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Background: Laryngeal cancer is the second most common cancer of the head and neck after cancer of the oral cavity. The primary causes of death in cases of laryngeal cancer are the recurrence of locoregional disease and distant metastasis. Anatomic and tissue alterations resulting from surgery and/or radiotherapy of primary laryngeal tumors can make it difficult to determine a locoregional recurrence or residual disease by physical examination or computed tomography (CT)/magnetic resonance imaging (MRI). The majority of studies have shown a high accuracy in the detection of local and regional recurrence of head and neck cancer after different treatment modalities, using fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. Aim: To determine the diagnostic accuracy of PET/CT in patients with suspicion of locoregional recurrence from laryngeal carcinoma after surgery with or without adjuvant radiotherapy. Materials and methods: This was a retrospective study. Forty-five patients who previously underwent surgical treatment with or without adjuvant radiotherapy for primary laryngeal squamous cell carcinoma and who underwent examination using FDG-PET/CT imaging after clinical and instrumental (CT/MRI) suspicion of locoregional recurrence (T or N) were recruited. Results: Overall specificity, sensitivity, and accuracy of PET/CT were found to be 88%, 100%, and 93.3%, respectively. With respect to the suspected cases of recurrence in the primary site, sensitivity, specificity, and accuracy of PET/CT were found to be 100%, 87.5%, and 91.6%, respectively. In patients with suspected metastatic neck disease, PET/CT revealed a sensitivity, specificity, and accuracy of 100%, 90%, and 95.4%, respectively. Conclusion: According to the results of this study, PET/CT imaging in laryngeal tumors is a useful tool in case of suspected locoregional recurrence where conventional imaging (CT and MRI) is unable to resolve the diagnostic doubt.

Background: Microlaryngoscopy is the preferred and most widely used technique in phonosurgery for the treatment of benign and early malignant glottic lesions. However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications. The aim of this study is to evaluate the efficacy and safety of our surgical approach for lesions of the vocal folds in patients who are not suitable for phonosurgery by microlaryngoscopy. This approach applies videolaryngoscopy during conscious sedation, which combines local anesthesia with moderate analgosedation by using midazolam and fentanyl with premedication. Methods: A total of 235 patients affected by benign diseases or suspicious cancerous lesions of the vocal folds were retrospectively evaluated. Results: The method has shown a success rate of 95.5, 89, 52.3, and 86.7% in cases of polyps of the vocal folds, Reinke's edema, cysts of the vocal folds, and suspicious lesions of the larynx, respectively. Only 3 patients (1.27%) have been reported to experience adverse events. Conclusion: The results suggest that the method is an effective and safe procedure without relevant local and/or general complications.

Multiple myeloma is a lymphoproliferative disease that may involve the bone marrow as well as extramedullary soft tissues. However, laryngeal localization of multiple myeloma is extremely rare. We herein present the case of a 68-year-old male patient with a history of dyspnea, dysphonia and dysphagia. Laryngoscopic examination revealed a lesion involving the right glottis and right vestibular (false) vocal fold, with absence of ipsilateral laryngeal motility and constriction of the airway. Computed tomography and magnetic resonance imaging revealed a gross swelling infiltrating the right glottis and right false vocal fold, sized 33×19×33 mm, with sub-centimeter laterocervical lymph nodes bilaterally. Careful integration of the clinical manifestations with the radiological and pathological data led to the diagnosis of multiple myeloma. Given the rarity of this localization, the purpose of this study was to increase knowledge of this disease among ear, nose and throat specialists, in order to enable a more timely diagnosis.

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