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At least 505 records · Page 28Linked to original sources
PubMed2006

Endoscopic treatment for atypical manifestations of gastroesophageal reflux disease.

OBJECTIVES: Atypical manifestations are common in patients with gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the response of atypical manifestations of GERD to endoscopic antireflux treatment. METHODS: Patients with atypical manifestations of GERD including hoarseness, cough, wheezing, and non-cardiac chest pain were studied. Endoscopic antireflux treatment consisted of placement of sutures below the squamo-columnar junction. Clinical response was defined as complete resolution of the atypical symptom. Patients were followed clinically for up to 3 yr after the procedure. Short-term response was evaluated within 6 months of the procedure, and long-term follow-up was determined 1-3 yr after the procedure. RESULTS: Forty-three patients met the inclusion criteria; four patients underwent repeat procedures during the study period and were excluded from the analysis. Long-term follow-up was available in all 39 patients. Short-term response counts were: hoarseness, 12 of 19 patients, cough, 17 of 19; wheezing, 8 of 9; and chest pain, 13 of 18. Long-term follow-up of patients (mean of 18 months) for these symptoms was not significantly different compared to short-term response. CONCLUSIONS: Endoscopic suturing of the gastroesophageal junction appears to be a possible treatment option for atypical manifestations of GERD and future studies are needed to determine its role in management.

Adult↗
PubMed2005

Iatrogenic cardiovocal syndrome caused by transcatheter coil closure of patent ductus arteriosus.

UNLABELLED: Two infants developed hoarseness unexpectedly the day after transcatheter coil closure of a slender patent ductus arteriosus (PDA). The pathogenesis of this complication appears to be similar to that of the classic cardiovocal syndrome. During the intervention, the inappropriately implanted coil might have distorted the slender PDA, thereby causing angulation of the pliable PDA itself and precipitating impingement on the left recurrent laryngeal nerve. Fortunately, both infants recovered spontaneously from the hoarseness within several weeks. At present, the definite underlying neuropathology of this complication is unknown as we have not yet confirmed recovery of the left vocal cord movement by follow-up fibreoptic bronchoscopy. CONCLUSION: Iatrogenic cardiovocal syndrome could occur in infants after transcatheter coil closure of a slender PDA, using the currently popular 0.038-inch coil. A coil with a smaller diameter might prevent the occurrence of this syndrome.

Ductus Arteriosus, Patent↗
PubMed1986

Frequency and amplitude perturbation analysis of electroglottograph during sustained phonation.

Electroglottography (EGG) was used to monitor vocal fold vibration patterns in normal subjects and patients with various laryngeal disorders. In order to evaluate the regularity of vocal fold vibration, frequency and amplitude perturbation of EGG waves during sustained phonation were measured with a laboratory computer. The data were compared to the degree of hoarseness evaluated by auditory perception and by sound spectrographic analysis. Frequency and amplitude perturbation measures showed some overlap between normal and pathological groups. However, there was a close relation between perturbation analysis of EGG waves and degree of hoarseness (Spearman's rank correlation coefficient rs = 0.73, p less than 0.0005). Amplitude perturbation was found to be a more sensitive measure of the irregularity of vocal fold vibration than frequency perturbation.

Adolescent↗
PubMedDate not supplied

Vocal fold paresis in Shy-Drager syndrome.

Twelve patients with Shy-Drager syndrome (SDS) presenting symptoms of multiple nervous system atrophy and orthostatic hypotension were examined for laryngeal movement disorders and vocal impairment in speech. Vocal fold abductor paresis was found in 11 patients and was bilateral in 10. Speech task performance was recorded in SDS patients, Parkinson patients and age- and sex-matched controls. Trained listeners with inter-rated reliability greater than or equal to .85 judged each recording on 20 attributes while blind to speaker identity. SDS patients had a breathy and strained voice quality, reduced loudness, monopitch and monoloudness, imprecise consonants, variations in rate and rate-slowing, suggesting a flaccid type of dysarthria. In comparison with Parkinson patients, SDS patients had excess vocal hoarseness, intermittent glottal fry and a slow and deliberate speaking rate. Orthostatic hypotension, laryngeal stridor, hoarseness, intermittent glottal fry and slow speech rate were found to be discriminating symptoms of SDS.

Aged↗
PubMed1979

Isaacs syndrome with laryngeal involvement: an unusual presentation of myokymia.

A woman with widespread myokymia presented initially at age 19 with hoarseness and mild dyspnea on exertion. The diagnosis of Isaacs syndrome was suggested by the clinical findings of widespread continuous muscle activity and depressed tendon reflexes, although she lacked the usually prominent increased muscle tone. The diagnosis was confirmed by the electromyographic demonstration of continuous spontaneous muscle action potentials that were abolished by neuromuscular blockade but not by local nerve blockade. Pulmonary function tests were consistent with fixed extrathoracic obstruction. The vocal cords were closely approximated. Electromyographic studies of the laryngeal muscles under general anesthesia revealed continuous muscle activity, which accounted for the hoarseness and much of the exertional dyspnea. The patient responded well to treatment with phenytoin and carbamazepine. This unusual syndrome should be considered in the differential diagnosis of patients with respiratory complaints and muscle fasciculations, even though they have normal muscle tone.

Action Potentials↗
PubMed1999

Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. The Vagus Nerve Stimulation Study Group E01-E05.

OBJECTIVE: To perform an open-label, long-term efficacy and safety/tolerability study of vagus nerve stimulation (VNS) of 454 patients with refractory epilepsy. METHODS: Subjects were enrolled from five clinical trials of VNS between 1988 and 1995 after undergoing an implantation of a pulse generator in the chest and a left cervical vagus nerve-stimulating lead coil. Patients were assessed at 6-month intervals until device approval. Seizure frequencies, medication treatment, and adverse events (AEs) were recorded and entered into a database. RESULTS: A total of 454 patients were implanted, and 440 patients yielded assessable data. A > or =50% seizure reduction postimplantation occurred in 36.8% of patients at 1 year, in 43.2% at 2 years, and in 42.7% at 3 years. Median seizure reductions compared with baseline were 35% at 1 year, 44.3% at 2 years, and 44.1% at 3 years. Most common AEs postimplantation at 1 year were hoarseness (28%) and paraesthesias (12%), at 2 years were hoarseness (19.8%) and headache (4.5%), and at 3 years was shortness of breath (3.2%). Continuation rates were 96.7% at 1 year, 84.7% at 2 years, and 72.1% at 3 years. CONCLUSION: Long-term, open-label vagus nerve stimulation (VNS) provided seizure reduction similar to or greater than acute studies, for median reductions and for those reaching a > or =50% seizure reduction. VNS remained safe and well tolerated, with nearly three-quarters of the patients choosing to continue therapy.

Adult↗
PubMed1999

Intraoperative electromyographic assessment of recurrent laryngeal nerve stress and pharyngeal injury during anterior cervical spine surgery with Caspar instrumentation.

OBJECT: Recurrent laryngeal nerve (RLN) injury occurs after anterior cervical spine procedures. In this study the authors used intraoperative electromyographic (EMG) monitoring of the posterior pharynx as a surrogate for RLN function and monitored endotracheal tube (ET) cuff pressure to determine if there was an association between these variables and clinical outcome. METHODS: Sixty patients in whom anterior cervical spine procedures were to be performed comprised the study population. After intubation, the ET cuff was adjusted to a just-seal volume and attached to a pressure monitor. A laryngeal surface electrode was placed in the posterior pharynx, and spontaneous EMG activity was monitored throughout the procedure. Cuff pressures and EMG activity were recorded during neck retraction and when EMG activity increased 20% above baseline. Patients were divided into two groups: those with sore throat/dysphonia and those without symptoms. Cuff pressures and EMG values were compared between groups, and the differences were correlated with clinical outcome. CONCLUSIONS: Hoarseness immediately after surgery was reported in 38% of patients whereas 15% exhibited severe symptoms. In symptomatic patients the period of intubation had been longer, and the ET cuff pressures had been elevated. In most patients EMG activity increased during insertion of the retractor and decreased after its removal. In these patients a greater number of episodes of elevated EMG activity during surgery were also noted. Two patients experienced prolonged hoarseness, and one required teflon injections of the vocal fold. This patient's EMG activity increased (15-18 times baseline) during surgery. In the few patients who were symptomatic with increased EMG activity, neither the timing nor direction of change could be associated with symptoms. Intubation time and elevated ET cuff pressure were the most important contributors to dysphonia and sore throat after anterior cervical spine surgery.

Analysis of Variance↗
PubMed2002

Cervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation.

OBJECT: The authors undertook a retrospective single-institution review of 261 patients who underwent anterior cervical corpectomy, reconstruction with allograft fibula, and placement of an anterior plating system for the treatment of cervical spinal stenosis to assess fusion rates and procedure-related complications. METHODS: Between October 1989 and June 1995, 261 patients with cervical stenosis underwent cervical corpectomy, allograft fibular bone fusion, and placement of instrumentation for spondylosis (197 patients), postlaminectomy kyphosis (27 patients), acute fracture (25 patients), or ossification of the posterior longitudinal ligament (12 patients). All patients suffered neck pain and cervical myelopathy or radiculopathy refractory to medical management. Of the procedures, 133 involved a single vertebral level (two disc levels and one vertebral body), 96 involved two levels, 31 involved three levels, and a single patient underwent a four-level procedure. Clinical and radiographic outcomes were assessed postoperatively and at 6-month intervals. The mean follow-up period was 25.7 months (range 24-47 months). Successful fusion was documented in 226 patients (86.6%). A stable, fibrous union developed in 33 asymptomatic patients (12.6%), whereas an unstable pseudarthrosis in two patients (0.8%) required reoperation. There were no cases of infection, spinal fluid leakage, or postoperative hematoma. Complications included transient unilateral upper-extremity weakness (two patients), dysphagia (35 transient and seven permanent), and hoarseness (35 transient and two permanent). In 14 patients (5.4%) radiological studies demonstrated evidence of hardware failure. CONCLUSIONS: Cervical corpectomy with fibular allograft reconstruction and anterior plating is an effective means of achieving spinal decompression and stabilization in cases of anterior cervical disease. Symptomatic improvement was achieved in 99.2% of patients. In their series the authors found a fusion rate of 86.6% and rates of permanent hoarseness of 3.4%, dysphagia of 0.7%, and an instrumentation failure rate of 5.4%.

Adolescent↗
PubMed1996

Zinc gluconate lozenges for treating the common cold. A randomized, double-blind, placebo-controlled study.

BACKGROUND: The common cold is one of the most frequent human illnesses and is responsible for substantial morbidity and economic loss. No consistently effective therapy for the common cold has been well documented, but evidence suggests that several possible mechanisms may make zinc an effective treatment. OBJECTIVE: To test the efficacy of zinc gluconate lozenges in reducing the duration of symptoms caused by the common cold. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Outpatient department of a large tertiary care center. PATIENTS: 100 employees of the Cleveland Clinic who developed symptoms of the common cold within 24 hours before enrollment. INTERVENTION: Patients in the zinc group (n = 50) received lozenges (one lozenge every 2 hours while awake) containing 13.3 mg of zinc from zinc gluconate as long as they had cold symptoms. Patients in the placebo group (n = 50) received similarly administered lozenges that contained 5% calcium lactate pentahydrate instead of zinc gluconate. MAIN OUTCOME MEASURES: Subjective daily symptom scores for cough, headache, hoarseness, muscle ache, nasal drainage, nasal congestion, scratchy throat, sore throat, sneezing, and fever (assessed by oral temperature). RESULTS: The time to complete resolution of symptoms was significantly shorter in the zinc group than in the placebo group (median, 4.4 days compared with 7.6 days; P < 0.001). The zinc group had significantly fewer days with coughing (median, 2.0 days compared with 4.5 days; P = 0.04), headache (2.0 days and 3.0 days; P = 0.02), hoarseness (2.0 days and 3.0 days; P = 0.02), nasal congestion (4.0 days and 6.0 days; P = 0.002), nasal drainage (4.0 days and 7.0 days; P < 0.001), and sore throat (1.0 day and 3.0 days; P < 0.001). The groups did not differ significantly in the resolution of fever, muscle ache, scratchy throat, or sneezing. More patients in the zinc group than in the placebo group had side effects (90% compared with 62%; P < 0.001), nausea (20% compared with 4%; P = 0.02), and bad-taste reactions (80% compared with 30%; P < 0.001), CONCLUSION: Zinc gluconate in the form and dosage studied significantly reduced the duration of symptoms of the common cold. The mechanism of action of this substance in treating the common cold remains unknown. Individual patients must decide whether the possible beneficial effects of zinc gluconate on cold symptoms outweigh the possible adverse effects.

Administration, Oral↗
PubMed2002

Unusual endolaryngeal extension of a large thyroglossal duct cyst.

INTRODUCTION: Thyroglossal duct cysts account for approximately 70% of congenital neck abnormalities. Hoarseness of voice and the extension of the cyst into the larynx are very uncommon. CLINICAL PICTURE: We present a patient with a long history of a large thyroglossal cyst who developed progressive hoarseness of voice. The cyst had protruded into the larynx producing the appearance of a laryngeal neoplasm. Computed tomography (CT) clearly demonstrated the nature of the cyst and its encroachment into the larynx. TREATMENT: This was safely excised with a Sistrunk procedure and a temporary tracheostomy to maintain a secure airway, in view of the possibility of postoperative supraglottic oedema. CONCLUSION: Endolaryngeal extension of the thyroglossal duct cyst is rare. Evaluation of unusual large midline neck masses should include a CT scan. The intralaryngeal component of the cyst can be easily dissected off from the neighbouring structures during dissection in the Sistrunk procedure. A tracheostomy may be needed.

Adult↗
PubMed2002

[Laryngeal papillomatosis: value of early diagnosis, apropos of 7 cases diagnosed at the University Hospital Center in Brazzaville, Congo].

Laryngeal papillomatosis is a benign tumor process that occurs most commonly in children but can also affect adults. The purpose of this report is to describe a series of 7 cases treated at the Otorhinolaryngology Department of the University Hospital Center in Brazzaville, Congo. Special focus is placed on particularities and pitfalls of management. There were 4 girls and 3 boys with a mean age of 8.4 years (range, 7 to 10 years). The mean duration between the onset of symptoms and diagnosis was 3.4 years (range, 1 to 5 years). The initial symptom was choking in 3 cases, hoarseness in 2, and combined choking and hoarseness in 2. Tracheotomy was required in 3 cases. Instrumental debulking was performed in all cases. Two patients died due to obstruction of the cannula. Outcome was favorable in the remaining 5 cases. Our experience highlights the need for early diagnosis for optimal therapeutic outcome. In this regard information campaigns are necessary to educate doctors and parents.

Airway Obstruction↗
PubMed2002

[Phonatory characteristics following different endolaryngeal microsurgical techniques in Reinke's disease].

The aim of the study was to compare different surgical techniques in treatment of Reinke's edema according to subjective and quantitative changes of voice characteristics. We evaluated 62 surgically treated patients from 34 to 68 years (mean 47.7 years) with Reinke's edema. Two endolaryngeal microsurgical methods were used: classical as mechanical stripping of the mucosa-Ist, mechanical stripping group (n = 30), and removal of fluid through aspiration with preservation of vocal cord medial edges mucosa-IInd, preserving mucosa group (n = 32). Clinical voice assessment was composed of laryngoscopy, subjective voice evaluation (GRBAS hoarseness scale, visual analogue scale of voice quality, and pitch) and quantitative voice evaluation (seven quantitative voice parameters obtained from voice range profile (VRP) and registering of maximum phonation time). Patients were evaluated twice--before operation and at mean 23.8 days after. Postoperative follow-up data was registered from 57 patients: 28 from Ist and 29 from IInd groups. According to our data the positive dynamics for all voice parameters was observed in both patients' groups. Surgical approach with preservation of vocal cord medial edges mucosa on overall benefit after operation according to the voice quality is statistically significantly better compared to classical operation technique (chi 2 = 8.9, p = 0.029). While comparing these two approaches statistically significant differences were found for subjective voice parameters--grades of hoarseness and roughness, and for quantitative VRP parameters: pitch range, maximum-minimum intensity range, total voice area, and overall vocal dysfunction degree. The mean values of most voice parameters in early postsurgery period significantly differed from normal. Clinical voice assessment may be useful for evaluation of surgical treatment efficacy as well as for comparison of surgical techniques.

Adult↗
PubMed2003

[Diagnosis and treatment in 45 patients with Hashimoto's thyroiditis associated with throat symptoms].

OBJECTIVE: To assess the diagnosis and treatment in the patients complaining of throat discomfort that resulted from Hashimoto's thyroiditis (HT). METHOD: Forty-five patients were reported for their clinical dates, 17 had abnormal sensation of pharynx, 5 stabbing feeling, 10 compressive feeling, 7 dry feeling, 6 sore throat. The pharyngeal symptoms were accompanied with hoarseness in 4. Thyroid uptake of 99mTc scan showed abnormal in 37 and normal in 8. Serum T3, T4 level was abnormal in 33 and normal in 12. Serum TSH level was abnormal in 26. Antithyroid antibodies estimated in 32 patients detected positive titers of TMAb and TGAb in 21 (66%) and in 18 (56%), respectively. Thirty were diagnosed as having HT by thyroid fine-needle aspiration biopsy (FNAB), 7 Hashimoto's hyperthyroidism. Tab. Thyroids were administrated to the patients at the period of euthyroidism or hypothyroidism and Propylthiouracilum to the ones at the period of hyperthyroidism. RESULT: Thirty-two patients received the follow-up for six months, throat symptoms disappeared in 27 and improved in 5. CONCLUSION: Abnormal sensation of pharynx and hoarseness as well as sore throat play an important role in symptomatology of HT. Medicine therapy may make the patients with HT free of throat symptoms.

Adolescent↗
PubMed1992

Pediatric laryngeal granular cell tumor.

Granular cell tumor of the larynx is an uncommon, benign tumor which has rarely been described in the pediatric population. Fewer than 10 cases in children under the age of 10 years have been reported. This paper describes two pediatric patients: An eight-year-old boy with a seven-year history of hoarseness due to an anterior subglottic tumor, and an 11-year-old boy with a one-year history of hoarseness due to a left true vocal cord tumor. Subglottic involvement by laryngeal granular cell tumor is rare in adults, but has been seen in half of the reported cases in the pediatric population. The clinical course of granular cell tumor and its pathology are reviewed.

Child↗
PubMed2003

[The pathogenesis and treatment exploration of vocal cord paralysis].

OBJECTIVE: To investigate the causes and effective treatment of vocal cord paralysis(VCP). METHOD: Sixty-five patients with VCP in our hospital in recent 10 years were analyzed. All the patients underwent examination by indirect laryngoscope, stroboscopy or electrolaryngostroboscopy, of which, 31 cases were operated by stiring arytenoid cartilage. RESULT: Fourteen cases with VCP were caused by neck and thoracic tumor; Nine cases were caused by infectations; sixteen cases were caused by neck, thoracic, abdominal openations; twelve cases were caused by trachea intubation; Three cases were caused by gastric intubation; Eleven cases were caused without obvious reason. All the symptoms of VCP were cured after treatment in 37 cases. The improvement rate of hoarseness was 58.46%. CONCLUSION: Patients with hoarseness should be routinely examinated by indirect laryngoscope, stroboscopy or electrolaryngostroboscopy. Arytenoid cartilage of patients with VCP should be stired by indirect laryngoscope or direct laryngoscope or self-retaining laryngoscope as early as possible.

Adolescent↗
PubMed2005

[Granular-cell myoblastoma of the larynx clinical analysis].

Clinical date of four cases of granular-cell myoblastoma tumors arising in the larynx and clinical analysis of 11 cases published in Polish literature were reviewed and studied. Granular-cell tumor is a rare, usually benign neoplasm that can occur in various part of the body. The larynx tumor is accounting for 7% to 10% of all reported cases. The most common laryngeal location in our study were the posterior part of true vocal cord. Sex predilection was no observed. The tumor was generally presented in patients in their forth and fifth decade. Slowly increasing hoarseness was the most common symptoms but some patients reported moderate dysfagia as well. Typically the tumors were painless. Only in one case the breathing difficulty was the reason of tracheotomy. Clinically the tumors were considered benign. The most common clinical impressions was a vocal polyp, cysts, granulomas or nodules. The surgical procedure and local excision in laryngoscopy (in 9 patients), laryngofissura (in 5 patients) were mostly sufficient to radical treatment. In one case because the location and size of the tumor subtotal laryngectomy was necessary to conduct. After surgery the voice often was preserved but sometimes slightly hoarseness were observed. Treatment is usually curative with no recurrences. The knowledge about natural history and therapeutic implications of such tumors is essential to choose appropriate therapy and planning surgery.

Adult↗
PubMed2006

Lipoid proteinosis in a 12-year-old child: a report from west India.

A 12-year-old male child born of non-consanguineous parents presented with multiple skin lesions, hoarseness of voice, and episodes of epilepsy since early childhood. The findings of characteristic beaded eyelid margins, patchy alopecia of the scalp, hoarseness of voice, and epilepsy were consistent with a rare clinical diagnosis, lipoid proteinosis. Skin biopsies obtained from representative skin lesions were subjected to histology and electron microscopy. Light microscopy demonstrated PAS-positive diastase-resistant material in the papillary dermis of skin. Ultrastructure revealed granulo-filamentary aspect of the accumulated material. Although this rare autosomal recessive disorder has been described in the literature, its occurrence is rare in India.

Alopecia↗
PubMed1991

[Twelve cases of laryngeal tuberculosis].

Between 1986 and 1990 we had twelve patients (ten males, two females, 19-65 years of age) with laryngeal tuberculosis who complained hoarseness and whose larynges were examined by fiberscopes. Chest roentgenograms revealed cavities in ten and in seven the lesions were extensive (Grade 3 according to the classification of Japanese Society for Tuberculosis). In all patients sputum smears were positive. Both patient's and doctor's delays were longer than those of patients with pulmonary tuberculosis without laryngeal involvements. Group infection was the source of infection in one patient. Since the diagnosis of laryngeal tuberculosis is difficult to make on clinical basis, it is important to make fiberscopic examinations of the larynx and do biopsies in patients with pulmonary tuberculosis who complain hoarseness.

Adult↗