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At least 1,369 records · Page 76Linked to original sources
PubMed2004

Laryngeal paraganglioma: an updated critical review.

Laryngeal paragangliomas are rare submucosal lesions that arise from paraganglion cells located in the false vocal fold and subglottic larynx. To date, 76 recognized cases have been reported in the world literature. Symptoms arise when the lesions become large enough to impair function. Supraglottic paragangliomas cause hoarseness and deglutition disorders, whereas subglottic tumors become symptomatic when they obstruct the airway. Evaluation of these tumors includes obtaining a complete history. Familial paragangliomas and hypertension should be sought but are rarely, if ever, associated with laryngeal paragangliomas. MRI can detect these lesions and permit characterization of the vascularity of the lesion. Adding 111In pentetreotide scanning can distinguish neuroendocrine tumors from other submucosal laryngeal lesions, making the preoperative diagnosis clearer and obviating the need for biopsy. The biggest dilemma regarding laryngeal paragangliomas is making the correct pathologic distinction between paraganglioma, typical carcinoid, atypical carcinoid and medullary thyroid cancer. Immunohistochemical markers, supplementing standard histopathologic evaluation, can distinguish paragangliomas from the aforementioned tumors. This distinction is critical as the prognosis for treated paragangliomas is excellent compared to that for other neuroendocrine neoplasms. Almost all alleged malignant paragangliomas of the larynx are in reality atypical carcinoid tumors that have been misdiagnosed. Treatment should always comprise excision. Thyrotomy has the best chance of achieving a sustained cure without damaging phonation or deglutition. Laser excision has been used successfully but there is no great experience with this modality. Surgery is preferable to radiation for paragangliomas in all locations but especially so in the larynx, due to issues such as swelling, airway protection and destruction of cartilage. With increased clinical suspicion and the use of modern imaging techniques, laryngeal paragangliomas should be routinely diagnosed and treated without loss of laryngeal functions.

Age Distribution↗
PubMed2006

Application of mitomycin C after endoscopic lysis of congenital laryngeal web combined with epiglottic hypoplasia in a middle-aged man.

Laryngeal webs and epiglottic hypoplasias are uncommon congenital anomalies. Anterior glottic web combined with epiglottic hypoplasia was found in a middle-aged man presenting with hoarseness and dyspnea on exertion. This can be considered as a unique isolated defect of the larynx during early fetal development. The laryngeal web can be successfully treated in a single stage with endoscopic lysis and topical application of mitomycin C for prevention of anterior glottic restenosis. This case and prior reports suggest that the novel approach may be effective in the treatment of laryngeal webs.

Antibiotics, Antineoplastic↗
PubMed2006

Six cases of Forestier syndrome, a rare cause of dysphagia.

Dysphagia is a common presenting complaint in otolaryngology practice, and there are many causes. Forestier syndrome is a rare cause of dysphagia. It is also known as diffuse idiopathic skeletal hyperostosis (DISH) syndrome or vertebral ankylosing hyperostosis. Forestier syndrome consists of anterolateral perivertebral ligament calcification. It was first described by Forestier and Rotes-Querol in 1950; diagnosis is primarily radiological and the etiology is unknown. In addition to dysphagia Forestier syndrome has been reported to cause laryngeal stridor, dyspnea, snoring and hoarseness. Other important symptoms associated with Forestier syndrome are stiffness and pain in the back, pain related to tendinitis, myelopathy related to core compression associated with the ossification of the posterior longitudinal ligament, and pain related to vertebral complications such as fracture or subluxation. We report six cases of Forestier syndrome as an etiologic factor in dysphagia and present clinical and radiological findings.

Aged↗
PubMed1998

Plexiform schwannoma of the neck extending deeply to the mediastinum.

We describe a 42-year-old man who had tumors occupying the right deep neck through the upper part of the mediastinum. The right vocal cord was fixed and bulgings of the pharyngeal and tracheal wall were observed. At surgery, the masses were subtotally removed as much as possible. Histological examination revealed that they were schwannomas. The postoperative course was uneventful, except for the presence of hoarseness.

Adult↗
PubMed1999

Glottic and supraglottic laryngeal carcinoma: differences in epidemiology, clinical characteristics and prognosis.

In order to evaluate differences in epidemiology, clinical characteristics and prognosis, 166 glottic and 127 supraglottic cases of laryngeal squamous cell carcinoma diagnosed between 1962 and 1991 at Tampere University Hospital, Finland, were reviewed. The annual age-adjusted incidence in males decreased from 6.7/100,000 to 2.6/100,000 and the proportion of glottic tumours increased from one-third to two-thirds during the study period. The proportion of early stage lesions was greater among glottic tumours, and patients with a supraglottic tumour presented more often with neck node metastases. Hoarseness was the most common symptom, being more prevalent in patients with a glottic tumour. The symptom pattern of supraglottic carcinoma was altogether more diffuse. The 5-year disease-specific survival was 81% in glottic and 70% in supraglottic disease, but the difference in survival was not statistically significant. In the multivariate Cox regression analysis, higher T-category and presence of neck node metastases had adverse prognostic effect, while location of the tumour did not significantly affect the prognosis. Favourable changes in smoking habits seem to be the main reason for the incidence decrease and obviously also for the decrease in the proportion of supraglottic tumours.

Age Factors↗
PubMed1992

Hypnotherapeutic intervention for voice disorders related to recurring juvenile laryngeal papillomatosis.

Recurring juvenile laryngeal papillomatosis is resistant to cure, and thus usually requires multiple operations which may lead to the extensive proliferation of vocal fold scar tissue. Severe hoarseness, sharply lower pitch, and weak loudness levels are common sequelae. Adjunctive hypnotherapy can increase motivation for change, speed up the acquisition of vocal skills, and possibly even facilitate or sustain remission of growths in selected patients. An 8-year-old girl with severe active eruptions went into remission after 16 sessions, and a 12-year-old boy, already in remission at the beginning of the intervention period, remained free of neoplasms throughout the regimen. Whether or not hypnosis contributed significantly to the sanguine results, it is probable that, at the least, the hypnotic intervention facilitated the achievement of certain technical objectives in voice therapy.

Child↗
PubMed1988

Unilateral vocal cord palsy in a diabetic patient.

Remittent isolated palsy of peripheral or of upper cranial nerves in patients with diabetes mellitus is well documented, but paralysis of a lower cranial nerve or an isolated branch of any cranial nerve has not been previously reported. In the case described, temporary paralysis of the left recurrent laryngeal nerve caused vocal cord palsy in a patient with insulin-dependent diabetes. The patient had hoarseness, which totally remitted within eight weeks, presumably owing to improved metabolic control.

Apraxias↗
PubMed1993

Atypical pneumonias. Clinical and extrapulmonary features of Chlamydia, Mycoplasma, and Legionella infections.

Pneumonias caused by atypical organisms usually have extra-pulmonary features. Chlamydial pneumonia often starts with hoarseness and fever, and respiratory tract symptoms may not appear for days. Mycoplasmal pneumonia may manifest with ear pain and a nonproductive cough. Legionnaires' disease presents with high fevers and central nervous system and gastrointestinal abnormalities. Diagnosis of chlamydial infection is accomplished with serologic testing. Patients are unresponsive to erythromycin treatment and should be started on empirical doxycycline (Doryx, Vibramycin) therapy. The presence of cold agglutinins in the appropriate clinical setting permits a presumptive diagnosis of mycoplasmal infection. Clinical diagnosis of Legionella pneumonia may be made in patients with pneumonia who also have relative bradycardia with elevated serum transaminases or hypophosphatemia with gastrointestinal or central nervous system symptoms. Erythromycin is the mainstay of treatment of legionnaires' disease, but treatment failures have been reported. Doxycycline is less expensive, has a better safety profile, and is better tolerated than erythromycin.

Anti-Bacterial Agents↗
PubMed2003

Effect of pantoprazole on the course of reflux-associated laryngitis: a placebo-controlled double-blind crossover study.

BACKGROUND: The optimal management of patients with reflux-associated laryngitis is unclear. We performed a placebo-controlled crossover trial in patients with proven reflux disease and associated laryngitis to determine the effect of pantoprazole and to gain information on the natural course of the disease. METHODS: Sixty-two consecutive non-smoking patients with hoarseness and proven laryngitis were examined. Scores with respect to the larynx and for subjective complaints were determined and 24-h pH-metry to assess acid reflux in the lower oesophagus and pharynx was performed. Patients with pathologic reflux were given the chance to enter a double-blinded randomized crossover trial with pantoprazole 40 mg b.i.d. and placebo for a duration of 3 months each, separated by a 2-week washout period. RESULTS: Twenty-four of 62 patients showed pathological reflux; 21 patients were included in the study and 14 concluded all parts of the study. Both pantoprazole and placebo resulted in a marked improvement in laryngitis scores (decrease of 8.0 +/- 1.4 versus 5.6 +/- 2.6; no significant difference between the 2 treatments) and symptoms after the first 3 months (decrease of oesophageal symptom score of 2.2 +/- 1.4 versus 5.4 +/- 2.8; decrease of laryngeal scores of 8.3 +/- 3.6 versus 10.3 +/- 3.9; also no significant difference between the 2 treatments). A second pH-metry 2 weeks thereafter proved the persistence of reflux in most of these patients. Switching to pantoprazole led to a further improvement of scores. In the group switched to placebo there was recurrence only in a minority of patients. CONCLUSIONS: The self-limited nature of reflux-associated laryngitis in non-smokers is largely underestimated. Laryngitis improves despite the persistence of reflux. Pantoprazole may be helpful especially in relieving acute symptoms, but the advantage of long-term treatment over placebo has been greatly overestimated.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2006

Endoscopic treatment of gastroesophageal reflux disease: effect of gender on clinical outcome.

OBJECTIVE: Gender differences in gastroesophageal reflux disease have been reported. Higher frequency and severity of symptoms, lower esophageal acid exposure and lower incidence of reflux-related complications have been observed in women. The aim of this study was to determine whether there are any gender differences in clinical presentation, diagnostic evaluations and response to endoscopic therapy in patients with gastroesophageal reflux disease. MATERIAL METHODS: Patients with gastroesophageal reflux disease referred for endoscopic therapy were scored for typical (heartburn and regurgitation) and atypical (chest pain, cough, wheezing, and hoarseness) symptoms at baseline. Upper endoscopy, manometry and pH studies were performed for all patients. Endoscopic treatment consisted of placement of two to three sutures within 2 cm of the squamocolumnar junction. Reflux symptoms were re-scored after endoscopic treatment. RESULTS: Ninety-five patients (37 M, 58 F, mean age 51 years) were included in the analysis. Male and female patients at baseline reported similar severity of typical reflux symptoms as well as comparable prevalence of atypical symptoms. Manometric findings were also comparable between the genders. Endoscopic and ambulatory pH studies revealed a higher incidence of erosive esophagitis and a trend towards higher acid exposures in male patients. The response to endoscopic therapy was similar for men and women. CONCLUSIONS: Apart from a higher incidence of erosive esophagitis in male patients, no major differences were found in endoscopic, manometric, esophageal acid exposure studies and clinical response to endoscopic therapy between the genders.

Endoscopy, Gastrointestinal↗
PubMed2004

Mycotic aneurysm caused by Burkholderia pseudomallei with negative blood cultures.

We describe a case of bacterial aortitis caused by Burkholderia pseudomallei. This patient presented with prolonged fever and hoarseness of voice. Aneurysm removal with Dacron graft replacement was performed, followed by a prolonged course of antibiotics. The patient has progressed satisfactorily without recurrence of symptoms. Previous case reports are summarized.

Aneurysm, Infected↗
PubMed2003

Perceptual evaluation of motor speech following treatment for childhood cerebellar tumour.

The speech characteristics, oromotor function and speech intelligibility of a group of children treated for cerebellar tumour (CT) was investigated perceptually. Assessment of these areas was performed on 11 children treated for CT with dysarthric speech as well as 21 non-neurologically impaired controls matched for age and sex to obtain a comprehensive perceptual profile of their speech and oromotor mechanism. Contributing to the perception of dysarthria were a number of deviant speech dimensions including imprecision of consonants, hoarseness and decreased pitch variation, as well as a reduction in overall speech intelligibility for both sentences and connected speech. Oromotor assessment revealed deficits in lip, tongue and laryngeal function, particularly relating to deficits in timing and coordination of movements. The most salient features of the dysarthria seen in children treated for CT were the mild nature of the speech disorder and clustering of speech deficits in the prosodic, phonatory and articulatory aspects of speech production.

Adolescent↗
PubMed1999

A cross-sectional validation study of Self-Evaluation of Communication Experiences after Laryngeal Cancer--a questionnaire for use in the voice rehabilitation of laryngeal cancer patients.

A psychometric evaluation of the questionnaire 'Self-Evaluation of Communication Experiences after Laryngeal Cancer' (S-SECEL) addressing communication dysfunction in patients with laryngeal cancer was carried out. Ninety-three patients with laryngeal cancer were studied. For comparison of response patterns and external validation, 21 patients with non-small cell lung cancer (NSCLC) and 26 patients with hoarseness, caused by benign laryngeal disease, were included in the analysis. The patients completed three questionnaires; the S-SECEL, the Sickness Impact Profile (SIP) and the Hospital Anxiety and Depression scale (HAD). The S-SECEL questionnaire was well-accepted by the patients, compliance was satisfactory, and missing value rates were low. The reliability of the S-SECEL was satisfactory for the Environment and Attitude subscales, whereas the General subscale did not reach the reliability levels recommended for group comparisons. In general, the response pattern in the three diagnostic groups and the pattern of correlations between the S-SECEL scores and the SIP- and HAD-subscales and dimensions lent support to the construct validity of the S-SECEL.

Aged↗
PubMed2003

An extremely rare case of synchronous occurrence in the larynx of intravascular lymphoma and in situ squamous cell carcinoma.

We present the first case of laryngeal intravascular lymphoma coexisting with in situ squamous cell carcinoma. The patient, a 53 years old man, presented with hoarseness starting a year ago and underwent laryngoscopy, which revealed two nodular lesions on his right vocal cord. The histological and immunohistochemical examination of the biopsy specimens established the diagnosis of in situ squamous cell carcinoma coexisting with intravascular lymphoma of T-cell origin. Taking in consideration all the available references, the larynx has not until now been reported as a primary site of involvement of intravascular (angiotropic) lymphomas, nor as a secondary location in the systematic course of this disease. Furthermore no cases have been reported in the literature, concerning the synchronous affection of the larynx by this lymphoma and in situ laryngeal carcinoma, or other type of neoplasm.

Antigens, CD↗
PubMed2003

Vocal hygiene in radio students and in radio professionals.

In this study 27 future professional voice users (i.e., radio students) and 53 professional voice users (i.e., radio professionals) were questioned on their vocal hygiene. Both groups differed clearly in age and in radio experience. The mean age of the radio students was 22 years, whereas the mean age of the radio professionals was 41 years; radio students had no radio experience and radio professionals' experience ranged from 2 to 32 years. This study shows that the vocal hygiene of radio professionals is not superior to the vocal hygiene of radio students. On the contrary, every group has a distinctive vocal hygiene profile. The intake of coffee was significantly higher in radio professionals (p < 0.001) and they indicated significantly more vocal fatigue (p = 0.028). The radio students, on the other hand, experienced more acid reflux problems (p < 0.001) and signalled significantly more hoarseness (p = 0.012). Next to this, both groups smoked more than one could expect from (future) professional voice users (radio students: 33%; radio professionals: 28%). This study demonstrates the necessity of an adapted vocal hygiene education programme for both future and professional voice users, as they seem to underestimate the negative implications of bad vocal hygiene.

Adult↗
PubMed2006

Occupational voice complaints and objective acoustic measurements-do they correlate?

To enable the development of appropriate diagnostics and treatment for occupational voice disorders, this study addresses connections between subjective voice complaints and objective observations. The subjects of this study were 24 female customer advisors, who mainly use the telephone during their working hours. During one working day, at four different times, speech samples covering 20 minutes of telephone conversation by the customer service advisors (CSAs) were recorded. In addition, the CSAs filled in a questionnaire (visual analogue scale) concerning their voice problems. To represent the vocal symptoms three variables were used: vocal fatigue, hoarseness and a general sum-variable. A 5-minute sample was taken from recordings for further analyses. This included fundamental frequency, sound pressure level, alpha ratio (the ratio between the spectral energy below and above 1000 Hz) and number of vocal fold vibrations. In the objective acoustic measurements, it was found that fundamental frequency (F0) rose significantly during the working day. Also the self-reported voice symptoms increased significantly during the working day. However, correlations between vocal symptoms and acoustic measures were not found.

Adult↗
PubMed2000

Review of thyroid cancer cases among patients with previous benign thyroid disorders.

A previous register linkage study showed an increased risk of thyroid cancer among patients previously discharged from a hospital with a diagnosis of a benign thyroid disorder. In this study, we have reviewed all available medical records, first to validate the earlier result and second to describe the symptomatology of patients with a history of benign thyroid disorder prior to the cancer diagnosis. The previous study identified 189 patients with a benign and subsequent malignant thyroid disorder. Medical records were obtainable for 156 of these patients and were reviewed. For 104 patients, benign and malignant thyroid diseases were metachronous (a clearly separated disease history of the benign and malignant diseases), and for 48 patients synchronous. In 4 cases, thyroid cancer could not be confirmed. Among patients with metachronous thyroid disorders, all major benign thyroid disorders were represented including hot nodules, diffuse and multinodular toxic and nontoxic goiter. Symptoms preceding diagnosis of thyroid cancer included growth of goiter/nodules, globulus, stridor, hoarseness, and metastasis. No major differences were found among patients with metachronous and synchronous benign and malignant thyroid disorder, apart from the fact that all metastases were found among metachronous cases. This study confirmed the conclusion that patients with a previous history of goiter or nodules have an increased risk of thyroid cancer. However, thyroid cancer still occurs too infrequently to warrant screening in all patients with a previous history of goiter or nodules.

Goiter↗
PubMed2003

Treatment of recurrent nodular goiters with percutaneous ethanol injection: a clinical study of twelve patients.

Twelve patients who had previously undergone thyroid surgery received percutaneous ethanol injection (PEI) treatment because of recurrent nodular goiter (3 with a toxic [TN], 2 with a nontoxic cystic [NCN], and 7 with a nontoxic solid nodule [NSN]). Two of the 12 had recurrent nerve palsy contralateral to the nodule. Each patient received a mean total dose of 0.88 mL of ethanol per milliliter of nodular volume. Ethanol was injected in a mean of 3.5 sessions for solid and 3 sessions for NCN. In most cases, a slight to moderate burning pain was experienced during and for 12-48 hours after PEI treatment, and one patient experienced temporary hoarseness. One patient with TN and 2 patients with NSN became hypothyroid, 7 patients with nontoxic nodules remained euthyroid, 1 with TN became euthyroid, and a previously hyperthyroid patient with TN became subclinically hyperthyroid 1-year posttherapy. The nodule shrank by more than 50% of the pretreatment volume in all patients (8.6 +/- 2.6 vs. 2.9 +/- 1.2 mL in TN, and 12.3 +/- 4.9 vs. 4.16 +/- 2.54 mL in nontoxic nodules, pretreatment vs. 1 year posttreatment volume, respectively). With regard to the increased risk of reoperation, PEI treatment can be proposed for patients with recurrent nodular goiter requiring surgery.

Administration, Cutaneous↗