جستجوی مقالات مرتبط با کلیدواژه "larynx" در نشریات گروه "پزشکی"

There needs to be more unanimity in the treatment approaches for supraglottic squamous cell carcinoma. This study evaluated the survival outcomes of patients who underwent transoral laser microsurgery for this type of cancer. This longitudinal study was conducted at a tertiary university hospital in Iran. Forty-one patients with supraglottic squamous cell carcinoma who underwent transoral laser microsurgery were included. The required data were extracted from medical records. Survival analysis using the Kaplan-Meier method was used to obtain the 5-year overall recurrence-free and laryngectomy-free survival rates. This study included 40 males (97.6%) and one female (2.4%). The mean ± standard deviation of patients' age was 55.17±8.43 years. The 5-year overall recurrence-free survival rate in all patients was 68.0%. In contrast, 76.0% of the cases were laryngectomy-free after five years. Patients in the T1 and T3 categories had better overall and laryngectomy-free survival rates when stratifying by disease stage, respectively. The 3-year local control rates of tumor were 80.0%, 63.1%, and 82.3% for T1, T2, and T3, respectively. The larynx could be preserved in four patients (80.0%) with T1, 15 patients (57.8%) with T2, and 14 patients (82.3%) with T3. Our results suggest that transoral laser microsurgery may result in satisfactory recurrence-free survival and good oncologic outcomes. However, considering the indication of radiotherapy in some patients, the therapeutic effects of radiotherapy are part of the survival rate observed in this study.

Laryngeal cancer is the most common malignant neoplasm in respiratory tract after lung cancer. The incidence is very different and male to female ratio has been decreased in previous decades. Different characteristics of laryngeal cancer in men and women have been described based on previous studies, so we decided to study its characteristics in Iranian women. This study's design is cross-sectional retrospective from 2010 to 2019 in Amir-Alam Hospital, Tehran University of Medicine. All patients with laryngeal cancer admitted to this hospital, were included. Females` records were studied exclusively. Among 1456 patients included in this study, 1391 were male and 65 were female(M/F=21.4:1). The mean age of males was 60.6 years and for females was 56.6. From 65 females, 60 were Squamous cell carcinoma and 5 were Sarcoma. Findings of 60 female SCC patients: The main risk factors were cigarette smoking and opium abuse. The subsite of tumor was supraglottic in 40%, glottis in 31% and transglottic in 29%. Treatment options were surgical (55%) and non-surgical (45%). Survival rates for one, two and five years were 84.3%, 67.4% and 44% respectively. Two-year survival of surgically treated patients is significantly better than non-surgically treated patients (P=0.048). The mean age of females was less than males. Two-year survival rate was better in surgically treated patients. The five-year survival of female patients was 44% and there is an emerging need for survival studies of male patients for comparison.

Spindle cell carcinoma (sarcomatoid carcinoma) is a rare carcinoma that accounts for 2-3% of all laryngeal malignancies. Here, we present a case with laryngeal tumor diagnosed as Spindle cell carcinoma.

Fifty-nine-year-old male patient was admitted to our clinic with the complaint of hoarseness and shortness of breath that has been increasing for 10 months. Indirect laryngoscopy performed on the patient, and a polypoid lesion was detected in the anterior of the left vocal cord. The patient was admitted to our clinic for direct laryngoscopy and the lesion was completelyexcised from the base. The case was diagnosed as “sarcomatoid carcinoma in histopathological examination.

Sarcomatoid carcinoma is usually diagnosed and treated at an early stage. So, it has a good prognosis. However, it has a poor prognosis in the advanced stage.

Head and neck is the second most common region for lymphomas. Extranodal lymphomas of the larynx are rare in the pediatric population. Non Hodgkin Lymphoma (NHL) of the larynx is common in the supraglottic region as its rich in lymphoid tissue. They may present with dysphagia, dysphonia, snoring and progressive respiratory distress. Early visualization of the larynx is essential in such cases for appropriate diagnosis to improve the survival rates.

Case Report:

We present a case of 9 year old boy who presented with a change in voice, snoring and feeding difficulties for one year. Video laryngoscopy revealed globular mass arising from the epiglottis. He underwent excision biopsy and by immunohistochemistry was diagnosed to have diffuse large B cell lymphoma. He was treated with chemotherapy and the child is clinically well in the follow-up, 1 year after the completion of therapy.

Although primary lymphomas of the larynx in children are rare, a high index of clinical suspicion is warranted to avoid diagnostic delays to initiate appropriate management to have better outcomes.

According to the prevalence of sexual enjoyment reduction in total or partial laryngectomy patients, the present study aimed to evaluate sexual disorders among men who had undergone total laryngectomy.In this cross-sectional case-control study, purposive sampling was carried out to select all the samples that had experienced total laryngectomy. The control group was selected among the male patients who were referred for a routine checkup. In order to compare the groups, the international index of erectile function (IIEF) was performed, and the data were statistically analyzed in SPSS software (version 21).Based on the obtained results, laryngectomy patients had experienced problems with sexual problems, especially in the field of erectile function, sexual desire, and intercourse satisfaction (P<001).According to various studies, sexual dissatisfaction negatively impacts the Quality of life. This problem, commonly observed in total laryngectomy patients, needs to be considered.

Squamous cell carcinoma (SCC) is the most prevalent malignancy of the larynx. Non-squamous cell carcinomas of the larynx are rare and consist of different pathology types. The present work is a retrospective study of non-SCC of the larynx in the south of Iran during a seven-year period. Among 517 patients with laryngeal cancers, seven (0.13%) had non-SCC. The mean age was 59.1 (39-71) years, and six were male. The main complaint of two of the patients was neck mass, five cases had hoarseness, and one had dyspnea. One subject had both dyspnea and hoarseness. Out of three cases of neuroendocrine tumor, two had radical surgery and afterwards, radiotherapy (RT) was given for one of them. Both cases are well and disease-free. The other patient was a 58-year-old man and was treated with chemoradiation. He died due to brain metastasis following 12 months. Our patient with osteosarcoma is well controlled with surgery, chemotherapy, and RT. We had two male cases of adenoid cystic carcinoma who had undergone total laryngectomy and supraglottic laryngectomy. Both of them received RT (60 or 70 Gy dose) and both are well after 60 and 48 months. A 51-year-old patient with chondrosarcoma had undergone total laryngectomy, who was well after 36 months. Treatment of non-SCC of the larynx is an extrapolation from the treatment of the more common site of each pathology type. Further studies are needed to draw a firm conclusion.

In patients with supraglottic carcinoma (SGLC), lymphatic metastasis is frequent and can cause a significant reduction in local control rate and survival. Currently, the preferred method of neck treatment in patients with supraglottic cancer is prophylactic bilateral neck dissection that could result in overtreatment in at least two thirds of patients. The purpose of this study is to evaluate factors influencing neck metastasis and to determine whether routine elective neck dissection is necessary for the management of all SGLCs. 66 patients with SGLCs who underwent transoral laser surgery and neck dissection were included in this study. The rate of overall and occult lymphatic involvement was 29% and 20%, respectively. The most common involvement site was level II, and factors such as T category, tumor grade, epilarynx involvement, and extension of tumor to the medial wall of pyriform sinus were significantly related to cervical lymph node metastasis. In conclusion, our results suggest that in selected patients with SGLC (such as small T1 or lateralized tumors), elective neck treatment could be ignored, and instead, close follow-up be considered.

Myxomas are benign mesenchymal neoplasms which arise mainly in the heart. The laryngeal localization is very rare. We aim to describe the clinical, histological and therapeutic features of this condition. 

We report two cases of laryngeal myxomas occurred in male and female patients, presenting with a history of prolonged hoarseness. Laryngoscopy revealed a polypoid mass on the true vocal folds. The lesions were excised with cold instruments. One patient presented a recurrence 4 years after the first surgery.

Laryngeal myxoma should be considered in case of a benign looking vocal fold lesion, especially a vocal cord polyp. Histologic exam is the only tool to confirm the diagnosis. It is treated by surgical resection. In the literature, recurrence is rare in laryngeal site, but patients need to be kept on close follow-up.

Concurrent chemo-radiation has proven to be beneficial in a majority of patients with locally advanced head and neck cancers. Despite modern techniques of radiation delivery, the trade-off is acute and entails late toxicities for a considerable number of patients. Very few studies have reported the outcomes of these patients. We aimed to prospectively assess and report the toxicities of patients undergoing definitive chemo-radiation by the volumetric modulated arc therapy (VMAT) for the treatment of advanced laryngeal and hypopharyngeal cancer. This prospective observational study was conducted in a single tertiary care center over a period of two years. We recorded acute and late toxicities during and after the treatment of patients with locally advanced laryngeal and hypopharyngeal cancer treated with definitive chemo-radiotherapy using VMAT. Chi square test and Fisher’s exact test were used for comparing the significance of outcome parameters with different variables. 28 patients who met the inclusion criteria were taken up for analysis. The median age was 59 years. The median treatment time was 48 days. The mean dose to parotid, superior, and mid constrictors was 32, 45, and 64 Grays (Gy). At completion, 7% of the patients had grade 3 or more dermatitis, 4% had grade 3 or higher mucositis, and no patient had grade 3 or higher xerostomia. Five patients treated for hypopharynx cancer developed strictures. Our results showed that concurrent chemo-radiotherapy using VMAT is a promising method of treatment for advanced laryngeal and hypopharyngeal squamous cell cancer with an acceptable toxicity profile.

Laryngeal web is a rare cause of pediatric stridor and respiratory distress. The clinical presentation is variable and symptoms usually correlate with the severity of the airway obstruction.

 Case Reports:

We describe the cases of three children unexpectedly diagnosed with laryngeal web after a severe episode of bronchiolitis and after thirteen and eleven years, respectively, of persistent symptoms despite asthma medications.

Even if it is a rare cause of stridor and respiratory distress, congenital subglottic web could be a life threatening condition and clinicians should always consider it in the differential diagnosis of persistent noisy breathing, even in adolescents and young adults.

Lymphangiomas are uncommon congenital lesions of the lymphatic system, and most of them are detected by the second year of life. Although head and neck region is the most common location, laryngeal involvement isextremely rare, and the literature is largely limited to few case reports.

Case Report:

A 51-year-old male patient was admitted to the hospital with clinical history of hoarseness. Performed direct laryngoscopy revealed a pedunculated cystic mass located in the right ventricle of the larynx. The mass was totally excised, and the case was reported as cavernous lymphangioma. 

Isolated laryngeal lymphangioma is extremely rare in adults. The other benign lesions or inflammatory processes in this region can mimic laryngeal lymphangioma. Therefore, this entity should be kept in mind in differential diagnosis especially in adults, to avoid overtreatment.

Clicking larynx syndrome is a rare condition that may be intriguing to the attending clinician. Patients typically present with clicking sensations in the neck, often obvious during head movement or swallowing. Due to the scarce presentation of such cases, clicking larynx syndrome harbors a high propensity to be an overlooked diagnosis, resulting in a clinical stalemate.  

Herein, we present a case of clicking larynx in a young girl followed by an overview of the latest literature on the aetiology and treatment options. This case aims to reinforce the presence of this entity further and subsequently increase its awareness among clinicians.

Expeditious diagnosis is imperative not just for the eventual treatment but also for timely relief to the anxious patients who would have been perplexed by the strange clicking in the throat.

Foreign body (FB) in throat is one of the common presentations in emergency departments (ED). The foreign body may be stuck in the neck region through ingestion or due to iatrogenic injury. FB ingestion is rare in adults but still occurs. The ED treatment plan for patients suspected to have ingested a foreign body depends on the type and location of the FB, as well as the patient’s condition. In adults, the most common FBs ingested are chicken bone and fishbone. The ingested FB often gets lodged in the oropharynx and cricopharyngeal muscle regions. 

We report a 15-year-old female patient who presented with a foreign body in the throat. Lateral neck radiograph (LNR) revealed a radio-dense vegetable foreign body in the supraglottic region, lying transversely above the vocal cord. This is an unusual clinical and radiological presentation. A 4-cm long piece of beetroot was removed successfully via direct laryngoscopy under safe procedural sedation. Post-procedure, the patient recovered well, discharged within a few hours. 

Even though foreign body in throat is a common presentation, we report this case due to its anatomical position, type, size, and the unusual radiological appearance of the FB.

External laryngeal trauma is rare. It has a population incidence of 1 in 137,000 in adults. In developing countries blunt trauma is more common than penetrating trauma. Blunt trauma may occur due to accidents, sports injuries or hanging. Laryngeal trauma manifests as a spectrum of symptoms and signs ranging from cardiopulmonary arrest to subtle changes in voice quality. The most common presenting feature of laryngeal trauma is hoarseness, followed by dysphagia and pain. Although blunt laryngeal trauma is rare, but it can be life threatening. So, its early and proper management will remarkably affect the immediate probability of patient’s survival and their long term quality of life.

In this cross-sectional and descriptive study, medical records of 30 patients with blunt laryngeal trauma, who were admitted in ENT ward of Imam Reza hospital over a 10-year period, were evaluated.

30 patients, including 27 (90%) males and 3 (10%) women were studied. Mean age of patients was 36.13±10.53 years. The most common cause of blunt laryngeal trauma was vehicle accidents. The most common presenting symptoms were neck pain and tenderness. Subcutaneous emphysema was the most common radiological finding. The most common laryngoscope findings were swelling and hematoma of true vocal cords. Treatment modalities were supportive therapy performed on 26(86.7%) patients, tracheotomy on 3(10%) patients and open surgery on 1(3.3%) patients. Also 2 (6.7%) patients required intubation.

In most patients suffering from mild trauma, conservative therapy is mostly administered. Any delay in early and proper diagnosis and treatment may be life threatening. So in such situations the patient's airway should be evaluated by skillful experts and emergency procedures have to be applied. Also any changes in patient's signs should be monitored frequently and the required diagnostic and therapeutic procedures must be applied.

Laryngeal fractures are one of the complications of direct damage to the neck, which can lead to airway obstruction and life-threatening conditions. Other causes of laryngeal fractures include injuries during fights, sports injuries, hangings, and iatrogenic causes. In this study, we introduce a child with a laryngeal fracture following an accidental hanging.

Case Report: 

A 9-year-old girl was presented to the emergency department with respiratory distress and inability to speak after being hanged by her scarf. We secured the cervical spine with a hard collar and provided two intravenous (IV) lines. Then, the patient was transferred to the radiology department to perform cervical and thoracic computerized tomography (CT) scans. In the cervical CT scan, the fracture of laryngeal cartilage was detected. We repaired the fracture by prolene sutures. Then the patient was transferred to the intensive care unit (ICU) ward. After 2 days, she was transferred to ward and discharged without any complications.

The cervical trauma is a critical condition that must be managed carefully and urgently. For the rapid diagnosis of possible damage, imaging is necessary. Among all modalities, CT scan is the best choice for detection of the vertebral injuri es and airway competence in emergent conditions.

In the lexicographic texts as well as in veterinary resources and specialized books on horses, the Islamic civilization period has focused on the types of sounds heard from horses; the concept of sounds has been explained as well. Exposure of horses to some infectious diseases affects their larynx in such a way that this consequently changes the animals’ sound. Laryngeal problems in horses have been identified in ancient veterinary medicine by examining or hearing how the horse whines. The methods of identifying laryngeal problems and changes in the sound of the infected horses have been mentioned in ancient veterinary and specialized horse books in detail (FARASNAMEH- BEITAREHNAMEH, etc.). The purpose of this study was to conceptually obtain and classify the sounds of an infected horse followed by identifying its laryngeal problems that altered its natural sound.This is a qualitative research article used to describe and document the analysis methods. Using the designed vocabulary keyword, references were searched in the veterinary, and some other medical literature resources, followed by employing various stages of content analysis method. Horses produce various sounds that include: Hamhameh, Sahil, Wahvaheh, Rahraheh, Shakhir, Nakhir, Karir, Dhabh, etc. For example, Sahil is divided in two: Salsaleh and Jaljaleh. For each of these voices, the meaning has been mentioned in the respective books. While infected, the animal’s voice is altered due to damage to the larynx, a vital member of the horse’s sound production. This impairs the horse’s communication with the rider or trainer.The findings showed that during the period of Islamic civilization, special attention was paid to horses. A variety of sounds produced by the animals were named, and their meanings were explained. Other unrelated Larynx problems also causing altered sounds due to laryngeal injuries were considered as independent illnesses, which they can be documented and read afterward.In conclusion, this study provides a comprehensive description of the identification and interpretation of sounds produced by horses in the history of the Islamic era. Also, further research in this field can determine the capability of veterinary knowledge in the Islamic regions more than before.