Pathological assessment of vocal folds infiltration in cases of cancer larynx

Abstract

There are different mechanisms of vocal folds fixation; larynx fixation in cancer larynx may result from weight of a bulky tumor, the involvement of vocal folds, intrinsic laryngeal muscles, cricoarytenoid joints, or recurrent laryngeal nerves by the tumor. The primary goal in treating laryngeal squamous cell carcinoma is to achieve local control of the tumor while preserving functions of speech and swallowing without a permanent tracheostomy so many studies have been performed in order to widen the indications for conservative procedures. This prospective study was carried out on individuals, who presented to the department of Otolaryngology at Ain Shams University hospitals and were diagnosed as laryngeal squamous cell carcinoma.All included patients were subjected to full clinical history taking, thorough clinical head and neck examination, fibropticnasopharyngolaryngoscopic examination, CT scan and direct laryngoscopy followed by total laryngectomy for all of them. The specimens were taken intra-operatively from the freshly resected larynx.The intrinsic muscles of the larynx that are associated with the arytenoid block were exposed which are: 1- Posterior cricoarytenoid muscle. 2- Interarytenoid muscle. 3- Thyroarytenoid muscle. 4- Lateral cricoarytenoid muscle. Histopathological examination of the haematoxylin and eosin stained sections were performed for those muscles with assessment of the degree of differentiation of the tumor in the muscles of the vocal fold.