PURPOSE: The most important function of the larynx is airway protection which is provided through a polysynaptic reflex closure triggered by the receptors in the glottic and supraglottic mucosa, evoking the reflex contraction of the laryngeal muscles especially by strong adduction of vocal cords. Based on the hypotheses that central facilitation is essential for this bilateral adductor reflex and that its disturbance can result in weakened laryngeal closure, we designed this study to elucidate the effect of central facilitation on this protective reflex. MATERIALS AND METHODS: Seven adult, 20 kg mongrel dogs underwent evoked response laryngeal electromyography under 0.5 to 1.0 MAC (minimum alveolar concentration) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles. RESULTS: Ipsilateral reflex closure was consistantly recorded regardless of anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels were deepened. Additionally, late responses (R2) were detected in one animal at lower level of anesthesia. CONCLUSIONS: Deepened level of anesthesia affects central facilitation and results in the loss of the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may possibly provide a way to prevent aspiration in unconscious patients.
Anesthesia/methods ; Animals ; Dogs ; Glottis/*physiology ; Laryngeal Nerves/physiology ; *Reflex

In recent years, radiofrequency ablation technique is widely used in Otolaryngology Head and Neck Surgery clinical work, domestic scholars preliminary study the efficacy to early glottic cancer. The review will discuss the definition and the main treatment strategy of early glottic cancer, theory and history of radiofrequency ablation technique, vocal endoscopic surgical procedures and safety margin, Clinical observation of radiofrequency ablation technique to treat early glottic cancer.
Catheter Ablation ; Endoscopy ; Glottis ; physiology ; Humans ; Laryngeal Neoplasms ; surgery ; Treatment Outcome

This work is directed at developing a virtual instrument system as an accessorial diagnostic instrument for laryngeal diseases. Programmed with LabWindows/CVI, the system combines the voice acoustic analyzing function with the glottal image measuring function. The voice acoustic analyzing system can sample, store and replay vocal signals; can extract and analyze parameters, including fundamental frequency (F0), frequency perturbation quotient (FPQ), amplitude perturbation quotient(APQ), harmonics-to-noise ratio (HNR), jitter frequency (JF), Shimmer; and can do 3D sound graph analysis. The glottal image analyzing system can sample and store the image observed by the laryngostroboscope; can display any phase in one cycle of the vibration of the vocal cords or a slow and continuous movement of vibrating vocal cords; can snap and save the diagnostic frame of image; and can extract the parameters of the image such as the length and area of the glottis, the length and area of the vocal cords and the diseased part.
Computer Simulation ; Diagnosis, Computer-Assisted ; instrumentation ; methods ; Glottis ; physiology ; Humans ; Image Processing, Computer-Assisted ; Laryngeal Diseases ; diagnosis ; User-Computer Interface ; Voice ; physiology

OBJECTIVE: To investigate the feasibility and results of laryngeal functional preservation surgery for piriform sinus carcinoma with paraglottic space involvement. METHOD: Fourteen cases of piriform sinus carcinoma with paraglottic space involvement were reviewed. Laryngoplasty was performed after tumor was resected, bilater al selective neck dissections were performed at the same stage. Postoperative chemoradiotherapy was applied to 11 patients while the other 3 patients did not receive chemotherapy nor radiotherapy. The follow-up time ranged from 6 months to 5 years, and the mean follow-up time was three and a half years. RESULT: Twelve cases healed primarily while 2 cases experienced delayed heal because of pharyngeal fistula. Postoperative swallow bucking occurred in all patients, the longest gastric feeding time was 2 months. For the patients underwent postoperative chemoradiotherapy, the tumor did not recur in ten cases during the 3 years follow-up, while recurred in another case and the patient died without further treatment. Among those 3 cases without postoperative radiotherapy or chemotherapy, the tumor recurred in 2 cases during the following 6 months and chemoradiotherapy was applied, no recurrence presented in one patient, another one lost of follow-up. For the patient with recurred tumor 8 months after surgery, total laryngectomy was employed with postoperative chemoradiotherapy, the case died of tumor recurrence one and half year after the first surgery. The 3-year survival rate was 78.6%. For the vocal cord at lesion side, the mobility was noticeable in 6 patients, and visible anatomic landmark was lost in the other 8 patients. CONCLUSION Laryngeal function preservated surgery could be performed in selected cases of piriform sinus carcinoma with para-glottic space involvement in order to achieve better clinical results and quality of life.
Aged ; Carcinoma ; surgery ; Female ; Follow-Up Studies ; Glottis ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; physiology ; Male ; Middle Aged ; Organ Sparing Treatments ; Pyriform Sinus ; pathology ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To study the function of lymphangiogenesis and the expression of Cathepsin D (Cath-D) in laryngeal carcinoma metabasis and clinical pathology character. METHOD: The expression of Cath-D were detected in 76 laryngeal carcinoma with immunohistochemistry (SP method). Podoplanin was used as the marker of lympgatic vessel endotheliocytes to label lympgatic vessel in 76 laryngeal carcinoma,lymphatic microvessel density were measured,and the paraneoplastic tissues was used as control group. RESULT: The positive rate of Cath-D in paraneoplastic tissue, laryngeal carcinoma and in pathology classification, in clinical stage, in cervicale lymphonode metastasis negative and positive group were significantly different. However, there had no difference between the positive rate of Cath-D in the age specific and clinical classification. c) The lymphatic microvessel density in paraneoplastic tissue, laryngeal carcinoma and clinical stage, in glottic carcinoma and supraglottic carcinoma, in cervical lymphonode metastasis negative and positive group were significantly different; but there had no difference in age-specific and pathology classification. CONCLUSION (1) The high expression of lymphatic microvessel density and the increasing expression of Cath-D could promote cervical lymphonode metastasis in aryngeal carcinoma. (2) There had a correlation between the high expression of lymphangiogenesis and Cath-D in laryngeal carcinoma, and had cooperation in aryngeal carcinoma lymphonode metastasis.
Biomarkers, Tumor ; metabolism ; Carcinoma ; metabolism ; pathology ; physiopathology ; Cathepsin D ; metabolism ; Female ; Glottis ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; physiopathology ; Lymphangiogenesis ; physiology ; Lymphatic Metastasis ; Lymphatic Vessels ; metabolism ; Male ; Membrane Glycoproteins ; metabolism