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INTRODUCTION: Laryngeal tuberculosis is often misdiagnosed and is a highly contagious public health problem. The changing pattern of the clinical involvement of this disease poses a diagnostic challenge. The authors report four cases of laryngeal tuberculosis encountered in a short span of one month. MATERIALS AND METHODS: All the four patients who presented to us with hoarseness had underlying active lesions in the lung. In spite of that they presented with mainly laryngeal symptoms and a multitude of findings on laryngeal examination. A diagnosis could be established owing to a high index of clinical suspicion, and due consideration given to the chest findings and positive sputum examination. The patients showed an excellent response to antituberculous therapy. RESULTS AND CONCLUSIONS: This study underlines the varied nature of laryngeal tuberculosis and the importance of addressing the hoarseness of a patient at the earliest, for the prompt diagnosis of this infectious condition.
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OBJECTIVES: Voice prosthesis is the standard of care for postlaryngectomy voice rehabilitation. We aimed to assess functional outcomes of Provox voice prosthesis, to study the impact of several clinical factors (timing of Provox insertion, type of pharyngeal closure, requirement of reconstruction, performance of myotomy, and radiotherapy) on the functional outcomes, and to record the complications associated with Provox voice prosthesis. STUDY DESIGN: Prospective nonrandomized cross-sectional observational study. METHODS: Thirty patients with postlaryngectomy speech rehabilitation with Provox prosthesis were studied. After the procedure, the patients were evaluated by a speech-language pathologist and assessed at immediate postoperative period and 6-month and 1-year interval using the parameters of functional outcomes GRBAS scale, maximal phonatory duration (MPD), and words per breath (WPB). SPSS Version 19 was used for statistical analysis. RESULTS: All patients had average good voice at the end of 1 year after Provox insertion with voice quality results improving with time. Number of patients having MPD more than 7 was 21, 29, and 30 at 0 months, 6 months, and 1 year, respectively. At the end of 1 year, 11 patients had WPB score between 15 and 19. Seven patients had complications: periprosthetic leak (4), central leak (1), hypertonic segment (1), and stricture of the neopharynx (1). Primary Provox insertion, nonrequirement of postoperative radiation, cricopharyngeal myotomy, and primary and vertical closure of neopharynx had a better influence on the outcome; however, the results were not statistically significant. CONCLUSIONS: Provox voice prosthesis provides consistent and good voice results, which improve with time. Periprosthetic leak is the most common complication.
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Laringe Artificial/estadística & datos numéricos , Voz Alaríngea/instrumentación , Femenino , Humanos , Laringectomía , Laringe Artificial/efectos adversos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Implantación de Prótesis , Calidad de la VozRESUMEN
The thyroid gland is a very rare site for head and neck schwannomas. Till date there have been only 19 reported cases in English literature. Only 25% of schwannomas occur in the head and neck region, most of them arising in relation to the peripheral nerves and cervical sympathetic chain. We report a similar case, with clinical and sonological features of a benign thyroid nodule. The diagnosis of schwannoma was established on the final histopathology report and a review of the slides and the imaging was done to confirm the site of origin. A thorough review of earlier reported cases was done. We summarize the existing knowledge on this entity, emphasizing the challenge of diagnosing it pre-operatively.
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Ameloblastomas are rare, slowly growing and locally invasive tumours with high recurrence rate, if not treated they can grow to enormous size; we report five such cases in our article and discuss their surgical management. We report five cases of giant ameloblastoma presented in our institute between 2007 and 2010, we treated them surgically with wide margin of resection. It is widely reported that recurrence of ameloblastoma in many cases reflects the inadequacy or failure of the primary surgical procedure. We treated all our cases with radical excision with free flap reconstruction with no recurrence in any of our patients in 2 years follow-up. Radical excision of these benign but locally invasive lesions, which grows to giant size with reconstruction using micro vascular free flaps forms the best modality of treatment.
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Angiofibroma/patología , Angiofibroma/terapia , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas/terapia , Recurrencia Local de Neoplasia , Pérdida de Sangre Quirúrgica , Embolización Terapéutica , Humanos , Invasividad Neoplásica , Estadificación de Neoplasias , Cuidados PreoperatoriosRESUMEN
One of the most common nasal pathologies to present to an otolaryngologist is polyposis. Two well-recognized forms occur, the common antrochoanal polyp and the rare sphenochoanal polyp. Differentiation between the two is necessary for proper management by endoscopic sinus surgery.
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Primary amyloidosis of larynx is an uncommon phenomenon, the precise etiopathogenesis of which is not yet clear. It can present with slowly increasing hoarseness or difficulty in breathing. It presents more commonly as infiltrative lesion, exophytic presentation is a rare occurrence.