• 대한기관식도과학회지
• /
• 제2권1호
• /
• pp.97-102
• /
• 1996

The larynx has three major functions such as protective reflex, respiration and phonation, and is richly innervated by sensory, sympathetic and parasympathetic nerves. The sensory innervation of the laryngeal mucosa, which is involved in the perception of pain, mechanical and chemical irritation, prtects the airway via various laryngeal reflexes. We studied the distribution of Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP) sensory fibers in the rat's larynx using the immuno-histochemical methods. Many SP and CGRP immunoreactive fibers were found in all regions of the laryngeal mucosa except the vocal cords. SP immunoreactive fibers showed a very similar distribution to the CGRP fibers in the epithelium and submucosa. But SP immunoreactive fibers were sparser than CGRP immunoreactive fibers in distribution density. Both reactive fibers were denser in the supraglottic region than subglottic region. Especially, intraepithelial fibers displayed the densest innervation to the laryngeal surface of the epiglottis. h the subepithelium, SP and CGRP immunoreactive fibers were distributed along the wall of vessels and around the glands. The present results suggest that the regional distribution of SP and CGRP immunoreactivity may be responsible for the protective reflex function of the laryngeal inlet.

• 대한두경부종양학회지
• /
• 제3권1호
• /
• pp.55-63
• /
• 1987

A retrospective investigation of 52 cases of carcinoma of the larynx, who underwent total laryngectomy $\bar{c}\;or\;\bar{s}$ neck dissection at Pusan National University Hospital from 1978 to 1985, was performed. The results obtained were as follows: 1) There were 32 glottic(62.7%), 18 supraglottic(35.3%) and 1 subglottic(2.0%) carcinoma. 2) In stage grouping, stage ill was the most(64.7%) and then stage II, stage IV, stage I in order. 3) Overall rate of cervical metastasis was 29.4%. In glottic carcinoma, 0% of $T_1,\;40%\;of\;T_2,\;18%\;of\;T_3\;and\;25%\;of\;T_4$. In supraglottic carcinoma, there was 0% of $T_1,\;29%\;of\;T_2,\;56%\;of\;T_3\;and\;50%\;of\;T_4$. 4) The incidence of postoperative complication was 31.4% and stomal stenosis was the most(13.7%) 5) There were 8 cases of local recurrence and 3 cases of distant metastasis(2 cases in lung, 1 case in esophagus) among 40 cases which were able to follow up. 6) 3 year estimated survival rate for glottic and supraglottic carcinoma were 73.3 % and 85.7% respectively.

• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
• /
• pp.7.2-7
• /
• 1977

Laryngeal web는 Laryngeal cavity가 막양조직으로 협착된 것으로 Fleischman이 1822년 처음 보고하였으며, 상기도폐색을 이르켜 호흡과 발성장해의 원인이 된다. Laryngeal web는 선천적으로나 후천적으로 생길수 있는데 선천적으로는 핵생기에 있어서의 후두발육이상에 기인한 것이며, 후천적으로는 염증성, 외상성과 술후성등으로 생기는데 국소병변의 치료과정에서 반흔조직에 의한 만성협착에 기인한다. 발생빈도는 성대간 성문하 및 성문상의 순으로 성문상이 제일 드물게 발생한다. 저자들은 28세 남자에서 결핵성병변으로 생겼다고 믿어지는 성문상 및 성문에 동시에 생기고 후두구는 작은 구명으로 협착된 Laryngeal web에 대하여 Endolaryngeal microsurgery 로써 치험하였기에 문헌적 고찰을 더하여 보고하는 바이다.

• 대한후두음성언어의학회지
• /
• 제9권2호
• /
• pp.147-151
• /
• 1998

Primary localized laryngeal amyloidosis is an uncommon disorder of unknown cause that occurs in the absence of systemic amyloidosis or associated disease. There is a risk of either missing concomitant systemic amyloidosis or exhaustively investigating for this when it is not present through failure to appreciate the nature of the disease. We present 2 cases of primary localized laryngeal amyloidosis in supraglottic region. Biopsy of the mass of patients revealed findings consistent with amyloidosis, which were Congo red reaction with a apple green birefringence in polarized light fluorescence microscopy. An extensive workup for systemic amyloidosis was negative. All of two cases were treated by vaporization via $CO_2$ LASER using "Swiftlase Flshscan" for creating a wide, shallow char-free treatment site by precisely controlling ablation depth without causing residual thermal damage to tissue. The postoperative recovery of all cases was uneventful with good vocal quality and no aspiration. At the present time, the patients have no evidence of disease, recurrence and complication.

• 대한두경부종양학회지
• /
• 제20권1호
• /
• pp.19-23
• /
• 2004

Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
• /
• pp.106-106
• /
• 1993

후두암은 두경부 영역의 가장 빈번한 악성종양으로 예후가 비교적 양호한 질환이다. 그러나 경부임파절로의 전이빈도는 원발병소의 위치에 따라 매우 다른 것으로 되어 있고, 특히 성문상부암의 경우에는 경부임파절 전이가 매우 많은 것으로 되어 있다. 이에 저자는 1986년 부터 1992년 까지 본 병원에서 후두암으로 진단되어 일차 수술을 시행하였던 111례중 성문상부암 49례을 대상으로 성문상부암의 경부임파절 전이 빈도 및 병기에 따른 경부 곽청술의 필요성에 대하여 후향적 분석을 시행하였다. 결과적으로 성문상부암 중에서 외측에 속하는 피열후두개추벽에서 발생한 환자에서 정중위(후두개)에서 발생한 환자보다 경부임파절전이 빈도가 높았다. 그리고 경부 임파절 전이률은 T 병기에 관계없이 평균 51.0%이었다. 따라서 성문상부암, 특히 T2이상인 경우에는 경부곽청술이 필요하다고 사료된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권15호
• /
• pp.6541-6544
• /
• 2015

Background: Laryngeal malignancy is a common malignancy of the head and neck region. Affected patients usually present with features that are characteristic of certain subsites. The larynx is oncologically divided into three: supraglottis, glottis and subglottis. Studies from Western countries have shown that the glottis is the commonest subsite to harbour laryngeal malignancy. However, the supraglottis has been reported to be the commonest subsite in developing countries, including examples in the Indian subcontinent. To our knowledge, no study has been carried out in western Nepal about the epidemiology of laryngeal cancer to date. The purpose of this study was to analyse the epidemiology of laryngeal cancer in relation to its risk factors, age distribution,and preferred subsites and to see if there is any recent change in the subsite wise distribution of laryngeal malignancy in western Nepal. Materials and Methods: Patients of all ages and both sexes with suspected laryngeal malignancy were enrolled in the initial study. Detailed history taking and clinical examination was performed to find out the involved subsite in relation to the clinical features. Direct laryngoscopy was performed to further confirm the subsite and to take biopsy from the growth under general anesthesia. After confirmation of malignancy from the biopsy report, patients were finally included in the study. Data were analysed and observations were made to find out the distribution of laryngeal malignancy in different subsites. Results: The supraglottic larynx was the commonest subsite to harbor laryngeal malignancy. Smoking and alcohol were found to be the common risk factors. The mean age of the patients was in their sixties. Conclusions: Laryngeal malignancy is common in elderly individuals. Supraglottic laryngeal malignancy is the commonest laryngeal malignancy in people who smoke and drink alcohol in Nepal. Avoidance of alcohol use and smoking will be a milestone to reduce the incidence of laryngeal cancers and associated mortality.

• 대한두경부종양학회지
• /
• 제3권1호
• /
• pp.15-24
• /
• 1987

This study is limited to epidermoid carcinoma arising in the larynx. The 623 patients in this series comprised 1.6% of all malignant neoplasms seen during the 20-year period .from 1965 to 1984 ; it comprised 13.2% of all cancers of the head and neck registered during this period. The male: female ratio was 11:1, and the highest incidence was in the fifth decade of life. Analysis by anatomical site revealed that 51.7% were supraglottic, 36.1% glottic, and 6.8% subglottic in oriain. One-hundred eighty-nine(79%) were clinically Stage III or Stage IV lesions at the time of the first visit. Of the total of 263 cases, 113 refused treatment, 4 definite radiation for $T_1$. lesion,21 underwent palliative therapy only, and 125 underwent surgical management with intent to cure. This surgical category included 53 patients who had surgical treatment only and 72 who underwent combined therapy(preoperative radiation, postoperative radiation, or inductive chemotherapy followed by surgery and postoperative radiation). The surgical management varied from partial laryngectomy to widefield laryngectomy and ipsilateral neck dissection. In 14.4% pathologically positive node or nodes were found in the clinically negative contralateral neck nedes. Such contralateral spread was most common in supraglottic site of origin(222%). Combined modality of management was compared to single therapy. Although results at three years showed no difference in determinate disease-free survival between patients treated by surgery only and those treated by surgery followed by postoperative radiation therapy at 5 years a statistically significant difference emerged, only 36% of those receiving surgery alone surviving as compared to 65.4% in the surgery with radiation group.

• 대한두경부종양학회지
• /
• 제11권2호
• /
• pp.132-136
• /
• 1995

The laryngeal cancer is a cancer of secondary sex organ, such as malignant tumors of the mammary gland, endometrium, and prostate. The clinical characteristics of the female laryngeal cancers are considered somewhat to be different from that of male. As cancer of the larynx is principally a disease of men, many investigations have showed the characteristics of the male laryngeal cancers. For understanding the clinical characteristics of the female laryngeal cancers, we analyzed 21 cases of laryngeal cancer in women, diagnosed and treated in our institute during the last 10 years. The results were, 1) In female subjects, supraglottis was most common subsite of laryngeal cancer(85.7%). 2) On histopathologic grade, the moderately differentiated squamous cell carcinoma was the most common (80.9%). 3) The positive neck nodes were 19 %, considered to be lower than that of total laryngeal cancer. 4) The treatment results, the 2 year disease free rate and 5 year survival rate were 88.9%, 83.3%, respectively. These results suggest, therefore, female laryngeal cancers are more likely to be supraglottic cancer than glottic cancer. In spite of high incidence of supraglottic cancer, the nodal metastases are rare, the prognosis appeared to be good.

• 대한후두음성언어의학회지
• /
• 제20권1호
• /
• pp.36-41
• /
• 2009

Background and Objectives: Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic. Methods: We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated. Results: Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III. Conclusion : Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.