Larynx

喉部
  • 文章类型: Case Reports
    背景:棉瘤,保留有异物反应的手术海绵,是开腹手术中一种不寻常但严重的并发症。头颈部手术后非常罕见。这里,我们介绍了一例气管造口术后上呼吸道的Gossyboma。
    方法:一名32岁男性在道路交通事故后严重头部受伤,气管造口术后一个月出现喘鸣和呼吸困难。颈部X光片并不明显,颈部的计算机断层扫描(CT)扫描显示,从下咽延伸到上气管的轮廓清晰的均匀曲线膜。喉和上气管的支气管镜评估显示保留的手术海绵,已被检索。患者的呼吸在干预后得到了显著改善。
    结论:棉瘤在X线片上可能未被发现,在颈部CT扫描上也可能表现为异型同质膜。虽然罕见,保留的手术物品会对医生产生深远的法医学和专业后果。因此,对于气管造口术后出现呼吸窘迫的患者,有必要强烈的临床怀疑和警惕gossyboma。
    BACKGROUND: Gossypiboma, a retained surgical sponge with a foreign body reaction, is an unusual but serious complication seen in open abdominal surgeries. It is exceptionally rare following head and neck surgeries. Here, we present a case of Gossypiboma of the upper airway following tracheostomy.
    METHODS: A 32-year-old male presented with stridor and difficulty breathing one-month post-tracheostomy after a severe head injury following a road traffic accident. A neck radiograph was unremarkable, and a computed tomography (CT) scan of the neck showed a well-defined homogenous curvilinear membrane extending from the hypopharynx to the upper trachea. Bronchoscopic evaluation of the larynx and upper trachea revealed a retained surgical sponge, which was retrieved. The patient\'s breathing improved drastically post intervention.
    CONCLUSIONS: Gossypiboma may go undetected in radiographs and may also present atypically as a homogenous membrane on a CT scan of the neck. Though rare, retained surgical items can have profound medicolegal and professional consequences on physicians. Hence, a strong clinical suspicion and vigilance for gossypiboma is necessary for patients presenting with respiratory distress post-tracheostomy.
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  • 文章类型: Case Reports
    喉部尤因肉瘤极为罕见,只有少数病例报告。在这份报告中,我们描述了一例伴有甲状软骨破坏的喉骨外尤因肉瘤。喉镜,2024.
    Ewing sarcoma of the larynx is extremely rare, only a few number of cases have been reported. In this report, we describe a case of extraskeletal Ewing sarcoma of the larynx with thyroid cartilage destruction. Laryngoscope, 2024.
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  • 文章类型: Journal Article
    Laryngeal air cyst (laryngocele) is a rare disease that is an abnormal cystic expansion of the deep structures of the laryngeal ventricle. They can be accompanied by serious complaints, such as shortness of breath, difficulty breathing during exercise, as well as at rest with large cysts. Computed tomography is the most effective method for determining the type, localization and degree of laryngocele. Although surgical treatment is considered the method of choice in cases of laryngeal air cyst, the approach significantly depends on the size of the lesion.
    Воздушная киста гортани (ларингоцеле) — редкое заболевание, представляющее собой аномальное кистозное расширение глубоких структур гортанного желудочка. Симптоматика ларингоцеле вариабельна: от незначительных жалоб на дискомфорт при глотании и фонации, затруднение дыхания вплоть до одышки при физической нагрузке и/или в покое. В дополнение к визуализации гортани при эндоскопическом осмотре может быть использована компьютерная томография, которая является эффективным методом определения типа, локализации и степени ларингоцеле. Оперативное лечение — основной метод лечения данной патологии; способ хирургического подхода зависит от размера и локализации патологического процесса.
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  • 文章类型: Case Reports
    吞咽困难是一种常见症状,具有各种潜在病因,使其管理具有挑战性,即使是经验丰富的医生。颈椎骨赘的存在通常会阻碍吞咽,使喉部移位,导致喉咙痛。我们描述了一例85岁的男性,他有两年的进行性吞咽困难病史,在过去的两个月里,尤其是固体食物和液体,提示耳鼻喉科评估。尽管之前有调查,包括正常胃镜检查和经验性疼痛管理,进一步评估显示下咽部肿块膨出,提示宫颈骨赘.保守管理,包括言语和吞咽疗法,饮食调整,和药物干预,在没有手术干预的情况下,症状明显改善。此病例证明了保守治疗措施治疗宫颈骨赘所致吞咽困难的有效性。强调多学科方法对优化患者护理的重要性。
    Dysphagia is a common symptom with various underlying etiologies, making its management challenging even for experienced physicians. The presence of osteophytes in the cervical spine may often impede swallowing, displace the larynx, and cause a sore throat. We describe a case of an 85-year-old male who presented with a two-year history of progressive dysphagia, exacerbated over the last two months, especially with solid foods and liquids, prompting an ENT evaluation. Despite prior investigations, including normal gastroscopy and empirical pain management, further assessment revealed bulging masses in the hypopharynx indicative of cervical osteophytes. Conservative management, including speech and swallow therapy, dietary modifications, and pharmacological interventions, resulted in significant symptom improvement without surgical intervention. This case demonstrates the effectiveness of conservative treatment measures in treating dysphagia caused by cervical osteophytes, emphasizing the significance of a multidisciplinary approach for optimal patient care.
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  • 文章类型: Case Reports
    喉神经鞘瘤是一种罕见的生长缓慢的良性神经鞘瘤。诊断是结合临床,放射学,和组织病理学发现,治疗的主要方法是切除。我们报告了一例69岁的患者,颈部肿块导致喘鸣,吞咽困难,和端坐呼吸。颈部CT显示肿块增大,长6.3厘米,延伸到喉上方。紧急气管切开术和肿块切除术,从支持神经鞘瘤的标本中获得组织病理学和免疫组织化学结果。总之,虽然罕见,神经鞘瘤应始终被视为喉部肿块的鉴别诊断。需要更多的研究来评估肿瘤的大小和预后。
    Laryngeal schwannoma is a rare benign nerve sheath tumor that is slow growing. The diagnosis is made from a combination of clinical, radiological, and histopathological findings, and the main method of treatment is resection. We report a case of a 69-year-old presenting with a neck mass causing stridor, dysphagia, and orthopnea. CT of the neck showed an enhancing mass measuring 6.3 cm and extending superior to the larynx. Emergent tracheostomy and mass resection were performed, and histopathology and immunohistochemical findings were obtained from the specimen supporting schwannoma. In conclusion, while rare, schwannoma should always be considered as a differential diagnosis for a laryngeal mass. More studies are needed to assess the size and prognosis of the tumor.
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  • 文章类型: Journal Article
    背景:口咽喉静脉畸形(VMs)的治疗仍然具有挑战性。这项研究评估了混合手术室(OR)中透视和内窥镜引导的经口硬化疗法对口咽喉VM的有效性和安全性。方法:纳入在混合OR中接受经口硬化治疗的口咽喉VM患者。结果:14例患者(6例女性,八名男性;平均年龄26岁;范围,4-71年)进行了分析。观察到的症状是呼吸困难(n=3),打鼾(n=2),睡眠呼吸暂停(n=1),和吞咽困难(n=1)。面部和颈部病变广泛(n=9),口咽喉部病变有限(n=5)。对两名患者进行了永久性气管切开术,同时对五名患者进行了临时气管切开术。治疗区域是软腭(n=8),咽部(n=7),舌根(n=4),和会厌(n=1)。硬化治疗的中位数为2.5(范围,1-9).中位随访时间为81个月(范围,6-141).治疗结果被评为优秀(n=2),好(n=7),或公平(n=5)。治疗后并发症为出血(n=1),导致紧急气管造口术。结论:混合OR中的透视和内窥镜引导的经口硬化疗法可以有效且安全地治疗口咽喉型VM。
    Background: Treatment of oropharyngolaryngeal venous malformations (VMs) remains challenging. This study evaluated the effectiveness and safety of fluoroscopy- and endoscopy-guided transoral sclerotherapy for oropharyngolaryngeal VMs in a hybrid operation room (OR). Methods: Patients with oropharyngolaryngeal VMs who underwent transoral sclerotherapy in a hybrid OR were enrolled. Results: Fourteen patients (six females, eight males; median age of 26 years; range, 4-71 years) were analyzed. The symptoms observed were breathing difficulties (n = 3), snoring (n = 2), sleep apnea (n = 1), and swallowing difficulties (n = 1). Lesions were extensive in the face and neck (n = 9) and limited in the oropharyngolarynx (n = 5). A permanent tracheostomy was performed on two patients, while a temporary tracheostomy was performed on five patients. The treated regions were the soft palate (n = 8), pharynx (n = 7), base of the tongue (n = 4), and epiglottis (n = 1). The median number of sclerotherapy sessions was 2.5 (range, 1-9). The median follow-up duration was 81 months (range, 6-141). Treatment outcomes were graded as excellent (n = 2), good (n = 7), or fair (n = 5). The post-treatment complication was bleeding (n = 1), resulting in an urgent tracheostomy. Conclusions: Fluoroscopy- and endoscopy-guided transoral sclerotherapy in a hybrid OR can be effective and safe for oropharyngolaryngeal VMs.
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  • 文章类型: Case Reports
    尤因肉瘤家族肿瘤是一组小的圆形肿瘤细胞。尤因肉瘤大部分发生在骨骼中,约占原发性骨肿瘤的10%。骨外尤因肉瘤(ESS)是不常见的,常见于躯干,椎旁,和胸壁区域。在头颈部很少见,占2-3%。在头部和颈部区域,ESS见于鼻腔或口腔,鼻窦.起源于喉部的EES非常罕见。这里,我们报告了一名22岁的女性,患有声音变化和呼吸嘈杂的抱怨,她被诊断为声门上型EES。随着疾病在诊断期间的进展,她不得不接受紧急气管切开术。该疾病无法手术,因此她接受了新辅助化疗,然后进行放疗,然后进行辅助化疗。目前,她的症状好转了。本报告的目的是提出尤因肉瘤的罕见部位,并强调IHC疑似病例的早期诊断,提供有效的多模态治疗。
    Ewing\'s Sarcoma family of tumors is a group of small round tumor cells. Ewing\'s sarcoma majority occurs in bone, accounts about 10 % of primary bone tumors. Extraskeletal Ewing\'s sarcoma (ESS) is unusual and commonly seen in trunk, paravertebral, and chest wall region. It is rarely seen in head and neck region, accounting to 2-3 %. In head and neck region, ESS is seen in nasal or oral cavities, sinuses. EES originating in the larynx is very rare. Here, we report a 22 years old female having the complaints of change in voice and noisy breathing who was diagnosed as a case of EES of supraglottis. As the disease progressed during the time of diagnosis, she had to undergo emergency tracheostomy. The disease was inoperable so she received neoadjuvant chemotherapy followed by radiation followed by adjuvant chemotherapy. At present she is symptomatically better. The aim of this report is to put forward the rare site of Ewing\'s Sarcoma and highlighting the early diagnosis in suspected case with IHC, providing effective multimodality treatment.
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  • 文章类型: Journal Article
    Reinke's水肿(RE)是声带的良性病理性非炎性病症,临床表现广泛。我们的目的是调查莱因克水肿与一些常见的吸入剂滥用之间的关系。在这项病例对照研究中,主观包括23例RE患者(病例),和50例鼻窦炎患者(对照组)在耳鼻咽喉科接受手术,2015年至2020年。人口特征,一些相关疾病的历史,方法,和香烟的持续时间,鸦片消费是通过病人档案收集的。进行卡方(χ²)检验,分析分类和分类的差异,独立样本T检验用于比较来自无关组的两个样本均值。显著水平(P值)被认为小于0.05。平均年龄为54±12岁,42±11年,分别用于莱因克水肿和鼻窦炎。更多的妇女被记录在RE组,与男人相比。过敏,无原则地使用声音和健谈,喉部手术史,疾病类型与RE相关(p<0.05)。此外,吸烟与莱因克水肿显著相关。平均每天的香烟数量,吸烟的持续时间,RE中鸦片的消耗频率更高(P<0.05)。90%的RE和4%的鼻窦炎患者是鸦片消费者。两组病例和对照组的物质使用方法差异有统计学意义(p<0.0001)。在不同的方法中,扑克和石头方法是最常见的(69.6%),鸦片烟斗是第二常见的方法。这项研究还证实了吸烟和吸入阿片类药物在咽喉病变形成中的危险作用。特别是,长期使用这些物质会带来更严重的副作用。因此,似乎对阿片类药物上瘾的人应该定期访问和咨询,以减少和停止使用它们。
    Reinke\'s edema (RE) is a benign pathological non-inflammatory disorder of the vocal folds with a wide range of clinical manifestations. We aim to investigate the relationship between Reinke\'s edema and some common inhalant abuse. In this case-control study, subjective consisted of 23 patients with RE (the cases), and 50 patients with sinusitis (control) who underwent surgery in the Department of Otolaryngology, between 2015 and 2020. Demographic characteristics, history of some related disease, methods, and the duration of cigarette, and opium consumption were collected through the patients\' files. The chi-square (χ²) test was run to analyze the differences in the categorical and, and the Independent Sample T-test was used to compare two sample means from unrelated groups. A significant level (p-value) was considered less than 0.05. The mean age was 54 ± 12 years, and 42 ± 11 years, respectively for Reinke\'s edema and sinusitis. More women had been recorded in the RE group, compared to men. Allergy, unprincipled use of voice and talkativeness, history of laryngeal surgery, and type of disease were correlated to RE (p < 0.05). Also, cigarette smoking was significantly correlated with Reinke\'s edema. The average number of cigarettes per day, the duration of smoking, and opium consumption were more frequent in RE (P < 0.05). 90% of the RE and 4% of sinusitis patients were opium consumers. There was a statistically significant difference in the methods of substance use in the two groups of cases and control (p < 0.0001). Among the different methods, the poker and stone method was the most common (69.6%), and the opium smoking pipe was the second most common method. This study also confirmed the hazardous effects of smoking and inhaling opiates in the formation of lesions of the pharynx and larynx. In particular, longer use of these substances will be associated with more serious side effects. Therefore, it seems that people who are addicted to opiates should undergo periodic visits and counseling to reduce and stop their use.
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  • 文章类型: Case Reports
    多发性内分泌瘤形成2B型(MEN2B)是一种常染色体显性遗传癌症综合征,由转染(RET)过程中重排的原癌基因突变引起,包括甲状腺髓样癌,嗜铬细胞瘤,胃肠神经瘤,和粘膜神经节神经瘤。甲状腺髓样癌是MEN2B综合征死亡的主要原因。甲状腺髓样癌经常出现在生命的最初几年。虽然MEN2B的粘膜神经瘤很常见,喉神经瘤极为罕见。我们介绍了第三例小儿患者,其喉神经瘤位于左侧真声带,并对MEN2B患者的声带神经瘤进行了文献综述。
    Multiple Endocrine Neoplasia type 2B (MEN2B) is an autosomal dominant cancer syndrome caused by a mutation in rearranged during transfection (RET) proto-oncogene and includes medullary thyroid carcinoma, pheochromocytoma, gastrointestinal neuromas, and mucosal ganglioneuromas. Medullary thyroid carcinoma is the major cause of mortality in MEN2B syndrome. Medullary thyroid carcinoma can often appear during the first years of life. While mucosal neuromas in MEN2B are common, laryngeal neuromas are extremely rare. We present a third case of a pediatric patient with a laryngeal neuroma localized to the left true vocal cord and conduct a literature review of vocal cord neuromas in MEN2B patients.
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  • 文章类型: Case Reports
    喉髓外浆细胞瘤是一种极为罕见的实体,占喉部恶性肿瘤的0.04-0.45%。本临床病例报告的目的是强调此类独特病例的诊断和管理。一位77岁的绅士提出了1年的声音嘶哑的抱怨。计算机断层扫描图像显示软组织肿块病变累及右侧真实声带。进行直接喉镜活检并进行组织病理学检查,显示浆细胞的收集。免疫组织化学证实了Kappa和Lambda细胞的存在。排除多发性骨髓瘤(MM)。患者使用3DCRT技术接受根治性意向放射治疗,剂量为50Gy,25#,持续5周。在随后的随访中,他的声音嘶哑有所改善。在1年的随访中,正电子发射断层扫描计算机断层扫描显示疾病的总分辨率接近没有进展到MM。众所周知,单独的放射治疗可以实现良好的局部控制,无复发生存率,和器官保存在这种情况下。
    Extramedullary plasmacytoma of the larynx is an extremely rare entity accounting for 0.04-0.45% of malignant tumours of the larynx. The objective of this clinical case report is to highlight the diagnosis and management of a unique case such as this. A 77-year-old gentleman presented with complaints of hoarseness for 1 year. Computed tomography image revealed a soft tissue mass lesion involving the right true vocal cord. Direct laryngoscopic biopsy was performed and subjected to histopathological examination, which showed collection of plasma cells. Immunohistochemistry confirmed the presence of Kappa and Lambda cells. Multiple myeloma (MM) was ruled out. The patient received radical intent radiation therapy using 3DCRT technique with a dose of 50Gy in 25# over 5 weeks. He experienced improvement in hoarseness on subsequent follow-up visits. At 1-year follow up, positron emission tomography computed tomography showed near total resolution of disease with no progression to MM. Radiation therapy alone is known to achieve good local control, recurrence free survival, and organ preservation in such cases.
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