To our knowledge only a few defined studies have been carried out on laryngeal cysts. These cysts represent a mixed group of benign laryngeal lesions that can cause diagnostic and therapeutic difficulties. The aim of this study was to characterize their histological structure and localizations in the larynx as well as to discuss theories about their genesis. Between 1973 and 1996, 342 laryngeal cysts were treated at Phillips University of Marburg, while from 1990 to 1996, 74 were treated at Justus Liebig University of Giessen. In all, 416 laryngeal cysts were treated by endolaryngeal microsurgery. All clinical charts were reviewed retrospectively and surgical specimens examined histomorphologically. Findings showed that 58.2% of the laryngeal cysts were located in the glottic area and 18.3% in the ventricular folds. The remainder were located on the aryepiglottic fold (2.2%) and interarythenoid region (0.7%). Two congenital cysts were also treated. Approximately 56% of the laryngeal cysts were lined by squamous cell epithelium, 37% by respiratory epithelium and 7% by oncocytic epithelium. In general, the laryngeal cysts were found to be a collection of inhomogenous lesions from different histogenetic origins with diverse symptoms related to their site and size. On the basis of our investigations, a new classification was established concerning the genesis and development of laryngeal cysts by subdividing cysts into congenital cysts, retention cysts, and inclusion cysts.

Polyps of the vocal cords are a separate entity occurring nowhere else in the larynx or in the human body. Gelatinous and telangiectatic, but mainly transitional types of polyps can be discriminated. Histological, histochemical and electron microscopic investigations on a series of polyps show that an alteration of the permeability of blood vessels may be of importance, allowing the extravasation of edema fluid, fibrin or erythrocytes. Following this, reactive processes develop with the formation of labyrinthine vascular spaces. This process is very similar to the organization of a thrombus. Since polyps occur mainly in people who use their voices very intensively, and develop at the site of maximum muscular and aerodynamic forces exerted during phonation, vocal cord polyps are considered a sequela of a phonotrauma.

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35 cases of continuous series of 841 laryngeal cancers were studied separately. Those patients had already been suffering from hoarseness for more than 2 years, in the average for 9 years. Many of these patients had been examined and treated by inhalations, and biopsies were taken because of a chronic laryngitis. Clinically in half of the cases a big carcinoma could be found. In 10 cases a chronic laryngitis had been diagnosed; in spite of the preceeding examination by microlaryngoscopy in 4 cases, however, the carcinoma could only be proved by histologic examination. The histologic examinations of the specimens regularly displayed an extended field of epidermisation of the laryngeal mucosa following chronic laryngitis, In these fields of epidermisation the carcinoma developed multicentrically and--in the early stages--mostly showed a covering-like, minutely infiltrating growth. Disseminated dot-like cancer-focuses in the epidermisation field and cancer buds arising from the basal layers of an intact covering of the hypertrophic epithelium could be observed several times. Chronic-hypertrophic laryngitis seems to favour the development of cancer within some patients (promoting factor), it even might accelerate it. As in about 6% of all the vocal cord cancers a preexistent chronic laryngitis is proved by history and clinical findings each patient with a chronic hypertrophic laryngitis must be examined by microlaryngoscopy as well as histological examinations and must be constantly observed.

A distinctive species of adenocarcinoma arising in the region of the middle turbinate and ethmoid is described. While these tumors generally behave rather benignly, some lesions are capable of invading the cranial cavity as well as metastasizing. Histologically the cells and the structure of these tubular-papillary cystadenocarcinomas show such a striking similarity to the terminal tubules of the seromucous glands that the term "terminal tubulus adenocarcinoma" is proposed. As similar glands can be found in all portions of the upper and lower aerodigestive tracts, it is also possible that these tumors may occur throughout this entire area.