Cases reported "Hoarseness"

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1/28. Anesthetic management of a patient with laryngeal amyloidosis.

    A 73-year-old woman who suffered from progressive hoarseness for 6 years and dysphagia without pain for 1 year presented with a soft tissue deposition on the posterior region of the vocal cords and narrowing in the subglottic area. biopsy of this soft tissue and histological examination revealed laryngeal amyloidosis. A tracheostomy and partial removal of the amyloid were performed with general anesthesia. The airway was secured with a smaller diameter endotracheal tube, which was inserted atraumatically with Magill's forceps. The larynx is a rare site for amyloidosis. Laryngeal amyloidosis is fragile and hemorrhagic. Therefore, massive bleeding may occur during intubation. Anesthetists should take care in intubating the tracheas of these patients and be aware of other systemic diseases in laryngeal amyloidosis.
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keywords = airway
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2/28. Laryngeal sarcoidosis: treatment with the antileprosy drug clofazimine.

    sarcoidosis is a chronic systemic granulomatous disease that occasionally affects the larynx. When the larynx is affected, the symptoms are frequently mild, but severe airway obstruction can occur. Although systemic corticosteroids are helpful, patients may become refractory to further drug administration. The current methods of treatment are here summarized, and the patient literature is reviewed. We also report a case of a young patient suffering from laryngeal sarcoidosis successfully treated by the antileprosy agent clofazimine and propose it as an alternative treatment of laryngeal sarcoidosis in patients refractory to corticosteroids.
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ranking = 8.2238480731865
keywords = airway obstruction, airway, obstruction
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3/28. Traumatic avulsion of the trachea associated with cricoid fracture.

    A 15-year-old girl sustained a cricoid fracture, avulsion of the trachea, and bilateral cord paralysis in a automobile injury. An airway was established by intubation, and primary repair was performed on the day of injury. A postoperative stricture was successfully managed by endoscopic dilatation and injection of triamcinolone into the stricture. Function of one vocal cord appears to be returning 6 months after the injury, and the patient is leading an active life.
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keywords = airway
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4/28. Unusual endolaryngeal extension of a large thyroglossal duct cyst.

    INTRODUCTION: Thyroglossal duct cysts account for approximately 70% of congenital neck abnormalities. hoarseness of voice and the extension of the cyst into the larynx are very uncommon. CLINICAL PICTURE: We present a patient with a long history of a large thyroglossal cyst who developed progressive hoarseness of voice. The cyst had protruded into the larynx producing the appearance of a laryngeal neoplasm. Computed tomography (CT) clearly demonstrated the nature of the cyst and its encroachment into the larynx. TREATMENT: This was safely excised with a Sistrunk procedure and a temporary tracheostomy to maintain a secure airway, in view of the possibility of postoperative supraglottic oedema. CONCLUSION: Endolaryngeal extension of the thyroglossal duct cyst is rare. Evaluation of unusual large midline neck masses should include a CT scan. The intralaryngeal component of the cyst can be easily dissected off from the neighbouring structures during dissection in the Sistrunk procedure. A tracheostomy may be needed.
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keywords = airway
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5/28. Laryngeal sarcoidosis.

    sarcoidosis is a chronic granulomatous disease that tends to involve the lungs, hilar and mediastinal lymph nodes, liver, eyes, skin, bones, and nervous system. sarcoidosis involves the larynx less commonly than it afflicts these other sites. Laryngeal sarcoidosis may occur in isolation or as a component of systemic sarcoidosis and it may produce hoarseness, dysphagia, and dyspnea. life-threatening airway obstruction can occur. Treatments used for laryngeal sarcoidosis have included tracheotomy, low-dose radiation, surgical excision, systemic steroids, and intralesional steroids. An autoimmune etiology has been suggested. The patient reported in this manuscript showed marked, sustained improvement following the use of inhaled steroids prescribed for obstructive pulmonary disease. The possible efficacy of steroid inhalers for treatment of laryngeal sarcoidosis warrants further investigation.
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ranking = 8.2238480731865
keywords = airway obstruction, airway, obstruction
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6/28. A puzzling cause for bilateral vocal cord palsies in a patient with relapsed metastatic nasopharyngeal carcinoma.

    Unilateral vocal cord paralysis (VCP) is a frequent complication of a variety of cancers. It is easy to diagnose and not fatal. Bilateral VCP is rare and it is fatal if not appropriately managed. We encountered a patient with nasopharyngeal carcinoma who developed bilateral VCP with hoarseness and respiratory distress 2 years after initial diagnosis. A tracheostomy was performed to restore airway patency.
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ranking = 1
keywords = airway
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7/28. Arytenoid subluxation.

    BACKGROUND: Disruption of the cricoarytenoid joint is uncommon and possibly underdiagnosed. AIM: To highlight the diagnosis of arytenoid subluxation and its management. METHOD: Two case reports. CONCLUSION: Arytenoid subluxation is a rare condition that should always be considered in patients presenting with symptoms following upper airway instrumentation or external trauma to the neck. early diagnosis optimises the possibility of restoring normal voice and laryngeal function.
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ranking = 1
keywords = airway
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8/28. A Christmas tree in the larynx.

    A 2 year-old boy presented with acute upper airway obstruction following a 15-month history of noisy breathing and hoarseness. An urgent laryngotracheal bronchoscopy was performed following inhalational induction of anesthesia. Using a fiberoptic bronchoscope, visualization of the larynx through a laryngeal mask airway revealed a flat plastic Christmas tree embedded within granulomatous cords causing almost complete obstruction and requiring tracheostomy prior to extraction. Twelve days later, the tracheostomy was successfully decannulated with the child's voice beginning to normalize. The family remembered the decoration from Christmas celebrations 2 years prior and recalled a coughing episode that predated the onset of hoarseness.
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ranking = 9.3847270582567
keywords = airway obstruction, airway, obstruction
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9/28. Unilateral recurrent laryngeal nerve neuropraxia following placement of a ProSeal laryngeal mask airway in a patient with crest syndrome.

    We report a severe unilateral recurrent laryngeal nerve neuropraxia following use of the ProSeal laryngeal mask airway (PLMA) in a 71-year-old female patient with crest syndrome. She required amputation of the 5th phalanx of foot because of gangrene due to Raynaud's syndrome. anesthesia was induced with propofol, and a size 3 PLMA was inserted. anesthesia was maintained with sevoflurane and nitrous oxide for 2 h and the operation was performed uneventfully. On removal of PLMA, the cuff volume was measured to 40 ml. The patient did not complain of respiratory discomfort shortly after PLMA removal. However, the next day she developed dysphagia and hoarseness. Laryngoscopic examination revealed unilateral vocal cord paralysis. Cricothyrotomy was required because of suspected silent aspiration pneumonia. The pharyngolaryngeal complications improved with a mobile vocal cord but slight hoarseness after 2 months. We considered the patient's crest syndrome with a potential of tissue ischemia, and the high intracuff pressure of the PLMA due to nitrous oxide influx, to be the cause of severe recurrent laryngeal nerve neuropraxia in this case.
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ranking = 5
keywords = airway
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10/28. Purulent chondritis of the laryngeal framework cartilages.

    This manuscript reports on our experience with purulent chondritis of the laryngeal cartilages (PCLC), an entity that has not yet been described. Three patients had a diagnosis of PCLC. The probable causes were relapsing polychondritis, a previous prolonged intubation, and an idiopathic cause. The patients suffered from hoarseness and inspiratory stridor for 1 to 3 months before diagnosis. None complained of pain in the neck. laryngoscopy showed supraglottic edema. A computed tomography scan revealed abscess formation between the intact inner and outer perichondria of the thyroid cartilage. The treatment included rigid endoscopy, external incision and drainage, and prolonged medical therapy. The culture results were staphylococcus aureus in the first 2 cases and aspergillus fumigatus in the third. The second patient (in whom the cricoid cartilage was also affected) required emergency tracheotomy. The other 2 patients did not require airway intervention. The rarity of PCLC and the relatively mild symptoms require a high index of suspicion for its diagnosis.
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keywords = airway
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