11/13. Laryngeal involvement by systemic lupus erythematosus.Indirect laryngeal photography with the rod laryngeal telescope provided an excellent method of documenting evolution of the laryngeal pathology in two cases of systemic lupus erythematosus. This disease may have mucosal or serosal manifestations in the larynx. Currently, management of mucosal disease includes acute and long-term corticosteroid therapy, and should the airway become compromised by edema or scarring, then tracheostomy and specific laryngeal reconstruction during a quiescent period in the disease is required. The course of serosal involvement, notably cricoarytenoid arthritis, may be followed by observing vocal cord motion sequentially and assessing the degree of throat pain. Oral corticosteroids in maintenance dosages is the accepted modality of treatment, with dosage being boosted for exacerbations.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/13. Coexistent asthma and functional upper airway obstruction. case reports and review of the literature.Three asthmatic patients with dyspnea and episodes of apparent bronchospasm unresponsive to conventional therapy are described. During these episodes variable extrathoracic upper airway obstruction and airflow limitation typical of bronchial asthma were demonstrated by spirometry test results. In one patient, paradoxical vocal cord motion was identified by fiberoptic laryngoscopy. We believe these patients represent an unusual subgroup of asthmatic subjects who manifest laryngeal dysfunction. Recognition of this upper airway component to airflow limitation in some asthmatic patients may help physicians avoid potentially unnecessary therapy with systemic steroids and endotracheal intubation.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
13/13. A classification scheme for paradoxical vocal cord motion.Paradoxical vocal cord motion (PVCM) is characterized by the inappropriate adduction of the true vocal cords during inspiration. Multiple causes have been proposed for this group of disorders, which share the common finding of mobile vocal cords that adduct inappropriately during inspiration and cause stridor by approximation. Management of this group of disorders has been complicated by the lack of a classification scheme to include all types of PVCM. We propose that PVCM be classified according to its underlying etiology and recognize the following causes of the disorder: 1. brainstem compression; 2. cortical or upper motor neuron injury; 3. nuclear or lower motor neuron injury; 4. movement disorder; 5. gastroesophageal reflux; 6. factitious or malingering disorder; 7. somatization/conversion disorder. case reports are presented to illustrate the characteristic features and diagnostic evaluation used in assessing patients with PVCM. Management varies depending on the cause of PVCM and entails speech therapy, pharmacologic therapy, behavioral modification, and/or surgical intervention. Recognition of the multiple causes of PVCM allows otolaryngologists to formulate well-directed diagnostic evaluation and treatment.- - - - - - - - - - ranking = 5keywords = motion (Clic here for more details about this article) |
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