| Vocal fold granulomas secondary to endotracheal intubation, vocal abuse, and laryngopharyngeal reflux are a well-described cause of hoarseness, generally in the adult population. The mean age of onset is usually in the fourth or fifth decade, and the position is most commonly on the vocal process or one of the arytenoids. We present an atypical case involving a pediatric patient with a large, anterior, true vocal fold granuloma following rigid endoscopy of the upper conductive airway. ( info) |
2/31. Lethal midline granuloma starting as granuloma laryngis. We report a case of lethal midline granuloma in a 34-year-old male patient. The patient was referred to our hospital because of long-lasting hoarseness. He was treated for granuloma laryngis. After two years nasal obstruction developed followed by ulceration of the hard palate and destruction of part of the nose and the upper lip. A biopsy demonstrated polymorphic infiltrate consisting of small lymphocytes, plasma cells, macrophages, atypical lymphoid cells and eosinophils. radiotherapy was very effective and led to long-term remission. The different etiological aspects of this syndrome are discussed. ( info) |
3/31. Neglected laryngeal foreign body. Laryngeal foreign bodies, especially in children, mostly present as an acute emergency. Few cases of long-standing laryngeal foreign bodies have been reported in the literature. This case illustrates one of the sequelae of a neglected laryngeal foreign body, resulting in significant granulation tissue formation in the larynx, and its management. ( info) |
4/31. Oro-facial granulomatosis: a laryngeal presentation. We report the first case of oro-facial granulomatosis (OFG) presenting in pregnancy with laryngeal manifestations. ( info) |
5/31. Pulmonary hyalinizing granuloma with laryngeal and subcutaneous involvement: report of a case successfully treated with glucocorticoids. We report a case of pulmonary hyalinizing granuloma (PHG) with laryngeal and subcutaneous involvement. A 43-year-old man was admitted to our hospital for assessment of hoarseness. Cervical and chest computed tomography, respectively, revealed a laryngeal tumor and two pulmonary masses. Specimens obtained from the pulmonary masses were compatible with PHG. The histopathology of biopsy specimens from both the laryngeal tumor and a subcutaneous tumor resembled that of the resected lung masses. Although there is no established treatment for PHG, the laryngeal tumor was diminished and all other lesions disappeared with glucocorticoid treatment. ( info) |
6/31. Lateral thyrotomy with strap muscle transposition for Teflon granuloma. Lateral thyrotomy and strap muscle transposition have been used independently before. However, the published literature does not record the coordinated use of both procedures in the treatment of Teflon granuloma. In this paper, we present a case of vocal fold paralysis that had been treated successfully by Teflon injection in 1999. Two years later, however, the patient developed a host of symptoms that included a husky voice, shortness of breath and suffocation, which indicated Teflon granuloma. He underwent surgery to excise the Teflon granuloma via a lateral thyrotomy. The affected paraglottic space was then reconstructed using strap muscle transposition. One year postoperatively, the glottis had closed completely on phonation, and the voice retained a moderate roughness due to a scarring change from the earlier Teflon reaction. The patient had no problems with aspiration or shortness of breath during speaking. Our experience indicates that a physician can remove the entire granuloma and create a smooth, straight vibratory surface with complete glottic closure during phonation by using a combination of lateral thyrotomy and strap muscle transposition. ( info) |
7/31. Left ventricular hypertrophy with outflow tract obstruction-a complication of dexamethasone treatment for subglottic stenosis. To our knowledge, this is the 1st reported case of steroid-induced obstructive cardiomyopathy in a child being treated for subglottic stenosis. As well, although born at 27 weeks, our patient was over 4 kg and 4 months of age (44 weeks corrected gestational age). This appears to be a phenomenon chiefly involving premature babies in the neonatal period with no reports of this occurring in patients greater than 40 weeks corrected gestational age. Signs of cardiac hypertrophy include tachycardia, new cardiac murmur, increased oxygen requirements, decreased urine output, and decreased peripheral perfusion. diagnosis and eventual recovery was confirmed with serial echocardiograms. knowledge of this serious side effect of dexamethasone will allow otolaryngologists to intervene early and prevent a potentially deadly complication. ( info) |
8/31. How I do it: miniplate reconstruction of the lateral thyroid lamina: one-stage restoration of voice after teflon granuloma resection. This case report describes a one-stage technique for long-term voice restoration and laryngeal reconstruction in the treatment of Teflon (Dupont, Wilmington, delaware) granuloma. A patient who presented with severe dysphonia underwent resection of a Teflon granuloma via a lateral laryngotomy. A pedicled strap muscle flap was used to reconstruct the paraglottic space. The muscle flap was positioned through the lateral laryngotomy with direct endoscopic visualization of the endolarynx to ensure correct vertical positioning and medialization of the vocal fold. The muscle flap was secured in this position with suture fixation. The trapdoor piece of cartilage that was elevated to create the window in the lateral thyroid lamina was repositioned over the pedicled muscle flap and reinforced with a titanium miniplate, which was secured to the remaining thyroid cartilage. The patient had excellent voice results and has not required revision or augmentation. Reinforcement of the lateral thyroid lamina using titanium miniplate fixation helps to stabilize the muscle pedicle flap and the position of the vocal fold, in this case resulting in good long-term voice results after a single-stage reconstruction. ( info) |
9/31. Obstructive subglottic granuloma after removal of a minitracheostomy tube. We report herein a patient with subglottic granuloma after removal of a minitracheostomy tube (Minitrach II, SIMS Portex Inc., Hythe, Kent, UK). The patient underwent pulmonary resection for lung cancer followed by insertion of the minitracheostomy tube for prevention of sputum retention. The tube was removed 4 days after insertion. Twelve weeks later, the patient developed severe dyspnea and stridor. bronchoscopy showed an obstructive subglottic granuloma arising from the anterior wall. The granuloma was removed by coring out using a conventional tracheal tube, followed by local injection of methylprednisolone acetate. The patient is now asymptomatic without regrowth of the granulation tissue 12 weeks after the treatment. With complication in mind, attention should be paid to patients suffering dyspnea or stridor after removal of a minitracheostomy tube. ( info) |
10/31. Voicing concern: an unusual sequalae of orthognathic surgery. Contact granuloma of the vocal cords is a recognised but unusual complication of prolonged endotracheal intubation. The authors have however encountered a case of contact granuloma associated with short-term intubation of just four hours following orthognathic surgery. Here we briefly describe the orthodontic case and orthognathic surgery. We further explain the presenting symptoms and treatment undertaken for the contact granuloma. ( info) |