Recurrent respiratory papillomatosis is a chronic airway disease that occurs in both children and adults. It is caused by the human papillomavirus, more than 90% by HPV types 6 and HPV 11. The clinical presentation is nonspecific and most patients present with hoarseness, stridor or dyspnea. Although there is no definitive treatment, the objective focuses on improving voice quality and maintaining airway patency, in our case it was achieved through the placement of a Y-shaped stent placed in airway added to adjuvant treatment with Bevacizumab. Surgical management is the mainstay of treatment and around 20% of patients benefit from adjuvant therapies.

Granulomatosis with polyangiitis (GPA) is a rare Antineutrophil Cytoplasmic Antibodies (ANCA)-associated vasculitis that typically affects the upper and lower respiratory tract and kidneys. In adolescents, atypical presentations with predominant neuro-otological features may delay diagnosis. We report a 15-year-old boy who presented with progressive bilateral sensorineural hearing loss, facial nerve palsy, multiple lower cranial nerve deficits, dysphagia, and hoarseness, initially suggestive of chronic meningitis. Magnetic resonance imaging showed pachymeningeal enhancement with skull-base involvement. There was no renal or classical sinonasal involvement. Pulmonary infiltrates were initially attributed to aspiration pneumonia, and an infectious etiology was suspected. Prolonged antimicrobial therapy, however, did not result in sustained improvement. Lung biopsy demonstrated necrotizing granulomatous inflammation, and PR3-ANCA positivity confirmed GPA. Immunosuppressive therapy led to marked clinical improvement. Predominant neuro-otological involvement with misleading pulmonary findings can pose a significant diagnostic challenge in adolescent GPA.

Riedel's thyroiditis (RT) is a rare IgG4-related disease typically presenting with fibrotic thyroid enlargement and compressive symptoms. However, we herein report an unusual case of probable RT that involved laryngeal invasion and the thyroid cartilage destruction. In this case, a 46-year-old man presented with hoarseness, dysphagia, and a laryngeal mass. Imaging further revealed the thyroid cartilage permeative destruction with communication into the laryngeal lumen, raising suspicion of malignancy. Subsequent surgical exploration showed inflammatory granulation tissue eroding the thyroid cartilage. Histopathological examination demonstrated fibrous hyperplasia with lymphoplasmacytic infiltration, in hotspots approximately 15 IgG4-positive plasma cells per high-power field, and an IgG4/IgG-positive plasma cell ratio of ∼43%. Storiform fibrosis and obliterative phlebitis were absent. These findings confirmed probable RT with inflammatory pseudotumor formation. To our knowledge, this appears to be among the first reported cases of RT causing thyroid cartilage destruction. The mechanism is speculative but may involve chronic vascular compromise or direct inflammatory erosion. Therefore, RT should be considered in the differential diagnosis of atypical laryngeal lesions with cartilage involvement.

The present study compared the efficacy and safety of non-intubated video-assisted thoracoscopic surgery (NIVATS) with intubated video-assisted thoracoscopic surgery (IVATS) for lobectomy in the treatment of lung cancer through a systematic review and meta-analysis. A total of six electronic databases were searched for studies comparing NIVATS and IVATS published up to October 2024. After rigorous screening and quality assessment, perioperative outcomes and postoperative complications were systematically analyzed from 18 studies, comprising three randomized controlled trials, six propensity score-matched studies and nine retrospective studies. A total of 2,313 patients with lung cancer underwent thoracoscopic lobectomy, of whom 1,082 underwent NIVATS and 1,231 underwent IVATS. The results revealed that NIVATS significantly reduced operative time [mean difference (MD)=11.02; 95% confidence interval (CI), -18.78 to -3.27], lymph nodes harvested (MD=-0.67; 95% CI, -1.24 to -0.11), anesthesia waking time (MD=-22.88; 95% CI, -33.13 to -12.64), feeding time (MD=-4.53; 95% CI, -5.74 to -3.32), chest tube indwelling time (MD=-0.68; 95% CI, -1.16 to -0.21) and hospital stay (MD=-1.16; 95% CI, -1.57 to -0.74) compared with the IVATS group. Total complications [odds ratio (OR)=0.53; 95% CI, 0.31 to 0.90], particularly sore throat (OR=0.18; 95% CI, 0.10 to 0.33) and pneumonia (OR=0.54; 95% CI=0.30 to 0.98) were significantly lower in the NIVATS group than in the IVATS group. Re-intubation occurred in 4.33% of NIVATS patients, while conversion to thoracotomy rates were similarly low in the NIVATS (0.69%) and IVATS (0.60%) groups. Importantly, NIVATS was associated with significantly improved overall survival [hazard ratio (HR)=0.63; 95% CI, 0.40 to 0.98] and recurrence-free survival (HR=0.62; 95% CI, 0.46 to 0.85). No significant differences were observed for anesthesia time, blood loss, hoarseness, air leakage or arrhythmia. Under the enhanced recovery after surgery framework, NIVATS appears to be a safe and technically feasible alternative to IVATS, with the potential to improve patient outcomes based on the available evidence. Its clinical adoption is supported by the evidence in the present study, offering a basis for informed decision-making.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the degeneration of dopamine-producing neurons, leading to a wide range of symptoms that significantly impact patients' quality of life. Among these, dysphagia (difficulty swallowing) and dysphonia (voice impairments) are particularly prevalent, affecting a majority of individuals with PD and contributing to serious health risks and social challenges.