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.
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.
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.
February 25, 2013 David N. Myerson, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS
Radiation-induced fibrosis can be found in tissues of the neck, pharynx, larynx, esophagus, ear, and temporomandibular joint. It is associated histologically with aggregates of macrophages, fibroblasts, vascular connective tissue changes, and deposition of extracellular matrix. This fibrosis can lead to strictures, stenosis, trismus, ulcerations, and scarring, which can present as dysphagia and dysphonia.