Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for "early" glottic carcinoma classified as T1-T2N0 invading the
anterior commissure. Am J Otolaryngol 1997;18(6):385-90.
Incidence of Injury to Soft Tissue Neck Structures in Blunt and Penetrating Trauma Vascular Laryngotracheal Blunt Up to 2.7% arterial injury (13-14) 1-3% (2) Penetrating 15-25% arterial injury, 2-7% (3-4;10) 51% venous injury (4,12) Pharyngoesophageal Blunt less common than in laryngotracheal trauma (11) Penetrating 1-6% (3-4;10) Finding Management implication Bilateral RLN paralysis Protective tracheostomy
Anterior commissure disruption Primary surgical repair and laryngeal stent Stable laryngeal cartilage fracture or buckle injury ORIF and plating Comminuted, displaced (unstable) skeletal fracture(s) ORIF and laryngeal stent Cricoarytenoid dislocation, subluxation Closed reduction Epiglottis avulsion Operative repair
Cardinal extremities slightly obtuse;
anterior commissure rectimarginate.
CAPs exposure altered IBA-1 immunostaining in the
anterior commissure and hippocampus only in males (Figure 3D,E).
Abbreviations: AC =
anterior commissure, ACA = anterior cerebral artery, ahPCG = arm-hand region of precentral gyrus, BRRC = Brain Rehabilitation Research Center, CIMT = constraint-induced movement therapy, CT = computed tomography, DTT = diffusion tensor tractographic, fMRI = functional magnetic resonance imaging, MAL = Motor Activity Log, MCA = middle cerebral artery, MRI = magnetic resonance imaging, PC = posterior commissure, PVWM = periventricular white matter, SD = standard deviation, UL = upper limb, VA = Department of Veterans Affairs.
Other interhemispheric connections include the
anterior commissure which is about 50,000 fibers, as well as the posterior commissure and the hippocampal commissure, both of which are smaller even than the
anterior commissure [7,8].
In terms of survival rates, T1 tumors involving
anterior commissure demonstrate control rates of 93% as compared to 60% in T2.18
Anterior commissure laryngoplasty for adjustment of vocal fold tension.
The optimal view of the larynx that could be achieved with each blade was scored according to the Cormack and Lehane (CL) classification, and the percentage of glottic opening (POGO) score (0 to 100%, 100 = full view of glottis from
anterior commissure to the interarytenoid notch, 0=even interarytenoid notch is not seen).
By far the largest and most important fibre tract to be cut was the corpus callosum, but in early operations other tracts were also sectioned, including the
anterior commissure and the hippocampal commissure.
Although cases of presenting laryngeal metastases leading to the discovery of an underlying RCC have been reported previously,[2-5] there have been only 2 reports in the English literature of metastasis to the larynx occurring years after initial nephrectomy, both of which were not isolated recurrences.[6,7] Review of the literature has revealed only 2 reported cases in the German literature of isolated laryngeal metastasis to the
anterior commissure and the false vocal cords, both occurring 6 years after nephrectomy.[8,9] We believe this case to be the first example of an isolated intralaryngeal, supraglottic RCC metastasis, occurring 7 years after potentially curative radical nephrectomy.