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At least 1,279 records · Page 71Linked to original sources
PubMed1997

Laryngeal inflammation mimicking laryngeal carcinoma.

A case of severe inflammation with an exuberant granulation lesion of the larynx that mimicked laryngeal tumour is presented. A patient who was a chronic smoker, with a history of hoarse voice underwent multiple endoscopies and biopsies, confirmed histopathologically as acute and, subsequently, as chronic inflammation. The tumour-like tissue in the larynx responded dramatically to prolonged antibiotic treatment. We emphasize the importance of histological confirmation before embarking on removal of an essential organ or part of the body which could lead to physical or emotional scarring.

Aged↗
PubMed1997

An unusual case of laryngeal carcinoma metastasizing to the small intestine.

An unusual case of laryngeal carcinoma metastasizing to the small intestine is reported. The patient was admitted to our hospital due to hoarseness, sore throat and dyspnoea. Pathological examination on the laryngeal mass revealed it to be moderately differentiated squamous cell carcinoma, staged as T4N0M0. A total laryngectomy and right modified neck dissection were performed. Over two years after the operation a small intestinal tumour was found, with a resultant resection of the ileum and sigmoid colon. An infiltration of the cell nests of squamous cell carcinoma were present at the submucosal regions of the ileum. These findings indicated that the laryngeal cancer had already metastasized to the small intestine at the time of the initial treatment.

Aged↗
PubMed1997

Asphyxial death caused by a laryngeal schwannoma: a case report.

Neurogenic tumours of the larynx are unusual, with approximately 115 cases reported in the literature to date. Most of these lesions are benign, solitary submucosal nodules which present with hoarseness and are amenable to surgical resection. We present a case of a large pedunculated schwannoma arising in the aryepiglottic fold associated with sudden asphyxial death in an otherwise healthy young female.

Adult↗
PubMed1998

Granular cell tumour of the larynx.

Granular cell tumour (GCT) is a benign tumour with abundant eosinophilic cytoplasm filled with granules of varying sizes. These granules are the defining characteristic of the GCT and are believed to represent lysosomes in varying stages of fragmentation. The commonly used term granular cell myoblastoma, found in the older literature, is a misnomer because the tumour is clearly not of muscle origin. Among the major theories of origin, some support the tumour's derivation from neuronal tissue, histiocytes, fibroblast or Schwann cells. In the larynx, pseudoepitheliomatous hyperplasia may predispose to confuse the GCT with squamous cell carcinoma. The most common region of GCT is in the head and neck, accounting for approximately 30 to 50 per cent of all lesions. The larynx is relatively an uncommon location for these tumours, accounting for approximately three to 10 per cent of the reported cases. Affected patients typically present with persistent hoarseness, stridor, haemoptysis, dysphagia, and otalgia, but the tumour may be asymptomatic and be discovered only incidentally during a routine examination. Complete excision with an attempt to maintain normal structures generally results in cure. We present the case of a patient with typical features of a GCT of the larynx. The gross appearance, histopathology and brief discussion of the current literature are also presented.

Adult↗
PubMed1998

Sudden onset aphonia caused by a Japanese-style bath.

An 86-year-old man was referred by his family physician to our clinic because of sudden onset aphonia immediately after a Japanese-style bath. On examination, the only abnormality was aphonia, with an otherwise normal physical examination. However, we found vocal fold oedema on laryngeal fibrescopy. For treatment, he was immediately given 30 mg prednisolone intravenously. Twelve hours after injection the oedema had completely disappeared and his aphonia had resolved. The patient was healthy for three months after returning home. However, at the beginning of a cold winter night he again complained of sudden onset hoarseness, after taking a Japanese-style bath. Japanese-style baths are completely different from Western-style baths. There is a temperature difference of almost 30 degrees C between the inside and outside of a bath; the transition may represent a type of physical exercise in elderly and exhausted individuals. This difference could cause a cold or heat-induced allergic reaction. We strongly recommend a laryngeal study in case of sudden onset aphonia.

Aged↗
PubMed2006

Benign mucous membrane pemphigoid of the upper aero-digestive tract: rare paraneoplastic syndrome presentation in renal cell carcinoma.

Benign mucous membrane pemphigoid is a rare autoimmune disorder affecting the upper aero-digestive tract and conjunctivae. This is a case presentation of benign mucous membrane pemphigoid affecting the oral mucosa, pharynx, oesophagus and larynx, leading to cicatricial lesions in the pharynx and larynx, causing dysphagia, hoarseness and stridor. The alternative forms of management for laryngeal scarring due to this disease are explained. The patient was later diagnosed with advanced renal cell carcinoma, raising the possibility of cicatricial pemphigoid manifesting as a paraneoplastic syndrome of underlying renal cell carcinoma.

Aged↗
PubMed2006

Ear, nose and voice problems in children with orofacial clefts.

The purpose of this study was to compare the prevalence of ear, nose and particularly voice problems in groups of children with cleft palate (CP) and with unilateral cleft lip, alveolus and palate (UCLP). On the basis of history, regular otorhinolaryngological examinations and hearing tests, the prevalence of different pathologies was assessed in 80 CP children (35 boys and 45 girls) and 73 UCLP children (47 boys and 26 girls). Ear pathology was reported in 53.8 per cent of CP children and in 58.9 per cent of UCLP children. Nasal breathing was impaired in 14 CP (17.5 per cent) and 36 UCLP (49.3 per cent) children. Dysphonia was detected in 12.5 per cent of CP and 12.3 per cent of UCLP children. In 9.2 per cent of all cleft children, functional voice disorder caused a hoarse voice. Two-thirds of cleft children with functional dysphonia had protracted hearing loss. Therefore, ENT specialists must take an active role early in the treatment of children with clefts.

Articulation Disorders↗
PubMed2006

Comparison of LMA Unique, Ambu laryngeal mask and Soft Seal laryngeal mask during routine surgical procedures.

BACKGROUND AND OBJECTIVE: This study was performed to compare three disposable airway devices, the LMA Unique (LMA-U), the Ambu laryngeal mask (Ambu LM) and the Soft Seal laryngeal mask (Soft Seal LM) for elective general anaesthesia during controlled ventilation in non-paralysed patients. METHODS: One hundred and twenty ASA I-III patients scheduled for routine minor obstetric surgery were randomly allocated to the LMA-U (n = 40), Ambu LM (n = 40) or Soft Seal LM (n = 40) groups, respectively. Patients were comparable with respect to weight and airway characteristics. A size 4 LMA was used in all patients and inserted by a single experienced anaesthesiologist. Oxygenation, overall success rate, insertion time, cuff pressure and resulting airway leak pressure were determined as well as a subjective assessment of handling and the incidence of sore throat, dysphagia and hoarseness. RESULTS: Time of insertion was shortest with the Ambu LM, while failure rates were comparable with the LMA-U, the Ambu LM and the Soft Seal LM (median 19 s; range 8-57 s; success rate 100% vs. 14; 8-35; 97% vs. 20; 12-46; 95%). Insertion was judged 'excellent' in 75% of patients in the LMA-U group, in 70% of patients in Ambu LM group and in 65% of patients in the Soft Seal LM group. There was no difference between devices with respect to postoperative airway morbidity at 6 h or 24 h following surgery. CONCLUSIONS: All three disposable devices were clinically suitable with respect to insertion times, success rates, oxygenation, airway and leak pressures, as well as to subjective handling and postoperative airway morbidity.

Air Pressure↗
PubMed1997

Dual-channel ambulatory esophageal pH monitoring. A useful diagnostic tool?

Ambulatory pH monitoring of the distal esophagus is the most accurate diagnostic study for patients with suspected gastroesophageal reflux disease (GERD). The measurement of proximal esophageal acid exposure time may be useful in patients with atypical reflux symptoms. The aim of this study is to evaluate if proximal esophageal pH monitoring provides useful information beyond that learned with distal esophageal pH monitoring. We routinely performed dual-channel pH monitoring with pH electrodes positioned at 20 and 5 cm above the manometric lower esophageal sphincter from January 1992 to August 1995. All patients scored their esophageal symptoms from zero (none) to four (severe). We compared proximal esophageal reflux (PR) in patients with typical symptoms (i.e., heartburn, regurgitation) and in patients with atypical symptoms (i.e., chest pain, cough, hoarseness, and asthma). We compared symptom profiles between patients with and without PR. We reviewed our experience in patients with abnormal PR, but with a normal amount of distal esophageal reflux (DR). We studied 441 consecutive patients. There were no significant differences in PR between patients with typical and atypical symptoms. There were no differences in symptom profiles between patients with normal and abnormal PR. There were no differences of PR between the different atypical symptoms. PR did not correlate with the severity of the patient's symptoms. PR correlated well only with DR. Twenty-four patients had isolated abnormal PR, but only six patients improved with antireflux therapy. We conclude that routine ambulatory esophageal pH monitoring of the proximal esophagus appears to be of little value. The decision to offer patients an empiric trial of antireflux therapy for suspected GERD should not be based on the presence or absence of PR.

Adult↗
PubMed2004

[Carcinoma of the mouth and pharynx--better prognosis by an early diagnosis!].

Carcinomas of the mouth and pharynx rank sixth of all malignant tumours worldwide. They are responsible for 10% of the newly diagnosed malignant tumours. The median five year survival rate is 50%, depending on tumour localisation and size, but mainly determined by lymph node metastases. Carcinomas of the mouth and pharynx cause symptoms that resemble those of common harmless diseases of the head and neck such as pharyngitis. This can lead to misinterpretation by both, the patient and the doctor. Since the initial delay by the patient is difficult to influence it is very important that the doctor is aware of a possible malignant disease. Persistent common symptoms such as swallowing impairment or hoarseness, mucosal lesions, such as leukoplakia, a persistent cervical lymph node and unresponsiveness to initial treatment, must prompt the doctor to initialise appropriate diagnostic steps (incisional biopsy, e.g.). Only early diagnosis can help to improve the prognosis of patients with carcinomas of the mouth and pharynx.

Adult↗
PubMed2005

[Laparoscopic fundoplication for gastroesophageal reflux disease (GERD)].

Laparoscopic fundoplication became the gold standard in the surgical therapy of GERD. In comparison with open procedures, laparoscopic antireflux surgery has a lower morbidity rate, a better early and late postoperative outcome and is more cost-effective. Antireflux surgery can be performed after a critical evalutation of the patient including gastroscopy, biopsy, 24h-pH-manometry and after a long lasting conservative medical treatment. Indications for antireflux surgery are given by a failed medical treatment, an insufficient compliance, complications of GERD, i.e. stenosis, Barrett-esophagus and atypical reflux symptoms like chronic cough, hoarseness or thoracic pain with presence of a pathological pH-monitoring. Laparoscopic 360 degrees Nissen-fundoplication with crurorrhaphy is our standard procedure, whereas the 270 degrees Toupet technique in our tailored approach is the technique of choice for esophageal motility disorders. Results of antireflux surgery published in literature are discussed and compared with our own ten years experience with 124 cases of laparoscopic fundoplication.

Female↗
PubMed2005

[Gastroesophageal reflux disease].

Gastroesophageal reflux disease (GERD) includes different manifestations of esophageal and extraesophageal affections, such as erosive reflux disease, Barrett's esophagus, laryngitis and even pulmonary diseases. Typical symptoms are heartburn and acid regurgitation, but there are a lot of atypical disturbances like hoarseness or chronic cough. Endoscopy is the most important diagnostic procedure for elderly patients and for those with atypical symptoms. Younger people without alarming symptoms can be tested for GERD by treatment with proton pump inhibitors (PPI). The therapeutic approach depends on the endoscopic findings. PPI are preferred drugs to manage most GERD-related problems. Anti reflux surgery is appropriate for selected patients. Long-term followup data will help to define the benefit of new endoscopic procedures. Barrett's esophagus has to be regarded as a precancerous lesion, therefore surveillance strategy is required.

Aged↗
PubMed2000

Amyloidosis of the larynx: a clinicopathologic study of 11 cases.

Laryngeal amyloidosis (LA) is uncommon and poorly understood, with limited long-term clinicopathologic and immunophenotypic studies in the literature. Eleven cases of LA were retrieved from the files of the Otorhinolaryngic-Head & Neck Tumor Registry from 1953 to 1990. The histology, histochemistry, immunohistochemistry, and follow-up were reviewed. All patients (three women and eight men) presented with hoarseness at an average age of 37.8 years. The lesions, polypoid or granular, measured an average of 1.6 cm and involved the true vocal cords only (n = 4), false vocal cord only (n = 1), or were transglottic (n = 6). An acellular, amorphous, eosinophilic material was present in the stroma, often accentuated around vessels and seromucous glands, which reacted positively with Congo red. A sparse lymphoplasmacytic infiltrate was present in all cases that demonstrated light chain restriction by immunohistochemistry in three cases (kappa = 2, lambda = 1). Serum and urine electrophoreses were negative in all patients. Treatment was limited to surgical excision, including a single laryngectomy. Six patients manifested either recurrent and/or multifocal/systemic disease: two patients with light chain restriction were dead with recurrent disease (mean, 11.1 years); two patients were dead with no evidence of disease (mean, 31.7 years); and two patients were alive, one with light chain restriction and recurrent and multifocal disease (41.6 years) and one with no evidence of disease after a single recurrence (43.4 years). The remaining five patients were either alive or had died with no evidence of disease an average of 32.4 years after diagnosis. No patient developed multiple myeloma or an overt B-cell lymphoma. LA is an uncommon indolent lesion that may be associated with multifocal disease (local or systemic). The presence of an associated monoclonal lymphoplasmacytic infiltrate and recurrent/multifocal disease in the respiratory or gastrointestinal tract of a few cases and the lack of development of a systemic plasma cell dyscrasia or overt systemic B-cell malignancy suggest that some LA may be the result of an immunocyte dyscrasia or tumor of mucosa-associated lymphoid tissue.

Adult↗
PubMed2001

Giant cell tumor of the larynx: a clinicopathologic series of eight cases and a review of the literature.

True giant cell tumors of the larynx (GCTL) are quite rare, and only individual case reports are documented in the literature. Eight cases of GCTL were identified in the Otorhinolaryngic Pathology Tumor Registry between 1966 and 2000. There were 2 women and 6 men, ages 26 to 62 years (mean, 44.5 yrs). Patients presented with a palpable neck mass (n = 5), airway obstruction (n = 3), hoarseness (n = 3), and dysphagia (n = 2). All tumors involved the thyroid cartilage, a few with local extension. The mean tumor size was 4.1 cm. Histologically, the tumors showed no connection to the surface epithelium and arose in sites of ossification. The tumors had an expansile, infiltrative growth and consisted of numerous multinucleated osteoclast-like giant cells within a cellular stroma composed of plump, oval mononuclear cells. Of interest was that the nuclei of the giant cells were similar to the nuclei of the stromal cells. Treatment included biopsy only with adjuvant therapy (n = 2), local resection (n = 3), and total laryngectomy (n = 3). Follow-up showed 5 patients were alive without evidence of disease (mean follow-up, 6.9 yrs); 2 died of unrelated causes (mean survival, 22.2 yrs). No patients developed recurrences. GCTL are rare tumors that can cause significant airway obstruction. Complete surgical resection yields an excellent outcome without adjuvant therapy.

Adult↗
PubMed1999

Physical and psychological symptoms of quality of life in the CHART randomized trial in head and neck cancer: short-term and long-term patient reported symptoms. CHART Steering Committee. Continuous hyperfractionated accelerated radiotherapy.

The randomized multicentre trial of continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in patients with advanced head and neck cancer showed no good evidence of a difference in any of the major clinical outcomes of survival, freedom from metastases, loco-regional control and disease-free survival. Therefore an assessment of the effect of treatment on physical and psychological symptoms is vital to balance the costs and benefits of the two treatments. A total of 615 patients were asked to complete a Rotterdam Symptom Checklist and the Hospital Anxiety and Depression Scale, which cover a variety of physical and psychological symptoms, at a total of ten time points. The data consisted of short-term data (the initial 3 months) and long-term data (1 and 2 years). The short-term data was split into an exploratory data set and a confirmatory data set, and analysed using subject-specific and group-based methods. Differences were only claimed if hypotheses generated in the exploratory data set were confirmed in the confirmatory data set. The long-term data was not split into two data sets and was analysed using a group-based approach. There was evidence of significantly worse symptoms of pain at day 21 in those treated with CHART and significantly worse symptoms of cough and hoarseness at 6 weeks in those treated conventionally. There was also evidence to suggest a higher degree of decreased sexual interest at 1 year and sore muscles at 2 years in those treated with conventional radiotherapy. There is no clear indication that one regimen is superior to the other in terms of 'quality of life', generally the initially more severe reaction in the CHART group being offset by the longer duration of symptoms in the conventionally treated group.

Anxiety↗
PubMed2004

Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.

To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah (n1 = 1,243 teachers and n2 = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p <.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p <.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.

Absenteeism↗
PubMed1976

Shaping behavior in voice therapy.

This study demonstrates the process of learning and shaping of behavior which occurs during a program of therapy for individuals with hyperfunctional hoarse voice quality. First a therapy program delineating the techniques and criteria to be used was written. The program was presented during 16 individual half-hour sessions over an eight-week period to three clients known to have vocal nodules. The clients' responses were charted at various points from audiotape recordings of each therapy session using a modification of the Boone-Prescott analysis system, to obtain data to demonstrate the learning processes. It was concluded that: (1) the client's behaviors in this vocal rehabilitation program reflected a learning process; (2) facilitating techniques were used to modify or shape behavior through successive approximations to the terminal goal; (3) self-evaluation is an important factor needed to bring about successful changes in behavior; (4) analysis of client's behaviors in relation to the learning process can aid in evaluating the effectiveness of the facilitating techniques; and (5) from such evaluation intraclient and interclient program changes are derived hopefully resulting in a greater success rate and maximum benefits from time spent in therapy.

Behavior Therapy↗
PubMed1990

Predicting voice quality of deaf speakers on the basis of glottal characteristics.

Twenty profoundly deaf and 5 normal-hearing subjects produced 225 sustained vowels/a, i, u/at different pitch levels and 75 phonetically balanced sentences, while vocal fold vibration was recorded through an electrolaryngograph (ELG). The utterances recorded on audio tape were judged by 10 experienced listeners on general voice quality, breathiness, hoarseness, and laryngeal strain on a 5-point scale. Seven parameters describing time-domain characteristics of the ELG-signal were extracted online by a special purpose computer system. Measurements were made over 500 consecutive vibratory cycles (10-cycle window), yielding a mean and standard deviation for each parameter per utterance. All data were submitted to analysis of variance and multiple regression analyses. Multiple correlations between glottal parameters and judged voice deviations varied between .46 and .70 indicating that overall prediction cannot reliably be based on these parameters, although severe cases of deaf voice deviations may be detectable.

Adolescent↗