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1.
Medicine (Baltimore) ; 99(27): e21014, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629721

RESUMO

INTRODUCTION: Multiple symmetric lipomatosis (MSL) is an uncommon medical condition characterized by symmetric fat accumulation mainly in the neck and other upper body regions. The involvement of the larynx is rare according to the literature, and we present a case of MSL with larynx involvement treated with a surgical approach. PATIENT CONCERNS: A 55-year-old male was admitted to our hospital due to progressively aggravated breathing difficulty, and tracheotomy was performed before transfer. When he tried to block the cannula, the breathing difficulty returned. The patient's neck had been thickening for the past 2 years. DIAGNOSIS: Pathological examination confirmed the diagnosis of MSL. INTERVENTIONS: The patient underwent lumpectomy and neck exploration. OUTCOMES: The lipoma was removed, the patient was free of any dyspnea symptoms and recovered well, and the tracheal cannula was removed at a local hospital. CONCLUSION: MSL can infiltrate the larynx and grow into the preepiglottic space and paraglottic spaces, resulting in breathing difficulties. Lipomas present in the spaces described above must be removed at the same time; otherwise, symptoms of dyspnea cannot be alleviated.


Assuntos
Doenças da Laringe/diagnóstico , Lipomatose Simétrica Múltipla/diagnóstico , Obstrução das Vias Respiratórias/etiologia , Progressão da Doença , Humanos , Doenças da Laringe/etiologia , Doenças da Laringe/patologia , Doenças da Laringe/cirurgia , Lipomatose Simétrica Múltipla/complicações , Lipomatose Simétrica Múltipla/patologia , Lipomatose Simétrica Múltipla/cirurgia , Masculino , Pessoa de Meia-Idade
3.
Otolaryngol Head Neck Surg ; 163(1): 51-53, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32340541

RESUMO

The novel coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, has quickly become a global pandemic since its initial outbreak in China in late 2019. Institutions are faced with the challenge of upholding the standard of care while maintaining safety for health care personnel and patients. Due to the common performance of aerosol-generating endoscopic procedures in the upper respiratory tract, otolaryngologists are at uniquely high risk for potential infection. When possible, alternative diagnostic and treatment strategies should be pursued. For patients suspected of having functional laryngeal abnormalities, transcervical laryngeal ultrasound provides a rapid and noninvasive evaluation of vocal fold motion to inform decisions about safety of feeding, airway, and progression of care.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Doenças da Laringe/diagnóstico , Laringe/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Ultrassonografia/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Humanos , Doenças da Laringe/complicações , Pescoço , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/transmissão
4.
Codas ; 32(4): e20190074, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049106

RESUMO

PURPOSE: To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. METHODS: 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). RESULTS: The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. CONCLUSION: The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.


Assuntos
Laringe/fisiopatologia , Fonação/fisiologia , Acústica da Fala , Qualidade da Voz/fisiologia , Treinamento da Voz , Idoso , Envelhecimento/fisiologia , Feminino , Ventilação de Alta Frequência/métodos , Humanos , Julgamento , Doenças da Laringe/complicações , Pessoa de Meia-Idade , Autoimagem , Autorrelato , Patologia da Fala e Linguagem/métodos , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia
5.
Otolaryngol Head Neck Surg ; 162(3): 322-325, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31959050

RESUMO

OBJECTIVE: The objective of this study was to determine the prevalence of benign vocal fold lesions (BVFLs) in patients with chronic cough over a 1-year period. STUDY DESIGN: Case series with chart review. SETTING: Tertiary academic medical center. SUBJECTS AND METHODS: A retrospective cohort study of patients with chronic cough seen in our tertiary multidisciplinary cough clinic from 2016 to 2017 was conducted. Patient characteristics, presence of BVFLs by laryngoscopy, and Leicester Cough Questionnaire (LCQ) were recorded. RESULTS: A total of 419 patients were included (average age: 61 years), and 67% of patients were female. Ten percent of patients had BVFLs: granuloma (5%), leukoplakia (3%), nodules (2%), and polyps (1%). Median cough duration was 2.9 years (interquartile range [IQR], 0.7-8.5); no significant difference in median cough duration was observed between patients with BVFLs and those with no lesions (2.6 vs 3.0 years, P = .86). In total, 178 patients (42%) had available LCQ data: median score of 10.2 (IQR, 7.9-13.9); no significant difference in median LCQ was observed between patients with BVFLs and those with no lesions (10.5 vs 10.1, P = .54). CONCLUSION: Prevalence of BVFLs in our cohort of patients with chronic cough was 10%, with posterior glottic lesions-granuloma-being the most common (5%). Prevalence of midmembranous lesions was as follows: vocal fold nodules (2%) and vocal fold polyps (1%). BVFLs were not associated with longer cough duration or more severe cough. We cannot determine a causative or noncausative relationship between BVFLs and chronic cough at this time due to lack of a control group.


Assuntos
Tosse , Doenças da Laringe/diagnóstico , Prega Vocal/patologia , Doença Crônica , Feminino , Humanos , Doenças da Laringe/epidemiologia , Laringoscopia , Masculino , Pessoa de Meia-Idade , Ohio/epidemiologia , Prevalência , Estudos Retrospectivos , Inquéritos e Questionários
6.
Vet Surg ; 49(1): 131-137, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31633204

RESUMO

OBJECTIVE: To describe the use of a silicone-covered laser guide and diode laser for surgical correction of epiglottic entrapment and report postoperative outcomes in horses with epiglottic entrapment. STUDY DESIGN: Retrospective case series. ANIMALS: Thoroughbred and standardbred racehorses (n = 29) with epiglottic entrapment. METHODS: A silicone-covered laser guide was placed endoscopically to direct the diode laser cutting action during transection of the entrapping subepiglottic membrane and to act as a physical barrier between the membrane and the epiglottic cartilage. Postoperative complications and trainer satisfaction were recorded via use of a follow-up questionnaire. Race records were reviewed to determine return to racing and detect differences in the number of starts, wins, or earnings before and after surgery. RESULTS: The entrapping membrane was successfully released in all horses. Mild postoperative complications such as swelling of the surgical site (12 horses) and coughing or mild nasal discharge (5 horses) were recorded during the first few days after surgery. Ninety-six percent of trainers were satisfied with the outcome of the procedure; 93% of horses returned to racing. CONCLUSION: Laser guide-assisted transection of the subepiglottic membrane corrected epiglottic entrapment in standing horses. CLINICAL SIGNIFICANCE: Ease of surgical technique, mild postoperative complications, and a good prognosis to return to racing make this a suitable alternative to the traditional laser procedure.


Assuntos
Epiglote/cirurgia , Doenças dos Cavalos/cirurgia , Doenças da Laringe/veterinária , Lasers Semicondutores/uso terapêutico , Complicações Pós-Operatórias/veterinária , Animais , Endoscopia/veterinária , Feminino , Cavalos , Doenças da Laringe/cirurgia , Masculino , Estudos Retrospectivos
8.
Vet Clin North Am Small Anim Pract ; 50(2): 295-310, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31882166

RESUMO

Laryngeal diseases are manifested by obstructive breathing patterns reflecting functional or mechanical upper airway obstruction. Laryngeal paralysis is the most common disease of the larynx. Diagnosis requires close attention to anesthetic plane and coordination of respiratory effort with laryngeal motion. Surgical arytenoid lateralization improves clinical signs and quality of life in dogs; however, aspiration pneumonia is a recognized complication, and generalized neuropathy can progress. Laryngeal collapse can result from any cause of chronic upper airway obstruction but is most often associated with brachycephalic obstructive airway syndrome. Although uncommon, laryngeal neoplasia has a guarded to grave prognosis regardless of treatment.


Assuntos
Doenças do Gato , Doenças do Cão , Doenças da Laringe/veterinária , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/etiologia , Doenças do Gato/terapia , Gatos , Doenças do Cão/diagnóstico , Doenças do Cão/etiologia , Doenças do Cão/terapia , Cães , Doenças da Laringe/diagnóstico , Doenças da Laringe/etiologia , Doenças da Laringe/terapia , Prognóstico
9.
Equine Vet J ; 52(1): 52-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30989701

RESUMO

BACKGROUND: Epiglottic entrapment can occur in yearling Thoroughbreds (TB); however, race performance following surgical correction is unknown. OBJECTIVES: To determine the race performance of horses treated surgically for epiglottic entrapment as yearlings as compared to an untreated cohort. A second objective was to identify risk factors for treated horses not racing post-operatively. STUDY DESIGN: Retrospective cohort and case-control studies. METHODS: Medical (1989-2014) and race records of 66 treated TB racehorses were reviewed. Observed abnormalities on pre- and post-operative endoscopic images and surgical method were recorded. Race records (EquineLine) were recorded. Racing performance of treated yearling TBs and two of their maternal half-siblings, which were used as the untreated cohort, was evaluated in a cohort study. A case-control study was used to investigate risk factors for not racing post-operatively among treated horses. Quarterly starts and earnings were compared to an untreated cohort. Survival analysis was used to assess career longevity. Rates of racing and earnings were compared between groups using Poisson and negative binomial regression respectively. Associations between clinical variables and not racing post-surgery were evaluated using logistic regression. RESULTS: Sixty-six treated horses were identified, 65 of which had at least one half-sibling. Proportions of horses that raced were similar for treated and maternal cohorts (70.0 vs. 70.8%, P = 0.9). Treated horses performed similarly to untreated horses. In treated horses, epiglottic entrapment with abnormal right arytenoid movement was associated with never racing (OR 15.40, 95% CI 1.64-144.23, P = 0.02). More females were affected by epiglottic entrapment than males (47/66 vs. 19/66 respectively, P<0.001). MAIN LIMITATIONS: The retrospective design over a prolonged period of time with cases obtained from a single hospital population. Low case numbers likely influenced the outcome of the multivariable analysis. CONCLUSIONS: Thoroughbred racehorses treated in their yearling year for epiglottic entrapment had no differences in performance variables compared to their untreated cohort. Epiglottic entrapment with abnormal right arytenoid movement might decrease odds of racing post-operatively.


Assuntos
Epiglote/cirurgia , Doenças dos Cavalos/cirurgia , Animais , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Cavalos , Doenças da Laringe/veterinária , Masculino , Condicionamento Físico Animal , Estudos Retrospectivos , Corrida , Esportes
10.
Otolaryngol Head Neck Surg ; 162(2): 234-240, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31842676

RESUMO

OBJECTIVE: To discuss the presentation, evaluation, and management of pediatric laryngeal web. STUDY DESIGN: Retrospective case series. SETTING: Single tertiary care center. SUBJECTS: All patients with laryngeal web at Boston Children's Hospital in the past 22 years. METHODS: No exclusion criteria. Charts mined for age at presentation, presenting symptoms, degree/location of web, associated syndromes, number/type of surgical procedures, and postoperative outcomes. RESULTS: Thirty-seven patients were included (13 male, 24 female). Average age at diagnosis was 3.7 years (0-19.5 years). Mean follow-up was 4.4 years (range, 0-16.4 years). There were 26 congenital webs (70.2%) and 11 acquired webs (29.8%). Presenting symptoms were vocal (29 patients, 78.4%) and respiratory (22 patients, 60%). Underlying syndromes or synchronous airway lesions included the following: premature (n = 5), congenital heart disease (n = 18), subglottic stenosis (n = 5), 22q11.2 deletion syndrome (n = 10), and recurrent respiratory papillomatosis (n = 4). There were 20 type 1 webs, 6 type 2 webs, 8 type 3 webs, and 3 type 4 webs; 10 had subglottic extension of the laryngeal web. Twelve patients were managed conservatively with observation. Eighty-four interventions were performed: 18 open and 66 endoscopic (sharp division, 32; dilation, 33; mitomycin C, 14; laser, 5; keel, 6; triamcinolone injection, 8; stent, 15; removal of granulation tissue, 5). Tracheotomy was required in 11 patients, and 5 patients were decannulated. Voice improved in 12 patients, with respiratory symptoms in 12 patients. Web recurred in 17 patients. One patient died due to airway complications. CONCLUSIONS: Pediatric laryngeal web is an uncommon but challenging lesion. Patients need to be evaluated for comorbid syndromes and synchronous airway lesions. Management includes open and endoscopic procedures. Procedures should be tailored to the child's presentation.


Assuntos
Gerenciamento Clínico , Doenças da Laringe/cirurgia , Laringoscopia/métodos , Laringe/diagnóstico por imagem , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Doenças da Laringe/diagnóstico , Laringe/cirurgia , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
11.
Laryngorhinootologie ; 98(12): 844, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31810102
14.
BMJ Case Rep ; 12(11)2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31732543

RESUMO

Recurrent respiratory papillomatosis (RRP) is caused by persistent infection of the respiratory epithelium by human papillomavirus (HPV), especially HPV 6 and 11. We present a case of surgically treated RRP. The main purpose of our protocol is to remove the lesions with a non-aggressive surgical technique and prevent recurrences with the use of cidofovir for local infiltrations in multiple sessions. We use low-power energy CO2 laser, directed towards the upper part of the vocal cord, to determine a retraction of the mucosa with consequent coverage of the epithelium of the free edge. The aim of this technique is to treat and stop the formation of synechia of the anterior commissure and the free margin of the vocal cords in the anterior commissure. After 8 years follow-up, there are no signs of recurrence of the disease. The voice had a net improvement confirming the effectiveness of the protocol.


Assuntos
Antivirais/uso terapêutico , Cidofovir/uso terapêutico , Doenças da Laringe/tratamento farmacológico , Doenças da Laringe/cirurgia , Lasers de Gás , Infecções por Papillomavirus/tratamento farmacológico , Infecções por Papillomavirus/cirurgia , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/cirurgia , Prega Vocal/cirurgia , Administração Oral , Feminino , Humanos , Indóis/uso terapêutico , Injeções Intralesionais , Doenças da Laringe/virologia , Pessoa de Meia-Idade , Recidiva , Prevenção Secundária , Prega Vocal/virologia
16.
Codas ; 31(6): e20180241, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31751443

RESUMO

PURPOSE: To analyze the acoustic-articulatory configuration of vowels in women with vocal nodules and with healthy voice. METHODS: Twelve women with vocal nodules (EG) and twelve vocally health women (CG) participated of this study. All women recorded vehicle phrases with the vowels /a/, /i/, and /u/ in stress position, preceded and followed by the occlusive consonant /p/: "Digo papa baixinho", "Digo pipa baixinho", and "Digo pupa baixinho". Subsequently, the first three formants (F1, F2, and F3) were extracted from these vowel targets. RESULTS: Between the two groups studied, F1 measures differed for vowels /a/ and /u/, and F2 measures differed for the vowel /a/. Women with vocal nodules showed lower values for these measures compared to vocally healthy women. Patients with vocal nodules showed a smaller interval in F1 and F2 values between vowels /a/, /i/, and /u/ compared to vocally healthy women. CONCLUSION: Women with vocal nodules show lower F1 and F2 values and lower range of motion of the articulators during vowel production compared to vocally healthy women.


Assuntos
Acústica da Fala , Prega Vocal/fisiopatologia , Qualidade da Voz , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Doenças da Laringe/fisiopatologia , Pessoa de Meia-Idade , Fonética , Medida da Produção da Fala/métodos
19.
Vestn Otorinolaringol ; 84(4): 48-50, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579058

RESUMO

Amyloidosis of the larynx is rare in the pediatric age group. We present a clinical case of laryngeal amyloidosis manifesting as false vocal fold bulging in a thirteen-year-old girl with hoarseness and with initial suspicion of laryngeal tumor. Computed tomography and ultrasound scanning of the larynx were useful in determining the laryngeal process size along with fibro laryngoscopy. There was performed a microsurgical removal of the larynx formation. The results of Congo red staining of the formation were characteristic of amyloid. Systemic manifestations of the disease were not revealed.


Assuntos
Amiloidose , Doenças da Laringe , Adolescente , Amiloidose/complicações , Amiloidose/diagnóstico , Amiloidose/cirurgia , Criança , Diagnóstico Diferencial , Feminino , Rouquidão , Humanos , Doenças da Laringe/complicações , Doenças da Laringe/diagnóstico , Doenças da Laringe/cirurgia , Neoplasias Laríngeas/diagnóstico , Laringoscopia
20.
Curr Opin Otolaryngol Head Neck Surg ; 27(6): 467-474, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31651423

RESUMO

PURPOSE OF REVIEW: Laryngeal amyloidosis is a rare hematological disorder of plasma cells. The cause is still considered idiopathic. The otolaryngology literature predominantly comprises case reports and short series. The present review summarizes the amyloid literature more generally in order to assist the otolaryngologist managing this disorder. RECENT FINDINGS: Distinguishing localized amyloidosis from systemic disease continues to be challenging. Both radiological and hematological investigations may assist. Surgery continues to be the predominant modality for treatment, but radiation and potentially medical approaches are on the horizon. SUMMARY: When localized, this benign laryngeal disease carries an excellent prognosis. Clinicians should however be aware of systemic presentations and ensure patients receive long-term follow-up.


Assuntos
Amiloidose/diagnóstico , Amiloidose/terapia , Doenças da Laringe/diagnóstico , Doenças da Laringe/terapia , Humanos
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