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Biomedical subjects

Mary J Hawkshaw

Publications and source records attributed to Mary J Hawkshaw.

4 recordsLinked to original sources

Vocal process avulsion.

Vocal process avulsion is a rare complication of intubation or external laryngeal trauma that can cause significant dysphonia. The vocal process develops independently from the body of the arytenoid cartilage, which results in a fusion plane that is vulnerable to trauma. The findings of vocal process avulsion may be subtle, and the relationship of the vocal process to the body of the arytenoid cartilage must be examined closely. Stroboscopy is critical in the evaluation. We describe three cases of vocal process avulsion encountered by the senior author (R.T.S.) over the last 5 years and discuss our approaches to evaluation and treatment. All cases were repaired endoscopically. However, we used three different techniques. These include chemical tenotomy with botulinum toxin, closed reduction with fat injection, and open reduction via cordotomy.

Adipose Tissue↗

Arytenoid cartilage dislocation: a 20-year experience.

SUMMARY: Arytenoid cartilage dislocation is an infrequently diagnosed cause of vocal fold immobility. Seventy-four cases have been reported in the literature to date. Intubation is the most common origin, followed by external laryngeal trauma. Decreased volume and breathiness are the most common presenting symptoms. We report on 63 patients with arytenoid cartilage dislocation treated by the senior author (RTS) since 1983. Significantly more posterior than anterior dislocations were represented. Although reestablishing joint mobility is difficult, endoscopic reduction should be considered to align the heights of the vocal processes. This process may result in significant voice improvement even long after the dislocation. Strobovideolaryngoscopy, laryngeal electromyography, and laryngeal computed tomography (CT) imaging are helpful in the evaluation of patients with vocal fold immobility to help distinguish arytenoid cartilage dislocation from vocal fold paralysis. Familiarity with signs and symptoms of arytenoid cartilage dislocation and current treatment techniques improves the chances for optimal therapeutic results.

Adolescent↗

Abnormal computerized dynamic posturography findings in dizzy patients with normal ENG results.

The complexities of the balance system create difficulties for professionals interested in testing equilibrium function objectively. Traditionally, electronystagmography (ENG) has been used for this purpose, but it provides information on only a limited portion of the equilibrium system. Computerized dynamic posturography (CDP) is less specific than ENG, but it provides more global insight into a patient's ability to maintain equilibrium under more challenging environmental circumstances. CD Palso appears to be valuable in obtaining objective confirmation of an abnormality in some dizzy patients whose ENG findings are normal. Our review of 33 patients with normal ENG results and abnormal CDP findings suggests that posturography is useful for confirming or quantifying a balance abnormality in some patients whose complaints cannot be confirmed by other tests frequently used by otologists.

Adult↗

Laryngeal sarcoidosis.

Sarcoidosis is a chronic granulomatous disease that tends to involve the lungs, hilar and mediastinal lymph nodes, liver, eyes, skin, bones, and nervous system. Sarcoidosis involves the larynx less commonly than it afflicts these other sites. Laryngeal sarcoidosis may occur in isolation or as a component of systemic sarcoidosis and it may produce hoarseness, dysphagia, and dyspnea. Life-threatening airway obstruction can occur. Treatments used for laryngeal sarcoidosis have included tracheotomy, low-dose radiation, surgical excision, systemic steroids, and intralesional steroids. An autoimmune etiology has been suggested. The patient reported in this manuscript showed marked, sustained improvement following the use of inhaled steroids prescribed for obstructive pulmonary disease. The possible efficacy of steroid inhalers for treatment of laryngeal sarcoidosis warrants further investigation.

Administration, Inhalation↗