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A 61 year old man was referred for upper digestive endoscopy having dyspeptic syndrome. He also associated hoarseness. The examination revealed an ulcer scar on the gastric angle (chronic gastritis upon histological examination) and a well differentiated spinocellular laryngeal carcinoma, further treated by surgical excision.
The endotracheal intubation and laryngeal mask airway confer many advantages for surgical patients. However, a number of problems and complications with airway management by endotracheal intubation and laryngeal mask airway have been documented. In this report, several problems by using endotracheal intubation (e.g. hoarseness, arytenoids dislocation) and laryngeal mask airway (e.g. aspiration, oropharyngeal leak, gastric distension) are summarized.
In developing countries like Indonesia, pulmonary tuberculosis still ranks among the major health problems and the prevalence of laryngeal tuberculosis are therefore still high. It is important for physicians and otolaryngologist to recognize the cardinal sign and symptoms of laryngeal tuberculosis in order to make an early diagnosis. An illustration of four cases with laryngeal tuberculosis is reported. All cases presented with hoarseness and diagnosis of laryngeal and pulmonary tuberculosis were made at ENT department.
Schwannomas of the larynx are rare, benign, slowly growing tumors. When they do occur, they are most often isolated in the aryepiglottic folds or false vocal folds. When a tumor originates in the larynx, it typically causes hoarseness and a globus sensation. As the tumor expands, it may cause dyspnea, stridor, and possibly asphyxiation as a result of the mass effect. In this article, we report an unusual case of a schwannoma of the true vocal fold in a young woman.
Extranodal laryngeal lymphoma is extremely rare. We report a case of primary laryngeal lymphoma in a 76-year-old man who had presented with a 7-week history of progressive hoarseness. Laryngoscopy revealed asymmetry of the right false vocal fold. Pathology of a deep biopsy specimen identified a malignant, diffuse, CD20-positive, B-cell lymphoma. The stage IE lymphoma completely resolved after treatment with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab. Despite its relative rarity, the consequences of a missed diagnosis warrant vigilance for this type of laryngeal tumor.
Lipoid proteinosis is a rare autosomal recessive disorder; it presents in early childhood with hoarseness, skin infiltration and thickening with beaded papules on eyelid margins, and facial acneiform or pock-like scars. Although 250 cases have been reported until now, the occurrence of disease in siblings is very rare. We report three familial cases of lipoid proteinosis involving a brother and sister and their nephew.
The purpose of this study is to define, analyse and discuss the incidence and severity of the complications associated with anterior cervical spine surgery for degenerative disc diseases. The results and the management of complications of anterior spine surgery are discussed in relation to numerous previous published reports: precise knowledge of all potential accidents and pitfalls related to the surgical approaches and of their aetiology may contribute to preventing failures. The most common complication was a recurrent laryngeal nerve injury that developed in 7.9% of the cases. Dysphagia occurred in 5.6%, hoarseness in 5.2%, transient sore throat in 4.8%, worsening of pre-existing myelopathy in 3%, graft extrusion in 1.7%; root injury, haematoma, and wound infection developed in 0.87%. There was one case of oesophageal injury (0.43%) and there were no deaths related to the surgical approach. The rate of complications in our series has been reduced in the past years by 1) better patients selection: all of the patients in fact had previously received conservative treatment for at least four weeks; 2) more care in correct positioning of the patient during the operation; 3) meticolous removal of all harmful structures.
A low cost microcomputer system for analysis of the voice of patients with laryngeal diseases is proposed. The system realizes an evaluation of the following speech parameters affected by laryngeal disease: voice degree of hoarseness; pitch period (T0); pitch period perturbations; degree of subharmonic components; and number of the stops in T0 generation during sustained vowel phonation. Other nonacoustic parameters concerning the patient's status are input into the computer using the keyboard. The hardware consists of a microphone and an ADC-board (plugged into the PC) allowing the PC to be used as a system for pathological voice analysis. Preliminary experimental research has shown the effectiveness of the system.
On the grounds of 5 own observations of primary tracheal cylindroma and under consideration of the cases mentioned in literature on this subject, the repeatingly occurring and, therefore, probably typical characteristics of this kind of tumour were described. In the course of the disease, three phases may quite easily be differentiated, and the special features of the main symptoms (dyspnoea, cough, expectoration, hoarseness) as well as apparently specific, however inconstant changes in the blood picture were set forth.
The symptoms and presentations of gastroesophageal reflux disease are rather numerous. These include the typical symptoms, such as heartburn, regurgitation, water brash, or dysphagia. However, reflux may also be responsible for such symptoms as hoarseness, pulmonary aspiration, or asthma. It may also be an important cause of noncardiac chest pain. Thus, gastroesophageal reflux disease may be considered a disease with more than just "esophageal" symptoms.
We report two cases of recurrent episodes of hoarseness, cough, flushing, pruritus, and rash occurring within 30 minutes of topical exposure to carbonless copy paper. Provocative challenges revealed that alkylphenol novolac resin was the ingredient responsible. Video endoscopy of the larynx was performed and plasma histamine levels were obtained prior to and 30 minutes after cutaneous challenge of a patient with alkylphenol novolac resin. We documented marked laryngeal edema and a sixfold increase in plasma histamine levels after challenge. We conclude that topical exposure to carbonless copy paper may cause mast cell/basophil-mediated acute systemic and potentially life-threatening reactions in susceptible patients.
The efficacy and side-effects of Deca-Durabolin (DD) were tested, in a double blind fashion, in twenty female primary Sjögren's syndrome (1 degree SS) patients. Ten randomly assigned patients received DD (100 mg IM bi-weekly) for six months, and ten others placebo, for the same period. Analysis of the results revealed that the DD-treated patients showed a moderate improvement of subjective xerostomia, a significant decrease of the erythrocyte sedimentation rate (ESR), and an overall improvement of their feeling of well-being, -judged by themselves and the investigator subjectively-, when compared with the placebo group. All the sicca objective parameters (results of Schirmer's I test, slit lamp eye examination after rose bengal staining, stimulated parotid flow rate measurements and labial minor salivary gland histopathology) were not significantly altered in either group. The clinical side-effects were the expected ones, i.e. hirsutism, hoarseness and an increase in libido, more pronounced in the DD-treated group. At the end of the study, one DD-treated patient, developed a diffuse well-differentiated B-lymphocytic lymphoma, which regressed spontaneously three months later.
Respiratory stridor and hoarseness were the predominant presenting symptoms in a 63-year-old woman with an hydralazine induced lupus syndrome. Laryngeal tomograms and direct laryngoscopy were consistent with cricoarytenoid arthritis. Proteinuria, anemia, arthritis, and leukocytoclastic vasculitis, as well as the laryngeal findings, all resolved after withdrawal of hydralazine. Laryngeal manifestations of systemic lupus erythematosus are reviewed.
A rare case of idiopathic fibrous mediastinitis is reported. Symptoms, etiology, diagnostic and therapeutic aspects are discussed with reference to the literature. In this case in which dysphagia and hoarseness were the presenting symptoms, a successful oesophageal myotomy was performed.
A case of isolated amyloidosis of the trachea in a woman aged 46 was described. The main clinical signs of the disease were dry cough, recurring hemoptysis and hoarseness of the voice. Endoscopy showed disseminated polypoid formations in the trachea. A histological study of mucosal biopsy from these formations revealed amyloid masses deposited in the submucosal layer. An additional study brought about no data on the generalized nature of amyloid dystrophy of any other organs. The use of computed tomography to determine the type of tracheal lesion in this localization of the process was shown to be promising.
Extension of the voice field (voice profile) by a third variable which characterizes the phonation has various advantages as well as drawbacks. Since the voice field evaluates the laryngeal function, the use of aerodynamic variables improve the representation of the laryngeal efficiency in the voice field. On the other hand, the measurement of these variables complicates the method. When voice quality measures (presence of singing formant, sharpness) are used as the third dimension, the limits of the voice field are unique references for the measures. However, the voice quality at the physiologic limits is not representative of the voice as produced in singing or speaking. Measures which characterize the "hoarseness" of the voice yield important results with respect to the perturbation of the voice production (jitter, shimmer, additive noise). The perturbation measures evaluate the laryngeal function at defined points in the frequency--intensity area. However, in forte phonation, the natural perturbation is reduced, in piano phonation, the perturbation is increased, and the results cannot be interpreted in relation to the perturbation magnitude within the voice field. Besides, the measurement of perturbation requires digital signal processing. If EMG data are used for the voice field, as it is shown for the M. vocalis, the voice field reveals interesting relationships between acoustic and physiologic features. For instance, in the piano phonation, the EMG signal power is constant on a low level. In the forte phonation, in the chest register, the EMG signal power shows a medium level and a high level in the head register. In the falsetto, however, the EMG signal power is low.(ABSTRACT TRUNCATED AT 250 WORDS)
A rare case is reported of an aneurysm of the inferior thyroid artery with hoarseness as the only presenting symptom. The aneurysm was excised. Six years after the operation the patient is well and free of symptoms.
Organs which contain collagen can have connective tissue new growth in systemic scleroderma. The occurrence of scleroderma of the larynx and organs of speech is rare. The disease develops in the mucous membrane in three stages: oedema; infiltration and induration; and atrophy. The oedema stage is generally the shortest. Three patients with systemic scleroderma with involvement of larynx and organs of speech have been seen. In one is described (graphically, sonographically and with stroboscopy) the progress of the disease from an initial severe hoarseness to later resolution of the oedema. In another patient involvement of the soft palate produced rhinolalia. In spite of the limitation of tongue movement in 2 patients there was no disorder of articulation.