A case of vocal polyps improved with herbal medicine: A case report.

Vocal polyps are benign vocal cord lesions, which mainly manifest as a hoarse voice. Laryngeal microsurgery is the most common treatment. However, because of anxiety regarding invasive treatment, it is necessary to have a non-invasive treatment option. A 43 year old female patient who is a teacher visited a Korean medical hospital for persistent hoarseness with a vocal polyp. After taking herbal medicine for hoarseness (Kyung-Hee-cheong-um-whan) and pharyngitis (cheong-in-li-gyok-tang and cheong-in-ryu-que-whan) for almost 10 weeks, the vocal polyp was reduced and symptoms improved. Herbal prescription for pharyngitis and hoarseness can be applied to vocal polyps as non-invasive treatment.

Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

INTRODUCTION: Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. MATERIAL AND METHODS: Review of literature on office-based procedures in laryngology and head and neck oncology. RESULTS: Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. CONCLUSION: Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process.

Chondronecrosis of the larynx following use of the laryngeal mask airway.

This case describes the development of laryngeal chondronecrosis after use of the laryngeal mask airway (LMA). A 69-year-old male with prior laryngeal irradiation underwent total knee replacement with general anesthesia via LMA. Postoperatively, he developed laryngeal chondronecrosis, bilateral vocal fold immobility, and aspiration, necessitating tracheostomy and gastrostomy placement. He improved with hyperbaric oxygen therapy, intravenous antibiotics, and endoscopic repair of a residual fistula. Vocal fold motion returned and he was decannulated. Chondronecrosis of the larynx may occur with the use of the LMA, and caution should be used in patients with a history of prior laryngeal irradiation.

[Treatment of vocal cord submucosal bleeding with pricking therapy].

OBJECTIVE: To observe the clinical efficacy of pricking bleeding of 3 points of the thumb tip, and 3 points of the auricular helix for treatment of vocal cord submucosal bleeding (VCSB), so as to provide a better therapy for it. METHODS: Sixty VCSB patients were equally randomized into pricking bleeding group and ultrasonic atomizing inhalation (UAI) group. Pricking bleeding was applied to Shaoshang (LU 11, 0. 1 cun to the nail on the radial side), Zhongshang (the center of the thumb back, 0. 1 cun to the nail), Laoshang (0. 1 cun to the nail on the ulnar side), Lun 1, 3 and 5 (MA-H) of the helix, once daily for 7 days. Ultrasonic atomizing inhalation treatment was given to patients of the UAI group for 15 min every time, once daily for 7 days. The scores of symptoms and signs and their difference values were calculated before and after the treatment. The acoustical parameters maximum phonation time (MPT), frequency perturbation quotient (FPQ), amplitude perturbation quotient (APQ), ratio of harmonic to noise (H/N) were detected by using a USSA Computer Language Phonetic Spectrum Analysis System. RESULTS: Of the two 30 cases of VCSB patients in the pricking bleeding and UAI groups, 20 (66.67%) and 12(40.00%)were cured, 7 (23.33%) and 6 (20.00%) were improved remarkably, 3 (10.00%) and 8 (26.67%) improved, and 0 and 4 (13.33%) failed, with the cure plus markedly effective rates being 90% and 60%, respectively. The cure plus markedly effective rate of the pricking bleeding group was significantly superior to that of the UAI group (P<0. 01). The difference values between pre-treatment and post-treatment in hoarseness, laryngalgia, throat dryness, throat burning sensation, throat clearing, vocal bleeding, glottis dysraphism, and total score were significantly higher in the pricking bleeding group than those in the UAI group (P<0.05). In comparison with the pre-treatment, MPT and H/N values were increased obviously (P<0. 05), and FPQ and APQ decreased clearly in the two groups after the treatment (P<0.05), suggesting an improvement of the acoustical parameters after the treatment. But, no significant differences were found between the two groups (P>0. 05). CONCLUSION: Pricking bleeding therapy is effective in relieving submucosal bleeding of the vocal cord and can improve its clinical symptoms and signs.

[The "intra-cordal polyp": a clinical alternative to recognize?]. / Le polype "intra-cordal" : une variante clinique à reconnaitre?

UNLABELLED: The vocal cord polyp is an inflammatory false tumour of the larynx. It is characterized mainly by the specific existence of fibrinous exsudats organized in loose network or mounds, surrounded by newly formed vascular slits. The epithelium covering the polyp is usually more or less impaired. CLINICAL CASES: The authors report two adult patients among whom the initial presentation in video-stroboscopy was that of an intracordal lesion of a cystic type, however; with unusual characteristics (purplish color, angiomatous aspect). The surgery consisted of a cordotomy, the surface epithelium appearing normal. After dissection, the two lesions seemed to be presenting the typical aspect of fibrinoïd mound of a polyp, observation confirmed by the anatomo-pathological study. In these cases, the resection was finally carried out with no mucous loss. CONCLUSION: The particular etiopathogeny of these lesions is been discussed. The treatment, medical and of rehabilitation could achieve a partial recovery. In the event of surgery, an access to the lesion through a cordotomy and not directly by removal with microcissors is advised.

[The potential uses and limitations of the flexible laryngoscopy under local anesthesia in clinical practice]. / Möglichkeiten und Grenzen der flexiblen chirurgischen Laryngoskopie in Lokalanästhesie.

Microsurgery of the larynx is commonly performed as direct laryngoscopy (DL) under general anesthesia. An alternative in selected cases is flexible laryngoscopy (FSL) under local anesthesia. We used a flexible laryngoscope that contained an additional working tunnel (Olympus ENF Type T3). Local anaesthesia of the larynx was achieved with 1% oxybuprocaine-HCl. Tissue samples were taken under endoscopic view and control. Twenty-five patients were studied and had benign lesions of the larynx or were being followed after treatment for cancer. The examination was tolerated well by all patients. The handling of the endoscope allowed precise targeting and sample taking. Due to the 2.2 mm diameter of the forceps the sizes of the biopsies were also limited. However, nearly all of the biopsies taken allowed sufficient histological examination. The advantage of the FSL was its simplicity and the minor inconvenience for patients. Although true histological results of suspect findings are possible, limitations in examining the hypopharynx prevent true staging of cancer patients. In general, FCL is a worth-while complement to DL.

Thalamo-olivary degeneration in a patient with laryngopharyngeal dystonia.

A 67 year old woman with a two year history of laryngopharyngeal dystonia, spasmodic dysphonia, and parkinsonism succumbed to Wernicke's encephalopathy and died six months later. Necropsy showed, besides Wernicke's encephalopathy, degenerative changes in selected thalamic nuclei (dorsomedial, pulvinar, and the medial geniculate bodies) and the inferior olives and numerous cerebellar torpedoes. The substantia nigra and basal ganglia were spared. Immunostaining for prion protein was negative. This patient indicated a new type of presentation of so-called pure thalamic degeneration, or more precisely thalamo-olivary degeneration.

Hyperbaric oxygen therapy for laryngeal radionecrosis.

Radionecrosis of the larynx is a debilitating disease associated with pain, dysphagia, respiratory obstruction, and, in some cases, the need for laryngectomy. Persistent poor wound healing can lead to death. A series of eight patients with advanced (grades III and IV, Chandler classification) radionecrosis of the larynx treated with adjunctive hyperbaric oxygen therapy is presented. Signs and symptoms of radionecrosis were dramatically ameliorated in seven of eight patients, while one patient, despite subjective improvement, eventually required laryngectomy. There were no deaths. These results are compared to previous series on radionecrosis of the larynx in which hyperbaric oxygen was not used. This series indicates that hyperbaric oxygen therapy is a useful and effective adjunctive treatment modality in the management of laryngeal radionecrosis.