotics. Inhalation of the airbag contents produced supraglottic and subglottic airway inflammation, resulting in sinusitis and exacerbation of her underlying asthma.

Air Bags↗
PubMed1997

[Prognostic factors in patients with early stages of supraglottic cancer treated by radiotherapy].

Three hundred patients with early stage supraglottic cancer were treated with radiotherapy in Center of Oncology in Kraków between 1973 and 1989. The 5-year NED survival rates after the radiotherapy only were 82.9% in stage I, and 70%in stage II cancer, after the radiotherapy and surgery for recurrences--90% and 75% respectively. The stage and tumor site were an important prognostic factors in the treated group of patients.

Adult↗
PubMed1998

[Disorders of the pharyngeal stage of deglutition after classical and extended supraglottic laryngectomies. Computerized tomographic analysis of x-ray images].

In 20 patients with laryngeal cancers, of both sexes and aged from 17 to 76 years, a partly classical or extended supraglottic laryngectomy was performed. The accomplished roentgenocinematographic analysis dealt with the disorders of the pharyngeal phase of deglutition act (RTGC). Next, by selecting characteristic schemas of frames for individual phases of deglutition, a computerized topokinetic analysis was carried out (CTA). The deglutition disorders were estimated in relation to the spared anatomical structures, formation of glosso-laryngeal recesses after this type of operations as well as leakage of contrast medium into the trachea.

Adolescent↗