共查询到20条相似文献,搜索用时 31 毫秒
1.
Douglas R. Johnston Karen Watters Lynne R. Ferrari Reza Rahbar 《International journal of pediatric otorhinolaryngology》2014
Objectives
Review the latest diagnostic and treatment modalities for laryngeal and laryngotracheoesophageal clefts as they can be a major cause of respiratory and feeding morbidity in the infant and pediatric population.Methods
Literature review of published reports.Results
The presentation of laryngeal cleft usually involves respiratory symptoms, such as stridor, chronic cough, aspiration, and recurrent respiratory infections. Clefts of the larynx and trachea/esophagus can occur in isolation, as part of a syndrome (Opitz-Frias, VATER/VACTERL, Pallister Hall, CHARGE), or with other associated malformations (gastrointestinal, genitourinary, cardiac, craniofacial). This publication reviews the presenting signs/symptoms, diagnostic options, prognosis, and treatment considerations based on over a decade of experience of the senior author with laryngeal clefts.Conclusions
Type I laryngeal clefts can be managed medically or surgically depending on the degree of morbidity. Types II, III, and IV require endoscopic or open surgery to avoid chronic respiratory and feeding complications. 相似文献2.
Tomidokoro Y Hayashi R Yamasaki M Ishii G Kamijo T Ebihara S 《Auris, nasus, larynx》2009,36(2):239-243
Objective
To present the first reported case of a simultaneous squamous cell carcinoma with a leiomyosarcoma of the larynx, our treatment of the patient, and the 9-month follow-up results.Study design
Case study.Methods
Review of diagnostic studies, the operative technique, and the patient's chart for the 9-month period after treatment.Results
A case with double laryngeal tumors with simultaneous evolution but different histological patterns is described. The squamous cell carcinoma and leiomyosarcoma involved both the vocal cords and the anterior commissure. A partial laryngectomy was performed, and the patient has been free of disease for 9 months.Conclusions
Multiple laryngeal tumors are exceedingly rare. To our knowledge, no previous reports of a simultaneous squamous cell carcinoma and a leiomyosarcoma of the larynx have been reported. Both tumors were not invasive in this case, so conservation surgery was feasible. 相似文献3.
Objective
The well-known relation of Helicobacter pylori to the MALT-lymphoma and gastric carcinoma suggested a possible presence in the laryngeal tissues of patients with squamous cell carcinoma of the larynx by using Polymerase Chain Reaction (PCR) investigations, and PCR results of benign laryngeal pathologies were compared.Methods
Polymerase Chain Reaction investigations were carried out in biopsy samples of 21 patients with squamous cell carcinoma of the larynx and of 19 patients with benign laryngeal pathologies like vocal polyp and nodules.Results
The PCR results of 17 out of the 21 samples (80.9%) of the patients with laryngeal squamous cell carcinoma were positive for H. pylori. Moreover, any genomic material of H. pylori was not found in the PCR results of the 19 patients with benign laryngeal pathology. It was also determined that the presence of the H. pylori in the patients with laryngeal squamous cell carcinoma was statistically significant (p = 0.0001).In the patients with laryngeal squamous cell carcinoma, the comparison of the H. pylori presence within the normal and tumoral tissues revealed that 16 normal tissue samples (76.19%) were positive, while 9 of the tumoral tissue samples (42.85%) were positive. The ratio of bacterial presence in both the normal and tumor tissue samples was 38.09% (8 patients). The rates of presence revealed a statistically significant difference between the normal and tumoral tissue samples (p = 0.039).Conclusions
The presence of the genomic material of H. pylori within the laryngeal tissue of patients with squamous cell carcinoma of the larynx is a proof of the colonization of the bacterium in that tissue. While this may suggest a possible relation of the bacterium to the development of laryngeal squamous cell carcinoma, no conclusion is possible to be drawn about the mechanism of the process. 相似文献4.
Objectives
This article reports the first evidence of a larynx osteoma of the false vocal fold.Study design
Case report and literature review.Methods
Case report and review of previously published cases of larynx osteomas.Results
A 79-year-old patient was referred to our institution for dysphagia and hoarseness. Fibrolaryngoscopy showed a regular surface tumefaction of the false fold and the left ventricle, with preserved cordal motility. Patient underwent direct laryngoscopy with CO2 laser excision of the lesion. Pathologic examination of the lesion (1.6 cm × 1 cm) showed features consistent with an osteoma. Complete regression of symptoms was observed after surgery, with no lesions found on routine 1-year follow-up.Conclusions
Osteomas are benign, slow growing tumors of the craniofacial bone area, very rarely located in the larynx. Although the etiology is unknown, accepted theories point to embryologic, post-traumatic and infectious causes. Surgical excision is indicated only in symptomatic cases. This case report is the fourth evidence of laryngeal osteoma and, to our knowledge, the first finding of a false vocal fold osteoma. 相似文献5.
José Luiz Proença-Módena Guilherme P. Buzatto Flávia E. Paula Tamara H. Saturno Luana S. Delcaro Mirela C. Prates Edwin Tamashiro Fabiana C.P. Valera Eurico Arruda Wilma T. Anselmo-Lima 《International journal of pediatric otorhinolaryngology》2014
Objective
To evaluate the oscillations on the viral detection in adenotonsillar tissues from patients with chronic adenotonsillar diseases as an indicia of the presence of persistent viral infections or acute subclinical infections.Study design
Cross-sectional prospective study.Setting
Tertiary hospital.Methods
The fluctuations of respiratory virus detection were compared to the major climatic variables during a two-year period using adenoids and palatine tonsils from 172 children with adenotonsillar hypertrophy and clinical evidence of obstructive sleep apnoea syndrome or recurrent adenotonsillitis, without symptoms of acute respiratory infection (ARI), by TaqMan real-time PCR.Results
The rate of detection of at least one respiratory virus in adenotonsillar tissue was 87%. The most frequently detected viruses were human adenovirus in 52.8%, human enterovirus in 47.2%, human rhinovirus in 33.8%, human bocavirus in 31.1%, human metapneumovirus in 18.3% and human respiratory syncytial virus in 17.2%. Although increased detection of human enterovirus occurred in summer/autumn months, and there were summer nadirs of human respiratory syncytial virus in both years of the study, there was no obvious viral seasonality in contrast to reports with ARI patients in many regions of the world.Conclusion
Respiratory viruses are continuously highly detected during whole year, and without any clinical symptomatology, indicating that viral genome of some virus can persist in lymphoepithelial tissues of the upper respiratory tract. 相似文献6.
Objectives
To describe our management of complex glottic stenosis in tracheotomy dependent children with severe recurrent respiratory papillomatosis.Methods
Retrospective chart review at a tertiary care children's hospital.Results
Three children with complex glottic stenosis secondary to severe recurrent respiratory papillomatosis were treated at our institution since 2011. Two patients had complete stenosis, and the third had near-complete stenosis. Two patients were managed using balloon dilation alone, and the third also underwent laryngotracheal reconstruction with posterior costal cartilage grafting. Two patients have been successfully decannulated and the third has been tolerating continuous tracheotomy capping for greater than twelve months. All three patients underwent aggressive debridement of papillomatosis and balloon dilation every 4–6 weeks until their burden of disease was controlled. In two patients, the glottic airway was patent, and the third continued to have complete restenosis between procedures and required laryngotracheoplasty with multiple post-operative dilation procedures to establish an adequate glottic airway.Conclusions
Severe laryngeal stenosis is a well-described complication of recurrent respiratory papillomatosis, but its management is not well-defined. Aggressive management of papillomatosis with frequent debridement is critical in successfully managing laryngeal stenosis. Balloon dilation alone may be surprisingly effective in these patients, and laryngotracheoplasty can be used as an adjunct procedure in those patients who fail balloon dilation. Given the quality of life issues and concerns regarding distal spread of disease with tracheotomies in these patients, we feel that aggressive management and early decannulation is in the patient's best interest. 相似文献7.
Introduction
Children surviving a strangulation event are unique from adults in that they are at risk for significant airway compromise due to the smaller relative size of their airways. To date, no study has specifically evaluated the laryngeal findings and management of pediatric near-hanging patients.Methods
A retrospective chart review was performed on all near-hangings presenting to the a tertiary care children's hospital from January 2001 until June 2010. Demographic information was compiled in addition to laryngeal findings.Results
Sixteen children were identified. Four had a documented laryngeal injury, one of which was a major injury requiring a tracheotomy.Conclusion
Laryngeal examination should be standard of care for any child presenting after a near-hanging event. 相似文献8.
Thankappan K 《Auris, nasus, larynx》2012,39(4):397-401
Objectives
This study pools all the cases of Basaloid squamous cell carcinoma of the larynx in the English literature to investigate the clinical course of this rare clinico-pathological disease entity.Methods
We found and analyzed 100 cases with individual patient data from 36 publications spanning 20 years.Results
It is a rare disease of the elderly with strong male predominance and more common in the supraglottis. Patients typically present with locoregionally advanced stage. Surgery alone or combined with radiotherapy is commonly reported. It has a worse survival outcome when compared to laryngeal cancers in general. Twenty-two percent eventually develop distant metastases with the lung being the predominant site.Conclusions
Given the rarity of this clinical condition and the lack of data from studies with adequate number of cases, this systematic literature analysis provides the best possible relevant evidence. 相似文献9.
B. Pullens L.J. Hoeve M.K. Timmerman M.P. van der Schroeff K.F.M. Joosten 《International journal of pediatric otorhinolaryngology》2014
Introduction
To describe the characteristics and surgical outcome of 98 infants and children treated for an acquired laryngeal stenosis after intubation for respiratory support.Material and methods
We retrospectively reviewed our data from the last 18 years (1994–2013) concerning infants and children with an acquired laryngotracheal stenosis who were treated in our hospital with a laryngotracheal reconstruction or a cricotracheal resection. Outcome was defined by decannulation ratio.Results
Of the 98 infants and children who were studied, 54% were preterm, 18% neonates, 13% infants and 14% children. Ninety-one SS-LTR’s, two DS-LTR’s and five CTR’s were performed as primary surgery; three revision operations were performed (DS-LTR). Seventy-seven children had a tracheostomy prior to surgery; decannulation ratio was 93% after primary surgery and 95% after inclusion of revision surgery. For SS-LTR, the decannulation ratio was 93%, including grade III stenosis with comorbidities. Male sex and glottic involvement of the stenosis are correlated to failure of decannulation. Intubation in the term neonatal period is correlated to complicated post-operative course after SS-LTR.Conclusions
Excellent results of surgery for acquired laryngotracheal stenosis can be obtained with a high decannulation rate. Even for higher grades of stenosis with comorbidities and glottic involvement, an SS-LTR is an effective surgical treatment for acquired laryngeal stenosis. 相似文献10.
Objective
To evaluate the stagewise treatment of anterior commissure laryngeal web caused by recurrent laryngeal papillomatosis.Methods
One patient with anterior commissure laryngeal web caused by recurrent laryngeal papillomatosis underwent laryngomicrosurgery three times. At the same time of using CO2 laser to remove papilloma, we performed vocal cord mucosal flap repair and suture.Results
After 1 year following up, laryngeal papilloma did not recur and the voice quality of the patient significantly improved with no wheezing sound.Conclusion
This method can resolve the problem of recurrence and adhesion in laryngeal papilloma. 相似文献11.
Armando De Virgilio Young Min Park Won Shik Kim Seung Jae Baek Se-Heon Kim 《Auris, nasus, larynx》2013
Objective
The aim of this study was to present the various strategies adopted in our center to improve and overcome problems with exposure of the operative field in 48 patients who underwent TORS for the treatment of laryngeal and hypopharyngeal cancer.Methods
We present our operative and preoperative treatment protocols for patients undergoing TORS for laryngeal and hypopharyngeal cancer. In particular, we emphasize the role of preoperative exposure assessment and the usefulness of simple measures to overcome problems with exposure of the operative field.Results
In 12 patients (25%), we experienced difficult laryngeal–hypopharyngeal exposure. However the correct positioning of the robotic arms, the proper use of the laryngeal and tongue blade and some simple maneuvers, such as the anterior traction of the tongue and the partial epiglottectomy, ensured the feasibility of TORS with negative margins in all patients.Conclusion
In TORS, the exposure of larynx and hypopharynx can be difficult, but the adoption of certain methods may make it possible in most patients. An accurate preoperative evaluation under general anesthesia is the primary strategy for reducing the number of cases terminated intraoperatively. Currently, TORS is not feasible in all patients, but in our opinion, reductions in the size of robotic equipment and development of new devices will extend the application of TORS to a larger number of patients. 相似文献12.
Lidia Zawadzka-Glos Magdalena Frackiewicz Agnieszka Biejat 《International journal of pediatric otorhinolaryngology》2009,73(12):1729-1731
Introduction
In larynx cysts may be localized in different regions: glottis, laryngeal pouch, epiglottis, aryepiglottic folds and subglottic area. It is difficult to estimate if the cyst is acquired or congenital. Symptoms of laryngeal cyst depend on the size and localization of the cyst and include: change in the tone of voice, dysphonia, hoarseness, dysphagia, laryngeal stridor and dyspnoea. Cysts of the larynx in infants are rare but the treatment is easy once the diagnosis is made. If mismanaged, the resulting respiratory obstruction can lead to serious complications.Objective
Analysis of cases of laryngeal cyst in children treated in the Department of Paediatric ENT Medical University of Warsaw.Materials and methods
A retrospective analysis of 10 cases of laryngeal cyst in children treated in the Department of Paediatric ENT in Warsaw between 2000 and 2008 was made.Results
The authors analyzed indications to directoscopy, endoscopic presentation, problems with establishing the right diagnosis and management.Conclusions
Using a direct laryngoscopy as a golden standard in children with stridor will reduce a number of false diagnosis. 相似文献13.
Objectives
Pediatric blunt laryngeal trauma is a rare and potentially life-threatening entity. External injuries can be misleading, and a high index of suspicion, as well as early intervention, is essential to achieve the best possible outcome. The authors of this report review the management of blunt laryngeal trauma in the pediatric population and describe the endoscopic management of posttraumatic supraglottic stenosis.Methods
Methods used were case report from a tertiary referral institution and review of the literature.Results
We describe the case of a 13-year-old girl whom developed supraglottic stenosis following blunt laryngeal trauma. Innovative endoscopic techniques were used in the successful management of this exceedingly rare entity.Conclusion
Early recognition and intervention are of paramount importance if successful endoscopic management of blunt laryngeal trauma is to be considered. 相似文献14.
Objective
In this study, we investigated histological and electron microscopic changes of the laryngeal and esophageal epithelium in an animal model of reflux to demonstrate: (1) the association between laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) and (2) the value of dilated intercellular space (DIS) as a marker of LPR.Methods
Eight New Zealand albino rabbits were utilized. Four rabbits underwent total cardiomyectomy to induce reflux. The remains underwent a sham operation as controls. The animals were sacrificed 12 weeks after surgery to obtain histological and electron microscopic results.Results
There were significant differences in the histological results between the study group and the control group in both the esophagus and the larynx (P = 0.041 and 0.014). Significant changes in the intercellular space (IS) were observed between the study group and the control group in the esophageal and laryngeal samples (P < 0.001).Conclusion
The results of this study suggest that LPR and GERD have a common mechanism and DIS is a morphologic marker of LPR in rabbits. 相似文献15.
A.J. Gonçalves A.A.T. Bertelli T.R. Malavasi W. Kikuchi A.N. Rodrigues M.B. Menezes 《Auris, nasus, larynx》2010
Objectives
This study analyzed oncological and functional results of supracricoid horizontal partial laryngectomy.Methods
A retrospective study was conducted involving 20 patients with squamous cell carcinoma (SCC) of the larynx who underwent SCPL between 1996 and 2005 in Faculty of Medical Sciences of Santa Casa Hospital of Sao Paulo, Brazil. There were 18 male and 2 female patients with ages ranging from 39 to 74 years (median = 58 years), of whom 19 were smokers and 14 alcoholics. The tumors were present in the glottis in 16 cases and supraglottis in 4; 5 were stage I or II and 15 were stage III or IV. We analyzed treatment given when rehabilitation was unsuccessful, oncological results of SCPL, including local and regional recurrences, time to recurrence and treatment given, distal metastases, global survival, survival free of disease, and appearance of second primary tumors. We also calculated the index of functional preservation of the larynx.Results
Rehabilitation of swallowing capabilities and speech was achieved in 18 patients. Removal of the tracheostomy varied between 1 and 9 months. Rehabilitation was unsuccessful in two patients. Three patients required a total laryngectomy, two for unsuccessful rehabilitation and one for recurrence. The preservation of a functional larynx was 85%, with 10% of patients requiring a total laryngectomy after failed rehabilitation.Conclusions
Supracricoid horizontal partial laryngectomy is an efficient surgical oncology technique that yields good functional results for the treatment of laryngeal cancer. 相似文献16.
Dhave Setabutr Myrza R. Perez Mai Thy Truong Craig W. Senders Brian K. Rubinstein 《American journal of otolaryngology》2014
Background
Neurofibromatosis type 1 can rarely present in the larynx. Patients typically do not present with complete obstructive symptoms, but partial obstruction and stridor. We review our health centers’ case series of two patients, the first of whom presented with persistent sleep apnea post tonsillectomy and adenoidectomy, and the second who presented with noisy breathing. Additionally, we will review the literature on the management and treatment options for children with this rare clinical entity.Methods
Retrospective case review.Case report & results
A two-year old male underwent a sleep endoscopy following persistent evidence of obstructive sleep apnea on polysomnography after initial tonsillectomy and adenoidectomy. Family elicited concerns about noisy breathing at night and an accompanying video documented stridor while sleeping during the monitored polysomnography. Flexible fiberoptic laryngoscopy in the operating room revealed what appeared to be a cystic mass along the right aryepiglottic fold causing deviation of the laryngeal introitus towards the contralateral side. Subsequent direct laryngoscopy and excisional biopsy revealed pathology results consistent with a plexiform neurofibroma.A six-month-old patient with stertor and stridor was found to have a laryngeal mass, subglottic stensosis, and progressive airway obstruction due to plexiform neurofirboma in the supraglottis, subglottis, and trachea.We present a series of two patients incidentally diagnosed with neurofibromatosis type 1 by way of a laryngeal neurofibroma and review the literature on management options. Both patients were found to have accompanying café au lait spots. Both patients required tracheostomy for airway management, and one was successfully decannulated.Conclusion
Laryngeal neurofibroma is a rare anomaly that can manifest with airway obstruction. Both patients presented here subsequently were noted to have café au lait spots on physical examination. The Otolaryngologist should be reminded of this anomaly when evaluating a child with evidence of a submucosal laryngeal mass. We present our series including that of a patient whose diagnosis was prompted by persistent sleep apnea following adenotonsillectomy tonsillectomy and a patient with airway obstruction and subglottic stenosis due to a neurofibroma. The treatment of choice is complete excision of the neurofibroma while maintaining functionality of the larynx. This can lead to successful decannulation. 相似文献17.
Objective
The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required.Methods
A prospective study was done on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal ligament preservation.Results
A recurrence of a clinically evident precancerous lesion was present in 13.2% of patients that had a laryngeal intraepithelial lesion (LIN) 1 lesion and in 28.95% of patients that had a LIN 2 lesion.Conclusion
In order to achieve a control of a precancerous lesion, we suggest: excisional biopsy/subepithelial cordectomy (type 1 cordectomy) for LIN 1 lesions and subligament cordectomy (type 2 cordectomy) in case of LIN 2 cases. In case of recurrences of LIN 1 lesion we suggest directly a type 2 cordectomy. 相似文献18.
K. Stenfeldt F. Enoksson J. Stalfors M. Hultcrantz A. Hermansson A. Groth 《International journal of pediatric otorhinolaryngology》2014
Objective
To investigate the occurrence, clinical signs and outcome of acute mastoiditis in infants under the age of 6 months in Sweden between the years 1993–2007.Methods
All ENT departments in Sweden reported children 0–5 months treated for acute mastoiditis 1993–2007 and all records were reviewed. The clinical course and various characteristics were recorded.Results
Seventeen young infants with acute mastoiditis were identified. Three patients had suffered acute otitis media earlier, otherwise the children were previously healthy. Preceding the episode of acute mastoiditis, the children had an upper respiratory tract infection or fever for seven days in mean (median three days) and the mean number of days with ear-symptoms was three days (median two days). Three patients were treated with antibiotics prior to admittance. Almost all children presented with clear retroauricular signs with protruding ear and redness behind the ear. The children were hospitalised for six days (mean and median). Eight patients (47%) suffered from a subperiosteal abscess. All but one patient underwent surgery: myringotomy (13); incision or punction of the mastoid (5); mastoidectomy (3). Streptococcus pneumoniae was the most frequent bacterium identified in cultures. No intracranial complications or other severe complications were found.Conclusion
Acute mastoiditis is extremely rare in infants under the age of 6 months. The patients in this study did not have any predisposing diseases. An upper respiratory tract infection had preceded the episode of acute mastoiditis for some time in the majority of cases, but the time from first ear symptoms to hospitalization was very short. Acute mastoiditis is a potentially life-threatening disease, but the timely administration of intravenous antibiotics and surgical intervention prevented the occurrence of severe complications in these young infants. 相似文献19.
Andrzej Kukwa Andrzej Dymek Adam Galazka Antoni Krzeski Wojciech Kukwa 《Otolaryngologia polska. The Polish otolaryngology》2014
Introduction
Nasal obstruction is often reported by patients. It is a consequence of a subjective feeling of impaired airflow through the nasal cavity. Currently, objective measures of nasal patency rates are very limited. Functional tests only analyze nasal breathing; they do not simultaneously assess airflow through the mouth.Objective
The aim of this study is to present a new functional test that assesses a single-stage nasal and oral breathing route.Methods
The NOFA (Nasal–Oral Flow Analyzer) is a three-channel flow meter used to perform continuous and simultaneous measurements of nasal and oral respiratory parameters. We present the application of the device and the proposed study protocol.Results
The respiratory tracks of four selected patients are presented. Different breathing patterns are visible: exclusive nasal, exclusive oral, and mixed nasal–oral ventilation pattern.Conclusions
The preliminary results suggest the potential use of the NOFA in ENT practice. Further studies are necessary to evaluate the usefulness of this device in the diagnosis of patients with upper respiratory tract disorders. 相似文献20.