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

Humans ; Laryngeal Diseases ; diagnosis ; therapy ; Leukoplakia ; diagnosis ; therapy

OBJECTIVETo investigate the histopathological subjective difference of laryngeal epitheliual premalignant lesions and to analyze the prognosis of every grade of laryngeal epitheliual premalignant lesion.

METHODSAccording to 2005 WHO classification system, 237 cases of laryngeal epitheliual premalignant lesions were reviewd by 3 pathologists, meanwhile, the histopathological consistency among 3 pathologists was estimated with κ-statistics method. The Kaplan-Meier survival analysis were performed to assess the prognosis of every grade of laryngeal epitheliual premalignant lesion with follow-up data.

RESULTSThere was totally a moderate consistency among 3 pathologists (κ values: 0.598 9), the histopathological difference was mainly between mild dysplasia and moderate dysplasia and between severe dysplasia and carcinoma in situ. The follow-up duration was between 18-120 months, and the median follow-up duration was 38 months. The carcinoma trsnformation rate was 8.44% (20/237) with an average malignant transformation duration of (19.45 ± 7.32) months, which was increased with the degree of dysplasia(mild dysplasia:1.67%, moderate dysplasia:3.57%, severe dysplasia:10.60%, carcinoma in situ:18.18%), no difference could be found between mild and moderate dysplasia, between moderate and severe dysplasia; Moreover, there was no difference between severe dysplasia and carcinoma in situ (P > 0.05).

CONCLUSIONSThe histopathological variability brought the uncertainty for classification of laryngeal epitheliual premalignant lesions, which might have an impact on clinical management of laryngeal epitheliual premalignant lesions; there was obvious difference in carcinoma transformation between low-risk and high-risk laryngeal epitheliual premalignant lesions, and more attention on treatment and prognosis assessment should be paid for severe dysplasia as carcinoma in situ.

Cell Transformation, Neoplastic ; Humans ; Hyperplasia ; Laryngeal Diseases ; Laryngeal Neoplasms ; diagnosis ; Larynx ; Male ; Precancerous Conditions ; diagnosis ; Prognosis

BACKGROUND AND OBJECTIVES: The survival rate of laryngeal cancer has improved in recent day. But in case of advanced cancer, radical destructive surgery is required for survival. So early detection of laryngeal cancer prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening tests using voice has many advantages of being simple, non invasive, and requiring less space. In this system, the most important factor is the selection of acoustic parameters to be used in voice analysis. Thus authors studied the acoustic parameters that can differentiate normal, benign, malignant laryngeal diseases by an acoustic analyzing system and we also checked the availability of parameters. MATERIALS AND METHODS: We evaluated the voice analyzed data from 25 laryngeal malignancy patients, 33 benign laryngeal disease patients, 35 normal control who visited PNUH otolaryngology department from October 1996 to May 1998. A computerized speech lab. 4300B (CSL) was used to carry out the analysis of each voice sample and statistical analysis, ANOVA. Canonical analysis and cumulative frequency curve were used. RESULTS: The statistically significant parameters that can differentiate normal and malignant laryngeal disease groups were 15 parameters and can differentiate normal and benign laryngeal disease group were 9 parameters and that can differentiate benign and malignant laryngeal disease group were 7 parameters. CONCLUSION: We consider that these parameters and detection programs may be effective in development of a screening system using voice only. Developing diagnostic tools and programs would need further study of phonetics and voice engineering.
Acoustics* ; Diagnosis, Differential* ; Fibrinogen ; Humans ; Laryngeal Diseases ; Laryngeal Neoplasms ; Mass Screening ; Otolaryngology ; Phonetics ; Survival Rate ; Voice*

BACKGROUND AND OBJECTIVES: Some objective and quantitative diagnositc methods are introduced to evaluate vocal cord paralysis, such as electro glottography (EGG) and laryngeal electromyography (LEMG). LEMG is an invasive and highly technical method requiring patient's cooperation. It records action potential generated when intrinsic laryngeal musculature contracts. EGG, on the other hand, records changes of impedence between both vocal cords when theses vibrate and represents many information of vocal cord movements. This method is non-invasive and very simple offering some valuable information about voice function of laryngeal diseases. MATERIALS AND METHODS: From January 1998 through May 2000, we evaluated 15 vocal cord paralysis patients by LEMG and EGG and compared the usefulness of these two methods by determining the lesions of vagal nerve injury. RESULTS: For patients who had severe recurrent laryngeal nerve injuries, EGG and dEGG showed no plateau phase but a loss of two-mass movements. Some showed very irregular saw-tooth shaped wave patterns. Patients with vagal nerve injury, EGG and dEGG showed relatively well maintained plateau phases because they had paralyzed cricothyroid muscles which are counteract to abductor of vocal cord. CONCLUSION: Although EGG did not provide information about such diseases as laryngeal myopathy and arthropathy, it is simple and non-invasive, and may he much valuable as a topodiagnostic method of vocal cord paralysis.
Action Potentials ; Diagnosis* ; Electromyography ; Hand ; Humans ; Laryngeal Diseases ; Laryngeal Muscles ; Muscular Diseases ; Ovum ; Recurrent Laryngeal Nerve Injuries ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice

In some specific measurement, observations, and analyses of certain aspects of the voice and voice production used in phoniatrics, signs of various laryngeal disorders were identified, indicating that these tools can be used as aids in the diagnosis of laryngeal disorders.
Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Human ; Laryngeal Diseases/diagnosis* ; Middle Age ; Voice Disorders/diagnosis*

Airway Obstruction ; diagnosis ; etiology ; Aspergillosis ; complications ; diagnosis ; Humans ; Laryngeal Diseases ; complications ; diagnosis ; microbiology ; Larynx

Castleman Disease ; complications ; diagnosis ; Female ; Humans ; Laryngeal Diseases ; diagnosis ; etiology ; Middle Aged

OBJECTIVE: To discuss the diagnosis and treatment method in children with mass in subglottic. METHOD: There were totally 35 patients with subglottic mass who complained with dyspnea in our department. All the patients got electronic laryngoscopy examination in order to get the preliminary judgment of the mass' property. Then they accepted ultrasound and CT scan to make the definite diagnosis. The patients with subglottic hemangioma accepted oral propranolol or intralesional Pingyangmycin injection. The other type of masses got the laryngoscope CO2 laser tumor resection. RESULT: There were 31 patients with subglottic hemangiomas, 2 patients with subglottic cysts, 1 patient with subglottic fibroma, 1 patient with subglottic granuloma. The substantial follow-up time was from 1 month to 3 years. 25 patients with subglottic hemangiomas were cured, 6 patients got improvement. The patients with non-hemangiomas were all cured. CONCLUSION There was a high incidence of hemangioma in children with subglottic mass. We suggested making a diagnosis by doing electronic laryngoscopy, ultrasound and CT scan step by step. Oral propranolol was a safe and effective method in treating subglottic hemangioma. For the patients with non-hemangiomas, we considered the laryngoscope CO2 laser tumor resection as the first choice of treatment.
Child ; Glottis ; pathology ; Hemangioma ; diagnosis ; therapy ; Humans ; Laryngeal Diseases ; diagnosis ; therapy ; Laryngeal Neoplasms ; diagnosis ; therapy ; Laryngoscopy ; Larynx ; pathology ; Tomography, X-Ray Computed

Paradoxical vocal fold movement (PVFM) is a rare disease characterized by the adduction of vocal folds during inspiration. Since patients with PVFM may suffer from acute airway distress or inappropriate treatment for a long period of time, proper diagnosis by the otolaryngologist is critical to proper management. Case 1 was treated with voice therapy which involved self-awarness about what was happening inside his larynx during inspiration, the use of diaphragmatic breathing and laryngeal muscle tension reduction. Case 2 could not be treated with the initial voice therapy but the botulium toxin injection which was used as the second treatment option proved be successful.
Botulinum Toxins ; Diagnosis ; Humans ; Laryngeal Muscles ; Larynx ; Rare Diseases ; Respiration ; Vocal Cords* ; Voice