Cases reported "Laryngeal Diseases"

Filter by keywords:



Filtering documents. Please wait...

1/75. epidermolysis bullosa of the head and neck: a case report of laryngotracheal involvement and 10-year review of cases at the Hospital for Sick Children.

    OBJECTIVE: epidermolysis bullosa (EB) involvement of the head and neck, particularly of the larynx, can represent a challenge to the otolaryngologist. In this article, we present a case report of an infant with laryngeal EB requiring tracheostomy. All cases of EB occurring over the past 10 years at The Hospital for Sick Children are reviewed, and the frequency and extent of head and neck involvement, including that of the larynx and trachea, is described. A review of current literature describing laryngeal EB is presented. METHOD: The charts of all patients diagnosed with EB from the period November 1986 to July 1997 were extracted and reviewed in detail. A literature review of reports of laryngeal EB over the past 20 years was completed via a medline search. RESULTS: Sixteen cases of EB were identified and reviewed. These cases were categorized into the three major subtypes of EB: dystrophic EB, junctional EB, and EB simplex. Three cases of laryngotracheal involvement were reported, one within each subtype. In our literature review, only 18 cases of laryngotracheal EB have been documented in the past 20 years, and most of these were diagnosed with the junctional EB subtype. The overall prognosis for patients with junctional EB based on review of cases in our institution, as well as in our review of literature, was poor. CONCLUSIONS: The extent of EB involvement of the head and neck is variable, often depending on subtype. Laryngeal involvement with EB is very rare but of significance, since mortality within this group of patients is high, with death resulting most often from sepsis.
- - - - - - - - - -
ranking = 1
keywords = neck
(Clic here for more details about this article)

2/75. Wegener's granulomatosis causing laryngeal and tracheobronchial obstruction in an adolescent girl.

    A 12-year-old girl presenting with a painful neck mass and ulcerated gingival lesions was found to have Wegener's granulomatosis involving the gingivae, paranasal sinuses, ears, mastoids, larynx, trachea, bronchial tree, lungs, kidneys and joints. The initial illness and two subsequent exacerbations were treated with intravenous and oral cyclophosphamide and prednisone. Secondary infections have been managed with establishment of good drainage and use of appropriate antibiotics. The patient is well with a normal sedimentation rate 4 1/2 years after the onset of her disease.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)

3/75. Delayed radionecrosis of the larynx.

    radiation has been used to treat carcinoma of the larynx for more than 70 years. Radionecrosis is a well-known complication of this modality when treating head and neck neoplasms. It has been described in the temporal bone, midface, mandible, and larynx. Laryngeal radionecrosis is manifested clinically by dysphagia, odynophagia, respiratory obstruction, hoarseness, and recurrent aspiration. The vast majority of patients who develop laryngeal radionecrosis present with these symptoms within 1 year of treatment; however, delayed presentations have been reported up to 25 years after radiotherapy. We present, in a retrospective case analysis, an unusual case of laryngeal radionecrosis in a patient who presented more than 50 years after treatment with radiotherapy for carcinoma of the larynx. The cases of delayed laryngeal necrosis in the literature are presented. This represents the longest interval between treatment and presentation in the literature. The details of the presentation, clinical course, and diagnostic imaging are discussed. The pathogenesis, clinical features, and treatment options for this rare complication are reviewed. Early stage (Chandler I and II) laryngeal radionecrosis may be treated conservatively and often observed. Late stage (Chandler III and IV) cases are medical emergencies, occasionally resulting in significant morbidity or mortality. Aggressive diagnostic and treatment measures must be implemented in these cases to improve outcome. This case represents the longest interval between initial treatment and presentation of osteoradionecrosis in the literature. A structured diagnostic and therapeutic approach is essential in managing this difficult problem.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)

4/75. Surgical management of acquired laryngopharyngeal fistulae.

    Pathological communication between the food and air passages in the neck region due to malignant disease is known. However, such a pathology arising as a result of a non malignant process is relatively uncommon, and only a handful of reports exists in the literature. The authors describe and discuss the management of two patients with laryngopharyngeal fistula of nonmalignant etiology.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)

5/75. laryngocele: an anatomical variant.

    It is commonly believed that external laryngoceles always penetrate the thyrohyoid membrane at the site of penetration of the neurovascular bundle. We present a case where the site of penetration was posterosuperior to this. Careful dissection of the neck of a laryngocele sac is important to prevent damage to the neurovascular bundle.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)

6/75. Bilateral laryngoceles in a young trumpet player: case report.

    We report the case of a 16-year-old trumpet player who was referred for an otolaryngologic consultation after his band leader noticed that a neck mass would protrude while the boy was playing. x-rays revealed the presence of bilateral laryngoceles, and computed tomography demonstrated bilateral, air-filled outpouchings of the laryngeal saccules during forced expiration. There was no evidence of any other intra-laryngeal or cervical pathology. Surgery was deferred while the laryngoceles remained reducible and asymptomatic, and the boy was cleared to continue playing.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)

7/75. hypnosis as a diagnostic modality for vocal cord dysfunction.

    vocal cord dysfunction (VCD) is a condition of paradoxical adduction of the vocal cords during the inspiratory phase of the respiratory cycle. VCD often presents as stridorous breathing, which may be misdiagnosed as asthma. The mismanagement of this disorder may result in unnecessary treatment and iatrogenic morbidity. An association with psychogenic factors has been reported, and a higher incidence of anxiety-related illness has been demonstrated in patients with VCD. Definitive diagnosis of VCD is made by visualization of adducted cords during an acute episode using nasopharyngeal fiber-optic laryngoscopy. diagnosis can be problematic, because it may be difficult to reproduce an attack in a controlled setting. To maximize diagnostic yield during laryngoscopy, provocation of symptoms using methacholine, histamine, or exercise challenges have been used. We report a case of an 11-year-old boy, wherein hypnotic suggestion was used as an alternative method to achieve a diagnosis of VCD. The patient was admitted to the pediatric intensive care unit for elective fiber-optic laryngoscopy to confirm a diagnosis of VCD. The patient had a 4-year history of refractory asthma, severe gastroesophageal reflux disease (GERD) for which he had undergone a Nissen fundoplication, and suspected VCD. At 9 years of age the patient began manifesting monthly respiratory distress episodes of a severe character different from those that had been attributed to his asthma. Typically, he awoke from sleep with shortness of breath and difficulty with inhalation. He described a "neck attack" during which he felt as if the walls of his throat were "beating together." The patient was at times noted by his mother to exhibit a "suckling" behavior before onset of his respiratory distress episodes. On 4 occasions the patient became unconscious during an attack and then spontaneously regained consciousness after a few minutes. On these occasions, he was transported by ambulance to the hospital and the severe difficulty with inhalation resolved within a few minutes on treatment with oxygen and bronchodilators. Sometimes he was noted to manifest wheezing for several hours, which was responsive to bronchodilator therapy. Given the severity of the patient's disease, it was imperative to determine whether VCD was a complicating factor. It was proposed that an attempt be made to induce VCD by hypnotic suggestion while the patient underwent a fiberscopic laryngoscopy to establish a definitive diagnosis. The patient and his mother gave written consent for this procedure. He was admitted for observation to the pediatric intensive care unit for the induction attempt. The patient requested that no local anesthesia be applied in his nose before passage of the laryngoscope because he wanted to eat right after the procedure. Therefore, the nasopharyngeal laryngoscope was inserted while he used self-hypnosis as the sole form of anesthesia. He demonstrated no discomfort during its passing. Once the vocal cords were visualized, the patient was instructed to develop an episode of respiratory distress while in a state of hypnosis by recalling a recent "neck attack." His vocal cords then were observed to adduct anteriorly with each inspiration. The patient then was asked to relax his neck. When he did, the vocal cords immediately abducted with inspiration, and he breathed easily. After removal of the laryngoscope, the patient alerted from hypnosis and said he felt well. He reported no recollection of the procedure, thus demonstrating spontaneous amnesia that sometimes is associated with hypnosis. Because the diagnosis of VCD was confirmed, the patient was encouraged to use self-hypnosis and speech therapy techniques to control his symptoms. He also was referred for counseling. To our knowledge this is the first description in the medical literature of the use of hypnotic suggestion for making a diagnosis of VCD. (ABSTRACT TRUNCATED)
- - - - - - - - - -
ranking = 0.42857142857143
keywords = neck
(Clic here for more details about this article)

8/75. Thorotrast (thorium dioxide) granuloma of the neck: Surgical considerations.

    Summary--Thorotrast (thorium dioxide) is a contrast material which was first used for angiography about 40 years ago. Its use was discontinued because of the reported incidences of malignancy following injection. Its long-term effects are related to its long half-life and slow excretion rate. Following extravasation into the soft tissues of the neck, the prolonged radiation effect results in tissue breakdown with formation of granulomas. There can also be cranial nerve palsies, occlusion of the major blood channels, laryngeal edema, pharyngeal and esophageal ulceration, and fistula formation. To avoid these late consequences, it is suggested that Thorotrast granuloma in the neck be excised radically. Partial or limited resections are inadequate.
- - - - - - - - - -
ranking = 0.85714285714286
keywords = neck
(Clic here for more details about this article)

9/75. actinomycosis of the post-cricoid space: an unusual cause of dysphagia.

    Cervicofacial actinomycosis is known to affect many soft tissues and bony structures in the head and neck. However to the authors' knowledge, actinomycosis of the post-cricoid region has not been previously reported. A case of a 74-year-old male who developed actinomycosis of the post-cricoid region after radiotherapy for a laryngeal carcinoma is presented. actinomycosis should be considered in the differential diagnosis of dysphagia following radiotherapy for squamous cell carcinoma of the larynx, as early treatment is likely to result in a favourable outcome.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)

10/75. Life-threatening upper airway edema caused by a distal rattlesnake bite.

    A 36-year-old man captured a timber rattlesnake and was accidentally envenomated in the thumb by the severed head. At a local emergency department, hypotension and confusion developed. Facial and glossal edema were also observed. oxygen was delivered by face mask, and crystalloids and dopamine were administered. Respiratory distress developed with progressive hypoxemia. intubation was unsuccessful because of massive glossal and epiglottic (laryngeal) edema, and an emergency cricothyrotomy was performed. High-dose antivenom therapy was administered, and mechanical ventilation was started. Recovery was rapid, and the patient was discharged from the hospital a week later. This is the first report of life-threatening upper airway edema caused by snake envenomation not in the vicinity of the head or neck.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = neck
(Clic here for more details about this article)
| Next ->


Leave a message about 'Laryngeal Diseases'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.