3.Role of laryngopharyngeal reflux on the pathogenesis of vocal cord leukoplakia and early glottic cancer.
Xiangping LI ; Zuofeng HUANG ; Ting WU ; Lu WANG ; Jianuan WU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2014;49(5):362-367
OBJECTIVETo explore the significance of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in patients with vocal cord leukoplakia and early glottic cancer.
METHODSPatients with vocal cord leukoplakia and early glottic cancer encountered in Nanfang Hospital between December 2012 to January 2014 were included in this study. Ambulatory 24 hour multichannel intraluminal impedance-pH monitoring (MII-pH) was applied to obtain LPR and GER events, as well as the reflux properties of substances. Tobacco and alcohol history was also evaluated. Sixteen healthy volunteers were recruited as normal controls.
RESULTSThere were 26.3% (5/19) LPR patients in glottic cancer group, 35.3% (6/17) LPR patients in vocal cord leukoplakia group and 12.5% (2/16) LPR volunteers in normal controls. There was no statistically significant difference in the positive rate of LPR between early glottic cancer patients and normal controls as well as between vocal cord leukoplakia patients and normal controls (P > 0.05). There was statistically significance in numbers of acid reflux events, time of acid exposure, and time of acid clearance between vocal cord leukoplakia patients and normal controls as well as between glottic cancer patients and normal controls (P < 0.05). GER was found in 26.3% (5/19) patients in glottic cancer group and 23.5% (4/17) patients in vocal cord leukoplakia group and 6.3% (1/16) volunteer in normal controls. There was no statistically significant difference in the positive rate of GER between early glottic cancer patients and normal controls as well as between vocal cord leukoplakia patients and normal controls (P > 0.05). However, there was statistically significance in DeMeester scores between glottic cancer patients and normal controls (P < 0.05), while no statistically significance between vocal cord leukoplakia patients and normal controls (P > 0.05). Reflux events were dominated by acid and weakly acidic reflux in upright position. Weakly alkaline reflux events in upright position, acid reflux events in supine position, and weakly alkaline reflux events in supine position in vocal cord leukoplakia patients were significantly more than those in normal controls (P < 0.05). No statistically significant difference existed in positions and contents between early glottic cancer patients and normal controls (P > 0.05). There was also no statistically significant correlation between happening LPR and GER, smoking and drinking in patients with vocal cord leukoplakia and early glottic cancer (P > 0.05).
CONCLUSIONSReflux events are more in vocal cord leukoplakia patients and early glottic cancer patients, however, the relationship between laryngopharyngeal reflux and canceration of the vocal cord is still needed to be investigated. The significance of mucosal injury induced by nonacid refluxes is needed to be further studies.
Adult ; Aged ; Case-Control Studies ; Esophageal pH Monitoring ; Female ; Humans ; Laryngeal Diseases ; complications ; Laryngeal Neoplasms ; complications ; Laryngopharyngeal Reflux ; complications ; Leukoplakia ; complications ; Male ; Middle Aged ; Vocal Cords ; pathology
5.Transoral CO2 Laser Surgery of Supraglottic Cancer.
Jong Chul HONG ; Kang Dae LEE ; Tae Hyun YU ; Hwan Ho LEE ; Joo Yeon KIM ; Sung Won KIM ; Young Jin HAN ; Woo Sung KIM ; Jae Hoon LEE
Korean Journal of Otolaryngology - Head and Neck Surgery 2008;51(11):1030-1035
BACKGROUND AND OBJECTIVES: Endoscopic supraglottic laryngectomy by CO2 laser for selected T1-T3 supraglottic cancer results in improved postoperative function and decreased morbidity, with comparable survival to open surgery. The aim of this study was to retrospectively evaluate oncologic and functional outcomes after transoral CO2 laser surgery for supraglottic cancers. SUBJECTS AND METHOD: Nineteen patients (Fresh group:13 patients, Radiotherapy failure group:6 patients) who were diagnosed as supraglottic cancer and treated with CO2 laser surgery between December, 1999 and September, 2006 were evaluated. All the patients were followed-up more than 12 months. Eleven patients in the Fresh group underwent neck dissection. RESULTS: Ultimate local control rate was 100% for both Fresh group and RT failure group. Survival rates of 3-year and 5-year for the Fresh group and the RT failure group were 100% and 68.6%, and 75% and 50%, respectively. There were no significant postoperative complications. CONCLUSION: Although our experience with supraglottic cancers treated by transoral CO2 laser surgery is still too limited to confirm the definite oncologic and functional results, transoral CO2 laser surgery seems to be a safe and reasonable tool, and a time and cost-effective alternative to the traditional surgery for selected supraglottic cancers.
Humans
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Laryngeal Neoplasms
;
Laryngectomy
;
Laser Therapy
;
Lasers, Gas
;
Neck
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Postoperative Complications
;
Retrospective Studies
;
Survival Rate
6.A Clinical Study of Extended-Conservation Surgery in Laryngeal Cancer.
Young Min KIM ; Gi Young PARK ; Kyoung Sup NA ; Young Soo RHO ; Young Min PARK ; Hyun Jun LIM
Korean Journal of Otolaryngology - Head and Neck Surgery 1999;42(11):1435-1440
BACKGROUND AND OBJECTIVES: The surgical goals of laryngeal cancer should not only be to preserve life but also to preserve laryngeal functions such as airway, aspiration prevention, and voice production. Classic, standard conservation laryngectomy such as horizontal supraglottic laryngectomy and vertical hemilaryngectomy has served well to those purposes but has the limits of resection. And so extended conservation laryngeal surgery was developed to extend surgical resection margin if we carefully select surgical indication. Our study was to determine the best surgical method according to the extent of tumor and evaluate the surgical outcome oncologically and physiologically in extended conservation laryngectomy. MATERIALS AND METHODS: Forty patients were treated with extended conservation surgery in laryngeal cancer at Department of Otorhinolaryngology, Head and Neck Surgery, at the Hallym university hospitals according to surgical algorithm invented by author (Young Min Kim, MD)from 1992 to 1998. They were reviewed retrospectively with respect to age, sex, endoscopic and radiologic evaluation, primary site, extended site, postoperative complications and results. RESULTS: Thirteen patients had glottic cancer, and were treated with extended vertical laryngectomy. Two patients showed recurrence at the primary site or neck nodes, one patient died due to other disease. Ten patients (76.9%)are alive without disease. Twenty-seven patients were supraglottic cancer. They treated with extended horizontal laryngectomy. Twenty patients (74.1%)are alive without disease. Three patients recurred at primary site or neck nodes. CONCLUSION: Extended conservation surgery was oncologically safe in both glottic and supraglottic cancer. Functional outcome was relatively satisfactory and so we could avoid total or near-total laryngectomy with careful evaluation of tumor extent.
Head
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Hospitals, University
;
Humans
;
Laryngeal Neoplasms*
;
Laryngectomy
;
Neck
;
Otolaryngology
;
Postoperative Complications
;
Recurrence
;
Retrospective Studies
;
Voice
7.Myxoma: life-threatening benign nonepithelial tumor of the larynx.
Kwang Moon KIM ; Shi Chan KIM ; Hyeon Joo JEONG ; Jeong Hae KIE
Yonsei Medical Journal 1997;38(3):187-189
Myxoma is a rare nonepithelial neoplasm of the larynx frequently misdiagnosed as a large vocal polyp due to its slow-growing nature. Myxoma is a benign but often infiltrating neoplasm of uncertain mesenchymal cell origin, characterized by irregular round, spindle or stellate cells within a matrix containing abundant mucoid material, scant vascularity and a variable meshwork of reticulum and collagen. We report one case of myxoma with life-threatening dyspnea requiring tracheotomy.
Case Report
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Critical Illness
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Human
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Laryngeal Neoplasms/complications*
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Male
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Middle Age
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Myxoma/complications*
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Respiration Disorders/surgery
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Respiration Disorders/etiology*
;
Tracheotomy
8.1 case of vocal cord plexiform schwannoma.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(23):1898-1899
Summary A 36 years old patient with hoarseness for 2 years and got worsen for one month, electronic laryngoscopy showed a red smooth-faced wide based neoplasm on the posterior 2/3 of the right side of the vocal cords. The neoplasm was excised under suspension laryngoscope . The pathologic results showed:Cells were weave patterned, infiltrative growth, mitotic figure was rare. Immunohistochemical results showed CD34 (-), SMA (-), DM (-), S - 100 (+). The pathological diagnosis was plexiform schwannoma.
Adult
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Hoarseness
;
etiology
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Humans
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Laryngeal Neoplasms
;
complications
;
diagnosis
;
surgery
;
Laryngoscopes
;
Laryngoscopy
;
Neurilemmoma
;
complications
;
diagnosis
;
surgery
;
Syndrome
;
Vocal Cords
;
pathology
9.Two cases of acute pulmonary embolism in head and neck tumor surgery.
Yongchao ZHANG ; Rui WANG ; Lan MU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(2):177-178
A male patient with hypopharyngeal cancer accepted operation under general anesthesia. Sixth day after surgery in patient with sudden chest pain and obvious difficulty in breathing. Blood oxygen saturation of 90%. The electrocardiogram showed: ST-T change,Tv6 flat;blood gas analysis: pH 7. 491, PCO2 34. 1 mmHg, PO2 54. 7 mmHg; D-Dimer 3. 87 mg/L; white blood cell 17. 50 × 10(9)/L. CTPA showed: right pulmonary artery embolism,pulmonary infection. Another male patient with the right tonsil cancer accepted operation under general anesthesia. Fourth day of patient suddenly appear bosom frowsty and obvious difficulty in breathing. Blood oxygen sat- uration of 88%. Blood gas analysis: pH: 7. 48, PCO2 : 33 mmHg, PO2 : 57 mmHg; D-Dimer: 2. 97 mg/L; white blood cell:11. 80 × 10(9)/L. CTPA showed: the main pulmonary artery and right pulmonary artery branch embolism, pulmonary inflammation. Both were diagnosised as acute pulmonary embolism and recovered well after giving anticoagulant therapy in time.
Anesthesia, General
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Electrocardiography
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Fibrin Fibrinogen Degradation Products
;
Humans
;
Hypopharyngeal Neoplasms
;
surgery
;
Laryngeal Neoplasms
;
surgery
;
Male
;
Oxygen
;
Postoperative Complications
;
Pulmonary Embolism
10.A Jarisch-Herxheimer reaction misdiagnosed as pneumonia after an operation for laryngeal papillary lymphoma.
Qing-jun LIU ; Guo-qi LIU ; Shi-you WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2011;46(4):341-342
Diagnostic Errors
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Humans
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Inflammation
;
diagnosis
;
etiology
;
Laryngeal Neoplasms
;
surgery
;
Male
;
Middle Aged
;
Papilloma
;
surgery
;
Pneumonia
;
diagnosis
;
Postoperative Complications
;
diagnosis