The Laryngoscope
-
In recent years the cochlear implant has been a subject of much discussion and controversy. The clinician has often been confused by the conflicting reports of success and failure. In this paper the development of the cochlear implant is reviewed and its present status summarized. ⋯ These patients have all benefited from their devices. They are able to perceive background sounds and receive a cadence or rhythm to speech which makes the device helpful in lipreading. None of the patients have developed significant speech discrimination.
-
Supraglottic cancer, because of the embryological development of the larynx, and of the arrangement of its lymphatic network, tends to remain limited within the vestibule of the larynx and the pre-epiglottic space also in its advanced stages of evolution. The cancer spread may superiorly involve the epilarynx, the vallecula, the base of the tongue, and the pyriform fossa; however, inferiorly, the invasion of the glottis is quite exceptional (1 percent of cases); therefore, supraglottic laryngectomy is the operation of choice. The lower the location of cancer in the vestibule, the safer the indication. ⋯ Five postoperative deaths have been recorded. Rehabilitation time for the breathing and swallowing function has been three weeks as an average. Complications, such as fistula or infection have been exceedingly rare: uneventful recovery followed in all cases.
-
Equipment is described for mirror and open tube direct laryngoscopic photography. It consists of specially constructed reflex camera systems that provide adequate exposure and depth of the desired field, sharpness of focus, correct color and effective composition for meaningful illustrations. ⋯ It is stressed that the laryngologist himself must be the photographer. The pictures are adjuncts to case recording, are supportive evidence of investigative work and may be used as chronologic sequences in study of physiology and pathology and in pre- and postoperative evaluation.
-
A compilation of late and early symptoms of patients who ultimately were found to have laryngeal disease was carried out. Notation of even minor changes in the indirect laryngoscopic appearance of the same patients was made routinely. Correlation of symptoms with signs has made possible a better understanding of the natural history of certain laryngeal lesions such as contact ulcer, polyps, nodes, dysphonia plica ventricularis as well as some of the pareses, paralyses and fixations. ⋯ The expanded list of symptoms (33 in number) and the detailed list of signs (54 in number) may now assist the Otolaryngologist in earlier diagnosis. Although the reported findings are not specifically diagnostic of cancer of the larynx, they should draw earlier attention to the larynx as the etiological site of such symptoms. Earlier recognition of minor laryngeal changes, as detailed in the text, should lead to earlier biopsy and tissue diagnosis, earlier and more enlightened public awareness, and earlier and, therefore, more effective utilization of present day day modalities in the management of carcinoma of the larynx.