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Laryngoscope Investigative... Jun 2024Cartilaginous tumors of the larynx are rare, representing less than 1% of all laryngeal tumors. Chondromas are benign mesenchymal tumors characterized by a slow-paced... (Review)
Review
OBJECTIVE
Cartilaginous tumors of the larynx are rare, representing less than 1% of all laryngeal tumors. Chondromas are benign mesenchymal tumors characterized by a slow-paced growth, primarily originated in the cricoid cartilage, followed by the thyroid, arytenoid, and epiglottic cartilages. This scoping review aims to understand the extent of evidence on the epidemiology, clinical characteristics, morbidity, and recurrence of the laryngeal chondroma (LC).
DATA SOURCES
MEDLINE (Ovid), Embase (Elsevier), Web of Science (Clarivate), Cochrane Central Register of Controlled Trials and Systematic Reviews, Lilacs, Scopus, and Google Scholar databases.
REVIEW METHODS
The scoping review was conducted from 1816 to 2023, for observational studies describing LC. Titles and abstracts were screened for relevance, followed by an evaluation of the full text for eligibility. The data were collected from the qualifying articles, and a narrative summary of the outcomes was prepared.
RESULTS
One hundred and nineteen studies met the inclusion criteria. Ninety-four case reports, 22 case series, and 3 cohorts. Two hundred and four participants with a diagnosis of LC were described. Male:female ratio was 2.8:1. The most common localization was the cricoid (113; 47.08%), followed by the thyroid (45; 18.75%), and the arytenoid cartilage (27; 11.25%). Dyspnea (78.85%) and hoarseness (74.28%) were the most reported symptoms. The recurrence rate was 11.25%, and complications were uncommon following the resection.
CONCLUSION
This scoping review found a low-frequency rate over all the cartilaginous laryngeal tumors. Most patients were treated with resection, with a low rate of malignancy conversion. This population has low attributable mortality, morbidity, and recurrence according to the current literature.
PubMed: 38835336
DOI: 10.1002/lio2.1265 -
The Laryngoscope Mar 2023Quantify differences in acoustics and intraglottal flow fields between Thyroplasty Type 1 (TT1) with and without arytenoid adduction (AA) using excised canine larynx...
OBJECTIVES/HYPOTHESIS
Quantify differences in acoustics and intraglottal flow fields between Thyroplasty Type 1 (TT1) with and without arytenoid adduction (AA) using excised canine larynx model.
STUDY DESIGN
Basic science experiments using excised larynges.
METHODS
Surgical procedures were implemented in eight excised canine larynges. Acoustics and intraglottal flow measurements were taken at low and high subglottal pressures in each experimental setup.
RESULTS
In all larynges, vocal efficiency (VE) and cepstrum peak prominence (CPP) were higher, and the mean phonatory flow rate was lower in TT1 with AA than without AA. The glottal asymmetry is reduced with AA and promotes the formation of stronger vortices in the glottal flow during the closing phase of the vibrating folds.
CONCLUSIONS
Findings suggest a clear acoustic and aerodynamic benefit to the addition of AA when performing TT1. It shows significant improvement in CPP, translating to decreased breathiness and dysphonia and increased VE, leading to easier and more sustainable phonation. Stronger intraglottal vortices are known to be correlated with the loudness of voice produced by phonation.
LEVEL OF EVIDENCE
N/A Laryngoscope, 133:621-627, 2023.
Topics: Animals; Dogs; Vocal Cord Paralysis; Larynx; Glottis; Arytenoid Cartilage; Phonation; Laryngoplasty; Acoustics; Vocal Cords
PubMed: 35655422
DOI: 10.1002/lary.30235 -
Ear, Nose, & Throat Journal Mar 2022Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage...
Arytenoid dislocation and subluxations commonly are reduced surgically using Holinger and straight Miller-3 laryngoscopes. We present a case of arytenoid cartilage subluxation returned to good position using a 28-Jackson dilator. A 66-year-old man was diagnosed previously with right vocal fold paresis and left vocal fold paralysis following a motor vehicle accident that required a 14-day intubation and tracheotomy maintained for 3 weeks. Evaluation by strobovideolaryngoscopy 3 months following the accident showed severe left vocal fold hypomotility and arytenoid height disparity; laryngeal electromyography showed only mild-to-moderate decreased recruitment in laryngeal muscles. No abnormalities were appreciated on neck computed tomography. Upon palpation of both arytenoid cartilages in the operating room, the left joint was found to be subluxed anteriorly and immobile. A 28-Jackson dilator was used to mobilize and reduce the left arytenoid cartilage, and steroid was injected into the cricothyroid joint. Increased mobility was obtained in the operating room and the patient reported significant improvement in his voice. Six months later, we saw improvement in arytenoid height disparity and left vocal fold movement, better glottic closure, and voice handicap index was improved. A 28-Jackson dilator can be used to manipulate the cricoarytenoid joint without trauma to the vocal process.
Topics: Aged; Arytenoid Cartilage; Humans; Laryngeal Muscles; Laryngoscopes; Male; Vocal Cord Paralysis; Vocal Cords
PubMed: 32804570
DOI: 10.1177/0145561320946901 -
Indian Journal of Otolaryngology and... Dec 2022The chondromas of laryngeal cartilage constitute less than 1% of common mesenchymal tumors of the larynx. 70-75% of chondroma is located at the endolaryngeal surface of...
The chondromas of laryngeal cartilage constitute less than 1% of common mesenchymal tumors of the larynx. 70-75% of chondroma is located at the endolaryngeal surface of the cricoid cartilage. Here is a case report of the chondroma of arytenoid cartilage-a rare site of occurrence. A middle aged male patient, presented to the outpatient department of otorhinolaryngology with a history of hoarseness of voice. On Flexible laryngoscopy [Pentax, Tokyo, Japan], the right vocal cord was found to be immobile along with a smooth bulge noted over the arytenoid cartilage. The computerized tomography scan of the neck showed a well-defined peripherally calcified lesion arising from the superior aspect of right arytenoid cartilage possibly chondroma. Patient underwent microlaryngeal surgery and sub mucosal excision of the arytenoid mass which was confirmed as chondroma on histopathological examination. High degree of suspicion is required while examining a patient with hoarseness of voice and one should have chondroma as one of the differential diagnosis.
PubMed: 36742926
DOI: 10.1007/s12070-021-02879-0 -
Cartilage Jul 2019The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some... (Review)
Review
The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some scaffolding materials and initial attempts at tissue engineering, especially of the trachea, have been made. The critical issues of providing protection, maintaining a patent airway, and controlling swallowing and phonation, require that the regenerated laryngotracheal cartilages must have mechanical and material properties that closely mimic native tissue. These properties are determined by the cellular and proteomic characteristics of these tissues. However, little is known of these properties for these specific cartilages. This review considers what is known and what issues need to be addressed.
Topics: Arytenoid Cartilage; Bioengineering; Cartilage; Cricoid Cartilage; Epiglottis; Female; Humans; Larynx; Male; Proteomics; Regenerative Medicine; Thyroid Cartilage; Tissue Engineering; Tissue Scaffolds; Trachea; Young Adult
PubMed: 29322878
DOI: 10.1177/1947603517749921 -
PloS One 2020Brachycephalic airway syndrome (BAS) is a well-established cause of respiratory distress in dogs. BAS without surgical correction results in eventual laryngeal collapse....
Brachycephalic airway syndrome (BAS) is a well-established cause of respiratory distress in dogs. BAS without surgical correction results in eventual laryngeal collapse. Arytenoid lateralization has been used to treat severe laryngeal collapse with some highly variable results. Chondromalacia and decreased stiffness of the arytenoid cartilage has been postulated a source of failure after arytenoid lateralization but no report of the histological characteristics and mechanical strength of arytenoid cartilage in brachycephalic dogs has been reported. Here we report histological and mechanical features in arytenoid cartilage of brachycephalic dogs. We identified the arytenoid cartilage in brachycephalic dogs presented degenerative histological characteristics and decreased load to failure and stiffness compared to that in non-brachycephalic dogs. Together, these observations suggest that degenerative condition of arytenoid cartilage in brachycephalic dogs could contribute to chondromalacia and mechanical weakness of arytenoid cartilage and result in cause of failure after arytenoid lateralization.
Topics: Airway Obstruction; Animals; Arytenoid Cartilage; Dog Diseases; Dogs; Pilot Projects; Tensile Strength
PubMed: 32941546
DOI: 10.1371/journal.pone.0239223 -
European Annals of Otorhinolaryngology,... Sep 2019Arytenoid dislocation is a rare occurrence, for which the pathophysiology is still unclear.
INTRODUCTION
Arytenoid dislocation is a rare occurrence, for which the pathophysiology is still unclear.
METHODS
We report here an unusual case of spontaneous arytenoid dislocation, which casts doubts on the prevailing classical theory of hemarthrosis.
RESULTS AND CONCLUSIONS
This case and a review of the literature suggest that arytenoid dislocation could be linked to congenital or acquired arytenoid instability, thus facilitating arytenoid dislocation after even minor trauma. Once the diagnosis is established, we recommend to first attempt reduction, followed by speech therapy, though underlying diseases should be researched.
Topics: Adult; Arytenoid Cartilage; Deglutition Disorders; Dysphonia; Endoscopy; Humans; Joint Dislocations; Male; Neck Pain; Tomography, X-Ray Computed
PubMed: 30910365
DOI: 10.1016/j.anorl.2019.02.018 -
The Laryngoscope Oct 2021There are currently no treatments available that restore dynamic laryngeal function after hemilaryngectomy. We have shown that dynamic function can be restored post...
OBJECTIVE/HYPOTHESIS
There are currently no treatments available that restore dynamic laryngeal function after hemilaryngectomy. We have shown that dynamic function can be restored post hemilaryngectomy in a rat model. Here, we report in a first of its kind, proof of concept study that this previously published technique is scalable to a porcine model.
STUDY DESIGN
Animal study.
METHODS
Muscle and fat biopsies were taken from three Yucatan minipigs. Muscle progenitor cells (MPCs) and adipose stem cells (ASCs) were isolated and cultured for 3 weeks. The minipigs underwent a left laterovertical partial laryngectomy sparing the left arytenoid cartilage and transecting the recurrent laryngeal nerve. Each layer was replaced with a tissue-engineered implant: 1) an acellular mucosal layer composed of densified Type I oligomeric collagen, 2) a skeletal muscle layer composed of autologous MPCs and aligned oligomeric collagen differentiated and induced to express motor endplates (MEE), and 3) a cartilage layer composed of autologous ASCs and densified oligomeric collagen differentiated to cartilage. Healing was monitored at 2 and 4 weeks post-op, and at the 8 week study endpoint.
RESULTS
Animals demonstrated appropriate weight gain, no aspiration events, and audible phonation. Video laryngoscopy showed progressive healing with vascularization and re-epithelialization present at 4 weeks. On histology, there was no immune reaction to the implants and there was complete integration into host tissue with nerve and vascular ingrowth.
CONCLUSIONS
This pilot study represents a first in which a transmural vertical partial laryngectomy was performed and successfully repaired with a customized, autologous stem cell-derived multi-layered tissue-engineered implant.
LEVEL OF EVIDENCE
NA Laryngoscope, 131:2277-2284, 2021.
Topics: Adipose Tissue; Animals; Cell Differentiation; Cells, Cultured; Deglutition; Disease Models, Animal; Humans; Laryngeal Cartilages; Laryngectomy; Laryngoplasty; Larynx; Mesenchymal Stem Cells; Motor Endplate; Muscle, Skeletal; Myoblasts; Phonation; Pilot Projects; Primary Cell Culture; Proof of Concept Study; Recurrent Laryngeal Nerve; Swine; Swine, Miniature; Tissue Engineering; Tissue Scaffolds
PubMed: 33247846
DOI: 10.1002/lary.29282