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Human Papilloma Viruses (HPV) have been implicated to cause 5% of human cancers. The role of HPV as an etiological agent in the development of precancerous lesions and cancers of head and neck is increasingly being explored. The wide variation in prevalence of HPV has, to some extent, impeded a full understanding of association between HPV and benign and malignant lesions of head and neck. We wanted to determine the proportion of Human Papilloma Virus in squamous epithelial lesions of head and neck using Polymerase Chain Reaction (PCR) studying snap frozen fresh biopsy samples.METHODSThis is a descriptive study of cases presenting to the Department of Pathology, Govt. T D Medical College, Alappuzha, Kerala, conducted over a period of one year. 40 cases of clinically suspicious premalignant or malignant squamous lesions of head and neck were biopsied and were subjected to histopathological study and PCR using primer MY11/GP6. Data was entered in Excel sheet. The association of HPV positivity with lesions of head and neck was assessed using SPSS softwareRESULTSOf the 40 cases studied, the mean age of the cases studied was 55.98 years. Male to female ratio was 29:11. Most of the cases were alcoholics (60%), with smokers (55%) and the habit of pan chewing in 20% of the cases. The histopathological lesions studied were mostly malignant cases (squamous cell carcinoma- 77.5% of cases) and rest were oral keratosis, vocal cord polyp and a lesion showing chronic inflammation only. The predominant site of biopsy was from oral cavity (80%), followed by larynx (16%) and oropharynx (13%). HPV positivity was obtained in 2.5% of the cases, which was not statistically significant. HPV positivity did not show statistically significant association with any of the risk factor behaviours like alcoholism, smoking or pan chewing. The morphological diagnosis associated with HPV was moderately differentiated, which was also not statistically significant.CONCLUSIONSHPV positivity was obtained in 2.5% of the cases studied with no significant correlation between HPV and squamous epithelial lesions of head and neck.
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Los pólipos de cuerda vocal son lesiones laríngeas benignas. Se asocian a micro-traumatismos por mal uso vocal que generan remodelación de la lámina propia y el epitelio. Es más frecuente en hombres entre los veinte y cuarenta años. En la gran mayoría de los casos se presenta de manera unilateral. Si bien estas lesiones están bien documentadas en la literatura, es raro encontrar presentaciones bilaterales, por lo que su enfrentamiento y manejo puede ser discutible. Se presenta el caso de una paciente de sexo femenino de 41 años, fumadora, que consulta por disfonía de larga data. Se diagnostican pólipos bilaterales de cuerda vocal, realizando una intervención quirúrgica en un tiempo, con un resultado favorable.
Vocal cord polyps are benign Iaryngeal lesions. They are associated to micro traumatisms because ofvocal misuse, generating a remodelation of the lamina propria and the epithelium. It is more common in men between twenty and forty years of age. In the vast majority of cases it unilaterally occurs. While these are well documented injuries in the literature, it is rare to find bilateral presentations, so their confrontation and management may be debatable. We present the case of a female patient, smoker, who consulted for chronic dysphonia. Bilateral vocal cord polyps were diagnosed, performing a bilateral resection with a positive outcome.
Subject(s)
Humans , Female , Adult , Polyps/surgery , Vocal Cords/surgery , Laryngeal Diseases/surgery , Laryngoscopy/methods , Microsurgery/methods , Polyps/diagnosis , Vocal Cords/pathology , Laryngeal Diseases/diagnosisABSTRACT
Objective To investigate the relationships between expressions of HPV and EBV in larynge-al carcinoma. Methods DNA flow-through hybridization and gene chip genotyping technology(HybriMax)and real-time quantitative PCR were used for 37 subtypes of HPV detection and quantitative detection of EBV in 101 cases of laryngeal cancer paraffin embedded tissue specimens. 43 cases of vocal cord polyp of paraffin embedded tissue specimens were used as the controls. Results The positive rate of laryngeal carcinoma was 13.86% in group HPV and 9.3% in the control group ,with no statistically significant difference between the positive expres-sions of HPV in the laryngeal carcinoma group and control group(P>0.05). The positive rate of laryngeal carci-noma was 63.37% and 13.95%,respectively ,in group EBV ,and the control group ,with significant difference between them(P 0.05),but the difference was statistically significant in highly differentiated EBV as compared with those with low differentiation type,medium differentiation and poor differentiation(P 0.05). Conclusions The incidence of laryngeal carcinoma is closely related with EBV infection ,possibly relationed with HPV and high-risk subtypes of HPV have a certain role in the process of induced laryngeal carcino-ma. The gender ,age and duration of disease have no significant correlation with EBV infection. This study will provide a basis for further invesgitation of pathogenesis of laryngeal cancer and prevention and treatment of larynge-al cancer.
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Objective To analyze the effect of CO2 laser under suspension laryngoscope on patients with vocal cord polyp. Method 118 patients with vocal cord polyp from November 2013 to August 2015 in our hospital were chose as research subjects, all patients were divided into observation group (n=54) and control group (n=64) accord﹣ing to different treatment. Control group: patients received conventional laryngoscope resection; observation group:patients received CO2 laser under suspension laryngoscope. Then compare the two group patients' voice indexes, a﹣cute phase proteins, rehabilitation and recovery speed after treatment. Results Observation group patients' F0, HNR values were higher than control group patients, PPQ, APQ, NNE values were lower than that in control group (P<0.05);early observation group patients' postoperative serum CRP, α1-AG, CER,β2-MG values were lower than con﹣trol group patients, ALB value was higher than control group patients (P< 0.05); observation group patients' cure rate was higher than control group patients, valid and invalid rates were lower than control group patients, the first sound time, sound full recovery time, discharge time were shorter than control group patients (P< 0.05). Conclusion Vocal cord polyp patients receive laser under suspension laryngoscope treatment, can effectively promote recovery rate, have advantages of minimally invasive and rapid recovery after surgery.
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Objective To compare the efficacy of CO2 laser and conventional laryngeal microsurgery in the treatment of benign lesions of vocal cord (polyp of vocal cord) and precancerous lesions (leukoplakia of vocal cord) of patients. Methods A total of 60 patients with vocal cord polyps were selected, and randomly divided into two groups, each with 30 patients. Thirty patients with vocal cord leukoplakia were selected and randomly divided into two groups, each with 15 patients. One group was performed by cold instruments for lesion resection (conventional group), the other by CO2 laser for removal of diseased tissue or mucosal ablative surgery (laser group). Two groups of patients were examined by laryngostroboscope, electronic laryngoscopy, GRABS, VHI subjective ratings and objective voice analysis before operation and one week, one month and three months after operation. ResuIts The outcomes of those with vocal cord polyps in early recovery (1 week) laser group were slightly worse than the conventional group. In later recovery (1~3 months), with electronic laryngoscopy inspection, laryngostroboscope mucosal wave observation, the analysis of subjective and objective data from the two groups showed no significantly differences. For patients with vocal cord leukoplakia in early recovery (1 week), laser group slightly worse than the conventional group, in later recovery (1~3 months), there were no obvious difference between the two groups in electronic laryngoscopy inspection, laryngostroboscope mucosal wave observation, the analysis of subjective and ob_jective data. Follow -up operations, the recurrence rates in laser group was significantly lower than conventional group. ConcIusion The treatment by CO2 laser can significantly improve their pronunciation quality for vocal cord polyps and vocal cord leukoplakia patients, it has a good therapeutic effect, especially the long-term effective of vo_cal cord leukoplakia is better than conventional operation.
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Objective To observe the variations in intraocular pressure(IOP)in vocal cord polyp resections supported by pedestal Iaryngoscope with Tono-Pen tonometer.Methods The IOP of patients (grade Ⅰ-Ⅱby ASA)who underwent vocal cord polyp resections supported by pedestal laryngoscope were detected by Tono-Pen tonometer 5 minutes later on supine position before the operation(T1),5 minutes later on cervical hyperextension position before the operation(T2),5 minutes later on cervical hyperextension position after the operation(T3),5 minutes lateron supine position after the operation(T4),20 minutes later on supine position after the operation(T5)after general anesthesia respectively.At each point the changes of mean arterial pressure(MAP),heart mte(HR),end-tidal carbon dioxide partial pressure(PETCO2),and airway pressure(PAW)were observed as well.Results There were no differences in MAP,HR,RETCO2,PAW at each point statistically.The IOP increased significantly at T2,T3,T4 compared with IOP at T1[(19.0±1.8),(25.7±1.9),(17.8±1.9)mm Hg(1 mm Hg=0.133 kPa)vs(11.9±1.7)mm Hg](P＜0.05).The differences between IOP at T2 and T3 were manifest(P＜0.05).So it Was the situation when the IOP at T3 and T4,T4 and T5 were compared(P＜0.05).The IOP at T5 was(12.1±1.5)mm Hg,there was no difference compared with T1.Conclusion The IOP increases gradually from the point when the patient put on cervical hyperextension position before the operation after general anesthesia and achieves the summit when the patient put on cervical hyperextension position after the operation,finally,decreases back to the preoperative level when the patient put on supine position after the operation.
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0.05).?-defensin 2 was detected in the specimens of vocal cord polyp,but very little in the subjects of other two groups.Its expression level was significantly higher in the vocal cord polyp than that of the other two groups(P