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Cricoid chondrosarcoma presenting as arytenoid hypertelorism
Jamie A Koufman1, Jacob T Cohen, Sumeer Gupta
1Center for Voice Disorders of Wake Forest University, Winston-Salem, NC, USA. jkoufan@wfubmc.edu
The Laryngoscope
|October 12, 2004
Summary
Arytenoid hypertelorism, a widening of the arytenoid cartilages, is a key sign of cricoid chondrosarcoma. Early diagnosis and conservative hemicricoidectomy are recommended for this rare laryngeal cancer.
Area of Science:
- Otolaryngology
- Laryngeal Oncology
- Surgical Pathology
Background:
- Arytenoid hypertelorism, characterized by widely spaced arytenoid cartilages, is the most common initial physical finding in patients with cricoid chondrosarcoma.
- This condition often results in an open posterior larynx and can cause aphonia, even with vocal fold contact during attempted phonation.
Observation:
- A retrospective study evaluated nine patients diagnosed with cricoid chondrosarcoma between 1991 and 2002.
- Patients presented with symptoms of dysphonia or aphonia, often after failed laryngeal surgeries.
- The mean age at diagnosis was 70 years, with a predominance of male patients.
Findings:
- Eight of nine patients (88%) presented with voice changes attributed to arytenoid hypertelorism.
- All tumors were low-grade.
- Hemicricoidectomy was the primary treatment for eight patients; one underwent total laryngectomy. Recurrence was observed in four cases.
Implications:
- Elderly patients with unexplained severe dysphonia and arytenoid hypertelorism require prompt evaluation for cricoid chondrosarcoma.
- Conservative surgical management, such as unilateral hemicricoidectomy, is recommended due to the typically benign behavior of these tumors.
- This approach serves as both a diagnostic and therapeutic modality, offering favorable outcomes for most patients.