Objectives: 1) Basic anatomical information to guide the surgeon in oncologically-safe methods of resecting portions of the larynx and pharynx when these areas are invaded by cancer; 2) A more precise system of clinical staging of laryngeal and hypopharyngeal cancer; this objective is essential for accurate comparison of treatment results among various treatment centers; 3) Demonstration of patterns of ossification within the laryngeal framework to clarify preoperative appearances of the larynx and hypopharynx on CT scan or NMR studies; correlations of this type are essential in interpreting pre-treatment appearances of the lesion, and allow a more appropriate selection of treatment on the basis of tumor volume, invasion of the laryngeal framework, pre-epiglottic space and subglottic area; 4) Studies of tumor angiogenesis factors in laryngeal cancer and their relation to patterns of invasion. Methods: The preoperative appearance of each patient's neoplasm as demonstrated by laryngoscopy, CT scan, and NMR study will be compared with the lesion's appearance in whole-organ serial section studies prepared in celloidin and Paraplast. These allow the identification of variations in soft-tissue densities seen on preoperative radiographic and magnetic resonance studies. A permanent record is kept on the patient's preoperative symptoms, clinical findings, and patterns of growth and spread of cancer as seen in the serially-sectioned larynx. Correlations of this type should provide more precise diagnosis of individual lesions, allowing better selection of appropriate treatment, and allowing the preservation of the functions of voice, airway protection and respiratory tract patency when the lesion is treated surgically.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA022101-11
Application #
3165716
Study Section
Hearing Research Study Section (HAR)
Project Start
1977-09-30
Project End
1989-11-30
Budget Start
1987-12-01
Budget End
1989-11-30
Support Year
11
Fiscal Year
1988
Total Cost
Indirect Cost
Name
Yale University
Department
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Zeitels, S M; Kirchner, J A (1995) Hyoepiglottic ligament in supraglottic cancer. Ann Otol Rhinol Laryngol 104:770-5
Zeitels, S M; Vaughan, C W (1991) Preepiglottic space invasion in ""early"" epiglottic cancer. Ann Otol Rhinol Laryngol 100:789-92
Isaacson, G; Kim, J H; Kirchner, J C et al. (1990) Histology of Isshiki thyroplasty type I. Ann Otol Rhinol Laryngol 99:42-5
Kirchner, J A (1989) Fifteenth Daniel C. Baker, Jr, memorial lecture. What have whole organ sections contributed to the treatment of laryngeal cancer? Ann Otol Rhinol Laryngol 98:661-7
Kirchner, J C; Kirchner, J A; Sasaki, C T (1989) Anatomic foramina in the thyroid cartilage: incidence and implications for the spread of laryngeal cancer. Ann Otol Rhinol Laryngol 98:421-5
Krespi, Y P; Meltzer, C J (1989) Laser surgery for vocal cord carcinoma involving the anterior commissure. Ann Otol Rhinol Laryngol 98:105-9
Dyess, C L; Carter, D; Kirchner, J A et al. (1987) A morphometric comparison of the changes in the laryngeal skeleton associated with invasion by tumor and by external-beam radiation. Cancer 59:1117-22
Kirchner, J A; Carter, D (1987) Intralaryngeal barriers to the spread of cancer. Acta Otolaryngol 103:503-13
Souliere Jr, C R; Kirchner, J A (1985) Laryngeal perichondritis and abscess. Arch Otolaryngol 111:481-4