OBJECTIVE: Review of the scientific medical literature dedicated to clinical data, diagnosis and treatment for laryngeal tuberculosis published since the turn of the 21st century.
METHODS: Search of the Medline, Cochrane and Embase databases for the period 2000-2022. Selection of cohorts and case reports documenting clinical data, diagnosis and treatment for laryngeal tuberculosis.
RESULTS: In total, 119 articles were analyzed. Immunodepression, HIV infection, history of lung tuberculosis, general symptoms suggesting tuberculosis, smoking and associated laryngeal cancer were noted in 18%, 3%, 20% and 41% of cases, respectively. No pathognomonic symptoms or signs emerged. Voice impairment, of various types and severity, isolated and/or associated with other signs, was the most frequent laryngeal symptom, in 86% of cases. All laryngeal sites were involved, with numerous and various associations. Impaired laryngeal motion and tracheotomy were noted in 6% and 1% of cases, respectively. Time to diagnosis varied from less than 1month to 36months, for a median 3months, in case reports. Laryngeal tuberculosis was diagnosed bacteriologically with certainty in 28% of cases while diagnosis was based on indirect criteria and/or involvement of another site in the other 72%, with lung involvement in 54%. Treatment duration ranged from 6 to 24months (median, 6months), using 3 to 5 (median: 4) antitubercular antibiotics, with 4 used in 80% of cohorts and 77% of case reports. Overall rates of cure, death, treatment resistance, adverse events, and laryngeal sequelae were 99%, 0.5%, 0.5%, 6% and 5%, respectively.
CONCLUSIONS: The clinical presentation and diagnostic difficulty in laryngeal tuberculosis did not change since the end of the 20th century. Quadritherapy is highly effective, with a low resistance rate and few adverse effects or laryngeal sequelae.

OBJECTIVE: The objective of this work was to gather an international consensus group to propose a global definition and diagnostic approach of laryngopharyngeal reflux (LPR) to guide primary care and specialist physicians in the management of LPR.
METHODS: Forty-eight international experts (otolaryngologists, gastroenterologists, surgeons, and physiologists) were included in a modified Delphi process to revise 48 statements about definition, clinical presentation, and diagnostic approaches to LPR. Three voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 8/10. Votes were anonymous and the analyses of voting rounds were performed by an independent statistician.
RESULTS: After the third round, 79.2% of statements (N = 38/48) were approved. LPR was defined as a disease of the upper aerodigestive tract resulting from the direct and/or indirect effects of gastroduodenal content reflux, inducing morphological and/or neurological changes in the upper aerodigestive tract. LPR is associated with recognized non-specific laryngeal and extra-laryngeal symptoms and signs that can be evaluated with validated patient-reported outcome questionnaires and clinical instruments. The hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing can suggest the diagnosis of LPR when there is >1 acid, weakly acid or nonacid hypopharyngeal reflux event in 24 h.
CONCLUSIONS: A global consensus definition for LPR is presented to improve detection and diagnosis of the disease for otolaryngologists, pulmonologists, gastroenterologists, surgeons, and primary care practitioners. The approved statements are offered to improve collaborative research by adopting common and validated diagnostic approaches to LPR.
METHODS: 5 Laryngoscope, 134:1614-1624, 2024.

Pediatric vocal ford paralysis is a vocal cord movement disorder caused by damage to the pediatric laryngeal motor nerves.It is mainly characterized by voice, breathing,and swallowing difficulties,and in severe cases,it can lead to choking in affected children. Currently, the diagnosis and treatment of this condition pose a significant challenge for pediatric otolaryngologists, as the goal is to minimize damage to the vocal folds and laryngeal framework.In order to standardize the diagnosis and treatment of pediatric vocal cord paralysis, the Pediatric Otolaryngology Committee of the Chinese Medical Association,in collaboration with multiple children\'s medical centers nationwide, have formulated this consensus document.
摘要: 儿童声带麻痹是小儿喉运动神经损伤导致的声带运动障碍，主要表现为发声、呼吸和吞咽功能障碍，严重可导致患儿窒息。目前对该疾病采取何种诊治方式，最大程度地减少对声门和喉框架结构的破坏，是小儿耳鼻喉科医师面临最棘手的问题。因此，为规范儿童声带麻痹的诊治，中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会联合全国多家儿童医疗中心特制定本共识。.

Congenital laryngeal cleft is a rare airway malformation, mainly manifested as choking, feeding difficulties, which affects the growth and development of children. Patients with a severe laryngeal cleft may have recurrent aspiration, leading to cyanotic spells, or even death. Advances in development of endoscopic techniques have made early diagnosis possible. Depending on the degree of cleft, management may involve a variety of approaches ranging from medical management alone to open repair. Therefore, it is important for pediatric ENT doctors to diagnose and evaluate in clinical practice. This consensus statement, developed by the Pediatric otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance on diagnosis and management of laryngeal cleft, based on symptomatology, physical examinations, and laboratory tests.
摘要: 先天性喉裂是一个罕见的气道畸形，主要表现为呛咳、喂养困难等，影响患儿的生长发育；严重的喉裂可以表现为严重的呛咳误吸，导致阵发性青紫，甚至死亡。随着内镜技术的发展，使得喉裂可以被早期发现和诊断。不同类型的喉裂治疗方案差异较大，早期的诊断与评估对于儿童耳鼻喉科医生至关重要。中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会联合全国多家儿童医疗中心讨论拟定诊治共识，从症状学、客观检查等方面给出喉裂的诊断治疗方案，为临床规范化诊疗提供指导性意见。.

The treatment of glottic cancer remains challenging, especially with regard to morbidity reduction and larynx preservation rates. The National Comprehensive Cancer Network (NCCN) has published guidelines to aid decision-making about this treatment according to the tumor site, clinical stage, and patient medical status.
The present review was conducted to identify changes in the NCCN guidelines for glottic cancer treatment made between 2011 and 2022 and to describe the published evidence concerning glottic cancer treatment and oncological outcomes in the same time period.
Clinical practice guidelines for head and neck cancer published from 2011 up to 2022 were obtained from the NCCN website (www.NCCN.org). Data on glottic cancer treatment recommendations were extracted, and descriptive analysis was performed. In addition, a review of literature registered in the PubMed database was performed to obtain data on glottic cancer management protocols and treatment outcomes from randomized controlled trials, systematic reviews, and meta-analyses published from 2011 to 2022. In total, 24 NCCN guidelines and updates and 68 relevant studies included in the PubMed database were identified. The main guideline changes made pertained to surgical and systemic therapies, the consideration of adverse features, and new options for the treatment of metastatic disease at initial presentation. Early-stage glottic cancer received the most research attention, with transoral endoscopic laser surgery and radiotherapy assessed and compared as the main treatment modalities. Reported associations between treatment types and survival rates for this stage of glottic cancer appear to be similar, but functional outcomes can be highly compromised.
NCCN panel members provide updated recommendations based on currently accepted treatment approaches for glottic cancer, constantly reviewing new surgical and non-surgical techniques. The guidelines support decision-making about glottic cancer treatment that should be individualized and prioritize patients\' quality of life, functionality, and preferences.

OBJECTIVE: To establish a consensus protocol for telerehabilitation in speech therapy for voice disorders.
METHODS: The study was conducted according to a modified Delphi method. Twenty speech therapist or laryngologist experts of the French Society of Phoniatrics and Laryngology assessed 24 statements of voice telerehabilitation with a 10-point visual analog scale ranging from 1 (totally disagree) to 10 (totally agree). The statements were accepted if more than 80% of the experts rated the item with a score of ≥ 8/10. The statements with ≥ 8/10 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected.
RESULTS: The French Society of Phoniatrics and Laryngology experts validated 10, 6, and 2 statements after the first, second and third voting round, respectively. Seven statements did not reach agreement threshold and were rejected. The validated statements included recommendations for setting (N = 4), medical/speech history (N = 2), subjective voice evaluations (N = 3), objective voice quality measurements (N = 3), and voice rehabilitation (N = 5). The experts agreed for a follow-up consisting of combined telerehabilitation and in-office rehabilitation. The final protocol may be applied in context of pandemic but could be assessed out of pandemic period for patients located in rural regions.
CONCLUSIONS: This Delphi study established the first telerehabilitation protocol of the French Society of Phoniatrics and Laryngology for patients with voice disorders. Future controlled studies are needed to assess its feasibility, reliability, and the patient perception about telerehabilitation versus in-office rehabilitation.

OBJECTIVE: Analysis and comparison of clinical guidelines (CG) on malignant neoplasms of the respiratory system, placed in the CG rubricator of the Ministry of Health of Russia, for the information they contain on the role of factors and working conditions of the working environment in the etiology of respiratory diseases, including the upper respiratory tract, and comparison this information with published and regularly updated data from the International Agency for Research on Cancer (IARC).
METHODS: Clinical recommendations from the heading of the Ministry of Health of Russia \"Cancer of the laryngopharynx\", \"Cancer of the nasopharynx\", \"Cancer of the oropharynx\", \"Cancer of the nasal cavity and paranasal sinuses\", \"Cancer of the larynx\", \"Cancer of the trachea\", \"Cancer of the lung\", and IARC data according to the List of Classifications by cancer sites with sufficient or limited evidence in humans dated 11/29/2019.
RESULTS: The low level of registration of occupational cancer of the upper respiratory tract in Russia is due to an inadequate system of criteria for detecting this form of occupational pathology, a long latency period of diseases, and insufficient assessment of the history of information on the potential role of occupational carcinogens. The CGs developed to optimize the diagnosis and treatment of malignant neoplasms of the respiratory system do not contain up-to-date information on the role of professional potential carcinogens in the genesis of malignant neoplasms.
CONCLUSIONS: Recognition of the professional nature of malignant neoplasms of the respiratory system implies, firstly, strengthening the role of otorhinolaryngologists in early diagnosis and rehabilitation of patients, and secondly, it has a pronounced preventive focus in the form of tasks facing the employer to reduce the carcinogenic load and develop preventive measures aimed to reduce and prevent the development of malignant tumors in workers, including the respiratory system.
UNASSIGNED: Анализ клинических рекомендаций (КР) по злокачественным новообразованиям органов дыхания, размещенных в рубрикаторе КР Минздрава России, на предмет содержащихся в них сведений о роли факторов и условий труда рабочей среды в этиологии заболеваний органов дыхания, в том числе верхних дыхательных путей, и сопоставление этих сведений с публикуемыми и регулярно обновляемыми данными Международного агентства по изучению рака (МАИР).
UNASSIGNED: Изучены клинические рекомендации из рубрикатора Минздрава России «Рак гортаноглотки» «Рак носоглотки», «Рак ротоглотки», «Рак полости носа и придаточных пазух», «Рак гортани» «Рак трахеи», «Рак легкого» и данные МАИР по List of Classifications by cancer sites with sufficient or limited evidence in humans от 29.11.19.
UNASSIGNED: Низкий уровень регистрации профессионального рака верхних дыхательных путей в России обусловлен неадекватной системой критериев выявления данной формы профессиональной патологии, длительным латентным периодом заболеваний, недостаточной оценкой имеющейся в анамнезе информации о потенциальной роли производственных канцерогенов. Разрабатываемые с целью оптимизации диагностики и лечения злокачественных новообразований органов дыхания КР не содержат актуальных сведений о роли профессиональных потенциальных канцерогенов в генезе злокачественных новообразований.
UNASSIGNED: Признание профессионального характера злокачественных новообразований органов респираторной системы подразумевает, во-первых, усиление роли специалистов оториноларингологов в вопросах ранней диагностики и реабилитации пациентов, во-вторых, носит выраженную профилактическую направленность в виде встающих перед работодателем задач по снижению канцерогенной нагрузки и разработке превентивных мер, направленных на снижение и профилактику развития у работников злокачественных опухолей, в том числе органов дыхания.

暂无摘要。

BACKGROUND: The modern availability in daily practice of different DICOM viewers allows physicians to routinely evaluate computed tomography (CT) and magnetic resonance (MR) scans of patients in the pre-, intra-, and postoperative settings. Their systematic use, together with a close surgeon-radiologist cooperation, may greatly improve outcomes of patients to be treated by transoral microsurgery for laryngeal cancer.
METHODS: We herein propose guidelines for systematic evaluation of CT/MR images taken from patients affected by supraglottic and glottic cancer to be treated by transoral microsurgery.
RESULTS: A methodical, step-by-step approach focused on laryngeal anatomy, systematically looking at each true and false vocal folds, anterior commissure, laryngeal ventricle, subglottic area, epiglottis, thyroid, cricoid, and arytenoid cartilages, posterior commissure, crico-arytenoid unit, paraglottic and pre-epiglottic spaces, and possible extra-laryngeal extension is proposed. This checklist may be useful before imaging performance (to focus on specific issues to be detailed by the radiologist), as well before and during surgery for the specific evaluation of details to be cleared during transoral microsurgery.
CONCLUSIONS: Detailed preoperative evaluation of supraglottic and glottic anatomy is essential prior to any transoral approach for neoplastic disease. The proposed imaging checklist described herein represents a step-by-step guide to surgeons performing this kind of interventions and an aid in achieving a meticulous approach from a surgical perspective.

UNASSIGNED: Three methods have been recently proposed for the delineation of the primary tumor clinical target volume (CTV-P) in Head and Neck Cancers: the anatomic method popularized in the French literature by Lapeyre et al. the geometric methods proposed by the DAHANCA group, and more recently the international guidelines promoted by Grégoire et al. integrating the latter two. The aim of this study was to perform a volumetric and dosimetric comparison of the French and the International consensus methods in laryngeal SCC.
UNASSIGNED: Two radiation oncologists independently delineated the high dose and low dose primary tumor CTV in four patients with T2 or T3 N0-M0 laryngeal SCC following either the so-called French guidelines or the International guidelines. For the 4 cases, the GTV was delineated by a single radiation oncologist. Nodal CTVs were delineated by one radiation oncologist for the 4 cases using International guidelines. Dose optimization was then performed with VMAT (MONACO version 5.11) using 6 MeV photons. Differences in target volumes and dose distributions in OARs and PTVs were then evaluated with various metrics such as the DICE Similarity Coefficient and the homogeneity index.
UNASSIGNED: Major differences were observed in the CTV delineation between the 2 delineation methods for the low dose volumes and to a lower extend for the high dose volumes. These differences translated into variations in dose distribution favoring the International guidelines for decreasing dose to various OARs. Such differences toned down when dose distribution on the primary tumors PTVs and nodal PTVs were combined.
UNASSIGNED: This study demonstrated large differences in CTV delineation between the 2 delineation guidelines. Such differences translated into differences in dose distribution.