Faculty Bibliography

A considerable body of literature advocates and defines treatment of vocal cord cancer with posterior extension by hemilaryngectomy. The present study was carried out to determine the feasibility of using a newly devised pedicle flap, composed of thyroid cartilage and inferior constrictor muscle, to replace the ablated arytenoid cartilage. Animal investigation revealed satisfactory viability of the pedicle flap in canines, and in humans, five patients with T2 glottic carcinoma demonstrated excellent postoperative deglutition and return of voice. The results of the study indicate that this surgical technique merits consideration for its use in minimizing protracted glottic incompetence following hemilaryngectomy. The thyroid cartilage-inferior constrictor muscle pedicle flap may also prove useful as partial cricoid replacement in selected cases of subglottic extension and in cricoid reconstruction following trauma

Use of commercially available urea differentiation disks is a rapid and convenient means of determining the urease activity of mycobacteria. In the study performed, paper disks containing Ewing's Urea R Broth were compared with two other methods of testing for urease production. Over 1,500 tests were performed with recent patient isolates from which at least 15 different species of mycobacteria were identified. The tests were read at intervals for 72 h, and a comparison of test results as to rapidity and accuracy for each species was tabulated. The urea disks showed a faster reaction time when compared with the other two methods. They also showed a high percentage (79 to 100%) of reliability for each species on the first run, based on the expected response.

The most challenging laryngotracheal stenosis are those that exceed 5 cm in length and involve more than one area of the larynx and trachea contiguously. A successful technique for the repair of these injuries with a three-stage laryngotracheal trough was created followed by anterior tracheal wall replacement with a skin-Marlex-muscle pedicle flap.

Indirect laryngoscopy is one of the procedural methods used for achieving a histopathologic diagnosis of cancer of the larynx. A chronologic historical summary of the development of mirror laryngoscopy is presented. The details of the procedure employed for obtaining a biopsy with the aid of topical anesthesia is discussed.

Summary--The laryngeal phonatory reflex through the internal branch of the superior laryngeal nerve (SLN) was investigated by means of anesthetization of the nerve, after which acoustic signals were subjected to computer analysis to determine how anesthesia affected basic vocal parameters. Results showed that the anesthetization did not affect the abrupt cycle-to-cycle frequency changes and also did not influence the gross control of the fundamental frequency. But slower fluctuation of the fundamental frequency increased following anesthesia. From these results, it is suggested that the anesthetization of the internal branch of the SLN may derange the fine control mechanism of the larynx without affecting overall or gross performance of the phonatory apparatus.