Browsing by Author "Milovanović, J. (6603250148)"

Computed tomography (CT) and magnetic resonance imaging (MRI) are enabling more precise diagnosis and treatment planning in patiensts with diseases of the larynx. The aim of this article is to describe the role of these methods in assessment of the laringeal diseases and key local anatomic characteristics important for spread of the disease. CT and MRI have a valuable contribution to the staging of the tumors due to the possibility to show the relationship to the ventricular complex, involvement of the subumucosal spaces, defining craniocaudal and anterposterior extension, laringeal cartilage invasion, as well as regional lymph node metastases.

AIMS: To evaluate diagnostic accuracy of pretreatment surgical magnetic resonance images (MRI) in assessment of patients with tumors of the larynx. MATERIALS AND METHODS: The study included 12 patients, 11 men and 1 women, age 61,4 years. All patients underwent laryngeal endoscopy and biopsy followed by MRI. The biopsy confirmed that all patient had squamous-cell carcinoma. The MRI images were evaluated for presence in supraglottic, glottic or subglottic region, invasion of submucosal space, cartilage, extension to extralaryngeal tissue, presence of regional lymph nodes in regions I to VII. Imaging data were compared to surgical findings. RESULTS: In 11 patients (92%) the tumor was supraglottic and glotic region and in 1 (8%) subglottic. None of them had tumor only in one region. Paraglottic ivasion was seen in 9 (75%) and preepiglottic in 2 (50%) patients. Paraglottic and preepiglotic invasion in the same time was seen in 3 (25%) patients. 7 (58%) patients had normal vocal cord mobility, 3 (25%) mobility was unilateral and 2 (17%) had no vocal cord mobility. Cartilage invasion has not been seen in present study. All patients had billateral limphadenopathy region II-IV. Extension to extralaryngeal tissue was absent. These findings were confirmed on surgery with high diagnostic accuracy. CONCLUSION: MRI has been shown to be a reliable method for presurgical assessment of patients with tumor of the larynx.

Endovideolaryngostroboscopy is the obliged evaluation tool in our everyday practice. Standardized protocol in management of broad spectrum of vocal pathology is useful in clinical, scientific and educational evaluation of patient from the first interview till the end of the treatment. Using of contemporary computerised multidimensional analysis of stroboscopic image we are approaching to optimum evaluation of any kind of interpersonal communication disorder. There were 66 patients in prospective clinical study of correlation between suspect endovideolaryngostroboscopic findings and histo-pathology verification of glottis carcinoma. Asymmetric and irregular vibrations with absent mucosal wave or absent vibrations of one part or of the whole vocal fold was improved as carcinoma in 85% of patients. The most frequent diagnosis was Ca planocellularae invasivum G2 NG 2, with subsequent open chordectomy. In every case of hoarseness longer more than 14 days, endovideolaryngostroboscopy is the golden standard for evaluating the need for microlaryngoscopy and biopsy.

Multidisciplinary approach in rehabilitation of laryngectomized patients is the basic of esophageal voice and speech establishing. Well trained and dedicated stuff is cornerstone for such helpless patients. Communication Disorders Care Center and Laryngectomized Patients Society are minimal administrative precautions in organized community. Modern technology implementation gives us objective evaluation of therapy effects, that is 84% of successful treatment in our daily work.