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At least 55 records · Page 3Linked to original sources
PubMed2000

[Effectiveness coefficient for laryngographic closure of the glottis as a way of evaluating airway protection against aspiration of gastric contents].

Laryngographic examination was conducted on 35 men aged 45 to 65 with good hearing and proper pronunciation. Based on the examination, the proposed by the authors of this paper laryngographic closure effectiveness coefficient of the glottis (LCEC) was calculated as a way for evaluating protection of airways against the aspiration of food. Glottis occlusion serves an essential function as a mechanism protecting airways, especially in patients who have undergone horizontal supraglottic laryngectomy. The examination was conducted with the purpose of obtaining numerical values of LCEC, which will be treated as results of the controlled group during the examination of swallowing disorders in patients with partial laryngectomy.

Aged↗
PubMed1984

Strip kymography of the glottis.

In this paper, a new photokymographical method of recording vocal cord vibrations is described, which has considerable advantages over the hitherto known method of larynx photokymography. Its temporal dissolving power is increased and the registration time can be prolonged to any extent. For one registration a series of so-called strip kymograms has to be made, where each single photo shows vibration-dependent, wave-formed distortions of the vocal cord margins of a selected section of the glottis. The possibilities of measurement are indicated. In some examples of strip kymograms the diagnostic efficiency of this method is demonstrated.

Glottis↗
PubMed2000

Normal configuration of the anterior commissure of the glottis on magnetic resonance imaging.

The purpose of this study was to evaluate the normal width of the anterior commissure of the glottis by measuring its dimensions in patients who had no laryngeal disease on magnetic resonance imaging (MRI), but had unrelated cervical pathology. In all, 27 patients were studied. Axial images through the arytenoid commissure at the level of the vocalis muscle and/or vocal process of the arytenoid cartilage were magnified on MRI. The anteroposterior width of the anterior commissure was measured by using an electronic ruler having 1-mm marks. The average width of the anterior commissure was 1.59 +/- 0.6 mm, varying from a minimum width of 1 mm to a maximum width of 3 mm. The width was less than or equal to 2 mm in 25 patients (92.5%). Our results showed that all of the patients studied had measurable mucosal thicknesses at the level of anterior commissure > or = 1.0 mm.

Cervical Vertebrae↗
PubMed1981

The soft tissue/cartilage relationship in the laryngeal glottis.

A study of 93 larynges obtained at autopsy was made with regard to the proportion of cartilage and soft tissue in the glottis. The relevant measurements showed that the cartilage formed 48 per cent of the glottic opening and soft tissue (vibrating portion of the vocal cord) formed 52 per cent. The importance of this relationship to the classification and origin of laryngeal cancer is discussed, as is its relation to vocal cord nodules.

Adolescent↗
PubMed1994

[Morphometric studies at the level of the glottis as a principle in larynx enlarging microlaryngoscopic surgical procedures in bilateral recurrent nerve paralysis].

Dimensions of laryngeal and tracheal cross-sectional areas are not well explored and yet are of definite interest in endoscopic airway restorative surgery for the treatment of bilateral vocal cord paralysis. Twenty fresh, intact human larynges were shock-frozen in liquid nitrogen. Four-millimetre horizontal sections were then produced with a slicing machine. Cross-sectional areas of the vocal cords and arytenoids were measured using a computer-aided morphometry device. In addition, casts of 14 larynges were available for morphometric investigation as well as video-laryngoscopic images of 50 volunteers. The results demonstrate that the glottis is the narrowest part of the larynx even in healthy subjects. Its diameter is reduced approximately by the factor 4 in the bilaterally paralysed larynx. Cordectomy potentially offers more enlargement of the glottic airway (169 +/- 20 mm2 in males and 138 +/- 22 mm2 in females) than arytenoidectomy (42 +/- 12 mm2 in males and 34 +/- 6 mm2 in females). The knowledge of morphometric details of the glottic plane should contribute to an individualized planning of airway restoring surgery in bilateral vocal cord paralysis.

Airway Resistance↗
PubMed1998

Dose-related tissue effects of the CO2 and noncontact Nd:YAG lasers in the canine glottis.

OBJECTIVES: The CO2 laser is the standard for control of recurrent respiratory papillomatosis because of its predictable action on laryngeal tissue. The noncontact neodymium:yttrium aluminum garnet (Nd:YAG) 1064-nm laser is generally not used in the larynx owing to the lack of data on its tissue effects, and its potential lack of safety in the larynx. Combined Nd:YAG and CO2 laser treatments have been used safely in the tracheobronchial tree to eradicate recurrent respiratory papillomas. The objectives of this study were to describe and evaluate a method for applying the noncontact Nd:YAG laser to the larynx, to compare the tissue effects of the Nd:YAG, CO2, and combined Nd:YAG and CO2 lasers in the canine larynx, and to extrapolate canine tissue data to the human. METHODS: The CO2, Nd:YAG, and combined Nd:YAG/CO2 lasers were applied to the glottis in four mongrel dogs. Laryngectomy was performed and the tissue was examined histologically. The nature and degree of tissue injury were analyzed relative to laser type and energy data. RESULTS: In the canine larynx, the CO2 laser vaporized the surface epithelium and caused varying degrees of edema and necrosis of the lamina propria. The Nd:YAG laser did not cause ulceration but did show a greater degree of thermal damage to the lamina propria. Combined Nd:YAG/CO2 applications resulted in separation of the perimysial fibers from the muscle fibers of the vocalis muscle. CONCLUSION: These findings suggest that the noncontact Nd:YAG laser can be applied in a controlled fashion to the canine larynx at appropriate power densities. Anatomical differences between human and canine larynges are considered. Extrapolation to humans is proposed.

Animals↗
PubMed1996

The view of the glottis at laryngoscopy after unexpectedly difficult placement of the laryngeal mask.

In 12 patients to whom a non-depolarising neuromuscular relaxant had been given and in whom placement of the laryngeal mask had failed unexpectedly, the view of the larynx at laryngoscopy and the ease of tracheal intubation were examined. The glottis was only partially seen at laryngoscopy in three patients and was not seen at all in another three patients. Tracheal intubation was difficult in three of them. It would appear that in some patients both placement of the laryngeal mask and tracheal intubation are difficult. It is thus inadvisable to paralyse patients electively and rely on the laryngeal mask to secure a clear airway when tracheal intubation is predicted to be difficult.

Adult↗
PubMed2000

Mucociliary transport pathway on laryngotracheal tract and stented glottis in guinea pigs.

We investigated the laryngotracheal mucociliary transport pathway of guinea pigs in vivo and immediately postmortem. Only intraperitoneal anesthesia was used during the procedure to avoid the disturbance of mucociliary function. Resin particles were used as the marking substance. A microcolpohysteroscope was placed at different levels in the laryngotracheal region for observing the marking particles and recording the transport pattern. The tracheal mucociliary transport flow primarily moved along the posterior wall and both lateral walls in a zigzag trace. Upon reaching the subglottis, the resin particles stayed underneath the vocal cords, and a whirlpool phenomenon developed. The majority of the particles were shifted and directed onto the posterior glottic area. With a short delay, some resin particles crossed over the free edge of the vocal cords and turned posteriorly along the medial upper cordal margin. No mucociliary transport could be observed on the entire upper surface of the true vocal cords, which is covered by squamous epithelium. Occasionally, a few resin particles in the vicinity of the epiglottic root traveled along the aryepiglottic folds toward the posterior commissure. All streams of mucociliary transport finally joined together in the interarytenoid area. After leaving the glottis, the resin particles traveled to the hypopharynx and entered the esophagus through the motion of deglutition. The pattern of mucociliary clearance in the laryngotracheal region was not delayed by stenting.

Animals↗
PubMed1989

Natural history of treated T1N0 squamous carcinoma of the glottis.

The records of 373 patients with T1N0 squamous carcinoma of the glottis were examined. Of these, 271 underwent initial hemilaryngectomy; 102 had full-course irradiation for cure. While the overall survival rates of the two initial therapies were similar, failure of the initial treatment modality was approximately twice as frequent in the irradiated patients (34.4%) as in the patients undergoing hemilaryngectomy (16.9%). The effect of this difference in initial failure rate on quality of life and on cost of overall therapy will be discussed.

Carcinoma, Squamous Cell↗
PubMed1989

Definitive radiotherapy in the management of stage I and II carcinomas of the glottis.

Definitive radiotherapy for early glottic carcinoma continues to offer excellent control and the advantage of voice preservation. In the 13 years from January 1972 through December 1984, there were 187 patients diagnosed with squamous cell carcinoma of the glottis at the University of Virginia Medical Center. One hundred forty-eight patients were treated with definitive radiotherapy as the initial management. The 3-year disease-free survival for the irradiated population was 93.6% in stage I and 75.5% in stage II. Twenty patients had recurrences following radiotherapy, and 13 of 20 were successfully surgically salvaged for an overall determinate survival of 100% in stage I and 85.7% in stage II at 3 years. These statistics are comparable to those from our previous 16-year review of 147 patients from 1956 through 1971. Factors of prognostic significance were persistent hoarseness after radiotherapy, impaired cord mobility, subglottic extension, and multiple sites of involvement in stage I. We conclude that definitive radiotherapy offers excellent survival and that a majority of the small number of treatment failures can be managed with surgical salvage.

Adult↗
PubMed2005

Negative pathology following endoscopic resection of T1a squamous carcinoma of the glottis.

Endoscopic CO(2) laser excision for T(1a) glottic cancer is a recognized treatment modality producing equivalent disease-free and voice results to external beam radiotherapy. On reviewing a series of 15 patients who had undergone endoscopic resection of a T(1a) glottic squamous cancer, it was noted that five patients had negative excisional pathology following the initial biopsy of an invasive squamous carcinoma. The histopathology of each patient's resected specimen was reviewed by a second pathologist who confirmed the accuracy of the results in all cases. We conclude that a significant number of early squamous carcinomas of the glottis present with very small localized, minimally invasive disease and that a proportion may be treated by biopsy alone.

Aged↗
PubMed1975

Radiotherapeutic management of cancer of the glottis, University of Virginia, 1956-1971.

All patients with cancer of the glottis treated by radiotherapy with curative intent at the University of Virginia from 1956 through 1971 have been reviewed. Follow-up is complete through December, 1973. Results are presented by both stage and treatment policy and indicate that with our present methods of management a high degree of local control is achieved. The complications of treatment are examined, particularly those arising as a result of combined radiotherapy and surgery. A small number of cases have been salvaged following local recurrence and these are described in detail. Particularly striking has been the effectiveness of radiotherapy in the treatment of advanced (Stage III and IV) lesions. In this group 58 percent of the patients survive with their larynges intact. Considering the poor general condition and advanced nature of the lesions in these cases this result is important and may indicate the nature of future trends in treatment, namely radiotherapy, with surgery held in abeyance until there is overt recurrence.

Carcinoma, Squamous Cell↗
PubMed1980

Hemilaryngectomy for verrucous carcinoma of the glottis.

Seven patients with verrucous carcinoma of the glottis treated by hemilaryngectomy are analyzed. The diagnostic criteria for this tumor are reviewed. Close cooperation between the clinician and pathologist is necessary for the correct diagnosis. The controversy regarding radiation therapy is discussed. Hemilaryngectomy is concluded to be a successful surgical modality for limited verrucous carcinoma of the larynx.

Adult↗
PubMed1993

Configuration of the glottis in laryngeal paralysis. I: Clinical study.

It is widely accepted in the American literature that the cricothyroid muscle is responsible for the paramedian position of the vocal fold in recurrent laryngeal nerve paralysis. However, support in the literature for this theory is not conclusive, and the cadaveric vocal fold position expected after lesions of the vagus nerve has also been reported in patients with an intact superior laryngeal nerve. This study compares the configuration of the glottis in patients with unilateral paralysis due to known lesions of either the recurrent laryngeal or vagus nerve. Normal subjects were studied as controls. Results indicate that the alteration of glottic configuration in laryngeal paralysis cannot be adequately characterized by standard terms of vocal fold position. The paralyzed vocal fold is shortened, with anterior rotation of the arytenoid. Patients with vagus nerve lesions had a statistically insignificant tendency for a more lateral vocal fold position, but a discrete difference in position between the two groups was not identified. This study also confirms prior observations that paralyzed vocal folds are frequently not denervated. These findings have significant implications for management of laryngeal paralysis.

Adult↗
PubMed1993

Configuration of the glottis in laryngeal paralysis. II: Animal experiments.

It is widely believed that in isolated recurrent laryngeal nerve paralysis, the paralyzed vocal fold assumes a median or paramedian position, due to the action of the cricothyroid muscle. A review of the literature reveals that support for this theory is not conclusive and, in particular, experiments indicate that the cricothyroid muscle does not appreciably affect vocal fold position in acute paralysis. The research in this study compares the configuration of the glottis in chronic unilateral recurrent laryngeal nerve paralysis in cats, with and without concomitant denervation of the cricothyroid muscle. Results indicate that vocal fold position is not determined by the cricothyroid muscle. Incomplete denervation of intrinsic laryngeal muscles as well as synkinetic reinnervation appear to be significant factors in determining vocal fold position in chronic laryngeal paralysis.

Animals↗
PubMed1995

Reconsidering a paradigm: the spread of supraglottic carcinoma to the glottis.

This study was performed to evaluate the spread of supraglottic carcinoma to the glottic level. Whole organ sections of total laryngectomy specimens from 37 patients with previously untreated supraglottic carcinomas were reviewed retrospectively. Of the 37 specimens, 20 (54%) were noted to have extension of cancer to the glottic level. A significant relationship was noted between glottic extension and abnormal cord motion (P = .0002). A statistically significant trend was noted for the relationship between inferior extension along the supraglottic mucosa and glottic level extension (P < .0001). Contrary to the prevailing model of the spread of supraglottic carcinoma, in which there is a distinct barrier to spread at the ventricle, this analysis of selected supraglottic carcinomas revealed a continuum of spread from the supraglottic to the glottis.

Chi-Square Distribution↗
PubMed1997

The normal anterior commissure of the glottis.

OBJECTIVE: We characterized the normal width of the anterior commissure of the glottis by measuring its dimensions on CT scans obtained in patients who had no laryngeal disorders. SUBJECTS AND METHODS: CT scans of patients referred for cervical CT myelography were prospectively reviewed by a single board-certified radiologist. Axial images through the anterior commissure (localized by vocal process of the arytenoid cartilage, the vocal muscle, or both) were magnified on the viewing console of the CT scanner. Window and level were chosen to simulate our routine settings for CT scans of the neck. Anteroposterior width of the anterior commissure was measured using an electronic ruler with 1-mm marks. RESULTS: Sixty-five patients were prospectively evaluated. Nine patients were excluded because of substantial motion artifact, and another 18 were excluded because CT images did not include the entire larynx. Thus, the final study group included 38 patients. The average width of the anterior commissure was 1.02 +/- 0.56 mm. The width was less than or equal to 1.1 mm in 22 (58%) of 38 patients. The width was less than or equal to 1.7 mm in 35 (92%) of 38 patients. Forty-two percent (16 of 38 patients) had anterior commissures wider than 1.0 mm. The maximum width of 2.2 mm was seen in only one patient. CONCLUSION: The mean width of the anterior commissure was approximately 1.0 mm. However, 42% of patients had anterior commissures wider than 1.0 mm. In our series, using an upper limit of 1.6 mm as a normal measurement for the anterior commissure would have included 92% of patients, and an upper limit of 2.1 mm would have encompassed the mean plus two SDs.

Female↗
PubMed1981

Mechanism of initiation of oscillatory motion in human glottis.

Phonatory onsets of 17 normal subjects under usual speech conditions were investigated by measuring the cross-sectional area of the glottic aperture, using a photoelectric device. During a normal soft or breathy onset of phonation, the vocal fold vibration begins with an open glottis; the pattern of the optical signal is a sine wave of increasing amplitude with one to eight cycles before steady state oscillation is achieved. The first deflection of the base-line is either towards adduction or towards abduction. The classically assumed--since van den Berg et al. (1957)--retro-aspiration phenomenon, consisting in a narrowing of the glottic chink due to the accelerated air flow, according to Bernoulli's law, is incompatible with these observations. An aerodynamic study, with accurate calibration of the photoelectric transducer in one trained subject, as well as flux and subglottic pressure measurements, suggests that the gas flux (air as well as a helium-oxygen mixture) reaches the condition of turbulence at the level of the glottic nozzle, just before vocal folds are set into oscillatory motion. The setting in motion of the free edge of the vocal folds in normal soft or breathy onset of phonation can be explained by a sudden modification of flow conditions within the expiratory gas : the flow is laminar in the trachea and suddenly becomes turbulent at the level of the glottic nozzle. On the other hand, approximately normal atmospheric pressure values are attained due to a Bernoulli-effect at that level, allowing the vocal folds to oscillate sinusoidally about their vibration axes, corresponding to their virtual resting position, like a forced oscillator.

Air↗