The goal is to provide information on: (1) premalignant changes distant from the primary growth; (2) infection and lymphocytic infiltration in and around the primary lesion; (3) patterns of vascularization in the neoplasm, particularly as related to the ossified and nonossified parts of the laryngeal framework; and (4) natural barriers within the larynx which limit the spread of cancer. Celloidin sections are cut at about 20 microns and will be limited to those areas of the head and neck in which the growth and spread of cancer have not yet been adequately described. These areas include the pyriform sinus and the posterior part of the larynx. Paraffin sections are cut at about 8 microns and will be done for cancer in part of the larynx other than those mentioned above. The characteristics of growth and spread of cancer within the larynx are now being computerized so that over 375 surgical specimens that have been sectioned in celloidin will now be available for quick analysis of features such as invasion of the laryngeal framework, anatomical barriers within the larynx, premalignant changes in other parts of the larynx distant from the primary growth, types of vascularization around the tumor, ossification patterns, etc. There has been an increase in the number of specimens being processed in Paraplast as compared with celloidin. This is partly because of the inordinate increase in the cost of celloidin and partly because we have succeeded in obtaining wrinkle-free sections in Paraplast at various thicknesses. Correlation of the preoperative characteristics of a lesion with its CT scan and its appearance on serial section also is being studied. Patterns of invasion of the laryngeal framework can be observed preoperatively by CT scan and are being compared with survival rates. (4)
