BACKGROUND: Many head and neck surgeons preferred the radiotherapy as a first choice in treating early laryngeal carcinoma(T1, T2) to surgical operation because of the relatively high curability(80-90%), organ preservation and better quality of life. If radiotherapy failed, some surgeons perform total laryngectomy as salvage operation, but others prefer to perform partial laryngectomy, which is increasing in tendency. OBJECTIVE: To investigate the pattern of cancer invasion to the laryngeal cartilages using salvage laryngectomized cancer specimens which had recurred after radiotherapy. MATERIALS & METHOD: Preoperative computerized tomograpy images were retrospectively compared to postoperative salvage laryngectomized cancer specimens which had recurred after radiotherapy 13 cases from March, 1985 to February, 1994. RESULTS: 1) In laryngeal cacer recurred after radiotherapy, incidence of cartilage invasion was not in early supragolttic cancer. but all in advanced supraglottic cancer, and 3cases of 5 cases(60.0%) in early glottic cancer, 4cases of 5 cases(80.0%) in advanced glottic cancer. 2) The order of laryngeal cartilage invasion was the first thyroid cartilage(61.5%), the second arytenoid cartilage(30.7%), and the third cricoid cartilage(23.1%). 3) The diagnostic accuracy of preoperative CT scan for laryngeal cartilage invasion was 66.7% in thyroid cartilage, 55.6% in arytenoid cartilage, 55.6% in cricoid cartilage, and 100% in epiglottis. CONCLUSION: Selection of partial laryngectomy as salvage operation should be considered carefully.
Arytenoid Cartilage ; Cartilage ; Cricoid Cartilage ; Epiglottis ; Head ; Incidence ; Laryngeal Cartilages* ; Laryngectomy* ; Neck ; Organ Preservation ; Quality of Life ; Radiotherapy ; Retrospective Studies ; Thyroid Cartilage ; Thyroid Gland ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Cancer invasion of the laryngeal cartilage is mainly found in the ossified portion of cartilage and contraindication for conservation surgery of laryngopharyngeal cancer. Thus, it is an important factor to consider in planning the management of laryngopharyngeal cancer. Computed tomographic (CT) scan is an useful tool for the evaluation of laryngopharyngeal cancer, but it is difficult to distinguish cancer invasion from non-ossified cartilage regions by the CT scan. Knowledge of the precise ossification pattern will be useful to determine the cancer invasion of laryngeal cartilage. The purposes of this study include ossi6cation pattern according to age, symmetry of ossification and incidence of bone marrow formation. MATERIALS AND METHODS: Fifty-three cases of normal laryngeal CT scans which were reviewed by two radiologists. They were all males, ranging in the ages from 40 to 69 (mean age 53). Ossification degree (%) was measured from the inferior cornu in the thyroid cartilage and the superior border of the posterior lamina in the cricoid cartilage. Age relation and symmetry of ossification and incidence of bone marrow formation were evaluated. RESULTS: There were no correlation between age and degree of laryngeal cartilage ossification (p> 0.05). But there was symmetry and definite pattern of ossification. Symmetry of ossification was 84.9% in the thyroid cartilage. Incidence of bone marrow formation was 60.6% in the thyroid cartilage and 82.8% in the cricoid cartilage. CONCLUSION: This study reveals that there is no ossification-age relationship, but the symmetry and the definite pattern of ossification in the laryngeal cartilage are useful clues in determining the cancer invasion on CT scan.
Bone Marrow ; Cartilage ; Cricoid Cartilage ; Humans ; Incidence ; Laryngeal Cartilages* ; Male ; Thyroid Cartilage ; Tomography, X-Ray Computed*

The thyroid cartilage, which is the biggest cartilage in laryngeal cartilages, undergoes the osseous changes with advancing age and the process is ordinary endochondral ossification. With respect to the spread pattern of ossification, there are several reports but study about the Korean is negligible. The purpose of this study is to estimate the age based on radiographic analysis of the Korean thyroid cartilage. Dedicated mammography was carried out on 124 specimens of the thyroid cartilage including 76 males and 48 females. We measured 14 qualitative measurements. The results were as followed ; The Ratio of radio-opacity exhibited increasing value with advancing age on both sexes. The ossification began at the posterior border and involved orderly the inferior border, the anterior angle (anterior border) and notch as advancing age in male subjects. We could propose the pattern of ossification for age-estimation in Korean male subjects. Concerning the female subjects, we could not propose the relation between age and the pattern of ossification. In conclusion, we can estimate the age for male subjects by radiographic quantitative analysis of the Korean thyroid cartilage.
Cartilage ; Female ; Humans ; Laryngeal Cartilages ; Male ; Mammography ; Thyroid Cartilage* ; Thyroid Gland*

The thyroid cartilage is located just below the hyoid bone and is the biggest cartilage in laryngeal cartilage. The purpose of this study is to identify the sex based on the morphological analysis of the thyroid cartilage of Koreans. This study was carried out on the thyroid cartilage of 109 specimens of adult subjects (age over twenty years old) including 69 males and 40 females. We measured 27 measurements, followed by the statistic procedures. The results were as followed ; 1. Male subjects exhibited larger values of width, height and length of the thyroid cartilage and height of lamina than female subjects (p < 0.01). 2. Female subjects exhibited larger values of angle of lamina, angle of inferior horn and angle of upper margin of lamina than male subjects (p < 0.01). 3. Discriminant functions were obtained with the measurement values of length of the thyroid cartilage and height of lamina. In conclusion, the thyroid cartilage in Korean is different depending on sexes. Therefore we can identify the sex for over twenty years old Koreans by the morphometric analysis of the thyroid cartilage.
Adult ; Animals ; Cartilage ; Female ; Horns ; Humans ; Hyoid Bone ; Laryngeal Cartilages ; Male ; Thyroid Cartilage* ; Thyroid Gland*

To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized for the closed reduction of the displaced arytenoid under local anesthesia. 23 patients who underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June 2001 were reviewed. The data were collected on the duration of the laryngeal injury, times of receiving reduction, side-effects after the treatment and the period for voice to return to normal. The relationship between the duration of the laryngeal lesion and the period of the voice rehabilitation was examined. 13 patients received the reduction under IL and 10 patients under DL. Except the times of the reduction, which showed significant difference, no differences were found between IL group and DL group in the course and the period of voice rehabilitation, as well as sore throat after the manipulation. The patients' voice recovery was positively related to their course of disease in both IL and DL group. It is concluded that the recovery of normal voice is obviously affected by the duration of arytenoid dislocation. The reduction under IL is as effective as under DL in the treatment of arytenoid dislocation. Reduction by DL is better suit the patients with long time course of disease.
Arytenoid Cartilage/*injuries ; Dislocations/diagnosis ; Dislocations/*etiology ; Dislocations/therapy ; Intubation, Intratracheal ; Laryngeal Cartilages/*injuries ; Laryngoscopes/adverse effects ; Laryngoscopy/*adverse effects ; Laryngoscopy/methods

To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized for the closed reduction of the displaced arytenoid under local anesthesia. 23 patients who underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June 2001 were reviewed. The data were collected on the duration of the laryngeal injury, times of receiving reduction, side-effects after the treatment and the period for voice to return to normal. The relationship between the duration of the laryngeal lesion and the period of the voice rehabilitation was examined. 13 patients received the reduction under IL and 10 patients under DL. Except the times of the reduction, which showed significant difference, no differences were found between IL group and DL group in the course and the period of voice rehabilitation, as well as sore throat after the manipulation. The patients' voice recovery was positively related to their course of disease in both IL and DL group. It is concluded that the recovery of normal voice is obviously affected by the duration of arytenoid dislocation. The reduction under IL is as effective as under DL in the treatment of arytenoid dislocation. Reduction by DL is better suit the patients with long time course of disease.
Adult ; Aged ; Arytenoid Cartilage ; injuries ; Female ; Humans ; Intubation, Intratracheal ; Joint Dislocations ; diagnosis ; etiology ; therapy ; Laryngeal Cartilages ; injuries ; Laryngoscopes ; adverse effects ; Laryngoscopy ; adverse effects ; methods ; Male ; Middle Aged

Adult ; Aged ; Cartilage Diseases ; diagnosis ; therapy ; Humans ; Laryngeal Cartilages ; Laryngeal Diseases ; diagnosis ; therapy ; Male ; Middle Aged

Ultrasonography has increasingly moved from being a modality confined to the radiology department to an active diagnostic and therapeutic aid available to the head and neck at the point of patient care. However, the application of ultrasonography to the laryngeal disorder is very rare due to progressive age-related ossification of laryngeal cartilage and the presence of air in the lumen, which contribute to difficult conditions for transmission of the ultrasonic waves. The observation about the movements of larynx or surrounding structures is important to understand the physiology of phonation or swallowing and to diagnose the disease. Ultrasonography is a noninvasive and safe imaging technique that can be used to investigate the anatomic structures of the head and neck. Recently, the development of high-frequency ultrasonography makes it possible to apply the ultrasound in the evaluation of larynx.
Deglutition ; Diagnosis ; Head ; Laryngeal Cartilages ; Larynx ; Neck ; Patient Care ; Phonation ; Physiology ; Ultrasonic Waves ; Ultrasonography

Humans ; Laryngeal Cartilages ; pathology ; Laryngeal Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local ; diagnosis ; Radiation Injuries ; diagnosis ; pathology

OBJECTIVETo investigate the operative effect and value of window partial laryngectomy for the treatment of stage T2-3 glottic laryngeal carcinoma.

METHODSFrom Oct. 2000 to Dec. 2006, the stage T2-3 glottic laryngeal carcinoma of 48 patients by properly selected were performed with window partial laryngectomy and laryngeal reconstruction. Twenty nine males and 19 females were included. Their ages ranged from 43 to 78 years (median 57.0 years). Before operation and in the 6 months after operation, these targets including auditory mental evaluation of hoarse degree, active degree and symmetry of vocal cord, glottic width in the time of quiet breathing, glottic closing degree in the time of phonating, respiratory function and swallowing function were surveyed. In addition, the things of recurrence and metastasis of tumors together with survival time of patients were following investigated.

RESULTSAll patients were decannulated successfully and incisions were healed smoothly. No operative complication occurred. Except active degree of vocal cord (P = 0.343), there were respectively significant difference between two group targets of auditory mental evaluation of hoarse degree (all P <0.01), symmetry of vocal cord (P = 0.000), glottic width in the time of quiet breathing (P = 0. 001), glottic closing degree in the time of phonating (P = 0.001) and respiratory function (P=0.001) those were investigated before operation and after operation. The swallowing function wasn't influenced (P= 0.310). There were laryngostenosis in 1 case, recurrence in 1 case (2.1%), cervical lymph node metastasis in 1 case and hepatic metastasis in 1 case. Two cases died. 3-year and 5-year overall survival rate were respectively 96.9% and 88.9%.

CONCLUSIONSThe study showed that window partial laryngectomy was successful for treating stage T2-3 glottic laryngeal carcinoma by properly selected. This operation was effective for reducing surgical invasion and beneficial to resume respiratory and vocal function.

Adult ; Aged ; Female ; Humans ; Laryngeal Cartilages ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Treatment Outcome ; Vocal Cords