• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.137-144
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• 1995

Malignant lymphoma affecting the larynx is uncommon, probably accounts for less than 1 percent of malignant lesion of the larynx. Malignant lymphoma of the larynx is predominantly localized to supraglottis such as epiglottis, aryepiglottic fold. Laryngoscopy reveals a irregular submucosal mass with a smooth surface and no ulceration. Most of which belongs to non­Hodgkin's lymphoma. After it has been determined that the disease is localized, radiation therapy is the choice of the treatment. Chemotherapy with or without irradiation is reserved for more advanced tumor. Then life-long follow-up is essential. This paper deals with 5 cases malignant lymphoma of the larynx to review our clinical experience and to suggest the optimum treatment in the course of the disease.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.31-33
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• 2015

The extranodal non-Hodgkin lymphoma is uncommonly occurred in larynx, accounting for less than 1% of all laryngeal neoplasm. In general, the laryngeal lymphoma is appeared as submucosal mass without mucosal ulceration and is most commonly found in supraglottis. The primary laryngeal lymphoma constitute a diagnostic challenge because they are characterized by absence of clinical and gross differential criteria, compared with squamous cell carcinoma (SCC). We encountered a 74-year-old man with hoarseness and lump sensation in the throat. On direct laryngoscope, multiple ulcerative and exudative mass in glottis and supraglottic areas were observed. The patient was finally diagnosed as large B-cell lymphoma through the laryngeal microsurgery. He received radiation therapy and there is no evidence of recurrence. Although the laryngeal mass has superficial mucosal change, primary laryngeal lymphoma must be included in the differential diagnosis.

• Korean Journal of Head & Neck Oncology
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• v.9 no.2
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• pp.193-199
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• 1993

The prognosis of supraglottic cancer is worse than that of glottic cancer. Supraglottic cancers by subsites have different microenvironment of cancer cells, locoregional spread patterns. Therefore we presume that high therapeutic efficacy, while preserving the organ, can be obtained when supraglottic cancer is treated effectively according to its biological behaviors. For the purpose of determination of clinical characteristics and causes of treatment failures by subsites of supraglottis, the authors analyzed 24 cases(stage III 14 cases, stage IV 10 cases) of supraglottic cancer which were managed mainly by surgery in our institute. The results were as follows; 1) The suprahyoid group had worse pathologic grades, more frequent spread to hypopharynx, more freguent recurrence at primary site, and better three-year survival rate than the infrahyoid group. 2) The infrahyoid group had more frequent spread to glottis, understaging, recurrence at cervical nodes than the suprahyoid group. 3) There was no differences in nodal metastasis by sub sites. These results suggest that the suprahyoid group may have more aggressive spread pattern but better prognosis than the infrahyoid group.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.104-108
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• 2021

The etiology of laryngeal hemangioma is unclear, and it is classified into infant and adult types. The former is capillary hemangioma and relatively common, the latter is cavernous type and very rare. The adult laryngeal hemangioma mainly occurs in supraglottis and glottis. A 75-year-old man came to our clinic with a voice change that started four months ago. The laryngoscopic finding showed that the surface of oval-shaped mass is covered with turbid exudates. We performed the laryngeal microsurgery with CO₂ laser. The mass was pathologically proven as cavernous hemangioma. We report a very rare and didactic case with review of relevant literature.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2439-2443
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• 2016

Purpose: To determine the risk factors, clinical symptoms and patterns of spread in laryngeal cancer. Materials and Methods: A cross sectional study was carried out in the Regional Cancer Centre, Imphal, Manipur, India. One hundred and sixteen patients with laryngeal cancer were retrospectively reviewed for epidemiological data and descriptive statistics were reported for various variables. Results: Median age at presentation was 65 years and 32.8% were undernourished at presentation. The male to female ratio was 5.4:1. Heavy smoking and tobacco chewing was associated in 91.4% and 33.6% of patients respectively. Tracheostomy was required in 21.5% leading to diagnosis of laryngeal cancer. Almost all were squamous cell carcinoma with neuroendocrine and verrucous carcinoma accounting for less than 2%. Supraglottic, glottic and trans-glottic tumors were 56.9%, 36.3% and 6.9% respectively. Nodal metastases were seen in 81.8% of supraglottic cancers and 31.6% of glottic cancers with supraglottic involvement. Level II neck nodes were the commonest site followed by level III. Distant metastases (only liver) were apparent in 1.7% at presentation. Including these liver metastases, unresectable cases were limited to 6% of the patients. Conclusions: Tobacco use is implicated in almost all of the cases and the sex ratio has also decreased due to increased female smokers. The supraglottis remains the commonest site and incidence of nodal metastases is higher than in other countries. There is also a higher requirement for tracheostomy at presentation in this region.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.45-50
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• 2016

Background and Objectives : This study aims to conduct post-voice therapy to patients with unilateral vocal fold paralysis for vocal improvement, motility recovery and analyze the results. Materials and Methods : Voice therapy was conducted to 13 patients who had shown response to voice therapy amongst 98 patients diagnosed with unilateral vocal fold paralysis. In order to be able compare before and after perceptual, acoustic and aerodynamic evaluations were conducted after voice therapy. Also, by using dysphagia checklist, we have verified whether if the patient had dysphagia prior to voice therapy. The therapy was conducted by improving the larynx movement and glottal contact, whilst removing hypertension of the supraglottic. Results : All 13 patients who underwent voice therapy had shown improvements that are statistically significant from 4 scales excluding the S scale from auditory perception evaluation (p<0.05), with enhanced glottal contact. In acoustic evaluation, Jitter, Shimmer and NHR had shown significant improvement after voice therapy. MPT was also notably improved among aerodynamical evaluation (p<0.001). All 11 patients had with dysphagia prior to voice therapy reported to have improved swallowing functions. Conclusion : Application of adequate voice therapy to patients with unilateral vocal fold paralysis, is an effective method that might be employed in the initial phase. Especially, the voice therapy proposed in this study is expected to be useful for patients in hypertension status due to secondary compensation after initial paralysis, since it focuses on improving vocal symptoms in a calm state with the supraglottis sufficiently relaxed. Also, the therapy is expected to be effective for improving swallowing functions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.47-53
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• 2008

Background and Objectives : Benign neoplasms of the larynx are rare, and papillomas account for approximately 90% of these neoplasms. Other benign neoplasms of the larynx are very rare and form a hetergenous group. We present clinical manifestations of unusual benign neoplasms based on our experiences and review of literatures. Materials and Method : We reviewed retrospectively the clinical records of 14 patients with benign neoplasms of the larynx, excluding papillomas, that were examined in our department during 11-year period from 1995 to 2006. Results : The presenting symptom was most commonly progressive dysphonia. Pathologic diagnosis revealed 5 cases of hemangioma, 3 granular cell tumor, 2 amyloidosis, 2 laryngocele, 1 schwannoma, 1 chondroma. Subsites of the neoplasms were 5 in true vocal cord, 3 in arytenoids, 2 in false vocal cord, 2 in supraglottis, and others were subglottis ; aryepiglottic fold. Treatment was surgical, by a external approach in 1 case of chondroma, and by laryngoscopic approach in other cases. In laryngoscopic approach, carbon dioxide laser was used in 10 cases. Postoperative course was satisfactory. Recurrence was encountered in I case of amyloidosis and revision operation was done 3 times. No recurrence was encountered in other cases. Conclusion : Uncommon benign neoplasms of the larynx require high index of suspicion and histological confirmation. Complete excision with an attempt to maintain normal structures generally results in cure.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.164-168
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• 1998

Background: Supraglottis and glottis have a different embryologic origin. Supraglottic cancer is characterized by high incidence of cervical lymph node metastasis at initial diagnosis, and favored surgical management of the early supraglottic cancer was partial supraglottic laryngectomy, however the procedure resulted in frequent incidences of postsurgical aspiration and voice disabilities. Objectives: We retrospectively analyzed the problems and the advantages of the endoscopic laser assisted supraglottic partial laryngectomy as a part of surgical management for early supraglottic cancer. Materials and Methods: During the past nine years 25 cases of supraglottic cancer(Tl 10 cases, T2 15 cases) were treated by tracheotomy and laser assisted supraglottic partial laryngectomy(KTP532, 15 Watt, continuous type) and in 10 cases with cervical lymph node metastasis, they were additionally managed by neck dissection one week later, and all cases received postoperative irradiation therapy. Results: At present, 19 cases are alive with no evidence of disease. During the follow up period total of six cases(primary failure: three cases, nodal failure: three cases) were recurred. In relation to tumor staging, One of the 10 Tl cases and two of the 15 T2 cases recurred showing 88% locoregional recurrence rate for early supraglottic cancer. Postoperative com-plication included bleeding in three cases who were controlled by electrocautery under general anesthsia, one case of longstanding aspiration and two cases of laryngeal stenosis as a delayed complication. Conclusion: High control rate suggests that the endoscopic laser assisted supraglottic partial laryngectomy may be a good initial management method for early supraglottic cancer, however it is difficult to determine the resection margin, therefore, accurate tumor staging must be done prior to surgery. In order to prepare for postoperative bleeding, edema and aspiration, the tracheotomy must be performed prior to surgery.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.142-147
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• 2003

Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion: FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.