ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
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The Evaluation of Preoperative Mobility of the Vocal Fold and Arytenoid with Postoperative Histopathologic Examinations in Carcinoma of the Larynx and Hypopharynx
Larenks ve Hipofarenks Kanserlerinde Preoperatif Kord ve Aritenoid Mobilitesinin Postoperatif Histopatolojik Tetkiklerle Değerlendirilmesi
KBB ve BBC Dergisi, 11 (3): 111-114, 2003
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
30 patients with laryngeal carcinomas evaluated for preoperative vocal fold and arytenoid movements were included into our study. The movements of vocal folds and arytenoids were defined clinically as mobile, fixed or limited. Postoperatively, the laryngeal specimens were divided into subglottic, glottic and supraglottic areas and fixed with formaldehit and evaluated with a pathologist. The involvement of thyroarytenoid muscle, posterior cricoarytenoid muscle, cricoarytenoid joint, paraglottic area, conus elasticus, arytenoid cartilage were investigated.In cases with limited movement of vocal fold and arytenoid movements preoperatively, the rate of thyroarytenoid muscle involvement was 33.3% (2/6), the rates of paraglottic area and arytenoid cartilage involvement were 50% (3/6) and 16.6 (1/6), espectively. There was no involvement of cricoarytenoid joint, conus elasticus and posterior cricoarytenoid muscle. In cases with fixed preoperative vocal fold and arytenoid, the rate of thyroarytenoid uscle involvement was %47.4 (9/19), the rate of cricoarytenoid joint involvement was %42.1 (8/19). The rate of involvement in conus elasticus was %47.4 (9/19). The rate of involvement in posterior cricoarytenoid muscle was %15.8 (3/19). The rates of involvement in paraglottic area and rytenoid cartilage were %68.4 (13/19) and %47.4 (9/19) respectively.The limitation and fixation in movements of arytenoid and vocal fold is usually associated with nvolvement of thyroarytenoid muscle and paraglottic area. The limited or fixed obility of vocal fold and arytenoid in pyriform sinus tumors may be a result of the greater size and extension of the tumor.
ÖZET
Kord ve aritenoid hareketleri klinik olarak hareketli, fikse veya kısıtlı seklinde tanımlanan 30 hasta çalısmaya alındı. Postoperatif larenks spesmeni subglottik, glottik ve supraglottik bölgelere ayrılarak formolinle fikse edildi ve patologla birlikte değerlendirildi. Tiroaritenoid kas, posterior krikoaritenoid kas, krikoaritenoid eklem, paraglottik bölge, konus elastikus ve aritenoid kartilaj tutulumu araştırıldı. Preoperatif kord ve aritenoid hareketi kısıtlı olanlarda tiroaritenoid kas tutulumu (2/6) %33.3, paraglottik bölge tutulumu (3/6) %50, aritenoid kartilaj tutulumu (1/6) %16.6 oranında olup konus elastikus, krikoaritenoid eklem ve posterior krikoaritenoid kas tutulumu yoktu. Preoperatif kord ve aritenoidi fikse olanlarda tiroaritenoid kas tutulumu (9/19) %47.4, krikoaritenoid eklem tutulumu (8/19) %42.1, konus elastikus tutulumu (9/19) %47.4, posterior krikoaritenoid kas tutulumu (3/19) %15.8, paraglottik bölge tutulumu (13/19) %68.4, aritenoid kartilaj tutulumu (9/19) %47.4 oranında idi. Paraglottik bölge, tiroaritenoid kas ve konus elastikus konservasyon cerrahisi açısından çok önemlidir. Aritenoid ve kord hareketlerindeki kısıtlılık ve fiksasyon genellikle tiroaritenoid kas ve paraglottik bölge tutulumu ile birliktedir. Piriform sinüs tümörlerindeki kord ve aritenoid hareketlerindeki kısıtlılık veya fiksasyon tümör büyüklüğüne veya basısına bağlı olabilir.