Laryngology

Well-differentiated squamous cell carcinoma arising from an area of an idiopathic acquired supraglottic web: An update

December 20, 2013     Napoleon Charaklias, MRCS, MSc, MCh; Zvoru G.G. Makura, FRCS (ORL-HNS); Sarah Mihangel, MBBS; Kenneth Maclennan, FRCS (Path); Anastasios Kanatas, FRCS (OMFS)
article

Infection after vocal fold lipoinjection

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

A case of cicatricial pemphigoid of the larynx successfully treated with plasmapheresis therapy

October 23, 2013     Takeshi Kusunoki, MD; Katsuhisa Ikeda, MD
article

Conventional therapy for cicatricial pemphigoid has consisted of the administration of a steroid alone or a steroid plus an immunosuppressant.

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.

Case report: Paraneoplastic neurologic syndrome associated with squamous cell carcinoma of the tonsil

October 23, 2013     Jeffrey R. Janus, MD; Sivakumar Chinnadurai, MD; Eric J. Moore, MD
article

Abstract

Paraneoplastic syndromes include a variety of disorders that affect the neurologic, endocrine, mucocutaneous, hematologic, and other systems as a result of neoplastic disease. Although their presentations vary, syndromes occur when tumor antigens exhibit cross-reactivity to similar antigens expressed by these systems. The antigens in the nervous system are called “onconeural” antigens. Although many disorders are associated with a comparatively high incidence of paraneoplastic neurologic syndromes, only a few cases have been associated with squamous cell carcinoma (SCC) of the tonsil. We report the case of a 69-year-old man who initially presented with weakness and spastic gait. He was subsequently found to have a characteristic paraneoplastic tractopathy on thoracic magnetic resonance imaging. The subsequent workup and operative intervention identified a T2N0M0 SCC of the tonsil. Following resection, the patient's overall symptoms were significantly alleviated, and his gait improved. A thorough literature search yielded no other report of a tonsillar SCC with associated paraneoplastic thoracic spine tractopathy.

Esophageal perforation in a patient with diverticulum following anterior discectomy and fusion

October 23, 2013     Aasif A. Kazi, PharmD; Nancy L. Solowski, MD; Gregory N. Postma, MD; Paul M. Weinberger, MD
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 Most perforations are thought to result from esophageal retraction, direct injury during manipulation, hardware failure, or movement of cervical vertebral bodies during hyperextension.

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
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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.

Ice-cream stick injury resembling torus palatinus

September 18, 2013     Rumi Khajotia, MBBS, MD, FAMA, FAMS; S.T. Kew, FRCP
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The size of a torus palatinus usually varies from barely discernible to very large, and it may be flat or lobular.

Larynx: Nodules and polyps

September 18, 2013     Lester D.R. Thompson, MD
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Nodules usually affect the anterior to middle thirds of the true vocal folds, and they are nearly always bilateral.

Hemangiopericytoma of the parapharyngeal space

September 18, 2013     Brian A. Fishero, MD; Kelly M. Guido, MD; Howard S. McGuff, DDS; Josefine M. Heim-Hall, MD; Frank R. Miller, MD, FACS
article

Abstract

Hemangiopericytomas of the head and neck are rarely found in the parapharyngeal space. We report the case of a 53-year-old woman who presented with a globus sensation in her throat. Imaging detected a left submucosal oropharyngeal mass that extended into the prestyloid parapharyngeal space. The tumor was surgically excised en bloc. Histopathologic examination identified it as a hemangiopericytoma. We discuss the diagnosis and management of this rare entity.

A systematic review of proton-pump inhibitor therapy for laryngopharyngeal reflux

August 21, 2013     Uchechukwu C. Megwalu, MD
article

Abstract

The author performed a MEDLINE literature search to identify and evaluate all randomized, placebo-controlled trials of the treatment of laryngopharyngeal reflux (LPR) with an oral proton-pump inhibitor (PPI) that have been published since 1966. Eight such trials that included a total of 358 patients were identified. These eight studies contained seven different definitions of LPR. Validity scores (maximum: 9) ranged from 5 to 9 (mean: 7.5). One study investigated low-dose once-daily therapy, two studies investigated low-dose twice-daily therapy, and five studies investigated high-dose twice-daily therapy. Outcomes measures were not consistent among studies, and most studies used unvalidated outcomes measures. Only two studies found that a PPI was significantly better than placebo-one in the low-dose twice-daily group and one in the high-dose twice-daily group. The author concludes that the current body of literature is insufficient to draw reliable conclusions about the efficacy of PPI therapy for the treatment of LPR.

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