[A pathophysiologic thesis of the development of laryngeal cancer]

Mucociliary transport in the subglottic region was assessed in 45 of 75 human larynges that had been removed for carcinoma. These were marked with India ink and observed through an operating microscope. Normal mucociliary pathways in this region are known to be symmetric, conducting all of the mucus of the bronchial tree effectively to the posterior commissure for passage into the hypopharynx. None of the examined larynges showed normal transport patterns. The alteration of mucociliary flow as an early effect of tumor development is not likely. It is therefore concluded that these abnormal mucociliary transport patterns existed before tumor development and wee probably genetically coded. Such an ineffective clearance of airborne pollutants from the subglottic space with prolonged contact times may promote carcinogenesis. This might explain the known variable risk for carcinogenic susceptibility.