Embryological study of the glottic site and clinical implications

Fatores prognósticos no tratamento do carcinoma epidermóide da laringe: cirurgia conservadora x radical

“…1,2,8,12 We started studying the subsites by the anterior commissure and its importance in indicating the surgical technique. The anterior commissure has important characteristics that should be taken into account in neoplasm dissemination, when approaching it surgically.…”

“…The anterior commissure has important characteristics that should be taken into account in neoplasm dissemination, when approaching it surgically. [1][2][3][4][5][6][7][8][9][10][11][12] Its embryologic and anatomic formation has drawn attention of many authors, when studying laryngeal cancer dissemination. 8 These formation aspects should be pointed out to indicate the open technique in initial tumors (T1 and T2).…”

“…2,4,[6][7][8][9][10][11][12] According to studies conducted by Rucci et al, the anterior commissure and the Broyles tendon have a clearly defined plane in which the blood vessel distribution is local, superficial, and restricted to the mucosa, with late maturation of these phonatory structures. 8,9,12 This characteristic would provide slower dissemination of the neoplasm. 8 The anterior commissure is considered a barrier by many authors.…”

“…Rucci described it as a cartilaginous plane including the arytenoid medial surface, the vocal process, glands and blood vessels on the lamina propria, elastic lamina, and internal cricoarytenoid ligaments on both sides. 8,12,13 Its structures are related to the sphincter function and it has an early maturation process. Consequently, it would make the neoplasm dissemination through the posterior commissure occur in a faster and more intense manner.8 Most tumors affecting the posterior commissure are located on the posterior two thirds of the vocal folds.…”

“…1,2 The need to study the internal structures or subsites of the larynx (anterior commissure, posterior commissure, ventricle and infraglottis) since their origin, evolution, and their relation with the invasion and barrier paths to the tumor have been well documented in the literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The objective of this study was to assess the laryngeal regions and subsites of 160 patients with laryngeal carcinoma, in the period between January 1998 and December 2004. Moreover, it aimed to check the proportion of affected subsites and their influence on determining conservative or radical surgery (total laryngectomy), as well as the repercussion on local control, organ preservation and survival.…”