Laryngology

The harm of ham hocks: Foreign body impaction in long-standing multiple sclerosis

March 2, 2015     Anish Patel, MD; Jacqueline Weinstein, MD; Mandy Weidenhaft, MD; Enrique Palacios, MD, FACR
article

The incidence of foreign body impaction in neurologic dysfunctional swallowing, such as in multiple sclerosis (MS), has been not widely reported.

A case of solitary fibrous tumor arising from the palatine tonsil

March 2, 2015     Takeharu Kanazawa, MD, PhD; Kozue Kodama, MD; Mitsuhiro Nokubi, MD, PhD; Kazuo Gotsu, MD; Akihiro Shinnabe, MD; Masayo Hasegawa, MD; Gen Kusaka, MD, PhD; Yukiko Iino, MD, PhD
article

Abstract

Solitary fibrous tumor (SFT) is a distinctive, relatively uncommon soft-tissue neoplasm that usually arises from the pleura. It occurs at various sites; head and neck lesions are very rare. While most of these tumors have a benign course, a small number have malignant potential. We describe a rare case of SFT arising from the left palatine tonsil in a 66-year-old Japanese woman. The mass was completely resected. Immunohistochemical studies were strongly positive for CD34 and bcl-2, mildly positive for phosphorylated protein kinase B and phosphorylated extracellular signal-regulated kinase 1/2, and negative for platelet-derived growth factor receptor alpha and p53. These findings suggested that this tumor was benign. The patient showed no evidence of recurrence during 2 years of follow-up. We believe that the candidate prognostic marker should be checked to distinguish malignant from benign SFTs.

Bilateral Eagle syndrome causing dysphagia

February 2, 2015     Lyndsay L. Madden, DO; Roxann Diez Gross, PhD; Libby J. Smith, DO
article

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.

Mixed verrucous and squamous cell carcinoma of the larynx

February 2, 2015     Giuseppe V. Staltari, BS; John W. Ingle, MD; Clark A. Rosen, MD
article

The lesion was removed en bloc, including the involved thyroarytenoid muscle.

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
article

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.

A case of transient cortical blindness associated with hypercapnia as a result of extremely enlarged adenoid tissue

January 19, 2015     Baris Malbora, MD; Nihan Malbora, MD; Zekai Avci, MD; Asburce Olgac, MD; Alper Nabi Erkan, MD
article

Abstract

Adenotonsillar hypertrophy is common among children, but it can lead to serious complications if left untreated. Among the well-known complications are obstructive sleep apnea syndrome, growth failure, cor pulmonale, and hypertension. One complication of adenotonsillar hypertrophy that has not been previously reported in the English-language literature is transient cortical blindness. We describe such a case, which occurred in a 6-year-old boy who presented with a sudden loss of vision and subsequent unconsciousness. He had experienced hypercapnia and was resuscitated via endotracheal tube ventilation. Laboratory and radiologic assessments found no pathology except for extremely enlarged adenoid tissue. Once the patient was stabilized, an urgent adenotonsillectomy was performed. The patient recovered well, and his vision and respiratory symptoms resolved. Severe hypertrophy of the adenoid tissue can cause hypercapnia and acidosis secondary to upper airway obstruction. The possibility of adenoid hypertrophy and hypercapnia should be kept in mind in cases of transient cortical blindness. Aggressive treatment, including early intubation and adenoidectomy, may lead to a rapid resolution of symptoms.

Bronchoscopic extraction of a chicken bone 5 years after aspiration

January 19, 2015     Parth Shah, MD; Angela Han, BA; Rishin Patel, MD; Paul Howlett, MD; Scott Akers, MD; Mitchell Margolis, MD; Sunil Singhal, MD
article

Abstract

A 58-year-old man with a remote history of choking on a chicken bone 5 years earlier presented with chronic cough but had no remarkable clinical examination findings. He was being followed for recurrent pneumonias complicated by a resistant empyema, for which he had undergone thoracotomy and decortication. Imaging studies initially missed a foreign body (the chicken bone), which was found on follow-up studies and was removed with a flexible bronchoscope despite the fact that 5 years had passed since the aspiration.

Metastatic squamous cell carcinoma of the tonsil presenting as otorrhea: A case report

January 19, 2015     Eelam Adil, MD; Dhave Setabutr, MD; Soha N. Ghossaini, MD; David Goldenberg, MD, FACS
article

Abstract

We describe the case of a 52-year-old man with a history of squamous cell carcinoma (SCC) of the tonsil who presented with right subacute otalgia and otorrhea. Dedicated computed tomography of the temporal bones showed opacification within the mastoid process with destruction of bony mastoid septations consistent with coalescent mastoiditis. Preoperative imaging showed no destruction or expansion of the bony eustachian tube that would indicate that a direct spread had occurred. An urgent cortical mastoidectomy was performed. Intraoperatively, a friable white mass surrounded with purulence and granulation tissue was biopsied and returned as SCC. The discrete metastasis was removed without complication. Postoperatively, the patient was prescribed palliative chemotherapy. This case shows that a metastatic SCC can be masked by an overlying mastoiditis, and thus it should be considered in the differential diagnosis of a patient with a history of oropharyngeal cancer.

Primary calcitonin-secreting neuroendocrine carcinoma of the supraglottic larynx

January 19, 2015     Arsheed H. Hakeem, MBBS, MS; Sultan Pradhan, MS, FRCS; Sanica Bhele, MD; Jagadish Tubachi, MS
article

The most troubling differential diagnosis for calcitonin-secreting neuroendocrine carcinoma of the larynx is medullary carcinoma of the thyroid, as these two tumors can be morphologically indistinguishable.

Amyotrophic lateral sclerosis presenting as bilateral abductor paralysis

December 19, 2014     Michelle Levian, DO; Reena Gupta, MD, FACS
article

Occasionally, patients who have amyotrophic lateral sclerosis initially present with vocal and respiratory signs and symptoms.

Superior omohyoid muscle flap repair of cervical esophageal perforation induced by spinal hardware

December 19, 2014     Christopher Chase Surek, DO; Douglas A. Girod, MD, FACS
article

Cervical esophageal perforation is a rare and life-threatening condition. Its prompt diagnosis and treatment require a high index of suspicion. Cervical spine hardware is an uncommon cause of posterior esophageal perforation. Management has included a variety of musculofascial flaps for surgical repair. We present 2 cases of cervical esophageal perforation induced by spinal hardware that were repaired with a superior omohyoid muscle (SOM) flap for closure and/or primary closure reinforcement. Advantages and techniques of the SOM flap are discussed.

Adult presentation of laryngeal cleft: Utility of the modified barium swallow study in diagnosis and management

December 19, 2014     Genevieve Houdet-Cote, MHSc; Simon R. McVaugh-Smock, MHSc
article

We present a case of laryngeal cleft in a 41-year-old man to illustrate the co-occurrence of laryngeal cleft and tracheoesophageal fistula. We advocate the use of the modified barium swallow study in the diagnosis of laryngeal cleft. We also review the advantages and limitations of the various diagnostic methods, as well as the potential for known tracheoesophageal fistula to mask laryngeal cleft. Finally, we discuss the importance of early identification of laryngeal cleft in the context of its potentially serious health implications.

PreviousPage
of 44Next