Clinical Embryology of Human Larynx for Conservative Compartmental Surgery. A Text and Atlas E-Book

Lucio Rucci

• Herausgeber: Firenze University Press
• Kategorie: Fachliteratur
• Sprache: Englisch
• Veröffentlichungsjahr: 2014

Beschreibung

The volume shows the morphogenesis and differentiation of the human larynx during the fetal period. This knowledge is relevant to understand laryngeal functions as well as the diffusion of cancer and the therapy of low stage cancer. Through embryological analysis, the anatomical basis of laryngeal functions may be best recognized and consequent indications may be given to perform conservative compartmental surgery. Each chapter of the volume describes a developmental step and compares the findings with the adult condition. Introductory remarks and comments to each chapter are completed by captions to individual figures, so that the text and images are offered to the reader as a single unit. He has authored several full papers, including papers on journals with impact factor, and presentations at scientific meetings. Lucio Rucci, MD and specialist in Otorhinolaryngology, Audiology and Dentistry; is associate professor of Otorhinolaryngology and co-ordinates the PhD course in surgical oncology of the head and neck, at the University of Florence.His main research and clinical interests are the surgical therapy of laryngeal cancer, the clinical embryology of the larynx and the microscopical and endoscopical surgery of the nose and paranasal sinuses.He has authored several full papers, including papers on journals with impact factor, and presentations at scientific meetings.

Leseprobe

Manuali

Biomedica

– 8 –

Clinical Embryology of Human Larynx for Conservative Compartmental Surgery

A Text and Atlas

by Lucio Rucci

Firenze University Press

2014

Clinical Embryology of Human Larynx for Conservative Compartmental Surgery : A Text and Atlas / Lucio Rucci. – Firenze : Firenze University Press, 2014.

(Manuali. Biomedica ; 8)

http://digital.casalini.it/9788866555865

ISBN 978-88-6655-582-7 (print)

ISBN 978-88-6655-586-5 (online PDF)

ISBN 978-88-6655-590-2 (online EPUB)

***

Peer Review Process

All publications are submitted to an external refereeing process under the responsibility of the FUP Editorial Board and the Scientific Committees of the individual series. The works published in the FUP catalogue are evaluated and approved by the Editorial Board of the publishing house. For a more detailed description of the refereeing process we refer to the official documents published in the online catalogue of the FUP (http://www.fupress.com).

Firenze University Press Editorial Board

G. Nigro (Co-ordinator), M.T. Bartoli, M. Boddi, R. Casalbuoni, C. Ciappei, R. Del Punta, A. Dolfi, V. Fargion, S. Ferrone, M. Garzaniti, P. Guarnieri, A. Mariani, M. Marini, A. Novelli, M. Verga, A. Zorzi.

© 2014 Firenze University Press

Università degli Studi di Firenze

Firenze University Press

Borgo Albizi, 28, 50122 Firenze, Italy

http://www.fupress.com/

Printed in Italy

Florence, February 2014 …to Andrea and Anna…

Clinical Embryology of Human Larynx

for Conservative Compartmental Surgery

A Text and Atlas

Lucio Rucci

With a participation of

Paolo Romagnoli

Full professor of Histology

University of Florence

Thanks are given to

Dr. Giuditta Mannelli for assistance in text and figure editing

Dr. Franca Maria Colonna,

for technical assistance in the preparation of microscopic slides

Preface

Oncologic surgery of the head and neck has always been a strength point of Oto-Rhino-Laryngology in Florence. This tradition is well illustrated by the names of Bono Simonetta and Ettore Alajmo, whom I devotedly remind, and has been followed by Lucio Rucci, who has been Associate Professor of Oto-Rhino-Laryngology in the Faculty of Medicine and Surgery of the University of Florence and has especially devoted himself to the conservative surgery of the head and neck.

Clinical Embryologycould appear like an oxymoron to most of practising physicians.Namely, Embryology represents a basic science and the clinical side of Medicine usually is related to description, discussion and management of clinical pictures, and depicts in detail individual patients by elements very far from those of basic science. However, embryology represents a very valuable tool to address surgical strategies aimed to perform at best theconservative surgery of the head and neck.

Such a perspective is reflected in this Text and Atlas of Clinical Embryology of the Larynx, where the primordia and furtherdevelopment of laryngeal structures are studied as a function oftheir functions and clinical implications andtherefore as a premise to perform conservative surgery for T1 and T2 glottic cancer.

Conservative surgery is often a valuable alternative to supracricoid subtotal laryngectomy for T1 and T2 glottic cancer which have escaped control by laser therapy. Supracricoid subtotal laryngectomy on the contrary is often used nowadays as salvage surgery when a first intervention fails to achieve eradication of tumour.

Supracricoid subtotal laryngectomy in T1 and T2, i. e.low class glottic cancer, leads to loss of severalfunctions of the larynx, which is disproportionate to thetumour class. Randomized clinical studies have shown that therapeutic controlof T1 and T2 laryngeal tumours can be effectively achieved even with conservative, endoscopic or open surgery.

In this perspective, Lucio Rucci’s Text and Atlas is of great value and shows how the study of organogenesiscan help the clinicians by improving the knowledge of glotticsite anatomy and of the clinical meaning of the structures in this site. By studying the embryonic larynx one can recognize the individualstructures and their reciprocal relationships since their first appearance; these in turnare relevant from the oncologic standpoint and may bedifficult to appraise by looking only at the adult larynx.

In this Text and Atlas, the clinical embryology of the glottic region of the larynx highlights the anatomical bases of tumour spreadingand of laryngeal functions and allows to recognize which structures, organized into functional compartments, may represent obstacles or alternatively spreading pathways to laryngeal cancer.

Lucio Rucci’s highly appreciable, constant and fruitful application to these studiesis highly relevant, since it is precisely theanalysis of laryngeal structures during ontogenesis which leads to setthe premises and indications for compartmental conservative surgery for T1 and T2 glottic cancer.

This Text and Atlas isthe fruit of intense labour, inspired by deep devotion to appliedresearch, which has allowed Lucio Rucci to create thisimportant instrument for clinical activity and teaching and to offer highly relevantindications for clinical applications designed to improve the quality of life of operated patients.

Therefore, it is my pleasure to acknowledge thefruitful work of Lucio Rucci, deeply sure that this Textand Atlas will provide very useful support both tostudents and fellows and to surgeons to better face the problems of conservative surgery of the head and neck.

Gian Franco Gensini

Dean of the Faculty of Medicine and Surgery of the University of Florence

Foreword

The mainstay of the management of the laryngeal neoplastic diseases is surgery. Albeit the laryngectomy is indicated for most advanced laryngeal cancers, nowadays the surgical approach for the treatment of early laryngeal neoplasms includes several procedures in order to spare one of the most important laryngeal function, that is the voice. Historically, the University of Florence is devoted to the conservative surgery of the larynx, and this devotion has been continuously perpetuated training surgeons. Moreover, an advanced surgical training should be cover all aspects of the diseases, reminding that a neoplastic disease involves and destroys important anatomical structures for laryngeal functions.

This book illustrates theembryological development of the larynx in a clinicaland a surgical view. This new perspective contributesto ameliorate the knowledges of everyhead & neck surgeon who is interested in conservative laryngealsurgery. The clinical based evidence revealing the naturalcourse of events determinated by the cancer, but a complete knowledge of the development of the larynx addresses the surgeon performing a conservative approach. The embryological study of the larynx performed by prof. Lucio Rucci,in the clinical and the surgical point of views, has the intentionto highlight the principal steps ofthe embryological development in order to understand the spreadpathways of the cancer and subsequently to conduct the decision processes of every head & neck surgeon.

The best conservative laryngeal surgery, either transoral and open, primary or salvage, is generated by the best knowledge ofthe laryngeal anatomical structures. In this book, thelaryngeal embryology described fits well in this framework.

The exact knolewdgeof pathway of spreading into laryngeal framework is crucialto spare central anatomical structures responsible for phonatory, respiratory and sphynteric laryngeal functions.

This work startingfrom the embriology throught the anatomy is ableto clearly elucidate why the cancer involves some structures sparing others,thus contributing to perform endoscopic and conservative surgical approaches able to safe patient avoiding permanent tracheostomy with a near-normal voice.

Therefore, I am sure that this book isa milestone work for not only anatomist butparticularly for laryngologist able to diagnose and treat laryngeal benign and malignant diseases.

Prof. Oreste Gallo

Chief Otolaryngology University Clinic

University of Florence