Transconioscopy in the Study of the Mucus Flow in the Human Larynx

Abstract

Transconioscopy has made it possible, for the first time, to study the mucus flow in the human larynx. Such studies were made in 30 patients. It was found that, over normal laryngeal mucosa, the mucus from the trachea is, as a rule, transported to the posterior commissure. The mucus from the anterior and lateral walls of the trachea then deviates in a dorsally directed flow on the under-surfaces of the vocal cords, and runs parallel to the edges of the cords towards the posterior commissure. In a few cases, a flow pattern was observed in which all mucus was transported to the anterior commissure. In all cases hitherto verified histologically, areas with inhibited mucus flow have proved to correspond to areas of metaplastic epithelium not detectable macro-scopically. In cases of laryngeal carcinoma, such areas consistently surrounded cancerous tissue. This metaplastic epithelium was also observed to cover areas in which the tumour grew submucously. It is pointed out that studies of the mucus flow by means of transconioscopy may be of great clinical importance for determining the extent of malignant laryngeal disease.