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At least 1,225 records · Page 68Linked to original sources
PubMedDate not supplied

Some aspects of fetal laryngeal development.

Some aspects of morphological and physiological development of the fetal larynx are presented. Histochemical confirmation and determinations of fetal glandular activity are needed. Anomalous development of the larynx is still conjecture, but congenital cystic formation with glandular development appears possible after the fifth month of human fetal life.

Female↗
PubMedDate not supplied

Hyoid autograft repair of chronic subglottic stenosis.

A previously unreported surgical technique has been evaluated for the correction of chronic subglottic (cricoid) stenosis. The principle of skeletal support as the primary means of repair was examined. Severe stenoses were created in sixteen adult, mongrel dogs. One to three months later a hyoid bone autograft on a sternohyoid muscle pedicle was employed for repair. The dogs were sacrificed at regular intervals from two weeks to six months. The majority of the animals maintained a widely patent lumen after repair. Vocal cord mobility remained normal in every case. The results are illustrated by photographs and histologic sections. This study convincingly demonstrates a successful surgical technique for correcting a most difficult laryngeal lesion.

Adult↗
PubMedDate not supplied

Bilateral abductor paralysis: 30 years experience with arytenoidectomy.

Modifications of the technique originally reported in 1946 are presented, which may help in improving the percentage of successful decannulations. The importance of a change in the level of the vocal cord by this procedure is emphasized. The ten cautions to be followed are reviewed in doing this procedure.

Airway Obstruction↗
PubMedDate not supplied

Otolaryngological manifestations of arthrogryposis multiplex congenita.

The important otolaryngological manifestations of arthrogryposis multiplex congenita (AMC), which heretofore have not been described in otolaryngological and other specialty journals, are reviewed. Thirty-seven patients with AMC were studied. Nine of these patients with neurogenic AMC, had otolaryngological manifestations. Six of these had Pierre Robin-like syndromes. Seven patients had severe dysphagia and aspiration pneumonitis. Five patients had voice changes, and three of these required tracheotomy to relieve laryngeal obstruction and prevent aspiration. Two of these patients were aphonic and had laryngeal paralysis. Three of the nine patients who had laryngeal examination showed supraglottic narrowing similar to laryngomalacia. Six patients with otolaryngological problems were autopsied, and two had pharyngeal biopsies. The histological examination demonstrated normal laryngeal and pharyngeal musculature. The cricoarytenoid joints were found normal in all the larynges examined. Central nervous system dysfunction rather than simple muscle weakness, caused the dysphagia and respiratroy difficulties in patients with neurogenic AMC. Dysphagia with aspiration was the single most important cause of death in approximately 20% of patients with AMC. A tracheotomy and feeding gastrostomy appears essential for successful management of the otolaryngological complications of AMC.

Airway Obstruction↗
PubMedDate not supplied

Anatomy and development of the cricoid: serial-section whole organ study of perinatal larynges.

Whole organ serial-section study contributes to our understanding of neonatal intubation injury by demonstrating the previously undescribed "V" configuration of the posterior cricoid lamina; this may be readily correlated with subarytenoid paramedian intubation injury. This technique also permits detailed study of an anomalous larynx and permits the precise identification of a "tracheal" anomaly as a cricoid malformation. The need for a fetal staging system is reemphasized.

Humans↗
PubMedDate not supplied

Cricothyroid muscle in respiration.

Although the phonatory activity of cricothyroid muscle is well-known, its respiratory role often remains unrecognized. Recent data suggest this muscle plays a major role in the overall regulation of breathing by its control of expiratory resistance and flow. Cricothyroid contraction in expiration results in vocal elongation increasing glottic size. Such a mechanical effect reduces airway resistance and shortens expiratory duration. By such a mechanism, the rate of respiration may ultimately be modified using the larynx as the principal effector of this control. In this regard, cricothyroid expiratory activity is a pressure-sensitive evoked response influenced by afferent vagal stimuli. Its activity is triggered by a critical threshold of pressure-increase with respect to time, and its duration is directly dependent on the duration of positive subglottic pressure. The threshold of cricothyroid activation is reduced in hypercapnia and elevated in hypocapnic states.

Animals↗
PubMedDate not supplied

Posterior glottis. Morphological study in excised human larynges.

Two sets of investigations were conducted with excised human larynges. The glottis was closely observed and photographed from above and below in three conditions: neutral, adduction, and abduction. The structure surrounding the posterior glottis was histologically investigated in the same three conditions. The results are as follows. The structure surrounding the posterior glottis consists of three portions: the posterior wall of the glottis, the lateral wall of the posterior glottis, and the cartilaginous portion of the vocal fold. During vocal fold adduction, the posterior part of the larynx closes completely not at the glottis but at the supraglottis, resulting in formation of a conic space in the posterior glottis that can be viewed only from below. The posterior glottis accounts for approximately 35% to 45% of the entire glottic length and 50% to 65% of the entire glottic area. The mucosa of the posterior glottis has ciliated epithelium. The lamina propria consists of two layers. The posterior glottis can be regarded as a respiratory glottis.

Adult↗
PubMed1989

Minor congenital laryngeal clefts: diagnosis and classification.

Cleft larynx is a rare congenital anomaly. Detection of an unsuspected minor cleft may be difficult, but the pediatric laryngologist should suspect the possibility of cleft larynx from the clinical features. Four minor clefts are reported, three cases of supraglottic interarytenoid cleft and one of partial cricoid cleft. The technique for endoscopic diagnosis and the distinctive features are described and a classification into four types is proposed.

Abnormalities, Multiple↗
PubMed1992

Collagen in the developing larynx. Preliminary study.

The primary purpose of this study was to determine the types of collagen in the developing human larynx that contribute to the structural framework and function of various components of this organ. The infant larynx is much more than a mere miniature of the adult "voice box." There are many age-related differences that occur in the larynx from the newborn period to the adult period of life. While collagen has been studied in numerous tissues, both normal and diseased, there have been no studies of the whole organ content, types, and/or changes of collagen in the developing human larynx that may account for many of the clinical findings. This study may at least in part explain whether collagen differences may account for the structural changes and responses that are seen in clinical practice.

Child, Preschool↗
PubMed1993

Whole organ evaluation of collagen in the developing human larynx and adjoining anatomic structures (hyoid and trachea).

The collagen composition (types I, II, and III) of the normal developing human larynx and trachea was examined by biochemical methods. Autopsy specimens of larynges with attached upper tracheal rings were obtained from 28 humans ranging in age from birth to 44 years. The specimens were randomly collected, but excluded if laryngeal disease existed. The age, sex, and cause of death were documented. Collagen is important in the growth, development, repair, regeneration, and structural and functional integrity of the laryngeal framework. A preliminary report of selected cartilaginous components of the larynx was previously published by the authors, which studied the changes in the phenotypic expression of the collagen genes in children from the newborn period to 5 years 10 months of age. The current study included all of the functioning components of the skeletal larynx and trachea. The results of biochemical examination of these tissues are reported, and the potential clinical significance of the results of the study is discussed.

Adult↗