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At least 145 records · Page 8Linked to original sources
PubMed1988

Surgical relief of severe laryngeal malformation in an English Bulldog.

A 22 month old English Bulldog was presented with progressive upper airway obstruction associated with an elongated soft palate, tonsillitis, everted laryngeal saccules and laryngeal malformation. Surgical management of the case consisted of resection of the elongated soft palate and everted laryngeal saccules, unilateral tonsillectomy and correction of the laryngeal stenosis. The latter was achieved by using a castellated incision through the laryngeal cartilages and first tracheal ring. From this case, it is postulated that, at least in some cases, the common upper airway obstruction syndrome in Bulldogs may not be due to laryngeal collapse as previously thought but rather to congenital malformation of the laryngeal cartilages.

Journal Article↗
PubMedDate not supplied

The reliability of endoscopic examination in assessment of arytenoid cartilage movement in horses. Part II. Influence of side of examination, reexamination, and sedation.

Twenty Thoroughbred and Standardbred horses underwent endoscopic evaluation of arytenoid cartilage movement twice within 1 week. Each time, a flexible endoscope was passed without sedation through the right nostril and the left nostril, and through the right nostril 5 minutes after administration of xylazine hydrochloride (0.55 mg/kg or 1.1 mg/kg intravenously). Laryngeal cartilage movement was videorecorded. All videotaped images were reviewed by three veterinarians and subjectively placed in one of four grades. The intraobserver agreement rate varied from 52.6% for examination under sedation with 1.1 mg/kg of xylazine to 89.5% for unsedated reexamination through the left nostril. The effect of the various observations on median laryngeal grade was calculated. Examination under xylazine hydrochloride at either dosage yielded a change in median laryngeal grade from the unsedated examination in 45% of the evaluations. Reevaluation through the right or left nostril resulted in a different median laryngeal grade in 21% and 5% of the examinations, respectively. Objective measurements of the rima glottidis obtained by computer-assisted morphometric analysis of the recorded laryngeal images allowed laryngeal images to be dichotomized regardless of the condition of endoscopic examination. Endoscopic evaluation of laryngeal cartilage movement is subjective and is influenced by sedation with xylazine, evaluation through the alternate nostril, and different day of examination. The most consistent evaluation was obtained during repeated examination through the left nostril.

Animals↗
PubMed1982

Pseudomass lesions due to occult trauma of the larynx.

Fracture of the laryngeal skeleton is best diagnosed by computed tomography. Deformity of the laryngeal cartilage may cause signs and symptoms that suggest neoplastic submucosal mass. Symptoms may not develop until years after the original injury. A series is described in which the patients demonstrate the characteristic signs, symptoms, and computed tomographic appearance of old, often forgotten, fractures of the thyroid cartilage. The diagnosis is best made by computed axial tomography of the neck.

Adult↗
PubMed1995

Comparison of preoperative computed tomographic findings with postoperative histopathological findings in laryngeal cancers.

In this study of 22 patients with laryngeal cancer, computed tomographic (CT) scans in the axial plane were compared with histopathological sections prepared in the same plane. The value of the preoperative CT for evaluating tumor invasion, location and size was then investigated. Findings demonstrated that CT was most sensitive in determining tumor invasion to the paralaryngeal and preepiglottic spaces, anterior and posterior commissures and subglottis. In contrast, CT was less sensitive in determining actual tumor invasion to the laryngeal cartilages, extralaryngeal tissues and metastases to cervical lymph nodes.

Carcinoma, Squamous Cell↗
PubMed1997

[Treatment of children with congenital diseases of the larynx and trachea].

+33 cases of vascular tumors, 15 of congenital membranes, 12 of papillomatosis, 5 of cysts, 12 of abnormal laryngeal cartilages, 3 of tracheomalacia, 9 of stridor, 1 of fibrous polyp and 1 of mucous membrane folding in the interarytenoid region are reported. Operative interventions primarily endoscopic laser surgery were performed in children with congenital vascular tumors, membranes, cysts. Removal of papillomas in congenital papillomatosis conducted with the use of micro-instruments and CO2-laser was combined with immunomodulation. Children with laryngeal cartilage anomalies, tracheomalacia and stridor were subjected to prolonged nasotracheal intubation of even tracheotomy only in case of severe respiratory failure..

Child↗
PubMed1997

Staging of laryngeal cancer: endoscopy, computed tomography and magnetic resonance versus histopathology.

An accurate pretherapeutic staging of laryngeal cancer is required for optimal treatment planning and for evaluation and comparison of the results of different treatment modalities. In this study, 45 consecutive patients with neoplasms of the larynx, treated surgically, were included in a prospective pretherapeutic staging protocol that included indirect laryngoscopy, direct microlaryngoscopy, contrast-enhanced computed tomography (CT) and Gd-DTPA-enhanced magnetic resonance imaging (MRI). The surgical specimens were cut in whole-organ slices parallel to the plane of the axial CT and MR images. The histologic findings were then compared with clinical findings, CT and MRI. These findings showed that clinical evaluation failed to identify tumor invasion of the laryngeal cartilages and extralaryngeal soft tissues, resulting in a low staging accuracy (55%). Many pT4 tumors were clinically understaged. The combination of clinical/endoscopic evaluation and either CT or MRI resulted in a significantly improved staging accuracy (80% vs 87%, respectively). MRI was significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. MRI tended to overestimate neoplastic cartilage invasion to possibly result in overtreatment, while CT was found to underestimate neoplastic cartilage invasion and could lead to inadequate therapeutic decisions.

Adult↗
PubMed1983

[Use of tomodensitometry in the evaluation of the extension of certain laryngeal cancers].

Radiopathological examinations were conducted on a frozen laryngeal specimen to determine its characteristics as seen on the CT scan image. Results of CT scan imaging of 37 patients with laryngeal cancer were then compared with results of clinicopathological examination in 20 cases (after fixation and decalcification, the 20 samples were sectioned in axial planes reproducing those of the CT scan as for as possible). The results of computed tomography are conclusive for investigation of tumoral extension to the hyothyo-epiglottic space, and may lead to modification of therapy; they are of marked value for assessment of tumoral extension to the laryngeal cartilages, with the reservation that ossification of these cartilages must be taken into account. Furthermore, they enable assessment of subglottal extension when the respiratory state of the patient or the size of tumor makes it impossible to perform direct laryngoscopy.

Epiglottis↗
PubMed2004

Supraglottic carcinoma treated with curative radiation therapy: identification of prognostic groups with MR imaging.

PURPOSE: To retrospectively assess the prognostic meaning of tumor characteristics depicted on pretreatment magnetic resonance (MR) images for local outcome in supraglottic squamous cell carcinoma treated with definitive radiation therapy. MATERIALS AND METHODS: Pretreatment MR images acquired in 84 patients with supraglottic carcinoma treated with curative radiation therapy were reviewed for tumor involvement of laryngeal sites including glottis, subglottis, pre-epiglottic space, laryngeal cartilages, and hypopharynx, and for extralaryngeal extension. The volume of each tumor was estimated, and mean tumor volume was calculated for the group of tumors in each T staging category. RESULTS: Results of univariate analysis showed MR imaging-determined primary tumor volume (P =.03), involvement of pre-epiglottic space (P =.008), abnormal signal intensity in thyroid cartilage (P =.04), and extralaryngeal extension beyond thyroid and/or cricoid cartilage (P =.02) to be significant predictors of local control rate. Results of multivariate analysis with the Cox regression model confirmed statistical significance for invasion of pre-epiglottic space (P =.004) and for abnormal signal intensities in thyroid cartilage adjacent to the anterior commissure (P =.04) and in cricoid cartilage (P =.01). Five-year local control rates were calculated from the regression coefficients of three independent MR imaging prognostic factors, and three prognostic groups were identified on the basis of these control rates. The 5-year local control rate in the high-risk group was 35%, significantly lower than the rates in the intermediate- and low-risk groups (60% and 89%, respectively; P =.002). CONCLUSION: MR imaging-determined pre-epiglottic space involvement and abnormal signal intensities in the thyroid cartilage adjacent to the anterior commissure and/or the cricoid cartilage are strong predictors of local outcome in supraglottic carcinoma treated with definitive radiation therapy.

Adult↗
PubMed1988

[Echo laryngography. A contribution to the method of ultrasonic diagnosis of the larynx].

This article describes a method for sonographic investigation of the larynx, the suggested term for which is "echo laryngography". It is more purposeful if M-mode is employed as well as B-mode for the assessment of laryngeal function and performance. Intra- und extralaryngeal sound windows are described and a discussion concerning their access by means of a systematic transversal section from caudal to cranial and coronary and sagittal sections in the vertical plane will ensue. The varying degrees of ossification of the laryngeal cartilage and the air-filled parts of the larynx make sonography more difficult. The transverse and vertical epiglottis function test which we developed extends the range for sonography of the larynx. The possibilities for clinical application of "echo laryngography" will be published in subsequent presentations.

Epiglottis↗
PubMedDate not supplied

Estrogen receptor in the larynx of the aged baboon (Papio cynocephalus).

Using autoradiographic techniques, tritiated estrogen-receptor complex intranuclear labeling was identified in certain laryngeal tissues of four aged female baboons; no complex labeling was found in the control animal. Three significant findings were felt to be derived from this study. One, surface epithelium of the larynx had essentially no estrogen-receptor activity. Two, all tissues of mesenchymal origin, especially lamina propria, muscle, dense connective tissue, and fat had consistently high levels of nuclear localization of the labeled estrogen. The binding affinity seemed to be the highest at the anterior commissure and the immediate anterior subglottic space. Three, there was a high level of receptor binding in laryngeal cartilage and perichondrium. Since the activated hormone-receptor complex modulates gene expression to alter the amount of mRNA, sex steroids have a direct regulatory effect upon the target cell and, perhaps through an induction process, can exert an indirect effect upon adjacent tissues. It is postulated that since the larynx is a sexually dimorphic organ, the sex steroids and their receptors may play a role in altered phonation during aging and possibly in the development of laryngeal neoplasms and other diseases. Therefore, hormonal manipulation may play a future role in the therapy of laryngeal diseases. This study represents the first demonstration of estrogen receptors by specific anatomic location in the primate larynx with significant localization in the mesenchymal tissues but not in the epithelial tissues.

Adipose Tissue↗
PubMed1998

Evaluation of pretreatment computed tomography as a predictor of local control in T1/T2 pyriform sinus carcinoma treated with definitive radiotherapy.

BACKGROUND: This study was undertaken to determine whether pretreatment computed tomography (CT) findings can predict local control in pyriform sinus carcinoma treated with definitive radiotherapy (RT). METHODS: Twenty-three patients with pyriform sinus carcinoma (T1: n = 5; T2: n = 18) were treated with high-dose RT and followed for a minimum of 2 years. Tumor volumes and extent were determined on pretreatment CT studies. The specific CT parameters assessed were analyzed as predictors of local control. RESULTS: There was a significant decrease in local control rate for tumors over 6.5 mL (1 of 4 [25%]) relative to tumors under 6.5 mL (17 of 19 [89%]; p = .021). Sensitivity and specificity for local control using this cutoff were 94% and 60%, respectively. Tumor score, as a measure of anatomic extent, was also found to be a significant predictor of local control (p = .033). The local control rate was not influenced significantly by the presence of "minimal" apex disease (< 10 mm in greatest dimensions as measured on CT) but decreased significantly when "bulk" apex disease (> OR = 10 mm) was present (p = .027). Laryngeal cartilage sclerosis was not a significant predictor of outcome. CONCLUSION: Computed tomography can stratify pyriform sinus carcinomas into groups more or less likely to be locally controlled with definitive RT.

Carcinoma, Squamous Cell↗
PubMed1997

Local control of piriform sinus cancer treated by radiation therapy alone.

Local control rate by radical radiation therapy was analyzed in 33 patients with a piriform sinus cancer. Twenty-five patients (76%) were in stage T3 + T4. Local recurrence-free survival at 3 years was 49% in T1 + T2 and 25% in T3 + T4 (p = 0.01). In T1 + T2 lesions, a biologically effective dose for an acute reaction over 80 Gy and total treatment time less than 70 days appeared to improve local control. In T3 + T4 lesions, good radiation response assessed by the regaining of laryngeal mobility affected local control favorably. An esophageal involvement and destruction of the laryngeal cartilage as well as soft tissue extension precluded the possibility of local control by radiation therapy alone. In addition to the T-stage, other tumor factors should also be considered for predicting local control with radiation therapy.

Aged↗
PubMed1991

Gender influences subsite of origin of laryngeal carcinoma.

The relationship of gender to laryngeal cancer is not well understood. We analyzed 688 laryngeal cancers diagnosed in Kansas from 1980 through 1989 for sex differences in subsite distribution (glottis, supraglottis, subglottis, and laryngeal cartilage) as well as survival, histologic grade, and age at diagnosis. The ratio of glottic to supraglottic tumors was 22.12:1 in men and 0.56:1 in women, a highly significant difference. Survival in glottic tumors was significantly better than in supraglottic tumors, but survival was not significantly better for women than it was for men. Glottic tumors were significantly more likely than were supraglottic tumors to be of low-grade malignancy for all subjects and for male subjects alone, but not for female subjects alone. Women were younger at time of diagnosis than were men, but not significantly so. Gender is an important factor in the genesis of laryngeal cancer.

Aged↗
PubMedDate not supplied

Pathology of the oropharyngeal cavity in six strains of rats: predisposition of Fischer 344 rats for inflammatory and degenerative changes.

The sagittolongitudinal histopathological evaluation of the oropharyngeal cavity in 6 strains of rats revealed a clear predisposition of the Fischer 344 strain for degenerative and inflammatory lesions in this region. A degeneration and calcification predominantly of the laryngeal cartilage is evident in 72%, granulomas of the seromucinous glands in 38%, and an inflammation with bacterial colonies or plant material in the basal part of the laryngotracheal junction in 26% of the Fischer 344 rats. The incidences of these types of lesions were negligible in the other rat strains evaluated. The comparison of control Fischer 344 rats from 2 carcinogenicity studies (untreated group; gavaged group with water, pH 10; gavaged group with propylene glycol/methocel) showed an influence of the gavage technique with the solvent on the survival rate in the female Fischer 344 rats. The lower survival rate was accompanied by the occurrence of food impaction in the oropharyngeal cavity. This increased mortality in female Fischer 344 rats was also associated with a degeneration of the laryngeal cartilages, whereas the formation of granulomas and inflammation seemed to have no direct relationship to the mortality. The gavage technique with the applied solvent was an enhancing factor in the female Fischer 344 rats on mortality, on cartilage degeneration, but not on inflammatory changes. In contrast to the females, male Fischer 344 rats had a higher incidence of granulomas and inflammation, which, however, did not influence the survival rate. In conclusion, Fischer 344 rats, especially the female sex, exposed to chronic daily irritation by gavage, are predisposed to have a high mortality rate in chronic toxicologic tests. An explanation lies in the disposition of the Fischer 344 rat to a high incidence of cartilage degeneration, which presumably leads to a dysfunction of the larynx.

Animals↗
PubMed1984

Xeroradiography of the lateral neck.

Because of its "edge enhancement" technique, xeroradiography provides an improved method for evaluation of the laryngeal cartilages and soft tissue coverings when compared to conventional radiographs. If one becomes familiar with the varied appearances of the normal structures, there is a large amount of information which can be obtained from a single lateral view of the neck which would otherwise be overlooked or misinterpreted. This article is intended to familiarize the reader with the various techniques available to study the structures of the larynx and associated soft tissues. However, much of the emphasis will be on the xeroradiographic appearance of normal structures and abnormal processes in both the adult and the pediatric patient.

Head and Neck Neoplasms↗
PubMed1999

Predicting the local outcome of glottic squamous cell carcinoma after definitive radiation therapy: value of computed tomography-determined tumour parameters.

BACKGROUND AND PURPOSE: The T-classification has shortcomings in the prediction of local outcome of glottic squamous cell carcinoma (SCC) treated by definitive radiation therapy. In this regard, the value of several CT-derived tumour parameters as predictors of local outcome was investigated. MATERIALS AND METHODS: The pretreatment CT studies of 119 patients with glottic SCC (T1, n=61; T2, n=40; T3, n=14; T4, n=4) treated with curative intent by radiation therapy were reviewed for tumoral involvement of specific laryngeal anatomic subsites (including laryngeal cartilages). Tumour volume was calculated with the summation-of-areas technique. Actuarial (life-table) statistical analysis was done for each of the covariates; multivariate analysis was performed using the Cox proportional hazards model. RESULTS: In the actuarial analysis tumour volume was significantly correlated with local recurrence rate (P=0.0062). Involvement of the cricoid cartilage (P=0.0052), anterior commissure (P=0.0203), subglottis (P=0.0481) and preepiglottic space (P=0.0134) and degree of involvement of the true vocal cord (P=0.0441) and paraglottic space at the level of the true vocal cord (P=0.0002) were also significantly correlated with local recurrence rate. In the multivariate analysis, only degree of involvement of the paraglottic space (at the level of the true vocal cord) (P=0.0001) and preepiglottic space (P=0.02) were found to be independent predictors of local recurrence. The T-category was significantly correlated with local outcome in the actuarial analysis (P=0.0001), but not in the multivariate analysis (P=0.5915). CONCLUSIONS: Several CT-derived parameters are powerful predictors of local outcome in glottic cancer treated with radiation therapy; some of these parameters are stronger linked to the local control rate than the T-classification.

Adult↗
PubMed2002

Alterations in the content and composition of glycosaminoglycans in human laryngeal carcinoma.

Glycosaminoglycans in normal and cancerous human laryngeal cartilage were isolated and characterized by means of enzyme susceptibility and high performance liquid chromatography. The known mammalian glycosaminoglycans were identified in all samples but their content and composition varied between normal and malignant samples. Chondroitin/dermatan sulphate was the major glycosaminoglycan in all cases, but its relative proportion was decreased in malignant samples. Its sulphation pattern showed that in normal samples it was sulphated mainly at the C6 position of galactosamine, whereas in malignant samples it was sulphated mainly at C4. Dermatan sulphate, expressed as a result of the different digestion of samples with chondroitinases, was present in very small amounts in normal samples (2.7% of total sulphated glycosaminoglycans) but increased in proportion up to 27.7% in malignant samples. The content of oversulphated chondroitin/dermatan was increased twofold in malignant samples. The content of heparan sulphate was increased almost fivefold in malignant samples as compared to normal ones. The content of hyaluronan was increased in malignant samples 3.5-fold, amounting to up to 11.4% of total glycosaminoglycans. These dramatic changes in the content and composition of glycosaminoglycans seemed to be characteristic of the tumour and independent of its status.

Carcinoma, Squamous Cell↗