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Schwannomas are well encapsulated mesenchymal tumors of peripheral nerves, with slow growth. The laryngeal schwanomma is exceptional, we present a case not described in the literature of shwannoma in the pre epiglottic space. A 50-year-old woman, who had a history of foreign body sensation for 4 years ago, progressing to high dysphagia and hoarseness. Direct laryngoscopy in suspension demonstrated a regular submucosal mass in the supraglottic space, reducing pharyngo-laryngeal space. CT and MRI concluded with a benign tumor of the preepiglottic space. External surgical excision was performed and a primary tracheotomy was required. The histological examination with an immunochemical study confirmed a benign schwannoma. There was no complication postoperatively. The outcome was excellent after 2 years of follow-up.

Introduction: Both radiotherapy and endoscopic or open functional surgery are recognised treatments for laryngeal cancer stage I and II. A comparison between two groups of patients treated with either modality may clarify the indications for both treatments., Methods: Over a period of 13 years two separate series of patients were treated for laryngeal cancer (stage I and II) by either surgery (n = 72) or radiotherapy (n = 81). We have analysed and compared the two groups., Results: Statistical analyses show a better local control among patients treated with surgery, when the anterior commissure was involved (p < 0.01) or with extension of the tumour (T2). However, long-term survivals were not significantly different in the two groups. As postradiation recurrence was diagnosed at an early stage, salvage (requiring total laryngectomy in many cases) was efficient but contributed to an appreciable difference in the long-term laryngeal preservation rate between the two groups (91% after radiotherapy and 99% after surgery)., Conclusion: The treatment of laryngeal cancer must always compromise between oncological efficiency and functional preservation. With anterior commissure involvement (T1b) or more extensive disease (T2), surgery appears to be better. Therefore, preservation of perfect laryngeal function should be subordinate to oncological safety.

Hyo-sub-glosso-epiglottectomy was performed in 56 patients with a tumour of the vallecula or the anterior laryngeal margin. Tumour classification in most of the patients was T2 and N0-N1. Survival rate at 3 years was 54% and 40% at 5 years. Major impairment of deglutition occurred in 5.4% of the cases. This operation is indicated for limited tumours of the vallecula and the anterior laryngeal margin.

The authors report a prospective and comparative study of the pre-operative staging of 90 laryngeal carcinomas by CT and MRI, with blind analysis of each examination. The radio-anatomic correlations and the inter-method correlations (CT versus MRI) are reported. According to the authors MRI seems to be the method of choice because of its capabilities in soft tissues differentiation and because of its multiplanar representation. The motion artefacts are resolved by the fast imaging technique and the spatial resolution is optimized by special surface coils.

The autors compare the interpretation of radiotomographic films and the results of pathological examination of total laryngectomy specimens in 60 cases without contrast and in 15 cases with contrast. They study the value of the interpretation of X-ray films according to the site in terms of height, size, shape, the extent of the carcinoma and possible involvement of the pre-epiglottic space, the thyroid cartilage and the base of the tongue. With the aim of determining the true value of radiotomographic examination in carcinoma of the larynx, comparative tables were drawn up between the radiological interpretation and findings on macroscopic examination of total laryngectomy operative specimens. Radiological examination included standard lateral films, AP tomograms and, more recently, contrast laryngography.