Vocal Fold

Bilateral Eagle syndrome causing dysphagia

February 2, 2015     Lyndsay L. Madden, DO; Roxann Diez Gross, PhD; Libby J. Smith, DO
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Patients with Eagle syndrome often report symptoms that include dysphagia, otalgia, throat pain, globus sensation, facial pain, headache, taste disturbances, and dental pain that worsen with chewing, head and tongue movements, and swallowing.

Glottic myxoma presenting as chronic dysphonia: A case report and review of the literature

January 19, 2015     Christopher G. Tang, MD; Daniel L. Monin, MD; Balaram Puligandla, MD; Raul M. Cruz, MD
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Abstract

Myxomas of the vocal fold are rare benign tumors often presenting with chronic dysphonia and less frequently with airway obstruction. The current consensus is that all laryngeal myxomas should be totally excised with clear margins to prevent recurrences. The recommendation for complete excision, however, has to be balanced with consideration of preserving vocal fold phonatory and sphincteric function. We report a case of vocal fold myxoma recurring twice after subtotal excision via two surgical approaches. This case illustrates a benign lesion with potential for recurrence and the need for a balanced treatment approach.

Amyotrophic lateral sclerosis presenting as bilateral abductor paralysis

December 19, 2014     Michelle Levian, DO; Reena Gupta, MD, FACS
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Occasionally, patients who have amyotrophic lateral sclerosis initially present with vocal and respiratory signs and symptoms.

Rapid growth of a laryngeal oncocytic cyst after surgical irritation

October 17, 2014     John T. Sinacori, MD; Robert A. Jack II, MD; Jonathan R. Workman, MD
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The origin of oncocytic lesions remains controversial. They occur more frequently with increasing age, and patients commonly present with a prolonged duration of hoarseness

Vocal fold tear in an operatic tenor

September 17, 2014     Joel E. Portnoy, MD; Robert T. Sataloff, MD, DMA, FACS
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The patient complained of increased throat clearing and coughing. He had experienced similar symptoms 3 months previously, which had resolved with voice rest.

Invasive primary aspergillosis of the larynx presenting as hoarseness and a chronic nonhealing laryngeal ulcer in an immunocompetent host: A rare entity

July 13, 2014     Mimi Gangopadhyay, MD; Kaushik Majumdar, MD; Arghya Bandyopadhyay, MD; and Anup Ghosh, MS(ENT)
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Abstract

Primary aspergillosis usually affects the paranasal sinuses, orbit, ear, and lower respiratory tract. Laryngeal aspergillosis usually occurs as a result of secondary invasion from the tracheobronchial tree, more commonly in immunocompromised hosts. Primary laryngeal localization of Aspergillus infection is seldom encountered. We report the case of an immunocompetent 42-year-old man who presented with hoarseness and a laryngeal ulcer of fairly long duration. A malignancy was initially suspected clinically, but a laryngoscopic biopsy led to a diagnosis of invasive primary laryngeal aspergillosis. No other focus of aspergillosis was found on x-ray and computed tomography. After identification of Aspergillus niger on culture, inquiries revealed no exposure to steroids, cytotoxic drugs, or irradiation, and workups for malignancy, human immunodeficiency virus infection, tuberculosis, and diabetes were negative. Although isolated laryngeal involvement is rare, aspergillosis may be considered in the differential diagnosis of a chronic nonhealing laryngeal ulcer that is clinically suggestive of a malignancy, even in an immunocompetent host.

Acute vocal fold hemorrhage after phonosurgery

July 13, 2014     Joel E. Portnoy, MD; Catherine Capo, BS; Robert T. Sataloff, MD, DMA, FACS
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In this case, the KTP laser was used to vaporize the bilateral vocal fold varicosities.

Laryngeal schwannoma presenting as a pedunculated mass in the glottis

March 18, 2014     Hideki Nakagawa, MD; Naoyuki Kohno, MD; Toshiyuki Kusuyama, MD; Hiroyuki Fukuda, MD
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This is the first case of laryngeal schwannoma that presented as a pedunculated tumor arising from the true vocal fold.

Two cases of granular cell tumors of the head and neck at different sites

March 18, 2014     Mustafa Paksoy, MD; Mehmet Eken, MD; Emin Ayduran, MD; Gokhan Altin, MD
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Abstract

Granular cell tumor (GCT) is an uncommon, primarily benign lesion. We describe 2 cases of GCT. Patient 1 was a 38-year-old man who presented with a reddish, vegetative lesion that involved the posterior third of the left true vocal fold. Patient 2 was an 18-year-old girl who presented with a firm, slightly extruded submucosal mass in the posterior lateral third of the tongue. Both lesions were identified as GCTs on biopsy. Both tumors were removed surgically, and both patients exhibited no signs of recurrence during follow-up. It is important that otolaryngologists be familiar with GCT and its management. Although the length of follow-up has varied substantially in the literature, we recommend long-term surveillance, including regular clinical examinations and periodic imaging with contrast-enhanced magnetic resonance imaging, at least until additional studies have clarified the natural history and recurrence patterns of GCT with greater certainty.

Laryngeal tuberculosis: Use of videostroboscopy in diagnosis

February 12, 2014     Michelle Levian, DO; Amy Chapman, MA-SLP; and Reena Gupta, MD
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The diagnosis of laryngeal tuberculosis is often suspected clinically, but in patients with less specific symptoms, flexible laryngoscopy may reveal only an inflammatory picture.

Vocal fold fixation caused by penetration of a high-velocity steel projectile

January 21, 2014     Chau-Shiang Guo, MD; Chi-Kung Ho, MD, MPH; and Ruey-Fen Hsu, MD, MPH
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Abstract

Vocal fold fixation as a result of trauma caused by a foreign body is rare. We report a unique case of vocal fold fixation caused by traumatic penetration of a shard of steel in a 31-year-old steelworker. While the patient was at work, an airborne projectile suddenly pierced his neck and entered his larynx, causing progressive hoarseness and dyspnea. Flexible laryngoscopy detected no obvious foreign body, but it did reveal that the right vocal fold had become immobile. Computed tomography revealed that a 2.5-cm sliver of steel had become impacted in the right cricoarytenoid joint, which made the arytenoid cartilage unable to rotate. An emergency tracheostomy was performed with local anesthesia to construct a functioning airway, and then rigid laryngoscopy was performed with general anesthesia. The foreign body was removed with the assistance of a microscope and microscissors. Postoperatively, the patient immediately regained control of his right vocal fold, and he experienced no permanent injury.

Infection after vocal fold lipoinjection

December 20, 2013     Christopher V. Lisi, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS
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