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PubMed1984

Cartilage involvement in laryngeal carcinoma: correlation of CT and pathologic macrosection studies.

Fifteen patients with laryngeal epidermoid carcinoma underwent CT of the larynx prior to surgery. Whole mount sections of the extirpated larynx cut in the horizontal plane were compared with the corresponding level of the preoperative CT sections. This study in particular was designed to evaluate the accuracy of diagnosing cartilage involvement by CT and to correlate CT findings with histologic involvement. Our results indicate that CT correlates well with anatomic location of gross cartilage involvement by the tumor; however, small macroscopic invasion of the laryngeal cartilages may be difficult to diagnose with CT. Microscopic involvement of the cartilages cannot be diagnosed with CT. Decisions regarding conservation surgery cannot be based on CT evaluation alone.

Aged↗
PubMedDate not supplied

MR evaluation of laryngohypopharyngeal cancer: value of gadopentetate dimeglumine enhancement.

PURPOSE: To investigate the value of gadopentetate dimeglumine-enhanced MR imaging in determining the extent of laryngohypopharyngeal cancer. METHODS: Unenhanced and contrast-enhanced T1-weighted, proton-density-weighted, and T2-weighted images from 24 patients with laryngohypopharyngeal cancer were reviewed and compared with the pathologic findings of resected specimens. In 18 patients, ex vivo MR images of the resected specimens were also compared with pathologic findings. RESULTS: Laryngohypopharyngeal cancer showed intermediate intensity on T1-weighted and proton-density-weighted images, high intensity on T2-weighted images, and moderate enhancement on T1-weighted enhanced images. Cartilage-invaded tumor enhanced moderately, whereas unossified cartilage in contact with tumors but without tumor invasion showed no enhancement. Laryngohypopharyngeal mucosa enhanced intensely; endolaryngeal muscles enhanced less. CONCLUSIONS: Enhanced MR images were more useful in assessing the extent of tumors and the presence of laryngeal cartilage invasion than were proton-density-weighted and T2-weighted images.

Aged↗
PubMed1994

CT evaluation of displaced superior cornu of ossified thyroid cartilage.

PURPOSE: To present and to demonstrate traumatic displacement of the superior cornu of the thyroid cartilage. PATIENTS AND METHODS: Four elderly patients following minor neck trauma were referred for computed tomography (CT). They complained of a feeling of a foreign body in the throat and painful swallowing. Unilateral bulging of the hypopharynx was observed in all of them on indirect laryngoscopy. The patients underwent axial CT with 3-D reconstructions. RESULTS: Axial CT demonstrated unilateral medial convexity of the ossified superior cornu of the thyroid cartilage. 3-D CT demonstrated medial convexity of the ossified complex (the lateral thyrohyoid ligament and superior cornu of the thyroid cartilage). CONCLUSION: The inflexible ossified laryngeal cartilages in elderly patients may not return to normal alignment following traumatic displacement.

Female↗
PubMed1975

[No corpora sesamoidea laryngis in man and animal].

The fact that the Corpora sesamoidea have never been precisely defined has led to a series of small cartilaginous bodies in the larynx being thus designated, for want of a better solution. Since the corpora sesamoidea have been identified as capsular bodies, however, originating in or in connection with a synovial capsule, there remained only one laryngeal cartilage which appeared to fulfill all the criteria of sesamoid cartilage, namely the papilionaceous cartilage found in all alar species from Monotremata to Carnivora, and which comparative anatomists term proarytaenoid cartilage. If Goeppert's findings are regarded as having an additional functional significance, then it is clear that this cartilage too, like cartilagines interarytaenoidea, postarytaenoidea (dorsoarytaenoidea in the dog?) pararytaenoidea, cunciformis, corniculata, intercorniculata and triticea, is a connecting cartilage.

Animals↗
PubMed2001

The interactions of cartilage proteoglycans with collagens are determined by their structures.

In the present work, the interaction of aggrecan, decorin and biglycan isolated from pig laryngeal cartilage and of the three squid cartilage proteoglycans with collagen type I and II was studied. The interaction was examined under conditions allowing the formation of collagen fibrils. It was found that biglycan interacted strongly with collagen type II and not with type I and the interaction seemed to proceed exclusively through its core proteins. Decorin interacted with collagen type I but not with type II. Aggrecan interacted very poorly with both collagen types. The two squid proteoglycans of large size, D1D1A and D1D2, interacted only with collagen type I through both glycosaminoglycans and core proteins. The third squid proteoglycan of small size, D1D1B, interacted poorly only with collagen type I. The results suggested that the interactions of cartilage proteoglycans with collagen were mainly due to the primary structure of both molecules, and would contribute to the maintenance of the integrity of the tissue. The biochemical significance of these interactions might be more critical in aged vertebrate cartilage, where loss of aggrecan and increase of the small proteoglycans was observed, a large proportion of which is found in the extracellular matrix free of glycosaminoglycan chains.

Achilles Tendon↗
PubMedDate not supplied

Ossification within the primate larynx.

Ossification of the laryngeal cartilages is a random occurrence possibly related to age and sex. A wide variety of primate larynges have been examined radiologically, by macroscopic section or after whole organ serial section with the aim of determining presence of ossification. The results of this investigation will be presented in an attempt to establish possible correlation between structure, function and degree of ossification within each specific larynx. This is a unique enquiry which may assist in the understanding of ossification within the human larynx.

Adult↗
PubMed1972

Biosynthesis of proteoglycans in cartilage slices. Fractionation by gel chromatography and equilibrium density-gradient centrifugation.

The kinetics of incorporation of [(35)S]sulphate into slices of pig laryngeal cartilage in vitro was linear with time up to 6h. The specific radioactivities of the extracted proteoglycans (containing about 80% of the uronic acid of the cartilage) and the glycosaminoglycans remaining in the tissue after extraction were measured after various times of continuous and ;pulse-chase' radioactivity incorporation. Radioactivity was present in the isolated chondroitin sulphate after 2 min, but there was a 35min delay in its appearance in the extractable proteoglycan fraction. Fractionation of the proteoglycans by gel chromatography showed that the smallest molecules had the highest specific radioactivity, but ;pulse-chase' experiments over 5h did not demonstrate any precursor-product relationships between fractions of different size. Equilibrium density-gradient centrifugation in 4m-guanidine hydrochloride showed that among the proteoglycan fractions the specific radioactivity increased as the chondroitin sulphate content decreased, but with preparations from ;pulse-chase' experiments there was again no evidence for precursor-product relationships between the different fractions. Differences in radioactive incorporation would seem to reflect metabolic heterogeneity within the proteoglycans extracted from cartilage. This may be due either to a partial separation of different types of proteoglycans or to differences in the rates of degradation of the molecules of different size and composition as a result of the nature and specificity of the normal degrading enzymes. The results suggest that molecules of all sizes were formed at the same time.

Animals↗
PubMed1993

[Spin-echo anatomy of the larynx in MRI at 1.5 T].

The larynges of 8 healthy and informed volunteers were studied with a superconductive MR unit at 1.5 T together with those of 10 patients with extra-laryngeal pathologic conditions. The study was performed with round surface coils (5'') and with delicated sellar coils in the anterior neck. Slices were 5 mm thick, and acquired on the coronal, axial, and sagittal planes, with T1-weighting; axial scans were repeated in the same locations with double echoes, with proton-density and T2-weighting. Five patients underwent additional scans after Gd-DTPA. The larynx of a semi-frozen cadaver was examined with sellar surface coils, on similar scanning planes and with similar pulse sequences to those described above; the larynx was removed, investigated with mammographic technique, and subsequently analyzed with thin CT slices and a high-resolution reconstruction algorithm for the study of laryngeal cartilage. Axial anatomical sections were then compared with MR and CT scans, and the anatomical structures were recognized on the triplanar MR scans of a volunteer's larynx. Besides MR anatomy of supporting laryngeal structures, the authors describe in detail the muscles, plicae, spaces and cavities which can be identified on the various planes, together with the changes in signal after Gd-DTPA.

Adult↗
PubMed2001

Arytenoid dislocation while using a McCoy laryngoscope.

Arytenoid dislocation (AD) involves either a complete disruption of the cricoarytenoid joint or a malpositioning of the arytenoid cartilages (AC) with reference to other laryngeal cartilages. In this report, we present a case of AD while using a McCoy laryngoscope. Although McCoy laryngoscope is recognized as a useful option for the cases of difficult endotracheal intubation, we are concerned that AD is likely with this device.

Adult↗
PubMed1999

Relapsing polychondritis diagnosed by Tc-99m MDP bone scintigraphy.

PURPOSE: Relapsing polychondritis is a generalized recurring disease of cartilage that involves joints, trachea, bronchi, laryngeal cartilages, costal cartilages, and cartilages of the ear and nose. It is associated with autoimmune diseases, including Hashimoto disease in some cases. METHODS: The authors evaluated a 29-year-old man with relapsing polychondritis who had symptoms and signs of a common cold for 2 months and anterior chest pain near the sternum for 1 month. RESULTS: After the diagnosis, the authors found that the patient had a history of thyroid therapy for hyperthyroidism 15 years before. Tc-99m MDP bone scintigraphy performed to evaluate anterior chest pain showed diffusely increased accumulation of radioactivity in all costocartilages and sternoclavicular joints. Based on that information, relapsing polychondritis was diagnosed. Ga-67 citrate scintigraphy was preformed to determine the optimum biopsy site of the cartilage. The diagnosis was histologically supported by the results of the open biopsy. CONCLUSIONS: In this case, Tc-99m MDP bone scintigraphy was useful for diagnosing relapsing polychondritis, and Ga-67 citrate scintigraphy was helpful in determining the biopsy site.

Adult↗
PubMed1990

The use of MRI in the identification of post-traumatic laryngeal deformities.

Suspected post-traumatic deformity of the laryngeal cartilages can be diagnosed by using current magnetic resonance imaging (MRI) scanning techniques. This is of particular aid to the clinician who is evaluating a laryngeal mass with no history of injury to the neck. Computed tomography (CT) and magnetic resonance imaging are both effective in this situation, but MRI appreciates better soft tissue contrast, and can offer coronal and sagittal views.

Aged↗
PubMed1982

Growth of the human prepubertal and pubertal larynx.

Prepubertal, pubertal, and adult measurements of human larynges were used to describe growth of the larynx from prepuberty to adulthood. Linear and weight measurements made of 10 Caucasian male and 10 Caucasian female prepubertal and pubertal cadaveric larynges were compared to adult measurement data obtained from another study on 20 male and 20 female larynges of adults, aged 37-70. In both studies measurements and experimental protocols were similar, allowing direct comparisons to be made between samples. Results highlight specific quantitative characteristics and trends in circumpubertal growth of the laryngeal cartilages and the vocal folds for each sex and with respect to sex differences. The results are discussed with respect to the literature on postnatal laryngeal development and to published research on adolescent voice change.

Adolescent↗
PubMed2004

Computerised tomography vs. pathological staging of laryngeal cancer: a 6-year completed audit cycle.

The aim of this audit was to examine the accuracy of computerised tomography (CT) staging of advanced laryngeal tumours. CT staging was evaluated against the T staging of laryngeal tumours as determined by pathological examination. Data from 38 patients, between 1996 and 2000 with laryngeal squamous cell cancer that fulfilled the audit criteria, were collected and compared. Subjects had to have a pre-operative CT scan of the larynx and a total laryngectomy specimen for pathological staging. The audit demonstrated that 45% of the patients were over staged and 10% were under staged using CT criteria as compared to pathological staging. Fourteen patients had been erroneously up staged to T4 on the basis of laryngeal cartilage invasion as judged by the radiological sign of cartilage sclerosis. While this radiological sign is used as a marker of neoplastic invasion in the literature, it was found to have a low sensitivity of 62% and low specificity of 42% in this study. Arytenoid cartilage sclerosis in isolation was no longer used as a radiological sign of neoplastic cartilage invasion. Following the change in practice, the CT staging of laryngeal cancer was re-evaluated in a second audit cycle. Correct CT staging of the tumour improved from 45 to 71%. Arytenoid cartilage sclerosis is no longer used as a sole CT criterion for predicting neoplastic cartilage invasion at our institution.

Cartilage↗
PubMed1983

Cartilage proteoglycan binding region and link protein. Radioimmunoassays and the detection of masked determinants in aggregates.

Antibodies have been raised in rabbits to the hyaluronate-binding region and link-protein components of aggregated proteoglycans from pig laryngeal cartilage. The anti-(binding region) antibodies did not bind 125I-labelled link protein, nor was 125I-labelled binding region bound by the anti-(link protein) antibodies. The antisera were applied in sensitive inhibition radioimmunoassays to determine binding region and link protein in purified proteoglycan preparations. With intact proteoglycan aggregates, the antigenic sites of link protein, and to a lesser extent binding region, were masked. Heat treatment in the presence of sodium dodecyl sulphate (0.025%, w/v) was found to overcome this masking, thereby allowing the determination of link protein and binding region in aggregated proteoglycan preparations in pure and impure samples.

Animals↗
PubMedDate not supplied

[The forensic medical assessment of the results of a study of laryngeal injuries in blunt trauma to the neck].

Presents the methodological principles and succession of examination of the basic formations of the larynx in cases with blunt injuries of the neck. Describes variants of anatomic structure of the sublingual bone and laryngeal cartilages influencing the morphology of injuries thereof. Offers differential diagnostic criteria of various mechanisms of fractures of the basic formations and recommendations on medical criminological assessment of laryngeal injuries.

Autopsy↗
PubMed1979

The role of link-protein in the structure of cartilage proteoglycan aggregates.

Proteoglycan fractions were prepared from pig laryngeal cartilage. The effect of link-protein on the properties of proteoglycan-hyaluronate aggregates was examined by viscometry and analytical ultracentrifugation. Aggregates containing link-protein were more stable than link-free aggregates at neutral pH, at temperatures up to 50 degrees C and in urea (up to 4.0M). Oligosaccharides of hyaluronate were able to displace proteoglycans from link-free aggregates, but not from the link-stabilized aggregates. Both types of aggregate were observed in the ultracentrifuge, but at the concentration investigated (less than 2 mg/ml) the link-free form was partially dissociated and the proportion aggregated varied with the pH and temperature and required more hyaluronate for saturation than did link-stabilized aggregate. The results showed that link-protein greatly strengthened the binding of proteoglycans to hyaluronate and suggest that under physiological conditions it 'locks' proteoglycans on to the hyaluronate chain.

Animals↗
PubMed1977

Degradative enzymes of cartilage. Effects of freeze-thawing of the tissue prior to extraction, and of protease inhibitors, on proteoglycans extracted with iso-osmotic neutral salt and 4 M guanidinium chloride.

The effects of freeze-thawing of the tissue, and of protease inhibitors, on proteoglycans extracted sequentially from pig laryngeal cartilage with 0.15 M sodium acetate and 4 M guanidinium chloride were examined. Freeze-thawing of the tissue prior to extraction resulted in an increase in the proportion of smaller-sized proteoglycans in the sodium acetate extracts and a decrease in the proportion of aggregated proteoglycans in 4 M guanidinium extracts. In addition, a slight decrease in the hydrodynamic size of purified disaggregated proteoglycans was noted after freeze-thawing of the cartilage. When the protease inhibitors EDTA, 6-aminohexanoic acid and benzamidine hydrochloride were added to the sodium acetate buffer the yields of proteoglycans from fresh and freeze-thawed cartilage were diminished, but the inhibitors had no effect on the hydrodynamic size of the proteoglycans extracted with sodium acetate. Addition of the protease inhibitors to the 4 M guanidinium solvent increased the proportion of proteoglycans present in aggregates. The highest proportion of aggregated proteoglycans was obtained when fresh tissue was extracted in the presence of the inhibitors.

Acetates↗