Carcinoma in situ of the larynx: an evaluation of its natural clinical course

The outcome of 75 patients with severe dysplasia or carcinoma in situ of the larynx has been reviewed. The patients were divided into three groups according to treatment; Group A (16 patients) had received irradiation. Group B (24 patients) had developed invasive carcinoma less than 1 year after the diagnosis of carcinoma in situ and Group C (41 patients) had been observed for more than 1 year, receiving no treatment other than repeat biopsies. Of the latter group, 46% developed invasive carcinoma of the vocal cords, with a mean observation time of 51 months. Mean age at the onset of the disease was 66 years in patients where the epithelium returned macroscopically to normal during observation compared to 59 years in patients who developed carcinoma (P less than 0.05). This may indicate that subgroups of carcinoma in situ exist with different biological behaviour. No extra benefit was seen for the patients who received irradiation for carcinoma in situ, and close follow-up with, eventually, stripping of the epithelium is therefore advocated. Both altered anatomical site during observation and an increase in area of the lesion should be regarded as a warning signal.     

Granular-cell myoblastoma of the larynx clinical analysis

Clinical date of four cases of granular-cell myoblastoma tumors arising in the larynx and clinical analysis of 11 cases published in Polish literature were reviewed and studied. Granular-cell tumor is a rare, usually benign neoplasm that can occur in various part of the body. The larynx tumor is accounting for 7% to 10% of all reported cases. The most common laryngeal location in our study were the posterior part of true vocal cord. Sex predilection was no observed. The tumor was generally presented in patients in their forth and fifth decade. Slowly increasing hoarseness was the most common symptoms but some patients reported moderate dysfagia as well. Typically the tumors were painless. Only in one case the breathing difficulty was the reason of tracheotomy. Clinically the tumors were considered benign. The most common clinical impressions was a vocal polyp, cysts, granulomas or nodules. The surgical procedure and local excision in laryngoscopy (in 9 patients), laryngofissura (in 5 patients) were mostly sufficient to radical treatment. In one case because the location and size of the tumor subtotal laryngectomy was necessary to conduct. After surgery the voice often was preserved but sometimes slightly hoarseness were observed. Treatment is usually curative with no recurrences. The knowledge about natural history and therapeutic implications of such tumors is essential to choose appropriate therapy and planning surgery.     

Tuberculosis of the larynx: clinical aspects in 19 patients

Laryngeal tuberculosis continues to exist in spite of extensive tuberculosis eradication campaigns. We present 19 cases of laryngeal tuberculosis seen in our institution between 1982 and 1987. From the clinical findings it is clear that the localization of the lesions has changed since the preantibiotic era. Today the spread appears to be mainly via lymphatic and hematogenic routes, as opposed to the direct spread more common previously. The fibrosis caused by the lesions is incapacitating and frequently requires surgical correction.     

Epithelial hyperplasia of the larynx a clinical follow-up study

In this retrospective study, the records of 40 patients with epithelial hyperplasia of the larynx, seen between 1980–1991, were reviewed to determine the incidence of malignant transformation during long term follow-up. The mean follow-up time was 58.6 months. The initial pathological diagnoses were hyperkeratosis in one case, parakeratosis in one, dyskeratosis in 12 and dysplasia in 26. During follow up, nine patients developed carcinoma in situ and/or invasive carcinoma. Of these, two patients had been diagnosed with dyskeratosis without dysplastic cells at the initial biopsy. It is therefore important to follow up patients with epithelial hyperplasia of the larynx even when no dysplastic cells are found at the time of diagnosis.     

成人喉部尖锐湿疣一例

患者女,30岁,会厌部新生物1年于2009年8月3日入院.体格检查:会厌喉面中段见淡红色乳头状样新生物,大小约1.0 cm ×2.0 cm;双声带光滑整齐,活动度可,闭合良好.     

Laryngeal structure and function in the pediatric larynx: clinical applications

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 in the pediatric population. Three other disorders, including laryngeal hyperfunction, unilateral vocal fold paralysis, are discussed because of their more common occurrence and the uniqueness of their etiology and intervention, particularly for the case of bilateral abductor vocal fold paralysis.     

Management of the patient with an incompetent larynx

Incompetency of the larynx may vary from minimal occasional aspiration of saliva with a somewhat annoying cough to severe and life threatening aspiration. Management of these problems remains a significant challenge to the ingenuity of the well trained otolaryngologist. A review of the anatomic and physiologic factors involved both in normal function of the larynx and in derangement resulting in varying degrees of laryngeal incompetency would seem worthwhile. Several procedures are available that may be useful individually or in combination in the management of these patients.     

Leishmaniasis donovani presenting as an isolated lesion in the larynx

A case of leishmaniasis of the larynx caused by Leishmania donovani occurring in a 42-year-old man is reported. The oral cavity and the upper respiratory tract are commonly involved in mucocutaneous American leishmaniasis, but are less frequently reported in the 'Old World'. The primary and isolated location in the larynx is exceptional. The immunoperoxidase technique using antisera to anti-L. donovani is a useful method to identify the parasite.     

Focal mucinosis: clinical and histological features of an unusual condition

Mucinoses constitute a diverse group of disorders that have in common the deposition of basophilic, finely granular and stringy material in the connective tissues of the dermis (known as dermal mucinoses); this also can occur in the hair follicles (follicular mucinoses) and finally in the epidermis (epithelial mucinoses). We present the clinical and histological findings of a case of focal mucinosis in a 76-year-old man who was otherwise fit and healthy. A literature review revealed a sparse number of such cases none of which was reported in the ENT literature. Focal cutaneous mucinosis is a benign condition but the authors believe it is of local and systemic interest to the Otolaryngologist as an addition to his or her armentarium of diagnoses.