Contrary to some reports, the voice quality is minimally affected by laser surgery for T1a glottic carcinoma, and outcome is similar to radiotherapy. The average fundamental frequency is higher than normal after laser surgery, but the effect on the quality of life was trivial.

This study quantified the effects of head rotation on pharyngeal swallowing in healthy subjects. Videofluoroscopic and oropharyngeal manometric examinations of pharyngeal swallowing were performed on seven volunteers with the head in neutral and rotated positions. Videofluoroscopic study revealed that head rotation swallow causes the bolus to lateralize away from the direction of head rotation. Pharyngeal manometric study indicated that the pharyngeal peak pressures toward the side of head rotation were significantly increased, whereas the pharyngeal pressures opposite the side of head rotation were not affected. Head rotation swallow produced a significant fall in upper esophageal sphincter (UES) resting pressure and a delay in UES closing. We concluded that the head rotation swallow in normal subjects not only alters the bolus pathway, but also has a useful effect on both pharyngeal clearance and UES dynamics.

Laser surgery, which is one type of surgical treatment for allergic and hypertrophie rhinitis, was investigated basically and clinically. The basic investigation showed morphological changes in the nasal mucosa before and after laser surgery. Before laser surgery, hyperplasia of the mucous epithelium, thickening of the basement membrane, edema of the lamina propria mucosa, eosinophilic infiltration, and enlargement of the nasal glands were noted. After laser surgery, the nasal mucosa was covered with 1) epithelium that was squamatized or cuboidal and/or 2) columnar epithelium that was stratified. Granulation-like tissue or cicatricial tissue was found in the lamina propria mucosa. Clinically, we performed laser surgery in 204 cases. Regarding the short-term results, laser surgery was effective in 87%. In the long term, the short-term results persisted in 81% of cases treated for sneezing, 78% for nasal discharge, and 76% for nasal obstruction. From these results, we concluded that laser surgery was a useful surgical treatment for allergic and hypertrophie rhinitis. KEY WORDS-allergic rhinitis, hypertrophie rhinitis, laser surgery, morphological changes.

Most patients have no response to injectable collagen or silicone, but some cases may have positive or ‘undersea’(= clinically negative but immunologically positive) response to collagen. From the results of the Macrophage migration inhibition test, the relative immunogenicity was augmented most when we used implants with the following combination. The firstimmunization was collagen and the second one was collagen with silicone.The augmented antigenicity might be enough to cause an allergic reaction to the patients who had no response to each implant alone. The purpose of this article is to warn of the potential hazard of injection.

No abstract

This study assessed the practicality of using autologous freeze-dried fascia to augment the vocal fold. Freeze-dried autologous fascia was injected into the vocal fold and skin of dogs in order to monitor sequential histological changes. Fascia lata was harvested from six adult dogs. After freeze-drying, minced fascia suspended in hyaluronic acid was injected subcutaneously into the abdominal wall and directly into the vocal fold. The specimens were extracted 3 weeks after injection and studied histologically. Freeze-drying destroyed all cellular components but did not affect the collagen fibers, which are the major components of fascia. There was no evidence of degeneration, necrosis or infection. Fibroblastic infiltration was seen in the fascia injected into the vocal fold, but the fascia remained as an unencapsulated mass at the site of injection. This study demonstrates that freeze-drying does not compromise the collagen in fascia and that the injection of freeze-dried collagen is well tolerated. Freeze-dried fascia is a promising new augmentation material.

No abstract

Seventeen patients with subglottic and tracheal stenosis were treated with laser surgery. Six patients had airway stenosis caused by malignant tumors. Out of 16 patients who required emergency endolaryngeal laser surgery, satisfactory results were achieved in 12, obtaining a sufficient lumen for ventilation. Five cases with airway tumors underwent laser surgery to increase the airway lumen, however, only one patient showed excellent results, with a sufficient airway lumen not being obtained in the others. Airway obstructions due to tumor can be treated satisfactorily by laser surgery, though long-term postoperative follow-up confirmed recurrence of tumor in some cases, which is a problem that must be overcome in the future.