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Laryngeal chondroma is a very rare laryngeal tumor that commonly presents as dysphonia and dyspnea. A combination of clinical, histological, and radiological data has paramount importance for accurate diagnosis of this rare disease. It is difficult to differentiate laryngeal chondroma from chondrosarcoma solely based on radiological imaging; therefore, radiologists need to specify the origin of the tumor and the level of extension. Here, we describe a case of a 60-year-old male patient who presented with upper airway obstruction. Radiologic imaging with a contrast-enhanced CT scan of the neck was done and showed a lobulated mass lesion with popcorn-like calcification arising from the endolaryngeal surface of the cricoid cartilage. An emergency tracheostomy was done, and at the same time, a biopsy was taken from the lesion intraoperatively.

Cancer ravages all aspects of a patient's life. In recent decades, there has been a substantial paradigm shift in the treatment of cancer with an emphasis on quality of life and patient comfort. Patients are treated holistically, a complex task given how multifaceted cancers are. Voice, a subtle indicator of patients' well-being is affected commonly by malignancies. One of the various ways by which voice is disturbed by non-laryngeal cancers is through metastasis to the larynx and adjacent areas. Metastasis to the larynx is rare but well-documented. If not diagnosed in a timely fashion, it can have devastating consequences on patients from life-threatening airway obstruction to progressive dysphonia that erodes their quality of life. Metastatic lesions of the larynx usually appear submucosal with intact overlying mucosa and are located most commonly in the supraglottis. Deep biopsies usually are needed for diagnosis, and management may entail endoscopic resection or other treatments. This paper reviews the literature to identify typical features of laryngeal metastatic lesions of the ten cancers that are among the most common worldwide, ie, skin, renal, breast, colorectal, lung, prostate, thyroid and liver. By summarizing their most prevalent locations in the larynx, type and appearance, the authors hope to aid physicians in their diagnostic process, particularly in cases in which laryngeal involvement is the first presenting sign of a malignancy. [ABSTRACT FROM AUTHOR]

Abstract Voice change is often the first sign of laryngeal cancer, leading to diagnosis through hospital laryngoscopy. Screening for laryngeal cancer solely based on voice could enhance early detection. However, identifying voice indicators specific to laryngeal cancer is challenging, especially when differentiating it from other laryngeal ailments. This study presents an artificial intelligence model designed to distinguish between healthy voices, laryngeal cancer voices, and those of the other laryngeal conditions. We gathered voice samples of individuals with laryngeal cancer, vocal cord paralysis, benign mucosal diseases, and healthy participants. Comprehensive testing was conducted to determine the best mel-frequency cepstral coefficient conversion and machine learning techniques, with results analyzed in-depth. In our tests, laryngeal diseases distinguishing from healthy voices achieved an accuracy of 0.85–0.97. However, when multiclass classification, accuracy ranged from 0.75 to 0.83. These findings highlight the challenges of artificial intelligence-driven voice-based diagnosis due to overlaps with benign conditions but also underscore its potential.

Voice change is often the first sign of laryngeal cancer, leading to diagnosis through hospital laryngoscopy. Screening for laryngeal cancer solely based on voice could enhance early detection. However, identifying voice indicators specific to laryngeal cancer is challenging, especially when differentiating it from other laryngeal ailments. This study presents an artificial intelligence model designed to distinguish between healthy voices, laryngeal cancer voices, and those of the other laryngeal conditions. We gathered voice samples of individuals with laryngeal cancer, vocal cord paralysis, benign mucosal diseases, and healthy participants. Comprehensive testing was conducted to determine the best mel-frequency cepstral coefficient conversion and machine learning techniques, with results analyzed in-depth. In our tests, laryngeal diseases distinguishing from healthy voices achieved an accuracy of 0.85–0.97. However, when multiclass classification, accuracy ranged from 0.75 to 0.83. These findings highlight the challenges of artificial intelligence-driven voice-based diagnosis due to overlaps with benign conditions but also underscore its potential. [ABSTRACT FROM AUTHOR]

Malignant and premalignant lesions of the vocal cords represent an important chapter in laryngeal pathology, raising a number of issues in the literature regarding diagnosis and optimal therapeutic approach. Surgical ablation of malignant tumor formations can be performed classically, by external approach to the cervical region, or endoscopically, transorally, using laser and cold instruments under the operating microscope. Regardless of the surgical technique used, the goal must be the complete tumor ablation, with or without oncological treatment, as determined by a specialized oncological committee. The authors present the case of a patient with laryngeal neoplasm located in the right vocal cord and anterior laryngeal commissure, on a background of chronic white hypertrophic laryngitis with multiple areas of keratin on the left vocal cord. The paper highlights the importance of laser technology in the successful resolution of both benign and malignant vocal cord pathologies, presenting multiple advantages over traditional surgery and offering superior oncological, functional and esthetic outcomes. [ABSTRACT FROM AUTHOR]

Background: The American Joint Committee on Cancer (AJCC) system is the most acceptable staging method. In this study, an attempt has been made to evaluate the survival rate of laryngeal cancer based on the AJCC and T and N integer scores (TANIS). Methods: In this prospective cohort study, from March 2004 to March 2021, laryngeal cancer patients who were considered for nonsurgical treatment were included. Radiation alone was considered for T1-T2 lesions without nodal involvement. Sequential or concomitant chemoradiation (based on physician choice) was considered for locoregionally advanced patients (T3/T4 or node positive). The 2-year, 5-year and 10-year overall survival (OS) and progression-free survival (PFS) rates were estimated using Kaplan-Meier method. Cox -Regression method was used for covariates analysis. Results: The 2-year, 5-year and 10-year overall survival (OS) rates in all patients were estimated to be 82%, 70% and 41%, respectively. The 2-year, 5-year and 10-year progression-free survival (PFS) rates in all patients were estimated to be 78%, 59% and 41%, respectively. The 5-year OS rates for stages I, II, III, IVa, and IVb were 83, 84, 51, 12, and 19 percent, respectively. The 5-year OS rates for TANIS 1, 2, and 3 were 85, 62 and 53 percent, respectively. Based on multivariate analysis, the group stage (p=0.001), TANIS group (p=0.003) and tumour subsite. (p=0.006) were independently effective in survival rates. Conclusion: TANIS-3 can simply predict the prognosis of non-surgically treated laryngeal cancers. The separation of different prognostic groups by TANIS is better than the AJCC system. More extensive studies are necessary to confirm this. [ABSTRACT FROM AUTHOR]

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Objective: To describe laryngeal abnormalities undergoing microlaryngeal surgery (MLS). Material and Methods: A retrospective analytical study by examining the central medical record and electronic medical record of patients with laryngeal disorders in the otorhinolaryngology head and neck surgery (ORL-HNS) Outpatient Unit and the Teratai ORL-HNS Surgery Inpatient Care Unit at Dr. Soetomo General Hospital, Surabaya, from January 1 until December 31, 2019, utilizing the chi-square test followed by the Wald test. Results: The number of patient visits from January 1 until December 31, 2019, amounted to 80 patients, most of whom were male and belonged to the 19-60 age group. The histopathology results of patients with neoplasms indicated moderately differentiated squamous cell carcinoma, while the same procedure applied to patients without neoplasms mainly indicated vocal nodules. In this case, the most used technique was a biopsy. Patients with smoking risk factors amounted to 38, while those without smoking risk factors amounted to 42. Conclusion: MLS is used as a means of diagnosis and therapy, including cases of benign and malignant neoplasms.

Background and Aims: This study assessed the applicability of C-MAC videolaryngoscope (VL) D-blade for awake intubation in patients with laryngeal tumour. The primary study objective was to determine the rate of successful intubation in the first attempt. The other parameters recorded were number of attempts required for intubation, duration of different stages of intubation, haemodynamics, ease of intubation and patient comfort on visual analogue scale (VAS) postoperatively. Methods: Thirty patients were studied. Patients were sedated with dexmedetomidine and fentanyl as a slow bolus (over 20 min) and Ramsay sedation score was assessed. Topicalisation of the oropharynx, tonsillar pillars and base of the tongue was done with lignocaine 10% spray. Four ml of 4% lignocaine using MADgic atomiser was used for anaesthetising the glottis and the tracheal lumen. Results: Successful intubation was achieved in 86.6% patients in first attempt and 13.3% in two attempts. Total time for all intubations was less than 30 seconds. Fremantle score was F-1-C-MAC D-blade (easy intubation with full view) in 60% patients, while 23.3% had F-2-C-MAC D-blade (full view and either required more than one attempt or a modified technique), 13.3% had P-1-C-MAC D-blade (partial view with easy intubation) and 3.3% had P-2-C-MAC D-blade (partial view and required more than one attempt or a modified technique). The VAS score for anaesthesiologist's ease and for patient's experience was 85.83 ± 7.20 and 86.66 ± 14.46, respectively. Conclusion: C-MAC VL D-blade-assisted awake intubation is an effective and safe method to manage the airway of patients with laryngeal tumour once adequate topicalisation is ensured before the procedure.

Hoarseness of voice is one of the common symptoms with which patient presents to an otorhinolaryngologist. Hoarseness is a symptom of diverse etiology. The aim of the study was to study the problem of hoarseness relating to its incidence and to identify the common etiologies and predisposing factors leading to hoarseness of voice. This study comprises of 70 cases of hoarseness presenting to Department of Otorhinolaryngology, VIMS, Ballari, Karnataka from October 2015 to March 2017. After taking a thorough history, a complete otolaryngological examination was carried out and supported by relevant investigations, diagnosis was reached. The incidence of hoarseness of voice was noted to be 0.21% in our study. The majority of patients were in 31–40 years and 51–60 years of age group, and male to female ratio was 3.7:1, farmers constituted single largest group (34.3%), and most of the patients were from the rural area (82.9%). Smoking was the commonest habit (54.29%) predisposing to hoarseness of voice. Maximum patients presented with hoarseness of duration of 1–3 months. Laryngeal malignancy was the commonest aetiology noted in our study (38.6%). A complaint of hoarseness may represent a serious disease and, therefore, should not be ignored, especially if present for more than 2 weeks. It needs a complete evaluation to rule out malignancy as a cause. [ABSTRACT FROM AUTHOR]

Background and Aims: This study assessed the applicability of C-MAC videolaryngoscope (VL) D-blade for awake intubation in patients with laryngeal tumour. The primary study objective was to determine the rate of successful intubation in the first attempt. The other parameters recorded were number of attempts required for intubation, duration of different stages of intubation, haemodynamics, ease of intubation and patient comfort on visual analogue scale (VAS) postoperatively. Methods: Thirty patients were studied. Patients were sedated with dexmedetomidine and fentanyl as a slow bolus (over 20 min) and Ramsay sedation score was assessed. Topicalisation of the oropharynx, tonsillar pillars and base of the tongue was done with lignocaine 10% spray. Four ml of 4% lignocaine using MADgic atomiser was used for anaesthetising the glottis and the tracheal lumen. Results: Successful intubation was achieved in 86.6% patients in first attempt and 13.3% in two attempts. Total time for all intubations was less than 30 seconds. Fremantle score was F-1-C-MAC D-blade (easy intubation with full view) in 60% patients, while 23.3% had F-2-C-MAC D-blade (full view and either required more than one attempt or a modified technique), 13.3% had P-1-C-MAC D-blade (partial view with easy intubation) and 3.3% had P-2-C-MAC D-blade (partial view and required more than one attempt or a modified technique). The VAS score for anaesthesiologist's ease and for patient's experience was 85.83 ± 7.20 and 86.66 ± 14.46, respectively. Conclusion: C-MAC VL D-blade-assisted awake intubation is an effective and safe method to manage the airway of patients with laryngeal tumour once adequate topicalisation is ensured before the procedure. [ABSTRACT FROM AUTHOR]

Abstract Objectives To investigate factors and complications associated with prolonged inpatient length of stay (LOS) in patients who receive total laryngectomy (TL), and to analyze its effect on short‐term and long‐term overall survival (OS). Methods The National Cancer Database (NCDB) was queried from 2004 to 2016 for patients with laryngeal cancer, who received TL within 60 days of diagnosis, and who had an inpatient LOS ≥1 night. Multivariable binary logistic regression and survival analyses on propensity score matched cohorts with Kaplan‐Meier analysis and extended Cox regression were utilized. Results Eight thousand two hundred and ninety‐eight patients from the NCDB were included. Median inpatient LOS was 8 days after TL (IQR: 7, 12). Prolonged LOS was defined as above the 75th percentile or 13 days or greater. On multivariable analysis, increasing patient age (OR 1.14 per 10 years, P = .003), female sex (OR 1.35, P

Purpose: To evaluate the prognostic value of the pretreatment maximum standardized uptake value (SUVmax) for locoregional control (LRC) of early glottic cancer treated with primary radiotherapy. Materials and Methods: We retrospectively reviewed the medical records of 101 patients with T1- T2N0 glottic cancer treated with helical tomotherapy between 2013 and 2016. The clinical T-stages were T1 in 87 (86.1%) and T2 in 14 (13.9%) patients. The median total dose was 63 Gy (63–67.5 Gy) in 2.25 Gy per fraction. The survival outcomes were plotted using Kaplan-Meier curves. Receiver operating characteristic curves were used to assess the optimal SUVmax cut-off value for predicting locoregional recurrence. Results: The median follow-up period was 58 months (range, 11 to 90 months). The 5-year overall survival (OS) and locoregional recurrence-free survival rates were 96.8% and 85.4%, respectively. The median pretreatment SUVmax of the primary tumor for all 101 patients was 2.3 (range, 1.1 to 9.1). The best cut-off value for SUVmax for predicting LRC was 3.3, with a sensitivity of 78.6% and specificity of 73.6%. Univariate analysis showed that T-stage, overall treatment time (≥43 days), and high SUVmax (≥3.3) were significant predictors of LRC. Multivariate analysis showed that LRC was independently affected by a high SUVmax (≥3.3) (hazard ratio = 5.505, p = 0.020). Conclusion: High pretreatment SUVmax (≥3.3) is a negative prognostic factor for LRC in early glottic cancer patients treated with primary radiotherapy. [ABSTRACT FROM AUTHOR]

Spindle cell/pleomorphic lipoma (SC/PL) is a subcutaneous mass usually localised on nape, shoulder or upper back. It is a benign lipogenic tumour composed of primitive CD34-positive spindle cells, floret-like multinucleated giant cells and mature adipocytes. Complete surgical excision is the optimal treatment. This unusual tumour in the larynx has only been reported in the medical literature once and was treated surgically by open approach. Actually, transoral robotic surgery (TORS) is most suitable because provides tridimensional magnified view plus a greater mobility with instruments, allowing complete and safe removal of the supraglottic mass, allowing rapid healing and recovery. We present the first case of a SC/PL of larynx managed with TORS. Four hours after surgery, the patient was able to take a soft diet and was discharged 2 h later. The follow-up showed an excellent clinical and functional outcome.

Abstract Background Hypopharyngeal and laryngeal neoplasms are both fatal and hard to catch in early stages. Yet which treatment is the most efficacious one still remain unanswered. This network meta-analysis (NMA) was conducted to investigate effectiveness of six therapies being utilized in clinical practice nowadays. Methods PubMed and Embase were retrieved to synthesize data. Direct and indirect evidence was combined to compare efficacy of treatments. A relative ranking of the six regimens was calculated by the surface under the curve ranking area (SUCRA). Results A total of 28 trials with 9109 patients were included in our NMA. Five endpoints investigated included 3/5-year overall survival (3/5-OS), 3/5-year disease free survival (3/5-DFS) and 5-year overall survival rate (5-OSR). In terms of all efficacy outcomes, radiotherapy combined with surgery (RT + S) proved to be better than other therapies while radiotherapy (RT) alone also performed well. Induction chemoradiotherapy (ICRT) was the best regarding 3-DFS (SUCRA = 0.846) while current chemoradiotherapy (CCRT) ranked first in 5-DFS (SUCRA = 0.933) according to SUCRA results. No significant differences were demonstrated in 5-DFS and 5-OSR as shown in the results of NMA. Conclusions RT combined with surgery turned out to be optimal therapy of all the outcomes while the efficacy of RT was relatively poorer in the treatment of patients with larynx stage III-IV and hypopharynx stage II-IV. Also, the good performance of CCRT and ICRT in terms of DFS made them as secondary recommended therapies. There is no significant difference between surgery and transoral laser microsurgery (TLM) alone.

60 year old woman with a history of laryngeal carcinoma-HPV 16 positive, presents seven years later with an abnormal Pap smear. Cervical biopsy showed squamous cell carcinoma. Clinical stage was IB1. Patient underwent open radical hysterectomy and lymphadenectomy. Based on pathologic findings no adjuvant therapy was recommended. Uterine cervix carcinoma was also positive for HPV-16. There are no guidelines for cervical cancer screening in patients with laryngeal cancer and vice versa. Our recommendation is that patient with HPV-positive laryngeal cancer should be encouraged HPV vaccine as current guidelines, but more frequent screening, as recommended for women with specific co-morbid conditions, needs to be investigated. Research is needed to assess the role of screening for laryngeal cancer in women with cervical cancer and the effect of HPV vaccine on laryngeal cancer prevention.

Background: Myeloma of laryngeal cartilage (MLC) is a rare plasma cell neoplasm which has not been well characterized. However, it is an important differential diagnosis of laryngeal cartilage mass as it can indicate the presence of underlying systemic hematological diseases, such as multiple myeloma (MM), that is associated with poor prognosis. This article is the first of its kind and aims to educate clinicians on future diagnosis and management of similar cases. Methods: Search of MLC was performed on the medical literature databases of Medline, PUBMED, and EMBASE. Additionally, institutional database at Gold Coast University Hospital Radiology Department was queried for relevant cases. Based on 16 cases that met the inclusion criteria, the etiology, epidemiology, clinical evaluation, investigations, management, and prognosis of MLC was summarized. Results: Of all, 94% of MLC occur in males and 81% in those older than 60 years. It is more commonly a manifestation of systemic MM, rather than localized extramedullary plasmacytoma (EMP), 81% and 19% respectively. Additionally, 67% of laryngeal EMPs progress to MM within 3 years from initial diagnosis. Although treatments involving both local and systemic therapy were effective at relieving local symptoms, 39% of MLC patients died during the follow-up period—all of which were due to septicemia caused by secondary infections. Conclusion: Myeloma of laryngeal cartilage is a relatively rare condition that requires accurate diagnosis in order to promptly manage the potentially underlying systemic hematological disease. Currently, more case reports and analytical studies are required to provide evidence-based guidance on etiology, diagnosis, and management of this condition. [ABSTRACT FROM AUTHOR]

Objectives: To investigate factors and complications associated with prolonged inpatient length of stay (LOS) in patients who receive total laryngectomy (TL), and to analyze its effect on short‐term and long‐term overall survival (OS). Methods: The National Cancer Database (NCDB) was queried from 2004 to 2016 for patients with laryngeal cancer, who received TL within 60 days of diagnosis, and who had an inpatient LOS ≥1 night. Multivariable binary logistic regression and survival analyses on propensity score matched cohorts with Kaplan‐Meier analysis and extended Cox regression were utilized. Results: Eight thousand two hundred and ninety‐eight patients from the NCDB were included. Median inpatient LOS was 8 days after TL (IQR: 7, 12). Prolonged LOS was defined as above the 75th percentile or 13 days or greater. On multivariable analysis, increasing patient age (OR 1.14 per 10 years, P =.003), female sex (OR 1.35, P <.001), and Charlson‐Deyo comorbidity score of ≥2 compared to a score of 0 (OR 1.43, P <.001) were associated with prolonged LOS. Patients treated at high surgical case volume centers had a decreased likelihood for prolonged LOS (OR 0.67, P <.001). Ninety‐day mortality increased over time in patients who stayed ≥13 days. Prolonged LOS was independently associated with worse OS on multivariable analysis (HR 1.40, 95% CI: 1.22, 1.61) in a matched cohort. Conclusions: Prolonged LOS after TL serves as a strong indicator for postoperative long‐term mortality and may help identify patients who warrant closer surveillance. Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Aims: To investigate the clinical features, treatment, and outcomes of laryngeal spindle cell carcinoma (SpCC).Methods: Between 2005 and 2014, patients from our hospital with SpCC of the larynx were retrospectively analyzed alongside patient data from the SEER database of America.Results: A total of 11 patients with SpCC of the larynx were diagnosed and underwent surgery in our hospital. All patients were male and all tumors were located in the glottis. The 3- and 5-year OS rates were both 54.5%. In the SEER database, 148 patients were diagnosed with SpCC of the larynx. The 3- and 5-year OS rates were 72.8 and 63.2%, respectively. According to the comparison of propensity score-matched analysis, the OS was longer in squamous cell carcinoma (SCC) of the larynx (p < 0.0001).Conclusion: SpCC of the larynx is rare and typically originates in the glottis. Its prognosis is worse than that of laryngeal SCC, and surgery is a reasonable treatment strategy. [ABSTRACT FROM AUTHOR]

Background: The various pathological types of non-squamous cell carcinomas (nSCCs) of the larynx accounted for about 5% laryngeal malignancies, but the knowledge regarding these pathological behaviors, therapeutic models and prognostic factors was limited. Objectives: To investigate the clinical characteristics and the survival outcomes of nSCCs of the larynx. Material and methods: A total of 106 patients diagnosed with laryngeal nSCC between 2003 and 2014 were retrospectively investigated from a cohort of 4,796 patients with laryngeal malignancies. Results: Spindle cell carcinoma, malignant salivary gland carcinoma, neuroendocrine carcinoma, non-Hodgkin's lymphomas, and carcinosarcoma accounted for the majority of the nSCCs of the larynx. In laryngeal nSCCs (excluding non-Hodgkin lymphomas), there was no significant difference in overall survival (OS) by tumor subsite (p =.818), clinical-stage (p =.051) or T stage (p =.412), but the difference in OS by N stage was statistically significant (p =.001). Upon comparison of propensity score-matched groups, the OS was longer in SCCs of the larynx (p =.0004). Conclusions and significance: Primary nSCC of the larynx is rare, and its diagnosis depends on comprehensive immunohistochemical examination, as the clinical characteristics are non-specific compared with SCC. The overall prognosis of nSCC is relatively poor compared with that of SCC in the larynx. [ABSTRACT FROM AUTHOR]

Background: The various pathological types of non-squamous cell carcinomas (nSCCs) of the larynx accounted for about 5% laryngeal malignancies, but the knowledge regarding these pathological behaviors, therapeutic models and prognostic factors was limited. Objectives: To investigate the clinical characteristics and the survival outcomes of nSCCs of the larynx. Material and methods: A total of 106 patients diagnosed with laryngeal nSCC between 2003 and 2014 were retrospectively investigated from a cohort of 4,796 patients with laryngeal malignancies. Results: Spindle cell carcinoma, malignant salivary gland carcinoma, neuroendocrine carcinoma, non-Hodgkin’s lymphomas, and carcinosarcoma accounted for the majority of the nSCCs of the larynx. In laryngeal nSCCs (excluding non-Hodgkin lymphomas), there was no significant difference in overall survival (OS) by tumor subsite (p = .818), clinical-stage (p = .051) or T stage (p = .412), but the difference in OS by N stage was statistically significant (p = .001). Upon comparison of propensity score-matched groups, the OS was longer in SCCs of the larynx (p = .0004). Conclusions and significance: Primary nSCC of the larynx is rare, and its diagnosis depends on comprehensive immunohistochemical examination, as the clinical characteristics are non-specific compared with SCC. The overall prognosis of nSCC is relatively poor compared with that of SCC in the larynx. [ABSTRACT FROM AUTHOR]

Introduction: Neuroendocrine neoplasm is an infrequent tumor in the larynx which can be sub-classified into five different types: typical carcinoid, atypical carcinoid, large cell carcinoma, small cell carcinoma, and paraganglioma. This tumor mostly occurs in smoker men. The common location of neuroendocrine tumor of the larynx is in the supraglottic area. Because of the complex nature of neuroendocrine neoplasms of the larynx, we found it so interesting to present. We emphasized the clinical importance and aggressive nature of this tumor despite its rarity. Case Presentation: In the present study, we presented 2 cases of atypical carcinoid in non-smoker females. Case 1 was a 74-year-old non-smoker woman who was referred with a history of chronic dysphagia and left otalgia since one year ago. Laryngoscopy revealed a nonulcerated supraglottic epitheliomatous lesion. Biopsy showed atypical carcinoid. The patient had no lymphadenopathy or metastasis in the further workup. The second case was a 60-year-old non-smoker woman with a 4-month history of hoarseness, odynophagia accompanied by cervical lymphadenopathy. Laryngoscopy showed a smooth surface non-ulcerated transglottic tumor. Right vocal cord mobility was restricted. Conclusions: Atypical carcinoid tumor is an underdiagnosed laryngeal malignancy. Although neuroendocrine tumor of the larynx is rare, physicians should be familiar with its unspecified presentations, pathology, clinical course, and prognosis. [ABSTRACT FROM AUTHOR]

Objective: To explore the role of T-helper 17 cells and their cascade in the pathogenesis of laryngeal cancer. Methods: Prospectively, 110 consecutive patients with a suspicious laryngeal lesion were evaluated for serum levels of T-helper 17 cell related interleukins, including interleukins 23, 17A and 22, determined by enzyme-linked immunosorbent assay. The patients were divided into 2 groups after pathological evaluation: 49 patients with malignancy and 61 with benign pathology. Associations between interleukin levels and malignancy were determined via correlation analyses. Results: Interleukin 17A and 22 levels were significantly higher in the malignancy group than the benign lesion group. Pearson correlation analysis showed that interleukins 17A and 22 acted in a cascade, but interleukin 23 did not. According to predictive values, interleukin 17A levels were 3.87 times and interleukin 22 levels were 1.09 times more likely to be associated with laryngeal cancer. The cut-off values for predicting laryngeal cancer were 3.55 pg/ml for interleukin 17A and 119.82 pg/ml for interleukin 22. Conclusion: T-helper 17 cell related interleukins are potential biomarkers that may be helpful in diagnosing laryngeal cancer. Moreover, these data may support neutralisation of T-helper 17 cell related cytokine activity, which could be an attractive strategy for treating laryngeal cancer. [ABSTRACT FROM AUTHOR]

Background: Hypopharyngeal and laryngeal neoplasms are both fatal and hard to catch in early stages. Yet which treatment is the most efficacious one still remain unanswered. This network meta-analysis (NMA) was conducted to investigate effectiveness of six therapies being utilized in clinical practice nowadays.Methods: PubMed and Embase were retrieved to synthesize data. Direct and indirect evidence was combined to compare efficacy of treatments. A relative ranking of the six regimens was calculated by the surface under the curve ranking area (SUCRA).Results: A total of 28 trials with 9109 patients were included in our NMA. Five endpoints investigated included 3/5-year overall survival (3/5-OS), 3/5-year disease free survival (3/5-DFS) and 5-year overall survival rate (5-OSR). In terms of all efficacy outcomes, radiotherapy combined with surgery (RT + S) proved to be better than other therapies while radiotherapy (RT) alone also performed well. Induction chemoradiotherapy (ICRT) was the best regarding 3-DFS (SUCRA = 0.846) while current chemoradiotherapy (CCRT) ranked first in 5-DFS (SUCRA = 0.933) according to SUCRA results. No significant differences were demonstrated in 5-DFS and 5-OSR as shown in the results of NMA.Conclusions: RT combined with surgery turned out to be optimal therapy of all the outcomes while the efficacy of RT was relatively poorer in the treatment of patients with larynx stage III-IV and hypopharynx stage II-IV. Also, the good performance of CCRT and ICRT in terms of DFS made them as secondary recommended therapies. There is no significant difference between surgery and transoral laser microsurgery (TLM) alone. [ABSTRACT FROM AUTHOR]

Spindle cell/pleomorphic lipoma (SC/PL) is a subcutaneous mass usually localised on nape, shoulder or upper back. It is a benign lipogenic tumour composed of primitive CD34-positive spindle cells, floret-like multinucleated giant cells and mature adipocytes. Complete surgical excision is the optimal treatment. This unusual tumour in the larynx has only been reported in the medical literature once and was treated surgically by open approach. Actually, transoral robotic surgery (TORS) is most suitable because provides tridimensional magnified view plus a greater mobility with instruments, allowing complete and safe removal of the supraglottic mass, allowing rapid healing and recovery. We present the first case of a SC/PL of larynx managed with TORS. Four hours after surgery, the patient was able to take a soft diet and was discharged 2 h later. The follow-up showed an excellent clinical and functional outcome. [ABSTRACT FROM AUTHOR]

Objective To estimate the incidence and mortality of laryngeal cancer in China based on the cancer registration data in 2014, collected by the National Central Cancer Registry (NCCR) , and to provide support data for the control and prevention of laryngeal cancer. Methods The incident and death data of laryngeal cancer in 2014 from 339 cancer registries met the quality criteria of NCCR, and then adopted for analysis. The incident and death number, crude rate, age standardized rate, truncated rate and proportion which stratified by areas (urban/rural) and age were calculated. The nationwide incidence and mortality of laryngeal cancer in 2014 were estimated by combining with those data on national population in 2014. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality rates. Results It was estimates that 23.4 thousand new cases of laryngeal cancer occurred in China in 2014. There were 20.8 thousand males and 2.6 thousand females. And 14.5 thousand occurred in urban areas, while 8. 9 thousand in rural areas. The age standardized rates of incidence by world standard population (ASRs world) in male, female and both genders were 2.05/100,000, 0.24/100,000 and 1.14/ 100,000, respectively, whereas those were 1.22/100,000 and 1.03/100,000 for urban and rural areas. The incidence was much higher in males than females, and slightly higher in urban areas than those in rural areas. Moreover, it was estimates that 13.2 thousand death cases of laryngeal cancer occurred in China in 2014. There were 11.5 thousand males and 1.7 thousand females. And 7.8 thousand occurred in urban areas, while 5.4 thousand in rural areas. The age standardized rates of mortality by ASRs world in male, female and both genders were 1.08/100,000, 0.14/100,000 and 0.60/100,000, respectively, whereas those were 0.60/100,000 and 0.59/100,000 for urban and rural areas. The mortality was much higher in males than females, and slightly higher in urban areas than those in rural areas. In males, the age specific incidence and mortality of laryngeal cancer increased greatly from 40-44 and 45-44 years old, respectively, and peaked at age group of 75-79 and >85 years old. In females, the age specific incidence and mortality increased slowly from 50-54 and 60-64 years old, respectively, and peaked at age group of 80-84 and >85 years old. The trends remained similar in urban and rural areas, except for the different peak ages. Conclusions The incidence and mortality of laryngeal cancer in China are at middle-low levels worldwide, and there are obvious differences between urban and rural areas with distinct gender disparity. Comprehensive prevention and control strategies should be carried out according to local status and age groups. [ABSTRACT FROM AUTHOR]

Background: The lack of standardized treatment is problematic in laser surgery for laryngeal cancer, and may result in an increased recurrence rate. This study analyzed the prognosis of early laryngeal carcinoma after different types of cordectomy with laser surgery. Methods: A cohort of 818 patients with stage Tis or T1 primary early glottic squamous cell carcinoma treated with CO2 laser surgery was retrospectively analyzed. Results: Of the 818 patients, According to the Kaplan-Meier method, the rate of 5-year overall survival was 92.8%, and the rates for 5-year disease-specific survival and 5-year locoregional control were 96.9% and 91.3%, respectively. Among the T1 patients, type II cordectomy with laser surgery had a significant impact on the 5-year locoregional control rate, but no obvious impact on the 5-year overall survival rate. Conclusions: There must be sufficient depth and extent of excision in T1 patientsand in early carcinoma especially those with possible microinvasive carcinoma [ABSTRACT FROM AUTHOR]

This article presents a review of the medical literature published between 1994 and 2014 with the use of the PubMed database concerning quality-of-life instruments for head and neck cancer patients used to assess general well-being of patients with laryngeal cancer. The PubMed database was searched for articles containing the keywords "quality of life", "laryngeal neoplasm" and "questionnaires". The resulting articles were reviewed and analyzed. After the identification of questionnaires, an additional search was performed. The articles and questionnaires were described and analyzed. In 43 articles, the authors used questionnaires specific to the head and neck regions in order to assess the quality of life in patients with laryngeal cancer. Four different questionnaires were identified. The European Organization for Research and Treatment of Cancer (EORTC) questionnaire is most commonly used to assess the quality of life in patients with laryngeal cancer. Questionnaires are generally used in order to select from a range of different treatment methods. There are a few head and neck cancer-related quality-of-life instruments which are widely used to assess the quality of life in patients with laryngeal cancer, but they are not dedicated to that region of the body. Today, there is much more attention paid to the quality of life; therefore, there is a real need to develop specific scales for different types of cancer. [ABSTRACT FROM AUTHOR]

Background: Narrow band imaging (NBI) and stroboscopy are non-invasive techniques to detect the malignant lesions of the vocal cord. This study was to assess the diagnostic value of combined endoscopic analysis in the applanate indiscernible early-stage vocal cord cancer. Methods: A total of 110 patients with 160 suspicious vocal cord malignant lesions were included in this retrospective study. Stroboscopy was immediately performed after NBI and white light endoscopy (WLE) were performed in all patients. Excisional biopsy was performed to examine histopathology examination. Results: We found that the diagnostic specificity and PPV were higher in the NBI and WLE combined with stroboscopy group than in the NBI and WLE group without stroboscopy (88.9% vs 72.5%, 88.4% vs 60.9%). However, the diagnostic sensitivity was not significantly different in those two groups (69.3% vs 67.7%). Conclusion: NBI and WLE combined with stroboscopy is a promising method to detect early-stage vocal cord cancer with the advantage of clinical feasibility and diagnostic specificity. [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore the expression and distribution of DNA‑dependent protein kinase catalytic subunit (DNA‑PKcs) in tumor tissues and adjacent normal mucosa tissues of patients with laryngeal squamous cell carcinoma (LSCC), and further analyze the association between the expression and the clinicopathological parameters of patients with LSCC. Clinical data of tumor tissues and corresponding adjacent normal mucosa tissues of pathologically diagnosed LSCC in 96 cases were collected in the present study. Of these specimens, the mRNA and protein expression levels of DNA‑PKcs in LSCC tissues and the adjacent normal mucosa tissues were analyzed via reverse transcription‑quantitative polymerase chain reaction and western blot analysis. Immunohistochemistry was used to detect expression and distribution of DNA‑PKcs protein in LSCC tissues and corresponding adjacent normal mucosa tissues. The association between DNA‑PKcs expression and the specific clinicopathologic features was evaluated by the χ2 test. Kaplan‑Meier and Cox proportional hazards regression models were used to analyze the data. It was revealed that the expression of DNA‑PKcs mRNA and protein was significantly higher in LSCC tissues than the adjacent normal mucosa tissues (P<0.05). DNA‑PKcs was expressed predominantly in the nucleus. DNA‑PKcs expression showed significant correlation with the differentiation degree of LSCC (P<0.05), and changes of DNA‑PKcs expression gradually increased with the decrease of the differentiation degree. However, DNA‑PKcs expression was not significantly associated with sex, age, lymph node metastasis or TMN stage (P>0.05). Patients with LSCC exhibited higher DNA‑PKcs expression had markedly shorter survival than those with lower DNA‑PKcs expression. In conclusion, the present results suggested that the expression levels of DNA‑PKcs were significantly increased in LSCC tumor tissues than in adjacent normal mucosa. DNA‑PKcs expression was correlated with differentiation of LSCC, and may become a novel prognostic marker for patients with LSCC. [ABSTRACT FROM AUTHOR]

Background: Narrow band imaging (NBI) and stroboscopy are non-invasive techniques to detect the malignant lesions of the vocal cord. This study was to assess the diagnostic value of combined endoscopic analysis in the applanate indiscernible early-stage vocal cord cancer. Methods: A total of 110 patients with 160 suspicious vocal cord malignant lesions were included in this retrospective study. Stroboscopy was immediately performed after NBI and white light endoscopy (WLE) were performed in all patients. Excisional biopsy was performed to examine histopathology examination. Results: We found that the diagnostic specificity and PPV were higher in the NBI and WLE combined with stroboscopy group than in the NBI and WLE group without stroboscopy (88.9% vs 72.5%, 88.4% vs 60.9%). However, the diagnostic sensitivity was not significantly different in those two groups (69.3% vs 67.7%). Conclusion: NBI and WLE combined with stroboscopy is a promising method to detect early-stage vocal cord cancer with the advantage of clinical feasibility and diagnostic specificity. [ABSTRACT FROM AUTHOR]

Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action. Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software. Results: A total of 197 patients (mean age, 40.72 ±15.17 years) participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes. Conclusion: Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.