Visual observations of glottal configuration and vocal outcomes in arytenoid adduction.

Arytenoid adduction procedures involve approximation of the arytenoid cartilages with the goal of reducing posterior glottal gap size and improving voice. However, voice outcomes after arytenoid adduction are not always optimal and may be improved by precise use of suture placements, forces, and direction angles. The development of intraoperative methods of assessing optimal suture direction appears critical for achieving the best voice outcome.

Age-related alterations in myosin heavy chain isoforms in rat intrinsic laryngeal muscles.

Deficits in voice and swallowing are found in the elderly, but the underlying neuromuscular mechanisms are unclear. A potential mechanism may be denervation-induced muscle fiber transformation to a slower-contracting type of muscle fiber. This study examined young, old, and denervated rat laryngeal muscles (lateral thyroarytenoid, lateral cricoarytenoid, and posterior cricoarytenoid) to examine differences in myosin heavy chain (MHC) composition.

Glottal configuration, acoustic, and aerodynamic changes induced by variation in suture direction in arytenoid adduction procedures.

Arytenoid adduction is a phonosurgical procedure in which the arytenoid cartilages are approximated to reduce posterior glottal gap size and improve voice. Voice outcomes following arytenoid adduction are not always optimal. The goal of this study was to systematically vary suture direction and force of pull on the arytenoid cartilages in a human excised laryngeal model to determine the optimal combination of factors for reducing glottal gap and improving voice.

Multiple primary malignancies in the head and neck: a clinical review of 121 patients.

A total of 121 multiple primary malignancies (quadruple, n = 2; triple, n = 11; and double, n = 108) were treated at the Department of Otorhinolaryngology, Kitasato University Hospital between July 1972 and December 1998. Of the 108 patients with double primary malignancies, 18 had synchronous double primary malignancies (SDPM), which were defined as occurrence of the index tumor and second malignancy within 6 months of each other, and 90 had metachronous double primary malignancies (MDPM), which were defined as occurrence of the index tumor and the second malignancy separated by a period of > 7 months. MDPM was subdivided into MDPM-F (head and neck malignancy occurred as the first tumor; n = 55) and MDPM-S (head and neck malignancy occurred as the second tumor; n = 35).

Clinical review of thyroid malignant tumor.

We reviewed the files of 120 patients with thyroid malignant tumor treated in our department between July 1971 and December 1996. Clinical features, pathological diagnosis, radiographic findings, treatment and prognosis were studied. The number of patients treated gradually increased over time in both the otorhinolaryngology and surgery departments.

Clinical study of benign lesions in the oral cavity.

This retrospective study was designed to investigate the detailed clinical features of benign oral diseases. A total of 792 patients with benign oral lesions were treated at Kitasato University Hospital over a 27-year period. Benign oral lesions were classified into nine groups as follows: epithelial proliferating lesions (n = 234); fibroma-like lesions (n = 150); cysts and cyst-like lesions of the minor salivary glands (n = 140); ranulas (n = 64); angiomas (n = 62); inflammation/ulcer/granulation lesions (n = 56); pyogenic granulomas (n = 44); pleomorphic adenomas (n = 23); and others (n = 19).

Clinical review of autopsy cases that succumbed to head and neck malignancies.

We investigated autopsy cases that had succumbed to head and neck malignancies in the light of the relationships between locoregional tumors and distant metastasis, between the frequency and site of distant metastasis and between the occurrence of locoregional tumors/distant metastasis and the cause of death. Of the 203 cases autopsied at the Kitasato University Hospital between 1972 and 1999, 174 had epithelial tumors and 29 had non-epithelial tumors (malignant lymphoma in 20/29). In terms of epithelial tumors, 107 patients (61%) had locoregional disease and 101 (58%) exhibited distant metastases; 39 cases (28%) had distant metastasis without locoregional tumors.

Clinical review of Wegener's granulomatosis.

The prognosis of Wegener's granulomatosis (WG) improved following the introduction of immunosuppressant agents. We, however, still experience some difficult cases that are resistant to treatment. Early diagnosis and treatment may improve the prognosis of WG.

Limited surgery for cancer of the larynx and hypopharynx: options and consequences.

We reviewed surgical options for laryngeal preservation (limited surgery) in laryngeal and hypopharyngeal cancers and the consequences of the options. Of 44 patients with laryngeal cancer, 11 (25%) received limited surgery and 33 (75%) received total laryngectomy. The survival rates were 91% for the limited surgery group and 73% for the total (radical) surgery group.

Three-dimensional analysis of supracricoid hemilaryngopharyngectomized hypopharyngeal cancer.

The aims of this study were to demonstrate the technical aspects of processing high-resolution three-dimensional (3D) images and to describe the value of this approach for studying partially removed hypopharyngeal cancer. Supracricoid hemilaryngopharyngectomy was conducted in three sinus-type hypopharyngeal cancers as a salvage operation. A histopathologic study was conducted in order to fully examine the resection margin of the surgical specimens and to ensure the credibility of our case selection.

Assessment of oropharyngeal cancer.

The records of 87 patients with squamous cell carcinoma of the oropharynx, treated between 1971 and 1998 at Kitasato University Hospital, were reviewed with the aim of investigating further directions for oropharyngeal cancer treatment. The patients were divided into four major treatment groups: a radiotherapy group; an operation group; a simultaneous chemoradiotherapy group; and a combination treatment group. The 5-year cumulative survival rates for Stages I-IV were 75%, 78%, 68% and 41%, respectively.

Treatment effects in patients with squamous cell carcinoma of the oral cavity.

A total of 221 patients (155 males, 66 females; stage I, n = 55: stage II, n = 58; stage III, n = 57; stage IV, n = 51) with squamous cell carcinoma of the oral cavity were studied. Tumor localization was as follows: cancer of the tongue, n = 161; cancer of the oral floor, n = 28; cancer of the hard palate, n = 12; cancer of the buccal mucosa, n = 11; and cancer of the gingiva, n = 9. In order to compare the effect of different treatments, three major treatment groups were defined, namely a surgery group, a radiotherapy group and a combination treatment group.

Carcinoma of the nasopharynx: analysis of treatment results in 91 patients.

The outcome of 91 patients (69 males, 22 females; age range 16-82 years) with nasopharyngeal carcinoma treated in our hospital between 1971 and 1999 was evaluated. Factors that appeared to influence prognosis were assessed using the Kaplan-Meier method. The cause-specific cumulative 5-year survival rate for the entire study population was 61.

Treatment of maxillary sinus carcinoma: clinical results using the Kitasato modality.

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions.

Clinical impact of using chemoradiotherapy as a primary treatment for hypopharyngeal cancer.

Eighty-eight patients with hypopharyngeal cancer who received chemoradiotherapy as the primary treatment between 1979 and 1997 were investigated. Forty-six patients who received surgery as the primary treatment were analyzed as a control group. There were no statistically significant differences regarding TN classification, tumor stage, tumor site, age or sex between the radiation and surgery groups.

A case of extramedullary plasmacytoma of the larynx.

An 84-year-old male with a complaint of hoarseness was examined. A mass lesion was recognized in the false vocal fold. The tumor was excised and found to consist of atypical plasmacytes.