Obstructive sleep apnea syndrome induced by laryngeal lesions: Two cases

October 31, 2012     Taha Tahir Bekci, MD; Mesut Tezer, MD; Nurdogan Ata, MD; Levent Emre, MD


We describe 2 cases of obstructive sleep apnea syndrome (OSAS) that were found to be caused by the presence of laryngeal masses. Both patients presented with a long-standing history of snoring, gasping for air while sleeping, excessive daytime sleepiness, and morning headaches. In both patients, the lesions were discovered by fiberoptic nasopharyngoscopy. Patient 1, a 46-year-old man, declined surgery, and his lesions (and OSAS) resolved spontaneously in 4 months. Patient 2, a 39-year-old man, did undergo excision of his mass, and he also experienced an alleviation of OSAS.

Nasal tip angiolipoma: The “Pinocchio” nasal deformity

October 4, 2012     David A. De Poortere, MD; Boris M. De Poortere, MD; Noam A. Cohen, MD, PhD


Angiolipoma is a rare, benign variant of lipoma; its distinctive feature is its prominent vascularity. It presents as a subcutaneous nodule of white adipose tissue; pain, which may be exacerbated by pressure, is the chief symptom. The anatomic distribution predominantly involves the trunk and extremities. Because of the rarity of this condition in otorhinolaryngology, our understanding of its diagnosis, treatment, and follow-up is limited. Microscopically, two different histopathologic forms of angiolipomas exist: circumscribed and infiltrating. The diagnosis of angiolipoma can be aided by ultrasound, computed tomography, or magnetic resonance imaging. Surgical excision remains the treatment of choice. Sites of previously reported otolaryngologic cases include the cheek, palate, mandible, nasal septum, and cervical area. We describe what we believe to be the second case of a nasal tip angiolipoma in a 78-year-old woman complaining of progressive aesthetic deformity.

Rosai-Dorfman disease with isolated laryngeal involvement

October 4, 2012     Elisa A. Illing, MD; Stacey L. Halum, MD


Rosai-Dorfman disease is a rare histiocyte disorder that is typically characterized by massive cervical lymphadenopathy. Isolated extranodal involvement is uncommon, and isolated laryngeal involvement is extremely rare. We report an unusual case of Rosai-Dorfman disease with isolated laryngeal involvement that led to recurrent dysphonia and airway obstruction. We discuss the challenges we faced in reaching a correct pathologic diagnosis and in deciding on an appropriate treatment regimen. Based on our experience, we believe that Rosai-Dorfman disease should be considered as a differential diagnosis in patients who present with a recurrent inflammatory (histiocytic) mass lesion of the larynx.

Intradermal melanocytic nevus of the external auditory canal

August 10, 2012     Kai-Chieh Chan, MD; Chi-Ju Yeh, MD; Wan-Ling Ho, MD

Intradermal melanocytic nevi are usually asymptomatic, but a patient with such a lesion in the external auditory canal can present with aural obstruction and conductive deafness.

Avoiding misdiagnosis in venous malformation of the parotid

August 10, 2012     Jason Hamilton, MD, FACS; Reena Gupta, MD, FACS

To avoid mistaking parotid masses and venous malformations for each other, based on imaging, requires a high level of clinical suspicioun, especially when operative findings and images are contradictory.

Sulcus vocalis

August 10, 2012     Johnathan B. Sataloff; Rima A. DeFatta, MD; Mary J. Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA, FACS

Sulcus vocalis causes stiffness of the vibratory margin of the vocal folds, and often in adynamic segments. Patients can experience hoarseness, breathiness, increased phonation threshold pressures, decreased vocal efficiency and, commonly, voice fatigue.

Angiofollicular lymphoid hyperplasia (Castleman disease) presenting as an isolated neck mass

August 10, 2012     Benjamin D. Liess, MD; Alan A.Z. Alexander, MD; Matthew E. Dahl, MD; Robert P. Zitsch III, MD; Jason Scott Lawrence Holly, MD


Castleman disease is a relatively uncommon lymphoproliferative disorder. A presentation as an isolated lesion in the neck is extremely rare. We report the case of a 26-year-old man who presented with a 4-month history of an enlarging right neck mass that was identified as Castleman disease on excisional biopsy. The biopsy was curative. In localized forms of Castleman disease, excisional biopsy is both diagnostic and curative. However, in multicentric forms, additional treatment is required.

Paranasal sinus mucocele

July 5, 2012     Lester D.R. Thompson, MD

Radiographic findings are essential to the diagnosis of paranasal sinus mucocele. Usually opacification of the sinus with thinning, erosion, or destruction of the sinus wall are seen.

Laryngeal lipoma

June 4, 2012     Rima A. DeFatta, MD; Tre Landrum, DO; Joseph Whitten, MD; Robert T. Sataloff, MD, DMA, FACS

Osteoid osteoma of the ethmoid sinus: A rare diagnosis

April 30, 2012     E. Bradley Strong, MD; James R. Tate, MD; Dariusz Borys, MD


Osteoid osteomas are benign osseous lesions. They have seldom been described in the otolaryngology literature, and they are extremely rare in the ethmoid sinuses. We report a new case of osteoid osteoma of the ethmoid sinus in a 15-year-old girl. The workup consisted of computed tomography. Treatment involved local excision via an external ethmoidectomy approach. The diagnosis was based on histopathologic examination.

Primary acquired cholesteatoma

April 30, 2012     Joseph A. Ursick, MD; Jose N. Fayad, MD

Cholesteatomas are believed to form as the result of poor eustachian tube function with resultant tympanic membrane retraction and a lack of normal epithelial migration.

Third branchial anomaly: Endoscopic management revisited

March 31, 2012     Mala Tanna, MD, Monica R. Sharma, DDS, and Bijal Patel, MD

Third and fourth branchial apparatus anomalies may be misidentified as a recurrent deep neck abscess that does not respond to appropriate medical or surgical therapy or as recurrent acute suppurative thyroiditis, respiratory distress, or retropharyngeal abscess.

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