Larynx

Laryngeal paraganglioma: Report of an unusual entity

October 31, 2010     Asim Kaytaz, MD, Emin Karaman, MD, Deniz Tuna Edizer, MD, Yusuf Haciyev, MD, and Buge Oz, MD
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Abstract

Paragangliomas are rare in the larynx. When they do occur there, the most common subsite is the supraglottic compartment. Unlike other neuroendocrine tumors of the larynx, laryngeal paragangliomas are three times as common in women as in men. Although a preoperative biopsy is often performed to establish the diagnosis, this procedure carries a considerable risk of bleeding, which may necessitate a tracheotomy to secure the airway. Immunohistochemical staining is useful in the differential diagnosis to distinguish a paraganglioma from other neuroendocrine tumors. Computed tomography and/or magnetic resonance imaging with preoperative angiography and possible embolization are important to obtain prior to treatment. Surgical excision is the treatment of choice.

Laryngeal candidiasis

October 31, 2010     Venu Divi, MD, Reena Gupta, MD, Robert T. Sataloff, MD, DMA, FACS, and Parmis Pebdani, DO
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Laryngeal paraganglioma

September 30, 2010     Yoav Hahn, MD, Richard Isaacs, MD, and Peter C. Belafsky, MD, PhD
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Recurrent vascular leiomyoma of the larynx: Clinical and histopathologic characteristics and treatment

July 31, 2010     Nir Hirshoren, MD, Jeffrey M. Weinberger, MD, FRCSC, Tzahi Neuman, MD, Ophir Ilan, MD, PhD, and Avraham Ben-Yaakov, MD
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Abstract

Laryngeal vascular leiomyomas are uncommon benign tumors that seldom recur following complete excision. The choice of excision procedure-via direct laryngoscopy or an open approach-is dictated by tumor size, the expected amount of blood loss, and any comorbidities the patient may have. We report an unusual case of a recurrent laryngeal vascular leiomyoma in a 64-year-old woman who also had a concurrent parathyroid adenoma and a history of breast carcinoma. A surgical resection via an external approach along with laser resection of a small glottic component was needed.

Seldinger technique for in-office tracheoesophageal puncture

July 31, 2010     Jacqui Allen, MBChB, FRACS and Peter C. Belafsky, MD, PhD
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Anatomic changes related to laryngeal descent from birth to 1 year of age: Do they play a role in SIDS?

June 30, 2010     Robert E. Stephens, PhD, Austin Bancroft, DO, Alan G. Glaros, PhD, and Lisa H. Lowe, MD
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Abstract

We conducted a retrospective study to measure laryngeal descent in human infants and to determine if there is any correlation between the associated anatomic changes and the timing of the peak incidence of sudden infant death syndrome (SIDS), which is 2 to 4 months of age. We performed a computerized search of hospital records at our institution to identify magnetic resonance imaging (MRI) scans of the head and neck and plain radiographs of the lateral neck in patients younger than 1 year of age (range: 1 to 357 days). After unusable images were excluded, 79 head and neck MRI scans and 111 lateral neck x-rays were suitable for study. Two measurements were taken from each image: one from the tip of the epiglottis to the uvula and one from the tip of the epiglottis to the center of the sella turcica. These measurements were then graphed against the subject's age. SPSS statistical software was used to determine growth curves of the various measurements. The first derivative of these curves was calculated to determine the rate of laryngeal descent at a given age. We found that most subjects did not have an overlapping epiglottis and uvula during the first few months of life. The rate of laryngeal descent, based on measurements of the distance between the epiglottis and uvula, gradually increased in a near-linear fashion from as low as 0.005726 mm/day at day 1 of life to as high as 0.028366 mm/day at 300 days of age. We found no sharp increase in the rate of descent at 2 to 4 months of age, and thus no support for our hypothesis that there might be a correlation between anatomic changes and the peak incidence of SIDS.

The challenge of rediscovering my voice after laryngectomy

June 30, 2010     Itzhak Brook MD, MSc
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I was shaken to my core 4 years ago when I was diagnosed with throat cancer. Even though my cancer was removed and I received local radiation, it recurred 20 months later. Unfortunately, my surgeons were unable to completely remove the tumor using laser, and I was left with no choice except to undergo laryngectomy. I faced the daunting realization that I could no longer continue to lecture and speak in public.

Laryngeal melanosis

May 31, 2010     James R. Tate, MD and Peter C. Belafsky, MD, PhD
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Laryngeal cancer in patients younger than 30 years: A review of 99 cases

March 31, 2010     Amy L. Rutt, DO, Mary J. Hawkshaw, BSN, RN, CORLN, and Robert T. Sataloff, MD, DMA, FACS
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Abstract

Laryngeal cancer in patients younger than 30 years is uncommon. We present data on this population obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. We identified 99 patients in this age group from the SEER 17 registry, which includes data submitted from 1973 through 2003. This population was made up of 52 females and 47 males; most were white, and most were aged 25 to 29 years. Malignancies of the glottis were the most common cancers, followed by supraglottic lesions. The 5-year relative survival rate was lowest among those aged 15 to 19 years-60.1%; 5-year relative survival among those aged 20 to 24 and 25 to 29 years was 87.7 and 87.4%, respectively. The etiology of squamous cell carcinoma (SCC) in children and adolescents remains uncertain, but in the adult population, a history of smoking, drinking, and poor oral hygiene cannot be ignored. Carcinoma of the larynx in young people has been related to malignant degeneration of papillomas and to complications of radiotherapy for papillomas. Infection with the human immunodeficiency virus possibly accelerates the development of SCC in patients with significant risk factors, presumably by impairing normal immune surveillance mechanisms.

Adenoid cystic carcinoma of the subglottic larynx: A case report and review of the literature

March 31, 2010     Philip B. Zald, MD, Stephen M. Weber, MD, PhD, and Joshua Schindler, MD
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Abstract

Laryngeal adenoid cystic carcinoma (ACC) is a rare clinical entity that poses a number of diagnostic and therapeutic challenges. We present a case of ACC of the subglottic larynx, and we review its diagnosis and management. We also discuss the workup of submucosal masses of the subglottic larynx, with an emphasis on clinical and radiologic diagnosis, surgical treatment, radiotherapy, and emerging therapies. The presence of a submucosal mass in the subglottic larynx should raise suspicion for the presence of ACC.

Non-Hodgkin lymphoma presenting as bilateral tonsillar hypertrophy: Case report

March 31, 2010     Sardar U. Khan, DLO, FCPS, FRCS(Ire), Cyril Kenefick, FRCS, FRCS(Edin), Gerard O'Leary, FRCS(Edin), FRCS(Ire), and James J. Lucey, FRCPath
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Abstract

We describe the case of a 57-year-old man who was referred to us with persistent sore throat, dysphagia, and enlarged tonsils. He had not responded to earlier treatment with antibiotic therapy and other routine measures. In view of the persistent nature of the patient's symptoms and the tonsillar hypertrophy, we decided to perform a tonsillectomy and to send the excised specimens for pathologic analysis. Histologic evaluation identified non-Hodgkin lymphoma in both tonsils. The patient was treated with postoperative chemo- and radiotherapy, and he was free of symptoms during 18 months of follow-up. To the best of our knowledge, only 4 cases of bilateral non-Hodgkin lymphoma of the tonsils have been reported in the English-language literature. We also discuss the importance of histologic analysis of excised tonsil tissue in selected cases.

Treatment of postradiation laryngeal compromise

February 1, 2010     Swapna K. Chandran, MD and Robert T. Sataloff, MD, DMA, FACS
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