Vocal Fold

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
article

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

Office assessment of vocal fold hypomobility

October 23, 2013     Ronak Shah, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS
article

Even though abductor-adductor fiber mismatch often leads to net vocal fold immobility, the preserved muscle tone sometimes permits glottic closure through compensation by the normal vocal fold.

Arteriovenous malformation of the neck: An unusual cause of hoarseness successfully treated with endovascular techniques

October 23, 2013     Joseph J. Gemmete, MD; Neeraj Chaudhary, MD; Aditya S. Pandey, MD; Dheeraj Gandhi, MD; Sameer A. Ansari, MD, PhD
article

Abstract

Hoarseness is a common presenting symptom in patients referred to the otolaryngology clinic. An arteriovenous malformation (AVM) in the neck is a previously unreported cause of hoarseness. We describe the case of a 61-year-old woman who presented with hoarseness and vocal fold paralysis, which was caused by an AVM. She was successfully treated with endovascular embolization. Devascularization of the AVM resulted in symptomatic relief of the hoarseness and resolution of the vocal fold paralysis, presumably secondary to interval reduction in edema and venous congestion.

Vocal fold atrophy after paralysis

September 18, 2013     Adam Rubin, MD; Jason D. Chesney, DO
article

Much debate currently exists as to the timing of vocal fold atrophy following denervation and as to why some patients maintain excellent muscle tone despite long-standing nerve injury.

Iatrogenic epiglottic inversion during intubation

August 21, 2013     Adam Rourke, DO and Adam Rubin, MD
article

The otolaryngologist must recognize when the epiglottis is inverted or risk inserting the laryngoscope too far and traumatizing the vocal folds.

Posterior cordectomy: How much is enough?

July 21, 2013     Reena Gupta, MD; Belinda Mantle, MD; Ryan F. Osborne, MD
article

Bilateral vocal fold paralysis has traditionally been treated with tracheotomy, which bypasses the source of obstruction and exerts a lesser impact on swallow function compared with other interventions, but fewer patients are willing to tolerate this option.

A false-positive FDG uptake in Teflon granuloma: A case report

April 17, 2013     Munir Demir Bajin, MD; Ali Sefik Hosal, MD
article

Abstract

Positron emmision tomography (PET) is successfully used to monitor malignancies. Unfortunately it is not tumor specific. We present a case with history of rectum cancer and lentigo maligna who underwent PET-CT which revealed an increased uptake in the larynx. What was first considered as a third pirmary turned out to be a Teflon granuloma.

Prolonged ulcerative laryngitis in an 18-year-old voice major

April 17, 2013     Brent L. Toland, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS
article

Management of prolonged ulcerative laryngitis requires close observation with strobovideolaryngoscopy; therapy involves steroids, antibiotics, antifungal drugs, and antireflux treatment.

Hemorrhagic vocal process granuloma

April 17, 2013     Farhad R. Chowdhury, DO; Kevin Hsu, DO; Robert T. Sataloff, MD, DMA, FACS
article

Most small vocal process granulomas will resolve spontaneously if the primary insult is removed, but these lesions have a very high tendency to recur.

Acute laryngitis superimposed on chronic laryngitis

February 25, 2013     David N. Myerson, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS
article

Radiation-induced fibrosis can be found in tissues of the neck, pharynx, larynx, esophagus, ear, and temporomandibular joint. It is associated histologically with aggregates of macrophages, fibroblasts, vascular connective tissue changes, and deposition of extracellular matrix. This fibrosis can lead to strictures, stenosis, trismus, ulcerations, and scarring, which can present as dysphagia and dysphonia.

Acute dystonic reaction to general anesthesia with propofol and ondansetron: A graded response

January 24, 2013     Matthew H.J. Size, MBChB, FRCA; John S. Rubin, MD, FACS, FRCS; Anil Patel, MBBS, FRCA
article

Abstract

Propofol and ondansetron, alone and in combination, have been associated with acute dystonic reactions during recovery from anesthesia. We report the case of a 44-year-old woman who had undergone microlaryngoscopic fat injection to the vocal folds three times over a period of 10 months. Each procedure was performed by the same surgeon. On each occasion, the patient received an identical anesthetic that was administered by the same anesthetist. The anesthetic regimen included propofol and ondansetron. Following the first procedure, the patient experienced no reaction to these agents. However, she experienced a mild reaction after the second procedure and a severe acute dystonic reaction after the third. We believe this is the first report of a graded reaction to either propofol or ondansetron.

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