Displaying publications 1 - 20 of 29 in total

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  1. Zaharudin I, Azizi ZA
    Med J Malaysia, 2016 Jun;71(3):139-41.
    PMID: 27495889
    Hoarseness due to left recurrent laryngeal nerve paralysis was first described in 1897 by Norbert Ortner. Various cardiopulmonary and thoracic arch aorta pathologies associated with left recurrent laryngeal nerve palsy have been described over the last 100 years and is also known as cardio-vocal syndrome. We report our experience with seven cases of Ortners syndrome due to thoracic aortic aneurysm with compression of the left recurrent laryngeal nerve and resultant hoarseness.
    Matched MeSH terms: Hoarseness*
  2. Tan HY, Sanudin SH, Lum SG, Wong EHC
    Int J Surg Case Rep, 2021 Apr;81:105723.
    PMID: 33713999 DOI: 10.1016/j.ijscr.2021.105723
    BACKGROUND: Hypopharyngeal carcinoma can involve thyroid gland due to their close proximity. However, an initial presentation as a thyroid abscess is rare in this malignancy. To our knowledge, this is the second reported case in the English literature.

    CASE PRESENTATION: We described a 45-year-old female who presented with dysphagia, hoarseness and anterior neck swelling. The initial CT scan revealed a right thyroid abscess which was incised and drained with no malignancy found in the biopsy of the thyroid tissue. Patient presented one month later with worsening dysphagia, weight loss and a fungating anterior neck mass. Further investigation revealed a locally advanced hypopharyngeal squamous cell carcinoma extending to the right thyroid, upper oesophagus, prevertebral muscles and bilateral cervical lymph nodes (T4bN2cM0). Unfortunately, the patient passed away prior to initiation of treatment.

    CONCLUSION: Clinicians should have raised index of suspicion of a possible underlying hypopharyngeal carcinoma in patients presenting with thyroid abscess and proceed to further investigations in order to ensure early diagnosis and treatment of the malignancy.

    Matched MeSH terms: Hoarseness
  3. Shariff RER, Abidin HAZ, Kasim SS
    Clin Med (Lond), 2020 11;20(6):e267-e268.
    PMID: 33199335 DOI: 10.7861/clinmed.2020-0750
    We present a rare case of delayed diagnosis of mitral stenosis, initially presenting with hoarseness in her voice due to left recurrent laryngeal nerve (LRLN) compression. A 60-year-old woman presented to the otorhinolaryngology department following complaints of progressive hoarseness in voice over a 6-month period. There was dysphonia but no additional evidence of a cranial nerve IX or X palsy on examination, with subsequent flexible nasopharyngolaryngoscopy demonstrating left vocal cord palsy. She was referred for a cardiology consult following findings of atrial fibrillation on electrocardiography. Transthoracic echocardiography revealed an enlarged left atrium with evidence of severe mitral stenosis. A diagnosis of Ortner's syndrome was made and the patient underwent mitral valve replacement. Common causes of Ortner's syndrome include mitral stenosis with left atrium compression of the LRLN, but it can occur due to other causes including pulmonary hypertension or aortic aneurysm compression, among others. There are few data at present to conclude that regression of left atrial enlargement and pulmonary arterial hypertension with symptoms are associated with Ortner's syndrome. Therefore, it remains pertinent for clinicians to be aware of clinical features linked to mitral stenosis including its more uncommon presentations, such as in our case, as earlier intervention may improve prognosis.
    Matched MeSH terms: Hoarseness/etiology
  4. Seevaunnamtum SP, Mohd Ariff Ghazali NA, Nazaruddin WM, Besari AM, Fariza NHN, Omar SC, et al.
    Respir Med Case Rep, 2017;22:292-294.
    PMID: 29159029 DOI: 10.1016/j.rmcr.2017.10.011
    Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy breathing for 3 days and hoarseness of voice for 6 months. Due to resistant bronchospasm, attempts were made to secure the airway which led to unanticipated difficult intubation and ventilation. Subsequent investigations confirmed the diagnosis of Endobronchial Tuberculosis and patient was managed successfully with anti TB medication, corticosteroids and multiple sessions of tracheal dilatation for tracheal stenosis. This case highlights the unusual cause of difficulty in intubation and ventilation due to Endobronchial Tuberculosis, which required medical and surgical intervention to improve the condition.
    Matched MeSH terms: Hoarseness
  5. See GB, Mesran I
    Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):45-48.
    PMID: 31741928 DOI: 10.1007/s12070-016-0992-2
    Subglottic cysts (SGCs) are a rare cause of airway obstruction in children. Medical advances, higher survival rates for preterm infants, and improved diagnostic equipment have increased the number of reported cases of SGCs over the last three decades, the majority occurring in infants who had been extremely premature neonates and had suffered from respiratory distress, therefore having been intubated and managed in neonatal ICUs. Symptoms of laryngeal cysts depend on the size and the location of the cyst and include a change in the tone of voice, dysphonia, hoarseness, dysphagia, stridor, and dyspnea. This condition is often misdiagnosed as laryngomalacia, asthma, croup, or other diseases, due to the fact that it manifests as recurring respiratory infections, stridor, and wheezing. Death can occur in severe cases that are not treated. When present, it may account for severe inspiratory stridor that compromise the airway. The accepted gold standard treatment is direct laryngoscopy with marsupialization of the cyst to prevent recurrence. Two cases of subglottic cyst in our centre are described here. Although all cases presented differently, but in both of our cases, which have previous history of intubation with prematurity were initially diagnosed as laryngomalacia and croup.
    Matched MeSH terms: Hoarseness
  6. Saud MRM, Salahuddin Z, Hassan A, Yunus MRM, Mohamad I, Zulkifli MM
    J Taibah Univ Med Sci, 2018 Apr;13(2):201-204.
    PMID: 31435324 DOI: 10.1016/j.jtumed.2017.10.002
    Giant cell tumours are benign lesions that are uncommonly found in the larynx. Patients with these tumours may present with dysphagia, hoarseness and anterior neck swelling. Giant cell tumours are extremely rare and only a few cases have been reported. We present a case of an elderly woman who presented with severe dysphagia and a mass at the base of her tongue. The mass was found to be a laryngeal giant cell tumour and was successfully treated with chemotherapy.
    Matched MeSH terms: Hoarseness
  7. Saniasiaya J, Kulasegarah J
    Int J Pediatr Otorhinolaryngol, 2020 Dec;139:110473.
    PMID: 33137676 DOI: 10.1016/j.ijporl.2020.110473
    OBJECTIVE: Aim of this review is to evaluate the relation between reflux (either laryngopharyngeal or gastroesophageal) and dysphonia in children.

    DATA SOURCES: PubMed, Scopus, Embase.

    REVIEW METHODS: A literature search was conducted over a period from January 1990 to March 2020. The following search words were used either individually or in combination: voice disorders, laryngopharyngeal reflux, and gastroesophageal reflux. The search was conducted over a period of a month: April 2020.

    RESULTS: Five clinical research were selected based on our objectives and selection criteria. Four studies were of level III evidence. Altogether, a total of 606 patients were pooled with male predominance of 63%. In all studies, reflux was suggested to have strong relation with dysphonia. Majority of cases used 24-h pH monitoring to confirm reflux which yielded positive results in 69%. The top three most common endoscopic findings include: interarytenoid erythema and edema (32/38), vocal cord erythema and edema (160/231) and postglottic edema (141/337). Vocal cord nodules were found in 28% of our patients. Acoustic analysis and perceptual assessment of voice was performed in only 1 study. No complication from any procedure was mentioned in any of the studies. Outcome of treatment was mentioned in 1 study, whereby after 4.5 months of follow-up, 68% of children showed improvement in symptoms.

    CONCLUSION: Current evidence shows that there is strong relation between reflux and dysphonia in children. Most common laryngoscopic findings suggestive of reflux includes interarytenoid erythema and edema, vocal cord erythema and edema and postglottic edema.

    Matched MeSH terms: Hoarseness
  8. Samarakkody, Z.M., Sayuti, K.A., Mat Zin, A.A., Wan Abdul Wahab, W.N.N., Mohamad, I.
    Malaysian Family Physician, 2018;13(3):40-43.
    MyJurnal
    Cervical vagal schwannoma is an uncommon, benign neoplasm. It is usually asymptomatic and
    presents as a painless, palpable mass in the neck. However, large schwannomas can cause dysphagia,
    dysphonia or dyspnea as a result of compression. We report a case of an extremely rare complication
    of vagal schwannoma in which neck palpation induced the patient to cough. As the patient refused
    any surgical intervention, conservative management was used.
    Matched MeSH terms: Hoarseness
  9. Samarakkody ZM, Sayuti KA, Mat Zin AA, Wan Abdul Wahab W, Mohamad I
    Malays Fam Physician, 2018;13(3):40-43.
    PMID: 30800234
    Cervical vagal schwannoma is an uncommon, benign neoplasm. It is usually asymptomatic and presents as a painless, palpable mass in the neck. However, large schwannomas can cause dysphagia, dysphonia or dyspnea as a result of compression. We report a case of an extremely rare complication of vagal schwannoma in which neck palpation induced the patient to cough. As the patient refused any surgical intervention, conservative management was used.
    Matched MeSH terms: Hoarseness
  10. Rahmat O, Prepageran N
    Ear Nose Throat J, 2008 Dec;87(12):668-9.
    PMID: 19105136
    Matched MeSH terms: Hoarseness/diagnosis; Hoarseness/etiology
  11. Ponnampalam SN, Tan WY, Wazir NN, George J
    Acta Radiol Short Rep, 2012;1(1):1-3.
    PMID: 23986826 DOI: 10.1258/arsr.2012.110028
    We report a very rare case of a high grade osteosarcoma of the cervical spine in a 62-year-old woman. She presented with a relatively short history of a swelling in the posterior neck and cervical lymphadenopathy. This was associated with hoarseness of the voice, significant weight loss, and right upper arm radicular symptoms initially, progressing to paraplegia. Based on MR and CT imaging of the neck and an excision biopsy of an enlarged right supraclavicular lymph node, the histology revealed a high grade primary osteosarcoma of the cervical spine.
    Matched MeSH terms: Hoarseness
  12. Norly, S., Noorizan, Y., Ros’aini, P.
    MyJurnal
    We present a case of 80-year-old man with two-year history of hoarseness of voice secondary to left vocal cord paralysis. CT scanning revealed a saccular thoracic aneurysm compressing the left recurrent laryngeal nerve. A review of literature on Ortner's or cardiovocal syndrome is presented.
    Matched MeSH terms: Hoarseness
  13. Mohamed AL, Zain MM
    Malays J Med Sci, 2004 Jul;11(2):65-8.
    PMID: 22973129 MyJurnal
    Rheumatic mitral stenosis is prevalent in this part of the world and it gives rise to wide array of manifestations. However, hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner's syndrome) is an uncommon manifestation. This case illustrates an uncommon presentation in a common disease. A 29-year-old lady presented with a 2-year history of hoarseness of voice. Physical examination revealed a mid-diastolic murmur and left vocal cord paralysis. Echocardiography confirmed mitral stenosis with pulmonary hypertension. She underwent percutaneous mitral balloon valvotomy in 1991 with return of normal speech after a few months. The recurrent laryngeal nerve paralysis is mainly due to the compression by an enlarged pulmonary artery as initially thought. This complication is rarely seen nowadays due to greater awareness of the disease and earlier intervention. With the advent of percutaneous transvenous mitral valvotomy in the nineties, effective non-surgical intervention is plausible.
    Matched MeSH terms: Hoarseness
  14. Mohamad I, Mohamad IS, Nik Hassan N
    Malays Fam Physician, 2018;13(1):57-58.
    PMID: 29796215 MyJurnal
    An elderly gentleman with a known history of
    well-controlled hypertension presented with
    a three-week history of hoarseness associated
    with mild breathlessness. There was no episode
    of cyanosis, no noisy breathing, and no
    reduction in effort tolerance. There was also no
    history of chest pain or orthopnea. He denied
    any feeling of food stuck in his throat or chest,
    and he had no history of choking sensations
    during meals. He, however, was unable to
    count from 1 to 10 in one breath, and lung
    auscultation revealed reduced air entry on both
    sides. A chest radiograph was then obtained. (Copied from article).
    Matched MeSH terms: Hoarseness
  15. Marina M.B., Hazleigh N.M., Thean, Y.K., Sani A.
    MyJurnal
    Isolated lower cranial nerve (CN) palsy affecting the CN X resulting from a skull base fracture is very rare. The clinical manifestation and natural history is related closely to the complex anatomy of this region and mechanism of injury. Here, we report a case of a 54 year-old man who presented with a delayed onset of dysphonia and dysphagia with aspiration following a closed head injury sustained from a motor vehicle accident. Injection laryngoplasty was implemented to alleviate symptoms of his CN X palsy, which eventually almost completely resolved. High index of suspicion should be maintained when investigating possible skull base fractures, especially with a suggestive clinical presentation of lower CN palsies affecting one or all the lower CNs. Delayed onset of these CN palsies are likely to have more favourable outcomes.
    Matched MeSH terms: Hoarseness
  16. Mahmud KA, Zakaria R, Azman M, Mat Baki M
    ORL J Otorhinolaryngol Relat Spec, 2021 05 05;83(4):295-298.
    PMID: 33951656 DOI: 10.1159/000515424
    Adult laryngeal haemangioma is normally seen in the supraglottic or glottic region. Transglottic haemangioma is unusual, and treatment with primary endolaryngeal surgical excision may lead to undesirable bleeding and poor voice outcomes. A 25-year-old female presented with hoarseness and progressive upper airway obstruction symptoms. Videoendoscopy showed haemangioma involving all unilateral subunits of the larynx obstructing half of the subglottis. The transglottic haemangioma was treated with endolaryngeal ethanol injection with prior tracheostomy under local anaesthesia. Endolaryngeal laser surgery was performed later on to remove small residual haemangioma and granuloma. The haemangioma resolved; however, the ethanol injection to the paraglottic space results in vocal fold immobility but with favourable position and good muscle tone and bulk. The patient was successfully decannulated. Post-intervention subjective and objective voice assessments showed normal parameters except slight impairment of voice handicap index-10 with a total score of 12. Adult transglottic haemangioma can cause upper airway obstruction and requires intervention. Excision of the lesion endoscopically without sacrificing voice is achievable.
    Matched MeSH terms: Hoarseness
  17. Lo SM, Ramarmuty HY, Kannan K
    Respirol Case Rep, 2021 Mar;9(3):e00718.
    PMID: 33614038 DOI: 10.1002/rcr2.718
    Ortner syndrome or cardiovocal syndrome is hoarseness of voice due to left recurrent laryngeal nerve palsy as a result of cardiovascular abnormality. It is not known that pneumothorax has any association with Ortner syndrome. A 56-year-old gentleman, with previous history of 20 pack-year smoking and 1-year history of hypertension, presented to us with cough for two weeks with intermittent haemoptysis, as well as hoarseness of voice for the past one year. Direct laryngoscopy confirmed that he had left vocal cord palsy. Clinical and radiological investigations suggested that he had left pneumothorax. Left chest tube thoracostomy was performed and computed tomography of chest revealed aortic isthmus aneurysm with dissection extending to distal left common iliac artery and residual left hydropneumothorax. The patient was then referred to the vascular team and cardiothoracic team for further management.
    Matched MeSH terms: Hoarseness
  18. Lim KH, Liam CK, Wong CM
    Postgrad Med J, 2000 Aug;76(898):512, 518-9.
    PMID: 10908387
    Matched MeSH terms: Hoarseness/etiology; Hoarseness/physiopathology
  19. Kep, Kee W., Nadia, M.N., Melvin, K., Muhammad, M., Raha, R., Nurlia, Y.
    MyJurnal
    Post-intubation airway related adverse effects such as coughing on the endotracheal tube (ETT), restlessness, hoarseness and sore throat are common and undesirable outcomes of anaesthesia using endotracheal intubation. This prospective randomized single blind study was carried out to compare the effectiveness of intra-cuff dexamethasone and alkalinized lignocaine in reducing the incidence of post-intubation airway related adverse effects. Eighty four patients aged 18 – 60 years, of ASA status I or II, were randomly allocated into three groups: air, dexamethasone and alkalinized lignocaine. Their ETT cuffs were inflated according to the group they were allocated to. The incidence of coughing on the ETT, restlessness, hoarseness and sore throat was assessed, postoperatively. The results showed a significant difference in the incidence of cough, restlessness, hoarseness and sore throat in the dexamethasone group compared to the air group. All the patients had minimal or no sore throat at all documented times. Both intra-cuff dexamethasone and alkalinized lignocaine significantly reduced the incidence of hoarseness. However, alkalinized lignocaine additionally lowered the incidence of restlessness, significantly.
    Matched MeSH terms: Hoarseness
  20. Jaafar R, Mohamad I
    Malays Fam Physician, 2014;9(1):25-7.
    PMID: 25606294 MyJurnal
    Unilateral vocal cord palsy secondary to thoracic aortic aneurysm is a rare occurrence. Direct compression of the enlarging thoracic aneurysm on the left recurrent laryngeal nerve causes neuronal injury of the nerve, which is manifested as hoarseness. We present a rare case of unilateral vocal cord palsy in a 60-year-old healthy gentleman caused by a large thoracic aortic aneurysm. This rare presentation, with a serious underlying pathology might be misdiagnosed or delayed. Therefore, it is important for us to have high index of suspicion in cases with a rare presentation such as this.
    Matched MeSH terms: Hoarseness
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