Thread by @TheKarenPinto

All you need to know about grossing the #larynx
Here's a #PathVideoTweetorial

#pathology #grosspath #headandneckpath

Video 1: Let's first get oriented by seeing some images

Since the main tumor completely involved the epiglottis, the surgeon had to excise a part of the tongue (which is seen in the specimen)

Now that you’ve seen the images, let’s take a look at the real deal

Video 2: Larynx specimen intact

After I took the cut margins, I had to bisect the specimen
(This is how I gross the specimen, others may have their own techniques)

Video 3: Bisecting the specimen

To make it easier to understand, I've taken images and explained them

Video 4: Images of the specimen after cutting open the posterior half

Video 5: What are the different parts of the larynx (as you see it in the actual specimen)

Video 6: Once the specimen has been bisected, we need to assess the extent of the tumor

Here it important to see it’s relation to the pre-epiglottic fat (involvement of the latter, upstages the tumor)

Another important landmark is the pyriform fossa

The mucosa lining the fossa may not always be removed entirely (since it’s used for flap closure)
So you need to be aware what the surgeon has taken out

Video 7: Pyriform fossa

The next step is to serially slice each half of the larynx and submit sections to show the extent of involvement of the tumor

Sometimes the cartilages are extensively calcified, making it difficult to cut

Video 8: Serial sectioning

Last but not the least, what is the paraglottic space?

Video 9: Paraglottic space and how to recognize it

I hope these videos help understand the anatomy and how to gross a specimen of the larynx better

I would like to acknowledge my amazing tech @Nora_almuttairi for recording all the above videos
& my awesome surgeon Dr. Hany Eldweny who I’ve learnt so much from

✌🏽