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1.
Proc Natl Acad Sci U S A ; 121(21): e2316799121, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38753511

RESUMEN

The mammalian brain implements sophisticated sensory processing algorithms along multilayered ("deep") neural networks. Strategies that insects use to meet similar computational demands, while relying on smaller nervous systems with shallow architectures, remain elusive. Using Drosophila as a model, we uncover the algorithmic role of odor preprocessing by a shallow network of compartmentalized olfactory receptor neurons. Each compartment operates as a ratiometric unit for specific odor-mixtures. This computation arises from a simple mechanism: electrical coupling between two differently sized neurons. We demonstrate that downstream synaptic connectivity is shaped to optimally leverage amplification of a hedonic value signal in the periphery. Furthermore, peripheral preprocessing is shown to markedly improve novel odor classification in a higher brain center. Together, our work highlights a far-reaching functional role of the sensory periphery for downstream processing. By elucidating the implementation of powerful computations by a shallow network, we provide insights into general principles of efficient sensory processing algorithms.


Asunto(s)
Odorantes , Neuronas Receptoras Olfatorias , Olfato , Animales , Odorantes/análisis , Neuronas Receptoras Olfatorias/fisiología , Olfato/fisiología , Drosophila melanogaster/fisiología , Algoritmos , Drosophila/fisiología , Vías Olfatorias/fisiología , Modelos Neurológicos , Red Nerviosa/fisiología
2.
Annu Rev Neurosci ; 40: 327-348, 2017 07 25.
Artículo en Inglés | MEDLINE | ID: mdl-28441115

RESUMEN

Animals are born with a rich repertoire of robust behaviors that are critical for their survival. However, innate behaviors are also highly adaptable to an animal's internal state and external environment. Neuromodulators, including biogenic amines, neuropeptides, and hormones, are released to signal changes in animals' circumstances and serve to reconfigure neural circuits. This circuit flexibility allows animals to modify their behavioral responses according to environmental cues, metabolic demands, and physiological states. Aided by powerful genetic tools, researchers have made remarkable progress in Drosophila melanogaster to address how a myriad of contextual information influences the input-output relationship of hardwired circuits that support a complex behavioral repertoire. Here we highlight recent advances in understanding neuromodulation of Drosophila innate behaviors, with a special focus on feeding, courtship, aggression, and postmating behaviors.


Asunto(s)
Conducta Animal/fisiología , Encéfalo/fisiología , Neuropéptidos/fisiología , Neurotransmisores/fisiología , Agresión/fisiología , Animales , Drosophila , Conducta Alimentaria/fisiología , Conducta Sexual Animal/fisiología
3.
Proc Natl Acad Sci U S A ; 119(5)2022 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-35091473

RESUMEN

A hallmark of complex sensory systems is the organization of neurons into functionally meaningful maps, which allow for comparison and contrast of parallel inputs via lateral inhibition. However, it is unclear whether such a map exists in olfaction. Here, we address this question by determining the organizing principle underlying the stereotyped pairing of olfactory receptor neurons (ORNs) in Drosophila sensory hairs, wherein compartmentalized neurons inhibit each other via ephaptic coupling. Systematic behavioral assays reveal that most paired ORNs antagonistically regulate the same type of behavior. Such valence opponency is relevant in critical behavioral contexts including place preference, egg laying, and courtship. Odor-mixture experiments show that ephaptic inhibition provides a peripheral means for evaluating and shaping countervailing cues relayed to higher brain centers. Furthermore, computational modeling suggests that this organization likely contributes to processing ratio information in odor mixtures. This olfactory valence map may have evolved to swiftly process ethologically meaningful odor blends without involving costly synaptic computation.


Asunto(s)
Percepción Olfatoria/fisiología , Neuronas Receptoras Olfatorias/fisiología , Animales , Conectoma , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/metabolismo , Odorantes , Vías Olfatorias/fisiología , Neuronas Receptoras Olfatorias/metabolismo , Órganos de los Sentidos/fisiología , Olfato/fisiología
4.
Cell ; 139(1): 45-59, 2009 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-19804753

RESUMEN

Remarkable advances in our understanding of olfactory perception have been made in recent years, including the discovery of new mechanisms of olfactory signaling and new principles of olfactory processing. Here, we discuss the insight that has been gained into the receptors, cells, and circuits that underlie the sense of smell.


Asunto(s)
Percepción Olfatoria , Neuronas Receptoras Olfatorias/fisiología , Receptores Odorantes/fisiología , Animales , Humanos , Vías Olfatorias
5.
BMC Biol ; 20(1): 230, 2022 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-36217142

RESUMEN

BACKGROUND: The nose of most animals comprises multiple sensory subsystems, which are defined by the expression of different olfactory receptor families. Drosophila melanogaster antennae contain two morphologically and functionally distinct subsystems that express odorant receptors (Ors) or ionotropic receptors (Irs). Although these receptors have been thoroughly characterized in this species, the subsystem-specific expression and roles of other genes are much less well-understood. RESULTS: Here we generate subsystem-specific transcriptomic datasets to identify hundreds of genes, encoding diverse protein classes, that are selectively enriched in either Or or Ir subsystems. Using single-cell antennal transcriptomic data and RNA in situ hybridization, we find that most neuronal genes-other than sensory receptor genes-are broadly expressed within the subsystems. By contrast, we identify many non-neuronal genes that exhibit highly selective expression, revealing substantial molecular heterogeneity in the non-neuronal cellular components of the olfactory subsystems. We characterize one Or subsystem-specific non-neuronal molecule, Osiris 8 (Osi8), a conserved member of a large, insect-specific family of transmembrane proteins. Osi8 is expressed in the membranes of tormogen support cells of pheromone-sensing trichoid sensilla. Loss of Osi8 does not have obvious impact on trichoid sensillar development or basal neuronal activity, but abolishes high sensitivity responses to pheromone ligands. CONCLUSIONS: This work identifies a new protein required for insect pheromone detection, emphasizes the importance of support cells in neuronal sensory functions, and provides a resource for future characterization of other olfactory subsystem-specific genes.


Asunto(s)
Receptores Odorantes , Animales , Antenas de Artrópodos/metabolismo , Drosophila/genética , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Proteínas de Insectos/genética , Insectos/genética , Feromonas/genética , Feromonas/metabolismo , ARN/metabolismo , Receptores Odorantes/metabolismo
6.
Bioessays ; 42(8): e2000026, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32613656

RESUMEN

In numerous peripheral sense organs, external stimuli are detected by primary sensory neurons compartmentalized within specialized structures composed of cuticular or epithelial tissue. Beyond reflecting developmental constraints, such compartmentalization also provides opportunities for grouped neurons to functionally interact. Here, the authors review and illustrate the prevalence of these structural units, describe characteristics of compartmentalized neurons, and consider possible interactions between these cells. This article discusses instances of neuronal crosstalk, examples of which are observed in the vertebrate tastebuds and multiple types of arthropod chemosensory hairs. Particular attention is paid to insect olfaction, which presents especially well-characterized mechanisms of functional, cross-neuronal interactions. These examples highlight the potential impact of peripheral processing, which likely contributes more to signal integration than previously considered. In surveying a wide variety of structural units, it is hoped that this article will stimulate future research that determines whether grouped neurons in other sensory systems can also communicate to impact information processing.


Asunto(s)
Neuronas Aferentes , Olfato , Animales , Insectos
8.
Nature ; 492(7427): 66-71, 2012 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-23172146

RESUMEN

Diverse sensory organs, including mammalian taste buds and insect chemosensory sensilla, show a marked compartmentalization of receptor cells; however, the functional impact of this organization remains unclear. Here we show that compartmentalized Drosophila olfactory receptor neurons (ORNs) communicate with each other directly. The sustained response of one ORN is inhibited by the transient activation of a neighbouring ORN. Mechanistically, such lateral inhibition does not depend on synapses and is probably mediated by ephaptic coupling. Moreover, lateral inhibition in the periphery can modulate olfactory behaviour. Together, the results show that integration of olfactory information can occur via lateral interactions between ORNs. Inhibition of a sustained response by a transient response may provide a means of encoding salience. Finally, a CO(2)-sensitive ORN in the malaria mosquito Anopheles can also be inhibited by excitation of an adjacent ORN, suggesting a broad occurrence of lateral inhibition in insects and possible applications in insect control.


Asunto(s)
Inhibición Neural/fisiología , Vías Olfatorias/fisiología , Neuronas Receptoras Olfatorias/metabolismo , Sinapsis , Animales , Anopheles/efectos de los fármacos , Anopheles/fisiología , Dióxido de Carbono/farmacología , Relación Dosis-Respuesta a Droga , Drosophila melanogaster/citología , Drosophila melanogaster/efectos de los fármacos , Drosophila melanogaster/fisiología , Femenino , Inhibición Neural/efectos de los fármacos , Vías Olfatorias/efectos de los fármacos , Neuronas Receptoras Olfatorias/citología , Neuronas Receptoras Olfatorias/efectos de los fármacos , Sensilos/citología , Sensilos/efectos de los fármacos , Sensilos/inervación , Sensilos/fisiología , Olfato/efectos de los fármacos , Olfato/fisiología , Transmisión Sináptica/efectos de los fármacos
9.
Nature ; 464(7285): 66-71, 2010 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-20130575

RESUMEN

The mosquito Anopheles gambiae is the major vector of malaria in sub-Saharan Africa. It locates its human hosts primarily through olfaction, but little is known about the molecular basis of this process. Here we functionally characterize the Anopheles gambiae odorant receptor (AgOr) repertoire. We identify receptors that respond strongly to components of human odour and that may act in the process of human recognition. Some of these receptors are narrowly tuned, and some salient odorants elicit strong responses from only one or a few receptors, suggesting a central role for specific transmission channels in human host-seeking behaviour. This analysis of the Anopheles gambiae receptors permits a comparison with the corresponding Drosophila melanogaster odorant receptor repertoire. We find that odorants are differentially encoded by the two species in ways consistent with their ecological needs. Our analysis of the Anopheles gambiae repertoire identifies receptors that may be useful targets for controlling the transmission of malaria.


Asunto(s)
Anopheles/metabolismo , Insectos Vectores/metabolismo , Malaria , Odorantes/análisis , Vías Olfatorias/metabolismo , Receptores Odorantes/metabolismo , Animales , Anopheles/anatomía & histología , Anopheles/genética , Drosophila melanogaster/citología , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Electrofisiología , Humanos , Mordeduras y Picaduras de Insectos/prevención & control , Malaria/prevención & control , Malaria/transmisión , Modelos Biológicos , Neuronas Receptoras Olfatorias/metabolismo , Receptores Odorantes/genética , Factores de Tiempo
10.
Proc Natl Acad Sci U S A ; 108(12): 5075-80, 2011 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-21383179

RESUMEN

Most natural odors are mixtures and often elicit percepts distinct from those elicited by their constituents. This emergence of a unique odor quality has long been attributed to central processing. Here we show that sophisticated integration of olfactory information begins in olfactory receptor neurons (ORNs) in Drosophila. Odor mixtures are encoded in the temporal dynamics as well as in the magnitudes of ORN responses. ORNs can respond to an inhibitory odorant with different durations depending on the level of background excitation. ORNs respond to mixtures with distinctive temporal dynamics that reflect the physicochemical properties of the constituent odorants. The insect repellent DEET (N,N-diethyl-m-toluamide), which attenuates odor responses of multiple ORNs, differs from an ORN-specific inhibitor in its effects on temporal dynamics. Our analysis reveals a means by which integration of information from odor mixtures begins in ORNs and provides insight into the contribution of inhibitory stimuli to sensory coding.


Asunto(s)
Odorantes , Neuronas Receptoras Olfatorias/fisiología , Olfato/fisiología , Animales , DEET/farmacología , Drosophila melanogaster , Repelentes de Insectos/farmacología , Olfato/efectos de los fármacos
11.
bioRxiv ; 2023 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-37546820

RESUMEN

The mammalian brain implements sophisticated sensory processing algorithms along multilayered ('deep') neural-networks. Strategies that insects use to meet similar computational demands, while relying on smaller nervous systems with shallow architectures, remain elusive. Using Drosophila as a model, we uncover the algorithmic role of odor preprocessing by a shallow network of compartmentalized olfactory receptor neurons. Each compartment operates as a ratiometric unit for specific odor-mixtures. This computation arises from a simple mechanism: electrical coupling between two differently-sized neurons. We demonstrate that downstream synaptic connectivity is shaped to optimally leverage amplification of a hedonic value signal in the periphery. Furthermore, peripheral preprocessing is shown to markedly improve novel odor classification in a higher brain center. Together, our work highlights a far-reaching functional role of the sensory periphery for downstream processing. By elucidating the implementation of powerful computations by a shallow network, we provide insights into general principles of efficient sensory processing algorithms.

12.
Nucl Med Mol Imaging ; 57(5): 247-250, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37720881

RESUMEN

Magnetic resonance imaging (MRI) is the most popular imaging modality for investigating intervertebral disc herniation. However, it has a high chance for identifying incidental findings that are morphologically or structurally abnormal but not responsible for patients' symptoms. Although a previous study suggested that 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) may help identify neuroinflammation in lumbar radiculopathy, there is currently no direct evidence obtained from surgery. Here, we describe the case of a 32-year-old man with low back pain and right leg paresthesia for 7 months. MRI demonstrated disc herniation at the L3-L4, L4-L5 and L5-S1 levels, causing bilateral L5 and left S1 root compression. 18F-FDG PET/MRI demonstrated increased 18F-FDG uptake at the right L5 root, which was compatible with the patient's symptoms. Transforaminal percutaneous endoscopic lumbar discectomy (PELD) was performed. Intraoperative images revealed a swollen nerve root at the right L5 after removal of the herniated disc. After surgery, the patient experienced immediate pain relief and had no recurrence at the 6-month follow-up. When performing PELD in patients with multilevel radiculopathy identified on MRI, the use of 18F-FDG PET/MRI can help in accurate localization of the symptomatic roots and minimize surgical incision and soft-tissue injury.

13.
Nat Commun ; 14(1): 1544, 2023 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-36941252

RESUMEN

Female fruit flies (Drosophila melanogaster) oviposit at communal sites where the larvae may cooperate or compete for resources depending on group size. This offers a model system to determine how females assess quantitative social information. We show that the concentration of pheromones found on a substrate increases linearly with the number of adult flies that have visited that site. Females prefer oviposition sites with pheromone concentrations corresponding to an intermediate number of previous visitors, whereas sites with low or high concentrations are unattractive. This dose-dependent decision is based on a blend of 11-cis-Vaccenyl Acetate (cVA) indicating the number of previous visitors and heptanal (a novel pheromone deriving from the oxidation of 7-Tricosene), which acts as a dose-independent co-factor. This response is mediated by detection of cVA by odorant receptor neurons Or67d and Or65a, and at least five different odorant receptor neurons for heptanal. Our results identify a mechanism allowing individuals to transform a linear increase of pheromones into a non-linear behavioral response.


Asunto(s)
Proteínas de Drosophila , Receptores Odorantes , Animales , Femenino , Drosophila melanogaster/fisiología , Oviposición , Feromonas , Drosophila , Conducta Sexual Animal/fisiología
14.
Biochemistry ; 51(9): 1933-41, 2012 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-22303823

RESUMEN

Parietopsin is a nonvisual green light-sensitive opsin closely related to vertebrate visual opsins and was originally identified in lizard parietal eye photoreceptor cells. To obtain insight into the functional diversity of opsins, we investigated by UV-visible absorption spectroscopy the molecular properties of parietopsin and its mutants exogenously expressed in cultured cells and compared the properties to those of vertebrate and invertebrate visual opsins. Our mutational analysis revealed that the counterion in parietopsin is the glutamic acid (Glu) in the second extracellular loop, corresponding to Glu181 in bovine rhodopsin. This arrangement is characteristic of invertebrate rather than vertebrate visual opsins. The photosensitivity and the molar extinction coefficient of parietopsin were also lower than those of vertebrate visual opsins, features likewise characteristic of invertebrate visual opsins. On the other hand, irradiation of parietopsin yielded meta-I, meta-II, and meta-III intermediates after batho and lumi intermediates, similar to vertebrate visual opsins. The pH-dependent equilibrium profile between meta-I and meta-II intermediates was, however, similar to that between acid and alkaline metarhodopsins in invertebrate visual opsins. Thus, parietopsin behaves as an "evolutionary intermediate" between invertebrate and vertebrate visual opsins.


Asunto(s)
Opsinas de los Conos/química , Proteínas del Ojo/química , Rodopsina/química , Animales , Ácido Glutámico/genética , Invertebrados , Fotoquímica , Células Fotorreceptoras/metabolismo , Filogenia , Especificidad de la Especie , Vertebrados
15.
Nat Ecol Evol ; 5(8): 1165-1173, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34155384

RESUMEN

Females that are highly selective when choosing a mate run the risk of remaining unmated or delaying commencing reproduction. Therefore, low female choosiness would be beneficial when males are rare but it would be maladaptive if males become more frequent. How can females resolve this issue? Polyandry would allow mating-status-dependent choosiness, with virgin females selecting their first mate with little selectivity and becoming choosier thereafter. This plasticity in choosiness would ensure timely acquisition of sperm and enable females to increase offspring quality during later mating. Here, we show that Drosophila melanogaster females display such mating-status-dependent choosiness by becoming more selective once mated and identify the underlying neurohormonal mechanism. Mating releases juvenile hormone, which desensitizes Or47b olfactory neurons to a pheromone produced by males, resulting in increased preference for pheromone-rich males. Besides providing a mechanism to a long-standing evolutionary prediction, these data suggest that intersexual selection in D. melanogaster, and possibly in all polyandrous, sperm-storing species, is mainly the domain of mated females since virgin females are less selective. Juvenile hormone influences behaviour by changing cue responsiveness across insects; the neurohormonal modulation of olfactory neurons uncovered in D. melanogaster provides an explicit mechanism for how this hormone modulates behavioural plasticity.


Asunto(s)
Drosophila melanogaster , Conducta Sexual Animal , Animales , Femenino , Masculino , Feromonas , Reproducción , Espermatozoides
16.
Elife ; 102021 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-34423777

RESUMEN

The biophysical properties of sensory neurons are influenced by their morphometric and morphological features, whose precise measurements require high-quality volume electron microscopy (EM). However, systematic surveys of nanoscale characteristics for identified neurons are scarce. Here, we characterize the morphology of Drosophila olfactory receptor neurons (ORNs) across the majority of genetically identified sensory hairs. By analyzing serial block-face electron microscopy images of cryofixed antennal tissues, we compile an extensive morphometric data set based on 122 reconstructed 3D models for 33 of the 40 identified antennal ORN types. Additionally, we observe multiple novel features-including extracellular vacuoles within sensillum lumen, intricate dendritic branching, mitochondria enrichment in select ORNs, novel sensillum types, and empty sensilla containing no neurons-which raise new questions pertinent to cell biology and sensory neurobiology. Our systematic survey is critical for future investigations into how the size and shape of sensory neurons influence their responses, sensitivity, and circuit function.


Asunto(s)
Drosophila/fisiología , Vías Olfatorias , Neuronas Receptoras Olfatorias/fisiología , Animales , Imagenología Tridimensional , Microscopía Electrónica , Modelos Biológicos , Sensilos , Olfato
17.
Curr Biol ; 31(15): 3382-3390.e7, 2021 08 09.
Artículo en Inglés | MEDLINE | ID: mdl-34111404

RESUMEN

Numerous hematophagous insects are attracted to ammonia, a volatile released in human sweat and breath.1-3 Low levels of ammonia also attract non-biting insects such as the genetic model organism Drosophila melanogaster and several species of agricultural pests.4,5 Two families of ligand-gated ion channels function as olfactory receptors in insects,6-10 and studies have linked ammonia sensitivity to a particular olfactory receptor in Drosophila.5,11,12 Given the widespread importance of ammonia to insect behavior, it is surprising that the genomes of most insects lack an ortholog of this gene.6 Here, we show that canonical olfactory receptors are not necessary for responses to ammonia in Drosophila. Instead, we demonstrate that a member of the ancient electrogenic ammonium transporter family, Amt, is likely a new type of olfactory receptor. We report two hitherto unidentified olfactory neuron populations that mediate neuronal and behavioral responses to ammonia in Drosophila. Their endogenous ammonia responses are lost in Amt mutant flies, and ectopic expression of either Drosophila or Anopheles Amt confers ammonia sensitivity. These results suggest that Amt is the first transporter known to function as an olfactory receptor in animals and that its function may be conserved across insect species.


Asunto(s)
Compuestos de Amonio , Proteínas de Drosophila , Drosophila melanogaster , Neuronas Receptoras Olfatorias , Receptores Odorantes , Amoníaco , Animales , Proteínas de Drosophila/genética , Drosophila melanogaster/genética , Receptores Odorantes/genética
18.
Ann Otol Rhinol Laryngol ; 119(5): 336-41, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20524580

RESUMEN

OBJECTIVES: Nasopharyngeal branchial cysts (NBCs) are derived from a remnant of the branchial apparatus and originate from the lateral wall of the nasopharynx. Total excision of these cysts was the standard treatment in the past. We present a simpler and less invasive approach for NBC treatment, involving marsupialization, and report on its effectiveness and advantages. METHODS: The surgical approach was transoral. A circular incision 2 to 3 cm in diameter was made directly through the inferior wall of the cyst. After the NBC was drained, its opening was widened with scissors. A disk of oropharyngeal mucosa and the connecting inferior wall of the cyst were excised together. The cut edges of the inner lining of the cyst and the oropharyngeal mucosa were approximated with sutures. RESULTS: All 4 patients were female. One patient was observed because of poor cardiovascular health. The 3 patients who were managed surgically underwent successful transoral cyst marsupialization. The mean follow-up period was 21 months (range, 8 to 40 months). No obvious postoperative complication or recurrence was noted. CONCLUSIONS: Transoral marsupialization is a simple, effective, and less invasive method for treatment of NBCs.


Asunto(s)
Branquioma/cirugía , Nasofaringe/anomalías , Adulto , Anciano , Branquioma/diagnóstico , Preescolar , Femenino , Humanos , Imagen por Resonancia Magnética , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos
19.
Ann Otol Rhinol Laryngol ; 119(5): 297-303, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20524574

RESUMEN

OBJECTIVES: The conventional method for preventing web formation after anterior glottic web surgery is keel insertion. However, this presents risks of airway compromise and granulation tissue formation, which could necessitate tracheotomy in addition to a secondary procedure for keel removal. We introduce a novel, 1-stage endoscopic laser anterior commissurotomy for preventing anterior glottic web re-formation. METHODS: Twenty patients with glottic webs involving the anterior commissure were studied. The lesions were removed by transoral carbon dioxide laser microsurgery. In all patients, the anterior glottic web was vaporized along with the inner perichondrium of the thyroid cartilage over the anterior commissure area, creating a raw vertical break "alley" between the anterior vocal folds that measured between 0.3 and 0.5 cm in width and between 0.8 and 2 cm in length. The preoperative and postoperative vocal folds and voice quality were evaluated by videostrobolaryngoscopy and voice recordings. RESULTS: All 20 patients had anterior glottic webs ranging from 11% to 64% of the length from the anterior commissure to the vocal process. None of the patients developed restenosis at the anterior commissure of a severity similar to that of the initial lesion during follow-up (mean, 13 months; range, 3 to 44 months).All patients except 1 reported satisfaction with their voice improvement. Outcome analysis revealed that partial re-formation of the web was noted in 4 patients. CONCLUSIONS: One-stage, endoscopic laser anterior commissurotomy was effective and relatively safe for removing glottic webs, for preventing anterior glottic web re-formation, and for improving vocal fold performance among our patients.


Asunto(s)
Endoscopía , Glotis , Terapia por Láser/métodos , Adolescente , Adulto , Anciano , Femenino , Glotis/anomalías , Humanos , Enfermedades de la Laringe/cirugía , Laringoscopía , Masculino , Microcirugia/métodos , Persona de Mediana Edad , Estroboscopía , Resultado del Tratamiento , Pliegues Vocales/cirugía , Calidad de la Voz
20.
Eur Arch Otorhinolaryngol ; 267(12): 1951-6, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20582549

RESUMEN

The objective of this study was to evaluate the functional results in patients with advanced pyriform sinus cancer treated with extended near-total laryngopharyngectomy (ENTLP) and free fasciocutaneous flap reconstruction. We reviewed the medical records of patients with pyriform sinus cancer who were treated at Kaohsiung Chang Gung Memorial Hospital, a tertiary medical center in Taiwan, between June 1998 and December 2008. This retrospective study enrolled the patients who had a stage III or IV pyriform sinus cancer and was surgically treated with ENTLP and free fasciocutaneous flap reconstruction. Thirteen patients meeting the inclusion criteria were enrolled. Three patients had stage III cancer, and ten had IVa. All were men with the age distribution ranged from 38 to 75 years. The average length of hospitalization was 19 days. Twelve (92.3%) patients could develop shunt speech postoperatively, and eight (61.5%) patients used shunt speech for their routine conversation. Eleven (84.6%) patients could ultimately return to an oral diet; the remaining two (15.4%) patients stayed dependent on a feeding tube for part or all of their nutrition. Two patients died from distant metastases, and one patient died from complications of postoperative concurrent chemoradiotherapy, while the other ten patients survived until the last follow-up without evidence of locoregional tumor recurrence. In conclusion, in the surgical treatment of patients with locally advanced pyriform sinus cancer, ENTLP and free fasciocutaneous flap reconstruction is an oncologically safe, voice-conserving, and prosthesis-free procedure which offers satisfactory functional speech and swallowing outcomes.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Colgajos Tisulares Libres , Neoplasias Hipofaríngeas/cirugía , Laringectomía , Faringectomía , Seno Piriforme , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/fisiopatología , Estudios de Cohortes , Deglución , Humanos , Neoplasias Hipofaríngeas/patología , Neoplasias Hipofaríngeas/fisiopatología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Recuperación de la Función , Estudios Retrospectivos , Resultado del Tratamiento , Calidad de la Voz
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