Author/Editor		Michaels, Leslie
Title		Pathology of elastic cartilage in the epiglottis and auricle
Translated title		Patologija elastičnega hrustanca poklopca in uhlja
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. Suppl 3
Publication year		2002
Volume		str. III-53-7
Language		eng
Abstract		Background. The purpose of this study was to define the pathological changes of some lesions of the elastic cartilage of the epiglottis of the larynx and the auricle and to consider their pathogenesis. Methods. Surgical histological material was examined from one patient with pseudocyst of the epiglottis, one with pseudocyst of the auricle of the ear and four with chondrodermatitis nodularis helicis, in one of whom the lesion was bilateral. Results. The pseudocyst of the epiglottis was situated between the anterior and posterior surfaces of that organ. In the anterior region of the epiglottic cartilage, but not the posterior, perichondrium was fibrotic, and chondrocytes and elastic fibres were markedly reduced. There were similar changes in relation to the auricular cartilage pseudocyst. In the auricles with chondrodermatitis the changes were those of focal necrossis of the rim of the cartilage at the helix with associated acute inflammation, ulceration and hyperplasia of the overlying epidermis. In one lesion necrotic cartilage had been extruded and lay on the floor of the ulcer. Thickening of the walls of small arteries was seen near the perichondrium of the heliceal region. Conclusions. The patient with pseudocyst of the epiglottis had severe gastro-oesophageal reflux which had necessitated recent gastric surgery. The acid reflux may have caused perichondrial ischaemia of the anterior epiglottic cartilage resulting in the pseudocyst. The auricular pseudocyst was associated with similar focal perichondrial damage on one surface only, probably caused by trauma. Chondrodermatitis nodularis helicis is likely produced by ischaemia of perichondrium at the poorly vascularized helix.
Summary		Izhodišča. Cilj raziskave je opredeliti patološke spremembe in patogenezo nekaterih sprememb elastičnega hrustanca poklopca grla in uhlja. Metode. Pregledali smo histološke vzorce bolnika s psevdocisto poklopca, bolnika s psevdocisto uhlja in štirih bolnikov z nodularnim hondrodermatitisom uhlja; pri enem od njih je bila sprememba obojestranska. Rezultati. Psevdocista poklopca je ležala med njegovo sprednjo in zadnjo površino. Na sprednji površini poklopca je bila pohrustančnica vezivno zadebeljena, hondrociti in elastična vlakna so bila izrazito razredčena. Podobne spremembe smo našli tudi pri psevdocisti hrustanca uhlja. Pri hondrodermatitisu smo našli žariščno nekrozo roba hrustanca z akutnim vnetjem, razjedo in hiperplazijo epidermisa. V enem primeru je bil v dnu razjede razgaljen hrustanec. Stene majhnih arterij v bližini pohrustančnice uhlja so zadebeljene. Zaključki. Bolnik s psevdocisto poklopca je imel hud gastroezofagalni refluks, zaradi katerega je bilo kasneje potrebno operativno zdravljenje. Kisli refliks je verjetno povzročil ishemijo pohrustančnice poklopca s posledičnim razvojem psevdociste. Tudi pri psevdocisti uhlja smo opazili podobne žariščne spremembe pohrustančnice le na eni strani hrustanca, okvaro je verjetno povzročila poškodba. Nodularni hondrodermatitis se najverjetno razvije zaradi ishemije pohrustančnice v predelu zarobka uhlja.
Descriptors		CARTILAGE EPIGLOTTIS EAR DEFORMITIES, ACQUIRED ADULT GASTROESOPHAGEAL REFLUX