Updates on larynx cancer epidemiology

Objective: Laryngeal cancer is an important oncologic entity, whose prognosis depends on establishing appropriate preventive and diagnostic measures, especially in populations at higher risk.Methods: Epidemiologic information including worldwide incidence, prevalence, burden of health loss(disability-adjusted life year;DALYs) and mortality of larynx cancer was obtained from the Global Health Data Exchange(GHDx) database.Results: The current incidence, prevalence and mortality of laryngeal cancer are estimated at 2.76 cases/year per 100,000 inhabitants, 14.33 cases/year per 100,000 inhabitants and 1.66 deaths/year per 100,000 inhabitants,respectively, averaging 3.28 million DALYs each year. Incidence and prevalence have increased by 12% and 24%,respectively during the past 3 decades, whilst mortality has declined by around 5%. The epidemiologic burden of this malignancy is approximately 5-fold higher in males and increases in parallel with ageing, peaking after 65 years of age. Both incidence and mortality rates are higher in Europe and lower in Africa, but the ratio between deaths and incidence is the highest in Africa. Incidence has gradually declined in Europe during the past 3 decades, whilst it has increased in South-East Asia and Western Pacific. Cigarette smoking and alcohol abuse contribute for about 90% of overall worldwide mortality for laryngeal cancer.Conclusions: Laryngeal cancer still poses a high clinical and societal burden, with an escalating temporal trend not expected to reverse soon.

Collision carcinoma of squamous cell carcinoma and small cell neuroendocrine carcinoma of the larynx: A case report and review of the literature

BACKGROUND Collision carcinoma is rare in clinical practice, especially in the head and neck region. In this paper, we report a case of squamous cell carcinoma(SCC) and neuroendocrine carcinoma(NEC) colliding in the larynx and review 12 cases of collision carcinoma in the head and neck to further understand collision carcinoma, including its definition, diagnosis, and treatment.CASE SUMMARY A 61-year-old man presented with a 1-year history of hoarseness. Contrastenhanced magnetic resonance imaging of the larynx revealed that the right vocal cord had a nodule-like thickening with obvious enhancement. Laryngoscopy revealed a neoplasm on the right vocal cord, and a malignant tumor was initially considered. A frozen section of right vocal cord was performed under general anesthesia. The pathological result showed a malignant tumor in the right vocal cord. The tumor was excised with a CO_2 laser(Vc type). Routine postoperative pathology showed moderately differentiated SCC with small cell NEC in the right vocal cord. No metastatic lymph nodes or distant metastases were found on postoperative positron emission tomography/computed tomography. Because of the coexistence of SCC and NEC, the patient received adjuvant chemotherapy and radiotherapy. The patient was followed for 8 mo, and no recurrence or distant metastasis was found.CONCLUSION The treatment of collision carcinoma in the head and neck region is uncertain due to the small number of cases.

Case Report: Gouty Tophus of the Larynx

Gout is a metabolic disorder that is characterized by a deposition of monosodium urate crystals in the joint or soft tissue. Gout manifestations in head and neck region are rare, and larynx is an infrequently affected location. We recently managed a case of a gouty tophus over the larynx. A 65-year-old male with a long history of gout without medical control. He has suffered from increasing hoarseness for six months. Laryngoscopy revealed a mass lesion over the right vocal process region without vocal paralysis. Laryngo-micro-surgery biopsy was taken, and pathology confirmed laryngeal gouty tophus without evidence of malignancy.

TREATMENT OF ACUTE DISEASES OF PHARYNX AND LARYNX WITH BLOOD-PRICKING THERAPY

This article deals with a treatment of acute diseases of pharynx and larynx with bloodpricking therapy, in this treatment, a group of 79 patients accepted the treatment with this therapy.The therapy contains mainly two methods: Acupoint pricking and local scattered pricking. A good result is achieved. It proves that blood-pricking method can replace the antibiotics and alleviate the sufferer’s pain and economic burden. It is simple and easy to carry out, thus it can be spread extensively.

PRIMARY MALIGNANT LYMPHOMA OF THE LARYNX: ANALYSIS OF 4 PATIENTS

From July 1969 to November 1991, 4 patients with primary malignant lymphoma of the larynx were treated.One case was received radiotherapy and followed- up survey for 20 years being healthy, 3 case were received radiotherapy and chemotherapy. A total dose of 45-60 Gy was delivered. The disease can be classified four clinical types, (1) localized laryngeal lymphoma; (2) cephalocevical and larynx lymphoma; (3) laryngeal pieces region lymphoma; and (4) laryngeal pieces wildly spreaded lymphoma. The favorable prognostic factors were clinical course, clinical staging and the mode of treatment.

Inhibitory Effects of Celecoxib and Sc-58125 on Proliferation of Human Carcinoma of Larynx Hep-2 In Vitro

Summary: The inhibitory effects of two kinds of selective cyclooxygenase-2 inhibitors on the proliferation of human carcinoma of larynx Hep-2 in vitro and their corresponding mechanisms were investigated. Hep-2 cells were cultured with two kinds of selective cyclooxygenase-2 inhibitors (Sc-58125 and Celecoxib) at various concentrations for 24 h. Morphological changes were observed under the phase microscopy and the growth suppression was detected by using MTT colorimetric assay. Apoptotic DNA fragments were observed by agarose gel electrophoresis, and the cell cycle and apoptotic rate were detected by flow cytometry (FCM) respectively. Hep-2 cells became rounded and detached from the culture dish after being treated with Celecoxib for 24 h, however, they remained morphologically unchanged with Sc-58125. Sc-58125 could increase G 2 phase cells, whereas, Celecoxib rose G 1 phase cells. Both of the two effects were dose-dependent. Moreover, the Hep-2 cells cultured with 50 μmol/L and 100 μmol/L Celecoxib showed obvious apoptosis, with the nuclear DNA of cells exhibiting characteristic DNA ladder. So Sc-58125 could inhibit the proliferation of Hep-2 cells by altering the G 2 phase cells. However, Celecoxib had the same effect by changing the G 1 phase cells and inducing apoptosis at higher concentration.

Primary Lymphoma of the Larynx: A Case Report and Literature Review

Background: Primary non-hodgkin lymphoma of the larynx is a rare entity accounting for 1% of laryngeal tumors. Fewer than 100 cases have been reported in the literature. Case presentation: A 52-year-old man, presented with a two-month history of dysphonia. Nasofibroscopy showed left submucosal bulging of the laryngeal supraglottic floor. Cervical computed tomography showed extensive left supraglottic mass, with partial lysis of the thyroid cartilage. Direct laryngoscopy showed left submucosal bulging of the supraglottic floor. Transmucosal biopsies were performed. Histological study concluded to the presence of a diffuse large-cell B lymphoma. The patient was treated with chemotherapy followed by external radiotherapy. Evolution was favourable. Conclusion: Although primary laryngeal non-hodgkin lymphoma is rare, it should be considered in the differential diagnosis of a mass in the neck region, especially in the supraglottic area. Direct laryngoscopy with biopsy makes the diagnosis. Treatment and prognosis depend on the stage and the grade of the lymphoma.

Low-grade chondrosarcoma of the larynx: A case report

BACKGROUND Chondrosarcomas of the larynx are malignant tumours that most commonly originate from the hyaline cartilage.Chondrosarcoma of the larynx,the most common type of low-grade tumour,accounts for 1%of all laryngeal neoplasms.CASE SUMMARY We present the case of a 60-year-old female patient who developed progressive hoarseness and shortness of breath over a 2-mo period.The patient had undergone resection of a laryngeal tumour 14 years before the aforementioned symptoms occurred,and histopathological analysis indicated that it was a chondroma.During the assessment of the patient,a submucosal,oval-shaped tumour was detected that was predominantly located on the left side of the larynx and was approximately 6 cm in size.The decision to perform left partial vertical laryngectomy was made.A pathohistological diagnosis of low-grade chondrosarcoma was made.Considering the results of pathohistological analysis and the positive margins of the resection,a total laryngectomy was performed.During the 12-mo follow-up,no local relapse or regional or distant metastases was detected.CONCLUSION Chondrosarcoma of the larynx must be considered in the differential diagnosis of laryngeal submucosal tumours.It is crucial to carefully sample of tumour tissue,differentiate chondroma and chondrosarcoma,and consider the possibility of malignant changes from chondroma to chondrosarcoma.

Late Complication of Tracheostomy: Larynx-Shaped Reorganization of the Tracheal Rings or the True Larynx?

Tracheostomy is a well-established, commonly used surgical procedure, whose early and late complications are widely described in literature. Some of them remain still poorly known, though. One of these rare complications is a peculiar larynx-shaped reorganization of the tracheal rings and cricoid cartilage. This tracheal narrowing seems to be non- symptomatic and not life-threatening, at least as long as the reduction of the lumen is <50% - 75%. Such a finding has never been described so far in the literature, and should be kept in mind as one of late complication of tracheostomy.

Papillary Cystadenoma of Larynx: A Case Report

An uncommon clinical entity of papillary cystadenoma of the larynx in a lady of 37-year-old is presented. The diagnosis after clinical examination was achieved by video-stroboscopy, CT scan of the neck, biopsy and histopathological examination. This case study emphasizes the importance of recognition of this lesion by the clinician as the differential diagnosis includes lesions with similar clinical appearance.

Changes in Breastfeeding and of Breasts before and after Babies’ Surgeries for Ankyloglossia with Deviation of the Epiglottis and Larynx (ADEL) —Healthy Breastfeedin

Background: Historically frenotomy was performed at newborn babies’ baptism for healthy breast-feeding over many centuries. Although it was necessary for nursing babies, its application was denied subjectively without clinical observation since the early 20th century. As a result solutions for breastfeeding and breast problems are confused now. Methods: We studied changes in breastfeeding and mothers’ breasts before and one month after the surgeries for ADEL by standards for healthy breastfeeding and breasts. Results: With regard to suckling, before the surgeries 24% of babies opened their eyes during breastfeeding, while after surgeries 76% opened eyes while nursing. 30% of the babies latched onto the mother’s breast with a wide-open mouth. After surgeries, 84% properly latched on. 73% of the babies had calluses on the upper lip before surgeries, and no calluses were observed after surgeries. 27% of babies before surgeries moved the jaws during breast-feeding, but after surgeries 88% moved the jaws while nursing. White debris was on the dorsum tongue in 70% of babies prior to surgeries. After surgeries, 22% were with debris. 67% of mothers experienced nipple pain before their babies’ surgeries while 6% had pain after the surgeries. Flattened nipples were observed in 55% of mothers before the infants’ surgeries, 7% after surgeries. 23% of mothers had breast pain before the surgeries, and 4% had breast pain after the surgeries. Mastitis was also reduced from 9% to 1% after surgeries. 73% of women had palpable breast masses, and after the surgeries 25% had palpable masses. Summary: Remarkable improvements in breastfeeding and in women’s breasts were achieved after their infants underwent operations for ADEL. These results indicate the necessity of surgical interventions in babies with ADEL for healthy breastfeeding and breasts (279).

Foreign Body Larynx in ORL Department of University Hospital-Yalgado Ouedraogo

Introduction: Foreign bodies of the larynx are serious. They can be immediately life-threatening. The aim of this study was to report the epidemiological and clinical features that characterize this affection. Material and method: We retrospectively reviewed the clinical records of patients admitted to foreign bodies of the lower airways in the Otorhinolaryngology (ORL) department of the University Hospital-Yalgado Ouedraogo (UH-YO) from 2008 to 2012. Results: Seventeen (17) foreign body records were compiled on a group of 76 foreign bodies of the lower airways. The average age was 5 years. Patients ranged in age from 6 months to 35 years with a sex ratio of 1.4. The call signs were the penetration syndrome that was found in 4 cases (23.5%), laryngeal dyspnea was found in 8 cases (47.05%) with stage II to III and dysphonia 10 cases (58.8%). The extraction was done endoscopically in all patients, and a tracheostomy was made in 2 cases (11.7%). A death was noted in 1 case (5.9%). Conclusion: The laryngeal foreign bodies are common and maintain their classical gravity. It should be thought about in front of any dyspnea associated with dysphonia in children previously healthy. The prevention is the key weapon in our context.

Granular Cell Tumour of Larynx— A Case Report

Granular cell tumors, also called Abrikossoff tumors, are benign, slowly growing neoplasms. They may occur anywhere in the body, but head and neck accounts to 45% - 65% of these cases. The most common site is the tongue. Larynx is relatively an uncommon location for these tumours, accounting for approximately three to 10 per cent of the reported cases. Laryngeal granular cell tumour is extremely rare accounting for only 19 reported cases under the age of 17 years. As many as 10% of patients experience multifocal synchronous or metachronous tumors. We present a rare case report of granular cell tumour of the larynx.

Synchronous occurrence of extramedullary plasmacytoma and squamous cell carcinoma in situ in the larynx: a case report

Extramedullary plasmacytoma of the larynx is rare, especially when coexisted with squamous cell carcinoma in situ. We report a 56-year-old woman with hoarseness for 6 months and dysphonia for a week. Fiberoptic laryngoscopic examination showed a red, smooth-surface swelling in the submucous region of the left ventricle and ventricular band of the larynx. The patient underwent vertical laryngectomy and modified left neck dissection. Postoperative pathologic examination revealed coexisting plasmacytoma and carcinoma in situ. Bone marrow biopsy and systemic radiogram showed no positive findings. The hepatic and renal functions were normal. Monoclonal immunoglobulin light chain of type kappa was detected in urine. Hence, a laryngeal extramedullary plasmacytoma with carcinoma in situ was diagnosed. No recurrence or progression was observed during a 2-year follow-up. Here, we discussed the risk factors, diagnosis, and therapy for this rare disease.

白细胞介素17及白细胞介素1β在成人喉乳头状瘤疾病进展中的相关性研究

目的探究白细胞介素17(interleukin-17,IL-17)及IL-1β与成人喉乳头状瘤疾病进展及人乳头状瘤病毒(human papilloma virus,HPV)感染状态的相关性。方法收集2010年1月~2020年12月首都医科大学附属北京同仁医院耳鼻咽喉头颈科手术治疗的成人喉乳头状瘤患者的组织样本,将患者分为乳头状瘤组和疾病进展组。对样本行RNA原位杂交判断HPV分型,免疫荧光检测IL-17及IL-1β表达,分析其表达的组间差异及与HPV高危亚型的相关性。结果乳头状瘤组及疾病进展组间IL-17及IL-1β免疫荧光阳性率存在显著差异,疾病进展组中IL-17及IL-1β阳性率显著升高(t=5.460,P<0.001;t=10.030,P<0.001)。HPV高危亚型与IL-17及IL-1β表达相关,HPV高危型患者中IL-17及IL-1β表达水平显著升高,其中,IL-17表达差异具有统计学意义(t=4.554,P=0.0004)。结论IL-17及IL-1β与成人喉乳头状瘤疾病进展及HPV高危型感染状态有着密切相关性,HPV高危型加剧组织局部IL-17及IL-1β聚集,造成局部免疫微环境改变,进而引发疾病进展。

Laryngeal leiomyoma:A case report and review of literature

BACKGROUND Leiomyomas(LMs)are mesenchymal tumors that arise from smooth muscle cells.LMs most commonly arise in organs with an abundance of smooth muscle such as the uterus and gastrointestinal tract.Conversely,LMs are rarely detected in the head and neck region.In this study,we report a rare case of laryngeal LM(LLM)and summarized the clinical characteristics of reported LLMs to help clinicians better understand this rare disease and improve its diagnosis,treatment,and postoperative course.CASE SUMMARY A 49-year-old man was admitted to our ENT outpatient clinic with a chief complaint of pharynx discomfort for 2 months.Laryngoscopy performed under topical anesthesia revealed a solitary,pink mass at the tubercle of epiglottis.Surgery via laryngeal endoscopy was performed under general anesthesia,and the lesion was excised easily.Positive immunohistochemical staining for desmin and smooth-muscle actin indicated a smooth muscle origin and the diagnosis was laryngeal leiomyoma.After surgery,the patient’s condition was stable,and he was discharged 2 d after surgery.During the 1-year postoperative period,the patient’s condition remained stable without evidence of recurrence.CONCLUSION Surgical resection is the preferred treatment for LLMs,its early diagnosis and differential diagnosis have important clinical significance.

颈内/颈外入路环状软骨前/后裂开自体肋软骨移植联合T管植入治疗儿童喉气管狭窄

目的探讨环状软骨前/后裂开自体肋软骨移植对儿童喉气管狭窄的治疗效果。方法回顾性分析首都医科大学附属北京儿童医院近年来采用环状软骨前/后裂开自体肋软骨移植联合T管植入治疗儿童喉气管狭窄12例。男5例,女7例,患儿年龄2岁6月~16岁9月,平均8岁9月。Ⅱ度狭窄2例,Ⅲ度狭窄9例,Ⅳ度狭窄1例。所有病例术前已行气管切开。病程4个月~6年,平均3年。结果10例(83.3%)患儿已治愈,成功拔除气管切开套管,恢复正常呼吸及发音功能。2例拔管失败,其中1例Ⅲ度狭窄和1例Ⅳ度狭窄。结论儿童喉气管狭窄病因复杂,治疗困难,颈内/颈外入路环状软骨前/后裂开自体肋软骨移植联合T管植入治疗儿童喉气管狭窄可取得良好的治疗效果。

中医喉科吹药研究进展

吹药法是众多中医外治法中的一种,多应用于耳鼻喉科的日常诊治中。喉科吹药则是将药粉吹布于咽喉患处,以达到治疗目的的方法。当前,抗生素广泛应用使中医喉科吹药法的使用大为减少,常用的也是一些成药,如西瓜霜等。由于抗生素的弊端日益显现,吹喉法疗效凸显。吹药具有局部直接作用、便携、安全性高、疗效可靠等优势,而当前相关研究相对较少,其制作工艺、具体机制、药方发掘等方面仍需深入研究。对相关文献进行综述,以期为喉科疾病的治疗提供新的思路。

鱼刺卡喉食管穿孔伴食管纵隔瘘患者1例的护理

食管穿孔是一种外科急症,一旦并发败血症、纵隔脓肿及多器官功能衰竭等情况,病死率高达40%~60%。本文回顾性分析2022年广州医科大学附属第一医院收治的1例鱼刺卡喉食管穿孔伴食管纵隔瘘患者的临床资料。患者因鱼刺卡喉并发纵隔脓肿紧急行“胸骨左侧半劈开+颈部脓肿切开+纵隔脓肿探查及置管引流+左锁骨下静脉缝扎止血术”治疗,术后护理人员通过对患者人工气道的管理、纵隔引流管的有效引流、合理镇静镇痛、营养支持、心理护理等护理措施,患者术后第92天治愈出院。通过总结分析该案例的治疗和护理,希望为以后的相关研究提供参考。

低温等离子喉良性肿物切除术的疗效

目的:研究低温等离子手术治疗喉良性肿物的安全性及有效性。方法:回顾性选择2021年1月—2022年1月清远市人民医院诊断为喉良性肿物的138例住院患者的资料,依据手术方式的不同将其分为常规手术组(n=87)与低温等离子手术组(n=51),常规手术组接受常规喉良性肿物切除手术,低温等离子手术组接受低温等离子手术。采用倾向性评分匹配(propensity score matching,PSM)进行1∶1匹配常规手术组(n=31)与低温等离子手术组(n=31),比较PSM后两组手术时间、术中出血量、手术效果,伤口愈合时间、术后并发症。结果:低温等离子手术组手术时间、伤口愈合时间较常规手术组短,术中出血量、术后并发症较常规手术组少,总有效率较常规手术组高,差异有统计学意义(P<0.05)。结论:低温等离子喉良性肿物切除术是安全且有效的手术方案。