Postoperative neuropsychiatric complications most commonly manifest as delirium or cognitive impairment; however, acute isolated mutism in the absence of frank delirium or structural brain injury-referred to in some literature as acute psychogenic mutism (APM)-represents an exceedingly rare and poorly understood postoperative phenomenon. This report presents a case of APM in a 69-year-old woman following elective total hip arthroplasty under general anesthesia. The patient developed acute selective aphonia upon emergence from anesthesia, despite preserved comprehension and nonverbal communication abilities, with symptoms resolving spontaneously 44 h postoperatively. Emergent neuroimaging revealed no evidence of acute ischemic or hemorrhagic stroke, making a macro-scale cerebrovascular event unlikely.This case is notable for three distinctive features: (1) context-dependent preoperative anxiety, reflected by an Observational Anxiety Scale (OAS) score of 0 in the presence of family preoperatively, which escalated to elevated situational anxiety (HADS-A score 12, suggesting clinically relevant anxiety but not necessarily pathological) upon entry into the operating room; (2) the potential contribution of severe cerebral white matter lesions (Fazekas grade III), which may have disrupted prefrontal-limbic regulation under anesthetic stress; and (3) its occurrence in an older patient undergoing orthopedic surgery, challenging the prior association of APM predominantly with younger plastic surgery patients. We propose a tripartite etiological model integrating environmental triggers, neural vulnerability, and psychogenic dissociation, offering preliminary insights into perioperative mental health risk stratification that warrant further investigation. Non-convulsive status epilepticus was considered unlikely given the patient's alertness and interactive behavior, though EEG was not performed acutely.

This case describes a poorly differentiated laryngeal carcinoma diagnosed at an advanced stage. The disease was associated with extensive metastasis and severe functional impairment. The patient had multiple risk factors, including tobacco and alcohol abuse, low health literacy, and poor therapeutic adherence. The patient initially presented with dysphonia, followed by progressive cervical swelling. A biopsy confirmed undifferentiated laryngeal carcinoma. Due to clinical deterioration, an emergency tracheostomy was performed. Imaging revealed an extensive infiltrative tumor involving the larynx and hypopharynx, with necrotic lymphadenopathy and distant metastases, including bone and peritoneum. Treatment with cisplatin, 5-fluorouracil, and pembrolizumab was initiated. The clinical course was further complicated by subclavian vein thrombosis. The patient developed aphonia and severe cervical involvement, with progressive functional decline and increased dependence. Care was ultimately transitioned to the home setting, provided mainly by family members, including a frail primary caregiver. This case highlights the impact of delayed diagnosis and social vulnerability on disease progression and functional outcomes. It underscores the importance of early recognition, timely intervention, and the central role of primary care-led palliative management and caregiver support in advanced head and neck cancer.

Laryngitis refers to larynx inflammation and can present in acute and chronic forms. Acute Laryngitis is often a mild and self-limiting condition typically lasting 3 to 7 days; if this condition lasts for over 3 weeks, then it is termed chronic laryngitis. The most common cause of acute laryngitis is viral upper respiratory infection, and this diagnosis can often be obtained by taking a thorough history of the present illness from the patient. In the absence of infectious history or sick contacts, additional causes of non-infectious laryngitis must be explored. Presenting symptoms often include voice changes (patients may report hoarseness or a "raspy" voice), early vocal fatigue (particularly in singers or professional voice users), or a dry cough. Breathing difficulties are rare (though possible) in acute laryngitis, but significant dyspnea, shortness of breath, or audible stridor should alert the clinician that a more dangerous disease process may be present. Suspicion should be heightened in smokers and the immunocompromised, as these patients are at higher risk for malignancy and more dangerous infections that may otherwise mimic acute laryngitis. Similarly, the presence of significant dysphagia, odynophagia, drooling, or posturing is very rare in simple acute laryngitis and warrants additional workup.

Patients with airway foreign bodies typically present with difficulty breathing or stridor. Nasopharyngeal airway (NPA)-related complications are rarely reported. We present a case of a patient with carcinoma of the tongue who underwent nasal intubation for surgery using a flexible bronchoscope. This case is unique because the patient experienced prolonged aphonia without respiratory distress, representing a first-of-its-kind report. We also propose a minor modification to the NPA design to reduce the risk of it slipping into the nasopharynx or larynx.

MEGDEL syndrome is a rare autosomal recessive disease characterized by 3-methylglutaconic aciduria, deafness-dystonia, hepatopathy, encephalopathy, and leigh-like syndrome, which results from biallelic pathogenic variants in SERAC1 gene. The diagnosis is commonly challenging due to the diverse clinical manifestations. Herein, we report the first case of MEGDEL syndrome from the Egyptian population. This is a 7-year-old boy born to first cousins Arab parents from Egypt with family history of unexplained deaths of 3 siblings during the neonatal period. He presented with developmental regression since the age of 2 years resulting in marked muscle weakness with no head support, generalized spasticity more prominent in lower limbs, and aphonia, but intact hearing. The child had excessive urinary excretion of 3-methylglutaconic acid, and his brain magnetic resonance imaging showed characteristic basal ganglia affection with "Putaminal eye sign." Whole-exome sequencing demonstrated a likely pathogenic homozygous c.1404-2A>G variant in SERAC1 gene. This report expands the epidemiological and phenotypic spectrum of MEGDEL syndrome by reporting the first case from the Egyptian population who had relatively delayed onset and no evident hepatopathy or deafness.

Hoarseness and dysphonia caused by vocal cord conditions or laryngeal surgeries significantly hinder communication and quality of life. This study presents a plug-and-play humidity-sensing respiratory microphone (HSRM) with generalized features for individual users. Leveraging gold nanoparticle-based humidity sensors integrated into commercially available wearable face masks, the system enables patients to produce verbal communication without relying on vocal cord activity. By integrating nanoparticle-enhanced humidity sensors with advanced convolutional neural networks, the HSRM system accurately decodes respiratory patterns into intelligible speech, achieving a recognition accuracy of 85.61%. Leveraging nanoparticle-polymer interfaces that effectively convert atmospheric humidity fluctuations into precise electrical signals, the system pioneers a contactless and non-invasive paradigm in assistive speech technology. This innovation addresses limitations of existing devices, such as reliance on residual vocal fold vibrations or skin-contact sensors, offering a practical generalized solution for individuals with aphonia. With its potential to facilitate naturalistic communication and transform healthcare applications, the HSRM system sets a new benchmark in wearable assistive technologies for voice rehabilitation and human-machine interaction.