Yasushi Nomura

Two cases of piriform sinus fistula which required a long time for diagnosis

Two cases of piriform sinus fistula which had contradistinctive occurrences, were reported. In case 1, a 58-year-old man suffered from the disease without having any symptom for a long time and in case 2, a 39-year-old woman had been troubled with repeated cervical abscess from 3 years old. In both cases, indirect laryngoscopy and laryngofiberscopy showed saliva pooling in the bilateral piriform sinus and barium fluoroscopy with the Valsalva maneuver revealed the fistula originating from the apex of left piriform sinus. In case 2, computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated an abscess in and around the left lobe of the thyroid. In both cases the fistulectomy was performed and their postoperative conditions have been uneventful for more than 2 years without recurrence. The etiology, cause, clinical features, diagnosis and therapy of piriform sinus fistula were reviewed.

Expression of Epithelial Membrane Antigen and Secretory Component in Carcinomas of the Laryngeal Ventricle, Epiglottis and Vocal Cord

Expression of epithelial membrane antigen (EMA) and secretory component (SC) in 11 laryngeal carcinomas from the laryngeal ventricle was studied immunohistochemically and the results were compared with findings in carcinomas originating from the epiglottis and vocal cord. EMA was almost constantly present in laryngeal carcinomas of each type, while the expression of SC was observed in 7 of 11 (64%) ventricle carcinomas, 9 of 34 (26%) carcinomas from the epiglottis and 2 of 11 (18%) carcinomas from the vocal cord. In 4 ventricle carcinomas, immunostaining for SC was intense. It would appear that some carcinomas in the laryngeal ventricle originate from cells of the secretory glandular acini or the epithelium.