MyMedR

Fulltext Glottic cancer in a non-smoking patient with laryngopharyngeal reflux

Zainuddin N, Mohd Kornain NK

Malays Fam Physician, 2016;11(2-3):35-37.

The onset of carcinoma of the larynx, especially of the glottis, is heralded mainly by a change of voice. It has a male preponderance and is almost exclusively common to smokers and patients with heavy alcohol consumption. We report a case of glottic carcinoma in a non-smoker female patient. The only possible risk factor for her is a history of laryngopharyngeal reflux.

Matched MeSH terms: Larynx

Pulmonary tuberculosis in a rural area of Sarawak, Malaysia

Yano K, Goto S, Sado M, Takeuchi M, Iguchi M

Southeast Asian J. Trop. Med. Public Health, 1974 Sep;5(3):417-23.

PMID: 4215145

Matched MeSH terms: Larynx/microbiology

A bizarre case of accessory larynx in an infant with OEIS syndrome

Wong TL, Baki MM, Ishak S, See GB

Int J Pediatr Otorhinolaryngol, 2018 Nov;114:134-137.

PMID: 30262351 DOI: 10.1016/j.ijporl.2018.08.037

We report a bizarre case of accessory larynx in an infant with OEIS syndrome (omphalocele, cloacal exstrophy, imperforated anus & spinal defects). This is the first reported case in literature of a duplicate accessory larynx which is a mirror image of the true larynx. A congenital duplication of the larynx is a rare anomaly and can present in various forms. In this case, the infant presented with recurrent lung infection and inability to wean off oxygen. Scope revealed severe laryngomalacia in addition to the accessory larynx. Hence, supraglottoplasty was done with aim to resolve the lung and airway problem.

Matched MeSH terms: Larynx/abnormalities*; Larynx/surgery

Fulltext An unexpected cause of hoarseness of voice in a healthy teenager

Wong SL, Ibrahim ZA

Malays J Med Sci, 2010 Jan;17(1):52-5.

PMID: 22135527 MyJurnal

Laryngeal amyloidosis is a rare cause of stridor in a healthy young adult. We report a case of localised laryngeal amyloidosis, including our MRI findings, which included a necrotic centre that has not previously been described. This case also highlights the need for a high index of clinical suspicion to achieve the correct histopathological interpretation.

Matched MeSH terms: Larynx

Fulltext Lateral thyroid cartilage thyrotomy approach to an embedded paraglottic fishbone

Wong HT, Tham SY, Elangkumaran K, Ng W, Sia KJ

Ann R Coll Surg Engl, 2017 Mar;99(3):e1-e2.

PMID: 28071949 DOI: 10.1308/rcsann.2017.0010

Fishbones are of particular interest to otolaryngologists. Most fishbones can be removed transorally or via endoscopic guidance. Transcervical neck exploration is occasionally necessary, especially in cases of an embedded foreign body. Computed tomography is the most sensitive and specific imaging modality for identifying embedded fishbones. To our knowledge, this is the first reported case of a laryngeal foreign body embedded in the paraglottic space that was removed using an open approach via a lateral thyroid cartilage window.

Matched MeSH terms: Larynx*

Fulltext Unilateral Congenital Choanal Atresia: A Rare Missed Cause of Chronic Nasal Discharge

Wan Nur Anis Wan Draman, Addina Mat Baki, Hashimah Ismail, Shamina Sara Moses, Irfan Mohamad

Malaysian Journal of Paediatrics and Child Health, 2020;26(1):14-20.

MyJurnal

Choanal atresia is an uncommon malformation of the upper airway. Bilateral choanal atresia usually detected earlier as it is often associated with severe asphyxia immediately after birth. The diagnosis is often delayed in unilateral type, and mostly presented with unilateral chronic nasal discharge. This condition is rarely encountered but should be considered as a possible differential diagnosis of persistent nasal discharge. We present a case of unilateral congenital choanal atresia in a 4-month-old baby girl presented with persistent unilateral nasal discharge. Diagnostic investigation and possible surgical treatment techniques were discussed.

Matched MeSH terms: Larynx

Argyrophilic nuclear organizer region and p73 expression in head and neck squamous cell carcinomas: Teammates or adversaries?

Venkateswaran SP, Nathan LE, Mutalik VS, Shamsuddin NH

J Oral Maxillofac Pathol, 2016 Sep-Dec;20(3):427-435.

PMID: 27721608

Head and neck squamous cell carcinoma (HNSCC) consists of squamous cell carcinomas (SCCs) arising in the upper aerodigestive tract and accounts for 5% of cancers worldwide. In Malaysia, cancers of the nasopharynx, larynx, tongue and oral cavity are among the top twenty most common cancers in men. Argyrophilic nuclear organizer regions (AgNORs) are increased from normal mucosa to premalignant lesions to malignant lesions and have been associated with tumor grade and prognosis of patients. Although p73 is not mutated in human cancers, high levels of p73 expression have been associated with tumor differentiation status and patient prognosis.

Matched MeSH terms: Larynx

Fulltext [A comparison of ramping position and sniffing position during endotracheal intubation: a systematic review and meta-analysis]

Tsan SEH, Ng KT, Lau J, Viknaswaran NL, Wang CY

Braz J Anesthesiol, 2020 11 09;70(6):667-677.

PMID: 33288219 DOI: 10.1016/j.bjan.2020.08.009

OBJECTIVES: Positioning during endotracheal intubation (ETI) is critical to ensure its success. We aimed to determine if the ramping position improved laryngeal exposure and first attempt success at intubation when compared to the sniffing position.

METHODS: PubMed, EMBASE, and Cochrane CENTRAL databases were searched systematically from inception until January 2020. Our primary outcomes included laryngeal exposure as measured by Cormack-Lehane Grade 1 or 2 (CLG 1/2), CLG 3 or 4 (CLG 3/4), and first attempt success at intubation. Secondary outcomes were intubation time, use of airway adjuncts, ancillary maneuvers and complications during ETI.

RESULTS: Seven studies met our inclusion criteria, of which 4 were RCTs and 3 were cohort studies. The meta-analysis was conducted by pooling the effect estimates for all 4 included RCTs (n=632). There were no differences found between ramping and sniffing positions for odds of CLG 1/2, CLG 3/4, first attempt success at intubation, intubation time, use of ancillary airway maneuvers and use of airway adjuncts, with evidence of high heterogeneity across studies. However, the ramping position in surgical patients is associated with increased likelihood of CLG 1/2 (OR=2.05, 95% CI 1.26 to 3.32, p=0.004) and lower likelihood of CLG 3/4 (OR=0.49, 95% CI 0.30 to 0.79, p=0.004), moderate quality of evidence.

CONCLUSION: Our meta-analysis demonstrated that the ramping position may benefit surgical patients undergoing ETI by improving laryngeal exposure. Large-scale well-designed multicentre RCTs should be carried out to further elucidate the benefits of the ramping position in the surgical and intensive care unit patients.

Matched MeSH terms: Larynx

Primary fungal laryngitis mimicking recurrent laryngeal carcinoma

Thomas RA, Kew TY, Mat Baki M

BMJ Case Rep, 2022 Feb 09;15(2).

PMID: 35140081 DOI: 10.1136/bcr-2021-245678

A 79-year-old smoker with a background history of a treated glottic carcinoma and chronic obstructive pulmonary disease presented with progressive hoarseness, symptoms of aspiration and shortness of breath for 6 months. Examination revealed an ulcero-fungating mass over the posterior commissure of the larynx. A tracheostomy, direct laryngoscopy and biopsy of the mass was performed to secure his airway and to exclude recurrent glottic carcinoma. Reassuringly, a histopathological examination of the mass revealed numerous fungal yeast bodies. He was then treated with itraconazole for 4 weeks and was followed up as and outpatient with complete resolution and no recurrence of the disease.

Matched MeSH terms: Laryngoscopy; Larynx*

Fulltext Laryngeal histoplasmosis: an occupational hazard

Teoh JW, Hassan F, Mohamad Yunus MR

Singapore Med J, 2013 Oct;54(10):e208-10.

PMID: 24154590

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.

Matched MeSH terms: Larynx/microbiology*; Larynx/pathology

Fulltext Repair of pharyngocutaneous fistula (PCF) using montgomery salivary bypass tube after salvage total laryngectomy following failed primary radiotherapy: a case report

Teh, H. M., Mohd Sayuti, R., Kahairi, A., Bathma, D. S., Salman, A., Nor Kamaruzaman Esa, et al.

Asian Journal of Medicine and Biomedicine, 2018;2(1):0-0.

MyJurnal

The occurrence of pharyngocutaneous fistula (PCF) after total salvage laryngectomy following radiotherapy
as primary treatment is quite common. In most cases, pharyngocutaneous fistula can heal spontaneously
with conservative measures. Here, we are reporting a 69-year-old male with a residual carcinoma of the
larynx following failed radiotherapy as primary treatment whose later underwent a salvage total
laryngectomy. Post-operatively, it was complicated by the formation of pharyngocutaneous fistula which
was failed to heal with conservative measures and few attempts of surgical repair. The fistula later healed
with the application of Montgomery Salivarybypass tube after 3 weeks. The application of the salivary
bypass tube should be considered and used to promote healing in persistent pharyngocutaneous fistula
especially in a post radiotherapy patient.

Matched MeSH terms: Larynx

Basaloid Squamous Cell Carcinoma: An Unusual Ball-Valve Laryngeal Obstruction

Tan SH, Hindi KW, Chandran PA, Chong AW

Iran J Otorhinolaryngol, 2015 May;27(80):243-6.

PMID: 26082908

INTRODUCTION: A rare case of basaloid squamous cell carcinoma (BSCC) of the larynx, which has not been previously reported, is described.

CASE REPORT: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords.

CONCLUSION: Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

Matched MeSH terms: Larynx

Fulltext Lipoma of vallecula-a case report

Tan KS, Jalaluddin WMS

BJR Case Rep, 2016;2(3):20150460.

PMID: 30459991 DOI: 10.1259/bjrcr.20150460

Lipomas of the larynx, oropharynx and hypopharynx are rare, accounting for approximately 1% of benign laryngeal neoplasms. We present a rare case of a simple lipoma arising from the right vallecula. A 55-year-old male presented with worsening dysphagia for 1 week. CT scan revealed a lesion of fat attenuation in the right vallecula. The patient underwent surgical excision and recovered uneventfully. To our knowledge, there are only two cases of vallecular lipoma that have been reported and they are both of spindle cell subtype and located on the left side. This is the first reported case of a simple lipoma arising from the right vallecula and causing obstructive symptoms. CT scan or MRI is essential in confirming the diagnosis and assessing the extent, thus allowing prompt excision, especially when the patient is symptomatic.

Matched MeSH terms: Larynx

Fulltext Histoplasmosis of the larynx

Subramaniam S, Abdullah AHR, Hairuzah I

Med J Malaysia, 2005 Aug;60(3):386-8.

PMID: 16379201

Primary histoplasmosis of the larynx is not a common disease. Most cases of laryngeal histoplasmosis results from hematogenous spread of disseminated histoplasmosis usually originating from pulmonary infection by Histoplasma capsulatum. We report a 52-year-old male chronic smoker who had prolonged hoarseness and was initially diagnosed with laryngeal carcinoma. However, biopsy of the laryngeal mucosa confirmed the diagnosis of histoplasmosis. There were no signs of pulmonary or systemic involvement. Treatment with intravenous amphotericin B was given for a week and oral ketaconazole was given for a month with complete resolution of symptoms.

Matched MeSH terms: Larynx/pathology*

Fulltext Delay in ludwig angina diagnosis is fatal

Siti Nidzwani, M.M., Loo, S.P.S.

Medicine & Health, 2018;13(2):170-174.

MyJurnal

Ludwig angina is a fulminant condition that is potentially lethal. If left unrecognized or untreated, this condition carries a mortality rate of up to 50%. We illustrate a case of 43-year-old male who presented with signs and symptoms of Ludwig angina over a period of two days. The patient had history of tooth extraction prior to the onset of symptoms. Despite typical clinical presentation, Ludwig angina was not considered during the first visit to medical. Ludwig angina is a clinical diagnosis that requires high index of suspicion. Delay in the diagnosis increase the risk of airway obstruction due to its rapidly spreading oedema of the upper airway.

Matched MeSH terms: Larynx

Fulltext Estimation of Andrographolides and Gradation of Andrographis paniculata Leaves Using Near Infrared Spectroscopy Together With Support Vector Machine

Sing D, Banerjee S, Jana SN, Mallik R, Dastidar SG, Majumdar K, et al.

Front Pharmacol, 2021;12:629833.

PMID: 34025404 DOI: 10.3389/fphar.2021.629833

Andrographis paniculata (Burm. F) Nees, has been widely used for upper respiratory tract and several other diseases and general immunity for a historically long time in countries like India, China, Thailand, Japan, and Malaysia. The vegetative productivity and quality with respect to pharmaceutical properties of Andrographis paniculata varies considerably across production, ecologies, and genotypes. Thus, a field deployable instrument, which can quickly assess the quality of the plant material with minimal processing, would be of great use to the medicinal plant industry by reducing waste, and quality grading and assurance. In this paper, the potential of near infrared reflectance spectroscopy (NIR) was to estimate the major group active molecules, the andrographolides in Andrographis paniculata, from dried leaf samples and leaf methanol extracts and grade the plant samples from different sources. The calibration model was developed first on the NIR spectra obtained from the methanol extracts of the samples as a proof of concept and then the raw ground samples were estimated for gradation. To grade the samples into three classes: good, medium and poor, a model based on a machine learning algorithm - support vector machine (SVM) on NIR spectra was built. The tenfold classification results of the model had an accuracy of 83% using standard normal variate (SNV) preprocessing.

Matched MeSH terms: Larynx

Fulltext Iatrogenic aspiration of custom-made keel: a case report

Sharouny H, Omar RB

Iran Red Crescent Med J, 2014 Dec;16(12):e17066.

PMID: 25763237 DOI: 10.5812/ircmj.17066

INTRODUCTION: Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during the later stage. They can be put in place either via the endoscopic approach or through a micro thyroidotomy and are held in place with a heavy suture through cricothyroid and thyrohyoid membranes. They are left in place for two to four weeks, and then removed through the endoscopic approach under general anesthetics.

CASE PRESENTATION: We report on a case of anterior glottis stenosis with keel aspiration for two weeks, after endoscopic CO2 laser resection of the stenotic section and keel placement. The patient was admitted to our center, where bronchoscopy was performed and the keel was removed. A new custom-made silastic keel was properly placed in raw areas and fixed to the skin with suture through the cricothyroid and thyrohyoid membranes. The keel was removed three weeks later.

CONCLUSIONS: Endoscopic keel placement should be done with heavy suture through cricothyroid and thyrohyoid membranes. Surgeons should suture the keel to the anterior laryngeal wall with specially designed Lichtenberger's needle-carriers to prevent complications such as keel aspiration, adhesion formation and imposing a second trip under general anesthetics, which put the patient at increased risk. The false vocal cord microflaps, as biological keels and a relatively new method may replace silastic keel placement in the future.

Matched MeSH terms: Larynx

Management of laryngeal foreign bodies in children

Sharma HS, Sharma S

J Accid Emerg Med, 1999 Mar;16(2):150-3.

PMID: 10191459

Foreign body aspiration is one of the leading causes of accidental death in children. Food items are the most common items aspirated in infants and toddlers, whereas older children are more likely to aspirate non-food items. Laryngeal impaction of a foreign body is very rare as most aspirated foreign bodies pass through the laryngeal inlet and get lodged lower down in the airway. Two rare cases of foreign body aspiration with subglottic impaction in very young children (under 2 years of age) are described. In both the cases subglottic impaction occurred consequent to attempted removal of foreign body by blind finger sweeping. The clinical presentation, investigations, and management of these rare cases are discussed.

Matched MeSH terms: Laryngoscopy; Larynx*

Laryngeal giant cell tumour presenting as a tongue base lesion causing severe dysphagia

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: Larynx

Fulltext Brain laryngeal mask--study in 50 spontaneously breathing patients

Reddy SV, Win N

Singapore Med J, 1990 Aug;31(4):338-40.

PMID: 2255930

Brain laryngeal mask (BLM) was used to assess its suitability in 50 spontaneously breathing patients by one lecturer and 4 Medical Officers. Insertion of the laryngeal mask was successful at the first attempt in 42 patients, second attempt in 7 and third attempt in one. The incidence of airway obstruction secondary to downfolding of the epiglottis, which was corrected by reinsertion, was 16%. Post-operative complications included clenching of teeth in 5 patients, vomiting in 2 and excessive salivation in 3. The incidence of sore throat was 10%.

Matched MeSH terms: Larynx*

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