1/18. Laryngeal sarcoidosis: treatment with the antileprosy drug clofazimine.sarcoidosis is a chronic systemic granulomatous disease that occasionally affects the larynx. When the larynx is affected, the symptoms are frequently mild, but severe airway obstruction can occur. Although systemic corticosteroids are helpful, patients may become refractory to further drug administration. The current methods of treatment are here summarized, and the patient literature is reviewed. We also report a case of a young patient suffering from laryngeal sarcoidosis successfully treated by the antileprosy agent clofazimine and propose it as an alternative treatment of laryngeal sarcoidosis in patients refractory to corticosteroids.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/18. A huge epiglottic cyst causing airway obstruction in an adult.An epiglottic cyst causing airway obstruction is rare in an adult. Early definitive diagnosis and management obviate an unnecessary tracheostomy. We report a case of a 64-year-old woman who arrived at our hospital with progressive stridor and foreign body sensation when swallowing for 6 weeks. A hot potato voice and biphasic stridor were remarkable upon physical examination. Indirect mirror and fibroscopic examination revealed a huge epiglottic cyst. The neck lateral X-ray and computed tomography scan demonstrated a huge cystic mass over the epiglottis. A 2.5 x 3.0 cm cystic mass was removed with endoscopic CO2 laser after needle decompression. The patient was discharged on the third day after surgery without complications. An epiglottic cyst in an adult seldom causes upper airway obstruction and is easily ignored by clinicians. We emphasize that complete airway evaluation including routine check-up of the larynx is mandatory for patients with intractable obstructive airway disease. Endoscopic laser surgery is effective in the surgical removal of an epiglottic cyst.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
3/18. A case of chondronecrosis of the epiglottis after laser chordotomy.A 30-year-old Caucasian female patient suffering from bilateral vocal-fold immobility developed a necrosis of the epiglottis with severe respiratory distress 35 days after fiber-guided Nd:YAG-laser chordotomy on the right side. Twenty-two years prior to surgery, she had received a high-dose radiotherapy, which had caused severe scarring of the whole neck and the larynx. This necrosis is more likely an inflammatory complication than a direct side effect of the laser surgery in the radiation-altered laryngeal tissue. It underlines the importance of carefully considering the indications for laser surgery of an irradiated larynx.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
4/18. paracoccidioidomycosis and larynx carcinoma.Report of a case of paracoccidioidomycosis associated with a carcinoma: both located in the larynx in a patient whose therapeutic response to antifungal treatment produced a recovery of physical conditions. This case shows the importance of taking into account the diagnosis of paracoccidioidomycosis in all patients with problems in the larynx, especially those who inhabit or inhabited endemic areas of paracoccidioides brasiliensis.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
5/18. Multidisciplinary management of the airway in a trauma-induced brain injury patient.laryngomalacia occurs in some brain injury patients secondary to global muscle hypotonia. Surgical therapies for epiglottis prolapse have centered around removal or reshaping of the epiglottis. This approach has brought mixed success and frequent complications. We present a case that demonstrates successful nonsurgical treatment of a 33-year-old male brain injury patient with moderate obstructive sleep apnea that is believed to be a consequence of post-brain injury nocturnal epiglottis prolapse. The presence of a tracheostomy performed at the time of emergency surgery had become an emotional and physical barrier to our patient's recovery. The tracheostomy could only be reversed if the obstructive sleep apnea disorder could be managed in an alternative fashion. A titratable mandibular repositioning appliance was prescribed and its effectiveness was demonstrated with nasolaryngoscopy and polysomnography. After initially fitting the oral appliance, a period of accommodation and gradual protrusive adjustments was allowed. Subsequent confirmation polysomnography demonstrated improvement, but not suitable resolution, of disordered breathing events. However, an additional 1.25-mm protrusive titration of the oral appliance during the course of the confirmation polysomnogram led to therapeutic success. The patient's tracheostomy was subsequently reversed with significant quality of life benefits.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
6/18. vocal cord dysfunction presenting as asthma.A 14 year old boy presented with deteriorating asthma and marked stridor. Neither asthma nor stridor responded to an increase in anti-asthma medication, including high dose oral steroids. Indirect laryngoscopy revealed adduction of the vocal cords throughout the respiratory cycle, a phenomenon previously identified as a psychosomatic conversion reaction. When gently confronted with these findings and offered psychological assistance the boy's symptoms abated totally. After two sessions of hypnotherapy he has had better control of both his physical (asthma) and psychological problems.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
7/18. Obligate mouth breathing during exercise. Nasal and laryngeal sarcoidosis.A young black man presented with simultaneous nasal and laryngeal sarcoidosis, each uncommon entities. Despite severe upper airway obstruction and emergent tracheostomy, there was an uncharacteristic rapid response to oral steroids alone. The patient's predominant initial complaint of early mouth breathing during routine army physical training demonstrates a symptom complex and an alternate mechanism of dyspnea to consider in sarcoidosis.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
8/18. Bilateral abductor vocal cord paralysis in charcot-marie-tooth disease.This report descirbes the unusual association of bilateral abductor vocal cord paralysis (BAbVCP) and charcot-marie-tooth disease in a boy and his natural mother who have been followed for eight years. The boy initially presented with life-threatening respiratory distress at age ten years; BAbVCP was documented by direct laryngoscopy. Mirror laryngoscopy confirmed BAbVCP in the mother. Neurological diagnosis was made by history, physical examination, electromyography, and nerve conduction velocity studies. The BAbVCP may represent an additional genetic marker within the spectrum of heredodegenerative disorders. Of clinical importance is examination of voice and respiratory symptomatology of patients with heredodegenerative diseases and neurological work-up of patients with familial vocal cord paralysis. Further genetic and clinical studies of X cranial nerve involvement in heredodegenerative disorders are warranted.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
9/18. Laryngeal spasm mimicking bronchial asthma.The list of asthma masqueraders grows, emphasizing the need for a careful analysis of the patient suffering from cough, wheezing and/or dyspnea. The present case report describes a 23-year-old patient with spastic vocal cord adduction, initially treated as bronchial asthma. Severe disruption in her arterial blood gases was present. The vocal cord adduction persisted in spite of valium anesthesia. The patient's symptoms and signs were relieved with a tracheostomy. However, the vocal cord spasm persisted.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
10/18. Pseudocarcinomatous hyperplasia of the larynx due to candida albicans.A female patient presented with hoarseness. Findings on physical examination showed whitish true vocal cords. Laryngeal biopsies were performed on two two occasions. On the first biopsy a histopathological diagnosis of candida albicans and acanthosis was controversial because the acanthosis resembled squamous cell carcinoma. On the second biopsy, several months later, the diagnosis of acanthosis was again controversial, but a diagnosis of pseudocarcinomatous hyperplasia was not determined until several months later. Finally, we can point out that pseudocarcinomatous hyperplasia can be associated with primary candidiasis and state that hoarseness, whitish true vocal cords, and pseudocarcinomatous hyperplasia can masquerade as squamous cell carcinoma of the larynx.- - - - - - - - - - ranking = 0.66743759774846keywords = physical (Clic here for more details about this article) |
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