Hirano M, Kurita S, Matsuoka H, Tateishi M
Department of Otolaryngology-Head and Neck Surgery, Kurume University, Japan.
Acta Otolaryngol. 1991;111(2):449-54. doi: 10.3109/00016489109137418.
The mechanisms of vocal fold fixation were determined by means of a whole-organ serial section study. A total of 80 laryngectomy specimens, 36 supraglottic and 44 glottic carcinomas, was investigated. In the supraglottic carcinomas, the most frequent cause of fixation of the ipsilateral vocal fold was a deep massive tumor invasion in the arytenoid eminence and the second most frequent cause was an extensive involvement of the thyroarytenoid (TA) muscle. Fixation of the contralateral vocal fold resulted from a deep tumor invasion in the contralateral arytenoid eminence. In the glottic carcinomas, fixation of the ipsilateral vocal fold resulted from an extensive invasion into the TA muscle. Fixation of the contralateral vocal fold was caused chiefly by an invasion into the contralateral TA muscle through the anterior commissure region. It resulted occasionally from an invasion into the interarytenoid muscle and contralateral arytenoid cartilage and cricoarytenoid joint via the posterior part of the larynx.
通过全器官连续切片研究确定声带固定的机制。共研究了80例喉切除标本，其中36例为声门上癌，44例为声门癌。在声门上癌中，同侧声带固定最常见的原因是杓状软骨隆起处深部大量肿瘤浸润，第二常见的原因是甲杓肌广泛受累。对侧声带固定是由于对侧杓状软骨隆起处深部肿瘤浸润所致。在声门癌中，同侧声带固定是由于广泛浸润甲杓肌。对侧声带固定主要是由于肿瘤通过前联合区浸润对侧甲杓肌所致。偶尔也可因肿瘤通过喉后部浸润杓间肌、对侧杓状软骨和环杓关节所致。
