XLVIII Pathology of the Subepithelial (Reinke's) Layer of the Vocal Cords

Waldapfel, Richard

doi:10.1177/000348944004900304

Cited by 12 publications

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“…Several reports have used indirect measures, such as oxygen tension, to study the vocal fold's blood flow 3,4 ; however, no direct measurement of flow has been reported. Although controversial, some authors have suggested that circulatory changes and possibly ischemie changes are important factors in the etiology of vocal polyps, nodules and polypoid changes.…”

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“…Although controversial, some authors have suggested that circulatory changes and possibly ischemie changes are important factors in the etiology of vocal polyps, nodules and polypoid changes. 3 " 7 This study used an in vivo canine model 8 • 9 to measure the blood flow of the vocal fold using the microsphere surface technique. This method allowed the measure ment of regional flow distribution (i.e., to the muscularis and lamina propria), as well as overall flow.…”

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“…I he microvascular anatomy of the canine and the hu man vocal fold have been described by Hirano et al 1 and Matsuo et al, 2 but less is known about the blood flow to this region. Several reports have used indirect measures, such as oxygen tension, to study the vocal fold's blood flow 3,4 ; however, no direct measurement of flow has been reported. Although controversial, some authors have suggested that circulatory changes and possibly ischemie changes are important factors in the etiology of vocal polyps, nodules and polypoid changes.…”

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Regional Blood Flow of the Canine Vocal Cord: The Microsphere Surface Technique

Arnstein

Berke

Trapp

et al. 1990

Otolaryngol.--head neck surg.

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The vocal fold's microcirculation has been well described, but there are few reports regarding the blood flow to this region. A number of methods have been used to evaluate the blood flow to an organ system. Among the most sensitive is the microsphere surface technique, which has been used to measure blood flow in many organ systems, including the cochlea. In this study, the blood flow to the canine vocal fold was assessed using the microsphere surface technique. Overall flow was measured, as well as flow to the lamina propria and muscularis layers. The technique and the results are reported.

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Regional Blood Flow of the Canine Vocal Cord: The Microsphere Surface Technique

Arnstein

Berke

Trapp

et al. 1990

Otolaryngol.--head neck surg.

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Vascular Polyp of the Vocal Cord

Myerson¹

1944

Archives of Otolaryngology - Head and Neck Surgery

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Vascular polyp is the most common of growths occurring on the vocal cords. It is known variously as hemangioma (Kramer and Yankauer1), varix (Faunce2; Imperatori3), inflammatory tumor (Tucker4), cavernous papilloma (Hooper5), angioma (Chiari6), hemangiectatic fibroma and papilloma (Eppinger7), capillary angioma (Schwartz8) and pseudoangioma (New9). I prefer the name vascular polyp. Vascular polyp is not a true growth but is inflammatory in nature. It is the result of trauma in the form of strain or abuse in the presence of chronic inflammation of the mucous membrane and the immediate subjacent tissue. Because vascular polyp is so distinctive, it is difficult to confuse with other benign growths of the larynx. It frequently is called papilloma or fibroma; this is evidence of the perpetuation of erroneous nomenclature.It is likely that vascular polyp has been occurring ever since man first found his voice. From a perusal of the literature of the prelaryngoscopic era one gets the impression that all conditions which might cause suffocation were included under the general heading of polyp of the larynx. In the writings of Ehrmann10 (1844) and Green11 (1852) there is mentioned a series of cases, all of which were considered as cases of laryngeal polyp. All the patients were threatened with asphyxia; 3 were saved by op¬ eration.After the invention of the laryngeal mirror by Garcia (1855) there was a better understanding and therefore a finer differentiation of the neo¬ plasms and other lesions found in the larynx. Yet it was not until fairly recently that a clear understanding and a fairly accurate diagnosis became the rule.The removal of a tumor of a vocal cord through the natural passages was recorded as early as 1750 by Kaderik.12 Fauvel13 is credited with having been the first to recognize what was probably a vascular polyp by mirror examination of the larynx. He found a polyp "in the for¬ ward part of the vocal cord of a man" ; the cavernous structure of the polyp was demon¬ strated microscopically. For the removal of laryngeal growths Desault14 recommended laryngotomy in 1813. Twenty years later Brauers15 attempted the removal of a polyp by this means. Three years after that, in 1836, Regnoli1G re¬ moved a neoplasm through the mouth after first performing tracheotomy. In 1844 Ehrmann10 also removed a polyp in this manner. By 1871 Mackenzie 1T was able to collect 28 cases in which thyrotomy had been performed for a growth in the larynx. In prelaryngoscopic days and for some time afterward, laryngeal growths were re¬ moved by means of thyrotomy. This operation was used until the establishment of indirect pro¬ cedures for the same purpose by the pioneers in laryngology. On rare occasions a laryngeal polyp has been encountered in the dissection room. It was only after Turck and Czermak had popularized the use of the mirror that reports

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Distribuição das fibras colágenas e do sistema de fibras elásticas na camada superficial da lâmina própria da prega vocal com edema de Reinke

Sakae¹

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O único homem que está isento de erros, é aquele que não arrisca acertar." Albert Einstein DedicatóriaAos meus queridos pais, Masao e Junko, por tudo que fazem por mim, pelo apoio incondicional e amor eterno. São os meus ídolos.A minha esposa, Renata, amor da minha vida, pela alegria de viver, companheirismo e incentivo constante.A minha irmã, Cristiane, por ter contribuído em todos os passos de minha vida. AgradecimentosAo meu orientador, Prof. Dr. Domingos Hiroshi Tsuji pela oportunidade e apoio na concretização deste sonho. Sua amizade e franqueza foram essenciais na elaboração deste trabalho. É o grande mestre. Ao Prof. Dr. Luiz Ubirajara Sennes pelos ensinamentos otorrinolaringológicos, pelas diversas oportunidades que ajudaram na minha formação e por tudo que faz na nossa clínica. Ao Dr. Rui Imamura foi fundamental na minha formação médica, a quem tenho uma grande admiração e respeito. Como sempre me ajudou muito, agradeço pela coorientação sincera e valiosa desta tese. Aos Prof(s). Dr. Aroldo Miniti e Dr. Ricardo Ferreira Bento por desenvolverem um trabalho árduo, de muita coragem e perseverança em nossa especialidade. Ao Prof. Dr. Ossamu Butugan é o maior exemplo de sabedoria e humildade, agradeço a todos os seus ensinamentos e conversas amigas nos corredores do Hospital. Ao Prof. Dr. Silvio Marone admiro pela sua bondade e liderança. Agradeço pelo total apoio, confiança e amizade desde o período em que ingressei no serviço da PUC de Campinas. A Dra. Thais Mauad, Profª. Associada do Departamento de Patologia da FMUSP, pela amizade e ajuda imensa na elaboração dos artigos deste trabalho e ao Dr. Luiz Fernando Ferraz, médico patologista, que me ajudou na leitura das lâminas.

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XLVIII Pathology of the Subepithelial (Reinke's) Layer of the Vocal Cords

Cited by 12 publications

References 1 publication

Regional Blood Flow of the Canine Vocal Cord: The Microsphere Surface Technique

Regional Blood Flow of the Canine Vocal Cord: The Microsphere Surface Technique

Vascular Polyp of the Vocal Cord

Distribuição das fibras colágenas e do sistema de fibras elásticas na camada superficial da lâmina própria da prega vocal com edema de Reinke

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