April 30, 2009 Emer E. Lang, FRCS(ORL), Eimear Phelan, AFRCSI, and Helena Rowley, FRCS(ORL)
article
Abstract
Amyloidosis confined to the trachea is an exceedingly rare entity. We describe the case of a 63-year-old man who presented with a history of dysphonia and stridor. Rigid bronchoscopy revealed a segment of abnormal tissue at the midtracheal level, resembling granulation tissue. A stent was placed in an attempt to secure the patient's airway, which was >50% narrowed. Although the patient's stridor disappeared completely, 5 days postoperatively it recurred, worsening within hours. Emergency bronchoscopy revealed that the tracheal stent was almost completely obstructed with amyloid and granulation tissue, despite high-dose steroid therapy, and had to be removed. Tracheostomy was performed to bypass the diseased trachea. We also highlight some of the problems encountered with tracheal stenting in benign tracheal disease.
April 30, 2009 Christopher Y. Chang, MD, Peter Chabot, PhD, and Christopher M. Walz, MD
article
Abstract
We conducted a survey to determine the current practices of a subset of physicians in the United States who treat patients with adductor spasmodic dysphonia. Surveys were sent to 169 physicians listed in the National Spasmodic Dysphonia Association database, and responses were returned by 43 (25.4%). Almost all respondents (95.4%) indicated that they use botulinum toxin type A injections, either alone or in combination with other treatments, to treat adductor spasmodic dysphonia, and most (69.8%) inject the toxin under electromyographic guidance. However, there were wide variations in the amount of sterile saline used to reconstitute the toxin, the size of the initial dose, and the use of other treatment strategies.
February 1, 2009 Jeremy D. Richmon, MD, Jessica Wang-Rodriguez, MD, and Apurva A. Thekdi, MD
article
Abstract
Ehlers-Danlos syndrome (EDS) comprises a group of related hereditary connective tissue diseases. EDS manifests as joint hypermobility, tissue elasticity, and easy bruising. Although affected patients typically present to primary care physicians, orthopedists, and rheumatologists, some head and neck symptoms (e.g., dysphonia, dysphagia, and/or temporomandibular joint complaints) may direct some to an otolaryngologist. We describe the cases of 2 patients who presented to our otolaryngology clinic for evaluation of dysphonia. On physical examination, both exhibited tongue hypermobility, and both were subsequently diagnosed with EDS. We also review the results of our comprehensive literature search, in which we found only 3 articles that specifically described tongue hypermobility; in each case, the hypermobility was related to EDS. Finally, we discuss presentations of EDS that otolaryngologists might encounter.
July 31, 2008 Iman Naseri, MD, Sarah K. Wise, MD, and Adam M. Klein, MD
article
Abstract
Although dysphonia is a common complaint among patients seen in an otolaryngology clinic, an autoimmune cause of the problem is less common. Autoimmune disease can be the source of various laryngologic manifestations, but diagnosis depends on a high index of suspicion, careful patient evaluation and testing, and videolaryngoscopy (videostroboscopy if available) to uncover specific identifying findings. This report describes a patient presenting with upper-range vocal difficulties who was found to have early systemic lupus erythematosus.
January 1, 2008 Soham Roy, MD and Richard J. Vivero, MD
June 30, 2007 Gauthier Desuter, MD, MS; Marc Hamoir, MD; Christophe Van Geem, MD; Donatienne Boucquey, MS
March 1, 2007 James R. Tate, MD; Peter C. Belafsky, MD, PhD; Kristen Vandewalker, MD
February 1, 2007 Robert Eller, MD; Mary Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA
August 31, 2006 George Koulouris, FRANZCR; Marcus Pianta, MBBS; Stephen Stuckey, FRANZCR
article
Abstract
Spontaneous retropharyngeal hemorrhage from a cervical parathyroid adenoma is a rare complication of primary hyperparathyroidism. Because of its rarity, it has seldom been documented in the radiologic or ENT literature. Patients may present with a variety of manifestations, ranging from dysphagia to dysphonia to life-threatening dyspnea or hemorrhage. Awareness of a possible thyroid or parathyroid etiology may expedite treatment and prevent unnecessary interventions. We present a case of spontaneous retropharyngeal hemorrhage in which the "sentinel clot" sign enabled us to identify the lesion of origin.
June 30, 2006 Laurie A. Brigandi, DO; Paul V. Lanfranchi, DO; Edward D. Scheiner, DO, FOCOO; Scott L. Busch, DO, FACS
article
Abstract
Evidence is accumulating that herpes simplex virus (HSV) infection is implicated in oncogenesis. HSV antigens have been observed in some oral cancers. We present the case of a 62-year-old man who presented with dysphagia, odyno-phagia, and dysphonia and who was found on computed tomography (CT) to have a mass in his piriform sinus. We suspected a malignancy, but histopathology of biopsy specimens revealed that the mass exhibited the classic signs of the HSV cytopathic effect, including the presence of intranuclear inclusion bodies, ballooning degeneration of epithelial cells, and a ground-glass appearance of some nuclei. The patient responded well to antiviral therapy, and posttherapy CT revealed that the mass had resolved completely. To the best of our knowledge, this is the first report in the literature of a case of HSV infection presenting as a piriform sinus mass.
September 30, 2005 Stacey L. Halum, MD; Jamie A. Koufman, MD
April 1, 2005 Adam Rubin, MD; Johnathan B. Sataloff; Robert T. Sataloff, MD, DMA
