Laryngeal and oropharyngeal cancer, and alcohol dehydrogenase 3 and glutathione S-transferase M1 polymorphisms.

In this study the GSTmu phenotype and ADH genotype at the ADH3 locus were investigated in a group of 39 alcoholic men with upper respiratory/digestive tract cancer: 21 with oropharyngeal cancer and 18 with laryngeal cancer. The results are compared with those of a control group of 37 alcoholic men without alcohol-related medical complications. Of the control subjects, 48% were found to be GSTmu deficient [GSTmu(-)] and 19% carried the ADH(3)1/ADH(3)1 genotype. In the laryngeal cancer patients, a significantly elevated frequency of both the GSTmu(-) (78%) and ADH(3)1/ADH(3)1 genotype (56%) was observed, relative to the control group. On the basis of this result, the risk of laryngeal cancer associated with the GSTmu(-) and ADH(3)1/ADH(3)1 genotypic combination within the population of alcoholics was estimated to be 12.9 with a 95% confidence interval of 1.8-92 (P < 0.01) relative to alcoholic individuals who have GSTmu [GSTmu(+)] and are not ADH(3)1/ADH(3)1. Thus, alcoholics who are GSTmu(-) and ADH(3)1/ADH(3)1 have at least an 80% greater risk of developing laryngeal cancer than alcoholics who are GSTmu(+) and who are not ADH(3)1/ADH(3)1. In addition, the oropharyngeal cancer patients had excess frequencies of both GSTmu(-) (62%) and ADH(3)1/ADH(3)1 (43%) relative to the control group, but these excess frequencies were not statistically significant. The GSTmu(-) and ADH(3)1/ADH(3)1 genotypic combination may be a constitutional risk factor for laryngeal cancer among alcoholics.

[Acute necrotizing sialometaplasia of the parotid gland]. / La sialométaplasie nécrosante aigüe de la parotide.

Parotidean localization of acute necrotizing sialometaplasia is exceptional. Based on one observation, the authors evoke the diagnostic and physiopathological problems raised by this localization. The association of facial paralysis and a parotidean tumor make the case presented interesting, leading to exploratory surgery which can alone provide a diagnosis.

[Treatment of subglottic stenoses using the Pearson's operation: apropos of 3 cases]. / Traitement des sténoses sous-glottiques par l'opération de Pearson: à propos de trois cas.

Surgery of stenoses of the laryngo-tracheal junction is governed by the necessity of maintaining the support of the cricoid-arytenoid articulations and of preserving the recurrent nerves. Sub-total cricoid resection with conservation of the recurrent nerves, known as Pearson's operation, enables the treatment of fixed sub-glottic stenoses with mobile larynx. On the basis of three recent observations, the authors define the indications and the performance of this surgery. The respiratory and vocal results are considered satisfactory in these three cases.