Larynx

The association between Helicobacter pylori and laryngopharyngeal reflux in laryngeal pathologies

March 1, 2012     Engin Çekin, MD, Mustafa Ozyurt, PhD, Evren Erkul, MD, Koray Ergunay, MD, Hakan Cincik, MD, Burak Kapucu, MD, and Atila Gungor, MD
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Abstract

We conducted a study to determine the presence or absence of Helicobacter pylori and laryngopharyngeal reflux (LPR) in 43 previously untreated patients who had presented with a laryngeal lesion. Our aim was to determine if there was any association among H pylori, LPR, and laryngeal lesions. H pylori status was determined by real-time polymerase chain reaction (PCR) assays of biopsy tissue obtained during direct laryngoscopy. The presence or absence of LPR was determined on the basis of patients' reflux symptom index (RSI) and reflux finding score (RFS), which were based on their questionnaire responses and findings on endoscopic examination of the larynx, respectively. Patients with an RSI of 14 or more and/or an RFS of 8 or more were considered to have LPR. H pylori was present in 24 patients (55.8%) and absent in 19 (44.2%)-not a statistically significant difference. The prevalence of LPR was higher than the prevalence of H pylori; it was present in 30 patients (69.8%) and absent in 13 (30.2%). The difference was statistically significant (p = 0.01). We found no association between H pylori status and LPR status. Additionally, we analyzed two subgroups based on whether their lesions were benign or malignant/premalignant and found a significant relationship between LPR positivity and the presence of malignant/premalignant laryngeal lesions (p = 0.03). We found no association between H pylori status and either of the two subgroup categories.

Ventricular cyst of the larynx

March 1, 2012     Johnathan B. Sataloff, Rima A. DeFatta, MD, Mary J. Hawkshaw, BSN, RN, CORLN, and Robert T. Sataloff, MD, DMA FACS
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Surgery for supraglottic cysts may not be necessary in patients in whom the cysts do not grow or interfere with phonation, if these patients will comply with follow-up for close observation. If the mass enlarges or causes severe enough symptoms to warrant the risks of surgery, excision is usually safe and effective.

Endolaryngeal lipoma: Case report and literature review

February 18, 2012     Saki Nader, MD, Soheila Nikakhlagh, MD, Fakher Rahim, PhD, and Payam Fatehizade, MD
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Abstract

Lipomas are the most common benign tumors affecting the soft tissues. They can occur at any age, but they typically appear in patients older than 40 years. They are found equally in men and women. Lipomas are uncommon in the head and neck, but when they do appear there, they can arise in any location, including the palate, tongue, tonsil, larynx, and parotid gland. We report the case of a 63-year-old man who presented to the emergency department with a large spindle-cell lipoma of the endolarynx. The patient was followed for 6 months, and he exhibited no snoring or breathing difficulties.

Suprahyoid pharyngotomy for excision of laryngeal venous malformation

January 25, 2012     Unnikrishnan K. Menon, MS(ENT), DNB(ENT), N.V. Deepthi, MBBS, and Indudharan R. Menon, MS(ENT), DLO, DNB(ENT)
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Abstract

We report an uncommon case of symptomatic venous malformation of the larynx in a 22-year-old man, and the successful surgical management thereof. A detailed radiologic investigation of the lesion was done, followed by surgical excision via a suprahyoid pharyngotomy using cold instruments. Long-term follow-up was maintained, and the patient had subjective and objective resolution of his symptoms and signs at 3 years postoperatively. We conclude that radiology can reveal hitherto unsuspected extensions of vascular malformations in the neck and that surgical excision is a viable mode of treatment in upper aerodigestive venous malformations.

Laryngeal thrush from asthma inhalers

January 25, 2012     Yolanda D. Heman-Ackah, MD, FACS, Mary J. Hawkshaw, BSN, RN, CORLN, and Karen M. Lyons, MD
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Dual laryngeal foreign body

November 22, 2011     Omar Rahmat, MBBS, MS(Orl) and Narayanan Prepageran, FRCS
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Idiopathic acquired supraglottic web: A case report

October 26, 2011     David Pegg, MBChB, BSc(Hons), Anastasios Kanatas, MRCS, PhD, and Zvoru Makura, MBChB, FRCSEd
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Abstract

We report a case of an idiopathic acquired supraglottic web in an 83-year-old man. The web was managed with a combination of dilation and unilateral CO2 laser excision. Subsequent to removal, the web recurred three times; it was removed in the same fashion twice and left alone once. To the best of our knowledge, this is the first reported case of a truly idiopathic acquired laryngeal web.

Alveolar ridge mucosa protection during suspension laryngoscopy in the edentulous patient

September 20, 2011     Mark R. Gilbert, MD, Sorena A. Ostlund, CRNA, and Clark A. Rosen, MD
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Papillary squamous cell carcinoma of the larynx

August 15, 2011     Candice Colby, MD and Adam M. Klein, MD
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Abstract

Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma of the aerodigestive tract that has been correlated with a more favorable prognosis than conventional squamous cell carcinoma of the head and neck. In this report, the authors present a case of papillary squamous cell carcinoma and a review of the literature on this topic.

Laryngeal spindle cell squamous cell carcinoma

April 30, 2011     Lester D.R. Thompson, MD
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An uncommon case of laryngeal oncocytoma

April 30, 2011     Brett Travis, MD, Enrique Palacios, MD, FACR, and Curt L. McCarty, MD
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Pathologic evaluation of primary laryngeal anterior commissure carcinoma both in patients who have undergone open surgery as initial treatment and in those who have undergone salvage surgery after irradiation failure

April 30, 2011     Wael A. Ahmed, MD, MSc, Kenji Suzuki, MD, PhD, Yoshimune Horibe, MD, PhD, Ichiro Kato, MD, Toshiyuki Fujisawa, MD, and Yoichi Nishimura, MD
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Abstract

Laryngeal anterior commissure (AC) cancer has been the subject of much controversy. Our study was aimed at pathologically evaluating the tendency of AC cancer to invade the thyroid cartilage and analyzing the role of thyroid cartilage invasion by tumor cells at the AC as an anatomic cause for irradiation failure. Our study included 36 patients with glottic cancer involving AC. Patients with recurrent or persistent disease after radiotherapy underwent salvage surgery. Surgical specimens from 22 patients who had open surgery, either as primary or salvage surgery, were available for pathologic examination to identify the presence of cartilage invasion. We found microscopic invasion of the thyroid cartilage in 40.9% of the studied tumors. Only 21.4% of patients who had open salvage surgery showed evidence of cartilage invasion at the AC. We concluded that laryngeal AC cancers are more likely to invade the cartilage, and that anatomic risk factors are not the main cause of irradiation failure.

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