{"title":"Evolution of Endoscopic Surgery for Laryngeal Cancer","authors":"M. Hinni","doi":"10.5426/LARYNX.27.90","DOIUrl":"https://doi.org/10.5426/LARYNX.27.90","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114625471","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}
Tetanus is generally diagnosed on the basis of presenting typical symptoms and a trauma incident. It often begins with mild spasms in the jaw muscles, or so called lockjaw. However, if the initial symptoms are not typical, accurate diagnosis is rather difficult. We observed generalized tetanus of a 76-year-old female who complained of progressive dysphagia without an obvious history of trauma. During the initial visit to our hospital, there was no definite evidence of cervical pain nor dysphagia. Eventually dysphagia and neck pain as well as stiffness gradually appeared and worsened. When she was no longer able to eat, she was admitted to our hospital. Videofluoroscopic findings revealed residue in both pyriform sinuses due to reduced pharyngeal contraction. The day after she was admitted, she had whole body convulsions for ten minutes. At this point, she was clinically diagnosed with tetanus. Immunoglobulin and an antibiotic were immediately administrated. Ten days later, her criti-cal symptoms including severe dysphagia gradually improved. The experience of our rare case indicate that tetanus should be included in the differential diagnoses for progressive dysphagia even if there was no definite history of injury.
{"title":"A Case of Generalized Tetanus with an Initial Complaint of Dysphagia","authors":"S. Sueyoshi, S. Chitose, K. Nagata, T. Nakashima","doi":"10.5426/LARYNX.27.24","DOIUrl":"https://doi.org/10.5426/LARYNX.27.24","url":null,"abstract":"Tetanus is generally diagnosed on the basis of presenting typical symptoms and a trauma incident. It often begins with mild spasms in the jaw muscles, or so called lockjaw. However, if the initial symptoms are not typical, accurate diagnosis is rather difficult. We observed generalized tetanus of a 76-year-old female who complained of progressive dysphagia without an obvious history of trauma. During the initial visit to our hospital, there was no definite evidence of cervical pain nor dysphagia. Eventually dysphagia and neck pain as well as stiffness gradually appeared and worsened. When she was no longer able to eat, she was admitted to our hospital. Videofluoroscopic findings revealed residue in both pyriform sinuses due to reduced pharyngeal contraction. The day after she was admitted, she had whole body convulsions for ten minutes. At this point, she was clinically diagnosed with tetanus. Immunoglobulin and an antibiotic were immediately administrated. Ten days later, her criti-cal symptoms including severe dysphagia gradually improved. The experience of our rare case indicate that tetanus should be included in the differential diagnoses for progressive dysphagia even if there was no definite history of injury.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116474122","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}
Malignant lymphoma rarely occurs in the larynx and sometimes presents with symptoms similar to those of acute epiglottitis. We experienced a case of malignant lymphoma that was difficult to diagnose based on atypical local findings. The patient was a 66-year-old male who had complained of a sore throat for one week and consulted a nearby otolaryngologist. He was diagnosed with acute epiglottitis and referred to our hospital. Upon presentation, his epiglottis was reddish and swollen, similar to the findings of acute epiglottitis, although there were no laboratory data indicative of acute inflammation. The patient’s symptoms and local findings were subsequently improved by treatment with antibiotics and an intravenous steroid drip for three days. However, seven months later,the same symptoms recurred and a white mass appeared on the surface of the oropharynx(anterior palatine arch and root of the tongue)with cervical lymph node swelling. No inflammatory reactions were observed on laboratory studies, and the finding of CT, MRI and PET examinations did not suggest any malignant tumors. Therefore, biopsies of the larynx, oropharynx and cervical lymph nodes were performed several times, and the patient was ultimately diagnosed with peripheral T-cell lymphoma. He was subsequently treated with chemoradiotherapy and completely recovered. However, the disease recurred in the intestines two years later, and he died of aspiration pneumonia and ileus. Although malignant lymphoma that occurs in the larynx is rare, it is necessary to consider this disease in the differential diagnosis in patients with symptoms similar to acute epiglottitis.
{"title":"A Case of Malignant Lymphoma that was Difficult to Diagnose Based on Symptoms Similar to Acute Epiglottitis","authors":"M. Harada, J. Ohori, Y. Kurono","doi":"10.5426/LARYNX.27.34","DOIUrl":"https://doi.org/10.5426/LARYNX.27.34","url":null,"abstract":"Malignant lymphoma rarely occurs in the larynx and sometimes presents with symptoms similar to those of acute epiglottitis. We experienced a case of malignant lymphoma that was difficult to diagnose based on atypical local findings. The patient was a 66-year-old male who had complained of a sore throat for one week and consulted a nearby otolaryngologist. He was diagnosed with acute epiglottitis and referred to our hospital. Upon presentation, his epiglottis was reddish and swollen, similar to the findings of acute epiglottitis, although there were no laboratory data indicative of acute inflammation. The patient’s symptoms and local findings were subsequently improved by treatment with antibiotics and an intravenous steroid drip for three days. However, seven months later,the same symptoms recurred and a white mass appeared on the surface of the oropharynx(anterior palatine arch and root of the tongue)with cervical lymph node swelling. No inflammatory reactions were observed on laboratory studies, and the finding of CT, MRI and PET examinations did not suggest any malignant tumors. Therefore, biopsies of the larynx, oropharynx and cervical lymph nodes were performed several times, and the patient was ultimately diagnosed with peripheral T-cell lymphoma. He was subsequently treated with chemoradiotherapy and completely recovered. However, the disease recurred in the intestines two years later, and he died of aspiration pneumonia and ileus. Although malignant lymphoma that occurs in the larynx is rare, it is necessary to consider this disease in the differential diagnosis in patients with symptoms similar to acute epiglottitis.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126069738","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}
S. Hamakawa, H. Umeno, S. Chitose, Chieko Koda, T. Nakashima
Introduction The severity of swallowing difficulties after head and neck surgery depends on the range of excision as well as the patient’s age, concurrent chemoradiotherapy and other diseases. Swallowing difficulties resulting from structural changes in the oropharyngolaryngeal area require rehabilitation. In the normal swallowing process, bolus propulsion in the oral phase is facilitated primarily by the actions of the tongue 1), and contact with the posterior pharyngeal wall by the tongue base plays an important part in the pharyngeal stage of swallowing 2, 3). During swallowing, the base of the tongue and pharyngeal walls make complete contact 4)in order to propel the bolus though the pharynx. The movement of the posterior pharyngeal wall, including peristalsis-like waves, has been measured and investigated 5, 6). In this report, we aim to discuss the conditions of oral feeding in cases of total glossectomy, laryngectomy and subtotal mandibulectomy, emphasizing the importance of making complete contact by the reconstructed tongue base with the pharyngeal wall. The degree of contact affects the food consistency of the patient’s oral intake and quality of life. We also emphasize the need for swallowing rehabilitation in patients without a risk of aspiration.
{"title":"Challenges of Overcoming of Swallowing Difficulty Following Total Glossectomy, Laryngectomy and Resection of the Mandible","authors":"S. Hamakawa, H. Umeno, S. Chitose, Chieko Koda, T. Nakashima","doi":"10.5426/LARYNX.27.18","DOIUrl":"https://doi.org/10.5426/LARYNX.27.18","url":null,"abstract":"Introduction The severity of swallowing difficulties after head and neck surgery depends on the range of excision as well as the patient’s age, concurrent chemoradiotherapy and other diseases. Swallowing difficulties resulting from structural changes in the oropharyngolaryngeal area require rehabilitation. In the normal swallowing process, bolus propulsion in the oral phase is facilitated primarily by the actions of the tongue 1), and contact with the posterior pharyngeal wall by the tongue base plays an important part in the pharyngeal stage of swallowing 2, 3). During swallowing, the base of the tongue and pharyngeal walls make complete contact 4)in order to propel the bolus though the pharynx. The movement of the posterior pharyngeal wall, including peristalsis-like waves, has been measured and investigated 5, 6). In this report, we aim to discuss the conditions of oral feeding in cases of total glossectomy, laryngectomy and subtotal mandibulectomy, emphasizing the importance of making complete contact by the reconstructed tongue base with the pharyngeal wall. The degree of contact affects the food consistency of the patient’s oral intake and quality of life. We also emphasize the need for swallowing rehabilitation in patients without a risk of aspiration.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121066305","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}
A. Tani, Y. Tada, Mitsuyoshi Imaizumi, F. Matsumi, K. Omori
Type I thyroplasty is a surgery performed for unilateral vocal cord paralysis to reduce hoarseness and aspiration. We herein report the case of a 69-year-old male whose implant was removed (Gore-Tex) after type I thyroplasty. The patient complained of hoarseness and aspiration after aortic aneurysm surgery, and was diagnosed with left vocal cord paralysis. He underwent type I thyroplasty 11 months after aortic dissection. Although his voice and swallowing disorders were improved, he had persistent cervical discomfort. The Gore-Tex was therefore removed two years and 10 months after the thyroplasty. The extraction was easily performed without adhesion of the implant, and did not affect the phonetic functions of the patient. Our case shows that with Gore-Tex thyroplasty, improved phonetic function is maintained if the implant is left in place for at least six months, as discussed in previous reports.
{"title":"A Case of Extraction of an Implant after Type I Thyroplasty","authors":"A. Tani, Y. Tada, Mitsuyoshi Imaizumi, F. Matsumi, K. Omori","doi":"10.5426/LARYNX.27.31","DOIUrl":"https://doi.org/10.5426/LARYNX.27.31","url":null,"abstract":"Type I thyroplasty is a surgery performed for unilateral vocal cord paralysis to reduce hoarseness and aspiration. We herein report the case of a 69-year-old male whose implant was removed (Gore-Tex) after type I thyroplasty. The patient complained of hoarseness and aspiration after aortic aneurysm surgery, and was diagnosed with left vocal cord paralysis. He underwent type I thyroplasty 11 months after aortic dissection. Although his voice and swallowing disorders were improved, he had persistent cervical discomfort. The Gore-Tex was therefore removed two years and 10 months after the thyroplasty. The extraction was easily performed without adhesion of the implant, and did not affect the phonetic functions of the patient. Our case shows that with Gore-Tex thyroplasty, improved phonetic function is maintained if the implant is left in place for at least six months, as discussed in previous reports.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122110405","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}
E. Tamura, H. Fukuda, C. Yamada, S. Niimi, Shinya Okada, M. Shibuya, M. Iida
We investigated whether laryngeal images can be used to determine the pathological condition and effects of treatment in daily observations. Fifty-four patients underwent intracordal fat injection with autologous fat between December 2003 and December 2012 at the Tokyo Hospital of Tokai University. The pre-operative laryngeal findings of these cases were assessed retrospectively. In terms of the association between the laryngeal images and the pre- and post-operative maximum phonation times, a significant relationship was noted with both pre- and post-operative maximum phonation times in cases in which a gap was found on the posterior portion of the glottis. In particular, the presence of a gap in the posterior region of the glottis was related to the maximum phonation time, and significantly related to improvements in voice following autologous fat injection.
{"title":"Findings on Laryngeal Imaging in Cases of Laryngeal Paralysis","authors":"E. Tamura, H. Fukuda, C. Yamada, S. Niimi, Shinya Okada, M. Shibuya, M. Iida","doi":"10.5426/LARYNX.27.1","DOIUrl":"https://doi.org/10.5426/LARYNX.27.1","url":null,"abstract":"We investigated whether laryngeal images can be used to determine the pathological condition and effects of treatment in daily observations. Fifty-four patients underwent intracordal fat injection with autologous fat between December 2003 and December 2012 at the Tokyo Hospital of Tokai University. The pre-operative laryngeal findings of these cases were assessed retrospectively. In terms of the association between the laryngeal images and the pre- and post-operative maximum phonation times, a significant relationship was noted with both pre- and post-operative maximum phonation times in cases in which a gap was found on the posterior portion of the glottis. In particular, the presence of a gap in the posterior region of the glottis was related to the maximum phonation time, and significantly related to improvements in voice following autologous fat injection.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124386373","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：