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[Anterior commissure status in patients with larynx cancer]
Andrzej Balcerowiak1, Aleksandra Kruk-Zagajewska, Katarzyna Iwanik
1Klinika Otolaryngologii i Onkologii Laryngologicznej Uniwersytetu Medycznego im. Karola Marcinkowskiego, Kierownik: prof. dr hab. med. Witold Szyfter, Poznań, Poland.
Aim Of The Work:
Assessment of directions and ways of cancer spreading in the anterior commissure of the larynx, depending on the tumor location, age, sex of patients in a clinical trial and in microscopic serial section study.
Materials And Methods:
The study included 50 larynx preparations obtained from open partial and total laryngectomies (F-7; M-43). For the assessment of larynx anterior commissure microscopic status 28 larynx preparations with macroscopic free anterior commissure were used. For study of the directions and ways of tumor spreading in the anterior commissure served 22 larynx with macroscopic infiltration of anterior commissure. Anterior Commissure (AC) and TNM classifications was used to determine the location and tumor stage. Larynx anterior commissure was extracted and divided into 3 subregions: supraglottic, glottic and subglottic.
Results:
The direction and the way of cancer propagation in larynx anterior commissure structures is dependent on morphological changes that occur with aging. Cancer spreads in the anterior commissure along the fibers anchoring voice muscle within the Broyles ligament and is seen in tumor cells microembolism.
Conclusions:
In patients with cancer of the larynx without macroscopically visible neoplastic lesions in the anterior commissure, cannot be excluded its microinfilration. Changed with age anterior commissure' Broyles ligament by the process of neovascularization and ossification is not an effective protection against the spread of cancer. Directions and the ways of cancer spread in the anterior commissure is similar in men and women. AC classification can be important in qualifying patients for organ preservation surgery and should be supplemented by an additional AC4 degree, taking into account subglottic changes in the anterior commissure of the larynx.
