Surgical resection of cervical schwannoma and paraganglioma: Speech and swallowing outcomes

August 26, 2015     Noah P. Parker, MD; Noel Jabbour, MD; Amy Anne Lassig, MD; Bevan Yueh, MD, MPH; Samir S. Khariwala, MD


We conducted a retrospective study (1999 to 2009) at our tertiary care institution to evaluate speech and swallowing outcomes after the resection of cervical schwannoma or paraganglioma. Of 6 patients treated for schwannoma, 5 (83.3%) had immediate dysphonia and dysphagia. All patients with deficits received primary reinnervation (n = 2) or subsequent medialization laryngoplasty (n = 3). At 6 months, 4 patients (66.6%) still had dysphonia and dysphagia. At final follow-up (median: 10 months; range: 8 to 12 months), 4 patients (66.7%) had dysphonia and 2 (33.3%) had dysphagia. Of 10 patients treated for paraganglioma, 6 (60.0%) had immediate dysphonia and dysphagia. Four patients received subsequent medialization laryngoplasty; none had primary reinnervation. At 6 months, 3 (30%) still had dysphonia and dysphagia. At final follow-up (median: 15.5 months; range: 1.25 to 48 months), 2 (20.0%) had dysphonia and dysphagia. All patients with deficits received speech and swallowing therapy. We conclude that cervical schwannoma and paraganglioma resection was associated with high rates of immediate postoperative dysphonia and dysphagia. Schwannoma had higher initial rates and poorer recovery. Primary and/or subsequent laryngeal procedures combined with therapy led to symptom resolution in some patients.

Lipoid proteinosis of the larynx

March 2, 2015     Jagdeep Singh Virk, MA(Cantab), MRCS, DOHNS; Sonal Tripathi, BSc, MBChB; Ann Sandison, FRCPath; Guri Sandhu, MD, FRCS, FRCS(ORL-HNS)

here is no accepted gold standard of management, but surgery should be used judiciously in selected patients to improve voice function and maintain the airway. Long-term follow-up and repeat procedures are usually required for disease control, and genetic counseling may be needed.

Amyotrophic lateral sclerosis presenting as bilateral abductor paralysis

December 19, 2014     Michelle Levian, DO; Reena Gupta, MD, FACS

Occasionally, patients who have amyotrophic lateral sclerosis initially present with vocal and respiratory signs and symptoms.

Vocal fold tear in an operatic tenor

September 17, 2014     Joel E. Portnoy, MD; Robert T. Sataloff, MD, DMA, FACS

The patient complained of increased throat clearing and coughing. He had experienced similar symptoms 3 months previously, which had resolved with voice rest.

Arytenoid cartilage chondroma

August 27, 2014     Joel E. Portnoy, MD; Johnathan B. Sataloff; Mary J. Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA, FACS

Strobovideolaryngoscopy revealed a mass along the medial aspect of the left arytenoid cartilage.

Laryngeal tuberculosis: Use of videostroboscopy in diagnosis

February 12, 2014     Michelle Levian, DO; Amy Chapman, MA-SLP; and Reena Gupta, MD

The diagnosis of laryngeal tuberculosis is often suspected clinically, but in patients with less specific symptoms, flexible laryngoscopy may reveal only an inflammatory picture.

Synovial sarcoma of the parapharyngeal space

December 20, 2013     Jagdeep Singh Virk, MA, MRCS; Dhafir Al-Okati, FRCPath; Hesham Kaddour, FRCS ORL-HNS

Infection after vocal fold lipoinjection

December 20, 2013     Christopher V. Lisi, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS

Arteriovenous malformation of the neck: An unusual cause of hoarseness successfully treated with endovascular techniques

October 23, 2013     Joseph J. Gemmete, MD; Neeraj Chaudhary, MD; Aditya S. Pandey, MD; Dheeraj Gandhi, MD; Sameer A. Ansari, MD, PhD


Hoarseness is a common presenting symptom in patients referred to the otolaryngology clinic. An arteriovenous malformation (AVM) in the neck is a previously unreported cause of hoarseness. We describe the case of a 61-year-old woman who presented with hoarseness and vocal fold paralysis, which was caused by an AVM. She was successfully treated with endovascular embolization. Devascularization of the AVM resulted in symptomatic relief of the hoarseness and resolution of the vocal fold paralysis, presumably secondary to interval reduction in edema and venous congestion.

Primary laryngeal actinomycosis in an immunosuppressed woman: A case report

July 21, 2013     Tarik Abed, MBBS; Jay Ahmed, MBBS; Niamh O'Shea, MBBS; Simon Payne, FRCPath; Gavin W. Watters, FRCS


We report a rare case of primary laryngeal actinomycosis, which occurred in a 35-year-old woman with end-stage renal failure secondary to systemic lupus erythematosus with membranous glomerulonephritis. The patient, who had been on long-term immunosuppression therapy, presented with hoarseness. Flexible laryngoscopy detected the presence of a granular glottic mass at the anterior commissure of the larynx. Histology revealed actinomycotic organisms associated with an abscess. The patient was treated with a prolonged course of oral penicillin V and speech therapy, and her dysphonia resolved almost completely. Although actinomycotic infection of the larynx is rare, it should be considered in the differential diagnosis of hoarseness in an immunocompromised patient.

Supraglottoplasty for airway obstruction

June 11, 2013     Nausheen Jamal, MD; Farhad Chowdhury, DO; Reena Gupta, MD; and Robert T. Sataloff, MD, DMA, FACS

Supraglottoplasty may be helpful in a patient with tracheotomy-dependent  adult obstructive sleep apnea/hypopnea syndrome that is causally related to or aggravated by supraglottic obstruction.

Prolonged ulcerative laryngitis in an 18-year-old voice major

April 17, 2013     Brent L. Toland, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS

Management of prolonged ulcerative laryngitis requires close observation with strobovideolaryngoscopy; therapy involves steroids, antibiotics, antifungal drugs, and antireflux treatment.

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