Pub Date : 2017-01-01DOI: 10.1177/014556131709600103
S. Ulusoy, N. Muluk, T. San, C. Cingi
We retrospectively investigated patient satisfaction with different types of hearing aids in 107 patients—60 males and 47 females, aged 8 to 84 years (mean: 53.8)—with unilateral or bilateral hearing loss, each of whom used two different hearing devices for at least 3 years per device. The International Outcome Inventory for Hearing Aids, Turkish edition (IOI-HA-TR) was used to evaluate satisfaction levels; we also calculated our own total individual subjective satisfaction (TISS) scores. We divided 16 different hearing devices into two types: device 1 and device 2; on average, device 2 had more channels, a lower minimum frequency, and a higher maximum frequency. We found that the IOI-HA-TR scores and TISS scores were higher and usage time was greater during device 2 use, and that there was a positive correlation between IOI-HA-TR and TISS scores. A total of 69 patients (64.5%) used device 2 for more than 8 hours per day, while 38 patients (35.5%) used it for 4 to 8 hours per day during the final 2 weeks of the trial. In contrast, 40 patients (37.4%) used device 1 for more than 8 hours, 50 (46.7%) used it for 4 to 8 hours, and the remaining 17 (15.9%) used it for less than 4 hours; the difference in the duration of use of the two devices was statistically significant (p < 0.001). Younger patients and patients with more education were more satisfied with their devices than were older patients and those who were not as well educated. We conclude that devices with good technologic features such as more channels, a lower minimum frequency, and a higher maximum frequency result in better hearing. Also, based on the age difference that we observed, we recommend that psychological support be provided to older patients with aided hearing to enhance their mental health and quality of life.
{"title":"Evaluation of Patient Satisfaction with Different Hearing Aids: A Study of 107 Patients","authors":"S. Ulusoy, N. Muluk, T. San, C. Cingi","doi":"10.1177/014556131709600103","DOIUrl":"https://doi.org/10.1177/014556131709600103","url":null,"abstract":"We retrospectively investigated patient satisfaction with different types of hearing aids in 107 patients—60 males and 47 females, aged 8 to 84 years (mean: 53.8)—with unilateral or bilateral hearing loss, each of whom used two different hearing devices for at least 3 years per device. The International Outcome Inventory for Hearing Aids, Turkish edition (IOI-HA-TR) was used to evaluate satisfaction levels; we also calculated our own total individual subjective satisfaction (TISS) scores. We divided 16 different hearing devices into two types: device 1 and device 2; on average, device 2 had more channels, a lower minimum frequency, and a higher maximum frequency. We found that the IOI-HA-TR scores and TISS scores were higher and usage time was greater during device 2 use, and that there was a positive correlation between IOI-HA-TR and TISS scores. A total of 69 patients (64.5%) used device 2 for more than 8 hours per day, while 38 patients (35.5%) used it for 4 to 8 hours per day during the final 2 weeks of the trial. In contrast, 40 patients (37.4%) used device 1 for more than 8 hours, 50 (46.7%) used it for 4 to 8 hours, and the remaining 17 (15.9%) used it for less than 4 hours; the difference in the duration of use of the two devices was statistically significant (p < 0.001). Younger patients and patients with more education were more satisfied with their devices than were older patients and those who were not as well educated. We conclude that devices with good technologic features such as more channels, a lower minimum frequency, and a higher maximum frequency result in better hearing. Also, based on the age difference that we observed, we recommend that psychological support be provided to older patients with aided hearing to enhance their mental health and quality of life.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"1 1","pages":"E22 - E28"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85913895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1177/014556131709600106
Todd J Wannemuehler, C. Deig, Brandon P. Brown, S. Morgenstein
An ex utero intrapartum treatment procedure was performed to deliver a fetus with a multiseptated, entirely cystic, 4.5 × 5.0 × 4.0-cm mass occupying the oropharynx and oral cavity with protrusion from the mouth. Surgical excision was performed, and final pathologic diagnosis revealed a lymphatic malformation arising within a cystic oropharyngeal teratoma. Lymphatic malformations are virtually indistinguishable radiologically from rare, purely cystic teratomata, and efforts have been made to distinguish between the two in utero because of differing available treatment modalities. This represents the first documented case in the literature of a lymphatic malformation arising from within an oropharyngeal teratoma.
{"title":"Obstructing in Utero Oropharyngeal Mass: Case Report of a Lymphatic Malformation Arising within an Oropharyngeal Teratoma","authors":"Todd J Wannemuehler, C. Deig, Brandon P. Brown, S. Morgenstein","doi":"10.1177/014556131709600106","DOIUrl":"https://doi.org/10.1177/014556131709600106","url":null,"abstract":"An ex utero intrapartum treatment procedure was performed to deliver a fetus with a multiseptated, entirely cystic, 4.5 × 5.0 × 4.0-cm mass occupying the oropharynx and oral cavity with protrusion from the mouth. Surgical excision was performed, and final pathologic diagnosis revealed a lymphatic malformation arising within a cystic oropharyngeal teratoma. Lymphatic malformations are virtually indistinguishable radiologically from rare, purely cystic teratomata, and efforts have been made to distinguish between the two in utero because of differing available treatment modalities. This represents the first documented case in the literature of a lymphatic malformation arising from within an oropharyngeal teratoma.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"21 1","pages":"E37 - E40"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89872674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1177/014556131709600105
Tyler P Swiss, S. Cervantes, M. Hinni, D. Lott
As the treatment of hematopoietic cancers evolves, otolaryngologists will see a higher incidence of opportunistic infections. We discuss a case of invasive fungal disease that invaded the larynx, pharynx, trachea, and pulmonary parenchyma after chemotherapy. The patient, a 46-year-old woman, presented 1 week after undergoing induction chemotherapy. Her initial symptoms were odynophagia and dysphagia. Despite encouraging findings on physical examination, her health rapidly declined and she required an urgent tracheotomy and multiple operations to address spreading necrosis. Because of her inability to heal, she was not a candidate for laryngectomy, so she was treated with conservative management. The patient was then lost to follow-up, but she returned 5 months later with laryngeal destruction and a complete laryngotracheal separation. While noninvasive fungal laryngitis is routinely encountered, its invasive counterpart is rare. The literature demonstrates that some cases completely resolve with medical therapy alone but that surgery is necessary in others. We recommend surgical debridement of all necrotic tissue.
{"title":"Invasive Fungal Laryngopharyngitis Resulting in Laryngeal Destruction with Complete Laryngotracheal Separation: Report of a Case","authors":"Tyler P Swiss, S. Cervantes, M. Hinni, D. Lott","doi":"10.1177/014556131709600105","DOIUrl":"https://doi.org/10.1177/014556131709600105","url":null,"abstract":"As the treatment of hematopoietic cancers evolves, otolaryngologists will see a higher incidence of opportunistic infections. We discuss a case of invasive fungal disease that invaded the larynx, pharynx, trachea, and pulmonary parenchyma after chemotherapy. The patient, a 46-year-old woman, presented 1 week after undergoing induction chemotherapy. Her initial symptoms were odynophagia and dysphagia. Despite encouraging findings on physical examination, her health rapidly declined and she required an urgent tracheotomy and multiple operations to address spreading necrosis. Because of her inability to heal, she was not a candidate for laryngectomy, so she was treated with conservative management. The patient was then lost to follow-up, but she returned 5 months later with laryngeal destruction and a complete laryngotracheal separation. While noninvasive fungal laryngitis is routinely encountered, its invasive counterpart is rare. The literature demonstrates that some cases completely resolve with medical therapy alone but that surgery is necessary in others. We recommend surgical debridement of all necrotic tissue.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"23 2-3 1","pages":"E33 - E36"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80271123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1177/014556131709600107
N. Ata, S. Erkilic
A 32-year-old man presented with a 10-year history of left-sided hearing loss and otorrhea. The otorrhea had turned purulent 6 months earlier. He had suffered from chronic otitis media for 10 years and had under-gone tympanomastoidectomy 5 years earlier. He de-nied tinnitus and vertigo. Otoscopic examination revealed a 2-mm perforation on the posteroinferior quadrant of the left tympanic membrane with purulent, foul-smelling fluid. The right ear was normal. Audiometry showed pro-found mixed hearing loss in the left ear. To evaluate the mastoid bone and middle ear cavity, computed tomography (CT) scans were performed that revealed an infiltrative, irregular, hypodense, heterogeneous,
{"title":"Mucous Retention Cyst of Mastoid Bone Mimicking Cholesteatoma","authors":"N. Ata, S. Erkilic","doi":"10.1177/014556131709600107","DOIUrl":"https://doi.org/10.1177/014556131709600107","url":null,"abstract":"A 32-year-old man presented with a 10-year history of left-sided hearing loss and otorrhea. The otorrhea had turned purulent 6 months earlier. He had suffered from chronic otitis media for 10 years and had under-gone tympanomastoidectomy 5 years earlier. He de-nied tinnitus and vertigo. Otoscopic examination revealed a 2-mm perforation on the posteroinferior quadrant of the left tympanic membrane with purulent, foul-smelling fluid. The right ear was normal. Audiometry showed pro-found mixed hearing loss in the left ear. To evaluate the mastoid bone and middle ear cavity, computed tomography (CT) scans were performed that revealed an infiltrative, irregular, hypodense, heterogeneous,","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"2 1","pages":"E41 - E42"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86569722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1177/014556131709600101
M. Dutta, I. Chatterjee, Mitrajit Mallik
{"title":"Chronic Discharging Sinus in the Parotid: Are we Missing Something?","authors":"M. Dutta, I. Chatterjee, Mitrajit Mallik","doi":"10.1177/014556131709600101","DOIUrl":"https://doi.org/10.1177/014556131709600101","url":null,"abstract":"","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"127 1","pages":"16 - 17"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79553009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1177/014556131709600102
Mehrzad Bahtouee, Gholamhosein Monavarsadegh, M. Ahmadipour, Mazyar Motieilangroodi, N. Motamed, J. Saberifard, S. Eghbali, H. Adibi, Hesam_oddin Maneshi, Hasan Malekizadeh
Sinusitis is a common disease with harmful effects on the health and finances of patients and the economy of the community. It is easily treated in most of its acute stages but is associated with some management difficulties as it goes toward chronicity. Therefore, we tried to improve the treatment of subacute sinusitis by using acetylcysteine, which is a safe mucolytic and antioxidant agent. Thirty-nine adult patients with subacute sinusitis proved by computed tomography (CT) were enrolled in a double-blind, placebo-controlled trial. They received oral amoxicillin-clavulanic acid and normal saline nasal drops for 10 days and oral pseudoephedrine for 7 days. In addition, the patients received acetylcysteine (600 mg orally, once daily) in the intervention group or placebo in the control group for 10 days. A paranasal CT scan was taken at baseline and 30 days after patients finished the treatment and was evaluated quantitatively by Lund-Mackay (LM) score. Symptoms and some aspects of quality of life also were assessed at baseline and 14 days after initiation and 30 days after termination of the treatment via the Sino-Nasal Outcome Test questionnaire. The groups showed no significant difference in LM score after treatment. A positive correlation was observed between the LM and SNOT-20 scores. We concluded that adding oral acetylcysteine to amoxicillin-clavulanic acid, pseudoephedrine, and intranasal normal saline has no benefit for the treatment of subacute sinusitis.
{"title":"Acetylcysteine in the treatment of subacute sinusitis: A double-blind placebo-controlled clinical trial","authors":"Mehrzad Bahtouee, Gholamhosein Monavarsadegh, M. Ahmadipour, Mazyar Motieilangroodi, N. Motamed, J. Saberifard, S. Eghbali, H. Adibi, Hesam_oddin Maneshi, Hasan Malekizadeh","doi":"10.1177/014556131709600102","DOIUrl":"https://doi.org/10.1177/014556131709600102","url":null,"abstract":"Sinusitis is a common disease with harmful effects on the health and finances of patients and the economy of the community. It is easily treated in most of its acute stages but is associated with some management difficulties as it goes toward chronicity. Therefore, we tried to improve the treatment of subacute sinusitis by using acetylcysteine, which is a safe mucolytic and antioxidant agent. Thirty-nine adult patients with subacute sinusitis proved by computed tomography (CT) were enrolled in a double-blind, placebo-controlled trial. They received oral amoxicillin-clavulanic acid and normal saline nasal drops for 10 days and oral pseudoephedrine for 7 days. In addition, the patients received acetylcysteine (600 mg orally, once daily) in the intervention group or placebo in the control group for 10 days. A paranasal CT scan was taken at baseline and 30 days after patients finished the treatment and was evaluated quantitatively by Lund-Mackay (LM) score. Symptoms and some aspects of quality of life also were assessed at baseline and 14 days after initiation and 30 days after termination of the treatment via the Sino-Nasal Outcome Test questionnaire. The groups showed no significant difference in LM score after treatment. A positive correlation was observed between the LM and SNOT-20 scores. We concluded that adding oral acetylcysteine to amoxicillin-clavulanic acid, pseudoephedrine, and intranasal normal saline has no benefit for the treatment of subacute sinusitis.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"38 1","pages":"E21 - E7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89159193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1177/014556131609501209
H. Balıkcı, M. Gurdal, Ş. Çelebi, I. Ozbay, M. Karakaş
We aimed to investigate the relationships among concha bullosa (CB), nasal septal deviation (NSD), and sinus disease. We retrospectively reviewed paranasal sinus computed tomography scans obtained from 296 patients—132 men and 164 women, aged 17 to 76 years (median: 39)—who had been evaluated over a 19-month period. CBs were classified as lamellar, bulbous, and extensive. In cases of bilateral CB, the larger side was designated as dominant. In all, 132 patients (44.6%) exhibited pneumatization of at least one concha, 176 (59.5%) had NSD, and 187 (63.2%) had sinus disease. Some 89 of 106 patients with unilateral or one-side-dominant CB (84.0%) had NSD, 89 of 132 patients with CB (67.4%) had sinus disease, and 109 of the 176 patients with NSD (61.9%) had sinus disease. We found a statistically significant relationship between CB and contralateral NSD, but no significant relationship between CB and sinus disease or NSD and sinus disease. While CB is a common anatomic problem that may accompany NSD, a causal relationship between CB or NSD and sinus disease is dubious.
{"title":"Relationships among Concha Bullosa, Nasal Septal Deviation, and Sinusitis: Retrospective Analysis of 296 Cases","authors":"H. Balıkcı, M. Gurdal, Ş. Çelebi, I. Ozbay, M. Karakaş","doi":"10.1177/014556131609501209","DOIUrl":"https://doi.org/10.1177/014556131609501209","url":null,"abstract":"We aimed to investigate the relationships among concha bullosa (CB), nasal septal deviation (NSD), and sinus disease. We retrospectively reviewed paranasal sinus computed tomography scans obtained from 296 patients—132 men and 164 women, aged 17 to 76 years (median: 39)—who had been evaluated over a 19-month period. CBs were classified as lamellar, bulbous, and extensive. In cases of bilateral CB, the larger side was designated as dominant. In all, 132 patients (44.6%) exhibited pneumatization of at least one concha, 176 (59.5%) had NSD, and 187 (63.2%) had sinus disease. Some 89 of 106 patients with unilateral or one-side-dominant CB (84.0%) had NSD, 89 of 132 patients with CB (67.4%) had sinus disease, and 109 of the 176 patients with NSD (61.9%) had sinus disease. We found a statistically significant relationship between CB and contralateral NSD, but no significant relationship between CB and sinus disease or NSD and sinus disease. While CB is a common anatomic problem that may accompany NSD, a causal relationship between CB or NSD and sinus disease is dubious.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"10 1","pages":"487 - 491"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81876296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1177/014556131609501206
Pei-Hsun Liao, Kuo‐Ping Chang
A 65-year-old man presented to our clinic for evaluation of a slowly enlarging nasal mass of 6 years' duration, with no nasal obstruction associated with the progression of the mass. He had experienced nasal trauma 8 years earlier. His medical history revealed that he had had gouty arthritis for approximately 20 years. His general practitioner had prescribed allopurinol for his gouty arthritis, but the patient's compliance had been poor. On examination, the patient was found to have a painless mass of the nasal bridge (figure 1). No punctum or fistula of the mass was noted. Intranasal examination revealed smooth nasal mucosa without purulent discharge or intranasal lesion. Computed tomography (CT) of the head confirmed a mass on the nasal bridge, not associated with destruction of bone or other local tissues (figure 2). Con sidering the slowing growth pattern of the mass and Figure 1. Frontal (A) and oblique (B) views in photos obtained at presentation show a mass over the patient's nasal bridge. There is no punctum or fistula of the mass.
{"title":"Nasal Gouty Tophus","authors":"Pei-Hsun Liao, Kuo‐Ping Chang","doi":"10.1177/014556131609501206","DOIUrl":"https://doi.org/10.1177/014556131609501206","url":null,"abstract":"A 65-year-old man presented to our clinic for evaluation of a slowly enlarging nasal mass of 6 years' duration, with no nasal obstruction associated with the progression of the mass. He had experienced nasal trauma 8 years earlier. His medical history revealed that he had had gouty arthritis for approximately 20 years. His general practitioner had prescribed allopurinol for his gouty arthritis, but the patient's compliance had been poor. On examination, the patient was found to have a painless mass of the nasal bridge (figure 1). No punctum or fistula of the mass was noted. Intranasal examination revealed smooth nasal mucosa without purulent discharge or intranasal lesion. Computed tomography (CT) of the head confirmed a mass on the nasal bridge, not associated with destruction of bone or other local tissues (figure 2). Con sidering the slowing growth pattern of the mass and Figure 1. Frontal (A) and oblique (B) views in photos obtained at presentation show a mass over the patient's nasal bridge. There is no punctum or fistula of the mass.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"93 1","pages":"478 - 480"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83867949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-01DOI: 10.1177/014556131609501204
G. Desuter, Delphine de Cock de Rameyen, Donatienne Boucquey
Figure. A: Direct laryngoscopy utilizinga chip-on-the-tip ENF-VT videoscope (Olympus, Inc.;Hamburg,Germany)showsa lakeroadsignvessel (whitearrow) on the left vocal fold without the use of NBI technology. B: Probing the pocket with a spatula under direct laryngoscopy demonstrates the presence of a left vocal fold sulcus vocalis. C: Illustration shows the similarity of the endoscopy images to roads skirting lakes. The recent emergence of the chip-onthe-tip flexible endoscope allows careful observation of subepithelial vascularization patterns. Recent literature has focused primarily on early detection of malignant lesions of the vocal folds and their differential diagnosi s with benign laryngeal papillomatosis. This effort is an attempt to guide-s-if not avoid-vocal fold biopsy, creating a paradigm shift from biopsy diagnosis to "photo diagnosis"!" Nevertheless, this trend could also be beneficial for the diagnosis of benign lesions, such as sulcus vocalis. A sulcus vocalis is characterized by the disappearance of the submucosal matri x, leading to an epithelial invagination associated with various degrees of adherence to the different layers of the underlying lamina propria. This "pocketing" of the mucosa forces the afferent vessels, progressing in the matrix , to make a detour. The afferent vessel that is perpendicular to the gap will usually split into two vessels, skirting the gap edges. We called this a "lake road sign:' referring to the same phenomenon that characterizes roads hitting lakes and skirting them (figure). Hypothetically, the lake road sign could be applicable to mucosal bridges, as well, although this has never been seen by the authors. With the new flexible endoscopy image-enhancing technologies that are available, this sign is much easier to notice than it was before. Perhaps narrow-band imaging (NBI) could add accuracy to the detection of lake road signs; however, this is still unknown and should be investigated in the future. Likewise, future studies should compare the specificity and sensitivity for sulcus diagnosis with the lake road sign and compare it to stroboscopy results.
{"title":"The “Lake Road Sign”: Another Way to Track the Sulcus Vocalis","authors":"G. Desuter, Delphine de Cock de Rameyen, Donatienne Boucquey","doi":"10.1177/014556131609501204","DOIUrl":"https://doi.org/10.1177/014556131609501204","url":null,"abstract":"Figure. A: Direct laryngoscopy utilizinga chip-on-the-tip ENF-VT videoscope (Olympus, Inc.;Hamburg,Germany)showsa lakeroadsignvessel (whitearrow) on the left vocal fold without the use of NBI technology. B: Probing the pocket with a spatula under direct laryngoscopy demonstrates the presence of a left vocal fold sulcus vocalis. C: Illustration shows the similarity of the endoscopy images to roads skirting lakes. The recent emergence of the chip-onthe-tip flexible endoscope allows careful observation of subepithelial vascularization patterns. Recent literature has focused primarily on early detection of malignant lesions of the vocal folds and their differential diagnosi s with benign laryngeal papillomatosis. This effort is an attempt to guide-s-if not avoid-vocal fold biopsy, creating a paradigm shift from biopsy diagnosis to \"photo diagnosis\"!\" Nevertheless, this trend could also be beneficial for the diagnosis of benign lesions, such as sulcus vocalis. A sulcus vocalis is characterized by the disappearance of the submucosal matri x, leading to an epithelial invagination associated with various degrees of adherence to the different layers of the underlying lamina propria. This \"pocketing\" of the mucosa forces the afferent vessels, progressing in the matrix , to make a detour. The afferent vessel that is perpendicular to the gap will usually split into two vessels, skirting the gap edges. We called this a \"lake road sign:' referring to the same phenomenon that characterizes roads hitting lakes and skirting them (figure). Hypothetically, the lake road sign could be applicable to mucosal bridges, as well, although this has never been seen by the authors. With the new flexible endoscopy image-enhancing technologies that are available, this sign is much easier to notice than it was before. Perhaps narrow-band imaging (NBI) could add accuracy to the detection of lake road signs; however, this is still unknown and should be investigated in the future. Likewise, future studies should compare the specificity and sensitivity for sulcus diagnosis with the lake road sign and compare it to stroboscopy results.","PeriodicalId":11842,"journal":{"name":"ENT Journal","volume":"11 1","pages":"473 - 473"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75685205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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