[Immunoglobulins G, A, M and circulatory immune complexes in patients with laryngeal carcinoma].

INTRODUCTION: Malignant tumors of the head and neck represent 5% of all malignancies, of which the most common are tumors of the larynx and oral cavity. In the blood serum of patients with malignant tumors increased levels of immunoglobulins and circulating immune complexes have been detected, with a diverse relevance to the clinical course and prognosis of the disease. AIM: Due to contradictory findings of the correlation between the humoral immune response and the clinical course of the disease, we examined 42 male patients with laryngeal carcinoma. All patients underwent surgery, of which 15 patients were treated postoperatively with radiotherapy. The changes in the levels of immunoglobulins and circulating immune complexes in the blood serum were recorded and evaluated. RESULTS: Analysis of the results showed an immunological disorder of an abnormal level of circulating immune complexes in the blood serum that normalized after the surgical removal of the tumor. The levels of immunoglobulins G and A were abnormal during the whole postoperative period of examination. CONCLUSION: The normalizing of the levels of circulating immune complexes in the blood serum, after surgical removal of the tumor, shows a strong association between the two, and this could consequently mean that it could be used as a prognostic tool, particularly in correlation with other immunological parameters.

[Bilateral vocal paralysis phonosurgery in adults].

Ordinary clinical manifestation of the patient with bilateral vocal fold paralysis is inability of abducting the cords with a result of narrowing the glottic space, causing inspiratory stridor and mild dysphonia. Such patients can be life threatened due to narrowing airway. Some kind of surgery has to be performed on these patients in order to enlarge the airway. When we treat patients with OPG, the most reasonable way is to gradually enlarge airway at glotic level and there are several surgical methods for achieving this. The least agresive and the safest procedures are posterior transversal cordectomy (PTC) or medial arytenoidectomy (MA), after which we can perform extended versions of some of these methods or combination of both. Bilateral vocal fold paralysis has to be diagnostically different from stenosis of posterior commissure, even though the procedures such as medial arytenoidectomy, posterior transversal cordectomy and total arytenoidectomy can be performed in both cases. The patients have to be explained that the aim of the procedure is to enlarge airway to the detriment of voice quality and voice capabilities.