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Staging of Head and Neck Cancer
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The hypopharynx extends from the superior border of the hyoid bone to the lower border of the cricoid cartilage. It includes the piriform sinuses, the postcricoid area, and the lateral and posterior pharyngeal walls. The postcricoid area (pharyngo-oesophageal junction) extends from the level of the arytenoid cartilages and connecting folds to the inferior border of the cricoid cartilage, thus forming the anterior wall of the hypopharynx.Piriform sinus extends from the pharyngo-epiglottic fold to the upper end of the oesophagus. It is bounded laterally by the thyroid cartilage and medially by the hypopharyngeal surface of the aryepiglottic fold and the arytenoid and cricoid cartilages.Posterior pharyngeal wall extends from the superior level of the hyoid bone (or floor of the vallecula) to the level of the inferior border of the cricoid cartilage and from the apex of one piriform sinus to the other.
Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
The valleculae are cup shaped spaces, separated by the median glossoepiglottic fold, posterior to the base of the tongue and anterior to the epiglottis. To the right and to the left of the larynx are the piriform sinuses, gutter-like structures that direct food to the esophagus.
Head and neck surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Cysts and sinuses of the third and fourth branchial pouch are clinically similar because of their common origin in the piriform fossa and presentation as a neck or thyroid abscess. Exploration of the neck with excision of the entire tract to the level of the piriform sinus is necessary to prevent recurrence. Operative endoscopy at the start of the operation may enable cannulation of the tract from above, which greatly facilitates localization of the tract during resection. Once the cyst and tract are resected, the histological finding of squamous cell epithelial lining confirms the diagnosis of a branchial anomaly.
Regularity of voice recovery and arytenoid motion after closed reduction in patients with arytenoid dislocation: a self-controlled clinical study
Published in Acta Oto-Laryngologica, 2020
Tingting Zheng, Zhewei Lou, Xiaxia Li, Yaoshu Teng, Yun Li, Xiaojiang Lin, Zhihong Lin
All patients were received oropharyngeal and laryngopharyngeal mucosa surface anesthesia before closed reduction under indirect laryngoscope. All operations were implemented by the same doctor. Laryngeal forceps were placed on the outside of arytenoid cartilage, inside of the pyriform sinus, immersed to the bottom of the pyriform sinus. Anterior dislocations were reduced with posterior-upward push on the arytenoids during phonation and posterior dislocations with anterior–upward push during inspiration. The procedure was performed no more than three times, repeated after one week unless the bilateral arytenoid cartilage was almost symmetrical, bowed vocal fold straighten in anterior dislocations and both vocal folds were of equal length in posterior dislocations. The patients were encouraged to talk more and make a voice while shaking the neck larynx from left to right. All patients tolerated the procedure well.
A case of idiopathic thyroid abscess caused by Escherichia coli
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Gurbaj Singh, Radhika Jaiswal, Neha Gulati, Elizabeth Campbell Granieri
Once the diagnosis is established, treatment should be started immediately with antibiotics to avoid progression. Parenteral antibiotics alone are usually not sufficient to treat the abscess and surgical drainage is required in most cases, be it open surgical drainage or a more minimally invasive incision and drainage [2,15]. Needle aspiration under ultrasound guidance is reported to be successful in certain cases as well. Another alternative approach is placement of a percutaneous drainage catheters via either CT or sonographic guidance; this may be considered in simple abscesses with no loculations [14]. Surgical drainage may also afford the opportunity for management of predisposing anatomic factors at the same time to avoid recurrence. The pyriform sinus may be resected or obliterated during the surgery [16].
The impact of surgical margin status on the outcomes of locally advanced hypopharyngeal squamous cell carcinoma treated by primary surgery
Published in Acta Oto-Laryngologica, 2018
Min Li, Ming Xie, Liang Zhou, Shuyi Wang
A total of 205 patients were enrolled in the present study for analysis. The entire population was followed up for 1–131 months up to the end of December 2016, with a median time of 26 months. All the patients were men. The median age of patients at diagnosis was 61 years, ranging from 39 to 82 years. Of the 205 patients, 129 (62.9%) had clear surgical margins and 76 (37.1%) had close surgical margins. The clinicopathological profiles between the two groups are listed in Table 1. The pyriform sinus was the principal subsite of involvement. Tumors in the nSM group had prevalent involvement of the posterior pharyngeal wall and worse histological differentiation characteristics compared to those in the cSM group. T3 tumors predominated in the cSM group (42.1%), while T2 in the nSM group (49.6%). Age, gender, pN classification, clinical stage and occurrence of vascular embolism were not significantly different between the two groups.