Summary--A case of primary oat-cell carcinoma of the larynx in a 68-year-old white female is described, bringing to a total of three the reported cases in the world literature. The tumor is highly malignant and notorious for the speed with which it metastasizes. Treatment should be aggressive from the beginning. We believe that even for a localized tumor of this kind, a minimal procedure should be widefield laryngectomy with elective radical neck dissection even if clinically, nodes are not palpable. Since the tumor is highly radiosensitive, radiotherapy should be used postoperatively.
Twenty‐six dogs underwent total laryngectomy and autogenous reconstruction of the pharynx for the purpose of construction of a pseudolarynx. This simplified larynx demonstrated that it subserved the three major functions of the larynx; respiration, deglutition, and phonation in six of our 26 dogs which survived long enough for meaningful evaluation. Our surgical endeavors involve one of the most critical of areas in the body “the crossroads for air and food.” Despite some aspiration which we are still encountering with our present technique, the innervated tongue flap holds promise as a possible solution to this problem, and a detailed report will be submitted in due course.
A conventional supraglottic laryngectomy with simultaneous bilateral arytenoidectomy and lateralization of the true vocal cords, in order to “freeze the glottic inlet,” was performed in 15 dogs. The posterior half of the hemi‐tongue was mobilized, everted and delivered into the hypopharynx where its free distal margins were sutured to a raw area created on the postcricoid and upper esophageal region. This flap constituted the innervated part hemi‐tongue pseudoepiglottis. The healing of the pseudoepiglottis was complete in eight dogs. Endoscopic examination demonstrated the pseudoepiglottis to cover the glottic inlet while the dog breathed around it. All these dogs ate solids and drank liquids by mouth. Four dogs demonstrated the ability to drink fluids well, as opposed to the rather laborious effort by the rest. Barium swallow showed the passage of dye over the superior surface of the pseudoepiglottis. The dogs were sacrificed at four to six weeks. A pneumonic process was demonstrable in one dog only. Prior to sacrifice the ipsilateral hypoglossal nerve was exposed in the neck of one dog. Its stimulation electrically demonstrated contraction of the pseudoepiglottis with elevation of the esophageal inlet.
A conventional supraglottic laryngectomy with simultaneous bilateral arytenoidectomy and lateralization of the true vocal cords, in order to "freeze the glottic inlet," was performed in 15 dogs. The posterior half of the hemi-tongue was mobilized, everted and delivered into the hypopharynx where its free distal margins were sutured to a raw area created on the postcricoid and upper esophageal region. This flap constituted the innervated part hemi-tongue pseudoepiglottis. The healing of the pseudoepiglottis was complete in eight dogs. Endoscopic examination demonstrated the pseudoepiglottis to cov,er the glottic inlet while the dog breathed around it. All these dogs ate solids and drank liquids by mouth. Four dogs demonstrated the ability to drink fluids well, as opposed to the rather laborious effort by the rest. Barium swallow showed the passage of dye over the superior surface of the pseudoepiglottis. The dogs were sacrificed at four to six weeks. A pneumonic process was demonstrable in one dog only. Prior to sacrifice the ipsilateral hypoglossal nerve was exposed in the neck of one dog. Its stimulation electrically demonstrated contraction of the pseudoepiglottis with elevation of the esophageal inlet.
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.