Extramedullary plasmacytoma of the true vocal fold

We report a rare case of extramedullary plasmacytoma (EMP) of the true vocal fold. Our patient, a 62-year-old woman, presented with dysphonia. On workup, fiberoptic laryngoscopy detected a lesion arising from the anterior half of her left true vocal fold. No evidence of other pathology was noted. The patient underwent radical radiotherapy, and the lesion resolved. Follow-up revealed no sign of recurrence. A type of myeloma, EMP is rare, especially in the larynx. To the best of our knowledge, our patient represents the sixth case of glottic EMP to be reported in the literature.     

Ancient schwannoma of the infratemporal fossa

This article describes a case of ancient schwannoma of the infratemporal fossa. Ancient schwannoma is a rare variant of the neurilemmoma, which clinical findings and radiographic features suggest is a slow-growing, benign tumour. Histopathologic features such as hypercellularity with nuclear atypia can make accurate diagnosis of this tumour difficult. The treatment of this tumour is complete resection, and the prognosis is good.     

Use of botulinum toxin to lateralize true vocal cords: a biochemical method to relieve bilateral abductor vocal cord paralysis

Using the mongrel dog as an animal model, we studied the effectiveness of botulinum toxin (Oculinum) to lateralize the true vocal cord. This experiment was undertaken in order to determine whether the toxin can improve the airway in subjects with bilateral abductor vocal cord paralysis. The toxin was injected into the cricothyroid muscle to block neuromuscular transmission at the motor end-plate. Paralysis of the cricothyroid muscle was achieved and documented by electromyography and videotaped endoscopy. Paralysis of the cricothyroid muscle decreases the tension of the true vocal cord and allows the cord to take a more lateral position. In this preliminary report, the literature is reviewed, the effect of and action of the toxin are discussed, and the results of the experimental protocol, establishment of dose-response curves, and techniques of injection are presented. Preliminary data suggest that there is an increase in the airway by lateralizing the true vocal cord with this biologic substance, and that this method may have many applications in clinical medicine for the otolaryngologist-head and neck surgeon.     

Isolated extramedullary plasmacytoma of the true vocal fold

We report a rare case of isolated extramedullary plasmacytoma (EMP) of the right true vocal fold in a 38-year-old male with a one-year history of hoarseness. Immunohistochemical staining of plasma cells in the tumour, showed over 90 per cent of them to be positive for kappa light chains. After two attempts at local surgical excision and recurrence within 10 months, the tumour was irradiated. Only seven reported cases of isolated EMP of the true vocal fold are reported in the literature. The therapeutic options are discussed.     

Lymphoepithelioma of the vocal cord

Lymphoepithelioma is a predominantly nasopharyngeal tumor with some incidence elsewhere in the pharynx. Occurrence in other sites is unusual. This report presents an example of a lymphoepithelioma arising in the vocal cord. The basal cells of the squamous epithelium lining the tonsillar crypts bear a close resemblance to the cells of this tumor, and they are intimately related to lymphoid tissue. It is our belief that lymphoepitheliomas arise from the basal zone and that the basal layer of epithelium even further afield might on occasion produce the lesion.     

A case of true vocal fold jaundice

ObjectivesWhile jaundice is frequently described in the sclera and skin, there are few reports of true vocal fold jaundice in patients with high bilirubin, and no reports by otolaryngologists in the literature. Here we describe a case of a patient with bilateral true vocal fold jaundice and discuss the potential pathogenesis and implications of this finding.MethodsA 29-year-old man with history of Dubin-Johnson Syndrome presented with cough and difficulty breathing and was incidentally found to have persistent yellow discoloration of the true vocal folds bilaterally.ResultsVideolaryngoscopic exam demonstrated bilateral true vocal fold yellow discoloration with sparing of nearby laryngeal structures on initial presentation and follow-up exam. Direct and total bilirubin levels were found to be elevated.ConclusionA patient with benign Dubin-Johnson Syndrome and elevated total and direct bilirubin was incidentally found to have bilateral vocal fold jaundice. Jaundice and the presence of bilirubin do not appear to cause harm to the function or health of the true vocal folds and may be related to the high concentration of elastin present in the true vocal folds.     

Partial laryngectomy for vocal cord cancer with marked limitation or fixation of the vocal cord

Partial laryngectomy was the procedure utilized to treat 26 patients with either marked limitation of vocal cord motion or fixation. The absolute 24-month tumor free control rate was 73% (19 of 26). Extended hemilaryngectomy with cricoid resection should be performed if subglottic extension of 5 mm or greater is present. Extended hemilaryngectomy has a greater complication rate than the classical hemilaryngectomy.     

低温等离子单侧声带离断并同侧杓状软骨切除术治疗双侧声带外展麻痹

目的 探讨在内镜支撑喉镜辅助下, 采用低温等离子消融刀头行单侧声带离断加同侧杓状软骨切除术治疗双侧声带外展麻痹的疗效。方法 对双侧声带外展麻痹的患者19例, 采用低温等离子消融术行单侧声带离断加同侧杓状软骨切除术进行治疗, 术后随访6～42个月, 分析评估该术式的临床效果。结果 19例术后呼吸功能恢复满意, 术后1个月内安全拔管18例, 其中术前已行气管切开8例。术后瘢痕挛缩喉腔狭窄未能拔管者1例, 经再次手术行对侧杓状软骨切除后成功拔管。嗓音评估发声效果满意14例, 轻微下降但患者能接受4例, 行2次手术者声嘶较前明显加重1例。结论 低温等离子单侧声带离断及同侧杓状软骨切除术治疗双侧声带外展麻痹, 术后呼吸困难完全缓解, 拔管率高, 发声功能保留良好。此术式创伤小, 术后愈合快, 安全、有效、微创。     

Epidermoid cysts,sulci, and mucosal bridges of the true vocal cord: A report of 157 cases

Presented is a summary of our experience with 157 patients having a diagnosis of epidermoid cyst, glottic sulcus, or mucosal bridge of the true vocal cord. Each patient in this group was diagnosed and treated jointly by a phoniatrist and microlaryngoscopist and then evaluated for results of surgical and phoniatric therapy. Included in the discussion are methods of examination and diagnosis, microanatomy and histopathology of the lesions, methods of treatment, and results of treatment. An argument for a common etiology for these lesions is advanced.