1/4. angiofibroma of the larynx: report of a case with clinical and pathologic literature review.BACKGROUND: Angiofibromas are uncommon vascular tumors with a strong predilection for the nasopharynx of adolescent males. Although they are slow growing and histologically benign, they have the potential to cause significant morbidity with laryngeal involvement. methods: We describe the clinical characteristics, histopathologic findings, differential diagnosis, preoperative evaluation, and management of a case of laryngeal angiofibroma. RESULTS: The patient was initially seen with a 2 1/2-year history of progressive dyspnea and dysphagia. Preoperative evaluation suggested a vascular mass involving the left supraglottic larynx. A partial laryngopharyngectomy was performed without complication. The patient is alive and disease free 3 years postoperatively. Final histopathologic diagnosis is consistent with angiofibroma. CONCLUSIONS: Laryngeal angiofibroma is an extremely rare entity. Adequate preoperative imaging is necessary to confirm the vascularity of this lesion, because ill-planned biopsy may lead to significant blood loss. The role of preoperative embolization of other laryngeal vascular lesions has been well documented and may be useful in the management of laryngeal angiofibroma.- - - - - - - - - - ranking = 1keywords = larynx (Clic here for more details about this article) |
2/4. laryngomalacia causing sleep apnea in an osteogenesis imperfecta patient.Obstructive sleep apnea is rarely caused by laryngomalacia in adult patients. To our knowledge, laryngomalacia secondary to osteogenesis imperfecta inducing obstructive sleep apnea has not been reported. We present an adult osteogenesis imperfecta patient with obstructive sleep apnea. Oral examination demonstrated an extremely long epiglottis in the oral cavity. Fiberoptic nasopharyngoscopy revealed that the epiglottis and redundant mucosa of the arytenoids were drawn into the laryngeal inlet during inspiration. Supraglottoplasty with intraoral and laryngoscopic approach was carried out and resulted in marked decreases in snoring, sleep apnea, and daytime sleepiness. In this report, we describe a unique laryngeal manifestation inducing obstructive sleep apnea in an adult with brittle bone disease. The anomaly of laryngeal structure can be corrected by surgical intervention with good response in the sleep-disordered breathing.- - - - - - - - - - ranking = 699.17982302647keywords = laryngomalacia (Clic here for more details about this article) |
3/4. Obstructive sleep apnea syndrome secondary to pharyngolaryngomalacia in a neonate with down syndrome.We described a case of obstructive sleep apnea secondary (OSAS) to pharyngomalacia and laryngomalacia in a neonate with down syndrome. She presented with oxygen requirement and paradoxical breathing without stridor. sleep polysomnography revealed obstructive apnea (obstructive apneic index of 14 h(-1)). Flexible bronchoscopy revealed collapsed velopharynx and omega-shaped larynx leading to the diagnosis of pharyngolaryngomalacia. She was treated with nasal prong continuous positive airway pressure. On this treatment, repeat polysomnography revealed abolition of obstructive apnea. Our case leads us to speculate that pharyngomalacia is an under-recognized condition in down syndrome because this is expected to occur as part of generalized floppiness of airway of down syndrome. In fact pharyngomalacia is a newly described clinical entity, which if unnoticed is associated with failure of supraglottoplasty in relieving symptoms of airway obstruction of laryngomalacia.- - - - - - - - - - ranking = 2447.3293805926keywords = laryngomalacia, larynx (Clic here for more details about this article) |
4/4. Monckeberg's sclerosis - is the artery the only target of calcification?BACKGROUND: Since its first description, Monckeberg's sclerosis has only been related to arterial media calcification, being listed among the primary diseases of the vessels. CASE PRESENTATION: We report here a clinically and histologically confirmed case of Monckeberg's sclerosis in which the patient presented with massive areas of soft tissue calcifications in the pharynx and larynx. Polysomnographic parameters showed severe obstructive apnea refractory to nasal continuous positive airway pressure. Clinical and laboratory findings excluded concomitant endocrine or rheumatological diseases. CONCLUSION: Our data provide a new insight about Monckeberg's sclerosis, i.e., the fact that the etiopathogenic process involved in the phenomenon of calcification may not be restricted only to the arteries, but may occur in the entire organism. Further studies of the etiopathogenesis of this disease are needed.- - - - - - - - - - ranking = 0.2keywords = larynx (Clic here for more details about this article) |