H Chijiwa1, K Sato, H Umeno, T Nakashima. 1. Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan. chijiwah@med.kurume-u.ac.jp
Abstract
OBJECTIVES: The paraglottic space and cricoid area of the larynx are made up of loose, areolar tissue composed of loose elastic and collagenous fibres and adipose tissue. They contain the main blood vessels of the larynx. We examined the correlation between the histopathological extension of glottic carcinoma into the paraglottic space or cricoid area and the development of cervical lymph node metastasis. STUDY DESIGN: We reviewed the medical charts of 45 patients (44 men and one woman) who had undergone total laryngectomy for squamous cell carcinoma of the glottis between 1991 and 2003. METHODS: Macroscopic and microscopic study of the removed larynges of the same patients was performed, and the histopathological evidence for invasion of the paraglottic space or cricoid area was analysed. RESULTS: Eight of the 24 patients (33 per cent) with invasion of the paraglottic space or cricoid area had cervical lymph node metastasis. In contrast, only one of the 21 patients (5 per cent) without any evidence of invasion of either space had lymph node metastasis. This difference was statistically significant (p < 0.05). In the 36 patients free of cervical lymph node metastasis, recurrence in the neck occurred in six (38 per cent) of the 16 patients with paraglottic space or cricoid area invasion, but in only one (5 per cent) of the 20 patients without paraglottic space or cricoid area invasion (p < 0.05). CONCLUSION: In patients with glottic carcinoma, invasion of cancer into the paraglottic space or cricoid area is an important prognostic factor for the development of cervical lymph node metastasis.
OBJECTIVES: The paraglottic space and cricoid area of the larynx are made up of loose, areolar tissue composed of loose elastic and collagenous fibres and adipose tissue. They contain the main blood vessels of the larynx. We examined the correlation between the histopathological extension of glottic carcinoma into the paraglottic space or cricoid area and the development of cervical lymph node metastasis. STUDY DESIGN: We reviewed the medical charts of 45 patients (44 men and one woman) who had undergone total laryngectomy for squamous cell carcinoma of the glottis between 1991 and 2003. METHODS: Macroscopic and microscopic study of the removed larynges of the same patients was performed, and the histopathological evidence for invasion of the paraglottic space or cricoid area was analysed. RESULTS: Eight of the 24 patients (33 per cent) with invasion of the paraglottic space or cricoid area had cervical lymph node metastasis. In contrast, only one of the 21 patients (5 per cent) without any evidence of invasion of either space had lymph node metastasis. This difference was statistically significant (p < 0.05). In the 36 patients free of cervical lymph node metastasis, recurrence in the neck occurred in six (38 per cent) of the 16 patients with paraglottic space or cricoid area invasion, but in only one (5 per cent) of the 20 patients without paraglottic space or cricoid area invasion (p < 0.05). CONCLUSION: In patients with glottic carcinoma, invasion of cancer into the paraglottic space or cricoid area is an important prognostic factor for the development of cervical lymph node metastasis.