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1.
Artigo em Chinês | MEDLINE | ID: mdl-32842185

RESUMO

Objective:To study the clinical characteristics and common etiology of vocal cord leukoplakia, and explore the treatment principle. Method:One hundred and fifty-seven patients with vocal cord leukoplakia were recruited in this study. They were assessed by routine laryngoscope, narrow band imaging (NBI), stroboscope, reflux finding score (RFs) and reflux symptom index (RSI), and given conservative treatment (smoking cessation, alcohol, acid suppression, sound cessation, etc.) and/or surgical treatment. Result:Among 157 patients with leukoplakia of vocal cord, 109 (69.4%) had basically improved or cured after conservative treatment. Forty-eight cases underwent operation. The postoperative pathological diagnosis was mild dysplasia in 2 cases (1.3%), moderate dysplasia in 15 cases (9.6%), severe dysplasia or carcinoma in situ in 19 cases (12.1%), and invasive carcinoma in 12 cases (7.6%). Conclusion:NBI and stroboscopic laryngoscopy showed that most of the leukoplakia of vocal cord was non-malignant in nature, which was not in accordance with the indication of operation. Conservative treatment is effective. Biopsy or operation was indicated in only a few patients. Moreover, most of the patients are accompanied by laryngopharyngeal reflux, and the treatment of acid suppression is effective.


Assuntos
Doenças da Laringe , Refluxo Laringofaríngeo/cirurgia , Humanos , Laringoscopia , Leucoplasia , Imagem de Banda Estreita , Prega Vocal
2.
Artigo em Chinês | MEDLINE | ID: mdl-32791602

RESUMO

Sensory laryngeal neuropathy(SLN) is a kind of peripheral neuropathy presenting globus pharyngeus, chronic cough, increased mucus, dry throat, sore throat, frequent clearing of the throat, etc. When the sensory nerve of the larynx is affected by chemical, biological, mechanical or nutritional factors. Because of its nonspecific signs and symptoms, SLN is easy to be misdiagnosed as chronic pharyngitis or laryngopharyngeal reflux disease. SLN was came up to ENT physician in recent years and there are rare systematic reports currently, therefore, this review aims to summarize the etiology, clinical manifestations, diagnosis and treatment of SLN, to raise awareness of this disease among our colleagues.


Assuntos
Doenças da Laringe , Refluxo Laringofaríngeo , Laringe , Doenças do Sistema Nervoso Periférico , Tosse , Humanos , Faringe
3.
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
4.
Respir Med ; 168: 105990, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32364960

RESUMO

BACKGROUND AND AIM: Vocal Cord Dysfunction (VCD) and chronic cough (CC) are challenging conditions which lead to significant quality of life impairment. The underlying mechanisms are poorly understood, but laryngeal dysfunction may be common to both conditions. The aim of this study was to determine the characteristics of cough in VCD and whether patients with cough have coexisting VCD. METHOD: Participants included 51 patients with VCD and a comparison group of 39 patients with chronic cough that was refractory to medical treatment. Participants underwent a comprehensive assessment including questionnaires, laryngoscopy, cough frequency monitoring and voice testing. RESULTS: Patients with VCD had significant cough morbidity with an increased cough frequency of 17.3 coughs/hour and reduced cough quality of life with mean Leicester Cough Questionnaire Score of 12.8. Breathing pattern abnormalities were also common in VCD and there was a strong correlation between the number of breathing pattern abnormalities and cough frequency (r = -0.827, p = 0.002). Cough measures were not significantly different between patients with VCD and those with CC. Moderate-severe PVFM was present in 69% of patients with CC. Abnormal vocal fold closure during phonation was also present in patients with chronic cough and was similar between the VCD (n = 40, 78.4%) and cough (n = 25, 64.1%) groups, p = 0.240. CONCLUSION: Cough is an important symptom in VCD. Patients presenting with chronic cough may have underlying VCD as a cause of their cough. Since cough and VCD symptoms co-occur clinicians need to consider cough when are treating VCD and VCD when treating chronic cough.


Assuntos
Tosse/diagnóstico , Doenças da Laringe/complicações , Disfunção da Prega Vocal/diagnóstico , Adulto , Idoso , Doença Crônica , Tosse/etiologia , Feminino , Humanos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Morbidade , Fonação , Respiração , Transtornos Respiratórios/complicações , Transtornos Respiratórios/fisiopatologia , Inquéritos e Questionários , Disfunção da Prega Vocal/etiologia , Prega Vocal/fisiopatologia
7.
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
8.
Ann Thorac Surg ; 110(1): 251-257, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32199826

RESUMO

BACKGROUND: Airway management during repair of laryngotracheal stenosis is demanding, and there is currently no accepted standard of care. Recently an increasing number of airway centers have started to use a laryngeal mask until the airway is surgically exposed and cross-table ventilation can be initiated. However detailed data on this approach are missing in the literature. METHODS: Patients receiving laryngotracheal surgery from November 2011 until October 2018 were retrospectively included in this single-center study, except for patients who presented with a preexisting tracheostomy at time of surgery. Airway management uniformly consisted of laryngeal mask ventilation until cross-table ventilation was established. Clinical variables, perioperative complications, and airway complications were analyzed. RESULTS: One hundred eight patients (65 women, 43 men) receiving tracheal resection (n = 50), cricotracheal resection (n = 49), or single-stage laryngotracheal reconstruction (n = 9) were included in the analysis. Of the included patients 23 (21.3%) had malignant disease and 85 (78.7%) a benign pathology. In the subgroup of patients with subglottic disease 85.1% had high-grade stenosis (Myer-Cotton III°). Airway management with a laryngeal mask was successful in all except 1 patient (99.1%). Mean pulse oximetry and mean end-tidal CO2 during laryngeal mask ventilation was 98.7% ± 2.4% and 34.8 ± 7.6 mm Hg, respectively. At the end of surgery 95 patients (88%) were successfully weaned from the respirator using the laryngeal mask. CONCLUSIONS: The laryngeal mask as the primary airway device is feasible and safe in patients undergoing laryngotracheal surgery even in cases with high-grade stenosis.


Assuntos
Doenças da Laringe/cirurgia , Máscaras Laríngeas , Doenças da Traqueia/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Doenças da Laringe/complicações , Doenças da Laringe/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças da Traqueia/complicações , Doenças da Traqueia/patologia , Resultado do Tratamento , Adulto Jovem
9.
Acta Vet Scand ; 62(1): 12, 2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131871

RESUMO

BACKGROUND: Ovine laryngeal chondritis is a rare entity of sheep in the USA, Great Britain, New Zealand and Iceland, but has not been reported in Germany so far. Here, two German cases are reported. CASE PRESENTATION: Two rams showed severe and progressive signs of dyspnea. Endoscopically, a severe bilateral swelling of the larynx was identified in both rams. Due to poor prognosis and progression of clinical signs one ram was euthanized, while the other ram died overnight. In both cases, a necrosuppurative laryngitis and chondritis of arytenoid cartilages was found at necropsy. Fusobacterium necrophorum and Streptococcus ovis were isolated from the laryngeal lesion in one animal. CONCLUSIONS: This is the first report of ovine laryngeal chondritis in continental Europe. This entity should be considered a differential diagnosis for upper airway disease in sheep.


Assuntos
Doenças das Cartilagens/veterinária , Infecções por Fusobacterium/veterinária , Doenças da Laringe/veterinária , Doenças dos Ovinos/diagnóstico , Doenças dos Ovinos/patologia , Infecções Estreptocócicas/veterinária , Animais , Autopsia , Doenças das Cartilagens/diagnóstico , Doenças das Cartilagens/microbiologia , Doenças das Cartilagens/patologia , Eutanásia Animal , Evolução Fatal , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/patologia , Fusobacterium necrophorum/isolamento & purificação , Alemanha , Doenças da Laringe/diagnóstico , Doenças da Laringe/microbiologia , Doenças da Laringe/patologia , Laringe/microbiologia , Laringe/patologia , Masculino , Ovinos , Doenças dos Ovinos/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/patologia , Streptococcus/isolamento & purificação
10.
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
11.
BMJ Case Rep ; 13(1)2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31937627

RESUMO

Sarcoidosis is a rare multisystem disorder of unknown aetiology characterised by non-caseating granulomas in involved organs; it is a diagnosis of exclusion. Laryngeal involvement affects only 0.5%-5% of those with sarcoidosis. It is an uncommon but important cause of supraglottic inflammation and oedema and should be considered in the differential diagnosis in patients with supraglottitis. This case describes a 30-year-old man who presented with stridor and shortness of breath. Flexible nasendoscopic examination revealed a grossly oedematous, pale pink, diffusely hypertrophied epiglottis. Surgical biopsy revealed non-caseating granulomatous inflammation. In the context of exclusion of hepatitis, anti-neutrophil cytoplasmic antibody (ANCA) positivity, malignancy and mycobacterial infection, the diagnosis of supraglottic laryngeal sarcoid was made. He is being treated with azathioprine immunosuppression with symptomatic improvement.


Assuntos
Azatioprina/uso terapêutico , Doenças da Laringe/tratamento farmacológico , Sarcoidose/tratamento farmacológico , Adulto , Diagnóstico Diferencial , Humanos , Imunossupressores/uso terapêutico , Doenças da Laringe/diagnóstico por imagem , Masculino , Diagnóstico Ausente , Sarcoidose/diagnóstico por imagem , Supraglotite/diagnóstico por imagem , Tomografia Computadorizada por Raios X
12.
J Med Case Rep ; 14(1): 2, 2020 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-31900189

RESUMO

BACKGROUND: Among the most common benign laryngeal lesions are vocal nodules and polyps. Their etiology is related to vocal abuse. Gastroesophageal reflux disease is a common condition presenting with a broad spectrum of symptoms, among which are extraesophageal manifestations such as laryngeal polyps. CASE PRESENTATION: A 24-year-old Middle Eastern woman presented to the author's institution with dysphonia and dyspepsia. She underwent endoscopy and was diagnosed with severe reflux disease. In addition, laryngoscopy revealed a polyp at the left vocal cord, and the patient underwent polypectomy. Histopathological examination revealed a laryngeal polyp of telangiectatic type characterized by hyperplastic epithelial covering with reactive atypia, prominent superficial acanthosis with neutrophils, and prominent chronic inflammation and thrombosed vessels in the stroma. CONCLUSION: This report focuses on the pathological findings associated with a laryngeal polyp in a young patient diagnosed with severe reflux disease. Acknowledging such characteristic changes in a laryngeal polyp could aid in the diagnosis of gastroesophageal reflux disease.


Assuntos
Refluxo Gastroesofágico/complicações , Doenças da Laringe/etiologia , Laringe/patologia , Pólipos/etiologia , Prega Vocal/patologia , Dispepsia/etiologia , Disfonia/etiologia , Endoscopia , Feminino , Humanos , Hiperplasia/patologia , Doenças da Laringe/cirurgia , Laringoscopia , Laringe/cirurgia , Pólipos/cirurgia , Telangiectasia/patologia , Prega Vocal/cirurgia , Adulto Jovem
13.
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
15.
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
16.
Int J Pediatr Otorhinolaryngol ; 130: 109815, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31846823

RESUMO

OBJECTIVE: to describe the frequency and predictive factors associated with laryngeal scarring caused by surgical treatment of recurrent respiratory papillomatosis (RRP) in children. INTRODUCTION: RRP is an important cause of hoarseness and respiratory obstruction in children. The current standard of care for RRP is the systematic and repetitive surgical interventions. The repetitive surgeries may increase the risk of sequelae. A larger number of surgeries, the surgical technique used, and disease severity are related to an increased risk of scarring. MATERIAL AND METHODS: A retrospective, descriptive review of the medical charts of patients with RRP younger than 18 years was conducted. Between 2014 and 2017, 79 patients were identified; five patients were excluded. Demographic and clinical data were recorded and analyzed. The patients were divided into two groups, one with and the other without surgical sequelae, for comparison to identify sequela-associated factors. RESULTS: 75 patients, 40 (53.3%) male, were analyzed. Age at symptom onset ranged from 2 months to 13 years. Median age at the time of diagnosis was 42 months. Overall, 44% presented with disseminated disease. A median of nine (range, 1 to 86) surgeries were performed in each patient with a median of two (range, 0.6 to 10) of the average number of surgeries per year per patient. 29 patients (38.7%) had laryngeal sequelae. When comparing the patients with and without sequelae, statistically significant differences were found in the variables of dissemination during the course of the disease, overall number of surgeries and mean number of surgeries per year, history and number of previous surgeries at an outside institution, urgent surgeries, and CO2 laser use. Patients who underwent more than 10 surgeries or who had a history of previous surgeries at an outside institution had a higher frequency of laryngeal scarring in multivariate analysis. CONCLUSION: Scarring secondary to surgical treatment for RRP is common. Surgery-related variables seem to be predisposing factors. A greater number of surgeries and surgeries performed at less specialized centers are strongly related to this complication. Future studies with a larger sample size are necessary to determine whether other factors are involved.


Assuntos
Doenças da Laringe/epidemiologia , Infecções por Papillomavirus/cirurgia , Complicações Pós-Operatórias/epidemiologia , Infecções Respiratórias/cirurgia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Progressão da Doença , Feminino , Rouquidão , Humanos , Masculino , Infecções por Papillomavirus/complicações , Infecções Respiratórias/complicações , Estudos Retrospectivos , Resultado do Tratamento
17.
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
18.
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
19.
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
20.
Laryngorhinootologie ; 98(12): 844, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31810102
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