Cases reported "Laryngeal Diseases"

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1/21. Sudden recurrent laryngeal nerve paralysis due to apoplexy of parathyroid adenoma.

    Neoplastic lesions of the parathyroid are rare, and most of these are adenomas. Even rarer is a secondary involvement of the recurrent laryngeal nerve. A case is presented of sudden onset hoarseness in a 64-year-old man caused by acute vocal cord paralysis due to bleeding within an adenoma of the lower right parathyroid gland. Acute onset of vocal cord paralysis is rarely associated with benign processes; the current case is only the second report associated with parathyroid adenoma.
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2/21. Laryngeal hamartoma: surgical management.

    A newborn female infant with severe inspiratory stridor was found to have a laryngeal non-encapsulated hamartoma in the supraglottic area, medial to the hyoid bone and extending into the petiole of the epiglottis. Histologic examination revealed an extremely uncommon glandular hamartoma. Surgical management in the newborn period consisted of conservative endoscopic excision combined with open laryngofissure. The hamartoma was removed in the newborn period to avoid tracheostomy, because decanulation after tracheostomy in infants can be difficult.
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3/21. Glandular hamartoma of the larynx.

    Glandular hamartoma of the larynx is an extremely rare lesion, and the number of well-documented and acceptable cases is limited. Presenting symptoms may include changes in voice, eating and activity levels, and respiratory complaints. We report on a 14-month-old infant with this rare clinical entity. Direct laryngoscopy revealed a well-mucosalized, encapsulated, firm, 0.5 cm wide and 2.5 cm long lesion that originated from the right aryepiglottic fold and reached into the nasopharynx. The mass was completely excised endoscopically. Histopathological examination revealed a hamartoma, which was composed of glandular elements, mixed with mesodermal tissues. After endoscopic removal of the hamartoma, the child was relieved of the obstruction.
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4/21. sarcoidosis with upper respiratory tract involvement.

    The aim of the study was to investigate the upper respiratory tract as a site of extrapulmonary sarcoidosis. diagnosis of sarcoidosis with upper respiratory tract involvement was performed on the basis of clinical, laboratory, radiographic and histological evidence and by excluding other granulomatous diseases in eight patients followed by the sarcoidosis Regional Reference Centre pneumologists in collaboration with an experienced ENT specialist at Siena University. In five cases, sarcoidosis was localized in the parotid glands, in the other three subjects larynx, nasopharynx and nose were involved. In four patients parotid gland, nasopharynx and upper respiratory tract mucous membrane involvement was the only clinical manifestation at onset of the disease. Upper respiratory tract involvement should be suspected in all patients with systemic sarcoidosis and in patients with persistent upper respiratory tract symptoms of unknown cause. What a general practitioner should do as not to miss SURT is underlined. Interdisciplinary management and collaboration are of paramount importance for rapid diagnosis and to avoid the possible complications of this form.
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5/21. Marginal zone B-cell lymphoma of minor salivary gland representing tumor-forming amyloidosis of the oral cavity. A case report.

    We report here a case of mucosa-associated lymphoid tissue (MALT)-type lymphoma arising from the minor salivary gland of the oral cavity exhibiting tumor-forming amyloidosis. The patient was a 64-year-old Japanese woman who presented with 4-year history of a left soft palate mass. Despite multiple and multifocal recurrences including the lip, soft palate, tongue, oral base and vocal code and soft palate, the tumor remained localized in the upper aerodigestive tract, and the patient did not develop multiple myeloma during the course of disease. Histologically, the majority of the lesion was occupied by amyloid deposition. Only the periphery of the lesion contained numerous plasmacytoid cells, along with occasional centrocyte-like cells. In addition, lymphoepithelial lesion and follicular colonization were noted. The present case indicates that primary minor salivary gland MALT-type lymphoma appears to be the cause of tumor-forming amyloidosis of the upper aerodigestive tract including the larynx.
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6/21. Sudden death due to a laryngeal cyst.

    A 68-year-old woman died suddenly at home; her body was found in an armchair in a sitting position. autopsy revealed a laryngeal cyst of a dilated secretory gland, located above the vocal cords, which obstructed the glottis, causing asphyxia. A review of the literature with forensic implications is given.
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7/21. Subglottic cysts in the premature infant.

    Supraglottic cysts in the newborn are a well-recognized entity, but subglottic cysts have been rarely reported. Over the past 6 years we have observed subglottic cysts in nine patients with relatively long intubations from the neonatal intensive care unit of two university hospitals. Most frequently the patients were extubated and did well for weeks or months, but then they had progressive biphasic stridor. On endoscopy the patients had a subglottic stenosis that was irregular but with a smooth mucosal lining. Usually the cysts were apparent, but in two patients the mucosa was thickened and the patients were treated as a subglottic stenosis with tracheostomy. These subglottic cysts were recognized at the time of laryngotracheoplasty. In six patients the cysts were managed either by marsupialization with cup forceps, endoscopic diathermy, or carbon dioxide laser without recurrence. It is our belief that this condition is most likely due to scarring and obstruction of mucus glands of the subglottic area from prolonged intubation. This entity should be recognized and looked for in the neonate who has an acquired subglottic stenosis and should first be treated conservatively with endoscopic marsupialization.
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8/21. Oncocytic cystic lesions of the upper respiratory tract.

    Oncocytic cystic lesions in the larynx comprise an uncommon but pathologically well-defined group, whereas only one case has been reported in the nasopharynx. The laryngeal cysts generally originate from the ventricle and occur in an older age group. hoarseness is the most common clinical manifestation, with lesions appearing as polypoid masses. Their pathogenesis is considered to be the result of oncocytic metaplasia, apparently related to aging of cells in the seromucinous gland and ducts. The cystic dilatation is probably due to an obstructive phenomenon. Complete endoscopic removal is the treatment of choice. Examples of these lesions in the larynx and in the nasopharyngeal mucosa are described.
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9/21. Subglottic cysts and asymmetrical subglottic narrowing on neck radiograph.

    The congenital subglottic hemangioma typically appears as an asymmetric subglottic narrowing or mass on frontal neck radiographs. Therefore, soft tissue neck radiography has been advocated as a definitive non-operative approach for diagnosing these lesions. However, we have noted similar asymmetric subglottic narrowing in patients with acquired subglottic cysts. These retention cysts occur following long-term intubation in the neonate. The mechanism probably involves subglottic fibrosis which obstructs glands with subsequent cyst formation. Acquired subglottic cysts typically appear as an asymmetric narrowing on frontal or lateral soft tissue neck radiographs. These lesions may produce airway compromise but are effectively treated by forceps or laser removal. Acquired subglottic cysts must be included in the differential diagnosis of asymmetric subglottic narrowing. The definitive diagnosis is made by direct laryngoscopy, not soft tissue neck radiograph.
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10/21. Routes of infection of acute suppurative thyroiditis diagnosed by barium examination.

    A fistula between the left pyriform sinus and the left thyroid gland region has been reported to be the route of infection in several cases of acute suppurative thyroiditis. Another four patients with acute suppurative thyroiditis have been encountered in whom a fistula from the hypopharynx was demonstrated radiographically. In three patients the fistulous tract was situated on the right side, and in one of these cases the fistula originated from the epiglottic vallecula rather than the pyriform sinus. These locations have not been reported earlier. Endoscopic examination was valuable for confirming the diagnosis.
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