- Laryngeal metastases from breast cancer: A rare clinical entity. [Journal Article]
- CPCurr Probl Cancer 2018 Aug 04
- Breast cancer is the most common malignancy in females. The common site for metastases is bone, lungs, liver, and regional lymph nodes. Larynx as a metastatic site from breast cancer is extremely rar...
Breast cancer is the most common malignancy in females. The common site for metastases is bone, lungs, liver, and regional lymph nodes. Larynx as a metastatic site from breast cancer is extremely rare. The authors report a 63-year-old female treated for carcinoma of right breast 5 years back who presented with hoarseness of voice. Clinicoradiological examination revealed a soft tissue lesion in larynx. Pathological evaluation of the laryngeal lesion revealed metastases secondary to breast cancer. The patient received systemic chemotherapy and local radiotherapy. Patients with a history of breast cancer presenting with hoarseness and shortness of breath should not only be evaluated for laryngeal primary but also for metastases. This case is reported in view of rarity of the case with laryngeal metastases from breast cancer masquerading as primary laryngeal disease. To the best of our knowledge, less than 20 cases of laryngeal metastases from breast cancer had been reported in literature till date. Patients with a history of breast cancer presenting with hoarseness and shortness of breath should not only be evaluated for laryngeal primary but also for metastases. Once the diagnosis is confirmed, the treatment of laryngeal metastases is multidisciplinary. Recognizing metastatic disease and prompt early treatment are very important to improve the quality of life.
- The management of laryngeal lipoid proteinosis. [Journal Article]
- JLJ Laryngol Otol 2018 Aug 13; :1-4
- CONCLUSIONS: Lipoid proteinosis is a rare genetic condition, which typically presents in infancy with dysphonia and subsequent skin involvement. Two cases are presented to demonstrate that laryngotracheal symptoms can be controlled with interval laser debulking and the 'pepper pot' technique without causing stenosis.
- Utility of Optical Coherence Tomography for Guiding Laser Therapy Among Patients With Recurrent Respiratory Papillomatosis. [Journal Article]
- JOJAMA Otolaryngol Head Neck Surg 2018 Aug 09
- CONCLUSIONS: Concurrent use of OCT imaging and laser therapy may improve postoperative outcomes for patients with RRP by delivering an optimal, patient-tailored treatment. Additional studies investigating the correlation between optical properties with vocal outcomes are required.
- Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review. [Journal Article]
- CCCrit Care Med 2018 Aug 09
- CONCLUSIONS: Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge of the association between particular injuries and corresponding functional impairments, improving understanding of both time course and prognosis for resolution of injury. Our findings identify targets for future research and highlight the long-known, but understudied, clinical outcomes from endotracheal intubation with mechanical ventilation in ICU.
- Intraoperative Corticosteroids for Voice Outcomes among Patients Undergoing Thyroidectomy: A Systematic Review and Meta-analysis. [Journal Article]
- OHOtolaryngol Head Neck Surg 2018 Aug 07; :194599818793414
- Objective To determine if a preoperative dose of intravenous corticosteroids reduces the risk of postoperative recurrent laryngeal nerve palsy and improves subjective voice outcomes among patients un...
Objective To determine if a preoperative dose of intravenous corticosteroids reduces the risk of postoperative recurrent laryngeal nerve palsy and improves subjective voice outcomes among patients undergoing thyroidectomy. Data Sources PubMed, Cochrane database, and EMBASE. Review Methods Randomized controlled trials comparing corticosteroids with placebo on voice outcomes in thyroid surgery were extracted with standardized search criteria. Systematic review and meta-analysis were performed. With random effects models, trial data were pooled to determine the overall rate of recurrent laryngeal nerve palsy as well as secondary outcomes of adverse events, including wound infection and hyperglycemia. Results Four studies with a total of 517 patients met inclusion criteria. The overall rate of recurrent laryngeal nerve palsy was 5.78%. There was no difference in the rate of palsy between the corticosteroid and placebo groups (risk ratio, 0.70; 95% CI, 0.34-1.44). There was also no difference between the groups in regard to wound infection, healing, or hyperglycemia. Conclusions Preoperative corticosteroids do not appear to reduce the risk of recurrent laryngeal nerve palsy following thyroid surgery. There is insufficient evidence to assess its effect on subjective voice outcomes. More robust randomized controlled trials are needed to assess the effectiveness of perioperative steroids in improving voice outcomes after thyroidectomy.
- Vocal Hygiene Education Program Reduces Surgical Interventions for Benign Vocal Fold Lesions: A Randomized Controlled Trial. [Journal Article]
- LLaryngoscope 2018 Aug 06
- CONCLUSIONS: Our results clearly indicate that the quality and features of the education program could affect the outcome of the intervention. We found that a reinforced vocal hygiene education program increased the rate of the resolution of benign vocal fold polyps and nodules in a multicenter randomized clinical trial.
- Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy. [Journal Article]
- AAActa Anaesthesiol Scand 2018 Aug 05
- CONCLUSIONS: Provided achievement of optimal acoustic window, TCLUS can reliably assess disabled VFs with FL reserved for their confirmation or doubtful cases. Subjective assessment of VF mobility should suffice in most cases with additional VFDV estimation reserved pre-operatively for situations with higher risk of VFs disability, and post-operatively when subjective VF assessment findings are discordant from pre-operative status.
- A comparison between laryngeal mask airway and endotracheal intubation for anaesthesia in adult patients undergoing NUSS procedure. [Journal Article]
- JTJ Thorac Dis 2018; 10(6):3216-3224
- CONCLUSIONS: Compared with ETT, the application of LMA for general anaesthesia may demonstrate promising advantages in airway management for the VATS-NUSS procedure.
- Allgrove syndrome and motor neuron disease. [Journal Article]
- NINeurol Int 2018 May 24; 10(2):7436
- Allgrove or triple A syndrome (AS or AAA) is a rare autosomal recessive syndrome with variable phenotype due to mutations in AAAS gene which encodes a protein called ALADIN. Generally, it's character...
Allgrove or triple A syndrome (AS or AAA) is a rare autosomal recessive syndrome with variable phenotype due to mutations in AAAS gene which encodes a protein called ALADIN. Generally, it's characterized by of adrenal insufficiency in consequence of adrenocorticotropic hormone (ACTH) resistance, besides of achalasia, and alacrimia. Neurologic features are varied and have been the subject of several case reports and reviews. A few cases of Allgrove syndrome with motor neuron disease have been already described. A 25-year-old white man, at the age of four, presented slowly progressive distal amyotrophy and weakness, autonomic dysfunction, dysphagia and lack of tears. He suffered later of orthostatic hypotension and erectile dysfunction. He presented distal amytrophy in four limbs, tongue myofasiculations, alacrimia, hoarseness and dysphagia due to achalasia. The ENMG showed generalized denervation with normal conduction velocities. Genetic testing revealed 2 known pathogenic variants in the AAAS gene (c.938T>C and c.1144_1147delTCTG). Our case presented a distal spinal amyotrophy with slow evolution and symptoms and signs of AS with a mutation in AAAS gen. Some cases of motor neuron disease, as ours, may be due to AAS. Early diagnosis is extremely important for symptomatic treatment.
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- Does the recurrent laryngeal nerve recover function after initial dysfunction in patients undergoing thyroidectomy? [Journal Article]
- LILaryngoscope Investig Otolaryngol 2018; 3(3):249-252
- CONCLUSIONS: Vocal cord dysfunction recovered in most patients in this high-risk cohort. There was a significant recovery even in the redo surgery group and a policy of watchful waiting is recommended in the absence of severe symptoms.