The role of smear cytology in laryngeal diagnosis.

There may be great difficulty especially in diffuse lesions, in obtaining representative laryngeal biopsy specimens. Therefore the reliability of laryngeal smear cytology was evaluated in comparison with the histologic diagnosis. The cytologic specimens were taken during 520 microlaryngoscopic examinations (direct technique).

Facial fractures: a review of 922 cases with special reference to incidence and aetiology.

During a 10 year period (1969-1978) 922 patients with facial fractures were hospitalized at the Department of Otolaryngology, Jönköping Central County Hospital, Sweden. Eighty percent were men. The peak incidence occurred at the age of 21-30 years.

Laryngeal carcinoma: problems in diagnosis and classification.

Premalignant and malignant laryngeal lesions still offer great problems in diagnosis and classification. Early diagnosis is of the utmost importance for a good functional therapeutic result. Microlaryngoscopic techniques have increased the number of premalignant lesions which have been found.

Hyperplasia, keratosis, dysplasia and carcinoma in situ of the vocal cords--a follow-up study.

Comparison of reported series of laryngeal lesions is complicated by the inconsistency in the terminology. The classification of these lesions should logically be based on the degrees of dysplasia, as this has a bearing on the prognosis. The material for this study consisted of 193 patients with hyperplasia and/or keratosis, with or without mild dysplasia (Group I), moderate dysplasia (Group II), and severe dysplasia and carcinoma in situ (Group III).

HISTOSCAN: computer program for cytophotometry in tissue sections and its application in the evaluation of nuclear atypia.

The grading of nuclear atypia has a great and well recognized value when predicting the malignancy of neoplastic processes. Although the basic criteria for the grading are generally agreed upon, in the individual case, the final judgement is to some extent still a matter of subjectivity, which naturally impairs reproducibility. The present paper describes a method for quantification of variability of nuclear size and Feulgen-stainability.

Computed tomography in carcinoma of the larynx and piriform sinus.

The conventional methods of examination do not furnish a complete picture of deep extension of carcinoma of the larynx and piriform sinus. Often the only sign of deep invasion is vocal cord fixation. The purpose of this study was to ascertain whether further information in this respect might be provided by computed tomography.

Photometric evaluation of laryngeal epithelium exhibiting hyperplasia, keratosis and moderate dysplasia.

Photometric examination of vocal cord epithelia disclosed no difference in the nuclear DNA content or nuclear area of normal and keratotic laryngeal epithelia. For 2 out of 3 epithelia displaying hyperplasia the values were slightly elevated. There seem to be no morphologic or photometric grounds for considering either hyperplasia or keratosis to be premalignant.

Exfoliative cytology in laryngology: comparison of cytologic and histologic diagnoses in 350 microlaryngoscopic examinations--a prospective study.

In a prospective study comprising 350 microlaryngoscopic examinations, the reliability of exfoliative cytologic diagnosis was evaluated in comparison with the histologic findings. In 157 of 190 lesions with histologically moderate and severe dysplasia, carcinoma in situ, and invasive carcinoma, the cytologic smears were positive. The sensitivity of the exfoliative cytologic method in the detection of "malignant" lesions was thus 83%.

Extramedullary plasmacytoma of the larynx.

Extramedullary plasmacytomas, indistinguishable histologically from multiple myeloma, are fairly uncommon tumors, which are most frequently located in the upper airways. However, the larynx is rarely involved. Ten per cent of reported cases have multiple lesions.

Malignant degeneration of a juvenile laryngeal papilloma--a follow-up study.

The patient, a non-smoking woman aged 51, had been suffering from recurrent juvenile papilloma for 38 years. After eight years during which there was increasing atypia, an extensive malignant papillary tumor, with extralaryngeal spread, was diagnosed. Only seven cases of malignant degeneration of non-irradiated juvenile laryngeal papilloma have been reported; at least four were heavy smokers.

Angiography in laryngeal carcinoma.

Angiography was performed in 8 patients with laryngeal carcinoma. The findings suggest that angiography can provide useful information on deep tumour invasion but further experiences are required before any definite conclusions can be drawn.

Chondrosarcoma of the larynx.

A chondrosarcoma arising in the posterior cricoid plate is presented. The tumour gave rise to increasing inspiratory stridor: laryngectomy was performed. The tumour consisted of loose cartilaginous tissue with great predominance of highly differentiated cartilage cells and only small areas with nuclear polymorphism.

Toluidine blue. An aid in the microlaryngoscopic diagnosis of glottic lesions?

The value of toluidine blue staining in vivo in the diagnosis of glottic lesions was examined by comparing the results obtained in a series with the histological findings. This material included 272 biopsy specimens from the vocal cords (202 microlaryngoscopic examinations). In 148 of these, the changes were classified as "malignant" (moderate and severe dysplasia and carcinoma) and in 124 as "benign.

Pharyngocutaneous fistulae following total laryngectomy.

Postoperative pharyngocutaneous fistula formation is a troublesome complication in head and neck surgery and occurred in 8 out of 53 patients following a total laryngectomy (15%). The incidence falls within the lower range of that reported in the literature (6-66%). Different factors which may influence the formation of fistulae were analysed.

Arterial anatomy in the normal larynx and in laryngeal carcinoma. Radiography of specimens.

For a correct selection of patients with laryngeal carcinoma for surgery, especially when partial surgery is contemplated, it is important to ascertain the extent of deep tumour invasion. The usual radiologic methods and microlaryngoscopy have shortcomings in this respect. Angiography of normal specimens demonstrated that the arterial anatomy is fairly constant and characteristic.

Amyloidosis of the larynx.

Amyloidosis of the larynx is a rare disease, accounting for less than 1% of all benign laryngeal 'tumours'. Three cases of this type of lesion are reported--one of the vocal cord, one of the false vocal cord and one of the subglottis and trachea. In 2 of the patients the amyloidosis was localized, while the third was later found also to have an epipharyngeal solitary plasmacytoma with amyloid deposits and in addition amyloidosis of the nasal cavity.

Radiologic assessment of laryngeal carcinoma. A clinico-pathologic comparison based on whole-organ serial sections.

In 33 patients with laryngeal carcinoma operated upon with laryngectomy, a comparison has been made of the findings yielded by radiography and microlaryngoscopy and a microscopic examination using whole-organ serial sectioning. The radiographic examinations were conventional films, tomography and laryngography. Radiography supplemented in microlaryngoscopy with information of clinical importance.

Hyposensitization in allergic seasonal rhinitis as evaluated by rhinomanometry.

Hyposensitization with Allpyral extracts was performed in 38 patients suffering from seasonal allergic rhinitis. An objective evaluation of the clinical course was obtained by rhinomanometry. After one year of hyposensitization therapy, 55% of the patients (21 out of 38) showed an improvement, and after the 3-year follow-up this figure had increased to 76% (19 out of 25 patients continuing with the treatment for this period).

Irradiation-induced tumours of the head and neck.

Though irradiation-induced tumours are uncommon they represent a well defined entity. At this Hospital, 14 "irradiation-induced" head and neck tumours were encountered in 11 patients over a 10-year period. The irradiation had been given for tuberculous lymph-adenitis in 6 of the patients, for lupus vulgaris in one, and thyrotoxicosis in another; the other 3 patients had received radiotherapy for malignant tumours.

The DNA content and nuclear size in normal, dysplastic and carcinomatous laryngeal epithelium. A spectrophotometric study.

The aim of the present study was to obtain a more objective evaluation of nuclear hyperchromasia and polymorphism in laryngeal epithelium. The method is based on a photometric assay of nuclear size and DNA content in Feulgen stained slides. The DNA content of hyperchromatic nuclei should exceed the mean for nuclei of normal epithelium by more than twice the standard deviation.

Hyposensitization in allergic rhinitis--a comparison of aqueous extracts and Allpyral by means of rhinomanometry.

Fifty-six patients with seasonal allergic rhinitis were hyposensitized with aqueous extracts (23 patients) and Allpyral extracts (33 patients). The clinical course was appraised objectively on the basis of rhinomanometry findings at examinations performed before hyposensitization and one year later. There was no essential difference between the two groups of patients as regards the relief of symptoms.

Juvenile laryngeal papilloma displaying malignant degeneration--a spectrophotometric investigation.

Spontaneous malignant degeneration of juvenile laryngeal papilloma in the absence of radiotherapy is exceedingly rare, and few such cases have been reported. The patient reported here, now a woman of 48, has been suffering from recurrent juvenile laryngeal papilloma since she was 13. During the last six years the papillomas have displayed increasing atypia and have spread to the trachea and the bronchus of the right inferior lobe.

Adenoid cystic carcinoma of the larynx: a report of four cases and a review of the literature.

Adenoid cystic carcinoma (cylindroma) is a well-recognized tumor that is frequently encountered in the major salivary glands, the lacrimal glands and in the minor salivary glands of the oral cavity and upper respiratory tract. Only 60 cases of adenoid cystic carcinoma have been described arising in the larynx. Four new cases are reported and the literature is reviewed.