BACKGROUND AND OBJECTIVES: Perichondritis or chondritis after salvage vertical partial laryngectomy is a rare but serious problem. Usually perichondritis is caused by contamination of oral and bronchial secretion to exposed cut surface of thyroid cartilage. We report about a new closing method which has posterior and inferior based perichondrial flap positioned to laryngeal surface of thyroid cartilage, which can be used follwoing a salvage vertical partial laryngectomy. MATERIALS AND METHODS: Seven salvage vertical partial laryngectomy patients were studied. We used conventional D shaped perichondrial flap closure for the three patients, while a news flap closure was used for the other four. RESULT: One of the three patients who recieved conventional flap closure showed severe perichondritis which resulted in laryngectomy. The other two patients and all others who received new flap cases healed without any problem. CONCLUSION: This preliminary result shows that the new flap could be used as a closing method following a heavily irradiated vertical partial laryngectomy.
Humans ; Laryngectomy* ; Thyroid Cartilage

Thyroid tumors are usually asymptomatic, but occasionally they can cause upper airway obstruction by compressing the trachea in cases of benign mass or invading intraluminal tracheal wall in locally advanced carcinoma. There were a few case reports of rapidly enlarging benign tumors of thyroid causing upper airway distress symptoms, but there has been no case report showing necrosis of tracheal cartilage by benign thyroid mass. When the thyroid cartilage wall is actually invaded by thyroid mass, we should consider of the possibility of malignant transformation. We experienced a case of unilateral benign thyroid mass causing acute airway obstruction and necrosis of tracheal cartilage. Therefore, we present the case with a literature review.
Airway Obstruction ; Cartilage* ; Necrosis* ; Thyroid Cartilage ; Thyroid Gland* ; Trachea

Transoral robotic thyroidectomy (TORT) is well consistent with the primary goal of remote-access thyroid surgery, which is to avoid a visible cervical scar. Additionally, the extent of transoral thyroidectomy dissection is less than that of other remote-access surgical procedures. Owing to these merits of the transoral approach, several institutions around the world are now performing this procedure. Since transoral thyroidectomy is performed in a confined, narrow space, and is characterized by a close distance from the ports to the working space, more benefits can be derived from multiarticulation of robotic instruments. Especially when performing left lobectomy by TORT, the surgeon can use right-handed robotic instruments over the thyroid cartilage with the merits of multiarticulation. In this study, we present our unique procedure of left lobectomy by TORT in detail.
Cicatrix ; Liability, Legal ; Thyroid Cartilage ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Aged ; Cartilage Diseases ; Humans ; Male ; Thyroid Cartilage ; pathology

Humans ; Male ; Middle Aged ; Thyroid Cartilage ; abnormalities

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*

The aim of this study was to provide accurate anatomical descriptions of the overall anatomy of the superior thyroid artery (STA), its relationship to other structures, and its driving patterns. Detailed dissection was performed on thirty specimens of adult's cadaveric neck specimens and each dissected specimen was carefully measured the following patterns and distances using digital and ruler. The superior thyroid, lingual, and facial arteries arise independently from the external carotid artery (ECA), but can also arise together, as the thyrolingual or linguofacial trunk. We observed that 83.3% of STAs arose independently from the major artery, while 16.7% of the cases arose from thyrolingual or linguofacial trunk. We also measured the distance of STA from its major artery. The origin of the STA from the ECA was 0.9±0.4 mm below the hyoid bone. The STA was 4.4±0.5 mm distal to the midline at the level of the laryngeal prominence and 3.1±0.6 mm distal to the midline at the level of the inferior border of thyroid cartilage. The distance between STA and the midline was similar at the level of the hyoid bone and the thyroid cartilage. Also, when the STA is near the inferior border of the thyroid cartilage, it travels at a steep angle to the midline. This latter point may be particularly important in thyroidectomies. We hope that anatomical information provided here will enhance the success of, and minimize complications in, surgeries that involve STA.
Arteries* ; Cadaver ; Carotid Artery, External ; Hope ; Hyoid Bone* ; Lingual Thyroid ; Neck ; Thyroid Cartilage* ; Thyroid Gland* ; Thyroidectomy

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