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At least 19 recordsLinked to original sources
PubMed1990

[Ultrasound diagnosis of the epiglottis].

In 1988 we described a method of diagnosis of the larynx using ultrasound, and called it echolaryngography. Now we discuss the ultrasound diagnosis of the normal epiglottis function and lesions of the epiglottis. In principle, three methods of examination are possible with simultaneous B- and M-mode display: transverse function test, sagittal function test and diagonal function test of the epiglottis. Transverse and sagittal transcutaneous access to the epiglottis is simple using a 7.5 MHz sector or linear transducer. Diagonal access, using a 5 MHz linear transducer, is not always successful. Lesions of the epiglottis in which ultrasound is useful include cysts, epiglottitis, and pretherapeutic staging of cancer. The pre-epiglottic space can also be assessed. The description of the clinical results is confined to carcinoma of the epiglottis. Ultrasound diagnosis before and after laser surgery for a lesion on the free edge of the epiglottis is described. In the second example the results of CT scans and ultrasound in a case of T4 supraglottic cancer of the larynx with invasion of the pre-epiglottic space are compared.

Cysts↗
PubMed1992

Acquired laryngomalacia: epiglottis prolapse as a cause of airway obstruction.

Epiglottis prolapse during inspiration is an unusual cause of upper airway obstruction. It occurs primarily in patients who have lost pharyngeal airway support because of previous surgery or after head injury and coma. Eight cases of epiglottis prolapse are presented. One patient had epiglottis prolapse after resection of floor of mouth cancer and another after laryngeal fracture. The rest of the cases were seen in patients recovering from head injury and coma. Videolaryngoscopy shows the larynx to assume an ovoid shape within the pharynx. There is loss of the usual anterior to posterior pharyngeal and laryngeal dimension. The epiglottis is in a more horizontal position at rest. During inspiration, the epiglottis prolapses into the endolarynx, causing subtotal airway obstruction. Laryngeal obstruction due to epiglottis prolapse can prevent decannulation in the head-injured and can be the cause of obstructive sleep apnea. Endoscopic carbon dioxide laser epiglottectomy was successful in management of these cases.

Adult↗
PubMed1987

Sensory nerve endings in the mucosa of the epiglottis--morphologic investigations with silver impregnation, immunohistochemistry, and electron microscopy.

This study was conducted in order to investigate the structure of sensory nerve endings of the human epiglottis and substance P immunoreactive nerve fibers of the canine epiglottis in relationship to physiologic functions of the larynx. The human epiglottis was observed by light microscopy (silver impregnation) and electron microscopy, and the canine epiglottis was studied by peroxidase-anti-peroxidase (PAP) immunohistochemistry. The results are summarized as follows: (1) In the membranes of the epiglottis, we observed free endings of simple or complex tree shape, corpuscle endings with glomerular patterns, and taste-bud-like structures, and (2) electron microscopic studies revealed varicosity of the terminal axon with processes that contained small, clear and large, dense cored vesicles. Substance P was observed in these structures, and it was suggested that substance P was related to perception in the larynx.

Animals↗
PubMed1976

Particular features of the innervation of taste buds of the epiglottis in monkeys.

The work is devoted to the study of the structure of the innervation apparatus of taste buds in the epiglottis of monkeys (Macacus rhesus). The Campos inpregnation method was used. It is established that several afferent myelinated fibers participate in the innervation of each taste bud of the epiglottis. The peculiarity of structure of their preterminal and terminal parts having the appearance of complex windings and spirals is noted. The polyaxonic principle of the innervation of taste buds of the epiglottis in monkeys is considered as a possible mechanism of generalization of the afferent impulses. It is suggested that the innervation apparatus of the taste buds of the epiglottis constitutes part of unique afferent system of this organ, ensuring its defensive function. The incongruity (from the histophysiological standpoint) of the term 'taste bud' in relation to the epiglottis is noted. It is proposed to call these formations special structures of the chemo-receptors.

Animals↗
PubMed1989

[Morphology of "asphyxia-induced epiglottis form" in newborn infants, infants and young children].

A systematic histological study of cross-sections of the larynx from 52 fatalities (neonates, infants and young children) revealed a broad spectrum of anatomical variants in the epiglottis form, which were caused by variations in the epiglottic cartilage. There was no correlation between the epiglottis form and the age of the child. Furthermore, no differences in shape could be established between cases of SIDS and control cases. The term "asphyxial-related epiglottis form" appears to be inappropriate. The commonly found supraglottic laryngitis on the laryngeal aspect of the epiglottis was seen in combination with histologically proven infections in the upper and lower respiratory tract. Histological investigation of the larynx provides valuable information for the morphological diagnosis in fatal cases in early life.

Asphyxia Neonatorum↗
PubMed1986

Calcitonin gene-related peptide-immunoreactive nerves in the tongue, epiglottis and pharynx of the rat: occurrence, distribution and origin.

The occurrence, distribution and nature of calcitonin gene-related peptide (CGRP) in the tongue, epiglottis and pharynx of the rat was investigated by immunocytochemistry and radioimmunoassay. Numerous CGRP-containing nerves were found to innervate and terminate freely within the epithelium of the tongue, epiglottis and pharynx. Immunoreactive fibres were also found in the muscle layer and around blood vessels in the tongue, and in motor end plates in the muscle of the epiglottis and pharynx. Section of the trigeminal nerve induced a marked reduction in the number of immunoreactive nerves in the anterior portion of the tongue, whereas glossopharyngeal denervation results in a depletion of CGRP immunoreactivity in the posterior portion of the tongue. Immunoreactive nerves of the epiglottis and pharynx were depleted only after superior laryngeal nerve section. A subpopulation of labelled primary sensory neurones were observed in trigeminal and glossopharyngeal ganglia following injection of True blue retrograde tracer in the tongue. Most of the labelled cells were also immunoreactive for CGRP. Following systemic treatment with capsaicin, a loss of intra- and subepithelial CGRP-immunoreactive nerves was observed in all investigated tissues, while immunoreactive motor end plates remained unchanged.

Animals↗
PubMed1988

Responses of lamb nucleus of the solitary tract neurons to chemical stimulation of the epiglottis.

Previous research has shown that applications of chemical stimuli to the epiglottis produced distinct patterns of activity in the lamb superior laryngeal nerve. To determine the response characteristics of second-order neurons, we recorded from single cells in the lamb nucleus of the solitary tract (NST) while stimulating the epiglottis with 0.5 M KCl, NH4Cl, NaCl, LiCl, distilled water, 0.005 M citric acid and 0.01 N HCl. Most neurons responded to more than one of the chemical solutions. The order of effective stimuli was KCl = NH4Cl greater than distilled water greater than HCl greater than citric acid greater than NaCl greater than LiCl. An analysis of the variation in response frequency over time found that different chemical stimuli produced significantly different response patterns in NST neurons. A comparison of the mean neural response profiles of NST neurons and superior laryngeal nerve fibers for each of the stimuli found that only the response profiles elicited by NH4Cl were significantly different. In addition to their responses to chemical solutions, almost one-third of the NST neurons responded to the rinse following application of at least some of the stimuli and 80% of the neurons were excited by mechanical stimulation of the epiglottis with a soft brush. Also, a small number of neurons exhibited a rhythmic response coordinated with respiration. The majority of recording sites were located in areas of the NST linked to swallowing and respiration suggesting that the response patterns of NST neurons elicited by chemical stimulation of receptors on the epiglottis may play a role in upper airway reflexes.

Animals↗
PubMed1989

Responses of neurons in the lamb nucleus tractus solitarius to stimulation of the caudal oral cavity and epiglottis with different stimulus modalities.

Receptors located in the posterior oral cavity and on the epiglottis play an important role in the initiation of upper airway reflexes such as swallowing, gagging, coughing and apnea. Peripheral nerves which innervate these receptor areas terminate in the nucleus tractus solitarius (NTS). We have recorded the responses of 61 neurons in the lamb NTS to stimulation of the caudal tongue, palate and epiglottis with mechanical, chemical and thermal stimuli and mapped receptive field location. Although there was some overlap in the areas of the NTS from which neurons with oral cavity and epiglottal receptive fields could be recorded, a significant difference was observed in the mean recording sites of the two groups of neurons. Neurons with oral cavity receptive fields were located more rostral, lateral and ventral in the NTS than neurons with receptive fields on the epiglottis. Little convergence of sensory input onto single cells in the NTS was observed between the oral cavity and the epiglottis. Only one NTS neuron had a receptive field in both of these receptor areas. In contrast, a large number of neurons with oral cavity receptive fields received input from two receptor areas. These neurons had a receptive field on the tongue which was located directly beneath the receptive field on the palate. Mechanical stimuli were the most effective for neurons with either oral cavity or epiglottal receptive fields and thermal stimuli were the least effective. Neurons which responded to mechanical stimuli responded better to a moving stimulus than to a punctate one, and large increases in the strength of a punctate stimulus were required to elicit significant increases in response frequency. Most NTS neurons responded to more than one of the stimulus modalities. However, a significant difference in the mean number of stimulus modalities which elicited responses was observed between neurons with oral cavity and epiglottal receptive fields. The number of multimodal neurons with epiglottal receptive fields was higher than those with oral cavity receptive fields. The multimodal nature of neurons which responded to epiglottal or oral cavity stimulation combined with their location in reflexogenic areas of the NTS suggests that these neurons could be important in the integration of afferent input from the oral cavity and upper airway. If these NTS neurons are involved in the control of oral and upper airway reflexes it would be important for them to respond to as many of the stimulus cues as possible and the majority of these neurons do just that.

Action Potentials↗
PubMed1979

Epiglottis acuta treated with nasotracheal intubation.

Twenty children, ranging in age from 1--9 years, and one adult suffering from epiglottis acuta were treated with nasotracheal intubation performed under general anaesthesia and with ampicillin. Clinical cure was obtained in all cases with a mean intubation time of 34 hours. The diagnosis, epiglottis acuta, was suspected by the referring physician in 10 cases. The incidence of epiglottis acuta compared to laryngitis acuta was found to be 1:30. The mean hospital stay was 5.4 days. It is concluded that treatment of acute epiglottis by nasotracheal intubation in the hands of experienced anaesthesiologists and with close observation in an intesnive care unit, is a safe method of management with negligible morbidity and mortality.

Acute Disease↗
PubMed1977

Postnatal descent of the epiglottis in man. A preliminary report.

The function of the epiglottis in adult man is unclear. However, during early infancy the epiglottic cartilage appears to play an important role in separating the upper respiratory tract from the upper digestive tract. This separation is accomplished by approximation of the epiglottis to the palate, providing a continuous airway from the nose through the larynx into the trachea. This structural arrangement, however, is uniquely lost in man during postnatal development. Maturational descent of the epiglottis, found to occur between 4 and 6 months of age, is verified by cineradiography. This structural change, requiring a reorganization of respiratory function, represents a discrete developmental event manifesting the potential for oral tidal respiration from a pattern of obligate nasal breathing. This period, four to six months postnatally, interestingly coincides with the peak incidence of sudden infant death syndrome (crib death), which similarly occurs at 3 to 5 months of age.

Aging↗
PubMed1992

Ossification of the epiglottis.

The epiglottis is formed of elastic cartilage. Unlike the hyaline cartilage which forms the thyroid cartilage, cricoid and arytenoids, the elastic cartilage of the epiglottis does not undergo ossification with age. A case of ossification of the epiglottis is presented and heterotopic ossification in the head and neck is discussed.

Aged↗
PubMed1976

Bifid epiglottis: a rare laryngeal anomaly.

Two cases of bifid epiglottis are presented: one with an associated laryngeal cyst and another with an associated cricoid stenosis. The occurrence of multiple laryngeal anomalies in association with bifid epiglottis has not previously been described. The occurrence of an extra digit is noted to be statistically significant both in the current series and in a review of the literature. A brief review of the embryologic classification and staging by the Carnegie System, and the correlation of the time sequence of development of the epiglottis is presented. No correlation is made as to the mechanism of the origin of this laryngeal anomaly, as adequate embryologic knowledge of the development of the pharynx is not available at this time.

Abnormalities, Multiple↗
PubMedDate not supplied

Biomechanics of the human epiglottis.

The mechanism that folds the epiglottis down over the closed larynx in the course of swallowing has been unclear. Measurements of the force needed to fold the epiglottis in cadaver specimens exceed the estimated force available from the aryepiglottic muscle. Frame-by-frame analysis of cinefluorograms reveals that deglutitional epiglottic downfolding occurs at the time of maximal elongation of the hyoepiglottic ligament. The observations lead us to propose a conical model of epiglottic downfolding which also explains the conical shape of the epiglottis usual in early infancy. The infant shape may be part of a protective partially closed entrance adaptive to suckling, while maturational widening of the opening adapts to the growing respiratory demands of increasing physical exertion.

Adult↗
PubMed1977

Pleomorphic adenoma of the epiglottis: report of a case.

We describe the clinical and pathologic aspects of an unusual case of pleomorphic adenoma of the epiglottis. A 69-year-old man had impaired speech and a "lumpy sensation" in the throat. Following clinical evaluation and a diagnostic biopsy, the tumor was totally excised with excellent results. Pleomorphic adenoma of the larynx is most uncommon. To our knowledge, no report describing the clinical and pathologic features of this entity in the epiglottis or larynx has been previously reported. This is the only example of an epiglottic pleomorphic adenoma among 391 cases seen at Presbyterian-University Hospital and the Eye and Ear Hospital of Pittsburgh during a 21-year period.

Adenoma↗
PubMed1988

Glial fibrillary acidic protein in chondrocytes of elastic cartilage in the human epiglottis: an immunohistochemical study with polyvalent and monoclonal antibodies.

Glial fibrillary acidic protein (GFAP), an intermediate filament, was first discovered in the cytoplasm of reactive astroglia and to this date is regarded as a rather characteristic component of both non-neoplastic and neoplastic astrocytes. It has, however, been found in other glial elements also, as well as in a few types of tissues outside the central nervous system. Chondrocytes in hyaline and fibrocartilage do not express GFAP, but in the elastic cartilage of the human epiglottis we found GFAP to be regularly present when tested with either polyclonal or monoclonal antibodies. While most types of cartilage in humans are believed to be of mesenchymal origin, embryologic relationship between epiglottal cartilage and the neural crest may play a role in the curious phenomenon of the regular presence of GFAP in the chondrocytes of the epiglottis.

Adult↗
PubMed1978

Significance of site and nodal metastases in squamous cell carcinoma of the epiglottis.

One hundred twelve patients treated by surgery alone for squamous cell carcinoma of the epiglottis were retrospectively reviewed. The results showed: (1) 27 per cent of patients with N0 disease had microscopic nodal metastases; (2) 35 to 47 per cent of patients with N0 and N1 disease and histologically positive nodes (micrometastases) in the initial neck dissection developed contralateral nodal metastases; (3) 36.9 per cent of the patients who had nodal micrometastases (histologically positive) survived five years, as contrasted with 94.5 per cent of those who did not have node involvement; (4) 53.2 per cent of the patients who had nodal metastases in one neck and 16 per cent of those who had metastases in both necks survived five years; (5) when the primary tumor in the epiglottis was located in the midline or there was bilateral supraglottic involvement, 18 to 50 per cent of patients developed contralateral ("second") neck nodal metastases; (6) performing early elective contralateral ("second") neck dissection shortly after recovery from the initial surgery may improve survival of patients in whom either the "first" neck dissection showed microscopic nodal metastases and/or the primary tumor was located either in midline or there was bilateral supraglottic involvement.

Adult↗
PubMed1989

Response characteristics of lamb trigeminal neurons to stimulation of the oral cavity and epiglottis with different sensory modalities.

A region of the trigeminal complex located at the border of the subnucleus interpolaris and subnucleus caudalis receives not only trigeminal nerve inputs from the face, tongue and palate, but also afferent terminations from other nerves which innervate the oral cavity and upper airway. To increase our understanding of the types of sensory information relayed to this region of the trigeminal nucleus, we investigated the response characteristics of single neurons to stimulation of the tongue, palate and epiglottis. Receptive field size and location of 83 trigeminal neurons were mapped, and responses to mechanical, thermal and chemical stimuli were recorded. About 90% of the neurons had one receptive field and no convergence between the oral cavity and epiglottis was observed. Furthermore, only about 15% of the trigeminal neurons responded to more than one stimulus modality. A moving mechanical stimulus elicited responses in over 90% of the cells, and 84% responded to moving and punctate mechanical stimuli. These mechanosensitive neurons generally exhibited rapidly adapting responses. Thermal and chemical stimuli were relatively ineffective. Cooling a receptor surface most often produced excitation, and warming inhibition. Responses to chemical stimuli were only observed for salts at high concentrations. These results suggest that, like oral cavity information relayed by the trigeminal nerve, afferent terminations in the trigeminal nucleus from other nerves subserving the oral cavity and upper airway function to relay mechanical sensory information.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1991

Amelanotic melanoma metastatic to the epiglottis.

Metastasis of melanoma in the head and neck region is often reported but the report of amelanotic melanoma metastatic to the epiglottis is an extremely rare entity. This paper describes a patients previously treated for cutaneous amelanotic melanoma who developed metastatic tumour involving his epiglottis. This legion was successfully excised by a intra-oral approach combined with KTP/532 laser surgery. The paper also describes the diagnostic evaluation, management, operative technique and DNA analysis of this rare case.

Adult↗