Chondroma of the laryngeal cartilage is a rare, benign neoplasm which can manifest as a neck mass or, if situated within the airway, as slowly progressive obstruction, hoarseness or dyspnea. The most common location for chondroma is the posterior lamina of the cricoid cartilage; the next most common locations are the thyroid, arytenoid and epiglottic cartilages. Chondroma and low-grade chondrosarcoma are difficult to distinguish from one another histologically. Although chondrosarcoma reportedly recurs, local surgical excision without radical margins and with long-term clinical follow-up is recommended. We report one case of thyroid cartilage chondroma and include a review of radiologic studies and histopathologic analysis results. We also report a second case with severe airway obstruction caused by a large cricoid chondroma. A review of the English language biomedical literature on laryngeal chondroma is included.
INTRODUCTIONLesions of the auricle constitute about 12% of all cutaneous basal and squamous cell carcinomas in the head and neck area.1 Because of the visibility of this area, aesthetic reconstruction is a concern after complete extirpation of the primary tumor. The authors present a J-shaped, conchal excision which allows superior rotation of the remaining pinna and simplified closure of moderately large, full-thickness defects of the auricle with minimal cupping of the helical rim. As the lower pinna is rotated into the defect, loss of vertical dimension is limited to the inferior portion of the auricle, which leaves the superior rim of the helix at its preoperative level.
TECHNIQUENeoplasms which affect the auricle margin were completely excised with a full-thickness wedge resection (Figs. 1,2), and negative margins were verified by examining frozen sections. The J-shaped, conchal excision was used when the remaining wedge defect was between 2 and 2.5 cm. Simple closure of such a large defect would have caused considerable cupping of the pinna. The J-shaped excision was drawn into the concha and excised to include skin and cartilage. Undermining was done about 3 mm beyond the edges of the conchal excision. The inferior portion of ear was rotated superiorly into place and held with one or two buried sutures of #4-0 clear nylon. These sutures were placed through cartilage and perichondrium along the potential stress points. The free edges of the wedge resection were trimmed to allow realignment of the au-From the Department of Head and Neck Surgery -5693. ricular margin, and care was taken to align the concha, antihelix, and helical rim. The subcutaneous tissues were reapproximated with a #4-0 absorbable suture, and interrupted, #5-0 monofilament sutures were used to reapproximate the skin edges (Fig. 3). Vertical mattress sutures along the helical rim reduced postoperative notching. A cup-shaped, external dressing was applied for the first 2 to 3 postoperative days, and sutures were removed after 7 days. The postoperative results were good, and the height of the helical rim was maintained (Fig. 4, left).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.