Augmentation of Scarred Vocal Folds With Centrifuged and Emulsified Autologous Fat Grafts.

OBJECTIVE: To review the results of a series of patients with glottic insufficiency caused by scarred vocal folds who underwent injection laryngoplasty with centrifuged and emulsified autologous fat. STUDY DESIGN: Prospective cohort. SETTING: Single center, tertiary institution. SUBJECTS AND METHODS: Examination of the medical records of 21 patients operated on through injection laryngoplasty with fat grafts for the treatment of dysphonia was performed. All patients were operated on between January of 2015 and September of 2019. The voice variables measured were the GRABS (Grade, Roughness, Breathiness, Asthenia, Strain) scale, the Voice Handicap Index-10 (VHI-10), maximum phonation time, jitter, shimmer, and harmonic/noise ratio before surgery and 8 months later. RESULTS: Twenty-six injection laryngoplasties were performed in 21 patients during the reviewed period. Seventeen were men, and 4 were women. Mean age was 57.2 (range, 18-80) years. Mean (SD) follow-up time was 20.7 (9.3) months. Etiology of dysphonia was scarring after tumor resection in 17 patients and sulcus vocalis in 4. Five patients received an additional injection laryngoplasty. Statistically significant improvements were observed in all the parameters evaluated (P < .05). CONCLUSIONS: Injection laryngoplasty with fat grafts processed through centrifugation and emulsification is an effective technique for the treatment of dysphonia caused by glottic insufficiency related to scarred vocal folds, with minimal complication rates.

Solitary polypoid laryngeal xanthoma.

We report the case of a 51-year-old male smoker with diabetes mellitus and hyperlipidaemia and a long history of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) infection treated with various antiretroviral regimes, who was referred to the otolaryngology department with progressive dysphonia. Fibre-optic laryngoscopy showed a solitary, yellowish-white pedunculated polyp on the anterior third of the left cord, with no other abnormality. Pathological analysis revealed a polypoid laryngeal xanthoma that was immunoreactive against CD68, perilipin, and adipophilin. This unusual laryngeal lesion in the clinical context of our patient suggests a possible role of antiretroviral treatment in the pathogenesis of these xanthomas.

[SDHB expression in Warthin's tumour]. / Expresión de SDHB en el tumor de Warthin.

INTRODUCTION: Succinic dehydrogenase subunit B (SDHB) is an enzyme belonging to the mitochondrial complex II. The aim of this study is to analyse SDHB expression in a series of Warthin's tumours, studying its relationship with oncocytic changes, constantly present in this form of tumour. MATERIAL AND METHODS: In resection tumour specimens from a series of ten Warthin's tumours (all from the parotid gland), immunohistochemical expression of SDHB was analysed using a commercially-available monoclonal antibody. RESULTS: The Warthin's tumours studied affected 10 men (mean age: 64.2 yrs, range 40-80), all with smoking habits, and 2 with metachronous bilateral involvement. Two patients presented associated urothelial carcinoma. Our SDHB study showed marked reactivity (++/+++) in all cases in the oncocytic epithelial component and also in striated duct cytoplasm (+) from non-tumorous parotid tissue. Expression was not influenced by age, smoking intensity or bilateral character. One of the tumours showed squamous metaplasia foci with SDHB-negativity at this level. DISCUSSION AND CONCLUSIONS: Due to the constant and intense SDHB reactivity in oncocytic cells in our observations, oncocytic changes are not considered to be associated with defective enzyme activity in the mitochondrial complex II. Strong SDHB reactivity is an additional marker of oncocytic changes in Warthin's tumour. Neither of these facts has been described previously.

Expresión de SDHB en el tumor de Warthin / SDHB expression in Warthin’s tumour

Introducción: El objetivo del presente estudio es analizar la expresión de la succinodeshidrogenasa B (SDHB), enzima perteneciente al complejo mitocondrial II, en el tumor de Warthin analizando su relación con los cambios oncocíticos, un dato morfológico constante en este tipo tumoral. Material y métodos: En una serie de 10 tumores de Warthin, todos parotídeos, se analizó en los especímenes de resección tumoral la expresión de SDHB utilizando un anticuerpo monoclonal comercializado. Resultados: Los 10 tumores afectaron a 10 varones (edad media: 64, 2 años; rango: 40-80), todos ellos con antecedentes de hábito tabáquico, y 2 con afectación bilateral metacrónica. Dos pacientes presentaron de forma asociada carcinomas del tracto urotelial. El estudio de la SDHB mostró en todos los casos acusada reactividad (++/+++) del componente epitelial oncocítico, así como del citoplasma de los conductos estriados del tejido parotídeo no tumoral. Esta expresión no se vio influida por el rango de edad, la intensidad del hábito tabáquico, ni por el carácter bilateral de los tumores. Uno de los tumores presentó focos de metaplasia escamosa con negatividad a la SDHB en esa localización. Discusión y conclusiones: La constante e intensa reactividad de la SDHB encontrada en nuestras observaciones, en las células oncocíticas, orienta a considerar que los cambios oncocíticos en el tumor de Warthin no se asocian a una actividad enzimática defectiva en este componente del complejo mitocondrial II. La reactividad de SDHB se conforma como un marcador adicional de la diferenciación oncocítica existente en el caso del tumor de Warthin, aspectos ambos previamente no descritos (AU)

Introduction: Succinic dehydrogenase subunit B (SDHB) is an enzyme belonging to the mitochondrial complex II. The aim of this study is to analyse SDHB expression in a series of Warthin’s tumours, studying its relationship with oncocytic changes, constantly present in this form of tumour. Material and methods: In resection tumour specimens from a series of ten Warthin’s tumours (all from the parotid gland), immune histochemical expression of SDHB was analysed using a commercially-available monoclonal antibody. Results: The Warthin’s tumours studied affected 10 men (mean age: 64.2 yrs, range 40-80), all with smoking habits, and 2 with metachronous bilateral involvement. Two patients presented associated urothelial carcinoma. Our SDHB study showed marked reactivity (++/+++) in all cases in the oncocytic epithelial component and also in striated duct cytoplasm (+) from non-tumorous parotid tissue. Expression was not influenced by age, smoking intensity or bilateral character. One of the tumours showed squamous metaplasia foci with SDHB-negativity at this level. Discussion and conclusions: Due to the constant and intense SDHB reactivity in oncocytic cells in our observations, oncocytic changes are not considered to be associated with defective enzyme activity in the mitochondrial complex II. Strong SDHB reactivity is an additional marker of oncocytic changes in Warthin’s tumour. Neither of these facts has been described previously (AU)