Nuclear protein in testis (NUT) carcinoma is a rare neoplasm arising mainly from midline structures. It is an aggressive type of carcinoma associated with poor survival despite the use of multiple treatment modalities. Here, we present a case of a 17-year-old paediatric patient with NUT carcinoma of larynx, which is even rarer among all reported cases. The patient underwent surgery followed by radiotherapy and systemic treatment and he died 15 months after the diagnosis. The management of this rare disease requires further investigation.

Background: Previous studies have assessed the capability of PRAAT for acoustic voice analysis in total laryngectomized (TL) patients, although this software was designed for acoustic analysis of laryngeal voice. Recently, we have witnessed the development of specialized acoustic analysis software, Tracheoesophageal Voice Analysis (TEVA). This study aims to compare the analysis with both programs in TL patients. Methods: Observational analytical study of 34 TL patients where a quantitative acoustic analysis was performed for stable phonation with vowels [a] and [i] as well as spectrographic characterization using the TEVA and PRAAT software. Results: The Voice Handicap Index (VHI-10) showed a mean score of 11.29 ± 11.16 points, categorized as a moderate handicap. TEVA analysis found lower values in the fundamental frequency vs. PRAAT (p < 0.05). A significant increase in shimmer values was observed with TEVA (>20%). No significant differences were found between spectrographic analysis with TEVA and PRAAT. Conclusions: Tracheoesophageal speech is an alaryngeal voice, characterized by a higher degree of irregularity and noise compared to laryngeal speech. Consequently, it necessitates a more tailored approach using objective assessment tools adapted to these distinct features, like TEVA, that are designed specifically for TL patients. This study provides statistical evidence supporting its reliability and suitability for the evaluation and tracking of tracheoesophageal speakers.

OBJECTIVE: Laryngeal cancer resections often require excision of portions of the larynx along with sacrifice of the ipsilateral recurrent laryngeal nerve (RLN). In such cases, there are no reconstructive options that reliably restore laryngeal function, rendering patients with severe functional impairment. To address this unmet clinical need, we extend our evaluation of a 3-implant mucosal, muscle, cartilage reconstruction approach aimed at promoting functional laryngeal restoration in a porcine hemilaryngectomy model with ipsilateral RLN transection.
METHODS: Six Yucatan mini-pigs underwent full-thickness hemilaryngectomies with RLN transection followed by transmural reconstruction using fabricated collagen polymeric mucosal, muscle, and cartilage replacements. To determine the effect of adding therapeutic cell populations, subsets of animals received collagen muscle implants containing motor-endplate-expressing muscle progenitor cells (MEEs) and/or collagen cartilage implants containing adipose stem cell (ASC)-derived chondrocyte-like cells. Acoustic vocalization and laryngeal electromyography (L-EMG) provided functional assessments and histopathological analysis with immunostaining was used to characterize the tissue response.
RESULTS: Five of six animals survived the 4-week postoperative period with weight gain, airway maintenance, and audible phonation. No tracheostomy or feeding tube was required. Gross and histological assessments of all animals revealed implant integration and regenerative remodeling of airway mucosa epithelium, muscle, and cartilage in the absence of a material-mediated foreign body reaction or biodegradation. Early voice and L-EMG data were suggestive of positive functional outcomes.
CONCLUSIONS: Laryngeal reconstruction with collagen polymeric mucosa, muscle, and cartilage replacements may provide effective restoration of function after hemilaryngectomy with RLN transection. Future preclinical studies should focus on long-term functional outcomes.
METHODS: NA Laryngoscope, 2024.

The larynx is in the lower respiratory tract and has the function of protecting the airways, controlling, and modulating breathing, assisting the circulatory system, and vocalizing. This study aims to describe the anatomy and histology of the skeleton of the larynx and trachea of the species Chelonia mydas, Caiman yacare and Caiman latirostris. The study was conducted at the Federal University of Espírito Santo (UFES), using nine specimens of Ch. mydas, 20 of Ca. yacare and four of Ca. latirostris. Samples of the larynx and trachea were collected, fixed, and sent for dissection of the structures and subsequent macroscopic analysis. For histology, samples were processed by the routine paraffin embedding method and stained with hematoxylin-eosin and Verhoeff. For the three species, two arytenoid cartilages, a cricoid cartilage, a hyoid apparatus composed of a base and two horns were found. In Ch. mydas, two structures called thyroid wings were observed, not found in crocodilians. The trachea of crocodilians presented incomplete tracheal rings and musculature, while the trachea of Ch. mydas presented complete tracheal rings. Histologically, the entire cartilaginous skeleton of the larynx of the three species, as well as the tracheal rings, are constituted by hyaline cartilage.

BACKGROUND: Leiomyomas (LMs) are mesenchymal tumors that arise from smooth muscle cells. LMs most commonly arise in organs with an abundance of smooth muscle such as the uterus and gastrointestinal tract. Conversely, LMs are rarely detected in the head and neck region. In this study, we report a rare case of laryngeal LM (LLM) and summarized the clinical characteristics of reported LLMs to help clinicians better understand this rare disease and improve its diagnosis, treatment, and postoperative course.
METHODS: A 49-year-old man was admitted to our ENT outpatient clinic with a chief complaint of pharynx discomfort for 2 months. Laryngoscopy performed under topical anesthesia revealed a solitary, pink mass at the tubercle of epiglottis. Surgery via laryngeal endoscopy was performed under general anesthesia, and the lesion was excised easily. Positive immunohistochemical staining for desmin and smooth-muscle actin indicated a smooth muscle origin and the diagnosis was laryngeal leiomyoma. After surgery, the patient\'s condition was stable, and he was discharged 2 d after surgery. During the 1-year postoperative period, the patient\'s condition remained stable without evidence of recurrence.
CONCLUSIONS: Surgical resection is the preferred treatment for LLMs, its early diagnosis and differential diagnosis have important clinical significance.

How we produce and perceive voice is constrained by laryngeal physiology and biomechanics. Such constraints may present themselves as principal dimensions in the voice outcome space that are shared among speakers. This study attempts to identify such principal dimensions in the voice outcome space and the underlying laryngeal control mechanisms in a three-dimensional computational model of voice production. A large-scale voice simulation was performed with parametric variations in vocal fold geometry and stiffness, glottal gap, vocal tract shape, and subglottal pressure. Principal component analysis was applied to data combining both the physiological control parameters and voice outcome measures. The results showed three dominant dimensions accounting for at least 50% of the total variance. The first two dimensions describe respiratory-laryngeal coordination in controlling the energy balance between low- and high-frequency harmonics in the produced voice, and the third dimension describes control of the fundamental frequency. The dominance of these three dimensions suggests that voice changes along these principal dimensions are likely to be more consistently produced and perceived by most speakers than other voice changes, and thus are more likely to have emerged during evolution and be used to convey important personal information, such as emotion and larynx size.

The initial treatment of open laryngeal trauma must be implemented immediately, with the primary focus on saving lives. However, in the later stages, various factors may cause changes in the structure and function of the larynx, which requires special attention. This article reports on the treatment process of a patient with depression who suffered from laryngeal trauma. Due to the late stage of laryngeal infection causing laryngeal defects, a hyoid epiglottis combined with sternocleidomastoid muscle clavicular flap repair was performed. Additionally, personalized functional exercise was performed, ultimately resulting in recovery.
摘要: 开放性喉外伤的初始救治需争分夺秒，以抢救生命为主，但后期可能会因各种因素导致喉结构及功能的改变，需要特别重视。本文报道1例抑郁症患者喉外伤的救治过程，因为后期伴有喉感染引起喉缺损行舌骨会厌联合胸锁乳突肌锁骨瓣修复，并行个体化的功能锻炼，最后痊愈。.

Objective:To investigate the therapeutic effect of laryngotracheal rupture injury and management of related complications. Methods:A retrospective analysis was conducted on 10 patients with laryngotracheal rupture injury caused by trauma, admitted between October 2014 and October 2022. Results:Anti-shock treatment, local debridement, tracheal-cricoid cartilage or tracheal-tracheal anastomosis, laryngeal cartilage reduction and fixation, local transposition flaps repair and phase-Ⅱ airway reconstruction were performed respectively on 10 patients. Nine patients underwent operations of tracheal-cricoid cartilage or tracheal-tracheal anastomosis, with five of these were performed by cartilage broken reduction and fixation, placed with intraluminal stents of iodoform gauze fingerstalls for （8.2±1.6） days. Tracheal reconstruction surgery was performed on 2 cases during phase-Ⅱ and both were placed with T-shaped silicone tube to support for 3 months. Two cases required tracheoesophageal fistula surgical repair, and vocal cord suturing was conducted for three vocal fold injuries. Anti-shock treatment was given to one emergency case and closed thoracic drainage treatment was given to another one. We removed the tracheal cannula from 10 patients after surgery and one case was diagnosed with Ⅰ-level swallowing function of sub-water test. All cases recovered to take food per-orally. Conclusion:Maintenance of circulation and respiration functions is the major target during early treatment of laryngotracheal rupture. It should strive to complete the reconstruction of airway structure on phase-Ⅰ, among which end-to-end anastomosis to reconstruct airway and broken laryngeal cartilage reduction and fixation are the vital methods for airway structure reconstruction to achieve good results. It is suggested that the reconstruction of trachea and esophagus structures should be performed simultaneously to patients with tracheoesophageal fistula.
目的：探讨喉气管断裂伤治疗效果及相关并发症处理。 方法：回顾性分析2014年10月至2022年10月收治的10例外伤导致喉气管断裂患者的治疗情况。 结果：10例患者分别采用抗休克治疗、局部清创、气管-环状软骨或气管-气管吻合以及喉部软骨复位固定、局部组织瓣修复、Ⅱ期气道重建等治疗。9例患者Ⅰ期行气管-环状软骨或气管-气管吻合手术，其中5例患者行喉软骨骨折固定复位、放置碘仿纱条指套内支撑，放置时间（8.2±1.6） d；2例患者Ⅱ期行气管重建手术，均放置T形硅胶管内支撑3个月。2例行气管食管瘘修复手术；3例声带损伤者行声带缝合术；1例患者急诊进行抗休克治疗，1例患者行胸腔闭式引流治疗。10例患者术后均拔除气管套管，1例患者洼田饮水试验吞咽功能Ⅰ级，全部患者恢复经口进食。 结论：喉气管断裂早期治疗主要维持循环和呼吸功能；喉气管断裂治疗应该争取Ⅰ期重建完整气道结构，其中端端吻合重建气道以及喉部软骨骨折复位固定是气道结构重建取得良好效果的重要手段；对于合并气管食管瘘的患者，建议同期进行气管和食管结构重建。.

BACKGROUND: The loss of laryngeal function affects breathing, swallowing, and voice, thus severely compromises quality of life. Laryngeal transplantation has long been suggested as a solution for selected highly affected patients with complete laryngeal function loss.
OBJECTIVE: To obtain insights regarding the advantages, weaknesses, and limitations of this procedure and facilitate future advances, we collected uniform data from all known laryngeal transplants reported internationally.
METHODS: A case series. Patients were enrolled retrospectively by each institutional hospital or clinic. Eleven patients with complete loss of laryngeal function undergoing total laryngeal transplantation between 1998 and 2018 were recruited.
RESULTS: After a minimum of 24 months follow-up, three patients had died (27%), and there were two graft explants in survivors, one total and one partial, due to chronic rejection. In the remaining cases, voice was functional in 62.5% and 50% achieved decannulation. Swallowing was initially restricted, but only one patient was gastrostomy-dependent by 6 months and all had normal or near-normal swallowing by the end of year two after transplantation. Median follow-up was 73 months. Functional (voice, swallowing, airway) recovery peaked between 12 and 24 months.
CONCLUSIONS: Laryngeal transplantation is a complex procedure with significant morbidity. Significant improvements in quality of life are possible for highly selected individuals with end-stage laryngeal disorders, including laryngeal neoplasia, but further technical and pharmacological developments are required if the technique is to be more widely applicable. An international registry should be created to provide better quality pooled data for analysis of outcomes of any future laryngeal transplants.
METHODS: IV Laryngoscope, 2024.

OBJECTIVE: This study aimed to compare the pharyngocutaneous fistula (PCF) between patients who underwent reconstruction using cervical fascia after total laryngectomy and those who did not and to investigate the factors affecting PCF rates.
METHODS: We retrospectively compared 22 patients operated between February 2021 and March 2023 who received cervical fascia flap as the study group and 21 patients operated between January 2018 and March 2023 who did not receive fascia flap as the control group. The study included patients who underwent total laryngectomy for Stage 3 and 4 squamous cell laryngeal cancer.
RESULTS: We included 43 patients, with 22 (51.2%) and 21 patients (48.8%) in the study and control groups, respectively. The age and sex were not different between the two groups (p = 0.471, p = 0.176, respectively). The distribution of patients as per sex, smoking, alcohol use, chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and multiple comorbidities was similar in both groups (p > 0.05). PCF was observed in one patient (4.5%) and seven patients (33.3%) in the study and control groups, respectively. The PCF rate was significantly lower in the study group (p = 0.021). When the relationship between flap use and risk factors was compared by correlation analysis, a moderate negative relationship was found between flap use and PCF (p = 0.015, r = -0.370).
CONCLUSIONS: The use of a cervical fascia flap is effective in reducing fistula rates after total laryngectomy. Its main advantages include being technically simpler than alternative techniques, locally available, cost-effective.
METHODS: Level 3 Laryngoscope, 2024.