Katilmiş Hüseyin, Oztürkcan Sedat, Ozdemir Ismail, Adadan Işil, Tunç Aziz, Akder Ayşegül, Başoğlu Sinan
Department of Otorhinolaryngology and Head and Neck Surgery, Atatürk Research and Training Hospital, Ministry of Health, Izmir, Turkey.
Otolaryngol Head Neck Surg. 2007 Feb;136(2):291-5. doi: 10.1016/j.otohns.2006.08.022.
This study evaluates the vocal cord and arytenoid mobility in relation to the tumoral involvement of the cricoarytenoid joint (CAJ), thyroarytenoid (TA) muscle, and posterior cricoarytenoid (PCA) muscle in whole-organ sections of total laryngectomy specimens.
The study was prospectively carried out between 1998 and 2003 and involved 133 primary squamous cell carcinoma cases of larynx or pyriform sinus that were treated with total laryngectomy. Preoperative mobility of vocal cords and arytenoids were evaluated separately and correlated with histopathologic findings.
In cases with fixed vocal cord CAJ, TA muscle, and PCA muscle were involved in 42.4%, 72.9%, and 27.1% of the cases, respectively, while in cases with fixed arytenoid these structures were affected in 40%, 66.3%, and 25.3% of the cases. Weight effect seemed to play a role in 60% and 50% of the cases of supraglottic and pyriform sinus carcinoma, respectively.
Careful evaluation of the mobility of the cord arytenoid unit separately helps the surgeon to better understand the patterns of tumoral extension guiding for the appropriate surgery which should be undertaken.
本研究在全喉切除术标本的全器官切片中，评估环状杓状软骨关节（CAJ）、甲杓肌（TA）和后环状杓状肌（PCA）的肿瘤累及情况与声带及杓状软骨活动度的关系。
本研究于1998年至2003年前瞻性开展，纳入133例行全喉切除术治疗的原发性喉或梨状窝鳞状细胞癌病例。分别评估术前声带和杓状软骨的活动度，并与组织病理学结果进行关联分析。
在声带固定的病例中，CAJ、TA肌和PCA肌分别有42.4%、72.9%和27.1%受累；而在杓状软骨固定的病例中，这些结构分别有40%、66.3%和25.3%受累。体重效应似乎在分别60%的声门上癌和50%的梨状窝癌病例中起作用。
分别仔细评估声带杓状软骨单元的活动度有助于外科医生更好地了解肿瘤扩展模式，从而指导应采取的适当手术。
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