Laryngeal interarytenoid neurilemmomas (LIN) is a benign encapsulated tumor originating from the schwann cells lining nerve fibers. Even though LINs are extremely rare in incidence, they could present with potential threat to the airway and thus requiring prompt diagnosis and treatment. Here, we report two cases of LINs. Both patients underwent excision of the tumor via microlaryngeal endoscopic procedures and recovered well postoperatively without complications. No recurrence was observed postoperatively on routine follow-up after 14 months.
Endoscopy ; Humans ; Larynx ; pathology ; surgery ; Neurilemmoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; Postoperative Period

PURPOSE: Wegener's granulomatosis (WG) is a rare multisystem inflammatory disease, which infrequently involves the subglottic area and trachea. Treatment usually involves the use of immunosuppressive agents with corticosteroids. Some patients, however, continue to have symptoms of airway obstruction after clinical remission following the standard therapeutic regimen. Objective: To investigate laser treatment for subglottic stenosis in five patients suffering from WG. MATERIALS AND METHODS: We endoscopically treated 5 patients with subglottic stenosis due to WG and airway obstruction by Nd:YAG and CO2 lasers. One of the patients had preoperative tracheostomy and after treatment was decannulated and could not breathe without dyspnea. Another patient required stenting of the subglottic area. RESULTS: All five patients were able to breathe without dyspnea after the treatment. Three patients were treated with an Nd:YAG laser but needed repeated laser treatment every four to six months, whenever they complained of dyspnea. The other two patients were treated with a CO2 laser; one of these patients had preoperative tracheostomy and was treated twice by CO2 laser and decannulated, with no further difficulty in breathing. The follow-up period was 1-5 years. CONCLUSIONS: Nd:YAG and CO2 lasers are recommended in the treatment of subglottic stenosis (SS) due to WG, particularly when the stenosis is in continuity or close proximity to the vocal cords.
Adult ; Aged, 80 and over ; Constriction, Pathologic/surgery ; Female ; Humans ; *Laryngoscopy ; Larynx/pathology/*surgery ; *Laser Therapy ; Male ; Wegener Granulomatosis/pathology/*surgery

OBJECTIVE: To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion. METHOD: Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy. RESULT Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.
Adenocarcinoma ; Humans ; Laryngectomy ; Larynx ; pathology ; Larynx, Artificial ; Neoplasm Invasiveness ; Prognosis ; Quality of Life ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery ; Trachea ; pathology

Objective: To evaluate the efficacy of surgical treatment of papillary thyroid carcinoma (PTC) involving larynx and trachea. Methods: A total of 1 436 cases of thyroid malignant tumors were admitted to the Department of Otolaryngology, Qilu Hospital of Shandong University from 2004 to 2019, including 110 cases of PTC involving larynx and trachea, and of which 105 cases with complete follow-up data were retrospectively analyzed. There were 42 males and 63 females, with a male/female ratio of 1∶1.5, aged from 28 to 81 years. All lesions involved trachea, including 11 cases involving both trachea and larynx. Of those 83 cases underwent laryngeal and airway wall tumor excision, and 22 cases underwent radical tumor excision plus laryngeal and trachea repair. Extubation rate was analyzed and the postoperative survival curve of patients was analyzed by Kaplan-Meier method. Results: Among 105 cases, 16 cases underwent tracheotomy and 12 cases were successfully extubated. The overall 3- 5- and 10-year survival rates were 100.0%, 86.4% and 72.5%, and the disease-free survival rates were 93.1%, 81.6% and 57.7%, respectively. There was significant difference in survival curve between the two groups (χ²=4.21, P=0.040). The 5-year and 10-year survival rates were 94.6% and 77.3% in laryngeal and tracheal tumor exclusion group, and 85.7% and 51.4% in the radical tumor resection group. There was no significant difference in the survival curves between the two groups (χ²=3.50, P=0.061). Conclusion: PTC patients with laryngeal and tracheal involvement can achieve long survival and good quality of life through reasonable surgical treatment.
Female ; Humans ; Larynx/surgery* ; Male ; Neoplasm Invasiveness ; Quality of Life ; Retrospective Studies ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/pathology* ; Trachea/surgery*

OBJECTIVETo discuss the method to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage.

METHODSLaryngeal defect was reconstructed with local tissues after vertical partial laryngectomy with resection of arytenoid cartilage on 87 patients with laryngeal carcinoma of glottic type (T1 7 cases, T2 54 cases, T3 26 cases). All the lesions invaded arytenoid area or vocal process. No filling tissues were used to increase the height of affected arytenoid area and no skin flap or other tissues were used to reconstruct the vocal cord in all the patients.

RESULTSAll the patients recovered normal swallow in 8 to 19 days postoperation and restored phonation. The decannulation rate was 98.9% (86/87). There were no pharyngeal fistula and pulmonary complications after operation. Local infection occurred in 3 patients and was cured in 7 days. The rate of local recurrence and cervical lymph node metastasis were 8.0% (7/87), 6.9% (6/87) respectively. Lost patients were assumed to death and direct method was used to calculate survival rate. In 87 patients postoperative period was above 3 years, 5 died in 3 years and 3 were lost 3- year survival rate was 90.8% (79/87). In 63 patients postoperative period was above 5 years, 10 died in 5 years and 2 were lost. 5- year survival rate was 81.0% (51/63).

CONCLUSIONSUtilizing local tissues to reconstruct laryngeal defect after vertical partial laryngectomy with resection of arytenoid cartilage will not lead to severe dysphagia. Phonation is acceptable. It not only saves the operation time but also avoids the negative effects of immoderate reparation.

Adult ; Aged ; Arytenoid Cartilage ; surgery ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; Larynx ; pathology ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods

Laryngeal hamartoma is a benign proliferative tumor-like lesion that occurs in the larynx. A case of supraglotic laryngeal hamartoma admitted by our department and 12 cases of laryngeal hamartoma reported in literature were retrospectively analyzed, the pathogenesis, clinicalmanifestation, diagnosis, treatment and prognosis of laryngeal hamartoma was explored, aiming to improve the understanding and diagnosis and treatment.of this disease.
Humans ; Child ; Retrospective Studies ; Larynx/pathology* ; Laryngoscopy ; Prognosis ; Hamartoma ; Laryngeal Neoplasms/surgery*

OBJECTIVE: To study the clinic and pathological features of leukoplakia of the larynx, and reduce canceration rate. METHOD: Seventy-four postoperative patients of leukoplakia of the larynx were followed up for four years by telephone or clinic service. RESULT: None of eighteen cases of pure leukoplakia was recurrence. Fifty-six cases were leukoplakia with epithelial dysplasia histologically. Seven out of fifty-six postoperative cases occurred hoarseness; three out of fifty-six postoperative cases recurred, and accepted twice or more operations successively; three out of fifty-six postoperative cases occurred canceration. CONCLUSION Operation is the main means for the treatment of leukoplakia of the larynx, and the effect is comparatively well. The patients with histological epithelial dysplasia should be pay great attention because of their higher canceration rate, and enlarged operation ranges appropriately with the patient consent could effectually prevent recurrence or canceration during the early lesions. Close observation is important for these patients.
Adult ; Aged ; Aged, 80 and over ; Carcinoma in Situ ; pathology ; surgery ; Female ; Humans ; Laryngeal Diseases ; pathology ; surgery ; Larynx ; pathology ; Leukoplakia ; pathology ; surgery ; Male ; Middle Aged

OBJECTIVE: To explore the application of double pedicle blood supply pectoralis major myocutaneous flap in reconstruction of laryngeal and hypo pharyngeal defect after carcinoma resection. METHOD: All the patients received initial treatment. Pectoralis major myocutaneous flap was Applied in one-stage reconstruction in 22 cases of laryngocarcinoma and hypopharyngeal carcinoma with post-operation defect. During operation, pectoral branches of thoracoacromial vessels and branch of lateral thoracic vessels were reserved and prepared to be double pedicle vessel fascia bundle without muscle at the beginning part, rearched to defect area through subclavian tunnel. After operation, it is necessary to closely observe the subcutaneous swelling, quantity and color of the drain and others of neck surgery area to exclude the occurrence of surgical hematoma. When there is suspicion, do timely exploration. RESULT: Pectoralis major myocutaneous flaps of 22 patients were all survived. Pharyngeal fistula occurred in 2 cases and was cured by change of dressing. Twenty-one cases received radiotherapy after operation without secondary flap necrosis. After follow-up of 6 months to 24 months, one case of roll repairment of circumferential defect in cervical esophagus,found to have anastomotic stenosis 8 months after radiotherapy and then underwent gastrostomy treatment,the other 21 cases showed good recovery of swallowing function. Among 13 cases with laryngeal function reserved, only 1 case wearing tube and the extubation rate was 92.3% without communication barriers, no patient died in the short follow-up period. CONCLUSION For double pedicle blood supply pectoralis major nyocutaneous flap, blood supply are fully guaranteed and does not require complicated equipment to observe and monitor the flap blood supply after operation, it is important to exclude factors that may lead to muscular flap necrosis to ensure the survival of pectoralis major myocutaneous flap.
Esophagus ; surgery ; Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Larynx ; surgery ; Myocutaneous Flap ; Pharynx ; pathology ; surgery ; Reconstructive Surgical Procedures

Objective:To investigate the clinical manifestations and treatment of laryngopharynx hamartoma in children. Methods:The clinical data of a child with piriform sinus hamartoma treated in our hospital were analyzed retrospectively. The age, gender, clinical manifestations, auxiliary examination, location of the tumor and surgical methods were analyzed. Results:The patient had a good prognosis after surgery, and no tumor recurrence was found after 1 year of follow-up. Conclusion:Laryngopharynx hamartoma is rare in children. It should be considered in children with laryngeal dysfunction and upper airway obstruction. Complete resection of the tumor is the key to postoperative recurrence.
Child ; Humans ; Hamartoma/surgery* ; Larynx/pathology* ; Neoplasm Recurrence, Local/pathology* ; Pyriform Sinus/pathology* ; Retrospective Studies ; Male ; Female

OBJECTIVE: To explore the surgical methods for management of early-stage glottic carcinoma involved anterior commissure. METHOD: Fifty-eight cases of early-stage glottic carcinoma (T1, n = 23; T2, n = 35) treated with vertical frontolateral partial laryngectomy and frontal partial laryngectomy or modified window partial laryngectomy without tracheostomy were retrospectively reviewed. RESULT: All patients can swallow smoothly and phonate clearly after operation. And the extubation rate with vertical fronto vertical partial laryngectomy is 97.2%. Tracheostomy was performed in one case after operation because of dyspnea. The most common postoperative complication was subcutaneous emphysema which developed postoperatively in 6 patients, but subsided after discharge. Follow-up was conducted for 8 months to 7 years, recurrence was observed in 3 cases. The 3 and 5 year survival rates were 97.5% and 91.8% respectively. CONCLUSION To choose the optimal surgical method for patients with early-stage glottic carcinoma not only can reduce the risk of recurrence but also can save the laryngeal function and thus improves the quality of life.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Larynx ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Tracheostomy