PURPOSE: To determine the value of CT(Computerized Tomography) in the diagnosis of laryngeal tuberculosis and to assess to what extent its characteristic findings different from those of aryngeal carcinoma. Materials and Methods : CT scans of twelve patients with laryngeal tuberculosis were reviewed and compared with those of fifteen patients with laryngeal cancer, retrospectively. Clinical symptoms, laryngoscopic examinations and the presence of pulmonary tuberculosis on chest radiographs were also reviewed. RESULTS: In laryngeal tuberculosis, bilater alsymmetric or asymmetric involvement was noted in nine(75%) patients, while unilateral involvement was seen in three(25%). This was significantly different from laryngeal cancer in which unilateral involvement was noted in twelve patients(80%). Diffuse thickening of the free margin of the epiglottis was a characteristic and frquent finding in tuberculosis(n=6, 50%). No deep submucosal infiltration of preepiglottic and paralaryngeal fat spacesis seen in tuberculosis in spite of large areas of involvement of laryngeal mucosa, while twelve patients(80%) with laryngeal cancer showed thickened deep infiltration which resulted in a submucosal mass. CONCLUSION: CT was useful in the diagnosis of laryngeal tuberculosis and its CT findings wee characterized by bilateral involvement, thickening of the free margin of the epiglottis and good preservation of preepiglottic and paralaryngeal fatspaces in spite of large areas of involvement.
Diagnosis ; Epiglottis ; Humans ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Laryngeal*

Laryngeal neoplasm is the second most common malignancy of the upper aerodigestive tract. About 85% to 95% of laryngeal malignancies are squamous cell carcinoma that arises from the epithelial lining of the larynx. The exact cause of laryngeal neoplasm is unknown, but certain risk factors can affect the chances of developing it. Chronic inflammation is a mutagen factor confirmed in the carcinogenesis of various tumor. Inhalation injuries cause histopathologic damage to laryngeal mucosa and inflammation change. This long term inflammation may leads to the development of dysplasia and malignant transformation. Recently, we experienced a case of malignant transformation of laryngeal mucosa after inhalation injury patient 25 years ago. Herein, we reported this rare case and review the relevant literature.
Burns ; Carcinogenesis ; Carcinoma, Squamous Cell ; Humans ; Inflammation ; Inhalation* ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Larynx ; Mucous Membrane* ; Risk Factors

BACKGROUND AND OBJECTIVES: A large body of evidence from a variety of experimental systems suggests that cyclooxygenase-2 (COX-2) is important in carcinogenesis. This study was to determine whether cyclooxygenase-1 (COX-1) and COX-2 were overexpressed in laryngeal squamous cell carcinoma, and discuss the possible causal role of COX-2 in the laryngeal squamous cell carcinoma formation. MATERIALS AND METHODS: Tissue samples from 21 pateints with laryngeal squamous cell carcinoma were analyzed by immunohistochemical staining. RESULTS: There was an elevation of COX-2 expression in laryngeal squamous cell carcinoma. Normal buccal mucosa biopsies and normal laryngeal epitheliums adjacent to laryngeal cancer showed nondetectable or weak staining for COX-2 protein. There is no difference in the expression of COX -1 in the normal buccal mucosa, normal laryngeal mucosa and laryngeal squamous cell carcinoma. CONCLUSION: There is an overexpression of COX-2, but not COX-1 in laryngeal squamous cell cancer. This may represent a causal role of COX-2 in the formation and proliferation of laryngeal squamous cell carcinoma. There may also be another role of selective COX-2 inhibition for treatment of laryngeal squamous cell carcinoma.
Biopsy ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Cyclooxygenase 1* ; Cyclooxygenase 2 ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Mouth Mucosa ; Neoplasms, Squamous Cell ; Prostaglandin-Endoperoxide Synthases*

BACKGROUND AND OBJECTIVES: Acute laryngotracheal injury is uncommon but can be a life-threatening event and often poses as a difficult airway management problem. Therefore, the immediate recognition and appropriate initial assessment and treatment are vital for a successful outcome. We performed this study to evaluate an appropriate management of acute laryngotracheal injury patients. MATERIALS AND METHOD: Twenty-two patients with acute external laryngotracheal injury who underwent conservative treatment or surgery from 1998 to 2003 were evaluated. The record of patients were reviewed retrospectively. These patients have been studied with attention to clinical symptoms, sign, injury mechanism, injury site, degree of injury, treatment and outcome after the treatment. RESULTS: Sixteen cases were categorized as blunt trauma and the other six cases as penetrating trauma. The main symptoms and signs were dyspnea and hoarseness. Common sites of injury were laryngeal mucosa, thyroid cartilage and trachea. The patients in group I, II were treated conservatively mainly and those in group III, IV, V were mainly treated surgically. All patients were decannulated. Sixteen patients made a full return to normal voice, and six were assessed fair. CONCLUSION: The immediate recognition of acute external laryngotracheal injury and early proper treatment are vital for life and successful outcome.
Airway Management ; Dyspnea ; Hoarseness ; Humans ; Laryngeal Mucosa ; Larynx ; Retrospective Studies ; Thyroid Cartilage ; Trachea ; Voice

BACKGROUND AND OBJECTIVES: Transforming growth factor-beta1 (TGF-beta1) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by TGF-beta1 plays important roles in neoplastic progression. So expression of TGF-beta1 has been described in several tumors, but little is known about the role of TGF-beta1 in neoplastic progression of human larynx. The aim of this study was to investigate the role of TGF-beta1 in the neoplastic progression of human larynx. MATERIALS AND METHODS: We evaluated the expression of TGF-beta1 using immunohistochemical study in 6 cases of normal laryngeal mucosa, 6 cases of laryngeal dysplasia, 20 cases of laryngeal carcinoma. RESULTS: The results were as follows: 1) Normal laryngeal mucosa has no expression of TGF-beta1. 2) The expression of TGF-beta was 16.7% in laryngeal dysplasia, 50.0% in laryngeal carcinoma. CONCLUSION: The TGF-beta1 expression rate was correlated to the progression of laryngeal lesions when compared to normal laryngeal mucosa, laryngeal dysplasia and laryngeal carcinoma.
Humans ; Laryngeal Mucosa* ; Larynx ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

BACKGROUND AND OBJECTIVES: The degree of dysplasia of premalignant lesion of the larynx is related to malignant transformation. However, no single molecular marker that could be used to predict malignant transformation has been identified. Melanoma antigen genes (MAGE), which are expressed in malignant tissues but not in normal tissues, might provide such a marker. So, we investigated MAGE expressions in the various epithelial lesions of the larynx. SUBJECTS AND METHOD: Nested RT-PCR with MAGE common primers were performed to detect the expression of MAGE A genes in fresh frozen tissues obtained from laryngeal lesions (34 benign, 20 premalignant, 22 malignant epitheliums) and 12 normal oropharyngeal epitheliums. RESULTS: The expression of MAGE was positive in 12 (35.3%) of benign, 10 (50%) of premalignant, 18 (81.8%) of malignant laryngeal epithelium and 1 (8.5%) of normal epithelium. These expressions were different with statistic significance (p=0.003) between benign, premalignant and malignant laryngeal epithelium. CONCLUSION: The MAGE A expression could be utilized as a biomarker to predict malignant transformation of laryngeal epithelium.
Epithelium* ; Genes, vif ; Laryngeal Mucosa ; Larynx* ; Melanoma* ; Precancerous Conditions ; Biomarkers, Tumor

OBJECTIVETo observe the expression of adrenomedullin (AM) in the patients with laryngeal carcinoma.

METHODSTwo-step immunohistochemistry method was used to examine the expression of AM in the patients with laryngeal carcinoma. Radioimmunoassay was applied to determine the concentration of AM in the laryngeal carcinoma tissues, adjacent laryngeal mucosa of carcinoma tissues and in the plasma of patients and controls.

RESULTSPositive stainings for AM were found in all 21 specimen examined,distributed mainly in the cytoplasm of the laryngeal carcinoma cells. Positive stainings were more stronger in the circumference than in the center of tumor tissue for the highly and moderately differentiated tumors. While the stainings were distributed homogeneously for poorly and moderately differentiated tumors. The concentration of AM in the laryngeal carcinoma tissues (n = 44) and the adjacent mucosa (n = 44) were (49.67 +/- 28.33) pg/ml and (14.71 +/- 7.17) pg/ml (x +/- s) respectively and laryngeal tumor showed much higher concentration of AM than the adjacent mucosa (u = 135.00, P < 0.01). The concentration of AM in patients with laryngeal carcinoma of T2, T3 and T4 stage were (31.52 +/- 15.22), (56.63 +/- 18.51) and (96.12 +/- 18.22) pg/ml (x + s) respectively,and there were statistically significant difference among them. In the N stage, patients with higher stages were found to express significantly higher AM concentration, but there was not statistically significant difference between NO stage and N1 stage. In the M stage,patients with M1 stage were found to express significantly higher AM concentration (u = 31.00, P < 0.01). But there was not statistically significant difference between AM plasma concentration of laryngeal carcinoma patients and that of healthy controls.

CONCLUSIONSThe results suggested that high expression of AM in tissues of laryngeal carcinoma was related with the TNM stage of laryngeal carcinoma, AM may play an important role in the development of the laryngeal neoplasma.

Adrenomedullin ; metabolism ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Laryngeal Mucosa ; metabolism ; pathology ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging

OBJECTIVE: To detect the expression of microRNAs (miRNAs) in laryngeal carcinoma and adjacent normal tissue using microarray, and to discuss the relationship between miRNAs and laryngeal carcinoma. METHOD: miRNA were extracted from 8 cases of laryngeal cancer tissue and its adjacent normal tissue. miRNA identification were performed by microarray of miRNA hybridization and cluster analysis was used with Significance Analysis of Microarrays (SAM, version 2.1) and Cluster 3.0 software. miRNA were confirmed by real time quantification RT-PCR with RNA-tailing and primer extension. RESULT: Totally 47 different miRNAs were found expressed in laryngeal cancer, with 23 of miRNA expression were up-regulated and 24 of miRNA expression were down-regulated. The expression of miR-1, miR-486-5p, miR-206, miR-487a,miR-375, miR-422a, miR-144, miR-384, miR-378, miR-133a were down-regulated by 5 multiple and while expression of miR-93, miR-31, miR-20b were up-regulated by 3 multiple. There are 5 miRNA clusters with coexpression in laryngeal cancer tissue and located on chromosome 8, 13, 14, 18 and X. Moreover, RT-PCR analysis demonstrated that there was no significantly difference of miRNA expression between microarray and RT-PCR. CONCLUSION The different expression of miRNA may play an important role in the pathogenesis and development of laryngeal cancer.
Adult ; Female ; Gene Expression Profiling ; Humans ; Laryngeal Mucosa ; pathology ; Laryngeal Neoplasms ; genetics ; pathology ; Male ; MicroRNAs ; genetics ; Microarray Analysis ; Middle Aged ; Oligonucleotide Array Sequence Analysis

OBJECTIVE: To investigate the expression of EMS1 in laryngeal carcinoma and its clinical significance. METHOD: The expression of EMS1 protein was measured in 40 samples of, 40 samples of para carcinoma tissues (which were near to cutting margin of laryngeal carcinoma tissue over 0.5 cm), and 20 samples of normal laryngeal mucosa as controls by Flow Cytometer (Epics-XL II). RESULT: The quantity and percentage of EMS1 protein expression in laryngeal carcinoma tissues was significantly higher than those in para carcinoma and in normal laryngeal mucosa tissues respectively (P<0.05). There was no significant expression difference between the para carcinoma tissues and normal laryngeal mucosa tissues. There were positive correlation between the expressions of EMS1 protein and metastasis, pathological grade and clinical stage in laryngeal carcinoma. But there were not relationship with patients' clinical classification, tumor size, smoking history, age and sex. CONCLUSION The high expression of EMS1 may contribute to the carcinogenesis and development of laryngeal carcinoma. The expression of EMS1 protein is an important index of judging differentiation, infiltration, metastasis and staging of laryngeal carcinoma.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cortactin ; metabolism ; Female ; Humans ; Laryngeal Mucosa ; metabolism ; pathology ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging

BACKGROUND: Endotracheal intubation can cause focal ischemia, damage or edema to the laryngeal mucosa, and may be followed by serious complications such as vocal cord paralysis, ulcers, and granulation tissue formation. Laryngeal granuloma is rare but also a significant late complication of endotracheal intubation, and anesthesiologists should be concerned about it.CASE: We experienced four cases of laryngeal granuloma that developed after two-jaw surgery January 2017–December 2018 in our hospital and would like to report these cases with brief review of literature.CONCLUSIONS: There are frequent movements on the head and neck in maxillofacial surgery and the nasotracheal intubation should be prolonged after bimaxillary osteotomy surgery because of post-operative airway problems. This may be why two-jaw surgery may have higher occurrence of laryngeal granuloma than others.
Edema ; Granulation Tissue ; Granuloma, Laryngeal ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Ischemia ; Laryngeal Mucosa ; Neck ; Osteotomy ; Surgery, Oral ; Ulcer ; Vocal Cord Paralysis