OBJECTIVE: To investigate the effect of the anteroposterior cricoid split on cartilage growth. METHOD: The rabbits were killed 8 months after the surgery of anteroposterior cricoid split. The larynxes were harvested and the cross-sectional area of the cricoid cartilage were calculated. RESULT: There was no significant difference in the cross-sectional area of the cricoid cartilage of these three groups. CONCLUSION The anteroposterior cricoid split might have no adverse effect on subsequent growth of cricoid cartilage.
Animals ; Cricoid Cartilage ; growth & development ; surgery ; Laryngostenosis ; surgery ; Rabbits

Cricoid Cartilage ; surgery ; Humans ; Laryngectomy ; methods ; rehabilitation ; Larynx ; Recovery of Function

Chondroma ; surgery ; Cricoid Cartilage ; Humans ; Male ; Middle Aged

This patient suffered from severe subglottic stenosis(grade Ⅳb). During partial cricotracheal resection, we cut through the cricothyroid membrane and the cricoid arch along the line from the lower edge of the thyroid cartilage to 5 mm of the inferior thyroid cartilage corner anteromedially. This can protect the cricothyroid joint, effectively protect the recurrent laryngeal nerve, and also support the airway. Strictly adhere to airway separation, avoid excessive separation of scars, and combine with reasonable postoperative management to achieve a safe extubation.
Humans ; Constriction, Pathologic/surgery* ; Trachea/surgery* ; Airway Extubation ; Laryngostenosis/surgery* ; Larynx/surgery* ; Cricoid Cartilage/surgery* ; Treatment Outcome

OBJECTIVETo evaluate the effect of conservative surgical management on patients with subglottic cancer.

METHODSNine cases with subglottic carcinoma were treated surgically from 1984 to 1999. There were T2N0 lesions in 2 cases, T3N0-1 in 3 cases and T4N0-1 in 4 cases. All the cases underwent partial laryngectomy including partial cricoid resection. Variations of a pedicled thyroid cartilage flap were used for reconstruct the cricoid defect. The pedicle based muscle was thyrohyoid, sterno-thyroid or inferior constrictor. Unilateral neck dissection was performed on 7 cases and bilateral on two.

RESULTSThe function of phonation were preserved in all cases. Eight of nine 8/9 were decanulated. Normal deglutition were achieved for all patients. The 3 and 5 year survival rates were 8/9 and 6/9, respectively.

CONCLUSIONPedicled thyroid cartilage flap is appropriate for reconstruction of the cricoid defect in the conservative surgery of selected subglottic carcinoma.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Thyroid Cartilage ; transplantation

BACKGROUND: This study evaluated the position and relationship between the right internal jugular vein (IJV) and the surrounding external landmarks using ultrasonography. METHODS: Fifty-four patients undergoing central vein access for cardiac surgery were enrolled in this study. The IJV, carotid artery (CA) and sternocleidomastoid muscle (SCM) at the cricoid cartilage level in 15o trendelenburg position with 30o head rotation were examined using a two dimensional ultrasound transducer of a TEE machine. Images of the vessels and the demographic data of the patients were recorded and analysed. RESULTS: At the level of the cricoid cartilage, the position of the right IJV was medial to middle of the clavicular head of the SCM muscle in 26 cases (48.2%), lateral in 11 cases (20.4%) and just above the middle of clavicular head of the SCM muscle in 17 cases (31.5%). In 43 patients (79.6%), the IJV overlapped the CA anterolaterlly < 5 mm, and these cases were regarded as normal. Ten patients (18.5%) had a medially positioned IJV overlapping the CA more than 5 mm and the IJV was positioned lateral to CA in 1 (2%) patient. The mean ratio of the overlapped diameter and the diameter of the CA was 33.6% and the overlapping ratios were greater than 50% in 10 patients (31.4%). The mean skin-to-vein distance at the angle of 30degrees was 1.82 cm. CONCLUSIONS: In 18.5% of patients positioned in the 15o Trendelenburg position, with their head turned to the left 30degrees, the IJV overlapped the CA medially more than 5 mm, which increased the risk of a carotid puncture using the blind technique.
Carotid Arteries* ; Catheterization ; Cricoid Cartilage ; Head* ; Head-Down Tilt* ; Humans ; Jugular Veins* ; Prospective Studies* ; Punctures ; Thoracic Surgery ; Transducers ; Ultrasonography ; Veins

Adult ; Aged ; Airway Obstruction ; therapy ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Diseases ; therapy ; Male ; Middle Aged ; Punctures ; methods ; Thyroid Cartilage ; surgery

OBJECTIVE: To compare the results of supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) and horizontal-vertical hemilaryngectomy in the treatment of mid and late laryngeal carcinoma. METHOD: Retrospective analysis on the types of mid and late stage of laryngeal carcinoma clinical material, 22 patients supracricoid partial laryngectomy-cricohyoidopexy, 20 patients horizontal-vertical hemilaryngectomy, each with the added radiotherapy. The long term results of operation and glottic reconstruction were evaluated by postoperative visiting, semi-quantitative speech intelligibility analysis, electroglottograph (EGG) and so on. RESULT: Forty-two cases of laryngeal cancer patients were decannulated, the decannulation rate was 100%. Postoperative decannulation time: surgical CHP for (44.0 +/- 4.6) d, 3/4 throat operation for (39.0 +/- 2.7) d, two groups of postoperative decannulation time difference was statistically significant (t = 4.2395, P < 0.01). Eight weeks after evaluation, two groups's swallowing function and postoperative evaluation of patients after one year speech intelligibility difference was not statistically significant (P > 0.05). GRBAS in the evaluation of G rating, the difference between the two groups was statistically significant (P < 0.05), CHP group showed,for most patients, a severe hoarse degree, but 3/4 throat operation group mainly represented a moderate degree lever. EGG parameters were checked after 1 years. F0 comparative differences was not statistically significant (P > 0.05), and the jitter, shimmer and NNE compared CHP group to 3/4 laryngectomy group were significantly increased (P < 0.05). Kaplan-Meier method statistics show: CHP group and 3/4 laryngectomy group 3 years and 5 year accumulate survival rates were 95.5% and 89.7%, 85.1% and 83.7% respectively, two groups of three, five years of survival difference was not statistically significant (P > 0.05). CONCLUSION According to the laryngeal of middle-late carcinoma, the region and the involvement of the scope were considered to choose appropriate surgical treatments, and both can complete resection of the tumor, and can retain good laryngeal functions,and CHP has a wider range of operation indications and clinical application prospect, is worthy to be popularized.
Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Cricoid Cartilage ; surgery ; Deglutition ; Humans ; Hyoid Bone ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Pharynx ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the surgical procedure and indication of the Extended supracricoid partial laryngectomy with tracheocricohyoidoepiglottopexy and tracheocricohyoidoglottopexy (ESCPL+-TCHEP/TCHP) as well as the rehabilitation of laryngeal functions. METHOD: ESCPL+TCHEP/TCHP were conducted in 10 cases with laryngeal carcinoma of T3 and T4 stages with subglottic invasion for 10-20 mm from 2000 to 2005. RESULT: All the 10 cases, 9 of them have survived until now and still be followed up. 1 of them succumbed to the recurrence of cervical lymph node metastasis 4 years after the surgery. Normal respiration, deglutition and the function of maintaining subglottic pressure were recovered in all the case. Postoperative phonation was also satisfactory among all of them. CONCLUSION If handle the surgical indication strictly, to some cases of laryngeal carcinoma with subglottic invasion for 10-20 mm, this surgical technique could replace the total laryngectomy.
Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Cricoid Cartilage ; surgery ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Larynx ; surgery ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo evaluate the oncological and functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL).

METHODSForty-three cases underwent supracricoid partial laryngectomy with functional reconstruction in stage T1b-T4. In these cases, 16 were supraglottic cancers, 21 were glottic cancers, and 2 were subglottic cancers. Three types of supracricoid partial laryngectomy (cricohyoidopexy CHP, cricohyoidoepiglottopexy CHEP and tracheocricohyoidoepiglottopexy TCHEP) were employed accordingly.

RESULTSThe 3- and 5-year accumulative survival rates were 90.7% and 83.7% respectively (Kaplan-Meier method). Median follow-up time was 57 months. Decannulation rate was 95.3% (41/43) in those. The mean time of decannulation was 14 days in patients preserved both cricoarytenoid units and 43 days in those only preserved one cricoarytenoid unit. The removal of epiglottis increased the risk of aspiration and prolonged time of decannulation (P < 0.05).

CONCLUSIONSSupracricoid partial laryngectomy for selected laryngeal cancer is feasible. The patients can gain satisfied survival rate and quality of life.

Aged ; Carcinoma, Squamous Cell ; mortality ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; mortality ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome