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Sample records for nonrecurrent inferior laryngeal

  1. Nonrecurrent inferior laryngeal nerves and anatomical findings during thyroid surgery: report of three cases.

    PubMed

    Kato, Kumiko; Toriumi, Yasuo; Kamio, Makiko; Nogi, Hiroko; Shioya, Hisashi; Takeyama, Hiroshi

    2016-12-01

    A nonrecurrent inferior laryngeal nerve (NRILN) is found more frequently on the right side than on the left, and it is closely associated with an aberrant right subclavian artery. The presence of the aberrant right subclavian artery on preoperative computed tomography (CT) scan suggests NRILN; however, different types of branching locations and pathways exist. Here, we report three NRILN cases with different pathways where the vagus nerve arises more medial than usual and a review of the literature. Case 1: A 30-year-old Japanese female presented with papillary thyroid carcinoma. Preoperative CT scan revealed an aberrant right subclavian artery, and an operation was performed under suspicion of NRILN. During the operation, the vagus nerve was found to arise more medially than usual and two NRILNs originated from it at the level of the cricoid cartilage and at a more caudal position; the two NRILNs were preserved. Case 2: A 33-year-old Japanese female with a thyroid nodule of increased size underwent surgery. Preoperative CT scan revealed an aberrant right subclavian artery, which suggested NRILN. During the operation, the vagus nerve was identified to run more medially than usual and NRILN was found to originate at the level of the cricoid cartilage; NRILN was preserved. Case 3: A 78-year-old Japanese female underwent an operation with a diagnosis of papillary thyroid carcinoma. Preoperative CT scan showed an aberrant right subclavian artery. During the operation, NRILN was found to originate from the vagus nerve at the level of the lower pole of the thyroid gland, and the vagus nerve ran medial to the common carotid artery at the caudal level. PMID:27188389

  2. Identifying the Non-recurrent Laryngeal Nerve: Preventing a Major Risk of Morbidity During Thyroidectomy

    PubMed Central

    Mahmodlou, Rahim; Aghasi, Mohammad Reza; Sepehrvand, Nariman

    2013-01-01

    Non-recurrent laryngeal nerve (NRLN) is a rare anomaly which is reported in 0.3%-0.8% of people on the right side and in 0.004% (extremely rare) on the left side. Damage to this nerve during the surgical procedure may lead to severe iatrogenic morbidity and should therefore be prevented from being damaged. The best way to avoid this damage to the nerve is to identify the nerve with a systematic diligent dissection based on usual anatomical landmarks and awareness about the possibility of their existence. Hereby, we are going to present a 26-year-old woman, a case of NRLN on the right side which was identified during thyroidectomy. The nervous anomaly was accompanied with vascular abnormality which was confirmed by computerized tomography (CT) angiography, post-operatively. PMID:23543847

  3. Recognition and Surgical Techniques for Management of Nonrecurrent Laryngeal Nerve during Carotid Endarterectomy.

    PubMed

    Jimenez, Juan Carlos; Jabori, Sinan; Gelabert, Hugh A; Moore, Wesley S; Quinones-Baldrich, William J; O'Connell, Jessica

    2016-05-01

    The presence of a nonrecurrent laryngeal nerve (NRLN) during carotid endarterectomy (CEA) may significantly limit the exposure of the surgical field during this operation. Although its reported incidence is rare, NRLN typically overlies the carotid bifurcation and failure to recognize this anatomic variation increases the risk of NRLN injury. A retrospective chart review of all patients who underwent CEA for hemodynamically significant extracranial carotid stenosis between January 2005 and December 2014 was performed. All patients with NRLN encountered intraoperatively were identified. Clinical outcomes, surgical techniques, and complications were reviewed and reported. Four left-sided NRLN were identified and 4 were right sided. No cranial nerve deficits or injuries occurred after CEA in patients where NRLN was encountered. Two distinct surgical techniques were used to manage patients with NRLN and they are discussed in detail. PMID:26965812

  4. Preoperative diagnosis and intraoperative protection of nonrecurrent laryngeal nerve: A review of 5 cases

    PubMed Central

    Wang, Zhihong; Zhang, Hao; Zhang, Ping; He, Liang; Dong, Wenwu

    2014-01-01

    Background Nonrecurrent laryngeal nerve (NRLN) is a risk factor for nerve injury during thyroidectomy or parathyroidectomy. It is usually associated with abnormal vasculature that can be identified by several imaging methods. The aim of this study was to retrospectively analyze the preoperative diagnosis and intraoperative protection of NRLN. Material/Methods Of the 7169 patients who underwent thyroid surgery at our hospital between August 2008 and January 2013, 5 patients with NRLN were identified. Preoperative chest X-rays, neck ultrasonography (US), and computed tomography (CT) findings were reviewed. NRLNs were carefully and systematically searched for in surgery. Results Preoperative CT predicted NRLN in all 5 cases (100% accuracy). The detection rate of NRLN by CT was 0.4% (5/1170). NRLNs were confirmed in surgery. All of them were right-sided NRLN with type IIA variant. The CT scans clearly revealed the vascular anomalies. The review of US images suggested that vascular anomalies could be identified on the images in 1 patient. No postoperative complications occurred in any patient. Conclusions The preoperative CT scan was a reliable and effective method for identifying abnormal vasculature to indirectly predict NRLN. Combining the CT and US findings with adequate surgical technique may help to reduce the risk of nerve damage, in addition to preventing nerve palsy. PMID:24518037

  5. Extralaryngeal division of the recurrent laryngeal nerve: a new description for the inferior laryngeal nerve.

    PubMed

    Yalcin, Bulent; Tunali, Selcuk; Ozan, Hasan

    2008-05-01

    Extralaryngeal division of the recurrent laryngeal nerve was contradictory in the literature. We aimed to investigate extralaryngeal division of the nerve, and also propose a new description for the inferior laryngeal nerve. Sixty specimens (120 sides) were examined for this project, including 41 men and 19 women cadavers between the ages of 40 and 89 years at death. In one right side, terminal segment of the nerve gave off many small branches surrounding the inferior thyroid artery then reaching the larynx, trachea, thyroid gland and esophagus. In eight sides, terminal segment of the nerve had no extralaryngeal division and entered the larynx as a single trunk. In 110 sides, the nerve had extralaryngeal division. One hundred and three nerves had two laryngeal and one to three extralaryngeal branches. Two types were described in this group. In type I (66 nerves), both branches arose from the same level of nerve. Type I had two subtypes: type Ia, the origin of the branches was just below the inferior constrictor muscle; type Ib, the origin of the branches was 15-35 mm below the muscle. In type II (37 nerves), the laryngeal branches arose just 3-5 mm above the extralaryngeal branches. We observed that the laryngeal and extralaryngeal branches arose generally from the same point of the recurrent laryngeal nerve. The inferior laryngeal nerve is thus very short, or even nonexistent. Therefore, we suggest that if the term "superior laryngeal nerve" is a given, standard, and accepted term, then the term "inferior laryngeal nerve" should also be accepted instead of the term "recurrent laryngeal nerve." PMID:18292961

  6. Three variations of the laryngeal nerve in the same patient: a case report

    PubMed Central

    2011-01-01

    Introduction A non-recurrent course is a rare anatomic variation of the inferior laryngeal nerve (ILN). Bilateral extra-laryngeal bifurcation of the ILN seldom occurs before its laryngeal entry. Anastomosis between the ILN and cervical sympathetic chain is another rare anatomic feature. The prevalence of extra-laryngeal branching of the non-recurrent nerve is unknown. We present an example of triple anatomic variations of ILNs in the same patient, and also two anatomic variations in the same nerve. Case presentation A 56-year-old Caucasian man with a large toxic multi-nodular goiter was surgically treated with total thyroidectomy. Both his right and left ILNs were identified, fully exposed and preserved along their cervical courses. We discovered many variations during bilateral exploration of the two ILNs. His right ILN was non-recurrent. This non-recurrent ILN showed a terminal division before laryngeal entry. The left nerve had a usual course as a recurrent laryngeal nerve (RLN) at his tracheaesophageal groove. We also discovered bifurcation of his RLN beginning at a neurovascular (RLN and inferior thyroid artery) crossing point. Anterior and posterior branches of both nerves entered his larynx separately. The sympathetic inferior laryngeal anastomotic branch (SILAB) between the posterior branch of his left ILN and the cervical sympathetic chain was established in the distal part of the nerve before laryngeal entry. Conclusion A non-recurrent nerve and extra-laryngeal branching of the ILN are two different variations. The coincidence of a right non-recurrent ILN and bilateral bifurcation of both nerves is a very interesting feature. SILAB is a rare additional finding as a third anatomic variation in the same patient. Extra-laryngeal terminal division of a non-recurrent ILN is an extremely unusual anatomic finding. Two anatomic variations have occurred in the same nerve, like "the variation of the variation". PMID:21722360

  7. A systematic review of variations of the recurrent laryngeal nerve.

    PubMed

    Ling, Xing Yao; Smoll, Nicolas Roydon

    2016-01-01

    With thyroid cancer fast becoming one of the most common endocrine cancers, the frequency of thyroid surgery has increased. A common and debilitating concern with thyroid surgery is recurrent laryngeal nerve (RLN) paralysis leading to glottal obstruction and airway compromise. A systematic review regarding the anatomical variation of the recurrent laryngeal nerve was performed to determine the position of anatomical variants of the RLN in relation to the inferior thyroid artery (ITA) as well as the prevalence of nonrecurrent laryngeal nerve (NRLN). MEDLINE, Web of Science, MEDITEXT, AMED, CINAHL, Cochrane, ProQuest, Pubmed, and ScienceDirect. Databases were searched using the search terms "inferior thyroid artery," "recurrent laryngeal nerve," "nonrecurrent laryngeal nerve," and "anatomical variation." The reference sections of the articles found were searched for additional reports. The references of all articles were searched to find articles missed in the database search. A total of 8,655 RLN sides were included in this study. One thousand eight hundred and thirteen (20.95%; 95% confidence interval (CI) 20.09, 2,182) showed a Type A configuration of RLN in relation to the ITA, 2,432 (28.10%; 95% CI 27.15, 29.06) showed a Type B configuration and 4,410 (50.95%; 95% CI 49.89, 52.01) showed a Type C configuration between the RLN and the ITA. The second search returned with 38,568 recurrent laryngeal sides and only 221 (0.57%; 95%CI 0.5, 0.65) NRLN documented. The RLN is most commonly found in the posterior position, relative to the ITA. The incidence of the NRLN is low, only occurring in 0.57% of people. PMID:26297484

  8. Hemostasis in Laryngeal Surgery.

    PubMed

    Athanasiadis, Theodore; Allen, Jacqui

    2016-06-01

    The larynx is a highly vascularized organ supplied by the superior and inferior laryngeal arteries. Both microphonosurgery and external laryngeal surgery require excellent hemostasis. Topical agents including adrenalin and fibrin-based products as well as surgical instrumentation, such as coagulation devices or in some cases embolization, are in the surgeon's armamentarium and facilitate efficient and successful surgery. PMID:27267020

  9. Expansivity properties and rigidity for non-recurrent exponential maps

    NASA Astrophysics Data System (ADS)

    Benini, Anna Miriam

    2015-07-01

    We show that an exponential map fc(z) = ez + c whose singular value c is combinatorially non-recurrent and non-escaping is uniquely determined by its combinatorics, i.e. the pattern in which its periodic dynamic rays land together. We do this by constructing puzzles and parapuzzles in the exponential family. We also prove that f is expanding on the postsingular set with respect to the Euclidean metric in the case that the singular value is non-recurrent. Finally, we show that boundedness of the postsingular set implies combinatorial non-recurrence if c is in the Julia set.

  10. Histoplasmosis laryngeal

    PubMed Central

    Moriones Robayo, Carlos Alberto

    2014-01-01

    Laryngeal histoplasmosis is a fungal infection that is frequent in Colombia. Laryngeal histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from the lungs to other organs. Histoplasmosis isolated laryngeal (primary) is rare. If a patient presents with a history of immunosuppression by renal transplant, primary laryngeal histoplasmosis with supraglottic granulomatous inflammation that was treated with amphotericin B and Itraconazole, with complete resolution of laryngeal lesions. PMID:25767308

  11. Laryngeal verruca vulgaris.

    PubMed

    Topdag, Murat; Erdogan, Selvet; Kara, Ahmet; Derin, Serhan

    2015-01-01

    Laryngeal verruca vulgaris is a rare disease of the larynx that is easily misdiagnosed as other laryngeal lesions. This article reports three patients with laryngeal verruca vulgaris and discusses the differential diagnosis of laryngeal verrucous lesions to avoid over treatment. PMID:25935911

  12. How Travel Demand Affects Detection of Non-Recurrent Traffic Congestion on Urban Road Networks

    NASA Astrophysics Data System (ADS)

    Anbaroglu, B.; Heydecker, B.; Cheng, T.

    2016-06-01

    Occurrence of non-recurrent traffic congestion hinders the economic activity of a city, as travellers could miss appointments or be late for work or important meetings. Similarly, for shippers, unexpected delays may disrupt just-in-time delivery and manufacturing processes, which could lose them payment. Consequently, research on non-recurrent congestion detection on urban road networks has recently gained attention. By analysing large amounts of traffic data collected on a daily basis, traffic operation centres can improve their methods to detect non-recurrent congestion rapidly and then revise their existing plans to mitigate its effects. Space-time clusters of high link journey time estimates correspond to non-recurrent congestion events. Existing research, however, has not considered the effect of travel demand on the effectiveness of non-recurrent congestion detection methods. Therefore, this paper investigates how travel demand affects detection of non-recurrent traffic congestion detection on urban road networks. Travel demand has been classified into three categories as low, normal and high. The experiments are carried out on London's urban road network, and the results demonstrate the necessity to adjust the relative importance of the component evaluation criteria depending on the travel demand level.

  13. Laryngeal histoplasmosis.

    PubMed

    Ansari, Hina A; Saeed, Noora; Khan, Nazoora; Hasan, Naba

    2016-01-01

    Histoplasmosis is a fungal infection, having interesting synonyms such as Cave disease, Darling's disease, Ohio Valley disease, reticuloendotheliosis, Spelunker's lung and Caver's disease. The aetiological agent is a dimorphic fungus, Histoplasma capsulatum, causing chronic granulomatous disease. The route of transmission is by inhalation of dust particles from soil contaminated by excrement of birds or bats, harbouring the small spores or microconidia, which is considered the infectious form of fungus. The spectrum of illness ranges from subclinical infection of the lung to progressive disseminated disease. The major bulk of histoplasmosis infections are asymptomatic or present with mild influenza like illness and involve immunocompetent individuals. However, the immunocompromised or immunodeficient cases have disseminated/haematogenous infections with multiple organs involved and are usually fatal unless treated immediately. Laryngeal involvement is associated with the disseminated form of the disease. Histoplasmosis of larynx is a rare entity and poses diagnostic difficulty to otolaryngologists because clinically it may be mistaken for malignancy. We report an unusual case of laryngeal histoplasmosis in a man aged 60 years who presented with provisional diagnosis of tuberculosis/malignancy. PMID:27535733

  14. Laryngeal pseudosarcoma

    SciTech Connect

    Giordano, A.M.; Ewing, S.; Adams, G.; Maisel, R.

    1983-06-01

    In the past laryngeal pseudosarcomas have been diagnosed as a. carcinosarcomas, b. pleomorphic or spindle cell carcinomas, or c. squamous cell carcinomas with pseudosarcomatous reactive stroma. Arguments have centered around the nature of the sarcomatous stroma. Because of this confusion there is disagreement as to the treatment and prognosis of these tumors. Seven pseudosarcomas were treated between 1969-1979, 4 were pedunculated and 3 exophytic. Treatment consisted of primary CO60 irradiation in 2 patients, surgery in 3 cases and combined therapy in 2 cases with no recurrences. Three of the 7 have died, 1 of a poorly differentiated adenosquamous carcinoma of the right main stem bronchus and the other 2 of natural causes at ages 77 and 85. From a review of the literature as well as our experience, we have reached the following conclusions. 1. Stromal cells are a malignant morphologic variant of the squamous cell and are best termed spindled cells. 2. Neck metastasis at any time is a poor prognostic sign. 3. The pattern of metastasis and survival seems to parallel laryngeal squamous cell carcinoma, and thus treatment should be similar for given stages.

  15. Laryngeal Paralyses: Theoretical Considerations and Effects on Laryngeal Vibration.

    ERIC Educational Resources Information Center

    Smith, Marshall E.; And Others

    1992-01-01

    A theoretical four-mass model of the larynx was developed to simulate laryngeal biomechanical behavior and used to evaluate states of asymmetric laryngeal vibration. Simulations of laryngeal paralyses were compared with data on glottal vibration in observed laryngeal function. (Author/JDD)

  16. Laryngeal nerve damage

    MedlinePlus

    Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box. ... Injury to the laryngeal nerves is uncommon. When it does occur, it can be from: A complication of neck or chest surgery (especially thyroid, lung, ...

  17. Laryngeal (Voice Box) Cancer

    MedlinePlus

    ... limited alcohol exposure. Other risk factors for laryngeal cancer include certain viruses, such as human papilloma virus (HPV), and likely acid reflux. Vitamin A and beta-carotene may play a protective role. Signs and Symptoms ...

  18. Stages of Laryngeal Cancer

    MedlinePlus

    ... and symptoms of laryngeal cancer include a sore throat and ear pain. These and other signs and ... hoarseness in the voice. Tests that examine the throat and neck are used to help detect (find), ...

  19. Nonrecurrent quantum states: Systems with singular-continuous and discrete spectra

    SciTech Connect

    Lahiri, A. )

    1993-03-15

    The energy spectrum for a tight binding model with on-site potentials forming a Cantor set is seen to have a globally self-similar structure, and an exact correlation of the wave functions with the energies is pointed out. With periodic driving the quasienergy spectrum is obtained from an equivalent lattice problem and is seen to imply nonrecurrent time evolution of states. A model system with a discrete spectrum shows similar behavior. Implications for the problem of microwave ionization of hydrogen atoms are indicated.

  20. General Information about Laryngeal Cancer

    MedlinePlus

    ... Research Laryngeal Cancer Treatment (PDQ®)–Patient Version General Information About Laryngeal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  1. Surgical Treatment of Laryngeal Paralysis.

    PubMed

    Monnet, Eric

    2016-07-01

    Unilateral arytenoid lateralization is the most commonly used technique to treat laryngeal paralysis. It is important not to overabduct the arytenoid cartilage during the unilateral lateralization to minimize exposure of the rima glottides. Dogs with laryngeal paralysis treated with unilateral lateralization have a good long-term prognosis. Idiopathic polyneuropathy is the most common cause of laryngeal paralysis in dogs. PMID:26947115

  2. Feeding Artery of Laryngeal and Hypopharyngeal Cancers: Role of the Superior Thyroid Artery in Superselective Intraarterial Chemotherapy

    SciTech Connect

    Terayama, Noboru Sanada, Junichiro; Matsui, Osamu; Kobayashi, Satoshi; Kawashima, Hiroko; Yamashiro, Masashi; Takanaka, Tsuyoshi; Kumano, Tomoyasu; Yoshizaki, Tomokazu; Furukawa, Mitsuru

    2006-08-15

    The purpose of this study was to elucidate the role of the superior thyroid artery in intra-arterial infusion chemotherapy for laryngeal and hypopharyngeal cancers. Thirty-nine patients with laryngeal cancer and 29 patients with hypopharyngeal cancer underwent intra-arterial infusion chemotherapy. We performed a retrospective analysis of the feeding arteries confirmed by computed tomography during selective arteriography and compared the results with the extent of the tumors. In 14 of 39 laryngeal and 15 of 29 hypopharyngeal cancers, the tumor did not cross the midline (group 1). In the remaining 25 and 14 cancers, respectively, the tumor crossed the midline or located in the center (group 2). For 13 of 14 laryngeal and 7 of 15 hypopharyngeal cancers in group 1 and for 6 of 25 laryngeal cancers in group 2, the entire tumor was contrast enhanced by the ipsilateral superior thyroid and/or superior laryngeal artery. For 12 of 25 laryngeal and 1 of 14 hypopharyngeal cancers in group 2, the entire tumor was contrast enhanced by the bilateral superior thyroid artery. For the other patients, infusion via the other arterial branches such as the inferior thyroid and the lingual arteries were needed to achieve contrast enhancement of the entire tumor. Superselective intra-arterial chemotherapy for laryngeal cancer from the superior thyroid artery is appropriate, whereas that for hypopharyngeal cancer is less sufficient. To accomplish contrast enhancement of the entire tumor, additional intra-arterial infusion from other arteries such as the inferior thyroid artery is often necessary.

  3. Laryngeal Paraganglioma: A Case Report

    PubMed Central

    Sharifkashany, Shervin; Yazdani, Nasrin; Ghazavi, Hossein; Tajdini, Ardavan

    2014-01-01

    Paragangliomas in the head and neck are found typically in the region of the carotid body, jugular body, and along the 9th and 10th cranial nerves. They can occur in multicenteric forms, but generally, laryngeal paragangliomas are not found in these patients. Only two cases of laryngeal paraganglioma have been reported with a synchronous lesion elsewhere. We report an additional case of a 34-year-old female with multiple paragangliomas beginning with laryngeal involvement. PMID:25763080

  4. Laryngeal hypersensitivity in chronic cough.

    PubMed

    Hull, J H; Menon, A

    2015-12-01

    Patients with chronic cough often report symptoms arising in the throat, in response to non-specific stimuli. Accordingly, the concept of a 'hypersensitivity' of the larynx in chronic cough has evolved over the past ten years. Patients with cough and laryngeal hypersensitivity frequently report features that overlap other laryngeal dysfunction syndromes, including a tendency for the vocal cords to inappropriately adduct. The mechanisms underlying laryngeal hypersensitivity in chronic cough are currently unclear, however recent studies provide new clinical and physiological techniques to aid detection and monitoring of laryngeal hypersensitivity. This review provides an overview of the current state of knowledge in this field. PMID:26325433

  5. [Intubating laryngeal mask].

    PubMed

    Langenstein, H; Möller, F

    1998-01-01

    To improve the success of blind intubation through a laryngeal mask, Dr. A.I.J. Brain constructed the intubating laryngeal mask airway (ILMA), marketed under the name Fastrach. The new construction allows blind intubation with highly flexible endotracheal tubes up to 8 mm ID with cuff (straight Woodbridge type), securing the airway around the intubation process and maintaining most of the characteristics of a standard laryngeal mask airway (SLMA), including contraindications. An additional contraindication is the existence of a Zenker diverticle. Up to now, eight working groups reported a success rate of blind intubation through the ILMA of more than 90% in about 1,200 patients, with a success rate of blind intubation of more than 50% for the first intubation attempt. Ten percent of the patients were difficult to intubate with the same success rate for blind intubation as in normal patients. Reduced mouth opening does not seem to hinder the use of the ILMA in spite of its increased outer diameter of 2 cm, as long as it is possible to enlarge the mouth opening to > 2 cm during anaesthesia. The new ILMA more than doubles the success of blind intubation compared to an SLMA, irrespective of a large variety of intubation difficulties. Correct judgement of endotracheal tube position is mandatory. The ILMA has the potential to be used in patients who are difficult to intubate and to substitute the SLMA in "cannot ventilate--cannot intubate" situations. The future will show if the ILMA also will improve emergency airway management by inexperienced personnel, including intubation, as has been shown for the standard laryngeal mask airway in cardiopulmonary resuscitation for ventilation only. PMID:9611362

  6. Laryngeal pressure receptors.

    PubMed

    Mathew, O P; Sant'Ambrogio, G; Fisher, J T; Sant'Ambrogio, F B

    1984-07-01

    We studied the response characteristics of laryngeal pressure receptors in anesthetized dogs, breathing through a tracheal cannula, by recording single unit action potentials from the peripheral cut end of the internal branch of the superior laryngeal nerve. The larynx, with the rest of the upper airway, was isolated and cannulated separately for the application of distending and collapsing pressures. We identified receptors responding to either negative or positive pressure and a few responding to both. All these receptors showed a marked dynamic sensitivity and had the characteristics of slowly adapting mechanoreceptors. The majority of pressure receptors were active at zero transmural pressure and the gain of their response to pressure was higher at lower values, suggesting a role for these receptors in eupnea. Reflex alterations in breathing pattern and upper airway muscle activity during upper airway pressure changes, previously reported, are presumably mediated by the receptors described here. Moreover, these receptors may play a role in certain pathological states, such as obstructive sleep apnea, in which the upper airway is transiently subjected to large collapsing pressure. PMID:6484319

  7. [Management of laryngeal cancers].

    PubMed

    Brunin, F; Rodriguez, J; Cougniot-Lescure, S; Point, D; Jaulerry, C; Brugère, J

    1995-04-01

    With 5,000 cases yearly, laryngeal carcinomas account in France for the third of squamous cell cancers of the upper digestive and respiratory tract. The crude survival rate is 50% at 5 years. Carcinomas of vocal cords are often diagnosed as early stages if dysphonia leads the patients to the ENT specialist within 2 weeks. Cure of the primary is achieved in 90% of the early stages by radiotherapy with narrow fields or partial surgery, with a 80% 5 years survival rate. Advanced tumors are often treated by total laryngectomy and postoperative radiotherapy. Supra-glottic cancers (epiglottis) are more serious. Unilateral dysphagia or upper cervical neck node often delay early diagnosis. A total laryngectomy is the commonest treatment. The 5 years survival rate of 40% is due to local and/or regional failures and metachronous cancers in head and neck, and radiotherapy remains the two major treatments. Primary prevention is based upon suppression of tobacco and reduction of alcoholic consumption, secondary prevention on resection of leucoplakia and close follow-up of patients with chronic laryngitis. PMID:7761753

  8. Treatment Option Overview (Laryngeal Cancer)

    MedlinePlus

    ... and symptoms of laryngeal cancer include a sore throat and ear pain. These and other signs and ... hoarseness in the voice. Tests that examine the throat and neck are used to help detect (find), ...

  9. Laryngeal disease in dogs and cats.

    PubMed

    Macphail, Catriona

    2014-01-01

    The most common disease process involving the larynx is laryngeal paralysis, which occurs much more frequently in dogs than in cats. Diagnosis of laryngeal paralysis requires close attention to anesthetic plane and coordination of respiratory effort with laryngeal motion. Surgical arytenoid lateralization improves respiration and quality of life in dogs with laryngeal paralysis; however, aspiration pneumonia is a recognized complication, and generalized neuropathy can progress. Laryngeal collapse can result from any cause of chronic upper airway obstruction, but is most often associated with unaddressed brachycephalic airway syndrome. Laryngeal neoplasia, while generally uncommon, occurs more frequently in cats than in dogs. PMID:24268331

  10. Impaired laryngeal voice production in a patient with foreign accent syndrome.

    PubMed

    Sakurai, Yasuhisa; Itoh, Kenji; Sai, Keiko; Lee, Seitetsu; Abe, Shoko; Terao, Yasuo; Mannen, Toru

    2015-01-01

    We report a Japanese-speaking monolingual woman who developed foreign accent syndrome (FAS) following an infarction in the precentral and premotor cortices (Brodmann Area 6) at and around the inferior frontal sulcus. Her speech sounded Chinese or Korean to our bilingual coauthor who speaks Chinese and Japanese. Quantitative acoustic analyses of words and sentences showed that pitch (fundamental frequency variation) and intensity variances appeared lowered and fully voiced glottal pulses were reduced. These findings suggest laryngeal dysfunction that contributes to the unusual speech production in a case of FAS. This may be caused by damage to a restricted area of the motor and premotor cortices that controls laryngeal function. PMID:24592816

  11. Homogeneous irradiation of the ''short-necked'' laryngeal cancer patient

    SciTech Connect

    Andrew, J.W.; Eapen, L.; Kulkarni, N.S.

    1984-04-01

    A technique for homogeneous irradiation of the ''short-necked'' laryngeal cancer patient is presented. The method is similar to a previously described technique in that inferiorly angled opposed lateral beams are used with tissue compensators and beam wedges. The advantages of the technique presented here are that the patient is treated supine rather than sitting and therapy simulation is more easily carried out. Experimental verification of the calculated radiation distributions was carried out in a water phantom having the same shape as the patient. These results show the extent of dose homogeneity and in addition show that neglecting tissue inhomogeneity, the measured and calculated dose distribuion agree within 2%.

  12. Pediatric Intussusception in Northern Iran: Comparison of Recurrent With Non-Recurrent Cases

    PubMed Central

    Esmaeili-Dooki, Mohammad Reza; Moslemi, Leila; Hadipoor, Abbas; Osia, Soheil; Fatemi, Seyed-Abbas

    2016-01-01

    Background: Intussusception represents as the invagination of a part of the intestine into itself and is the most common cause of intestinal obstruction in infants and children between 6 months to 3-years-old. Objectives: The objective of this study was to determine the recurrence rate and predisposing factors of recurrent intussusception. Patients and Methods: The medical records of children aged less than 13-years-old with confirmed intussusception who underwent reduction at a tertiary academic care in northern Iran (Mazandran), from 2001 to 2013 were reviewed. Data were extracted and recurrence rate was determined. The two groups were compared by chi square, Fisher, Mann-Whitney and t-test. Diagnosed cases of intussusception consisted of 237 children. Results: Average age of the patients was 19.57 ± 19.43 months with a peak of 3 to 30 months. Male to female ratio was 1.65 and this increased by aging. Recurrence rate was 16% (38 cases). 87 (36.7%) underwent surgery. These were mainly children under one year old. In 71% (40) of episodes recurrence occurred 1 to 7 times within 6 months. The recurrence occurred in 29 (23.5%) children in whom a first reduction was achieved with barium enema (BE) and 5 (5.7%) children who had an operative reduction (P < 0.001) in the first episode. Pathological leading points (PLPs) were observed in 5 cases; 2.6% in recurrence group versus 2% in non-recurrence group (P = 0.91). Three patients had intestinal polyp, 2 patient’s lymphoma and Mackle’s diverticulum. Age (P = 0.77) and sex (P = 0.38) showed no difference between the two groups. PLPs were observed in 1.4% of children aged 3 months to 5 years. This was 13.3%, in older children (P = 0.02). Conclusions: The recurrence of intussusception was related to the method of treatment in the first episode and it was 5-fold higher in children with BE than in operative reduction. Recurrent intussusceptions were not associated with PLPs, they were more idiopathic. PMID:27307967

  13. Helicobacter pylori infection in laryngeal diseases.

    PubMed

    Siupsinskiene, Nora; Jurgutaviciute, Vilma; Katutiene, Inga; Janciauskas, Dainius; Vaitkus, Saulius; Adamonis, Kęstutis

    2013-08-01

    Clinical studies have shown that Helicobacter pylori can be found not only in the mucosa of the stomach, but in the pharyngeal and laryngeal regions as well. The aim of this prospective case-control study was to identify H. pylori infection in the biopsy material from the larynx of the patients suffering from benign laryngeal diseases (vocal fold polyps, laryngitis) and laryngeal cancer and to investigate the possible relationships between the laryngeal H. pylori and patients' socio-demographic data and laryngopharyngeal reflux. The results of the biopsy material from 67 adult patients treated for benign laryngeal diseases and laryngeal cancer and 11 individuals of the control group revealed that H. pylori infection could be identified in more than one-third of the patients. In the majority of cases H. pylori was found in the patients with chronic laryngitis (45.5%) and laryngeal cancer (46.2%). The findings of these sub-groups significantly differed from those of the control group (9.1%) (p < 0.05). No significant relationships between H. pylori infection found in the laryngeal region and patients' demographic data, their unhealthy habits and reflux-related symptoms or signs were obtained. It could be concluded that H. pylori can colonize in the larynx of patients with benign laryngeal diseases and laryngeal cancer. To clarify the role of H. pylori as a risk factor for laryngeal diseases further research is needed. PMID:23572292

  14. Laryngeal amyloidosis causing hoarseness and airway obstruction.

    PubMed

    Gallivan, Gregory J; Gallivan, Helen K

    2010-03-01

    Amyloidosis constitutes a fraction of 1% of benign localized laryngeal tumors and may occasionally be associated with systemic disease. A chronic, insidious, progressive, recurrent disease characterized by hoarseness, dyspnea, and stridor, it is caused by extracellular deposition of insoluble, abnormal tissue injurious fibrils. Submucosal lesions occur frequently in the vestibular folds and ventricles, less commonly in the subglottis and aryepiglottic folds and least on the vocal folds. Apple green birefrigence under polarized light after Congo red staining, electron microscopic fibrillar structure, and a beta-pleated sheet structure observed by x-ray diffraction are confirmatory. Two presented cases add to the small literature review of similar patients. Case 1 was a 70-year-old man with severe hoarseness, incomplete glottic closure, ovoid concentric stenosis of the inferior glottis and subglottis, who initially was not diagnosed by several laryngologists and speech therapists. He required multiple microlaryngoscopic excisions and dilations. Because low dose radiation induces plasma cell apoptosis in other diseases, external beam radiation therapy (EBRT) was hypothesized to eliminate amyloidogenic plasma cells. Case 2 was a 46-year-old welder with progressive dyspnea for 2-3 years and hoarseness, voice loss, and stridor over 6-7 months. Masses caused airway obstruction of the anterior commissure, vestibular, and vocal folds, with extension to the subglottis. Two phonomicrosurgical CO(2) laser-assisted resections relieved upper airway obstruction and restored voice. Conservative surgical intervention and long-term followup are essential. Further studies are needed to determine if a radiation dose response relationship exists to control laryngeal amyloidosis. PMID:19111441

  15. Lifestyle Changes After Laryngeal or Hypopharyngeal Cancer

    MedlinePlus

    ... laryngeal or hypopharyngeal cancer affect your emotional health? Lifestyle changes after laryngeal or hypopharyngeal cancer You can’ ... people want to know if there are specific lifestyle changes they can make to reduce their risk ...

  16. Cytokeratin 20 expression by non-invasive transitional cell carcinomas: potential for distinguishing recurrent from non-recurrent disease.

    PubMed

    Harnden, P; Allam, A; Joyce, A D; Patel, A; Selby, P; Southgate, J

    1995-08-01

    Although approximately 50% of patients with non-invasive (Ta) papillary transitional cell carcinoma show no recurrence of their disease, current histopathological approaches cannot distinguish this sub-group from those patients in whom the disease will recur. In this 5 year retrospective study, we have shown that cytokeratin 20 (CK20) was expressed in 19 of 29 (65.5%) of non-invasive papillary tumours of grades 1 or 2. CK20 expression patterns were predictive of disease non-recurrence in a sub-group of eight patients, representing 51.7% of patients with non-recurrent disease. In normal bladder mucosa, CK20 expression was restricted to the terminally-differentiated superficial cell. In eight CK20-positive tumours which showed no recurrence at 5 years, CK20 expression was either restricted to, or most intense in, the luminal cells of the papillae. This pattern of expression was not seen in any of the 15 tumours from the recurrent group. Disruption of normal CK20 expression was highly significantly correlated with recurrent tumours. These results suggest that changes in the expression of differentiation-associated antigens, such as CK20, may be useful in predicting benign versus malignant behaviour and may, therefore, be useful in defining treatment strategies. PMID:8835265

  17. Bilateral inferior turbinate osteoma.

    PubMed

    Sahemey, R; Warfield, A T; Ahmed, S

    2016-01-01

    Osteomas are the most common benign osteoclastic tumours of the paranasal sinuses. However, nasal cavity and turbinate osteomas are extremely rare. Only nine middle turbinate, three inferior turbinate and one inferior turbinate osteoma cases have been reported to date. The present case report describes the management and follow-up of symptomatic bilateral inferior turbinate osteoma.A 60-year-old female presented with symptoms of bilateral nasal obstruction and right-sided epiphora. Radiological investigation found hypertrophic bony changes involving both inferior turbinates. The patient was managed successfully by endoscopic inferior turbinectomies in order to achieve a patent airway, with no further recurrence of tumour after 3 months postoperatively.To the best of our knowledge, this is the first reported case of bilateral inferior turbinate osteoma. We describe a safe and minimally invasive method of tumour resection, which has a better cosmetic outcome compared with other approaches. PMID:27534890

  18. Laryngeal release with slide tracheoplasty for long-segment congenital tracheal stenosis.

    PubMed

    Komori, Koji; Toma, Miki; Shimojima, Naoki; Yamamoto, Yuki; Uto, Keiichi; Ogata, Satsuki; Kano, Motohiro; Hirobe, Seiichi

    2015-10-01

    Slide tracheoplasty is a standard treatment for long-segment congenital tracheal stenosis (LCTS). However, in severe cases of LCTS, aggressive divisions of inferior constrictor muscle from the thyroid cartilage and extensive circumferential dissection of the upper tracheal segment are often necessary to mobilize the upper tracheal segment enough to make an anastomosis, but they increase the risks of anastomotic dehiscence, recurrent nerve injury, and impaired deglutition. Alternatively, laryngeal release provides safe mobilization of the upper tracheal segment, minimizing dissection of the inferior constrictor muscle and preserving the lateral tissue pedicle without circumferential dissection. We successfully performed laryngeal release with slide tracheoplasty on six patients with severe LCTS, and report our findings. PMID:24113995

  19. Role of perineural invasion as a prognostic factor in laryngeal cancer

    PubMed Central

    MESOLELLA, MASSIMO; IORIO, BRIGIDA; MISSO, GABRIELLA; LUCE, AMALIA; CIMMINO, MARIANO; IENGO, MAURIZIO; LANDI, MARIO; SPERLONGANO, PASQUALE; CARAGLIA, MICHELE; RICCIARDIELLO, FILIPPO

    2016-01-01

    The diffusion of laryngeal cancer cells in the perineural space is a parameter associated with a negative prognosis, high loco-regional recurrence and low disease-free survival rates. The spread of tumor cells on the perineural sheath highlights the histopathological and clinically aggressive behavior of this type of tumor, which may extend proximally or distally in the nerve for >10 cm. Therefore, the surgical resection margin is generally insufficient to treat patients with laryngeal cancer presenting with perineural invasion (PNI) with surgery alone. In PNI, the minor laryngeal nerves are frequently involved, rather than the superior and inferior laryngeal nerves. The aim of the present study was: i) To evaluate the prognostic importance of PNI; ii) to correlate the rate of infiltration with factors associated with the tumor, including histotype, site and tumor-node-metastasis stage, and with the type of surgery (total or partial laryngectomy); and iii) to evaluate the rate of disease-free survival according to the outcome of combined surgery and radiotherapy (RT) treatment, by means of retrospective analysis. The results of the present study highlighted the importance of performing a closer clinical and instrumental follow-up in patients with laryngeal cancer whose histopathological examination is positive for PNI. In such cases, it is important to complement the surgical therapeutic treatment with adjuvant RT. PMID:27073523

  20. NUMERICAL SIMULATION OF LARYNGEAL FLOW

    EPA Science Inventory

    In this study, we have investigated laryngeal air flows by numerically solving the corresponding Navier-Stokes equations expressed in a two-dimensional cylindrical coordinate system. The glottal aperture, defined by the geometry of the vocal folds was allowed to change with the v...

  1. Laryngeal obstruction by heroin packets.

    PubMed

    Colombage, Senarath M

    2003-06-01

    A 28-year-old healthy man collapsed while being arrested by the police for alleged possession of heroin and was found dead on admission to the hospital. Autopsy revealed complete occlusion of the laryngeal opening by a cellophane bag containing 24 packets of heroin powder. PMID:12773851

  2. Mechanisms for nonrecurrent genomic rearrangements associated with CMT1A or HNPP: rare CNVs as a cause for missing heritability.

    PubMed

    Zhang, Feng; Seeman, Pavel; Liu, Pengfei; Weterman, Marian A J; Gonzaga-Jauregui, Claudia; Towne, Charles F; Batish, Sat Dev; De Vriendt, Els; De Jonghe, Peter; Rautenstrauss, Bernd; Krause, Klaus-Henning; Khajavi, Mehrdad; Posadka, Jan; Vandenberghe, Antoon; Palau, Francesc; Van Maldergem, Lionel; Baas, Frank; Timmerman, Vincent; Lupski, James R

    2010-06-11

    Genomic rearrangements involving the peripheral myelin protein gene (PMP22) in human chromosome 17p12 are associated with neuropathy: duplications cause Charcot-Marie-Tooth disease type 1A (CMT1A), whereas deletions lead to hereditary neuropathy with liability to pressure palsies (HNPP). Our previous studies showed that >99% of these rearrangements are recurrent and mediated by nonallelic homologous recombination (NAHR). Rare copy number variations (CNVs) generated by nonrecurrent rearrangements also exist in 17p12, but their underlying mechanisms are not well understood. We investigated 21 subjects with rare CNVs associated with CMT1A or HNPP by oligonucleotide-based comparative genomic hybridization microarrays and breakpoint sequence analyses, and we identified 17 unique CNVs, including two genomic deletions, ten genomic duplications, two complex rearrangements, and three small exonic deletions. Each of these CNVs includes either the entire PMP22 gene, or exon(s) only, or ultraconserved potential regulatory sequences upstream of PMP22, further supporting the contention that PMP22 is the critical gene mediating the neuropathy phenotypes associated with 17p12 rearrangements. Breakpoint sequence analysis reveals that, different from the predominant NAHR mechanism in recurrent rearrangement, various molecular mechanisms, including nonhomologous end joining, Alu-Alu-mediated recombination, and replication-based mechanisms (e.g., FoSTeS and/or MMBIR), can generate nonrecurrent 17p12 rearrangements associated with neuropathy. We document a multitude of ways in which gene function can be altered by CNVs. Given the characteristics, including small size, structural complexity, and location outside of coding regions, of selected rare CNVs, their identification remains a challenge for genome analysis. Rare CNVs may potentially represent an important portion of "missing heritability" for human diseases. PMID:20493460

  3. Dosimetric Predictors of Laryngeal Edema

    SciTech Connect

    Sanguineti, Giuseppe . E-mail: gisangui@utmb.edu; Adapala, Prashanth; Endres, Eugene J. C; Brack, Collin; Fiorino, Claudio; Sormani, Maria Pia; Parker, Brent

    2007-07-01

    Purpose: To investigate dosimetric predictors of laryngeal edema after radiotherapy (RT). Methods and Materials: A total of 66 patients were selected who had squamous cell carcinoma of the head and neck with grossly uninvolved larynx at the time of RT, no prior major surgical operation except for neck dissection and tonsillectomy, treatment planning data available for analysis, and at least one fiberoptic examination of the larynx within 2 years from RT performed by a single observer. Both the biologically equivalent mean dose at 2 Gy per fraction and the cumulative biologic dose-volume histogram of the larynx were extracted for each patient. Laryngeal edema was prospectively scored after treatment. Time to endpoint, moderate or worse laryngeal edema (Radiation Therapy Oncology Group Grade 2+), was calculated with log rank test from the date of treatment end. Results: At a median follow-up of 17.1 months (range, 0.4- 50.0 months), the risk of Grade 2+ edema was 58.9% {+-} 7%. Mean dose to the larynx, V30, V40, V50, V60, and V70 were significantly correlated with Grade 2+ edema at univariate analysis. At multivariate analysis, mean laryngeal dose (continuum, hazard ratio, 1.11; 95% confidence interval, 1.06-1.15; p < 0.001), and positive neck stage at RT (N0-x vs. N +, hazard ratio, 3.66; 95% confidence interval, 1.40-9.58; p = 0.008) were the only independent predictors. Further stratification showed that, to minimize the risk of Grade 2+ edema, the mean dose to the larynx has to be kept {<=}43.5 Gy at 2 Gy per fraction. Conclusion: Laryngeal edema is strictly correlated with various dosimetric parameters; mean dose to the larynx should be kept {<=}43.5 Gy.

  4. Perinatal development of laryngeal function.

    PubMed

    Harding, R

    1984-06-01

    The resistance of the upper airway is strongly influenced by the action of opposing sets of laryngeal muscles. Expiratory airflow may be retarded by active adduction of the arytenoid cartilages or by a reduction in the activity of abductor muscles. In developing sheep the adductor muscles appear to represent the principal means by which lung recoil is opposed. This mechanism, which is most pronounced during non-rapid-eye-movement sleep, is regulated by afferent traffic from the lungs. In fetal sheep the laryngeal muscles are also influenced by breathing movements and sleep states. The adductor muscles are normally tonically active during non-rapid-eye-movement sleep when rhythmical breathing movements are absent. It is possible that this activity is at least partially responsible for elevated tracheal pressures and depressed flow of tracheal fluid during fetal apnea. This hypothesis has been tested by observing the effects of fetal paralysis and recurrent laryngeal nerve section. These experiments suggest that in the fetus near term the larynx makes a major contribution to upper airway resistance and hence to the maintenance of pulmonary expansion which has been shown to influence lung development. PMID:6747226

  5. Progress in laryngeal framework surgery.

    PubMed

    Isshiki, N

    2000-03-01

    This paper reviews progress in laryngeal framework surgery since it was first reported about 25 years ago. The success of this type of surgery requires both a basic knowledge of the physiology of phonation, in order to make decisions about the surgical procedure, and surgical skill, in order to accomplish the intended procedure successfully. The main reason for hoarseness is imperfect closure of the glottis, but the second most important reason for hoarseness, increased stiffness of the vocal fold, cannot be corrected by mere medialization of the vocal fold. Laryngeal framework surgery is different in concept from conventional surgery, which is intended to remove the lesion. Controversial points discussed here regarding type I thyroplasty include: (i) whether the cartilage window should be removed; (ii) materials for fixation of the window; and (iii) comparison of type I thyroplasty with arytenoid adduction. A new surgical treatment for spasmodic dysphonia and its results in three patients are described briefly. Surgery for raising the vocal pitch requires further improvement. In the future, laryngeal framework surgery will have wider application in treatment of dysphonias, such as asthenic voice due to atrophy in professional singers or aging, pitch problems in females and gender identity disorder and spasmodic dysphonia. PMID:11603755

  6. Multidisciplinary Management of Laryngeal Carcinoma

    SciTech Connect

    Mendenhall, William M. Mancuso, Anthony A.; Hinerman, Russell W.; Malyapa, Robert S.; Werning, John W.; Amdur, Robert J.; Villaret, Douglas B.

    2007-10-01

    The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor.

  7. Expression of p27 and PTEN and clinical characteristics in early laryngeal squamous cell carcinoma and their correlation with recurrence.

    PubMed

    Yang, Jun-Quan; Liang, Zhen; Wu, Meng; Sun, Yu-Man; Liu, Hong-Xia

    2015-01-01

    Laryngeal squamous cell carcinoma is a common malignant tumor of otolaryngeal region. At present, effective treatment of laryngeal squamous cell carcinoma still depends on surgery and radiotherapy. In recent years, application of CO2 laser resection in the treatment of stage T1 glottic carcinoma can remove the tumor completely and reduce the injury of laryngeal tissues. But recurrence still happened in some postoperative patients. Here, we selected 131 patients to compare the therapeutic effects of CO2 laser resection and traditional split laryngeal surgery on the early laryngeal cancer, examined the expression of p27 and PTEN by immunohistochemistry in early laryngeal squamous cell carcinoma tissues in correlation to clinical outcome. After two years follow-up 14/85 (16.5%) of CO2 laser treatment group presented with local recurrence (recurrent group), while that of split laryngeal surgery group was 6/46 (13.0%). There was no statistical significance in recurrence rate between the two groups (P>0.05). 10 of all the 111 (9.0%) non-recurrent patients did not follow the doctor's advice to quit smoking after the operation, while 12 in the 20 (60.0%) recurrent patients did not; the difference between the two groups was statistically significant (P<0.01). The positive rates of p27 were 80.2% (105/131) and 43.5% (57/131), and that of PTEN were 83.2% (109/131) and 48.9% (64/131) in the cancer adjacent tissues (negative surgical margin tissues) and in laryngeal carcinoma tissues, respectively (P<0.001). The expression rates of p27 and PTEN in laryngeal carcinoma tissues of the recurrent group were 20.0% (4/20), 10.0% (2/20) and that in non recurrent group were 47.7% (53/111) and 55.9% (62/111), respectively, with a significant difference (P<0.001). In addition, the expression of p27 and PTEN in tumor resected marginal tissues of the recurrence group was 50.0% (10/20), 40.0% (8/20) and that in non recurrence group was 85.6% (95/111) and 91.0% (101/111), respectively; the

  8. Concurrent Chemotherapy and Intensity-Modulated Radiotherapy for Locoregionally Advanced Laryngeal and Hypopharyngeal Cancers

    SciTech Connect

    Lee, Nancy Y. O'Meara, William; Chan, Kelvin; Della-Bianca, Cesar; Mechalakos, James G.; Zhung, Joanne; Wolden, Suzanne L.; Narayana, Ashwatha; Kraus, Dennis; Shah, Jatin P.; Pfister, David G.

    2007-10-01

    extent, those with laryngeal cancer. Strategies using IMRT to limit the dose delivered to the esophagus/inferior constrictor musculature without compromising target coverage might be useful to further minimize this late complication.

  9. Laryngeal sarcocystosis accompanying laryngeal squamous cell carcinoma: case report and literature review.

    PubMed

    Larbcharoensub, Noppadol; Cheewaruangroj, Wichit; Nitiyanant, Prawat

    2011-09-01

    Laryngeal sarcocystosis is an uncommon zoonotic coccidian protozoal infestation of human beings. The authors reviewed the pathology of 1,063 laryngeal biopsies over the past 10 years (2000 to 2009). Only one case of laryngeal sarcocystosis accompanying laryngeal squamous cell carcinoma was identified. The overall prevalence of laryngeal sarcocystosis was 0.094%. The case was a 66-year-old man who presented with voice hoarseness for six months. Physical examination and computed tomography revealed an ulcerative exophytic mass on the right true vocal cord, suggestive of laryngeal carcinoma. He underwent a right frontolateral partial laryngectomy. Histopathology showed a nonkeratinizing squamous cell carcinoma with Sarcocystis spp in the vocalis muscle. He was followed up and enrolled in speech therapy. The authors briefly review the clinicopathologic features and pathogenesis of muscular sarcocystosis and concurrent laryngeal sarcocystosis and squamous cell carcinoma. PMID:22299431

  10. SVA retrotransposon insertion-associated deletion represents a novel mutational mechanism underlying large genomic copy number changes with non-recurrent breakpoints

    PubMed Central

    2014-01-01

    Background Genomic disorders are caused by copy number changes that may exhibit recurrent breakpoints processed by nonallelic homologous recombination. However, region-specific disease-associated copy number changes have also been observed which exhibit non-recurrent breakpoints. The mechanisms underlying these non-recurrent copy number changes have not yet been fully elucidated. Results We analyze large NF1 deletions with non-recurrent breakpoints as a model to investigate the full spectrum of causative mechanisms, and observe that they are mediated by various DNA double strand break repair mechanisms, as well as aberrant replication. Further, two of the 17 NF1 deletions with non-recurrent breakpoints, identified in unrelated patients, occur in association with the concomitant insertion of SINE/variable number of tandem repeats/Alu (SVA) retrotransposons at the deletion breakpoints. The respective breakpoints are refractory to analysis by standard breakpoint-spanning PCRs and are only identified by means of optimized PCR protocols designed to amplify across GC-rich sequences. The SVA elements are integrated within SUZ12P intron 8 in both patients, and were mediated by target-primed reverse transcription of SVA mRNA intermediates derived from retrotranspositionally active source elements. Both SVA insertions occurred during early postzygotic development and are uniquely associated with large deletions of 1 Mb and 867 kb, respectively, at the insertion sites. Conclusions Since active SVA elements are abundant in the human genome and the retrotranspositional activity of many SVA source elements is high, SVA insertion-associated large genomic deletions encompassing many hundreds of kilobases could constitute a novel and as yet under-appreciated mechanism underlying large-scale copy number changes in the human genome. PMID:24958239

  11. [Laryngeal and larynx-associated reflexes].

    PubMed

    Ptok, M; Kühn, D; Miller, S; Jungheim, M; Schroeter, S

    2016-06-01

    The laryngeal adductor reflex and the pharyngoglottal closure reflex protect the trachea and lower respiratory tract against the entrance of foreign material. The laryngeal expiration reflex and the cough reflex serve to propel foreign material, which has penetrated in the cranial direction. The inspiration reflex, the sniff reflex, and the swallowing reflex are further larynx-associated reflexes. In patients with dysphagia the laryngeal adductor reflex can be clinically tested with air pulses. The water swallow test serves to show the integrity of the cough reflex. The sniff reflex is useful to test the abduction function of the vocal folds. Future studies should address laryngeal reflexes more specifically, both for a better understanding of these life-supporting mechanisms and to improve diagnostic procedures in patients with impaired laryngeal function. PMID:27240793

  12. Occupational risk for laryngeal cancer

    SciTech Connect

    Flanders, W.D.; Rothman, K.J.

    1982-04-01

    In a case-control analysis, we studied the effects of type of employment on laryngeal cancer risk using the interview data from the Third National Cancer Survey. Effects were measured relative to the risk for those employed in a group of arbitrarily defined industries and occupations with low risk. We excluded females and controlled for age, tobacco use, alcohol use, and race in the analysis. We found ratio estimates above 3.0 for workers in the railroad industry and the lumber industry; and for sheetmetal workers, grinding wheel operators, and automobile mechanics.

  13. Inferior alveolar nerve repositioning.

    PubMed

    Louis, P J

    2001-09-01

    Nerve repositioning is a viable alternative for patients with an atrophic edentulous posterior mandible. Patients, however, should be informed of the potential risks of neurosensory disturbance. Documentation of the patient's baseline neurosensory function should be performed with a two-point discrimination test or directional brush stroke test preoperatively and postoperatively. Recovery of nerve function should be expected in 3 to 6 months. The potential for mandibular fracture when combining nerve repositioning with implant placement also should be discussed with the patient. This can be avoided by minimizing the amount of buccal cortical plate removal during localization of the nerve and maintaining the integrity of the inferior cortex of the mandible. Additionally, avoid overseating the implant, thus avoiding stress along the inferior border of the mandible. The procedure does allow for the placement of longer implants, which should improve implant longevity. Patients undergoing this procedure have expressed overall satisfaction with the results. Nerve repositioning also can be used to preserve the inferior alveolar nerve during resection of benign tumors or cysts of the mandible. This procedure allows the surgeon to maintain nerve function in situations in which the nerve would otherwise have to be resected. PMID:11665379

  14. Neurological Complications in Thyroid Surgery: A Surgical Point of View on Laryngeal Nerves

    PubMed Central

    Varaldo, Emanuela; Ansaldo, Gian Luca; Mascherini, Matteo; Cafiero, Ferdinando; Minuto, Michele N.

    2014-01-01

    The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB) is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle) varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified, the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN) runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction, and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve, which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a low range. PMID

  15. Treatment Options by Stage (Laryngeal Cancer)

    MedlinePlus

    ... Patient Hypopharyngeal Cancer Treatment Laryngeal Cancer Treatment Lip & Oral Cavity Treatment Metastatic Squamous Neck Cancer with Occult Primary ... Nasal Cavity Cancer Treatment Salivary Gland Cancer Treatment Oral Cavity and Oropharyngeal Cancer Prevention Oral Cavity and Oropharyngeal ...

  16. Chondrosarcoma of the Laryngeal Thyroid Cartilage.

    PubMed

    Righi, Stefano; Boffano, Paolo; Pateras, Dimitrios; Chiodo, Domenico; Zanardi, Fabio; Patetta, Roberta

    2015-09-01

    Chondrosarcoma of the larynx is a rare tumor, accounting for 0.07% to 2% of all laryngeal cancers. Nevertheless, it represents the most frequent nonepithelial neoplasm of the laryngeal region.Laryngeal chondrosarcomas are usually characterized by slow growth and low metastatic potential.The exact etiopathogenesis of chondrosarcoma is still debated. Diagnosis can be difficult given the slow rate of growth and nonspecific patient symptoms at presentation.Because of its rarity, literature about laryngeal chondrosarcoma is mainly made up of case reports and small case series.Therefore, it is important to add any information regarding this pathology.The aim of this article was to present and discuss a new case of chondrosarcoma located in the thyroid cartilage in a 63-year-old woman. PMID:26267570

  17. Laryngeal Reflexes: Physiology, Technique and Clinical Use

    PubMed Central

    Ludlow, Christy L.

    2015-01-01

    This review examines the current level of knowledge and techniques available for the study of laryngeal reflexes. Overall, the larynx is under constant control of several systems (including respiration, swallowing and cough) as well as sensory-motor reflex responses involving glossopharyngeal, pharyngeal, laryngeal and tracheobronchial sensory receptors. Techniques for the clinical assessment of these reflexes are emerging and need to be examined for sensitivity and specificity in identifying laryngeal sensory disorders. Quantitative assessment methods for the diagnosis of sensory reductions as well as sensory hypersensitivity may account for laryngeal disorders such as chronic cough, paradoxical vocal fold disorder and muscular tension dysphonia. The development of accurate assessment techniques could improve our understanding of the mechanisms involved in these disorders. PMID:26241237

  18. Two Cases of the Laryngeal Cystic Lesions

    PubMed Central

    Kusunoki, Takeshi; Wada, Ryo; Homma, Hirotomo; Kidokoro, Yoshinobu; Yanai, Aya; Ikeda, Katsuhisa

    2016-01-01

    We experienced two rare cases with laryngeal cystic lesions (laryngocele and laryngeal cyst). In the first case, the laryngocele case was removed by laryngomicrosurgery using an oral approach under general anesthesia. In the second case, the magnetic resonance imaging demonstrated a dumbbell-type cyst with mucus widely extending from the laryngeal lumen to the neck through the thyroid cartilage. The patient had undergone chemotherapy for renal carcinoma with multiple lung and bone metastases. Therefore, we performed only fine needle aspiration rather than aggressive surgery for extirpation of the cyst using an external approach. This fine needle aspiration could improve the quality of life by decreasing both the left laryngeal swelling and the resulting pain, which were the chief complaints. PMID:27162605

  19. Laryngitis

    MedlinePlus

    ... swelling and irritation (inflammation) of the voice box (larynx). The problem is most often associated with hoarseness ... The voice box (larynx) is located at the top of the airway to the lungs (trachea). The larynx contains the vocal cords. When ...

  20. Laryngitis

    MedlinePlus

    ... BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015: ... et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg . 2009;141(3 Suppl 2):S1-S31. ...

  1. Intralesional Cidofovir application in recurrent laryngeal papillomatosis.

    PubMed

    Pudszuhn, Annett; Welzel, Cornelia; Bloching, Marc; Neumann, Kerstin

    2007-01-01

    Recurrent laryngeal papillomatosis is a benign disease of the larynx often leading to organic and functional restrictions. The therapeutic treatment of choice in larynx-obstructing papillomatosis is at present surgical laser ablation. The effectiveness of adjuvant intralesional injection of the virustaticum Cidofovir has been investigated recently in a variety of therapeutic models. The present case study deals with the treatment of recurrent laryngeal papillomatosis by means of surgical laser ablation of the laryngeal papillomas with adjuvant local injection of the virustaticum Cidofovir (dose of 5 mg/1 ml). Within the period from October 2001 to August 2004, ten patients aged between 5- and 70 years were treated with intralesional injections of Cidofovir. Papillomatosis was confirmed histologically in all cases, and the virus types were defined in part. Each of the patients underwent clinical-phoniatric examinations and was photographed for documentation. After 2-7 treatments with surgical laser papilloma ablation and intralesional Cidofovir injections, all patients showed a definite papilloma reduction, while in six cases complete remission was achieved. During the follow-up period of 8-30 months, not a single recurrence of the laryngeal papillomatosis occurred. In the majority of patients, a clear improvement in the voice was achieved. There were no local or systemic side effects caused by the virustaticum. Intralesional injection of Cidofovir is an adjuvant, but not a curative therapeutic option in recurrent laryngeal papillomatosis. Remission of previously frequently recurrent laryngeal papillomas can be achieved, but recurrence after longer treatment-free intervals is also possible. PMID:17058091

  2. Inferior Vena Cava Thrombosis.

    PubMed

    Alkhouli, Mohamad; Morad, Mohammad; Narins, Craig R; Raza, Farhan; Bashir, Riyaz

    2016-04-11

    Thrombosis of the inferior vena cava (IVC) is an under-recognized entity that is associated with significant short- and long-term morbidity and mortality. In absence of a congenital anomaly, the most common cause of IVC thrombosis is the presence of an unretrieved IVC filter. Due to the substantial increase in the number of IVC filters placed in the United States and the very low filter retrieval rates, clinicians are faced with a very large population of patients at risk for developing IVC thrombosis. Nevertheless, there is a paucity of data and societal guidelines with regards to the diagnosis and management of IVC thrombosis. This paper aims to enhance the awareness of this uncommon, but morbid, condition by providing a concise, yet comprehensive, review of the etiology, diagnostic approaches, and treatment strategies in patients with IVC thrombosis. PMID:26952909

  3. What's New in Laryngeal and Hypopharyngeal Cancer Research and Treatment?

    MedlinePlus

    ... Additional resources for laryngeal and hypopharyngeal cancers What’s new in laryngeal and hypopharyngeal cancers research and treatment? ... to better tests for early detection and to new targeted treatments. Chemoprevention Chemoprevention is the use of ...

  4. What Are the Key Statistics about Laryngeal and Hypopharyngeal Cancers?

    MedlinePlus

    ... laryngeal and hypopharyngeal cancers? What are the key statistics about laryngeal and hypopharyngeal cancers? The American Cancer ... 000 cancers will start in the hypopharynx. Survival statistics for these cancers are discussed in “ Survival rates ...

  5. An unusual cause of hoarseness and recurrent laryngeal nerve palsy.

    PubMed

    Truong, Phat; Dickerson, Lisa

    2016-08-01

    Recurrent laryngeal nerve palsy and thyroid disease suggest locally invasive thyroid malignancy. In contrast, recurrent laryngeal nerve palsy caused by benign multinodular goiters or ectopic thyroid tissue accounts for only 1% of cases. This article describes an unusual case of recurrent laryngeal nerve palsy secondary to a benign ectopic retrosternal thyroid tissue mass. Recurrent laryngeal nerve palsy should be considered in the differential diagnosis of patients presenting with progressive voice weakness and hoarseness. PMID:27467296

  6. Effects of carbon dioxide on laryngeal receptors

    SciTech Connect

    Anderson, J.W.; Sant'Ambrogio, F.B.; Orani, G.P.; Sant'Ambrogio, G.; Mathew, O.P. )

    1990-02-26

    Carbon dioxide (CO{sub 2}) either stimulates or inhibits laryngeal receptors in the cat. The aim of this study was to correlate the CO{sub 2} response of laryngeal receptors with their response to other known stimuli (i.e. pressure, movement, cold, water and smoke). Single unit action potentials were recorded from fibers in the superior laryngeal nerve of 5 anesthetized, spontaneously breathing dogs together with CO{sub 2} concentration, esophageal and subglottic pressure. Constant streams of warm, humidified air or 10% CO{sub 2} in O{sub 2} were passed through the functionally isolated upper airway for 60 s. Eight of 13 randomly firing or silent receptors were stimulated by CO{sub 2} (from 0.4{plus minus}0.1 to 1.8{plus minus}0.4 imp.s). These non-respiratory-modulated receptors were more strongly stimulated by solutions lacking Cl{sup {minus}} and/or cigarette smoke. Six of 21 respiratory modulated receptors (responding to pressure and/or laryngeal motion) were either inhibited or stimulated by CO{sub 2}. Our results show that no laryngeal receptor responds only to CO{sub 2}. Silent or randomly active receptors were stimulated most often by CO{sub 2} consistent with the reflex effect of CO{sub 2} in the larynx.

  7. Tumor Volumes and Prognosis in Laryngeal Cancer

    PubMed Central

    Issa, Mohamad R.; Samuels, Stuart E.; Bellile, Emily; Shalabi, Firas L.; Eisbruch, Avraham; Wolf, Gregory

    2015-01-01

    Tumor staging systems for laryngeal cancer (LC) have been developed to assist in estimating prognosis after treatment and comparing treatment results across institutions. While the laryngeal TNM system has been shown to have prognostic information, varying cure rates in the literature have suggested concern about the accuracy and effectiveness of the T-classification in particular. To test the hypothesis that tumor volumes are more useful than T classification, we conducted a retrospective review of 78 patients with laryngeal cancer treated with radiation therapy at our institution. Using multivariable analysis, we demonstrate the significant prognostic value of anatomic volumes in patients with previously untreated laryngeal cancer. In this cohort, primary tumor volume (GTVP), composite nodal volumes (GTVN) and composite total volume (GTVP + GTVN = GTVC) had prognostic value in both univariate and multivariate cox model analysis. Interestingly, when anatomic volumes were measured from CT scans after a single cycle of induction chemotherapy, all significant prognosticating value for measured anatomic volumes was lost. Given the literature findings and the results of this study, the authors advocate the use of tumor anatomic volumes calculated from pretreatment scans to supplement the TNM staging system in subjects with untreated laryngeal cancer. The study found that tumor volume assessment after induction chemotherapy is not of prognostic significance. PMID:26569309

  8. Laryngeal aspergilloma: a complication of inhaled fluticasone therapy for asthma

    PubMed Central

    Darley, David; Lowinger, David; Plit, Marshall

    2014-01-01

    Primary laryngeal aspergillosis in immunocompetent patients is rare. We describe a case of a 59-year-old woman with laryngeal aspergillosis thought to be secondary to long-term inhaled fluticasone therapy. Laryngeal aspergillosis may be an underrecognized complication of inhaled corticosteroid therapy. PMID:25530858

  9. Inferior epigastric artery pseudoaneurysms

    PubMed Central

    Avula, SK

    2015-01-01

    Introduction Inferior epigastric artery (IEA) pseudoaneurysms are recognised complications of abdominal wall procedures, and a variety of approaches including surgical excision and ligation, percutaneous procedures and conservative management have been employed in treating this rare complication. Methods We describe a case of an IEA pseudoaneurysm diagnosed on computed tomography (CT) angiography, 14 days following a laparoscopic assisted low anterior resection, which was managed successfully with surgical excision and ligation. A review of the literature identified 32 reports of this complication since 1973 with 69% of cases occurring since 2000. Findings The main aetiology of IEA pseudoaneurysm was abdominal surgery (n=20); 65% of cases were attributable to abdominal wound closure or laparoscopic surgery. Two-thirds (66%) of patients presented between 11 and 63 days, and all except 1 case presented with discomfort, abdominal mass or haemodynamic instability. Colour Doppler ultrasonography was the imaging modality of choice (n=18), either alone or in combination with computed tomography and/or angiography. Surgical ligation and excision and percutaneous coil embolisation formed the mainstay of attempted treatments (69%), particularly following treatment failure using an alternative technique. Conclusions The incidence of iatrogenic IEA pseudoaneurysms appears to be increasing. Awareness of this rare complication is of clinical importance to avoid excessive morbidity for affected individuals. PMID:26263930

  10. [The review of transoral laser microsurgery in laryngeal cancer].

    PubMed

    Xu, Bin; Wang, Jihua; Xiao, Xuping

    2016-02-01

    Transoral laser microsurgery (TLM) has developed more than 40 years in the treatment of laryngeal cancer. TLM is especially important in the minimally invasive surgery of laryngeal carcinoma. Compared with the traditional open surgery, it is a major breakthrough, which has the significant advantages such as safety, effectiveness, low rate of local recurrence and high rate of larynx preservation. Not only can cure early laryngeal cancer, but also more and more the use of TLM in advanced supraglottic and glottic laryngeal cancer were reported. This article will review the characteristics, indications, superiority, surgical options and efficacy of the TLM in laryngeal carcinomas. PMID:27373106

  11. Challenges in the Management of Laryngeal Stenosis.

    PubMed

    Nair, Satish; Nilakantan, Ajith; Sood, Amit; Gupta, Atul; Gupta, Abhishek

    2016-09-01

    Laryngeal stenosis is one of the most complex and challenging problems in the field of head and neck surgery. The management involves a multidisciplinary approach with multiple complex procedures. In this study we discuss our experience of laryngeal stenosis with regards to patient characteristics, cause and management. A retrospective analysis of 35 patients of laryngeal stenosis treated at a tertiary care centre was evaluated. Inclusion criteria were all patients with laryngeal stenosis who required surgical intervention. Exclusion criteria were patients with associated tracheal stenosis and laryngeal stenosis due to cancer. Demographic data was recorded and findings relating to aetiology, characteristics of stenosis and the various aspects of therapeutic procedures performed are discussed with review of literature. Among 35 patients, 24 were males and 11 females of the age group 2-79 years. 2 (5.7 %) patients had supraglottic stenosis, 11 (31.4 %) had glottis stenosis, 16 (45.7 %) had subglottic stenosis and 6 (17.1 %) had combined multiple sites stenosis. Each patient underwent an average of 3.22 surgical procedures like microlaryngoscopy and excision with cold instrument, CO2 laser excision or open procedures like laryngofissure and excision and laryngoplasty. Montgomery t tube insertion was a common procedure in 17 patients (48.6 %). Of the total 35 patients with severe LS, 27 (77.1 %) patients were successfully decanulated. The results of glottic (100 %) and supraglottic stenosis (100 %) are excellent as compared to subglottic (68.8 %) and combined stenosis (50 %) of multiple sites. Laryngeal stenosis with airway compromise causes significant morbidity to the patients and is a difficult condition to treat in both adult and pediatric population. The need for multiple surgical procedures is common in the treatment of laryngeal stenosis with the t-tube being an important aid in the management of this condition. Trauma especially post intubation

  12. [Diagnosis and therapy of laryngitis gastrica].

    PubMed

    Pahn, J; Schlottmann, A; Witt, G; Wilke, W

    2000-07-01

    We treated 64 patients with the diagnosis of laryngitis gastrica with Antra (Omeprazol) in doses of 10, 20, and 40 mg. To determine the success of the therapy, pH monitoring of the esophagus and hypopharynx, the voice status and measurement of vocal penetrating capacity were used. The results prove that a 20-mg dose of Antra is suitable for the therapy of laryngitis gastrica with a high rate of success. Problems which arose during the investigation, consequent changes of the original concept of the project as well as new aspects and questions which resulted from this are discussed with respect to further investigation. PMID:10955230

  13. Laryngeal Leishmaniasis with Extra-pulmonary Tuberculosis.

    PubMed

    Tayal, Swati; Khatiwada, Saurav; Sehrawat, Priyanka; Nischal, Neeraj; Jorwal, Pankaj; Soneja, Manish; Sharma, M C; Sharma, S K; Verma, Pankaj; Singh, Anup

    2015-09-01

    Clinical presentations of Leishmania infection include visceral (most common form), cutaneous, mucocutaneous, mucosal and post-kala-azar dermal leishmaniasis. Mucosal form of leishmaniasis mostly involves oral and nasal mucosa. Rarely, laryngeal and pharyngeal mucosa may also be involved. Its concomitant presence with tuberculosis (TB), a disease rampant in India, is uncommon. Here we are reporting a case of isolated laryngeal leishmaniasis associated with extra-pulmonary tuberculosis (EPTB), with approach to diagnosis and treatment in a tropical resource-limited setting. PMID:27608871

  14. Laryngeal schwannoma as an acute airway presentation.

    PubMed

    Markou, Konstantinos; Dova, Stamatia; Poulios, Christos; Karkos, Petros

    2016-01-01

    A schwannoma is a neurogenic tumour arising from nerve sheaths. Between 25% and 45% of schwannomas occur in the head and neck region. Schwannomas of the larynx are extremely rare. They usually occur in women during the fourth and fifth decades of life. We present a case of a laryngeal schwannoma in a 76-year-old patient with acute stridor, hoarseness and dysphagia. Laryngeal conservation surgery was performed without the need for a tracheostomy. One year later, the patient remains symptom-free with no evidence of recurrence. Clinical presentation, diagnosis and management are discussed and the literature is reviewed. PMID:26969364

  15. Squamous cell carcinoma of the respiratory tract following laryngeal papillomatosis.

    PubMed

    Lie, E S; Engh, V; Boysen, M; Clausen, O P; Kvernvold, H; Stenersen, T C; Winther, F O

    1994-03-01

    With the object to disclose an association between laryngeal papillomatosis and laryngeal carcinoma, we reviewed 102 patients with laryngeal papillomatosis treated between 1950 and 1979. Seven cases of laryngeal carcinomas were recorded and 1 patient with spread of papilloma to the bronchial tree developed a bronchial carcinoma. The time between onset of papilloma and diagnosis of carcinoma was 4-55 years (mean 24 years). For laryngeal carcinoma the ratio of observed to expected cases was 88. Of the 8 patients developing respiratory tract carcinoma, 2 had received treatment with radiation and 2 had been treated with Bleomycin. Four of these 8 patients were known smokers. This study shows that papillomatosis is more often associated with laryngeal carcinoma than previously reported. It appears, however, that laryngeal papillomas alone seldom induce carcinomas. Apart from irradiation and smoking, Bleomycin could be an important co-factor. PMID:7515551

  16. Neurotrophin expression and laryngeal muscle pathophysiology following recurrent laryngeal nerve transection

    PubMed Central

    WANG, BAOXIN; YUAN, JUNJIE; XU, JIAFENG; XIE, JIN; WANG, GUOLIANG; DONG, PIN

    2016-01-01

    Laryngeal palsy often occurs as a result of recurrent laryngeal or vagal nerve injury during oncological surgery of the head and neck, affecting quality of life and increasing economic burden. Reinnervation following recurrent laryngeal nerve (RLN) injury is difficult despite development of techniques, such as neural anastomosis, nerve grafting and creation of a laryngeal muscle pedicle. In the present study, due to the limited availability of human nerve tissue for research, a rat model was used to investigate neurotrophin expression and laryngeal muscle pathophysiology in RLN injury. Twenty-five male Sprague-Dawley rats underwent right RLN transection with the excision of a 5-mm segment. Vocal fold movements, vocalization, histology and immunostaining were evaluated at different time-points (3, 6, 10 and 16 weeks). Although vocalization was restored, movement of the vocal fold failed to return to normal levels following RLN injury. The expression of brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor differed in the thyroarytenoid (TA) and posterior cricoarytenoid muscles. The number of axons did not increase to baseline levels over time. Furthermore, normal muscle function was unlikely with spontaneous reinnervation. During regeneration following RLN injury, differences in the expression levels of neurotrophic factors may have resulted in preferential reinnervation of the TA muscles. Data from the present study indicated that neurotrophic factors may be applied for restoring the function of the laryngeal nerve following recurrent injury. PMID:26677138

  17. Atraumatic laser treatment for laryngeal papillomatosis

    NASA Astrophysics Data System (ADS)

    McMillan, Kathleen; Pankratov, Michail M.; Wang, Zhi; Bottrill, Ian; Rebeiz, Elie E.; Shapshay, Stanley M.

    1994-09-01

    Ten to fifteen thousand new cases of recurrent respiratory papillomatosis (RRP) are diagnosed each year in the United States. RRP is caused by the human papillomavirus (HPV) and is characterized by recurrent, non-malignant, proliferative lesions of the larynx. Patients with RRP undergo numerous microsurgical procedures to remove laryngeal papilloma threatening airway patency and interfering with phonation. The standard surgical technique involves CO2 laser vaporization of laryngeal epithelium affected by the lesions, and requires general anesthesia. The pulsed dye laser operating at 585 nm has previously been demonstrated to be effective in clearing HPV lesions of the skin (verrucae). For treatment of RRP, the fiber- compatible pulsed dye laser radiation may be delivered under local anesthesia using a flexible intranasal laryngoscope. Potential advantages of the pulsed dye laser treatment over CO2 laser surgery include (1) reduced morbidity, especially a lower risk of laryngeal scarring; (2) lower cost; (3) reduced technical difficulty; and (4) reduced risk of viral dissemination or transmission. In vivo studies are underway to determine the effect of pulsed dye laser radiation on normal canine laryngeal tissue.

  18. Ventricular pressures in phonating excised larynges

    PubMed Central

    Alipour, Fariborz; Scherer, Ronald C.

    2012-01-01

    Pressure in the laryngeal ventricle was measured with a beveled needle connected to a pressure transducer in excised canine larynges. Air pressures within the ventricle were obtained for different adduction levels of the true vocal folds (TVFs), false vocal folds (FVFs), and subglottal pressures (Ps). Results indicated that the air pressures in the ventricle appear to be strongly related to the motion of the FVFs rather than to the effects of TVF vibration. Both dc and ac pressures depend on FVF adduction, amplitude of motion of the FVFs, and whether the FVFs touch each other during the vibratory cycle. Mean and peak-to-peak pressures in the ventricle were as high as 65% of the mean and peak-to-peak Ps, respectively, when the FVFs vibrated with large amplitude and contact each cycle. If the glottis was not closed, a medial movement of the FVFs appeared to create a positive pressure pulse on the Ps signal due to an increase in the laryngeal flow resistance. The electroglottograph signal showed evidence of tissue contact for both the TVFs and the FVFs. The study suggests that the laryngeal ventricle acts as a relatively independent aero-acoustic chamber that depends primarily upon the motion of the FVFs. PMID:22894222

  19. Epidemiological evidence indicates asbestos causes laryngeal cancer

    SciTech Connect

    Smith, A.H.; Handley, M.A.; Wood, R. )

    1990-06-01

    A variety of opinions have been expressed in the literature concerning asbestos and laryngeal cancer. This paper presents an analysis of epidemiological studies based on criteria that prioritized the most heavily exposed cohorts. Emphasis was given to the six cohorts or subcohorts with lung cancer relative risk estimates of 2 or more. The two groups of workers with the highest lung cancer relative risk estimates (4.06 and 3.28) both gave strong support for a causal association of asbestos and laryngeal cancer, with relative risk estimates of 1.91 (90% confidence limits 1.00 to 3.34) and 3.75 (90% confidence limits 1.01 to 9.68), respectively. Confounding with cigarette smoking or alcohol consumption does not explain the findings. Case-control studies gave mixed results, but generally supported the hypothesis. It was concluded that asbestos is a probable cause of laryngeal cancer in view of the reasonable consistency of the studies, the strength of the association in key studies, the evidence for dose-response relationships, and the biological plausibility for asbestos being a cause of laryngeal cancer. 48 references.

  20. A genetic view of laryngeal cancer heterogeneity.

    PubMed

    de Miguel-Luken, María José; Chaves-Conde, Manuel; Carnero, Amancio

    2016-05-01

    During the recent decades significant improvements in the understanding of laryngeal molecular biology allowed a better characterization of the tumor. However, despite increased molecular knowledge and clinical efforts, survival of patients with laryngeal cancer remains the same as 30 years ago. Although this result may not make major conclusions as preservation approaches were not broadly used until the time of database collection, it seems to be clear that there is still window for improvement. Although the cornerstone for laryngeal cancer eradication is to implement smoking cessation programs, survival progresses will be hopefully seen in the future. Introducing molecular biomarkers as predictive factors to determine which patients will benefit of preservation treatments may become one of the next steps to improve survival. Furthermore, the development of new therapeutic modalities joint to biomarkers to selectively apply such new therapy in these patients may help to define new modalities with improved survival. New inhibitors against Notch pathway, EGFR, VRK1 or DNA damage repair may become gold standard if we are able to identify patients that may benefit from them, either on survival or functional larynx preservation. It is the moment for an inflexion point on the way laryngeal cancer is clinically managed. PMID:26940775

  1. Development and validation of the Newcastle laryngeal hypersensitivity questionnaire

    PubMed Central

    2014-01-01

    Background Laryngeal hypersensitivity may be an important component of the common disorders of laryngeal motor dysfunction including chronic refractory cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. Patients with these conditions frequently report sensory disturbances, and an emerging concept of the ‘irritable larynx’ suggests common features of a sensory neuropathic dysfunction as a part of these disorders. The aim of this study was to develop a Laryngeal Hypersensitivity Questionnaire for patients with laryngeal dysfunction syndromes in order to measure the laryngeal sensory disturbance occurring in these conditions. Methods The 97 participants included 82 patients referred to speech pathology for behavioural management of laryngeal dysfunction and 15 healthy controls. The participants completed a 21 item self administered questionnaire regarding symptoms of abnormal laryngeal sensation. Factor analysis was conducted to examine correlations between items. Discriminant analysis and responsiveness to change were evaluated. Results The final questionnaire comprised 14 items across three domains: obstruction, pain/thermal, and irritation. The questionnaire demonstrated significant discriminant validity with a mean difference between the patients with laryngeal disorders and healthy controls of 5.5. The clinical groups with laryngeal hypersensitivity had similar abnormal scores. Furthermore the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ) showed improvement following behavioural speech pathology intervention with a mean reduction in LHQ score of 2.3. Conclusion The Newcastle Laryngeal Hypersensitivity Questionnaire is a simple, non-invasive tool to measure laryngeal pesthesia in patients with laryngeal conditions such as chronic cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. It can successfully differentiate patients from

  2. Epidemiological review of laryngeal cancer: An Indian perspective

    PubMed Central

    Bobdey, Saurabh; Jain, Aanchal; Balasubramanium, Ganesh

    2015-01-01

    Background: Laryngeal cancer is one of the 10 leading causes of cancer in Indian men. The association of laryngeal cancer and tobacco smoking is well-established, but the peculiarities such as wide variation of disease distribution and survival, role of tobacco chewing, indoor air pollution, and dietary factors in laryngeal cancer causation needs to be understood. In this study, we review the descriptive and observational epidemiology of laryngeal cancer in India. Materials and Methods: MEDLINE and Web of science electronic database was searched from January 1995 to December 2013, using the using keywords “laryngeal cancer, laryngeal cancer outcome, epidemiology, etiological factor and their corresponding Mesh terms were used in combination like OR, AND.” Two authors independently selected studies published in English and conducted in India. A total of 15 studies were found to be relevant and eligible for this review. Results: In India, laryngeal cancer contributes to approximately 3-6% of all cancers in men. The age-adjusted incidence rate of cancer larynx in males varies widely among registries, highest is 8.18 per 100,000 in Kamprup Urban District and the lowest is 1.26 per 100,000 in Nagaland. The 5-year survival for laryngeal cancer in India is approximately 28%. Indian studies show tobacco, alcohol, long-term exposure to indoor air pollution, spicy food, and nonvegetarian diet as risk factors for laryngeal cancer. Conclusion: There is wide regional variation in the incidence of laryngeal cancer in India. Survival rates of laryngeal carcinoma are much lower as compared to other Asian countries. Studies conducted in India to identify important risk factors of laryngeal cancer are very limited, especially on diet and indoor air pollution. Hence, more research is required for identifying the etiological factors and development of scientifically sound laryngeal cancer prevention programs. PMID:26855523

  3. Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve

    PubMed Central

    Hydman, Jonas; Svensson, Mikael

    2015-01-01

    Loss of function in the recurrent laryngeal nerve (RLN) during thyroid/parathyroid surgery, despite a macroscopically intact nerve, is a challenge which highlights the sensitivity and complexity of laryngeal innervation. Furthermore, the uncertain prognosis stresses a lack of capability to diagnose the reason behind the impaired function. There is a great deal of literature considering risk factors, surgical technique and mechanisms outside the nerve affecting the incidence of RLN paresis during surgery. To be able to prognosticate recovery in cases of laryngeal dysfunction and voice changes after thyroid surgery, the surgeon would first need to define the presence, location, and type of laryngeal nerve injury. There is little data describing the events within the nerve and the neurobiological reasons for the impaired function related to potential recovery and prognosis. In addition, very little data has been presented in order to clarify any differences between the transient and permanent injury of the RLN. This review aims, from an anatomical and neurobiological perspective, to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves. PMID:25713777

  4. Diagnosis and management of laryngeal trauma in sports.

    PubMed

    Hanft, K; Posternack, C; Astor, F; Attarian, D

    1996-06-01

    The management of sports-related laryngeal trauma presents a diagnostic and therapeutic challenge. The application of basic treatment principles such as airway monitoring, thorough physical examination, and fiberoptic laryngeal examination will direct the management. Further radiologic examination or surgical intervention may be required to adequately assess and manage the injury. We review the diagnosis, treatment, and management in a case of laryngeal fracture that occurred during a National Hockey League game. PMID:8638209

  5. Simulation of the Inferior Mirage

    NASA Astrophysics Data System (ADS)

    Branca, Mario

    2010-09-01

    A mirage can occur when a continuous variation in the refractive index of the air causes light rays to follow a curved path. As a result, the image we see is displaced from the location of the object. If the image appears higher in the air than the object, it is called a "superior" mirage, while if it appears lower it is called an "inferior" mirage.2 The most common example of an inferior mirage is when, on a hot day, a stretch of dry road off in the distance appears to be wet (see Fig. 1). Many lab activities have been described that simulate the formation of superior mirages. In these demonstrations light beams curve downward as they pass through a nonuni-form fluid.3-6 Much less common are laboratory demonstrations of upward-curving light rays of the kind responsible for inferior mirages. This paper describes a simple version of such a demonstration.

  6. Organ preservation surgery for laryngeal cancer

    PubMed Central

    Chawla, Sharad; Carney, Andrew Simon

    2009-01-01

    The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented. PMID:19442314

  7. [One case of laryngeal pleomorphic adenoma].

    PubMed

    An, Huiqin; Bu, Guiqing; Guo, Mingli

    2013-05-01

    A male patient, 55 years old, suffered from intermittent sound,voice depression and shortness of breath for one year,and from dysphagia for 3-4 months. Through fiber laryngoscopy,we could see tumor in the left posterior aryepiglottic fold. The tumor's surface was smooth. A portion of the tumor protruded to the laryngeal cavity and the aryepiglottic fold external,it also covered most of the glottis. Bilateral vocal cord were smooth and had good mobility. Throat CT demonstrated an irregular soft tissue mass on the left side of the aryepiglottic fold in supraglottic area with obscure normal boundary from adjacent structure. The left side of pyriform sinus became shallow without obvious bone destruction. The pathological report showed pleomorphic adenoma. The diagnosis was laryngeal pleomorphic adenoma. PMID:23898619

  8. Assessment of laryngeal dysfunctions of dysarthric speakers.

    PubMed

    Surabhi, V; Vijayalakshmi, P; Steffina, Lily; Jayanthan, Ra V

    2009-01-01

    Dysarthria is a neuromotor impairment of speech that affects one or more of the speech sub-systems. It is reflected in the acoustic characteristics of the phonemes as deviations from their healthy counterparts. In the current work, the deviations associated with laryngeal dysfunctions are analysed in order to assess and quantify parameters that will help evaluate dysarthria. Perturbation measures, pitch period statistics and Pitch Variation Index (PVI) are computed for the assessment of laryngeal dysfunctions of dysarthric speakers. The assessments were performed on the Nemours database of dysarthric speech and compared with normal speakers available in the TIMIT speech corpus. The results were correlated with Frenchay Dysarthria Assessment (FDA) scores. The analysis resulted in a technique to predict the degree of severity of dysarthria and illustrate the multi-causal nature of the disorder. PMID:19965223

  9. Respiratory and laryngeal function during whispering.

    PubMed

    Stathopoulos, E T; Hoit, J D; Hixon, T J; Watson, P J; Solomon, N P

    1991-08-01

    Established procedures for making chest wall kinematic observations (Hoit & Hixon, 1987) and pressure-flow observations (Smitheran & Hixon, 1981) were used to study respiratory and laryngeal function during whispering and speaking in 10 healthy young adults. Results indicate that whispering involves generally lower lung volumes, lower tracheal pressures, higher translaryngeal flows, lower laryngeal airway resistances, and fewer syllables per breath group when compared to speaking. The use of lower lung volumes during whispering than speaking may reflect a means of achieving different tracheal pressure targets. Reductions in the number of syllables produced per breath group may be an adjustment to the high rate of air expenditure accompanying whispering compared to speaking. Performance of the normal subjects studied in this investigation does not resemble that of individuals with speech and voice disorders characterized by low resistive loads. PMID:1956183

  10. Primary laryngeal leishmaniasis: a rare case report.

    PubMed

    Kumar, Bipin; Ghimire, Anand; Karki, Smriti; Upadhyaya, Paricha

    2009-01-01

    Laryngeal leishmaniasis is extremely rare. We report a case of primary laryngeal leishmaniasis in a 70-year-old male who was admitted with complaints of gradual progressive hoarseness of the voice, dyspnea, cough for the past 3 months and noisy breathing for the past 5 days. An X-ray of the soft tissue of the neck showed a prevertebral soft tissue mass causing narrowing of the airway at the C6-C7 vertebral level. A computerized tomography (CT) scan showed a soft tissue mass in the subglottic region causing significant narrowing of the airway. A direct laryngoscopy showed a pinkish-white, friable mass involving the subglottic region and the anterior half of the vocal cords. With the clinical suspicion of malignancy, an endoscopic biopsy was done. A histopathological examination showed diffuse mixed inflammatory cell infiltrate in subepithelium with numerous Leishmania donovani bodies in the cytoplasm of histiocytes. PMID:19136784

  11. Applications of robotics for laryngeal surgery

    PubMed Central

    Hillel, Alexander T.; Kapoor, Ankur; Simaan, Nabil; Taylor, Russell H.; Flint, Paul

    2014-01-01

    Synopsis The author presents the clinical application of robotics to laryngeal surgery in terms of enhancement of surgical precision and performance of other minimally invasive procedures not feasible with current instrumentation. Presented in this article are comparisons of human arm with robotic arm in terms of degrees of freedom and discussion of surgeries and outcomes with use of the robotic arm. Robotic equipment for laryngeal surgery has the potential to overcome many of the limitations of endolaryngeal procedures by improving optics, increasing instrument degrees of freedom, and modulating tremor. Outside of laryngology, a multi-armed robotic system would have utility in microvascular procedures at the base of the skull, sinus surgery, and single port gastrointestinal and thoracic access surgery. PMID:18570959

  12. Laryngeal biomechanics of the singing voice.

    PubMed

    Koufman, J A; Radomski, T A; Joharji, G M; Russell, G B; Pillsbury, D C

    1996-12-01

    By transnasal fiberoptic laryngoscopy, patients with functional voice often demonstrate abnormal laryngeal biomechanics, commonly supraglottic contraction. Appropriately, such conditions are sometimes termed muscle tension dysphonias. Singers working at the limits of their voice may also transiently demonstrate comparable tension patterns. However, the biomechanics of normal singing, particularly for different singing styles, have not been previously well characterized. We used transnasal fiberoptic laryngoscopy to study 100 healthy singers to assess patterns of laryngeal tension during normal singing and to determine whether factors such as sex, occupation, and style of singing influence laryngeal muscle tension. Thirty-nine male and 61 female singers were studied; 48 were professional singers, and 52 were amateurs. Examinations of study subjects performing standardized and nonstandardized singing tasks were recorded on a laser disk and subsequently analyzed in a frame-by-frame fashion by a blinded otolaryngologist. Each vocal task was graded for muscle tension by previously established criteria, and objective muscle tension scores were computed. The muscle tension score was expressed as a percentage of frames for each task with one of the laryngeal muscle tension patterns shown. The lowest muscle tension scores were seen in female professional singers, and the highest muscle tension scores were seen in amateur female singers. Male singers (professional and amateur) had intermediate muscle tension scores. Classical singers had lower muscle tension scores than nonclassical singers, with the lowest muscle tension scores being seen in those singing choral music (41%), art song (47%), and opera (57%), and the highest being seen in those singing jazz/pop (65%), musical theater (74%), bluegrass/country and western (86%), and rock/gospel (94%). Analyzed also were the influences of vocal nodules, prior vocal training, number of performance and practice hours per week

  13. Erythromycin in acute laryngitis in adults.

    PubMed

    Schalén, L; Eliasson, I; Kamme, C; Schalén, C

    1993-03-01

    Moraxella catarrhalis and Hemophilus influenzae are isolated from the nasopharynx in 50% to 55% and 8% to 15%, respectively, of cases of acute laryngitis in adults. This finding indicates that these organisms, M catarrhalis in particular, are in some way involved in the pathogenesis of the disorder. In the present double-blind, placebo-controlled trial, the effect of erythromycin ethylsuccinate (0.5 g twice a day for 5 days) on the elimination of nasopharyngeal pathogens and reduction of clinical signs of upper respiratory tract infection, as well as on subjective complaints, was evaluated in 106 adults with acute laryngitis. The bacterial isolation rates at presentation were M catarrhalis 50%, H influenzae 18%, and Streptococcus pneumoniae 4%. In the 99 patients who completed the study, the elimination of M catarrhalis after 1 week was better in the erythromycin group (25 of 30 cases) than in the placebo group (6 of 19 cases; p < or = .00038). The elimination of H influenzae was unaffected by erythromycin. Otolaryngologic examination did not reveal any significant group differences regarding laryngitis, pharyngitis, or rhinitis. Voice quality was improved after 1 week, irrespective of treatment. However, as compared to the placebo group, the erythromycin group reported fewer voice complaints after 1 week and fewer coughing complaints after 2 weeks. As acute laryngitis in adults is self-limiting, and subjective symptoms are spontaneously reduced after 1 week in most cases, antibiotic treatment does not seem warranted as a general policy. However, erythromycin may be justified in patients who are professionally dependent on voice function. PMID:8457123

  14. Diaphragm and Laryngeal FDG Uptake With Hiccups.

    PubMed

    Srivastava, Madhur K; Jain, Avani S; Panneer, Venkat; Muthukrishnan, Indirani; Simon, Shelley

    2015-11-01

    F-FDG PET/CT study is a well-established investigation in diagnosis, treatment evaluation, and follow-up of malignant tumors. It is very important to know the normal biodistribution and physiologic uptake of F-FDG to prevent it from confusing as malignant disease. This article describes unusual but physiological uptake in the laryngeal and diaphragmatic muscles in a patient presenting as metastatic adenocarcinoma with unknown primary having hiccups. PMID:26204217

  15. Undifferentiated Laryngeal Carcinoma with Pagetoid Spread.

    PubMed

    Sarioglu, Sulen; Dogan, Ersoy; Sahin, Yasemin; Uzun, Evren; Bekis, Recep; Ada, Emel; Sagol, Ozgul; Akman, Fadime

    2016-06-01

    Pagetoid spread, is used to define intraepithelial spread of cancer cells, when a massive carcinoma is identified beneath the basal membrane. There are only few reports of pagetoid spread at the head and neck region. Herein a 74 year old male patient with bilateral transglottic laryngeal high grade malignant epithelial tumor with pagetoid spread is presented. The tumor was located at the submucosa and there was spread of the CK7 and CK19 positive tumor cells into the non neoplastic mucosa, which was CK5/6 positive, sparing the basement membrane, creating a typical pagetoid pattern. Radiographic and positron emission tomography scan examination of the patient was unremarkable at presentation other than the laryngeal and neck lesions; but extensive systemic metastasis developed at 6 months following operation. To the best of our knowledge no epithelial malignancy with pagetoid spread was described at the larynx. Pagetoid spread may be a hallmark of very aggressive behavior in laryngeal carcinoma. PMID:26292650

  16. Microhomology-mediated mechanisms underlie non-recurrent disease-causing microdeletions of the FOXL2 gene or its regulatory domain.

    PubMed

    Verdin, Hannah; D'haene, Barbara; Beysen, Diane; Novikova, Yana; Menten, Björn; Sante, Tom; Lapunzina, Pablo; Nevado, Julian; Carvalho, Claudia M B; Lupski, James R; De Baere, Elfride

    2013-01-01

    Genomic disorders are often caused by recurrent copy number variations (CNVs), with nonallelic homologous recombination (NAHR) as the underlying mechanism. Recently, several microhomology-mediated repair mechanisms--such as microhomology-mediated end-joining (MMEJ), fork stalling and template switching (FoSTeS), microhomology-mediated break-induced replication (MMBIR), serial replication slippage (SRS), and break-induced SRS (BISRS)--were described in the etiology of non-recurrent CNVs in human disease. In addition, their formation may be stimulated by genomic architectural features. It is, however, largely unexplored to what extent these mechanisms contribute to rare, locus-specific pathogenic CNVs. Here, fine-mapping of 42 microdeletions of the FOXL2 locus, encompassing FOXL2 (32) or its regulatory domain (10), serves as a model for rare, locus-specific CNVs implicated in genetic disease. These deletions lead to blepharophimosis syndrome (BPES), a developmental condition affecting the eyelids and the ovary. For breakpoint mapping we used targeted array-based comparative genomic hybridization (aCGH), quantitative PCR (qPCR), long-range PCR, and Sanger sequencing of the junction products. Microhomology, ranging from 1 bp to 66 bp, was found in 91.7% of 24 characterized breakpoint junctions, being significantly enriched in comparison with a random control sample. Our results show that microhomology-mediated repair mechanisms underlie at least 50% of these microdeletions. Moreover, genomic architectural features, like sequence motifs, non-B DNA conformations, and repetitive elements, were found in all breakpoint regions. In conclusion, the majority of these microdeletions result from microhomology-mediated mechanisms like MMEJ, FoSTeS, MMBIR, SRS, or BISRS. Moreover, we hypothesize that the genomic architecture might drive their formation by increasing the susceptibility for DNA breakage or promote replication fork stalling. Finally, our locus-centered study

  17. Cartilage invasion patterns in laryngeal cancer.

    PubMed

    Gómez Serrano, Manuel; Iglesias Moreno, María Cruz; Gimeno Hernández, Jesús; Ortega Medina, Luis; Martín Villares, Cristina; Poch Broto, Joaquín

    2016-07-01

    The cartilaginous invasion determines the T and is one of the most common sources of mistake in tumor staging. Also it is of great importance when planning any therapeutic alternative. In the latest revision of the TNM classification a clear distinction is made between infiltration of cartilage without going through it, considered a T3 recently and that would be a T4 according to the previous classification, and those going through the cartilage, classified as T4a. While this classification makes the difference in depth of infiltration, it does not emphasize the extent of invasion. This paper provides a detailed description of the laryngeal cartilage tumor infiltration by whole organ serial section in which the invasion is considered both horizontal (transcartilaginous) and vertical (extent of invasion) and establishing patterns of three-dimensional infiltration of the cartilage. This is a cross-sectional study of prevalence. 275 records of patients treated for laryngeal squamous cell carcinoma between 1995 and 2000 were reviewed. The pathological processing of laryngectomy surgical specimens was performed following the method of whole organ serial section described by G. F. Tucker. The following patterns of cartilaginous infiltration were defined: (1) transcartilaginous infiltration; (2a) partial focal infiltration of the cartilage: infiltration not going through the cartilage but occupying one third or less of its extent; (2b) partial extensive infiltration of the cartilage: infiltration occupying two thirds or more of its length and (3) no cartilage infiltration: tumor in contact with the cartilage (paraglottic space) but without affecting it. 161 patients met the inclusion criteria. The most frequent tumor location was supraglottic (58 cases) followed by glottic (47). 109 patients (67.7 %) were treated with total laryngectomy. Partial surgical techniques were performed in the remaining cases. TNM tumor staging was performed according to the results of

  18. Expression of Fos-protein activated by tactile stimulation on the laryngeal vestibulum in the cat's lower brain stem.

    PubMed

    Tanaka, Y; Yoshida, Y; Hirano, M

    1995-01-01

    To demonstrate morphologically the neurons participating in the laryngeal reflex, Fos-expression, activated with tactile stimulation of the laryngeal vestibulum, was mapped in the cat's lower brain stem utilizing immunohistochemistry. In the stimulation group, many Fos-immunoreactive (ir) neurons were recognized in the nucleus tractus solitarii (NTS) from the level of the most rostral portion of the dorsal motor nucleus of the vagus to the level of the most caudal portion of the inferior olivary nucleus (IO), and in the nucleus ambiguus (NA) from the level of the rostral end of the hypoglossal nucleus to the level of the caudal end of the IO, bilaterally. While some Fos-ir cells were found in the spinal nucleus of the trigeminus, they were also found in the reticular nuclei bilaterally. In the control group, Fos-ir cells were distinctly fewer in number than those in the stimulation group. The results suggested that in the brain stem, the laryngeal reflex pathways have more than two synaptic relays through the interneurons in between the NTS and the NA. PMID:7876735

  19. Laryngeal structure and function in dogs with cough.

    PubMed

    Johnson, Lynelle R

    2016-07-15

    OBJECTIVE To investigate the prevalence and type of laryngeal abnormalities in dogs examined because of cough that did not have signs of upper airway disease and to compare the prevalence of those abnormalities among dogs with various respiratory tract diseases. DESIGN Prospective study. ANIMALS 138 dogs with cough that did not have signs of upper airway disease. PROCEDURES The study was conducted between July 2001 and October 2014 and included dogs examined for cough that had laryngoscopic and bronchoscopic examinations performed by 1 examiner. Laryngeal hyperemia and swelling were recorded, and laryngeal function was assessed before and after doxapram stimulation when indicated. Results were compared among dogs on the basis of cough duration (acute [< 2 weeks], subacute [2 weeks to 2 months], and chronic [> 2 months]) and disease diagnosed (inflammatory airway disease, airway collapse, lower respiratory tract infection, and eosinophilic bronchopneumopathy). RESULTS Laryngeal hyperemia was detected in 73 of 134 (54%) dogs with cough of subacute or chronic duration, and its prevalence did not vary significantly among dogs with various diseases. Thirteen dogs had laryngeal paresis, and 13 dogs had laryngeal paralysis; dysphonia (n = 2) and stridor (1) were uncommon findings in those dogs. The prevalence of laryngeal dysfunction (paresis or paralysis) did not differ significantly among diseases. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that 26 of 138 (19%) dogs examined because of cough alone had laryngeal dysfunction, which suggested that a complete laryngoscopic examination should be included in the diagnostic evaluation of dogs with cough. PMID:27379595

  20. Laryngeal Structure and Function in the Pediatric Larynx: Clinical Applications

    ERIC Educational Resources Information Center

    Sapienza, Christine M.; Ruddy, Bari Hoffman; Baker, Susan

    2004-01-01

    This article presents an overview of the normal anatomy and physiology of the pediatric larynx, followed by some examples of pediatric voice disorders that were chosen to exemplify the alterations to the laryngeal anatomy and the subsequent modifications to laryngeal function. Vocal fold nodules are primarily reviewed due to their high incidence…

  1. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal...

  2. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal...

  3. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal...

  4. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal...

  5. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Laryngeal prosthesis (Taub design). 874.3730 Section 874.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal...

  6. Quantitative PCR Analysis of Laryngeal Muscle Fiber Types

    ERIC Educational Resources Information Center

    Van Daele, Douglas J.

    2010-01-01

    Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses…

  7. Description of Laryngeal Pathologies in Children Evaluated by Otolaryngologists.

    ERIC Educational Resources Information Center

    Dobres, Rachel; And Others

    1990-01-01

    Data were collected on 731 patients (age birth to 18) at a children's hospital otolaryngology clinic. Most frequent laryngeal pathologies were subglottic stenosis, vocal nodules, laryngomalacia, and vocal fold paralysis. Laryngeal pathologies were more common to males than females, were most common in the youngest patients, and were distributed…

  8. Using Laryngeal Electromyography to Differentiate Presbylarynges from Paresis

    ERIC Educational Resources Information Center

    Stager, Sheila V.; Bielamowicz, Steven A.

    2010-01-01

    Purpose: Differential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from…

  9. Differentiation of pyriform sinus cancer from supraglottic laryngeal cancer by computed tomography

    SciTech Connect

    Larsson, S.; Mancuso, A.; Hoover, L.; Hanafee, W.

    1981-11-01

    Nine pyriform sinus tumors and 16 supraglottic laryngeal lesions were studied by computed tomography. The pyriform sinus tumors had a much higher incidence of thyroid cartilage invasion (five of nine patients) and involved the posterolateral margins of the cartilage. Only two of 16 supraglottic tumors reached the thyroid cartilage, involving the midline or more inferior margins. The supraglottic tumors grew in a circumferential pattern, and when the preepiglottic space was involved, extension was bilaterial. Lesions of the pyriform sinus more frequently showed unilateral involvement. Lymph node metastases were seen in an approximately equal proportion of patients in the two groups, and they correlated more with the size of the primary tumor than with its site of origin. Posteroinferior invasion of the space between the thyroid and cricoid cartilage was seen only with pyriform sinus lesions.

  10. Paralaryngeal Abscess with Laryngeal Hemiplegia and Fistulation in a Horse

    PubMed Central

    Barber, S. M.

    1981-01-01

    A three year old Thoroughbred filly was examined because of bilateral nasal discharge and external swelling of the left laryngeal area. Endoscopy revealed an enlarged left arytenoid cartilage, left laryngeal hemiplegia and drainage of purulent material into the lumen of the larynx. Radiographs showed a large fluid and gas filled cavity overlying the caudal larynx and cranial trachea. Surgical drainage and debridement of the abscess led to complete healing by secondary intention. Laryngeal ventriculectomy was performed as a treatment for left laryngeal hemiplegia, but a grave prognosis for respiratory soundness was given due to the extensive laryngeal fibrosis. The etiology of the Staphylococcus aureus abscess is unknown but may have originated from oral trauma to the larynx. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5. PMID:7337917

  11. Central nervous system control of the laryngeal muscles in humans

    PubMed Central

    Ludlow, Christy L.

    2005-01-01

    Laryngeal muscle control may vary for different functions such as: voice for speech communication, emotional expression during laughter and cry, breathing, swallowing, and cough. This review discusses the control of the human laryngeal muscles for some of these different functions. Sensori-motor aspects of laryngeal control have been studied by eliciting various laryngeal reflexes. The role of audition in learning and monitoring ongoing voice production for speech is well known; while the role of somatosensory feedback is less well understood. Reflexive control systems involving central pattern generators may contribute to swallowing, breathing and cough with greater cortical control during volitional tasks such as voice production for speech. Volitional control is much less well understood for each of these functions and likely involves the integration of cortical and subcortical circuits. The new frontier is the study of the central control of the laryngeal musculature for voice, swallowing and breathing and how volitional and reflexive control systems may interact in humans. PMID:15927543

  12. Serotonin in the inferior colliculus.

    PubMed

    Hurley, Laura M; Thompson, Ann M; Pollak, George D

    2002-06-01

    It has been recognized for some time that serotonin fibers originating in raphe nuclei are present in the inferior colliculi of all mammalian species studied. More recently, serotonin has been found to modulate the responses of single inferior colliculus neurons to many types of auditory stimuli, ranging from simple tone bursts to complex species-specific vocalizations. The effects of serotonin are often quite strong, and for some neurons are also highly specific. A dramatic illustration of this is that serotonin can change the selectivity of some neurons for sounds, including species-specific vocalizations. These results are discussed in light of several theories on the function of serotonin in the IC, and of outstanding issues that remain to be addressed. PMID:12117504

  13. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... laryngeal muscle tissue. 310.15 Section 310.15 Animals and Animal Products FOOD SAFETY AND INSPECTION... of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human food. (b) Livestock thyroid glands and laryngeal muscle tissue may...

  14. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... laryngeal muscle tissue. 310.15 Section 310.15 Animals and Animal Products FOOD SAFETY AND INSPECTION... of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human food. (b) Livestock thyroid glands and laryngeal muscle tissue may...

  15. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... laryngeal muscle tissue. 310.15 Section 310.15 Animals and Animal Products FOOD SAFETY AND INSPECTION... of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human food. (b) Livestock thyroid glands and laryngeal muscle tissue may...

  16. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... laryngeal muscle tissue. 310.15 Section 310.15 Animals and Animal Products FOOD SAFETY AND INSPECTION... of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human food. (b) Livestock thyroid glands and laryngeal muscle tissue may...

  17. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... laryngeal muscle tissue. 310.15 Section 310.15 Animals and Animal Products FOOD SAFETY AND INSPECTION... of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human food. (b) Livestock thyroid glands and laryngeal muscle tissue may...

  18. Unexpected radiation laryngeal necrosis after carbon ion therapy using conventional dose fractionation for laryngeal cancer.

    PubMed

    Demizu, Yusuke; Fujii, Osamu; Nagano, Fumiko; Terashima, Kazuki; Jin, Dongcun; Mima, Masayuki; Oda, Naoharu; Takeuchi, Kaoru; Takeda, Makiko; Ito, Kazuyuki; Fuwa, Nobukazu; Okimoto, Tomoaki

    2015-11-01

    Carbon ion therapy is a type of radiotherapy that can deliver high-dose radiation to a tumor while minimizing the dose delivered to organs at risk. Moreover, carbon ions are classified as high linear energy transfer radiation and are expected to be effective for even photon-resistant tumors. A 73-year-old man with glottic squamous cell carcinoma, T3N0M0, refused laryngectomy and received carbon ion therapy of 70 Gy (relative biological effectiveness) in 35 fractions. Three months after the therapy, the patient had an upper airway inflammation, and then laryngeal edema and pain occurred. Five months after the therapy, the airway stenosis was severe and computed tomography showed lack of the left arytenoid cartilage and exacerbation of laryngeal necrosis. Despite the treatment, 5 and a half months after the therapy, the laryngeal edema and necrosis had become even worse and the surrounding mucosa was edematous and pale. Six months after the therapy, pharyngolaryngoesophagectomy and reconstruction with free jejunal autograft were performed. The surgical specimen pathologically showed massive necrosis and no residual tumor. Three years after the carbon ion therapy, he is alive without recurrence. The first reported laryngeal squamous cell carcinoma case treated with carbon ion therapy resulted in an unexpected radiation laryngeal necrosis. Tissue damage caused by carbon ion therapy may be difficult to repair even for radioresistant cartilage; therefore, hollow organs reinforced by cartilage, such as the larynx, may be vulnerable to carbon ion therapy. Caution should be exercised when treating tumors in or adjacent to such organs with carbon ion therapy. PMID:26355161

  19. Simulation of the Inferior Mirage

    ERIC Educational Resources Information Center

    Branca, Mario

    2010-01-01

    A mirage can occur when a continuous variation in the refractive index of the air causes light rays to follow a curved path. As a result, the image we see is displaced from the location of the object. If the image appears higher in the air than the object, it is called a "superior" mirage, while if it appears lower it is called an "inferior"…

  20. Laryngeal cancer mortality trends in European countries.

    PubMed

    Chatenoud, Liliane; Garavello, Werner; Pagan, Eleonora; Bertuccio, Paola; Gallus, Silvano; La Vecchia, Carlo; Negri, Eva; Bosetti, Cristina

    2016-02-15

    After a steady increase between the 1950s and the 1970s, laryngeal cancer mortality has been levelling off since the early 1980s in men from most western and southern European countries and since the early 1990s in central and eastern Europe. To update trends in laryngeal cancer mortality, we analyzed data provided by the World Health Organization over the last two decades for 34 European countries and the European Union (EU) as a whole. For major European countries, we also identified significant changes in trends between 1980 and 2012 using joinpoint regression analysis. Male mortality in the EU was approximately constant between 1980 and 1991 (annual percent change, APC=-0.5%) and declined by 3.3% per year in 1991-2012. EU age-standardized (world population) rates were 4.7/100,000 in 1990-91 and 2.5/100,000 in 2010-2011. Rates declined in most European countries, particularly over the last two decades. In 2010-11, the highest male rates were in Hungary, the Republic of Moldova, and Romania (over 6/100,000), and the lowest ones in Finland, Norway, Sweden, and Switzerland (below 1/100,000). In EU women, mortality was stable around 0.29/100,000 between 1980 and 1994 and slightly decreased thereafter (APC=-1.3%; 0.23/100,000 in 2000-01). We also considered male incidence trends for nine European countries or cancer registration areas. In most of them, declines were observed over recent decades. Laryngeal cancer mortality thus showed favourable trends over the last few decades in most Europe, following favourable changes in tobacco and, mostly for Mediterranean countries, alcohol consumption. PMID:26335030

  1. Trauma-induced schwannoma of the recurrent laryngeal nerve after thyroidectomy.

    PubMed

    Kennedy, William P; Brody, Robert M; LiVolsi, Virginia A; Wang, Amber R; Mirza, Natasha A

    2016-06-01

    Laryngeal schwannomas are rare, benign tumors, most often arising from the superior laryngeal nerve. We describe a case of a 68-year-old female with a laryngeal schwannoma of the recurrent laryngeal nerve after traumatic injury. We postulate that trauma to the recurrent laryngeal nerve during thyroidectomy or thyroplasty incited growth of a nerve sheath tumor. This is the first reported case of a trauma-induced schwannoma of the recurrent laryngeal nerve and second case of a recurrent laryngeal nerve schwannoma. Although rare, this case demonstrates that these tumors should be considered during workup of vocal cord paresis after surgery or failed thyroplasty. Laryngoscope, 126:1408-1410, 2016. PMID:26421595

  2. Laryngeal schwannoma: excision via a laryngofissure approach

    PubMed Central

    Tse, Antonia; Anwar, Bilal

    2015-01-01

    Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis. Excision was undertaken by a laryngofissure approach and tracheostomy. Histology confirmed a benign ancient schwannoma. PMID:26034238

  3. Autofluorescence spectroscopic imaging for laryngeal cancer detection

    NASA Astrophysics Data System (ADS)

    Kan, Lin; Zheng, Wei; Huang, Zhiwei

    2008-02-01

    Autofluorescence imaging has shown a high sensitivity for early diagnosis and detection of cancer and precancer in humans, however, this diagnostic technique has a limitation with high false positive rates resulting in a low diagnostic specificity. In this study, we develop an endoscope-based autofluorescence imaging system in combination with spectroscopy measurement system for tissue diagnostics and characterization in the head and neck. The results show that combining the spectroscopy and imaging techniques can improve both the diagnostic sensitivity and specificity for discriminating laryngeal carcinoma from normal tissue.

  4. [Oral blastomycosis, laryngeal papillomatosis and esophageal tuberculosis].

    PubMed

    Montoya, Manuel; Chumbiraico, Robert; Ricalde, Melvin; Cazorla, Ernesto; Hernández-Córdova, Gustavo

    2012-06-01

    Esophageal involvement is an extremely rare complication of tuberculosis even in countries with high prevalence of infection. We report the case of a 57 year-old hiv-seronegative patient with simultaneous diagnoses of oral blastomycosis and laryngeal papillomatosis. Both were confirmed by anatomopathological analysis. The esophageal biopsy revealed granulomatous esophagitis with necrosis and ziehl-neelsen stain showed acid-fast alcohol resistant bacilli suggestive of tuberculosis. The patient's history included pulmonary tuberculosis twice and previous abandonment of therapy. Thus, it was necessary to use oral itraconazole combined with second-line anti-tuberculosis drugs administered through a gastrostomy tube. The clinical development was favorable. PMID:22858774

  5. Laryngeal actinomycosis in an immunocompromised patient.

    PubMed

    Patel, Sheylan; Jaworek, Aaron J; Patel, Vatsal; Duckworth, Lizette Vila; Sawhney, Raja; Chheda, Neil N

    2014-11-01

    Actinomycosis of the larynx represents an unusual presentation for a common bacterium comprising the oral and oropharyngeal florae. There are few cases reported in the literature of laryngeal actinomycosis occurring primarily in the immunocompromised population. Here, we present a case in a 74-year-old man that occurred in the setting of neutropenia as a result of chemotherapy. Once the diagnosis was made with biopsy of the larynx, the infection was resolved after a prolonged course of penicillin-based therapy. PMID:24930374

  6. The laryngeal mask airway in obstetrical anaesthesia.

    PubMed

    Gataure, P S; Hughes, J A

    1995-02-01

    The laryngeal mask airway (LMA) has been used extensively to provide a safe airway in spontaneously breathing patients who are not at risk from aspiration of gastric contents. The role of the LMA in the event of a failed intubation in an obstetrical patient, and its place in a failed intubation drill remains unclear. Two hundred and fifty consultant obstetric anaesthetists in the United Kingdom were asked to complete an anonymous questionnaire regarding their views about using the laryngeal mask airway (LMA) in obstetrical anaesthesia. The LMA was available in 91.4% of obstetric units. Seventy-two per cent of anaesthetists were in favour of using the LMA to maintain oxygenation when tracheal intubation had failed and ventilation using a face mask was inadequate. Twenty-four respondents had had personal experience with the LMA in obstetrical anaesthesia, eight of whom stated that the LMA had proved to be a lifesaver. We believe that the LMA has a role in obstetrical anaesthesia when tracheal intubation has failed and ventilation using a face mask proves to be impossible, and it should be inserted before attempting cricothyroidectomy. PMID:7720155

  7. Laryngeal complications by orotracheal intubation: Literature review

    PubMed Central

    Mota, Luiz Alberto Alves; de Cavalho, Glauber Barbosa; Brito, Valeska Almeida

    2012-01-01

    Sumamry Introduction: The injuries caused for the orotracheal intubation are common in our way and widely told by literature. Generally the pipe rank of or consequence of its permanence in the aerial ways of the patient is caused by accidents in. It has diverse types of larynx injuries, caused for multiple mechanisms. Objective: To verify, in literature, the main causes of laryngeal complications after- orotracheal intubation and its mechanisms of injury. Revision of Literature: The searched databases had been LILACS, BIREME and SCIELO. Were updated, books and theses had been used, delimiting itself the period enters 1953 the 2009. The keywords used for the search of articles had been: complications, injuries, larynx, intubation, endotracheal, orotracheal, granulomas, stenosis. 59 references had been selected. The used criteria of inclusion for the choice of articles had been the ones that had shown to the diverse types of injuries caused for the orotracheal intubation and its pathophysiology. Final Considerations: This revision of literature was motivated by the comment in the practical clinic of a great number of laryngeal sequels in patients submitted to the orotracheal intubation. Of that is ahead important the knowledge, for the professionals of the area of health, the types of complications and its causes, with intention to prevent them, adopting measured of prevention of these injuries. PMID:25991942

  8. Diet, cigarettes and alcohol in laryngeal cancer

    SciTech Connect

    Freudenheim, J.L.; Graham, S.; Byers, T.E.; Marshall, J.R.; Haughey, B.P.; Swanson, M.K.; Wilkinson, G. )

    1991-03-11

    Diet and other risk factors for cancer of the larynx were examined in a case-control study among white males in Western New York, conducted in 1975-1985. Incident, pathologically-confirmed cases and age- and neighborhood-matched controls were interviewed to determine usual diet, and lifetime use of tobacco and alcohol. Because response rates were low for both cases and controls, this cannot be considered a population-based study. A strong association of risk with cigarette but not pipe and cigar smoking was found. Beer and hard liquor but not wine were associated with increased risk. After control for cigarettes, alcohol and education, the upper quartile odds ratio for fat was 2.40, while the odds ratio for high intake of carotenoids was 0.51. There was effect modification by smoking. Carotenoids were most negatively associated with risk among lighter smokers; dietary fat was most positively associated with risk among heavier smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamins C and E or carbohydrate. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high fat may increase risk.

  9. Effect of inhaled steroids on laryngeal microflora.

    PubMed

    Turan, Mahfuz; Ekin, Selami; Ucler, Rıfkı; Arısoy, Ahmet; Bayram, Yasemin; Yalınkılıç, Abdulaziz; Bozan, Nazım; Garca, Mehmet Fatih; Çankaya, Hakan

    2016-07-01

    Conclusions As is known, this study is the first study to evaluate the effect of inhaled steroids on laryngeal microflora. The data support that ICS usage causes changes in the larynx microflora. Purpose The aim of this study was to determine the alteration in larynx microbial flora of the patients treated with ICS comparing the culture results of a control group. In addition, laryngeal microflora was compared to the smears obtained from the vallecula and pharynx. Materials and methods The study included 39 patients (mean age = 45.56 ± 12.76 years) who had been using a corticosteroid inhaler and control group consisting of 27 persons (mean age = 43.07 ± 13.23 years). Culture samples were obtained from the pharynx, larynx, and vallecula in the patient and control groups, and they were evaluated in the microbiology laboratory. Obtained culture results were named by the same microbiologist according to the basic microorganism classification method. Results Coagulase-negative staphylococci (CNS), Streptococcus viridians (VGS) and candida albicans were detected to grow significantly more in the patient group in all three anatomic localizations compared to the control group. Neisseria spp, basillus spp, and Non-viridans alpha-hemolytic streptococcus were detected to grow significantly more in the control group in all three anatomic localizations compared to the patient group. PMID:26901427

  10. Histopathological study of radionecrosis in laryngeal carcinoma

    SciTech Connect

    Keene, M.; Harwood, A.R.; Bryce, D.P.; van Nostrand, A.W.

    1982-02-01

    With modern radiotherapy techniques, clinical radionecrosis is uncommon following eradication of primary squamous cell carcinoma from the larynx. Histologic sections from 265 specimens, prepared by the technique of whole organ subserial step-sectioning were studied to determine the incidence and location of chondronecrosis and/or osteomyelitis in both irradiated and non-irradiated cases. Chondronecrosis occurred in only 1 of 41 early (pT1 - pT2) tumors but in 143 advanced tumors (pT - pT4) treated with radical radiotherapy and containing residual carcinoma, 27% had evidence of significant necrosis, compared with 24% of those not irradiated. Age, sex, tumor grade and previous laryngeal surgery did not appear to be significant factors in the development of necrosis in irradiated patients. The arytenoid cartilage was most frequently involved when chondronecrosis occurred in association with radiotherapy. Six total laryngectomy specimens (3%) were received from patients with symptoms of chondronecrosis and in whom no residual tumor was present. We conclude that although the incidence of clinical perichondritis is low, histologic chondronecrosis and/or osteomyelitis occurred in 26% of all the larynges studied. Radiotherapy appears to be a significant causative factor only in advanced supraglottic tumors.

  11. Nonrecurrent 17p11.2p12 Rearrangement Events that Result in Two Concomitant Genomic Disorders: The PMP22-RAI1 Contiguous Gene Duplication Syndrome

    PubMed Central

    Yuan, Bo; Harel, Tamar; Gu, Shen; Liu, Pengfei; Burglen, Lydie; Chantot-Bastaraud, Sandra; Gelowani, Violet; Beck, Christine R.; Carvalho, Claudia M.B.; Cheung, Sau Wai; Coe, Andrew; Malan, Valérie; Munnich, Arnold; Magoulas, Pilar L.; Potocki, Lorraine; Lupski, James R.

    2015-01-01

    The genomic duplication associated with Potocki-Lupski syndrome (PTLS) maps in close proximity to the duplication associated with Charcot-Marie-Tooth disease type 1A (CMT1A). PTLS is characterized by hypotonia, failure to thrive, reduced body weight, intellectual disability, and autistic features. CMT1A is a common autosomal dominant distal symmetric peripheral polyneuropathy. The key dosage-sensitive genes RAI1 and PMP22 are respectively associated with PTLS and CMT1A. Recurrent duplications accounting for the majority of subjects with these conditions are mediated by nonallelic homologous recombination between distinct low-copy repeat (LCR) substrates. The LCRs flanking a contiguous genomic interval encompassing both RAI1 and PMP22 do not share extensive homology; thus, duplications encompassing both loci are rare and potentially generated by a different mutational mechanism. We characterized genomic rearrangements that simultaneously duplicate PMP22 and RAI1, including nine potential complex genomic rearrangements, in 23 subjects by high-resolution array comparative genomic hybridization and breakpoint junction sequencing. Insertions and microhomologies were found at the breakpoint junctions, suggesting potential replicative mechanisms for rearrangement formation. At the breakpoint junctions of these nonrecurrent rearrangements, enrichment of repetitive DNA sequences was observed, indicating that they might predispose to genomic instability and rearrangement. Clinical evaluation revealed blended PTLS and CMT1A phenotypes with a potential earlier onset of neuropathy. Moreover, additional clinical findings might be observed due to the extra duplicated material included in the rearrangements. Our genomic analysis suggests replicative mechanisms as a predominant mechanism underlying PMP22-RAI1 contiguous gene duplications and provides further evidence supporting the role of complex genomic architecture in genomic instability. PMID:26544804

  12. Nonrecurrent 17p11.2p12 Rearrangement Events that Result in Two Concomitant Genomic Disorders: The PMP22-RAI1 Contiguous Gene Duplication Syndrome.

    PubMed

    Yuan, Bo; Harel, Tamar; Gu, Shen; Liu, Pengfei; Burglen, Lydie; Chantot-Bastaraud, Sandra; Gelowani, Violet; Beck, Christine R; Carvalho, Claudia M B; Cheung, Sau Wai; Coe, Andrew; Malan, Valérie; Munnich, Arnold; Magoulas, Pilar L; Potocki, Lorraine; Lupski, James R

    2015-11-01

    The genomic duplication associated with Potocki-Lupski syndrome (PTLS) maps in close proximity to the duplication associated with Charcot-Marie-Tooth disease type 1A (CMT1A). PTLS is characterized by hypotonia, failure to thrive, reduced body weight, intellectual disability, and autistic features. CMT1A is a common autosomal dominant distal symmetric peripheral polyneuropathy. The key dosage-sensitive genes RAI1 and PMP22 are respectively associated with PTLS and CMT1A. Recurrent duplications accounting for the majority of subjects with these conditions are mediated by nonallelic homologous recombination between distinct low-copy repeat (LCR) substrates. The LCRs flanking a contiguous genomic interval encompassing both RAI1 and PMP22 do not share extensive homology; thus, duplications encompassing both loci are rare and potentially generated by a different mutational mechanism. We characterized genomic rearrangements that simultaneously duplicate PMP22 and RAI1, including nine potential complex genomic rearrangements, in 23 subjects by high-resolution array comparative genomic hybridization and breakpoint junction sequencing. Insertions and microhomologies were found at the breakpoint junctions, suggesting potential replicative mechanisms for rearrangement formation. At the breakpoint junctions of these nonrecurrent rearrangements, enrichment of repetitive DNA sequences was observed, indicating that they might predispose to genomic instability and rearrangement. Clinical evaluation revealed blended PTLS and CMT1A phenotypes with a potential earlier onset of neuropathy. Moreover, additional clinical findings might be observed due to the extra duplicated material included in the rearrangements. Our genomic analysis suggests replicative mechanisms as a predominant mechanism underlying PMP22-RAI1 contiguous gene duplications and provides further evidence supporting the role of complex genomic architecture in genomic instability. PMID:26544804

  13. Inferior mirages: an improved model.

    PubMed

    Young, Andrew T

    2015-02-01

    A quantitative model of the inferior mirage is presented, based on a realistic temperature profile in the convective boundary layer, using Monin-Obukhov similarity theory. The top of the inverted image is determined by the logarithmic part of the profile; the bottom is the apparent horizon, which depends on optical obstruction by roughness elements. These effects of surface roughness are included in the model, which is illustrated with a simulation. The vertical magnification varies throughout the mirage, becoming infinite at Minnaert's ill-named "vanishing line"-which makes green flashes apparent to the naked eye. PMID:25967823

  14. Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis

    PubMed Central

    Kökoğlu, Kerem; Canöz, Özlem; Doğan, Serap; Gülmez, Emrah; Yüce, İmdat; Çağlı, Sedat

    2014-01-01

    Laryngeal chondrosarcoma (CS) is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature. PMID:25197601

  15. Partial airway obstruction following manufacturing defect in laryngeal mask airway (Laryngeal Mask Silken™).

    PubMed

    Jangra, Kiran; Malhotra, Surender Kumar; Saini, Vikas

    2014-10-01

    Laryngeal mask (LM) airway is commonly used for securing airway in day-care surgeries. Various problems have been described while using LM airway. Out of those, mechanical obstruction causing airway compromise is most common. Here, we describe a case report of 4-year-old child who had partial upper airway obstruction due to LM manufacturer's defect. There was a silicon band in upper one-third of shaft of LM airway. This band was made up of the same material as that of LM airway so it was not identifiable on external inspection of transparent shaft. We suggest that such as non-transparent laryngeal mask, a transparent LM airway should also be inspected looking inside the lumen with naked eyes or by using a probe to rule out any manufacturing defect before its insertion. PMID:25422617

  16. INTERDEPENDENT SUPERIORITY AND INFERIORITY FEELINGS

    PubMed Central

    Ingham, Harrington V.

    1949-01-01

    It is postulated that in neurotic persons who have unrealistic feelings of superiority and inferiority the two are interdependent. This is a departure from the concept of previous observers that either one or the other is primary and its opposite is overcompensation. The author postulates considerable parallelism, with equal importance for each. He submits that the neurotic person forms two logic-resistant compartments for the two opposed self-estimates and that treatment which makes inroads of logic upon one compartment, simultaneously does so upon the other. Two examples are briefly reported. The neurotic benefits sought in exaggeration of capability are the same as those sought in insistence upon inferiority: Presumption of superiority at once bids for approbation and delivers the subject from the need to prove himself worthy of it in dreaded competition; exaggeration of incapability baits sympathy and makes competition unnecessary because failure is conceded. Some of the characteristics of abnormal self-estimates that distinguish them from normal are: Preoccupation with self, resistance to logical explanation of personality problems, inconsistency in reasons for beliefs in adequacy on the one hand and inadequacy on the other, unreality, rationalization of faults, and difficulty and vacillation in the selection of adequate goals. PMID:15390573

  17. Laryngeal Adductor Function in Experimental Models of Recurrent Laryngeal Nerve Injury

    PubMed Central

    Paniello, Randal C.; Rich, Jason T.; Debnath, Nick L.

    2014-01-01

    Objectives/Hypothesis Most patients with unilateral vocal fold paralysis experience some degree of spontaneous reinnervation, which depends upon the type and severity of recurrent laryngeal nerve (RLN) injury. After partial recovery, the paretic vocal fold may or may not adduct adequately to allow glottic closure, which in turn affects phonatory and swallowing outcomes. This process was studied in a series of canine laryngeal nerve injury models. Study Design Animal (canine) experiments. Methods Maximum stimulable laryngeal adductor pressure (LAP) was measured pre-treatment (baseline) and at 6 months following experimental RLN injuries (total n=59). The 9 study groups were designed to simulate a range of severities of RLN injury. Results The greatest LAP recovery, at 108% of original baseline, was seen in a 50% transection model; the least recovery was seen when the RLN underwent complete transection with repair, at 56% with precise alignment and 50% with alignment reversed. Intermediate models (partial RLN injuries) gave intermediate results. Crush models recovered 105% of LAP, while a half-transection, half-crush injury recovered 72% and cautery injuries recovered 61%. Controls (complete transection without repair) had no measurable recovery. Conclusions The injured RLN has a strong tendency to recover. Restoration of adductor strength, as determined by the LAP, was predictably related to the severity of RLN injury. The model RLN injuries studied provide a range of expected outcomes that can be used for future experiments exploring interventions that may improve post-injury adductor function. PMID:25283381

  18. The Laryngeal Motor Cortex: Its Organization and Connectivity

    PubMed Central

    Simonyan, Kristina

    2014-01-01

    Our ability to learn and control the motor aspects of complex laryngeal behaviors, such as speech and song, is modulated by the laryngeal motor cortex (LMC), which is situated in the area 4 of the primary motor cortex and establishes both direct and indirect connections with laryngeal motoneurons. In contrast, the LMC in monkeys is located in the area 6 of the premotor cortex, projects only indirectly to laryngeal motoneurons and its destruction has essentially no effect on production of species-specific calls. These differences in cytoarchitectonic location and connectivity may be a result of hominid evolution that led to the LMC shift from the phylogenetically “old” to “new” motor cortex in order to fulfill its paramount function, i.e., voluntary motor control of human speech and song production. PMID:24929930

  19. Sonographically guided superior laryngeal nerve block during awake fiberoptic intubation.

    PubMed

    Sawka, Andrew; Tang, Raymond; Vaghadia, Himat

    2015-04-15

    We report 5 patients who underwent ultrasound-guided superior laryngeal nerve block before awake intubation and general anesthesia. We used a 8- to 15-MHz hockey stick-shaped ultrasound transducer (HST15-8/20 linear probe, Ultrasonix) to visualize the superior laryngeal nerve. A 3.8-cm 25-G needle was inserted in real time and directed toward the superior laryngeal nerve followed by circumferential placement of local anesthetic. All 5 patients tolerated subsequent awake fiberoptic intubation with either minimal or no sedation. Sonographically guided superior laryngeal nerve block may be useful in patients where identification of landmarks in the neck is difficult as a result of patient anatomy. PMID:25867195

  20. CHALLENGES OF OBSTETRIC ANESTHESIA: DIFFICULT LARYNGEAL VISUALIZATION.

    PubMed

    Alanoğlu, Zekeriyya; Erkoç, Süheyla Karadağ; Güçlü, Çiğdem Yildirim; Meço, Başak Ceyda Orbey; Baytaş, Volkan; Can, Özlem Selvi; Alkiş, Neslihan

    2016-03-01

    Obstetric anesthesia is one of the high risk subspecialties of anesthesia practice. Anesthesia related complications are the sixth leading cause of maternal mortality. Difficult or failed intubation following induction of general anesthesia for CS remains the major contributory factor to anesthesia-related maternal complications. The airway management of obstetric patients is a challenging issue for several reasons. Anatomic and physiologic changes related to pregnancy may increase the difficult and failed intubation rates compared to the general surgical population. Proper evaluation of the airway anatomy and airway structures is vital to prevent airway management related catastrophes. In addition to basic airway and intubation equipment, each anesthesia department must have difficult intubation equipment cart including fiber optic laryngoscope, video laryngoscopes, and different types of laryngeal masks. It is essential that all anesthesiologists have a preconceived and well thought-out algorithm and emergency airway equipment to deal with airway emergencies during difficult or failed intubation of a parturient. PMID:27276775

  1. Hyperbaric oxygen therapy for laryngeal radionecrosis

    SciTech Connect

    Ferguson, B.J.; Hudson, W.R.; Farmer, J.C. Jr.

    1987-01-01

    Radionecrosis of the larynx is a debilitating disease associated with pain, dysphagia, respiratory obstruction, and, in some cases, the need for laryngectomy. Persistent poor wound healing can lead to death. A series of eight patients with advanced (grades III and IV, Chandler classification) radionecrosis of the larynx treated with adjunctive hyperbaric oxygen therapy is presented. Signs and symptoms of radionecrosis were dramatically ameliorated in seven of eight patients, while one patient, despite subjective improvement, eventually required laryngectomy. There were no deaths. These results are compared to previous series on radionecrosis of the larynx in which hyperbaric oxygen was not used. This series indicates that hyperbaric oxygen therapy is a useful and effective adjunctive treatment modality in the management of laryngeal radionecrosis.

  2. Human laryngitis caused by Clinostomum complanatum.

    PubMed

    Hara, Hirotaka; Miyauchi, Yuji; Tahara, Shinsaku; Yamashita, Hiroshi

    2014-02-01

    A 64-year-old Japanese man visited our outpatient department complaining of an irritable sensation in the throat, occurring two days after eating raw freshwater fish (carp sashimi) at a Japanese-style inn. During laryngeal endoscopy, a slow-moving worm (fluke) was found attached to the surface of the right aryepiglottic fold. After inhalation of 4% lidocaine, the fluke was removed using endoscopic forceps. Patient's throat symptoms immediately improved. The worm was microscopically identified as Clinostomum complanatum. C. complanatum is a digenetic trematode that usually infects fish-eating water birds. Clinostomum infections in humans are rare, and only 21 cases have been described in Japan and Korea. C. complanatum infection is known to occur after eating raw freshwater fish, which is a secondary intermediate host. In humans, the metacercariae are released into the stomach and migrate through the esophagus before lodging in the throat. Primary therapy involves endoscopic removal of the worm. PMID:25130004

  3. Transoral robotic surgery (TORS) for laryngeal and hypopharyngeal cancers.

    PubMed

    Dziegielewski, Peter T; Kang, Stephen Y; Ozer, Enver

    2015-12-01

    Transoral robotic surgery (TORS) is increasingly used in laryngeal/hypopharyngeal cancer surgery. Ablative procedures described in these anatomical sites include: (i) supraglottic laryngectomy, (ii) total laryngectomy, (iii) glottic cordectomy, and (iv) partial pharyngectomy. TORS supraglottic laryngectomy remains the most commonly performed of these procedures. Initial oncologic and functional outcomes with these procedures are promising and comparable to other treatment options. As robotic instrumentation technology advances a rise in TORS laryngeal/hypopharyngeal surgery is anticipated. PMID:26266762

  4. [Intubation treatment of acute laryngeal obstruction: a case report].

    PubMed

    Guo, Xingguang; Liu, Shibo; Li, Huilian

    2015-11-01

    Acute laryngeal obstruction is one of the most common diseases in Department of ENT, and it can cause suffocation without prompt treatment. Methods by using Nasopharyngofiberoscope guided tracheal intubation treatment of a case of acute laryngeal obstruction patients in a timely manner. This method is well tolerated, less trauma, high success rate, in the shortest time to improve the patient's ventilation, for the next step of the treatment to win the time. PMID:26911075

  5. Laryngeal paralysis-polyneuropathy complex in young Rottweilers.

    PubMed

    Mahony, O M; Knowles, K E; Braund, K G; Averill, D R; Frimberger, A E

    1998-01-01

    Five Rottweiler puppies from 3 unrelated litters developed inspiratory stridor at 11-13 weeks of age. Physical examination disclosed tetraparesis in all dogs, and bilateral lenticular cataracts in 4 dogs. Laryngeal examination under light anesthesia showed laryngeal paralysis in all dogs. Electrodiagnostic testing revealed denervation potentials in the distal appendicular muscles of 4 dogs tested and in the intrinsic laryngeal muscles of 2 dogs tested. Motor nerve conduction velocity was slightly low in 1 dog. Neurogenic muscular atrophy was found in distal appendicular muscles (n = 3) and intrinsic laryngeal muscles (n = 2), and degenerative changes were found in peripheral nerves (n = 3) and recurrent laryngeal nerves (n = 2). No abnormalities were detected in the spinal cord, spinal nerve roots, or ganglia of 3 dogs autopsied. The clinical, electrophysiologic, and histopathologic findings support a diagnosis of polyneuropathy and resemble the finding reported in young Dalmatians. Young dogs with laryngeal paralysis should be evaluated neurologically to rule out a more generalized polyneuropathy. The condition is suspected to be hereditary in nature and the prognosis is poor. PMID:9773408

  6. Alterations in the laryngeal mucosa after exposure to asbestos.

    PubMed Central

    Kambic, V; Radsel, Z; Gale, N

    1989-01-01

    The laryngeal mucosa of 195 workers in an asbestos cement factory (Salonit Anhovo, Yugoslavia) and in a control group was examined. The factory manufactures asbestos cement products containing about 13% of asbestos (8% amosite, 12% crocidolite, and 80% chrysotile) of different provenance. Alterations in the laryngeal mucosa were more frequent in the factory workers than in the control group. The changes, mostly consistent with chronic laryngitis, were closely related to the degree of workplace pollution and less so to the duration of employment Ten workers exhibiting the most severe clinical changes underwent biopsy, the results of which showed histomorphological changes characteristic of hyperplastic chronic laryngitis. Four tissue specimens were examined also by scanning electron microscopy and in three of them asbestos fibres were found on the epithelial surface. No case of laryngeal carcinoma was identified. On the basis of our results it is thought that asbestos related changes of the larynx should receive more attention and that the use of the term "laryngeal asbestosis" is justified. The clinical picture is non-specific but in view of their frequency such changes should be considered a consequence of exposure to asbestos. Images PMID:2489023

  7. Epidemiology of laryngeal carcinoma in Germany, 1998-2011.

    PubMed

    Peller, Maximilian; Katalinic, Alexander; Wollenberg, Barbara; Teudt, Ingo U; Meyer, Jens-E

    2016-06-01

    Constituting 25-30 % of all head and neck cancer cases, laryngeal carcinoma is the most prevalent entity. Major risk factors of laryngeal cancer are smoking and excessive alcohol consumption. This study presents the recent developments in the incidence of laryngeal cancer from 1998 to 2011 in Germany. Laryngeal carcinoma was identified using International Statistical Classification of Diseases and Related Health Problems (ICD10) from German population-based cancer registries. The incidence was provided by the Robert Koch Institute, and the mortality data were derived from German death statistics for further evaluation. Both descriptive and analytical analyses were conducted. From 1998 to 2011, a total of 14,847 laryngeal carcinoma cases were reported, in 13,195 men and 1652 women. Glottic carcinoma represented the main entity, constituting 69 % of male cases and 50 % of female cases. For men, a decline in incidence was observed starting in 2006. The incidence rate for women remained stable for the period of observation. The incidence of laryngeal cancer resembles the development of smoking behaviour in Germany. To maintain the positive trend of the male population and to reduce the incidence in women, it is crucial to continue and to improve the prevention of smoking campaigns in Germany. PMID:26879991

  8. Identification of key target genes and pathways in laryngeal carcinoma

    PubMed Central

    Liu, Feng; Du, Jintao; Liu, Jun; Wen, Bei

    2016-01-01

    The purpose of the present study was to screen the key genes associated with laryngeal carcinoma and to investigate the molecular mechanism of laryngeal carcinoma progression. The gene expression profile of GSE10935 [Gene Expression Omnibus (GEO) accession number], including 12 specimens from laryngeal papillomas and 12 specimens from normal laryngeal epithelia controls, was downloaded from the GEO database. Differentially expressed genes (DEGs) were screened in laryngeal papillomas compared with normal controls using Limma package in R language, followed by Gene Ontology (GO) enrichment analysis and pathway enrichment analysis. Furthermore, the protein-protein interaction (PPI) network of DEGs was constructed using Cytoscape software and modules were analyzed using MCODE plugin from the PPI network. Furthermore, significant biological pathway regions (sub-pathway) were identified by using iSubpathwayMiner analysis. A total of 67 DEGs were identified, including 27 up-regulated genes and 40 down-regulated genes and they were involved in different GO terms and pathways. PPI network analysis revealed that Ras association (RalGDS/AF-6) domain family member 1 (RASSF1) was a hub protein. The sub-pathway analysis identified 9 significantly enriched sub-pathways, including glycolysis/gluconeogenesis and nitrogen metabolism. Genes such as phosphoglycerate kinase 1 (PGK1), carbonic anhydrase II (CA2), and carbonic anhydrase XII (CA12) whose node degrees were >10 were identified in the disease risk sub-pathway. Genes in the sub-pathway, such as RASSF1, PGK1, CA2 and CA12 were presumed to serve critical roles in laryngeal carcinoma. The present study identified DEGs and their sub-pathways in the disease, which may serve as potential targets for treatment of laryngeal carcinoma. PMID:27446427

  9. Inferior vena caval masses identified by echocardiography

    NASA Technical Reports Server (NTRS)

    Sun, J. P.; Asher, C. R.; Xu, Y.; Huang, V.; Griffin, B. P.; Stewart, W. J.; Novick, A. C.; Thomas, J. D.

    1999-01-01

    The most common cause of an inferior vena caval mass is renal cell carcinoma that extends through the lumen, occurring in 47 of 62 patients (85%). Detection of an inferior vena caval mass affects the surgical approach requiring cardiopulmonary bypass for resection when the mass extends to the heart.

  10. Dietary consumption patterns and laryngeal cancer risk.

    PubMed

    Vlastarakos, Petros V; Vassileiou, Andrianna; Delicha, Evie; Kikidis, Dimitrios; Protopapas, Dimosthenis; Nikolopoulos, Thomas P

    2016-06-01

    We conducted a case-control study to investigate the effect of diet on laryngeal carcinogenesis. Our study population was made up of 140 participants-70 patients with laryngeal cancer (LC) and 70 controls with a non-neoplastic condition that was unrelated to diet, smoking, or alcohol. A food-frequency questionnaire determined the mean consumption of 113 different items during the 3 years prior to symptom onset. Total energy intake and cooking mode were also noted. The relative risk, odds ratio (OR), and 95% confidence interval (CI) were estimated by multiple logistic regression analysis. We found that the total energy intake was significantly higher in the LC group (p < 0.001), and that the difference remained statistically significant after logistic regression analysis (p < 0.001; OR: 118.70). Notably, meat consumption was higher in the LC group (p < 0.001), and the difference remained significant after logistic regression analysis (p = 0.029; OR: 1.16). LC patients also consumed significantly more fried food (p = 0.036); this difference also remained significant in the logistic regression model (p = 0.026; OR: 5.45). The LC group also consumed significantly more seafood (p = 0.012); the difference persisted after logistic regression analysis (p = 0.009; OR: 2.48), with the consumption of shrimp proving detrimental (p = 0.049; OR: 2.18). Finally, the intake of zinc was significantly higher in the LC group before and after logistic regression analysis (p = 0.034 and p = 0.011; OR: 30.15, respectively). Cereal consumption (including pastas) was also higher among the LC patients (p = 0.043), with logistic regression analysis showing that their negative effect was possibly associated with the sauces and dressings that traditionally accompany pasta dishes (p = 0.006; OR: 4.78). Conversely, a higher consumption of dairy products was found in controls (p < 0.05); logistic regression analysis showed that calcium appeared to be protective at the micronutrient level (p < 0

  11. Bilateral inferior petrosal sinus sampling

    PubMed Central

    Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo

    2016-01-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  12. Bilateral inferior petrosal sinus sampling.

    PubMed

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. PMID:27352844

  13. [Evidence-Based Review of Laryngeal Cancer Surgery].

    PubMed

    Wiegand, S

    2016-04-01

    Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number of organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery and transoral robotic surgery, have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the U.S.. Improving the evidence base in laryngeal cancer surgery by successful establishment of surgical trials should be the future goal. PMID:27128401

  14. [Occupational risks for laryngeal cancer: a case-control study].

    PubMed

    Sartor, Sergio Guerra; Eluf-Neto, José; Travier, Noemie; Wünsch Filho, Victor; Arcuri, Arline Sydneia Abel; Kowalski, Luís Paulo; Boffetta, Paolo

    2007-06-01

    The most solidly established risk factors for laryngeal cancer are tobacco and alcohol. As for occupational factors, the only established carcinogen is exposure to strong inorganic acid mists. However, asbestos, pesticides, paints, gasoline, diesel engine emissions, dusts, and other factors have been reported in the literature as occupational agents that increase the risk of laryngeal cancer. A hospital-based case-control study was conducted to investigate occupational risk factors for laryngeal cancer. Detailed data on smoking, alcohol consumption, and occupational history were collected for 122 laryngeal cancers and 187 controls matched by frequency (according to sex and age). Laryngeal cancer was associated with exposure to respirable free crystalline silica (OR = 1.83; 95%CI: 1.00-3.36), soot (from coal, coke, fuel oil, or wood) (odds ratio - OR = 1.78; 95% confidence interval - 95%CI: 1.03-3.03), fumes (OR = 2.55; 95%CI: 1.14-5.67), and live animals (OR = 1.80; 95%CI: 1.02-3.19). PMID:17546338

  15. State of the Art Laryngeal Imaging: Research and Clinical Implications

    PubMed Central

    Deliyski, Dimitar D.; Hillman, Robert E.

    2010-01-01

    Purpose of Review This paper provides a review of the latest advances in videostroboscopy, videokymography and high-speed videoendoscopy, and outlines the development of new laryngeal imaging modalities based on optical coherence tomography, laser depth-kymography, and magnetic resonance imaging, published in the past 2 years. Recent Findings Videostroboscopy and Videokymography Image quality has improved and several image processing and measurement techniques have been published. High-speed videoendoscopy Significant progress has been made through increased sensitivity and frame rates of the cameras, and the development of facilitative playbacks, phonovibrography and several image segmentation and measurement methods. Clinical evidence was presented through applications in phonosurgery, comparisons with videostroboscopy, normative data, and better understanding of voice production. Optical coherence tomography Latest developments allow for the capture of dynamic high resolution cross-sectional images of the vibrating vocal fold mucosa during phonation. Depth-kymography New laser technique allowing recording of the vertical movements of the vocal folds during phonation in calibrated spatial values. Laryngeal magnetic resonance New methods allow high-resolution imaging of laryngeal tissue microstructure, or measuring of dynamic laryngeal structures during phonation. Summary The endoscopic laryngeal imaging techniques have made significant advances increasing their clinical value, while techniques providing new types of potentially clinically-relevant information have emerged. PMID:20463479

  16. Laryngeal hypersensitivity in the World Trade Center-exposed population: the role for respiratory retraining.

    PubMed

    McCabe, Daniel; Altman, Kenneth W

    2012-09-01

    Upper airway symptoms among responders to the terrorist attack on 9/11 are progressive and multifactorial. For those symptoms that are laryngeal in origin, we are using a multidisciplinary approach that includes respiratory retraining and laryngeal desensitization through a speech pathologist trained in airway disorders. Our treatment paradigm and laryngeal hypersensitivity are discussed in this essay. PMID:22942344

  17. Aerodynamic and Nonlinear Dynamic Acoustic Analysis of Tension Asymmetry in Excised Canine Larynges

    ERIC Educational Resources Information Center

    Devine, Erin E.; Bulleit, Erin E.; Hoffman, Matthew R.; McCulloch, Timothy M.; Jiang, Jack J.

    2012-01-01

    Purpose: To model tension asymmetry caused by superior laryngeal nerve paralysis (SLNP) in excised larynges and apply perturbation, nonlinear dynamic, and aerodynamic analyses. Method: SLNP was modeled in 8 excised larynges using sutures and weights to mimic cricothyroid (CT) muscle function. Weights were removed from one side to create tension…

  18. Exolaryngoscopy: a new technique for laryngeal surgery.

    PubMed

    Carlucci, C; Fasanella, L; Ricci Maccarini, A

    2012-10-01

    The aim of this study is to assess the use of a telescope with a high definition endoscopic video system as an alternative to the operating microscope in endoscopic laryngeal surgery. The system is economic, and allows optimal vision and improved surgeon comfort and ease. In exolaryngoscopy, the optic vitom is positioned in place of the microscope. An extracorporeal optical system (exoscope) is positioned 25 cm from the surgical field. Under exoscopic control, it is possible to use the same series of instruments using a long handle through the laryngoscope. The CO2 laser may also be used by fixing it coaxially to the optical system, and it is possible to use a classic set of microinstruments for phonosurgery. Endoscopic study with auto-fluorescence (NBI; narrow band imaging) can be easily used to visualize both precancerous and cancerous lesions. We treated 12 patients with benign and malign pathologies of the vocal cords; in all cases, the predicted result was reached, and the optic vitom showed its potential advantages in ease and comfort of the surgeon. PMID:23326013

  19. Laryngeal transplantation in minipigs: early immunological outcomes

    PubMed Central

    Birchall, M A; Ayling, S M; Harley, R; Murison, P J; Burt, R; Mitchard, L; Jones, A; Macchiarini, P; Stokes, C R; Bailey, M

    2012-01-01

    Despite recent tissue-engineering advances, there is no effective way of replacing all the functions of the larynx in those requiring laryngectomy. A recent clinical transplant was a success. Using quantitative immunofluorescence targeted at immunologically relevant molecules, we have studied the early (48 h and 1 week) immunological responses within larynxes transplantated between seven pairs of National Institutes of Health (NIH) minipigs fully homozygous at the major histocompatibility complex (MHC) locus. There were only small changes in expression of some molecules (relative to interindividual variation) and these were clearest in samples from the subglottic region, where the areas of co-expression of CD25+CD45RC-CD8- and of CD163+CD172+MHC-II- increased at 1 week after transplant. In one case, infiltration by recipient T cells was analysed by T cell receptor (TCR) Vβ spectratype analysis; this suggested that changes in the T cell repertoire occur in the donor subglottis mucosal tissues from day 0 to day 7, but that the donor and recipient mucosal Vβ repertoires remain distinct. The observed lack of strong immunological responses to the trauma of surgery and ischaemia provides encouraging evidence to support clinical trials of laryngeal transplantation, and a basis on which to interpret future studies involving mismatches. PMID:22288599

  20. Recurrent laryngeal neuropathy in a systemic lupus erythematosus (SLE) patient.

    PubMed

    Lee, Jung Hwan; Sung, In Young; Park, Jin Hong; Roh, Jong-Lyel

    2008-01-01

    A 41-yr-old woman with hoarseness, multiple joint pain, and generalized myalgia was diagnosed with systemic lupus erythematosus (SLE) 7 mos before visiting our clinic. SLE-related vocal cord palsy of the left side was identified after otolaryngologic evaluation. We performed laryngeal electromyography (LEMG) on both cricothyroid and thyroarytenoid muscles. The findings indicated left recurrent laryngeal neuropathy with ongoing processes of denervation and reinnervation. Laryngeal involvement is a rare complication of SLE, but it is of clinical significance because serious consequence such as upper-airway obstruction can occur. LEMG identified this complication and precisely defined the neuromuscular status, and this information assisted in creating a therapeutic plan. LEMG may be useful for evaluating the neuromuscular status in vocal cord palsy. PMID:17993990

  1. Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis

    PubMed Central

    Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria

    2016-01-01

    Introduction Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. Objective To identify factors associated with clinical and topographical features of LTB. Method a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Results Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Conclusions Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement. PMID:27077734

  2. Fraser syndrome with laryngeal webs: Report of two cases and a review of the literature.

    PubMed

    Izadi, Farzad; Ahmadi, Aslan; Zobairy, Hosna; Bakhti, Sepideh; Hirbod, Hengameh; Safdarian, Mahdi

    2015-11-01

    Fraser syndrome is a rare genetic disorder characterized by cryptophthalmos, syndactyly and laryngeal atresia. Although laryngeal webs occur uncommonly, they are the main cause of death in the first week of life in these patients. In this paper, we report two cases of Fraser syndrome with laryngeal webs. One of them was a twelve-year-old girl, primarily diagnosed with a supraglottic laryngeal web. In the course of treatment, a second web was also identified at the level of vocal cords, which is to our knowledge the first case of Fraser syndrome with two laryngeal webs in different levels. PMID:26384833

  3. Critical analysis of robotic surgery for laryngeal tumours.

    PubMed

    Esteban, Francisco; Menoyo, Alicia; Abrante, Antonio

    2014-01-01

    In recent years, transoral robotic surgery (TORS) with the Da Vinci robot has been used for the removal of laryngeal cancers with the objective to improve functional and aesthetic outcomes without worsening survival. The advantages of TORS are described in this article. However, its disadvantages, mainly high cost amongst others, do not make robotic surgery the current treatment of choice for laryngeal tumours; transoral laser surgery is superior in most cases. Major technical improvements are expected. Smaller, more ergonomic, new-generation robots better adapted to the head and neck will probably be available in the near future. PMID:24626048

  4. Experimental and numerical study of patterns in laryngeal flow

    NASA Astrophysics Data System (ADS)

    Chisari, N. E.; Artana, G.; Sciamarella, D.

    2009-05-01

    Unsteady airflow is investigated in a channel with a geometry approximating that of the human larynx. The laryngeal flow is simulated by solving the Navier-Stokes equations for an incompressible two-dimensional viscous fluid, and visualized using the Schlieren technique in an experimental setup consisting of a rigid replica of the larynx, with and without ventricular bands. This study shows the spontaneous formation of vortex couples in several regions of the laryngeal profile, and at different stages of the evolution of the starting glottal jet.

  5. Laryngeal carcinoma presenting as polymyositis: A paraneoplastic syndrome

    PubMed Central

    Sahu, Ritesh; Rathaur, Bhanu Pratap; Chaudhari, Tejendra Sukdeo; Shukla, Rakesh; Malhotra, Kiran Preet

    2016-01-01

    Laryngeal carcinoma is rarely associated with paraneoplastic syndrome. Inflammatory myopathy presenting as paraneoplastic event is commonly associated with carcinomas of ovary, lung, pancreas, stomach, colorectal, and non-Hodgkin's lymphoma. We report a case of elderly male, who presented with proximal muscle weakness and found to be associated with laryngeal carcinoma. Diagnosis of polymyositis (PM) was confirmed based on clinical features, laboratory test, and muscle biopsy. Exclusion of other commonly associated malignancies was done. This patient improved gradually after 6 months of immunosuppressive therapy and management of underlying cancer. PMID:27011653

  6. Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy

    PubMed Central

    Silva, Carlos Eduardo Dilen da; Niedermeier, Bruno Taccola; Portinho, Fernando

    2015-01-01

    Introduction The indirect laryngoscopy has an important role in the characterization of reflux laryngitis. Although many findings are nonspecific, some strongly suggest that the inflammation is the cause of reflux. Objective The aim of this study was to evaluate the correlation between reflux symptoms and the findings of indirect laryngoscopy. Methods We evaluated 27 patients with symptoms of pharyngolaryngeal reflux disease. Results Laryngoscopy demonstrated in all patients the presence of hypertrophy of the posterior commissure and laryngeal edema. The most frequent symptoms were the presence of dry cough and foreign body sensation. Conclusion There was a correlation between the findings at laryngoscopy and symptoms of reflux. PMID:26157498

  7. Multidimensional voice analysis of reflux laryngitis patients.

    PubMed

    Pribuisienë, Rûta; Uloza, Virgilijus; Saferis, Viktoras

    2005-01-01

    The aim of the study was to analyze and quantify the voice characteristics of reflux laryngitis (RL) patients and to determine the most important voice tests and voice-quality parameters in the functional diagnostics of RL. The voices of 83 RL patients and 31 persons in the control group were evaluated. Vocal function was assessed using a multidimensional set of video laryngostroboscopic, perceptual, acoustic, aerodynamic and subjective measurements according to the protocol elaborated by the Committee on Phoniatrics of the European Laryngological Society. The mean values of the hoarseness visual analogue scale assessment and voice handicap index were significantly higher (P<0.05) in the group of RL patients as compared to the controls. Objective voice assessment revealed a significant increase in mean values of jitter, shimmer and normalized noise energy (NNE), along with a significant decrease in pitch range, maximum frequency, phonetogram area (S) and maximum phonation time (MPT) in RL patients, both in the male and female subgroups. According to the results of discriminant analysis, the NNE, MPT, S and intensity range were determined as an optimum set for functional diagnostics of RL. The derived function (equation) makes it possible to assign the person to the group of RL patients with an accuracy of 86.7%. The sensitivity and specificity of eight voice parameters were found to be higher than 50%. The results of the present study demonstrate a reduction of phonation capabilities and voice quality in RL patients. Multidimensional voice evaluation makes it possible to detect significant differences in mean values of perceptual, subjective and objective voice quality parameters between RL patients and controls groups. Therefore, multidimensional voice analysis is an important tool in the functional diagnostics of RL. PMID:15004705

  8. Observation of the laryngeal movements for throat singing

    NASA Astrophysics Data System (ADS)

    Sakakibara, Ken-Ichi; Konishi, Tomoko; Murano, Emi Z.; Imagawa, Hiroshi; Kumada, Masanobu; Kondo, Kazumasa; Niimi, Seiji

    2002-11-01

    Throat singing is a traditional singing style of people who live around the Altai Mountains. Khoomei in Tyva and Khoomij in Mongolia are representative styles of throat singing. The laryngeal voices of throat singing is classified into (i) a drone voice which is the basic laryngeal voice in throat singing and used as drone and (ii) a kargyraa voice which is very low pitched with the range outside the modal register. In throat singing, the special features of the laryngeal movements are observed by using simultaneous recording of high-speed digital images, EGG, and sound wave forms. In the drone voice, the ventricular folds (VTFs) vibrate in the same frequency as the vocal folds (VFs) but in opposite phases. In the kargyraa voice, the VTFs can be assumed to close once for every two periods of closure of the VFs, and this closing blocks airflow and contributes to the generation of the subharmonic tone of kargyraa. Results show that in throat singing the VTFs vibrate and contribute to producing the laryngeal voice, which generates the special timbre and whistle-like overtone.

  9. Photocoagulation therapy for laryngeal dysplasia using angiolytic lasers.

    PubMed

    Kishimoto, Yo; Suzuki, Ryo; Kawai, Yoshitaka; Hiwatashi, Nao; Kitamura, Morimasa; Tateya, Ichiro; Hirano, Shigeru

    2016-05-01

    In the management of laryngeal pre-cancerous lesions such as dysplasia or carcinoma in situ (CIS), it is important that lesion regression occur without any complications. As a minimally invasive treatment option, photocoagulation therapy using angiolytic lasers has been attracting attention. Therapeutic effects have been reported for this type of treatment, however, vocal function after treatment has not been well discussed. In this retrospective case series, we examined the therapeutic effects of photocoagulation therapy on laryngeal dysplasia and the impact on vocal function. Twenty-four patients with laryngeal dysplasia or CIS were treated with photocoagulation therapy using angiolytic lasers. Two patients were treated under general anesthesia, the remaining 22 patients were treated with topical anesthesia. Before and after treatment the extent of the lesion and vocal function was evaluated by endoscopic examination and acoustic and aerodynamic analyses, respectively. More than 50 % disease regression was observed in 20 of 24 patients. Acoustic and aerodynamic analyses revealed improvement in pitch perturbation quotient with no impairment in other parameters. Photocoagulation therapy using angiolytic lasers has proven to be feasible and safe for the treatment of laryngeal dysplasia. PMID:26742908

  10. Refinements in modeling the passive properties of laryngeal soft tissue.

    PubMed

    Hunter, Eric J; Titze, Ingo R

    2007-07-01

    The nonlinear viscoelastic passive properties of three canine intrinsic laryngeal muscles, the lateral cricoarytenoid (LCA), the posterior cricoarytenoid (PCA), and the interarytenoid (IA), were fit to the parameters of a modified Kelvin model. These properties were compared with those of the thyroarytenoid (TA) and cricothyroid (CT) muscles, as well as previously unpublished viscoelastic characteristics of the human vocal ligament. Passive parameters of the modified Kelvin model were summarized for the vocal ligament, mucosa, and all five laryngeal muscles. Results suggest that the LCA, PCA, and IA muscles are functionally different from the TA and CT muscles in their load-bearing capacity. Furthermore, the LCA, PCA, and IA have a much larger stress-strain hysteresis effect than has been previously reported for the TA and CT or the vocal ligament. The variation in this effect suggests that the connective tissue within the TA and CT muscles is somehow similar to the vocal ligament but different from the LCA, PCA, or IA muscles. Further demonstrating the potential significance of grouping tissues in the laryngeal system by functional groups in the laryngeal system was the unique finding that, over their working elongation range, the LCA and PCA were nearly as exponentially stiff as the vocal ligament. This paper was written in conjunction with an online technical report (http://www.ncvs.org/ncvs/library/tech) in which comprehensive muscle data and sensitivity analysis, as well as downloadable data files and computer scripts, are made available. PMID:17412782

  11. Laryngeal elevation by selective stimulation of the hypoglossal nerve

    NASA Astrophysics Data System (ADS)

    Hadley, Aaron J.; Kolb, Ilya; Tyler, Dustin J.

    2013-08-01

    Objective. Laryngeal elevation protects the airway and assists opening of the esophagus during swallowing. The GH, thyrohyoid, and MH muscles provide a majority of this elevatory motion. This study applied functional electrical stimulation to the XII/C1 nerve complex using a nerve cuff electrode to determine the capabilities of neural stimulation to induce laryngeal elevation. Approach. Multi-contact FINE electrodes were implanted onto the XII/C1 nerve complex at locations proximal and distal to the thyrohyoid branching point in five anesthetized canines. Motion of the thyroid cartilage and the hyoid bone was recorded during stimulation of nerve cuffs and intramuscular electrodes. Main Results. Nerve stimulation induced 260% more laryngeal elevation than intramuscular stimulation (18.8 mm versus 5.2 mm, p ≪ 0.01), and 228% higher velocity (143.8 versus 43.9 mm s-1, p ≪ 0.01). While stimulation at all cuff and electrode locations elevated the larynx, only the proximal XII/C1 nerve cuff significantly elicited both thyroid-hyoid approximation and hyoid elevation. In all proximal XII/C1 nerve cuffs (n = 7), stimulation was able to obtain selectivity of greater than 75% of at least one elevatory muscle. Significance. These results support the hypothesis that an implanted neural interface system can produce increased laryngeal elevation, a significant protective mechanism of deglutition.

  12. Quantitative PCR analysis of laryngeal muscle fiber types

    PubMed Central

    Van Daele, Douglas J.

    2013-01-01

    Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses have shown changes in laryngeal muscle fiber MyHC isoform with denervation. RNA analyses in this setting have not been performed, and understanding RNA levels will allow interventions better designed to reverse processes such as denervation in the future. Total RNA was extracted from bilateral rat thyroarytenoid (TA), posterior cricoarytenoid (PCA), and cricothyroid (CT) muscles in rats. Primers were designed using published MyHC isoform sequences. SYBR Green real time reverse transcription-polymerase chain reaction (SYBR-RT-PCR) was used for quantification. The electropherogram showed a clear separation of total RNA to 28S and 18S subunits. Melting curves illustrated single peaks for all type MyHC primers. All MyHC isoforms were identified in all muscles with various degrees of expression. Quantitative PCR is a sensitive method to detect MyHC isoforms in laryngeal muscle. Isoform expression using mRNA analysis was similar to previous analyses but showed some important differences. This technique can be used to quantitatively assess response to interventions targeted to maintain muscle bulk after denervation. PMID:20430402

  13. Laryngeal Aerodynamics Associated with Oral Contraceptive Use: Preliminary Findings

    ERIC Educational Resources Information Center

    Gorham-Rowan, Mary; Fowler, Linda

    2009-01-01

    The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p[subscript alpha] /repetitions were obtained using a…

  14. Diode Laser for Laryngeal Surgery: a Systematic Review

    PubMed Central

    Arroyo, Helena Hotz; Neri, Larissa; Fussuma, Carina Yuri; Imamura, Rui

    2016-01-01

    Introduction The diode laser has been frequently used in the management of laryngeal disorders. The portability and functional diversity of this tool make it a reasonable alternative to conventional lasers. However, whether diode laser has been applied in transoral laser microsurgery, the ideal parameters, outcomes, and adverse effects remain unclear. Objective The main objective of this systematic review is to provide a reliable evaluation of the use of diode laser in laryngeal diseases, trying to clarify its ideal parameters in the larynx, as well as its outcomes and complications. Data Synthesis We included eleven studies in the final analysis. From the included articles, we collected data on patient and lesion characteristics, treatment (diode laser's parameters used in surgery), and outcomes related to the laser surgery performed. Only two studies were prospective and there were no randomized controlled trials. Most of the evidence suggests that the diode laser can be a useful tool for treatment of different pathologies in the larynx. In this sense, the parameters must be set depending on the goal (vaporization, section, or coagulation) and the clinical problem. Conclusion: The literature lacks studies on the ideal parameters of the diode laser in laryngeal surgery. The available data indicate that diode laser is a useful tool that should be considered in laryngeal surgeries. Thus, large, well-designed studies correlated with diode compared with other lasers are needed to better estimate its effects. PMID:27096024

  15. The Icatibant Outcome Survey: treatment of laryngeal angioedema attacks

    PubMed Central

    Aberer, Werner; Bouillet, Laurence; Caballero, Teresa; Maurer, Marcus; Fabien, Vincent; Zanichelli, Andrea

    2016-01-01

    Objective To characterize the management and outcomes of life-threatening laryngeal attacks of hereditary angioedema (HAE) treated with icatibant in the observational Icatibant Outcome Survey (NCT01034969) registry. Methods This retrospective analysis was based on data from patients with HAE type I/II who received healthcare professional-administered or self-administered icatibant to treat laryngeal attacks between September 2008 and May 2013. Results Twenty centers in seven countries contributed data. Overall, 42 patients with HAE experienced 67 icatibant-treated laryngeal attacks. Icatibant was self-administered for 62.3% of attacks (healthcare professional-administered, 37.7%). One icatibant injection was used for 87.9% of attacks, with rescue or concomitant medication used for 9.0%. The median time to treatment was 2.0 h (n=31 attacks) and the median time to resolution was 6.0 h (n=35 attacks). Conclusions This analysis describes successful use of icatibant for the treatment of laryngeal HAE attacks in a real-world setting. PMID:27116379

  16. Laryngeal Muscles Are Spared in the Dystrophin Deficient "mdx" Mouse

    ERIC Educational Resources Information Center

    Thomas, Lisa B.; Joseph, Gayle L.; Adkins, Tracey D.; Andrade, Francisco H.; Stemple, Joseph C.

    2008-01-01

    Purpose: "Duchenne muscular dystrophy (DMD)" is caused by the loss of the cytoskeletal protein, dystrophin. The disease leads to severe and progressive skeletal muscle wasting. Interestingly, the disease spares some muscles. The purpose of the study was to determine the effects of dystrophin deficiency on 2 intrinsic laryngeal muscles, the…

  17. Management of laryngeal radionecrosis: Animal and clinical experience

    SciTech Connect

    Oppenheimer, R.W.; Krespi, Y.P.; Einhorn, R.K.

    1989-05-01

    Radiation necrosis of the laryngeal cartilages is an uncommon complication of radiotherapy for laryngeal carcinoma. It is a devastating process for which there is no one acceptable treatment. Medical management offers only temporary, symptomatic relief, which further necessitates surgical treatment. Surgical management may start with a tracheotomy; however, it often ends with a total laryngectomy. Physiologically, the necrotic cartilages are the source of the problem. It is a general surgical principle that nonviable tissue must be excised to promote healing. Therefore, if the affected laryngeal cartilages were removed, the larynx should heal. Total or near total removal of the thyroid and cricoid cartilages with preservation of the endolaryngeal soft tissues has not been reported in the literature. Theoretically, if the entire cartilaginous framework is removed, there would be no structural support for the airway. We have found using animal models, that submucosal resection of the laryngeal cartilages, leaving the perichondrium and endolaryngeal soft tissues intact can result in a competent airway. Animal and clinical experience will be presented.

  18. Spasmodic Dysphonia: a Laryngeal Control Disorder Specific to Speech

    PubMed Central

    Ludlow, Christy L.

    2016-01-01

    Spasmodic dysphonia (SD) is a rare neurological disorder that emerges in middle age, is usually sporadic, and affects intrinsic laryngeal muscle control only during speech. Spasmodic bursts in particular laryngeal muscles disrupt voluntary control during vowel sounds in adductor SD and interfere with voice onset after voiceless consonants in abductor SD. Little is known about its origins; it is classified as a focal dystonia secondary to an unknown neurobiological mechanism that produces a chronic abnormality of laryngeal motor neuron regulation during speech. It develops primarily in females and does not interfere with breathing, crying, laughter, and shouting. Recent postmortem studies have implicated the accumulation of clusters in the parenchyma and perivascular regions with inflammatory changes in the brainstem in one to two cases. A few cases with single mutations in THAP1, a gene involved in transcription regulation, suggest that a weak genetic predisposition may contribute to mechanisms causing a nonprogressive abnormality in laryngeal motor neuron control for speech but not for vocal emotional expression. Research is needed to address the basic cellular and proteomic mechanisms that produce this disorder to provide intervention that could target the pathogenesis of the disorder rather than only providing temporary symptom relief. PMID:21248101

  19. An OT Account of Laryngealization in Cuzco Quechua.

    ERIC Educational Resources Information Center

    Parker, Steve

    Classical phonemic accounts of Cuzco (Peru) Quechua posit three distinct types of stops: plain, aspirated, and glottalized. A later analysis argued instead for a root-level feature of laryngealization governed by a small number of formal mechanisms. This latter analysis is taken one step further, showing that even greater explanatory power may be…

  20. A bony connection signals laryngeal echolocation in bats.

    PubMed

    Veselka, Nina; McErlain, David D; Holdsworth, David W; Eger, Judith L; Chhem, Rethy K; Mason, Matthew J; Brain, Kirsty L; Faure, Paul A; Fenton, M Brock

    2010-02-18

    Echolocation is an active form of orientation in which animals emit sounds and then listen to reflected echoes of those sounds to form images of their surroundings in their brains. Although echolocation is usually associated with bats, it is not characteristic of all bats. Most echolocating bats produce signals in the larynx, but within one family of mainly non-echolocating species (Pteropodidae), a few species use echolocation sounds produced by tongue clicks. Here we demonstrate, using data obtained from micro-computed tomography scans of 26 species (n = 35 fluid-preserved bats), that proximal articulation of the stylohyal bone (part of the mammalian hyoid apparatus) with the tympanic bone always distinguishes laryngeally echolocating bats from all other bats (that is, non-echolocating pteropodids and those that echolocate with tongue clicks). In laryngeally echolocating bats, the proximal end of the stylohyal bone directly articulates with the tympanic bone and is often fused with it. Previous research on the morphology of the stylohyal bone in the oldest known fossil bat (Onychonycteris finneyi) suggested that it did not echolocate, but our findings suggest that O. finneyi may have used laryngeal echolocation because its stylohyal bones may have articulated with its tympanic bones. The present findings reopen basic questions about the timing and the origin of flight and echolocation in the early evolution of bats. Our data also provide an independent anatomical character by which to distinguish laryngeally echolocating bats from other bats. PMID:20098413

  1. Laryngeal obstruction caused by lymphoma in an adult dairy cow

    PubMed Central

    Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Chénier, Sonia

    2014-01-01

    A Holstein cow was presented for inspiratory dyspnea. Endoscopic evaluation revealed swollen arytenoids and a presumptive diagnosis of bilateral arytenoidal chondritis was made. A partial arytenoidectomy was performed, the right arytenoid was submitted for histopathology, and a diagnosis of laryngeal lymphoma was made. Due to the poor prognosis, the cow was euthanized. PMID:24489391

  2. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids

    PubMed Central

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-01-01

    Abstract The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No

  3. Association between UGT1A1 Polymorphism and Risk of Laryngeal Squamous Cell Carcinoma

    PubMed Central

    Huangfu, Hui; Pan, Hong; Wang, Binquan; Wen, Shuxin; Han, Rui; Li, Li

    2016-01-01

    Laryngeal cancer is one of the largest subgroups of head and neck cancers. In addition to smoking and alcohol consumption, genetic polymorphisms are also risk factors for the development of laryngeal cancer. However, the exact relation between genetic variants and pathogenesis of laryngeal cancer has remained elusive. The aim of this study was to examine UGT1A1*6 (rs4148323 A/G) polymorphisms in 103 patients with laryngeal cancer and 220 controls using the high resolution melting curve (HRM) technique and to explore the association between UGT1A1*6 (rs4148323 A/G) polymorphisms and laryngeal cancer. The results showed an association between the rs4148323 G allele and increased risk of laryngeal cancer. While there was no statistically significant difference between rs4148323 genotype frequencies and different histological grades or different clinical stages of laryngeal cancer, stratification analysis indicated smoking or alcohol consumption and rs4148323 G allele combined to increase the risk of laryngeal cancer. In conclusion, the rs4148323 G allele is associated with the high UGT1A1 enzyme activity, and might increase the risk of laryngeal cancer. Furthermore, smoking or alcohol consumption and the rs4148323 G allele act synergistically to increase the risk of laryngeal cancer. PMID:26751466

  4. [Inferior alveolar nerve repositioning in implant surgery].

    PubMed

    Ardekian, L; Salnea, J; Abu el-Naaj, I; Gutmacher, T; Peled, M

    2001-04-01

    Severe resorption of the posterior mandible possesses one of the most difficult restorative challenges to the implant surgery today. This resorption may prevent the placement of dental implants without the potentially damage to the inferior alveolar nerve. To create the opportunity of insertion dental implants of adequately length in those cases, the technique of nerve repositioning has been advocated. The purpose of this article is to describe two cases of nerve repositioning combined with placement of dental implants. Both cases showed appropriate postoperative healing without damage to the inferior alveolar nerve. The inferior alveolar nerve repositioning technique seems to be an acceptable alternative to augmentation procedure prior to dental implants placement in cases exhibiting atrophic posterior mandibular ridges. PMID:11494807

  5. [Ventricular Septal Perforation after Inferior Myocardial Infarction].

    PubMed

    Sato, Hisashi; Nakayama, Yoshihiro; Tanaka, Hideya; Takahashi, Baku

    2016-07-01

    We report a rare case of ventricular septal perforation (VSP) after inferior myocardial infarction. Surgical repair of VSP after inferior infarction is technically difficult because of its anatomical location. An 81-year-old female presented with dyspnea on the 8th day after percutaneous coronary intervention for acute inferior myocardial infarction. Echocardiography revealed a ventricular septal perforation. Urgent operation was performed. There was a VSP around the base of the ventricular septum. The myocardial infarction extended to the adjacent muscle of the mitral valve annulus. Two bovine pericardial patches were used in the left ventricular cavity. The patches were sewn on the mitral valve annulus which was the only normal tissue in the region. The 1st patch was used to close the VSP directly, and the 2nd patch was sutured to the normal myocardium to exclude the infracted area. No residual shunt flow was observed. The postoperative course was uneventful. PMID:27365060

  6. Lateralization Technique and Inferior Alveolar Nerve Transposition

    PubMed Central

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  7. [Airway equipment and its maintenance for a non difficult adult airway management (endotracheal intubation and its alternative: face mask, laryngeal mask airway, laryngeal tube)].

    PubMed

    Francon, D; Estèbe, J P; Ecoffey, C

    2003-08-01

    The airway equipment for a non difficult adult airway management are described: endotracheal tubes with a specific discussion on how to inflate the balloon, laryngoscopes and blades, stylets and intubation guides, oral airways, face masks, laryngeal mask airways and laryngeal tubes. Cleaning and disinfections with the maintenance are also discussed for each type of airway management. PMID:12943860

  8. Tensile properties of the inferior glenohumeral ligament.

    PubMed

    Bigliani, L U; Pollock, R G; Soslowsky, L J; Flatow, E L; Pawluk, R J; Mow, V C

    1992-03-01

    The tensile properties of the inferior glenohumeral ligament have been determined in 16 freshly frozen cadaver shoulders. The inferior glenohumeral ligament was divided into three anatomical regions: a superior band, an anterior axillary pouch, and a posterior axillary pouch. This yielded 48 bone-ligament-bone specimens, which were tested to failure in uniaxial tension. The superior band was consistently the thickest region, averaging 2.79 mm. The thickness of the inferior glenohumeral ligament decreased from antero-superiorly to postero-inferiorly. The resting length of all three anatomical regions was not statistically different. Total specimen strain to failure for all bone-ligament-bone specimens averaged 27%. Variations occurred between the three regions, with the anterior pouch specimens failing at a higher strain (34%) than those from the superior band (24%) or the posterior pouch (23%). Strain to failure for the ligament midsubstance (11%) was found to be significantly less than that for the entire specimen (27%). Thus, larger strain must occur near the insertion sites of the inferior glenohumeral ligament. Stress at failure was found to be nearly identical for the three regions of the ligament, averaging 5.5 MPa. These values are lower than those reported for other soft tissues, such as the anterior cruciate ligament and patellar tendon. The anterior pouch was found to be less stiff than the other two regions, perhaps suggesting that it is composed of more highly crimped collagen fibers. Three failure sites were seen for the inferior glenohumeral ligament: the glenoid insertion (40%), the ligament substance (35%), and the humeral insertion (25%). In addition, significant capsular stretching occurred before failure, regardless of the failure mode. PMID:1740736

  9. Anatomy of Inferior Mesenteric Artery in Fetuses

    PubMed Central

    Nuzhat, Ayesha

    2016-01-01

    Aim. To analyze Inferior Mesenteric Artery in fetuses through its site of origin, length, diameter, and variation of its branches. Method. 100 fetuses were collected from various hospitals in Warangal at Kakatiya Medical College in Andhra Pradesh, India, and were divided into two groups, group I (second-trimester fetuses) and group II (third-trimester fetuses), followed by dissection. Result. (1) Site of Origin. In group I fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra in 33 out of 34 fetuses (97.2%). In one fetus it was at first lumbar vertebra, 2.8%. In all group II fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra. (2) Length. In group I fetuses it ranged between 18 and 30 mm, average being 24 mm except in one fetus where it was 48 mm. In group II fetuses the length ranged from 30 to 34 mm, average being 32 mm. (3) Diameter. In group I fetuses it ranged from 0.5 to 1 mm, and in group II fetuses it ranged from 1 to 2 mm, average being 1.5 mm. (4) Branches. Out of 34 fetuses of group I, 4 fetuses showed variation. In one fetus left colic artery was arising from abdominal aorta, 2.9%. In 3 fetuses, Inferior Mesenteric Artery was giving a branch to left kidney, 8.8%. Out of 66 fetuses in group II, 64 had normal branching. In one fetus left renal artery was arising from Inferior Mesenteric Artery, 1.5%, and in another fetus one accessory renal artery was arising from Inferior Mesenteric Artery and entering the lower pole of left kidney. Conclusion. Formation, course, and branching pattern of an artery depend on development and origin of organs to attain the actual adult position. PMID:27313956

  10. Anatomy of Inferior Mesenteric Artery in Fetuses.

    PubMed

    Nuzhat, Ayesha

    2016-01-01

    Aim. To analyze Inferior Mesenteric Artery in fetuses through its site of origin, length, diameter, and variation of its branches. Method. 100 fetuses were collected from various hospitals in Warangal at Kakatiya Medical College in Andhra Pradesh, India, and were divided into two groups, group I (second-trimester fetuses) and group II (third-trimester fetuses), followed by dissection. Result. (1) Site of Origin. In group I fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra in 33 out of 34 fetuses (97.2%). In one fetus it was at first lumbar vertebra, 2.8%. In all group II fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra. (2) Length. In group I fetuses it ranged between 18 and 30 mm, average being 24 mm except in one fetus where it was 48 mm. In group II fetuses the length ranged from 30 to 34 mm, average being 32 mm. (3) Diameter. In group I fetuses it ranged from 0.5 to 1 mm, and in group II fetuses it ranged from 1 to 2 mm, average being 1.5 mm. (4) Branches. Out of 34 fetuses of group I, 4 fetuses showed variation. In one fetus left colic artery was arising from abdominal aorta, 2.9%. In 3 fetuses, Inferior Mesenteric Artery was giving a branch to left kidney, 8.8%. Out of 66 fetuses in group II, 64 had normal branching. In one fetus left renal artery was arising from Inferior Mesenteric Artery, 1.5%, and in another fetus one accessory renal artery was arising from Inferior Mesenteric Artery and entering the lower pole of left kidney. Conclusion. Formation, course, and branching pattern of an artery depend on development and origin of organs to attain the actual adult position. PMID:27313956

  11. Expiratory-modulated laryngeal motoneurons exhibit a hyperpolarization preceding depolarization during superior laryngeal nerve stimulation in the in vivo adult rat.

    PubMed

    Bautista, Tara G; Sun, Qi-Jian; Pilowsky, Paul M

    2012-03-22

    Swallowing requires the sequential activation of tongue, pharyngeal and esophageal muscles to propel the food bolus towards the stomach. Aspiration during swallow is prevented by adduction of the vocal cords during the oropharyngeal phase. Expiratory-modulated laryngeal motoneurons (ELM) exhibit a burst of action potentials during swallows elicited by electrical stimulation of the superior laryngeal nerve (SLN). Here we sought to investigate changes in membrane potential in ELM during superior laryngeal nerve stimulation in the anaesthetised, in vivo adult rat preparation. Intracellular recordings of ELM in the caudal nucleus ambiguus (identified by antidromic activation from the recurrent laryngeal nerve) demonstrated that ELM bursting activity following SLN stimulation is associated with a depolarization that is preceded by a small hyperpolarization. During spontaneous ELM bursts, the preceding hyperpolarization separated the bursting activity from its usual post-inspiratory activity. These findings demonstrate that the in vivo adult rat preparation is suitable for the study of swallow-related activity in laryngeal motoneurons. PMID:22326041

  12. Sound signature for identification of tracheal collapse and laryngeal paralysis in dogs.

    PubMed

    Yeon, Seong-Chan; Lee, Hee-Chun; Chang, Hong-Hee; Lee, Hyo-Jong

    2005-01-01

    The aims of this study were to investigate whether upper airway sounds of dogs with laryngeal paralysis and tracheal collapse have distinct sound characteristics, compared with unaffected dogs. The sounds of 5 dogs with laryngeal paralysis and 5 dogs with tracheal collapse were recorded. Honking sound appeared as predominant clinical signs in dogs with tracheal collapse. Laryngeal stridors appeared as predominant clinical signs in dogs with experimentally produced laryngeal paralysis by resection of laryngeal nerve, in which two types of stridor, I and II, were recorded. All these sounds were analyzed using sound spectrogam analysis. There were significant differences in duration (sec), intensity (dB), pitch (Hz), first formant (Hz), second formant (Hz), third formant (Hz), fourth formant (Hz) of sounds between the normal bark and two types of stridor or honking sound, indicating that the sound analysis might be a useful diagnostic modality for dogs with tracheal collapse and laryngeal paralysis. PMID:15699602

  13. Identification of the motor laryngeal nerves - a new electrical stimulation technique.

    PubMed

    Spahn, J G; Bizal, J; Ferguson, S; Lingeman, R E

    1981-11-01

    Head and neck surgeons are familiar with the technique of identifying motor nerves in the head and neck region by using electrical stimulation especially in the identification of the facial and the spinal accessory nerves. The identification of the motor laryngeal nerves by electrical stimulation intra-operatively has been described; but, the difficulty of visualization of intrinsic laryngeal muscle movement has prevented the wide spread use of this technique. This paper will introduce a simple, safe and reliable method to allow the surgeon to recognize true vocal cord movement while stimulating the recurrent laryngeal nerve. The movement of a two inch 27 gauge needle placed through the cricothyroid membrane into the ipsilateral true vocal cord permits identification of intrinsic laryngeal muscle movement during electrical stimulation of the recurrent laryngeal nerve. This method has been successfully used in confirming conductivity of the laryngeal nerve during thyroid surgery, Zenker's diverticulum surgery, cricotracheal trauma and recurrent nerve neurectomy for spasmodic dysphonia. PMID:7300536

  14. Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs.

    PubMed

    Brisebois, Simon; Samson, Nathalie; Fortier, Pierre-Hugues; Doueik, Alexandre A; Carreau, Anne-Marie; Praud, Jean-Paul

    2014-08-15

    Reflux laryngitis in infants may be involved not only in laryngeal disorders, but also in disorders of cardiorespiratory control through its impact on laryngeal function. Our objective was to study the effect of reflux laryngitis on non-nutritive swallowing (NNS) and NNS-breathing coordination. Two groups of six newborn lambs, randomized into laryngitis and control groups, were surgically instrumented for recording states of alertness, swallowing and cardiorespiratory variables without sedation. A mild to moderate reflux laryngitis was induced in lambs from the experimental group. A significant decrease in the number of NNS bursts and apneas was observed in the laryngitis group in active sleep (p=0.03). In addition, lower heart and respiratory rates, as well as prolonged apnea duration (p<0.0001) were observed. No physiologically significant alterations in NNS-breathing coordination were observed in the laryngitis group. We conclude that a mild to moderate reflux laryngitis alters NNS burst frequency and autonomous control of cardiac activity and respiration in lambs. PMID:24893350

  15. Spontaneous improvement of laryngeal sarcoidosis resistant to systemic corticosteroid administration

    PubMed Central

    Tsubouchi, Kazuya; Hamada, Naoki; Ijichi, Kayo; Umezaki, Toshiro; Takayama, Koichi; Nakanishi, Yoichi

    2015-01-01

    We report herein a case of laryngeal sarcoidosis that was refractory to systemic corticosteroids, but that improved spontaneously. A 49-year-old woman complained of dysphagia and hoarseness with accompanying edematous swellings of both arytenoid regions. She was referred to our hospital after systemic corticosteroid therapy failed to achieve any improvement. Laryngoscopy showed marked edema of the epiglottis and both arytenoid regions. The flow–volume curve on spirometry showed flattening of the expiratory flows. Histopathological examination of the arytenoid region showed non-caseating epithelioid granulomas, and laryngeal sarcoidosis was diagnosed with the result of BAL study. She was observed without treatment as symptoms were mild. Although edema of the left arytenoid region seemed to be somewhat worsened after 6 months, she continued to be followed closely because of improvements in the flow–volume curve and increasing peak expiratory flow. By 1 year after onset, symptoms and epiglottal swelling had spontaneously improved. PMID:26392860

  16. [Jejunal perforation as initial metastatic manifestation of laryngeal carcinoma].

    PubMed

    Claros González, I; Santonja Garriga, J L; Rubio Barbón, S; Santamaría Girón, L; Triviño López, A; Velasco Alvarez, A

    1994-01-01

    A case of acute abdominal pain due to jejunal perforation in a patient with dissemination of laryngeal carcinoma is presented. Six jejunal intramural nodes of squamous cell carcinoma, one of them perforated, were observed at laparotomy. At the same time, a lesion suspicious of local recurrence in the tracheostomy orifice was observed. The patient died in the postoperative period. The rarity of intestinal perforation as an initial manifestation of metastatical dissemination of a laryngeal squamous cell carcinoma as well as its poor prognosis are discussed. The hematogenous spread is proposed in our case. Finally the inclusion of metastases in the differential diagnosis in a clinical episode of intestinal perforation in patients with a history of neoplasm is emphasized. PMID:8186002

  17. Swallowing and speech therapy after definitive treatment for laryngeal cancer.

    PubMed

    Samlan, Robin A; Webster, Kimberly T

    2002-10-01

    As the trend in laryngeal cancer treatment shifts towards organ-conservation surgeries and organ-preservation protocols, patients will more often retain anatomy vital to communication and swallowing. Despite a conservative approach, results of treatment may have debilitating effects. Rehabilitation efforts are directed towards a return to functional, if not normal, status. Although there are predictable trends in voice and swallowing disorders of patients with laryngeal cancer, posttreatment dysphonia and dysphagia are diverse in presentation. Considering the significant diversity of this population, speech pathologists should work closely with otolaryngologists to determine the most appropriate treatment for each patient. As this article demonstrates, voice and swallowing therapy are necessary components of the rehabilitation process following treatment for head and neck cancers. As always, treatment is tailored to the specific individual and based on information obtained during a thorough evaluation by a speech pathologist. Fortunately, with the help of voice and swallowing therapy, many patients return to functional communication and oral feeding. PMID:12587251

  18. Fetal lung growth in laryngeal atresia and tracheal agenesis.

    PubMed

    Scurry, J P; Adamson, T M; Cussen, L J

    1989-02-01

    Three cases of airway obstruction in fetuses born at 21, 32 and 40 weeks gestation are reported. The first had laryngeal atresia, cystic dysplastic kidneys, oligohydramnios and immense fluid-filled lungs. The second had upper tracheal agenesis, a tracheo-oesophageal fistula, a cystic dysplastic horseshoe kidney, oligohydramnios and normal-sized lungs. The third had a pin-hole mucosal tract through an otherwise atretic larynx, normal kidneys, no oligohydramnios and normal-sized lungs. Lung weight:body weight ratios, radial alveolar or radial canalicular counts and point-counting of sections of lungs in cases 1 and 2 show that laryngeal or tracheal obstruction may prevent or reduce the pulmonary hypoplasia associated with renal dysplasia, and in cases 2 and 3, that grossly enlarged, hyperplastic lungs may not be seen unless obstruction is complete. PMID:2730470

  19. Speed, accuracy, and stability of laryngeal movement in singing

    NASA Astrophysics Data System (ADS)

    Titze, Ingo R.

    2001-05-01

    Motor performance is often quantified in terms of speed, strength, accuracy, and stability of a target gesture, or maintaining a given posture. In the vocal system, this involves primarily the intrinsic laryngeal muscles and the respiratory muscles. Agonist-antagonist pairs of muscles are used to position the vocal folds for phonation (vocal onset), for pitch change, and for registration (as in yodeling). Maximum speed and accuracy are discussed for vocal embellishments such as trills, trillo, scales, arpeggios, yodel, and glissando. This speed and accuracy are interpreted in terms of muscle twitch and tetanic responses obtained in vitro on animal muscles, from electromyographic recordings on humans, and from muscles not easily tested on humans. The laryngeal reflex system is also described, particularly with regard to its ability to stabilize (or destabilize) neurologic tremor originating from the central nervous system.

  20. Leptomeningeal metastasis from early glottic laryngeal cancer: A case report

    PubMed Central

    PAN, ZHENYU; YANG, GUOZI; QU, LIMEI; YUAN, TINGTING; PANG, XIAOCHUAN; WANG, YONGXIANG; SHI, WEIYAN; DONG, LIHUA

    2015-01-01

    The present study reports the case of a 53-year-old man with leptomeningeal metastasis from early glottic laryngeal cancer. The patient had been diagnosed with squamous cell carcinoma of the glottic larynx 9 years previously. The current symptoms included a recurring headache that had persisted for 1 month and vomiting for 1 week. A magnetic resonance imaging scan of the head revealed multiple enhancing lesions in the brain and multiple line-like enhancements in the brain fold. Computed tomography scans of the head, neck, chest and abdomen showed no nodular lesions. Cytological examination of the cerebral spinal fluid (CSF) revealed malignant cells with a scattered distribution pattern. The patient received intra-CSF methotrexate chemotherapy concurrent with whole-brain radiotherapy, which relieved the neurological symptoms. To the best of our knowledge, this is the first case of cytologically-confirmed LM from early glottic laryngeal cancer. PMID:26722263

  1. Treatment of laryngeal sarcoidosis with intralesional steroid injection.

    PubMed

    Krespi, Y P; Mitrani, M; Husain, S; Meltzer, C J

    1987-01-01

    Laryngeal sarcoidosis presents with hoarseness, cough, and dysphagia. Shortness of breath due to upper airway obstruction may occur. Indirect laryngoscopy reveals mucosal edema and erythema, granulomas, and nodules. The supraglottic larynx is the most frequently affected area. Systemic corticosteroids can be used initially; however, with persistent symptoms and/or severe airway problems, intralesional steroid injections may be more effective, as in the six patients presented. PMID:3688765

  2. Usefulness of ultrasonography in assessment of laryngeal carcinoma

    PubMed Central

    Xia, C-X; Zhao, H-X; Yan, F; Li, S-L; Zhang, S-M

    2013-01-01

    Objective: To evaluate the usefulness of ultrasonography in assessing laryngeal cancer. Methods: 72 patients with laryngeal carcinoma proven by surgery and pathology were enrolled. The pre-therapeutic ultrasonography and CT images were retrospectively evaluated, including tumour detection, localisation and invasion of intra- and extralaryngeal structures. A comparative assessment was made between the detection rate, correspondence rate of localisation and sensitivity and specificity of ultrasonography and CT. The mobility of the larynx was observed on real-time ultrasonography and compared with laryngoscopy. Results: The detection rate of ultrasonography [63 (87.5%)/72] was lower than that of CT [72 (100.0%)/72] (p=0.006). The primary foci were accurately located in 59 (93.7%) of 63 lesions using ultrasonography compared with 70 (97.2%) of 72 lesions using CT (p=0.392). In the evaluation of invasion, the sensitivity and specificity of ultrasonography were similar to that of CT in most of the intra- and extralaryngeal structures (p=0.059–1.000). A higher specificity was obtained during the assessment of the paraglottic space involvement when using ultrasonography than CT (94.9% vs 66.7%, p=0.001). For vocal cord fixation, no statistical difference was found between ultrasonography and laryngoscopy (p=0.223). Conclusion: Ultrasonography could be used as a valuable supplementary imaging method to CT and laryngoscopy in the assessment of laryngeal carcinoma, even in male adults with some calcifications of the thyroid cartilage. Advances in knowledge: Our study demonstrates that ultrasonography, which has been used scarcely in the larynx, could supply useful information on the detection, localisation and intra- and extralaryngeal invasion of laryngeal carcinoma. PMID:24004487

  3. Reconstructive procedures for impaired upper airway function: laryngeal respiration

    PubMed Central

    Müller, Andreas

    2005-01-01

    The larynx is the "bottleneck" of the human airway. For this reason, the effects of stenosing laryngeal pathologies on the vital factor respiratory gas exchange are particularly critical. Internal stabilization is a prerequisite for recovery of the laryngeal respiratory function in severe forms of inspiratory collapse (laryngomalacia). Effective laser surgery techniques have been developed to this end in recent years. Glottis-dilating surgery in cases of bilateral vocal cord motion impairment is now moving in the direction of endoscopic laser cordotomy or cordectomy, whereas arytenoidectomy and open surgical procedures are now used only rarely due to higher secondary morbidity rates. In individual cases, in particular if functional recovery is expected, temporary laterofixation of a vocal cord using an endoscopic suturing technique can be a helpful approach. Extensive laryngeal defects can be covered by means of composite grafts with mucosal lining, a supporting skeleton and their own vascularization. Autologous transplantation of the larynx, with its complex surgical and immunological problems, has become a manageable procedure. The problems of post-transplantation reinnervation and risk assessment of immunosuppression-induced recurrence of the tumor are still under consideration. Reanimation of the bilaterally paralyzed larynx by means of neurorrhaphy (neurosuture), neural grafting and, more recently, functional electrostimulation (pacemaker) represents a challenge for the coming years. In most cases of paralysis of the recurrent laryngeal nerve, a part of the muscles is maintained by synkinetic reinnervation when therapy is carried out, which however also prevents effective vocal cord movement due to simultaneous activity of agonists and antagonists. Modulation of reinnervation by means of electrostimulation and modern genetic therapy approaches justify hopes of better outcomes in the future. PMID:22073057

  4. [Laryngeal interarytenoid neurilemmoma excised via microlaryngeal endoscopy: two case reports].

    PubMed

    Shen, Yi; Cheng, Lixin; Tang, Ming

    2015-12-01

    Laryngeal interarytenoid neurilemmomas (LIN) is a benign encapsulated tumor originating from the schwann cells lining nerve fibers. Even though LINs are extremely rare in incidence, they could present with potential threat to the airway and thus requiring prompt diagnosis and treatment. Here, we report two cases of LINs. Both patients underwent excision of the tumor via microlaryngeal endoscopic procedures and recovered well postoperatively without complications. No recurrence was observed postoperatively on routine follow-up after 14 months. PMID:27101688

  5. Laryngeal Tumor Detection and Classification in Endoscopic Video.

    PubMed

    Barbalata, Corina; Mattos, Leonardo S

    2016-01-01

    The development of the narrow-band imaging (NBI) has been increasing the interest of medical specialists in the study of laryngeal microvascular network to establish diagnosis without biopsy and pathological examination. A possible solution to this challenging problem is presented in this paper, which proposes an automatic method based on anisotropic filtering and matched filter to extract the lesion area and segment blood vessels. Lesion classification is then performed based on a statistical analysis of the blood vessels' characteristics, such as thickness, tortuosity, and density. Here, the presented algorithm is applied to 50 NBI endoscopic images of laryngeal diseases and the segmentation and classification accuracies are investigated. The experimental results show the proposed algorithm provides reliable results, reaching an overall classification accuracy rating of 84.3%. This is a highly motivating preliminary result that proves the feasibility of the new method and supports the investment in further research and development to translate this study into clinical practice. Furthermore, to our best knowledge, this is the first time image processing is used to automatically classify laryngeal tumors in endoscopic videos based on tumor vascularization characteristics. Therefore, the introduced system represents an innovation in biomedical and health informatics. PMID:25438330

  6. Phonation threshold power in ex vivo laryngeal models

    PubMed Central

    Regner, Michael F.; Jiang, Jack J.

    2011-01-01

    This study hypothesized that phonation threshold power is measureable and sensitive to changes in the biomechanical properties of the vocal folds. Phonation threshold power was measured in three sample populations of ten excised canine larynges treated with variable posterior glottal gap, variable bilateral vocal fold elongation, and variable vocal fold lesioning. Posterior glottal gap was varied from 0 mm to 4 mm in 0.5 mm intervals. Bilateral vocal fold elongation was varied from 0% to 20% in 5% intervals. Vocal fold lesion treatments included unilateral and bilateral vocal fold lesion groups. Each treatment was investigated independently in a sample population of ten excised canine larynges. Linear regression analysis indicated that phonation threshold power was sensitive to posterior glottal gap (R2=0.298, p<0.001) and weakly to vocal fold elongation (R2=0.052, p=0.003). A one-way repeated measures ANOVA indicated that phonation threshold power was sensitive to the presence of lesions (p<0.001). Theoretical and experimental evidence presented here suggests that phonation threshold power could be used as a broad screening parameter, sensitive to certain changes in the biomechanical properties of the larynx. It has not yet been measured in humans, but because it has the potential to represent the airflow-tissue energy transfer more completely the phonation threshold pressure or flow alone, it may be a more useful parameter than these and could be used to indicate that laryngeal health is likely abnormal. PMID:20817475

  7. Multidirectional Instability Accompanying an Inferior Labral Cyst

    PubMed Central

    Ji, Jong-Hun; Kim, Sung-Jae

    2010-01-01

    Paralabral cyst of the shoulder joint can be observed in 2% to 4% of the general population, particularly in men during the third and fourth decade. On average, these cysts measure 10 mm to 20 mm in diameter and are located preferentially on the postero-superior aspect of the glenoid. The MRI has increased the frequency of the diagnosis of paralabral cysts of the shoulder joint. Paralabral cysts of the shoulder joint usually develop in the proximity of the labrum. The relationship between shoulder instability and labral tears is well known, however, the association of shoulder instability with a paralabral cyst is rare. Shoulder instability may cause labral injury or labral injury may cause shoulder instability, and then injured tear develops paralabral cyst. In our patient, the inferior paralabral cyst may be associated with inferior labral tears and instability MRI. PMID:20514270

  8. A novel technique for inferior rectus recession

    PubMed Central

    Gokyigit, Birsen; Akar, Serpil; Yilmaz, Omer Faruk

    2014-01-01

    Purpose To introduce a novel technique of inferior rectus recession operation to allow larger amounts of recession without causing lower lid retraction and to compare this method with the results obtained in standard inferior rectus recession. Material and methods This study included 20 patients operated on in the authors’ clinic. The median age of the patients was 24.5±18.6 (4–73) years and the median follow-up was 9.3±11.8 (3–43) months. Ten patients operated on with the standard method were labeled Group 1 and ten patients operated on with the new method were labeled Group 2. Without exceeding 4 mm, inferior rectus recession to the whole muscle was performed in Group 1 patients. Inferior rectus recession was also performed on patients in Group 2 following the new method. Using a spatula, approximately 10% of the muscle surface fibers were detached intact as a thin layer, and the remaining 90% of deeper fibers were recessed 4–8 mm as planned. Patients’ preoperative deviations and lower lid positions were recorded. The same parameters were checked in the first and third month postoperatively. Both groups were evaluated retrospectively by screening their files, and the Mann–Whitney U test was used for statistical evaluation. Results Lower lid retraction was seen in four patients of Group 1. There was no retraction in Group 2. While there was a need to perform additional vertical muscle procedures for vertical deviations and lower lid retractions in Group 1, it was observed that there was no need for additional procedures in Group 2 patients. There was a statistically meaningful difference between the two procedures (P<0.05). Conclusion This novel technique was found to be an effective surgical method for permitting more recession without the risk of lower lid retraction. PMID:24492531

  9. [Potentialities of autofluorescent spectroscopy in diagnosis of laryngeal and pharyngeal tumors].

    PubMed

    Mareev, O V; Pravdin, A B; Afonina, O I; Filina, E V

    2008-01-01

    Laryngeal and pharyngeal mucosa of 50 patients with malignant (n=56%) and benign (n=44%) laryngeal and pharyngeal tumors was examined with autofluorescent spectroscopy using nitrogen laser LGI-505 (337,1 nm). It was found that autofluorescent spectrum of malignant tumors is significantly less intensive than relevant spectrum of healthy mucosa and benign tumors. PMID:18427510

  10. Acoustic and Perceptual Effects of Left-Right Laryngeal Asymmetries Based on Computational Modeling

    ERIC Educational Resources Information Center

    Samlan, Robin A.; Story, Brad H.; Lotto, Andrew J.; Bunton, Kate

    2014-01-01

    Purpose: Computational modeling was used to examine the consequences of 5 different laryngeal asymmetries on acoustic and perceptual measures of vocal function. Method: A kinematic vocal fold model was used to impose 5 laryngeal asymmetries: adduction, edge bulging, nodal point ratio, amplitude of vibration, and starting phase. Thirty /a/ and /?/…

  11. 3D reconstruction and heat map of porcine recurrent laryngeal nerve anatomy: branching and spatial location.

    PubMed

    Mason, Nena Lundgreen; Christiansen, Marc; Wisco, Jonathan J

    2015-01-01

    Recurrent laryngeal nerve palsy is a common post-operative complication of many head and neck surgeries. Theoretically, the best treatment to restore partial function to a damaged recurrent laryngeal nerve would be reinnervation of the posterior cricoarytenoid muscle via anastomosis of the recurrent laryngeal and phrenic nerves. The pig is an excellent model of human laryngeal anatomy and physiology but a more thorough knowledge of porcine laryngeal anatomy is necessary before the pig can be used to improve existing surgical strategies, and develop new ones. This study first identifies the three most common recurrent laryngeal nerve branching patterns in the pig. Secondly, this study presents three-dimensional renderings of the porcine larynx onto which the recurrent laryngeal nerve patterns are accurately mapped. Lastly, heat maps are presented to display the spatial variability of recurrent laryngeal nerve trunks and primary branches on each side of 15 subjects (28 specimens). We intend for this study to be useful to groups using a porcine model to study posterior cricoarytenoid muscle reinnervation techniques. PMID:27086418

  12. Association between tea and coffee consumption and risk of laryngeal cancer: a meta-analysis

    PubMed Central

    Ouyang, Zhiguo; Wang, Zhaoyan; Jin, Jian

    2014-01-01

    Objective: Epidemiological studies evaluating the association of tea and coffee consumption and the risk of laryngeal cancer have produced inconsistent results. Thus, we conducted a meta-analysis to assess the relationship between tea and coffee consumption and laryngeal cancer risk. Methods: Pertinent studies were identified by a search in PubMed, Web of Knowledge and Wan Fang Med Online. The random effect model was used based on heterogeneity test. Publication bias was estimated using Egger’s regression asymmetry test. As a result, 11 articles were included in this meta-analysis. Results: For tea consumption and laryngeal cancer, data from 8 studies including 2167 laryngeal cancer cases were used, and the pooled results suggested that highest tea consumption versus lowest level wasn’t associated with the risk of laryngeal cancer [summary RR = 0.909, 95% CI = 0.674-1.227]. Eight studies comprising 2596 laryngeal cancer cases for coffee consumption and laryngeal cancer risk were included, and no association was found (summary RR = 1.218, 95% CI = 0.915-1.622). Conclusions: Finding from this meta-analysis suggested that tea and coffee consumption weren’t associated with the risk of laryngeal cancer. Since the potential biases and confounders could not be ruled out completely in this meta-analysis, further studies are warranted to confirm this result. PMID:25664021

  13. Tea and Coffee Consumption and Risk of Laryngeal Cancer: A Systematic Review Meta-Analysis

    PubMed Central

    Chen, Jiangbo; Long, Shuo

    2014-01-01

    Background Tea and coffee are the most commonly consumed beverages in the worldwide. The relationship between tea and coffee consumption on the risk of laryngeal cancer was still unclear. Methods Relevant studies were identified by searching electronic database (Medline and EMBASE) and reviewing the reference lists of relevant articles until Oct. 2013. Observational studies that reported RRs and 95% CIs for the link of tea and coffee consumption on the risk of laryngeal cancer were eligible. A meta-analysis was obtained to combine study-specific RRs with a random-effects model. Results A total of 2,803 cases and 503,234 controls in 10 independent studies were identified. The overall analysis of all 10 studies, including the case-control and cohort studies, found that tea drinking was not associated with laryngeal carcinoma (RR = 1.03; 95% CI: 0.66–1.61). However, coffee consumption was significantly associated with the laryngeal carcinoma (RR = 1.47; 95% CI: 1.03–2.11). A dose-response relationship between coffee intake and laryngeal carcinoma was detected; however, no evidence of dose-response link between tea consumption and laryngeal carcinoma risk was detected. Conclusions The results from this meta-analysis of observational studies demonstrate that coffee consumption would increase the laryngeal cancer risk, while tea intake was not associated with risk of laryngeal carcinoma. PMID:25502726

  14. Respiratory and Laryngeal Responses to an Oral Air Pressure Bleed during Speech

    ERIC Educational Resources Information Center

    Huber, Jessica E.; Stathopoulos, Elaine T.

    2003-01-01

    Researchers have hypothesized that the respiratory and laryngeal speech subsystems would respond to an air pressure bleed, but these responses have not been empirically studied. The present study examined the nature of the responses of the respiratory and laryngeal subsystems to an air pressure bleed in order to provide information relevant to the…

  15. MicroRNAs in laryngeal cancer: implications for diagnosis, prognosis and therapy

    PubMed Central

    Li, Pei; Liu, Hui; Wang, Zhiyuan; He, Feng; Wang, Haifeng; Shi, Zhi; Yang, Ankui; Ye, Jin

    2016-01-01

    Laryngeal cancer is the most common head and neck cancer (skin excluded) with the increasing rates of morbidity and mortality in the world. The emerging roles of microRNAs (miRs) in laryngeal cancer have been deeply investigated in recent years. Deregulated miRs are frequently detected in tissues and cells of laryngeal cancer, which work as oncogenes or tumor supressors to regulate cancer cell proliferation, metastasis and invasion, etc. Here we reviewed the recognized roles of miRs in the diagnosis, prognosis and therapy of laryngeal cancer. Although there are lots of challenges in miRs including sensitivity, specificity, accuracy and safety, the growing improvements of miRs in laryngeal cancer remain encouraging and promising. PMID:27347304

  16. Molecular cloning and characterization of human papilloma virus DNA derived from a laryngeal papilloma.

    PubMed Central

    Gissmann, L; Diehl, V; Schultz-Coulon, H J; zur Hausen, H

    1982-01-01

    Papilloma virus DNA from a laryngeal papilloma was cloned in phage lambda L 47 and characterized after cleavage with different restriction enzymes. Hybridization with the DNAs of human papilloma virus types 1, 2, 3, 4, 5, and 8 showed no homology under stringent hybridization conditions. Human papilloma virus type 6 DNA, however, was partially identical to laryngeal papilloma virus DNA; different restriction enzyme fragments hybridizing with the other DNA were identified on each genome. The degree of homology was determined by reassociation kinetics to be 25%. According to the present nomenclature, laryngeal papilloma virus therefore represents a different type of human papilloma virus and is tentatively designated as human papilloma virus type 11. Sequences homologous to laryngeal papilloma virus DNA were also found in four of nine additional laryngeal papillomas. Attempt to detect homologous DNA in 12 carcinomas of the larynx were negative. Images PMID:6292500

  17. Value of a bipolar modified inferior lead in detection of inferior myocardial ischaemia.

    PubMed Central

    Jespersen, C M; Rasmussen, V

    1988-01-01

    Only bipolar leads are normally available for ambulatory monitoring. Bipolar precordial leads are reliable for detecting left coronary artery insufficiency, but may not detect changes caused by right coronary artery insufficiency. The magnitude and polarity of ST segment changes in a bipolar modified inferior lead and in CM5 were compared with those in standard electrocardiographic leads in 10 consecutive patients with acute myocardial infarction (eight inferior and two anteroseptal). The polarity of the ST segment in the modified orthogonal y lead was the same as that in aVF in all eight patients with inferior myocardial infarction and in six the size of the ST segment shift was identical in the two leads as well. In two patients the ST segment shift was larger in the modified orthogonal y lead than in aVF. In one of the two patients with anteroseptal myocardial infarction the polarity of the ST segment shift was the same in the modified orthogonal y lead and aVF. In the other patient it was slightly different. The CM5 lead did not reliably detect inferior myocardial ischaemia. A modified orthogonal y lead is suitable for the detection of inferior myocardial ischaemia. PMID:3190957

  18. Myeloid sarcoma: An unusual and rare laryngeal presentation

    PubMed Central

    Tan, S.N.; Gendeh, H.S.; Sani, A.; Mat-Baki, M.

    2016-01-01

    Introduction Myeloid Sarcoma (MS) or Granulocytic Sarcoma is an uncommon laryngeal malignancy. It may arise from myelodysplastic syndromes, malignancy or de novo. Presentation in the larynx is rare and some may present with Acute Myeloid Leukaemia (AML) whereby the later may be asymptomatic. Case Presentation A 44-year-old South East Asian lady presented with a six months history of hoarseness, shortness of breath, reduced exercise tolerance, weight loss and laryngeal irritation. Symptoms progressed to coughing with liquids two months prior. On examination, she had a resting biphasic stridor and laryngoscopy revealed right immobile vocal cord with a firm right ventricle mass extending into the right paraglottic space. She was pale and haematology investigations revealed microcytic hypochromic anaemia. Magnetic Resonance Imaging (MRI) of the neck and thorax showed thickening of the right false cord, true cord and aryepiglottic fold. A biopsy taken during endolaryngeal microsurgery (ELMS) confirmed myeloid sarcoma of the right ventricle and para glottic mass. Further investigation revealed a background of AML and she then underwent chemotherapy. Discussion MS is a rarity with only nine reported cases between the years of 1954 until 2015. Immunohistochemistry and immunophenotyping are definite for diagnosis confirmation as MS cells often exhibit myeloperoxidase (MPO), lymphocyte common antigen (LCA) and CD117 markers. MS is treated with are chemotherapy (either systemic or intrathecal), radiotherapy, surgical excision or in combination. Systemic chemotherapy has better efficacy and prognosis as compared to localised treatment of radiotherapy or surgical excision. However, there has yet to be a definitive chemotherapy protocol. Prognosis is poor with a 5-year survival rate of 48%. Conclusion Although laryngeal MS is a rare phenomenon, early recognition is key and patients should always be investigated for an underlying myeloproliferative or dysplastic disease. PMID

  19. Laryngeal myofibroblastic tumor: case series and literature review

    PubMed Central

    Alhumaid, Humaid; Bukhari, Manal; Rikabi, Ammar; Farahat, Mohamad; Mesallam, Tamer A.; Malki, Khalid H.; Aldkhyyal, Ahmed

    2011-01-01

    Inflammatory myofibroblastic tumor (IMT) or (plasma cell granuloma) of the larynx is a rare benign lesion that usually involves the lungs and broncopulmonary tree, as well as abdominal viscera. Overall this kind of tumor represents less than 1% of all tumors in the lung and respiratory tract with only 31 cases reported to date in the English language literature of laryngeal IMT. We report the first 2 cases in Saudia Arabia of IMT of the larynx treated at King Abdulaziz University Hospital (KAUH) with literature review. PMID:23267296

  20. Laryngeal involvement in Behcet's disease--a challenge for treatment.

    PubMed

    Gross, Menachem; Ben-Chetrit, Eldad

    2013-03-01

    A patient with severe Behcet's disease (BD) was referred to our clinic because of severe pharyngolaryngeal involvement. This complication developed under treatment of prednisone and etanercept (Enbrel) 25 mg twice a week. A surgical approach was considered, but following three daily doses of Solu-Medrol (500 mg each) and 300 mg infliximab on the fourth day, the patient improved significantly. This is the first case reporting treatment with infliximab in laryngeal involvement of BD. Although some cases may still require surgical intervention, the therapeutic option of anti-TNF agents, specifically anti-TNF antibodies such as infliximab, may decrease the need for the surgical option. PMID:20532579

  1. [Diagnosis of para-laryngeal tumors using computerized tomography].

    PubMed

    Höing, R

    1990-04-01

    Computed tomography of the larynx is generally recommended for carcinoma, laryngoceles, and laryngeal trauma. On the basis of several case examples, in which dysphagia and hoarseness were caused by a submucosal thickening of the arytenoid and aryepiglottic fold, the authors propose that these unclear symptoms also be regarded as indication for larynx CT. It must be borne in mind that the underlying process may be one of the rare tumors in the space between the thyroid cartilage and elastic cone, often called the paraglottic space (or paralaryngeal space, by many American authors). PMID:2162176

  2. Raman spectroscopy for optical diagnosis of laryngeal cancer

    NASA Astrophysics Data System (ADS)

    Teh, Seng Khoon; Zheng, Wei; Lau, David P.; Huang, Zhiwei

    2008-02-01

    In this report, the diagnostic ability of near-infrared (NIR) Raman spectroscopy for identifying the malignant tumors from normal tissues in the larynx was studied. A rapid NIR Raman system was utilized. Multivariate statistical techniques were employed to develop effective diagnostic algorithms. Raman spectra in the range of 800-1,800 cm-1 differed significantly between normal and malignant tumor tissues. The diagnostic algorithms can yielded a diagnostic sensitivity of 92.9% and specificity 83.3% for separating malignant tumors from normal laryngeal tissues. NIR Raman spectroscopy with multivariate statistical techniques has a potential for the non-invasive detection of malignant tumors in the larynx.

  3. Intraoperative photodynamic therapy in laryngeal part of pharynx cancers

    NASA Astrophysics Data System (ADS)

    Loukatch, Erwin V.; Trojan, Vasily; Loukatch, Vjacheslav

    1996-12-01

    In clinic intraoperative photodynamic therapy (IPT) was done in patients with primal squamous cells cancer of the laryngeal part of the pharynx. The He-Ne laser and methylene blue as a photosensibilizator were used. Cobalt therapy in the postoperative period was done in dose 45 Gr. Patients of control groups (1-th group) with only laser and (2-th group) only methylene blue were controlled during three years with the main group. The statistics show certain differences of recidives in the main group compared to the control groups. These facts are allowing us to recommend the use of IPT as an additional method in ENT-oncology diseases treatment.

  4. A case of laryngeal leiomyosarcoma and review of the literature

    PubMed Central

    Selçuk, Ömer Tarik; Renda, Levent; Erol, Bekir; Osma, Üstün; Eyigor, Hülya; Öztürk, Hülya

    2015-01-01

    Leiomyosarcoma (LMS) of the larynx is a very rare malignancy that originates from blood vessel, smooth muscle or from the heterotopic mesenchymal tissue in the larynx. The histological diagnosis of LMS depends on the immunohistochemical investigation. The case is here presented of an 82-year-old man with shortness of breath and hoarseness. Indirect laryngoscopy showed a pedunculated large glottic lesion causing airway obstruction. Direct laryngoscopy was performed and biopsies were taken. From the pathological examination, the diagnosis of LMS was made. This case is presented of laryngeal LMS with the clinical, radiological, and histological findings. PMID:26981488

  5. Monitoring the morphochemistry of laryngeal carcinoma by multimodal imaging

    NASA Astrophysics Data System (ADS)

    Meyer, Tobias; Krafft, Christoph; Guntinas-Lichius, Orlando; von Eggeling, Ferdinand; Ernst, Günther; Dietzek, Benjamin; Popp, Jürgen

    2012-01-01

    Multimodal nonlinear imaging constitutes a contemporary approach to investigate the morphochemistry of complex samples noninvasively and without administration of external labels. Here we discuss our recent success in jointly using various nonlinear microspectroscopic approaches such as coherent anti-Stokes Raman scattering (CARS), two-photon fluorescence (TPF) and second-harmonic generation (SHG) to study the chemical composition of surgically removed tissue sections from laryngeal carcinoma. In particular it will be shown how multimodal nonlinear imaging can be employed to study the structural and chemical development of disease formation as well as to monitor the clinically important aspect of tumor boundary detection.

  6. The quality of voice in patients irradiated for laryngeal carcinoma

    SciTech Connect

    Karim, A.B.; Snow, G.B.; Siek, H.T.; Njo, K.H.

    1983-01-01

    Data from 150 patients with laryngeal carcinoma, consecutively treated primarily by radiotherapy from 1965 through 1974 was analyzed to assess the quality of voice. The voice appears to improve in majority of the successfully irradiated patients. In 76% of the evaluable patients in this group, the quality of voice appears to have attained normalcy or near normalcy. Smoking appears to have a negative influence. High incidence of bronchogenic carcinoma along with the negative influence of smoking on the quality of voice in this series of patients indicate that the patients should be advised against smoking in day-to-day clinical practice.

  7. [Experimental subendocardial postero-inferior infarctions].

    PubMed

    Medrano, G A; de Micheli, A

    1990-01-01

    In 30 mongrel dog hearts, epicardial and thoracic unipolar records were obtained after myocardial damage was produced by infiltration of 96% alcohol in the postero-inferior free left ventricular wall. Necrosis was transmural in 5 cases, subendocardial in 11 and intramural in 10. In 4 dogs, intramural unipolar and bipolar leads were recorded in order to determine the electrical subendocardium and its relation to potentials of Purkinje's fibres. At the end of each experiment, left posterior subdivision block (LPSB) was provoked. In 90% of the cases, direct epicardial records were QS in transmural infarction, qrS or less frequently QRS in subendocardial ones, and rS or qRS in the presence of intramural necrosis. In several cases myocardial necrosis was located in the middle third instead of the inferior third, but the direct registries were similar. Nevertheless the surface leads (II, III and aVF) did not show abnormal Q waves or greater voltage of Q and S, but there were RS complexes in V1 and V2. In 80% of the cases, transmural necrosis of inferior third was manifested by QS complexes and subendocardial necrosis by rS or qRS complexes with increased Q and S waves and reduced R waves. LPSB masked the signs of necrosis. There is no justification for speaking of myocardial infarction with or without abnormal Q waves, because it does not add more precision. Moreover these expressions can create confusion in cases of middle or high posterior myocardial necrosis, revealed by RS complexes in V1 and V2. PMID:2268169

  8. p53 codon 72 polymorphism and its overexpression in patients with laryngeal carcinoma: Prognostic implications.

    PubMed

    Kalsotra, Gopika; Gupta, Ashok K; Gupta, Rijuneeta; Rathi, Ritu; Prasad, Rajender

    2016-06-01

    Abnormalities in the p53 gene are the most common genetic alterations seen in laryngeal carcinoma. No data exist regarding the association between laryngeal carcinoma and a distinct codon 72 variant and its expression. We conducted a prospective study (1) to analyze the p53 codon 72 polymorphic variants in patients with laryngeal carcinoma, (2) to analyze the expression of p53 mRNA in tissues of patients with laryngeal carcinoma using the reverse transcriptase-polymerase chain reaction (RT-PCR) assay, and (3) to detect p53 antibodies in the plasma of patients with laryngeal carcinoma before and after treatment. Tissue and blood samples were taken from 40 patients with laryngeal carcinoma-36 men and 4 women, aged 40 to 65 years (mean: 56)-and 20 age-matched controls with laryngeal conditions other than carcinoma. RT-PCR was used to measure p53 mRNA expression, and PCR-restriction fragment length polymorphism was used to determine p53 polymorphism. In addition, p53 antibodies were detected in plasma by Western blot testing. The 40 patients were treated with either surgery (total laryngectomy or conservation surgery) or radiotherapy. Tissue and blood samples were analyzed before treatment and 4 weeks after treatment. The findings were compared with those of the 20 controls. The results revealed that (1) homozygosity of the Pro72 variant of p53 was present in 26 laryngeal carcinoma patients (65%), (2) heterozygosity for the Pro/Arg genotype was present in 13 patients (32.5%), and (3) the Arg72 variant of the p53 allele was present in 1 patient (2.5%) before treatment. Overexpression of p53 mRNA was found in all patients with laryngeal carcinoma and in none of the controls before treatment; the difference was approximately 3.3 folds higher in the carcinoma group. However, p53 expression was not related to the biologic aggressiveness of these tumors. It is interesting that 4 weeks after definitive therapy, the expression levels of p53 mRNA in the 40 patients were

  9. Quantitative proteomics approach to screening of potential diagnostic and therapeutic targets for laryngeal carcinoma.

    PubMed

    Li, Li; Zhang, Zhenwei; Wang, Chengyu; Miao, Lei; Zhang, Jianpeng; Wang, Jiasen; Jiao, Binghua; Zhao, Shuwei

    2014-01-01

    To discover candidate biomarkers for diagnosis and detection of human laryngeal carcinoma and explore possible mechanisms of this cancer carcinogenesis, two-dimensional strong cation-exchange/reversed-phase nano-scale liquid chromatography/mass spectrometry analysis was used to identify differentially expressed proteins between the laryngeal carcinoma tissue and the adjacent normal tissue. As a result, 281 proteins with significant difference in expression were identified, and four differential proteins, Profilin-1 (PFN1), Nucleolin (NCL), Cytosolic non-specific dipeptidase (CNDP2) and Mimecan (OGN) with different subcellular localization were selectively validated. Semiquantitative RT-PCR and Western blotting were performed to detect the expression of the four proteins employing a large collection of human laryngeal carcinoma tissues, and the results validated the differentially expressed proteins identified by the proteomics. Furthermore, we knocked down PFN1 in immortalized human laryngeal squamous cell line Hep-2 cells and then the proliferation and metastasis of these transfected cells were measured. The results showed that PFN1 silencing inhibited the proliferation and affected the migration ability of Hep-2 cells, providing some new insights into the pathogenesis of PFN1 in laryngeal carcinoma. Altogether, our present data first time show that PFN1, NCL, CNDP2 and OGN are novel potential biomarkers for diagnosis and therapeutic targets for laryngeal carcinoma, and PFN1 is involved in the metastasis of laryngeal carcinoma. PMID:24587265

  10. Quantitative Proteomics Approach to Screening of Potential Diagnostic and Therapeutic Targets for Laryngeal Carcinoma

    PubMed Central

    Wang, Chengyu; Miao, Lei; Zhang, Jianpeng; Wang, Jiasen; Jiao, Binghua; Zhao, Shuwei

    2014-01-01

    To discover candidate biomarkers for diagnosis and detection of human laryngeal carcinoma and explore possible mechanisms of this cancer carcinogenesis, two-dimensional strong cation-exchange/reversed-phase nano-scale liquid chromatography/mass spectrometry analysis was used to identify differentially expressed proteins between the laryngeal carcinoma tissue and the adjacent normal tissue. As a result, 281 proteins with significant difference in expression were identified, and four differential proteins, Profilin-1 (PFN1), Nucleolin (NCL), Cytosolic non-specific dipeptidase (CNDP2) and Mimecan (OGN) with different subcellular localization were selectively validated. Semiquantitative RT-PCR and Western blotting were performed to detect the expression of the four proteins employing a large collection of human laryngeal carcinoma tissues, and the results validated the differentially expressed proteins identified by the proteomics. Furthermore, we knocked down PFN1 in immortalized human laryngeal squamous cell line Hep-2 cells and then the proliferation and metastasis of these transfected cells were measured. The results showed that PFN1 silencing inhibited the proliferation and affected the migration ability of Hep-2 cells, providing some new insights into the pathogenesis of PFN1 in laryngeal carcinoma. Altogether, our present data first time show that PFN1, NCL, CNDP2 and OGN are novel potential biomarkers for diagnosis and therapeutic targets for laryngeal carcinoma, and PFN1 is involved in the metastasis of laryngeal carcinoma. PMID:24587265

  11. Laryngeal reflex responses are not modulated during human voice and respiratory tasks

    PubMed Central

    Henriquez, Victor M; Schulz, Geralyn M; Bielamowicz, Steven; Ludlow, Christy L

    2007-01-01

    The laryngeal adductor response (LAR) is a protective reflex that prevents aspiration and can be elicited either by electrical stimulation of afferents in the superior laryngeal nerve (SLN) or by deflection of mechanoreceptors in the laryngeal mucosa. We hypothesized that because this reflex is life-sustaining, laryngeal muscle responses to sensory stimuli would not be suppressed during volitional laryngeal tasks when compared to quiet respiration. Unilateral electrical superior laryngeal nerve stimulation was used to elicit early (R1) and late (R2) responses in the ipsilateral thyroarytenoid muscle in 10 healthy subjects. The baseline levels of muscle activity before stimulation, R1 and R2 response occurrence and the integrals of responses were measured during each task: quiet inspiration, prolonged vowels, humming, forced inhalation and effort closure. We tested whether R1 response integrals during tasks were equal to either: (1) baseline muscle activity during the task added to the response integral at rest; (2) the response integral at rest minus the baseline muscle activity during the task; or (3) the response integral at rest. R1 response occurrence was not altered by task from rest while fewer R2 responses occurred only during effort closure and humming compared to rest. Because the R1 response integrals did not change from rest, task increases in motor neuron firing did not alter the LAR. These findings demonstrate that laryngeal motor neuron responses to sensory inputs are not gated during volitional tasks confirming the robust life-sustaining protective mechanisms provided by this airway reflex. PMID:17962327

  12. Functional organ preservation in laryngeal and hypopharyngeal cancer

    PubMed Central

    Ambrosch, Petra; Fazel, Asita

    2012-01-01

    The principles of open versus laser microsurgical approaches for partial resections of the larynx are described, oncologic as well as functional results discussed and corresponding outcomes following primary radiotherapy are opposed. Over the last decade, the endoscopic partial resection of the larynx has developed to an accepted approach in the treatment of early glottic and supraglottic carcinomas thus leading to a remarkable decline in the use of open surgery. Comparing the various surgical approaches of laryngeal partial resections, the oncological outcome of the patients, as far as survival and organ preservation are concerned, are comparable, whereas functional results of the endoscopic procedures are superior with less morbidity. The surgical procedures put together, are all superior to radiotherapy concerning organ preservation. Transoral laser microsurgery has been used successfully for vocal cord carcinomas with impaired mobility or fixation of the vocal cord, supraglottic carcinomas with infiltration of the pre- and/or paraglottic space as well as for selected hypopharyngeal carcinomas. It has been well documented that laser microsurgery achieves good oncological as well as functional results with reasonable morbidity. However, patients with those tumours have been successfully treated by open partial resections of the larynx at medical centres with appropriate expertise. The initially enthusiastic assessment of study results concerning the efficacy of various protocols of chemoradiation with the intent of organ preservation for laryngeal and hypopharyngeal carcinomas are judged more cautious, today, due to recent reports of rather high rates of late toxicity complications. PMID:22558052

  13. Fiber components of the recurrent laryngeal nerve in the cat.

    PubMed

    Gacek, R R; Lyon, M J

    1976-01-01

    Experimental neuroanatomical methods were employed in 21 adult cats to determine 1) the number and size of myelinated motor and sensory fibers in the recurrent laryngeal nerve (RLN), and 2) the fiber components originating in the nucleus ambiguus (NA) and retrofacial nucleus (RFN) of the brain stem. Intracranial transection of the X and XI cranial nerves and selective destruction of the NA or RFN were the experimental lesions inflicted in order to obtain the following results. About 55% (312) of the right RLN (565 fibers) is composed of myelinated motor nerve fibers which measure 4 mu - 9 mu in diameter. Nine percent come from the RFN and are smaller (4-6 mu) than the 46% which emanate from the NA and measure 6-9 mu in diameter. The remaining 45% of the RLN is made up of sensory neurons which can be divided into three groups. 1) The largest numerical group (32%) is very small in caliber (1-3 mu) and supplies extralaryngeal regions (trachea, esophagus). 2) The intermediate size fiber group (4-9 mu) comprises 11% of the RLN and probably supplies the subglottic mucosa. 3) The smallest group (2%) of sensory fibers is the largest in diameter (10-15 mu) and may represent either the innervation of muscle spindles or afferents from the superior laryngeal nerve coursing down into the chest. PMID:949153

  14. Intraglottal geometry and velocity measurements in canine larynges

    PubMed Central

    Oren, Liran; Khosla, Sid; Gutmark, Ephraim

    2014-01-01

    Previous flow velocity measurements during phonation in canine larynges were done above the glottal exit. These studies found that vortical structures are present in the flow above the glottis at different phases of the glottal cycle. Some vortices were observed to leave the glottis during the closing phase and assumptions were proposed regarding their formation mechanism. In the current study, intraglottal velocity measurements are performed using PIV, and the intraglottal flow characteristics are determined. Results from five canine larynges show that at low subglottal pressure the glottis assumes a minimal divergence angle during closing and the flow separates at the glottal exit. Vortical structures are observed above the glottis but not inside. As the subglottal pressure is increased, the divergence angle between the folds during closing increases and the location of the flow separation moves upstream into the glottis. Entrainment flow enters the glottis to fill the void that is formed between the glottal jet and the fold. Vortical structures develop near the superior edge at medium and high subglottal pressures from the flow separation. The magnitude of their swirling strength changes as a function of the wall dynamics. PMID:24437778

  15. Multifunctional laryngeal motoneurons: an intracellular study in the cat.

    PubMed

    Shiba, K; Satoh, I; Kobayashi, N; Hayashi, F

    1999-04-01

    We studied the patterns of membrane potential changes in laryngeal motoneurons (LMs) during vocalization, coughing, swallowing, sneezing, and the aspiration reflex in decerebrate paralyzed cats. LMs, identified by antidromic activation from the recurrent laryngeal nerve, were expiratory (ELMs) or inspiratory (ILMs) cells that depolarized during their respective phases in eupnea. During vocalization, most ELMs depolarized and most ILMs hyperpolarized. Some ILMs depolarized slightly during vocalization. During coughing, ELMs depolarized abruptly at the transition from the inspiratory to the expiratory phase. In one-third of ELMs, this depolarization persisted throughout the abdominal burst. In the remainder ("type A"), it was interrupted by a transient repolarization. ILMs exhibited a membrane potential trajectory opposite to that of type A ELMs during coughing. During swallowing, the membrane potential of ELMs decreased transiently at the onset of the hypoglossal burst and then depolarized strongly during the burst. ILMs hyperpolarized sharply at the onset of the burst and depolarized as hypoglossal activity ceased. During sneezing, ELMs and ILMs exhibited membrane potential changes similar to those of type A ELMs and ILMs during coughing. During the aspiration reflex, ELMs and ILMs exhibited bell-shaped hyperpolarization and depolarization trajectories, respectively. We conclude that central drives to LMs, consisting of complex combinations of excitation and inhibition, vary during vocalization and upper airway defensive reflexes. This study provides data for analysis of the neuronal networks that produce these various behaviors and analysis of network reorganization caused by changes in dynamic connections between the respiratory and nonrespiratory neuronal networks. PMID:10087084

  16. Laryngeal cancer and occupational exposure to sulfuric acid

    SciTech Connect

    Soskolne, C.L.; Zeighami, E.A.; Hanis, N.M.; Kupper, L.L.; Herrmann, N.; Amsel, J.; Mausner, J.S.; Stellman, J.M.

    1984-09-01

    Workers on an ethanol unit which used sulfuric acid in strong concentrations at a large refinery and chemical plant in Baton Rouge, Louisiana were reported in 1979, at excess risk for upper respiratory cancer. The carcinogen implicated by indirect evidence was diethyl sulfate. However, with the continued use of sulfuric acid in the same plant, and with additional cases not attributable to the ethanol process, the hypothesis of an association between sulfuric acid exposure and upper respiratory cancer was tested. Each of 50 confirmed cases of upper respiratory cancer diagnosed between 1944 and 1980, was matched to at least three controls on sex, race, age, date of initial employment, and duration of employment. Thrity-four of the 50 cases were laryngeal cancers. Data were obtained from existing plant records. Retrospective estimates of exposure were made without regard to case or control status. Findings from conditional logistic regression techniques were supported by other statistical methods. Among workers classified as potentially highly exposed, four-fold relative risks for all upper respiratory cancer sites combined were exceeded by the relative risk for laryngeal cancer specifically. Exposure-response and consistency across various comparisons after controlling statistically for tobacco-use, alcoholism and other previously implicated risk factors, suggest increased cancer risk with higher exposure.

  17. Radiotherapy of advanced laryngeal cancer using three small fractions daily

    SciTech Connect

    Bradley, P.J.; Morgan, D.A. )

    1991-06-01

    Since 1983, the authors have treated advanced (UICC stages 3 and 4) squamous carcinomas of the larynx by primary radiotherapy, using three small fractions a day, 3-4 h interfraction interval, 5 days per week. The early patients received doses per fraction of 1.5 Gy, and a total dose of approximately 70 Gy, given as a split-course over 6 to 7 weeks. While overall tumor control and laryngeal preservation was good, a number of severe late radiation reactions were seen. The schedule was then modified, with a reduction in the fraction size to 1.1 Gy, the total dose to 60 Gy, and the overall time to 4 weeks, with omission of the mid-treatment split. Since 1986, we have treated 26 patients in this way. Acute reactions are brisk, but rapidly healing. Loco-regional control was achieved in 22 patients, only one of whom has relapsed to date, in a solitary node, salvaged by radical neck dissection. Four have died of uncontrolled loco-regional malignancy, and three of intercurrent disease while in clinical remission. No serious late morbidity has been observed in surviving patients, and vocal quality is good in the majority. These results suggest that this hyperfractionated and accelerated radiotherapy schedule may offer an acceptable nonsurgical, voice-preserving treatment for advanced laryngeal carcinoma; it can be used in a normally working radiotherapy department.

  18. Coordination of oral cavity and laryngeal movements during swallowing.

    PubMed

    Gay, T; Rendell, J K; Spiro, J; Mosier, K; Lurie, A G

    1994-07-01

    In this study, dynamic imaging was used to track the movements of oral cavity and laryngeal structures during swallowing in 10 normal adults subjects. The movements of tiny lead pellet markers attached to the lips, tongue, mandible, and soft palate, as well as anatomic landmarks on the hyoid bone, were measured in relation to a reference pellet affixed to the upper central incisors. Sagittal views of the oral cavity were obtained using standard videofluorography. Each subject produced 10 swallows of 12 ml of tap water followed by 5 swallows with a bite block placed between the molars. The recorded video images were input to a microcomputer where the x- and y-coordinates of the pellets were measured. Results of the analyses revealed considerable temporal overlap in the timing of oral cavity and laryngeal movements, widespread individual variability in coordination patterns and movement trajectories, and selective effects of the bite block. These data suggest the existence of individual adaptive strategies in the programming and control of swallowing movements. PMID:7961257

  19. Acoustic Analysis Before and After Voice Therapy for Laryngeal Pathology.

    PubMed

    Chhetri, S S; Gautam, R

    2015-01-01

    Background Voice problems caused by pathologies in vocal folds are well known. Some types of laryngeal pathologies have certain acoustic characteristics. Objective evaluation helps characterize the voice and voice problems providing supporting evidences, severity of disorders. It helps assess the response to the treatment and measures the outcomes. Objective The objective of the study is to determine the effectiveness of the voice therapy and quantify the results objectively by voice parameters. Method Study includes 61 patients who presented with different types of laryngeal pathologies. Acoustic analyses and voice assessment was done with Dr. Speech ver 4 (Tiger DRS Inc.). Acoustic parameters including fundamental frequency, jitters, shimmers, Harmonic to noise ratio (HNR), Normalized noise energy (NNE) were analyzed before and after voice therapy. Result Bilateral vocal nodules were the most common pathologies comprising 44.26%. All acoustic parameters showed a significant difference after the therapy (p<0.05) except for NNE. Dysphonia due to vocal fold polyp showed no improvement even after voice therapy (p>0.05). Conclusion Acoustic analysis provides an objective, recordable data regarding the voice parameters and its pathologies. Though, few pathology require alternative therapy rather than voice therapy, overall it has a good effect on glottic closure. As the voice therapy can improve the different indices of voice, it can be viewed as imperative part of treatment and to monitor progression. PMID:27423282

  20. Voice quality following laryngeal reinnervation by ansa hypoglossi transfer.

    PubMed

    Crumley, R L; Izdebski, K

    1986-06-01

    Recurrent laryngeal nerve injury resulting in chronic unilateral vocal fold paralysis has been treated traditionally by implantation of various materials into the paralyzed vocal fold. Although the usage of these techniques, especially Teflon-glycerin paste injection, has been clinically established, they do not restore full functionality to the larynx (abduction, adduction, and vibratory synchronization of the vocal folds). Restoration of these functions, necessary for improved phonation, has been achieved at least on an experimental basis by reinnervation techniques previously described. This study demonstrates excellent human voice quality following reinnervation of the vocal folds in two cases using ansa hypoglossi-recurrent laryngeal nerve anastomosis. Although the reinnervated vocal fold neither abducted nor adducted, it presented itself in the midline for precise apposition with the nonparalyzed cord. Voice data were analyzed within a single subject experimental design at the following intervals; preoperatively, immediately postoperatively, midterm, and long-term (3 and 6 years). The data was analyzed by subjective and objective means, including acoustics and electroglottography. Patient selection, surgical techniques, results, and implications are reviewed. PMID:3713403

  1. Automated speech analysis applied to laryngeal disease categorization.

    PubMed

    Gelzinis, A; Verikas, A; Bacauskiene, M

    2008-07-01

    The long-term goal of the work is a decision support system for diagnostics of laryngeal diseases. Colour images of vocal folds, a voice signal, and questionnaire data are the information sources to be used in the analysis. This paper is concerned with automated analysis of a voice signal applied to screening of laryngeal diseases. The effectiveness of 11 different feature sets in classification of voice recordings of the sustained phonation of the vowel sound /a/ into a healthy and two pathological classes, diffuse and nodular, is investigated. A k-NN classifier, SVM, and a committee build using various aggregation options are used for the classification. The study was made using the mixed gender database containing 312 voice recordings. The correct classification rate of 84.6% was achieved when using an SVM committee consisting of four members. The pitch and amplitude perturbation measures, cepstral energy features, autocorrelation features as well as linear prediction cosine transform coefficients were amongst the feature sets providing the best performance. In the case of two class classification, using recordings from 79 subjects representing the pathological and 69 the healthy class, the correct classification rate of 95.5% was obtained from a five member committee. Again the pitch and amplitude perturbation measures provided the best performance. PMID:18346812

  2. Podoplanin expression in the development and progression of laryngeal squamous cell carcinomas

    PubMed Central

    2010-01-01

    Background Podoplanin expression is attracting interest as a marker for cancer diagnosis and prognosis. We therefore investigated the expression pattern and clinical significance of podoplanin during the development and progression of laryngeal carcinomas. Results Podoplanin expression was determined by immunohistochemistry in paraffin-embedded tissue specimens from 84 patients with laryngeal premalignancies and 53 patients with laryngeal squamous cell carcinomas. We found podoplanin expression extending from the basal to the suprabasal layer of the epithelium in 37 (44%) of 84 dysplastic lesions, whereas normal epithelium showed negligible expression. Patients carrying podoplanin-positive lesions had a higher laryngeal cancer incidence than those with negative expression reaching borderline statistical significance (51% versus 30%, P = 0.071). Podoplanin expression in laryngeal carcinomas exhibited two distinct patterns. 20 (38%) cases showed diffuse expression in most tumour cells and 33 (62%) focal expression at the proliferating periphery of tumour nests. High podoplanin expression was inversely correlated with T classification (P = 0.033), disease stage (P = 0.006), and pathological grade (P = 0.04). There was a trend, although not significant, towards reduced disease-specific survival for patients with low podoplanin levels (P = 0.31) and diffuse expression pattern (P = 0.08). Conclusions Podoplanin expression increases in the early stages of laryngeal tumourigenesis and it seems to be associated with a higher laryngeal cancer risk. Podoplanin expression in laryngeal squamous cell carcinomas, however, diminishes during tumour progression. Taken together, these data support a role for podoplanin expression in the initiation but not in the progression of laryngeal cancers. PMID:20196862

  3. Is papillomavirus detectable in the plume of laser-treated laryngeal papilloma

    SciTech Connect

    Abramson, A.L.; DiLorenzo, T.P.; Steinberg, B.M. )

    1990-05-01

    The carbon dioxide laser is widely used for the vaporization of lesions in patients with laryngeal papillomatosis. In this study, the smoke plume resulting from the laser treatment of laryngeal papillomas was analyzed for the presence of human papillomavirus DNA. Plumes were collected with a suction tip and trapped in phosphate-buffered saline. The aspirates were then analyzed for the presence of human papillomavirus DNA by Southern blot hybridization. Human papillomavirus DNA cannot be detected in the smoke plume from vaporization of laryngeal papillomas unless direct suction contact is made with the papilloma tissue during surgery. The implications of these findings are discussed.

  4. [Two further cases of rare laryngeal tumors. Lipoma and chemodectoma (author's transl)].

    PubMed

    Basset, J M; Paraire, F; François, M; Fleury, P

    1982-01-01

    The cases of laryngeal tumors requiring surgical excision are presented. The first case was that of patient with a laryngeal lipoma of atypical appearance, histological findings suggesting a hamartoma. The second patient had a chemodectoma, diagnosis being difficult but facilitated by super-selective arteriography, requiring delicate excision which was almost bloodless as a result of previous embolization. Clinical and pathological features of these tumors reviewed, and problems related to their treatment discussed. The authors have previously reported 4 other rare types of laryngeal tumor. PMID:6285794

  5. Anatomic Variant of Liver, Gall Bladder and Inferior Vena Cava

    PubMed Central

    Gladwin, V.; Chand, Parkash

    2016-01-01

    The morphology and relations of liver, gall bladder and inferior vena cava are cardinal. Their anatomical variations may be a reason for the adverse surgical outcome. During routine anatomy dissection of an abdomen, we noticed a variant liver, gall bladder and inferior vena cava in a 63-year-old male cadaver. In the specimen, a retrohepatic segment of inferior vena cava was found to be intrahepatic. On dissection, it was observed that inferior vena cava was covered entirely by a liver tissue on its dorsal aspect. In the same specimen, the gall bladder had undulated inferior surface. On dissection of the gall bladder, numerous mucosal folds were present in the interior. A band of fibrous tissue was found, which was extending from the right side of the gall bladder to the falciform ligament. Hence, preoperative scanning of congenital variations of the liver, gall bladder and inferior vena cava may be compassionate in planning safe surgeries and interventional abdominal procedures.

  6. Injuries of the inferior vena cava.

    PubMed

    Burch, J M; Feliciano, D V; Mattox, K L; Edelman, M

    1988-12-01

    Beginning in 1946, 577 patients with inferior vena cava injuries were managed at a single institution. After decreasing from 37 to 30 percent, the mortality rate showed a distinct increase in the last 7 years studied. This increase was related to an increasing percentage of patients who arrived in the emergency center in severe shock and required resuscitative thoracotomy. In-hospital care advances have not kept pace with improvements in prehospital care. Although venous complications have not been infrequent, morbidity has not been a significant long-term problem. Fatal pulmonary embolism occurred and was a special problem for patients over the age of 50. More basic research is needed to expedite diagnosis and vascular control in addition to understanding and treating the severe metabolic problems of patients dying from shock and hemorrhage. PMID:3202271

  7. Bilateral inferior petrosal sinus sampling using vasopressin

    PubMed Central

    Kotwal, Narendra; Kumar, Yogesh; Upreti, Vimal; Singh, Amandeep; Garg, M. K.

    2016-01-01

    Context: Anatomical localization of pituitary adenoma can be challenging in adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome, and bilateral inferior petrosal sinus sampling (BIPSS) is considered gold standard in this regard. Stimulation using corticotrophin-releasing hormone (CRH) improves the sensitivity of BIPSS, however, same is not easily available in India. Therefore, we undertook this study of BIPPS using vasopressin as agent for stimulation owing to its ability to stimulate V3 receptors present on corticotrophs. Aims: To study the tumor localization and lateralization in difficult to localize cases of ACTH-dependent Cushing's syndrome by bilateral inferior petrosal sinus sampling using vasopressin for corticotroph stimulation. Settings and Design: Prospective observational study. Subjects and Methods: Six patients (5 females) meeting inclusion criteria underwent BIPSS using vasopressin for stimulation. Results: All six patients had nonsuppressible overnight and low dose dexamethasone suppression test with elevated plasma ACTH levels suggestive of ACTH-dependent Cushing's syndrome. High dose dexamethasone suppression test showed suppressible cortisol in two cases, and microadenoma was seen in two patients on magnetic resonance imaging pituitary. Contrast enhanced computed tomography of the abdomen showed left adrenal hyperplasia in one case and anterior mediastinal mass with bilateral adrenal hyperplasia another. Using BIPSS four patients were classified as having Cushing's disease that was confirmed histopathologically following surgery. Of the remaining two, one had primary pigmented nodular adrenocortical disease, and another had thymic carcinoid with ectopic ACTH production as the cause of Cushing's syndrome. No serious adverse events were noted. Conclusions: Vasopressin may be used instead of CRH and desmopressin for stimulation in BIPSS. PMID:27186561

  8. What Should You Ask Your Doctor about Laryngeal and Hypopharyngeal Cancer?

    MedlinePlus

    ... or hypopharyngeal cancer? What should you ask your doctor about laryngeal or hypopharyngeal cancer? It is important ... we can decide on treatment? Are there other doctors I need to see? How much experience do ...

  9. Varices of inferior epigastric veins caused by chronic inferior vena cava obstruction: mimicking normal venous flow pattern on radionuclide venography.

    PubMed

    Karacalioglu, Ozgur; Sonmez, Alper; Ilgan, Seyfettin; Soylu, Kenan; Emer, Ozdes; Ozguven, Mehmet

    2005-05-01

    A 21-year-old patient with long-standing inferior vena cava obstruction secondary to idiopathic thrombosis extending from the external iliac veins underwent a radionuclide venography with Tc-99m pertechnetate labeled erythrocytes. The blood pool phase of the study revealed bilaterally distorted inferior epigastric veins mimicking normal venous flow pattern. The authors present this case to discuss the possible alternative routes and the underlying physiopathologic mechanism of this unusual flow pattern in chronic inferior vena cava obstruction. PMID:15981678

  10. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

    PubMed

    Roberts, Rachel Margaret; Mukherjee, Jayanta; Phillips, David

    2016-01-01

    We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection. PMID:27329097