Experience with three-dimensional exoscope-assisted surgery of giant mastoid process osteoma.

BACKGROUND: The excision of a giant mastoid process osteoma can be challenging. In such situations, the three-dimensional exoscope intra-operative optic may be a promising tool. CASE REPORT: This paper provides a technical description of a giant mastoid osteoma excised under three-dimensional exoscope magnification. A fragmented excision by intralesional curettage was adopted to prevent peri-tumoural damage. This technique had been previously described for the excision of large osteomas of the sinus. CONCLUSION: The three-dimensional exoscope magnification tool had excellent applicability during surgery of a rare mastoid osteoma. In complex anatomical areas, the cavitation and fragmented excision of the tumour may prevent complications and is therefore recommended.

In reply to the letter to the editor regarding "Palisade cartilage tympanoplasty compared to one-piece composite cartilage-perichondrium grafts for transcanal endoscopic treatment of subtotal tympanic membrane perforations: a retrospective study".

This is a reply letter to the manuscript "The size and diameter of pieces of cartilage are not fixed for the palisade technique and one-piece technique", regarding the elevation of a tympanomeatal flap and keratin pearl formation in "Palisade cartilage tympanoplasty compared to one-piece composite cartilage-perichondrium grafts for transcanal endoscopic treatment of subtotal tympanic membrane perforations: a retrospective study" ( https://doi.org/10.1007/s00405-020-05947-3 ).

Comentario sobre «Vértigo posicional paroxístico benigno y su tratamiento con maniobras de reposicionamiento: revisión sistemática» / Comments on «Benign paroxysmal postional vertigo and its treatment with repositioning manoeuvres: a systematic review»

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Cross-cultural adaptation and validation of the Spanish version of the Paediatric Throat Disorders Outcome Test (T-14).

OBJECTIVES: The Paediatric Throat Disorders Outcome Test (T-14) is a disease-specific questionnaire that parents are requested to complete; it aimed to assess the quality of life related to tonsil and adenoid disease or its treatment in children with throat disorders. The aim of this study was to validate the Spanish adaptation of the T-14, thus allowing comparison across studies and facilitating international multicentre projects. DESIGN, SETTING AND PARTICIPANTS: This was a multicentre prospective instrument validation study. Guidelines for the cross-cultural adaptation process from the original English-language scale into a Spanish-language version were followed. The psychometric properties (reproducibility, reliability, validity, responsiveness) of the Spanish version ("T-14-s" for "T-14-Spanish") were assessed in 50 consecutive children undergoing adeno/tonsillectomy (both before and 6 months after surgery) and in a separate cohort of 50 unaffected children in a comparable age range. MAIN OUTCOME MEASURES AND RESULTS: Test-retest reliability (γ = 0.83) and internal consistency reliability (α = 0.94) were adequate. The T-14-s demonstrated satisfactory construct validity (r > 0.40). The instrument showed excellent between-group discrimination (P < .0001) and a high responsiveness to change (effect size = 2.09). CONCLUSIONS: The Spanish version of the T-14 (T-14-s) is a valid tool for measuring the subjective severity of throat disorders, and its use is recommended.

Aphysiologic performance on dynamic posturography in work-related patients.

It has been suggested that malingering should be suspected in patients suffering from dizziness or imbalance and who had a potential gain associated with insurance and worker's compensation claims. This study aimed to assess and compare the prevalence of aphysiologic performance on computerized dynamic posturography (CDP) in patients with the potential for secondary gain using a retrospective review of two groups of patients: work-related patients referred for dizziness and/or imbalance (Group 1) were compared against a group of patients with complaints of dizziness or imbalance, who had no history of work-related injury, or litigation procedures (Group 2). CDP and videonystagmography (VNG) were carried out in all patients. The Sensory Organization Test summaries were scored as normal, aphysiologic, or vestibular using the scoring method published by Cevette et al. in Otolaryngol Head Neck Surg 112:676-688 (1995). 24 out of 88 (27%) patients had aphysiologic CDP in Group 1 and 9 out of 51 (18%) in Group 2 but these differences were not significant (p > 0.05). Definite signs of vestibular dysfunction were found in 12 out of 24 (50%) of patients with aphysiologic performance in Group 1 although the presence of VNG abnormalities was significantly higher (p = 0.005) in Group 2. The hypothesis that the occupational group could show a significantly higher rate of aphysiologic results than a control group is not confirmed. Furthermore, VNG abnormalities were found in 50% of the work-related cases with non organic sway patterns. These results suggest that patient's complaints should be considered genuine in work-related cases and due caution exercised when evaluating aphysiologic CDP patterns.

Resultados de pruebas de control postural y función vestibular en 51 pacientes con antecedente de latigazo cervical y síntomas de vértigo e inestabilidad / Results of balance control and vestibular function tests in 51 patients with whiplash injury complaining of dizziness and imbalance

Introducción y objetivos. El vértigo y la inestabilidad tienen una importante implicación médico-legal en el paciente con antecedente de latigazo cervical (LC). En estos casos la posturografía dinámica computarizada (PDC) aporta información adicional a las pruebas vestibulares estándar y tiene descritos patrones compatibles con escasa colaboración o falta de sinceridad al esfuerzo, también denominados afisiológicos. El objetivo de este trabajo es valorar las características de las pruebas de equilibrio y función vestibular en pacientes con LC y especialmente, los resultados afisiológicos. Material y métodos. Estudio retrospectivo de pacientes con antecedente de LC con vértigo y/o inestabilidad. Se realizó videonistagmografía (VNG) y PDC. Los resultados de la prueba de organización sensorial (SOT) se valoraron como normales, vestibulares o afisiológicos usando el método de cálculo publicado por Cevette et al. en 1995. Resultados. Cincuenta y uno pacientes (24 varones, 27 mujeres); edad media: 42,2 años; tiempo de evolución medio: 3,8 m; PDC afisiológica: 13 (25,5%); PDC vestibular: 9 (17,6%); PDC normal: 29 (56,9%); VNG normal: 29 (56,9%); VNG alterada: 22 (43,1%); VNG vestibular: (n=11); VNG central: (n=6), y VNG cervical: (n=5). En el 46,2% de pacientes con PDC afisológica la VNG estaba alterada. Conclusiones. La prevalencia de pruebas afisiológicas en la PDC en el LC es relativamente elevada sin que deba suponerse simulación o exageración ya que en muchos casos existen signos objetivos de disfunción vestibular. Sería recomendable realizar pruebas de función vestibular a los pacientes con LC con síntomas vertiginosos. La rehabilitación vestibular podría ser de utilidad en estos casos (AU)

Introduction. The medical legal implications of dizziness and imbalance among patients with whiplash-associated disorders (WAD) are important. In these cases, Computerized Dynamic Posturography (CDP) provides information to standard vestibular tests and patterns consistent with scarce collaboration or lack of sincerity on efforts have been described. Objectives. This work has aimed to assess the prevalence of altered balance and vestibular function tests in patients with whiplash injury, and especially the aphysiologic results. Material and methods. A retrospective review of patients with whiplash injury referred for assessment of dizziness and/or imbalance was carried out. Standard videonistagmophgraphy (VNG) assessment including CDP was performed in all patients. The Sensory Organization Test (SOT) summaries were scored as normal, aphysiologic, or vestibular using the scoring method published by Cevette et al. in 1995. Results. The study included 51 patients (24 men, 27 women) with mean age: 42.2 years. Mean evolution time was 3.8 m. Aphysiologic CDP 13 (25.5%); vestibular CDP 9 (17.6%); normal CDP 29 (56.9%). Normal VNG 29 (56.9%); altered VNG in 22 (43.1%): vestibular VNG (n=11); central VNG (n=6); cervical VNG (n=5). VNG was altered in 46.2% of patients with aphysiologic CDP. Conclusions. The prevalence of aphysiologic results on CDP among whiplash injury patients is relatively high, however, this should not necessarily be consider to be related to malingering or exaggeration since objective signs of vestibular dysfunction are found in many cases. Thus, we recommend these tests should be done in whiplash injury patients complaining of dizziness and imbalance. Vestibular rehabilitation could be of interest in the recovery of these patients (AU)

Meiotic abnormalities underlying pollen sterility in wild potato hybrids and spontaneous populations.

Wild potato species are widely distributed in the Americas, where they spontaneously grow in very diverse habitats. These species - with low chromosome differentiation - form polyploid series with 2n = 2x, 3x, 4x and 6x (x =12). They are isolated in nature by external and internal hybridisation barriers that can be incomplete, allowing hybridisation in areas of sympatry. Nevertheless, most accessions in germplasm banks, regardless of genetic background of the sampled spontaneous populations, have been assigned specific categories based on morphological characters. To further investigate the extent of hybridisation in the group and for comparative purposes, pollen viability was estimated in (i) artificial hybrids between a commercial cultivar (Calén INTA) of the common potato (tetraploid Solanum tuberosum ssp. tuberosum) and the tetraploid cytotype of the related wild species S. gourlayi, and (ii) samples of plants (accessions) and inflorescences of natural populations from Argentina, tentatively classified as 'presumed hybrids' (S. infundibuliforme-S. gourlayi) and 'species' (S. infundibuliforme, S. gourlayi and S. chacoense). Regardless of origin, 98 out of 103 plants analysed had zero to 70% pollen viability (zero to 40% in eight of them). Pollen grains were of variable size and morphology and, in mostly male sterile plants, the only viable pollen grains were 2n and/or 4n. Furthermore, male sterile plants shared various abnormalities in meiosis I and II (unpaired chromosomes, unequal chromosome distribution, precocious/lagging chromosomes, parallel, tripolar, fused and multiple spindles, unequal size nuclei, dyads, triads and pentads in addition to normal tetrads, among others). These results provide novel evidence to support field observations of early potato botanists on the extent of spontaneous hybridisation in wild Argentinian potato populations, which is not reflected in the current taxonomy and has significant consequences for germplasm conservation and breeding.

Efectividad de las intervenciones asistenciales en el servicio de pacientes crónicos con hipercolesterolemia de Atencion Primaria / Effectiveness of health care interventions in the Primary Health Care service of chronic patients with hypercholesterolemia

OBJETIVO. Medir la efectividad sobre el control lipídico en el servicio de pacientes crónicos con hipercolesterolemia de Atención Primaria. MÉTODOS. Estudio observacional, prospectivo, realizado en cuatro centros de salud urbanos, sobre 285 pacientes dislipémicos atendidos en el programa del adulto. El seguimiento se ha efectuado según la práctica clínica habitual durante 18 meses en seis consultas de Atención Primaria. Se registró el perfil lipídico y el tratamiento hipolipemiante al inicio y a los 18 meses. El control lipídico se clasificó según las recomendaciones del NCEP II y III. RESULTADOS. Al finalizar el estudio, se observa una reducción porcentual de los parámetros lipídicos del colesterol total (12,9%), colesterol LDL (16,5%) y triglicéridos (7,6%) y un aumento de los niveles de colesterol HDL (15,0%). Por sexos, la reducción de los valores de colesterol LDL es mayor en las mujeres (18,9%) y en los pacientes en prevención secundaria (22,6%). El grado de control óptimo de los niveles de colesterol LDL es más elevado (40,7%) al final del estudio. Las mujeres tienen un porcentaje de control óptimo mayor (45,3%) que los hombres (33,6%). Si se utilizaran los nuevos criterios del NCEP III el porcentaje de control descendería hasta el 31,9%. CONCLUSIONES. Se ha observado en los pacientes una reducción clara de los niveles plasmáticos de lípidos, con resultados más moderados en los pacientes en prevención primaria y varones

OBJECTIVE. Measure effectiveness on lipid control in the primary health service of chronic patients with hypercholesterolemia. METHODS. Observations, prospective study conducted in four urban health care sites on 285 dyslipidemic patients seen in the adult program. Follow-up was done according to the usual clinical practice for 18 months in six primary health care consultations. Lipid profile and lipid-lower drug treatment were recorded at onset and at 18 months. Lipid control was classified according to NCEP II and III recommendations. RESULTS. At the end of the study, a percentage reduction of the lipid parameters of total cholesterol (12.9%), LDL-cholesterol (16.5%) and triglycerides (7.6%) and an increase in the HDL-cholesterol levels (15.0%) were observed. By gender, reduction in the LDL-cholesterol values is greater in women (18.9%) and in patients in secondary prevention (22.6%). Grade of optimum control of the LDL-cholesterol levels is higher (40.7%) at the end of the study. Women have a greater optimum control percentage (45.3%) than men (33.6%). If the new NCEP III criteria are used, the control percentage decreased to 31.9%. CONCLUSIONS. A clear reduction of lipid plasma levels has been observed in patients, with more moderate results in patients in primary prevention and men

Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?

The high prevalence of habitual snoring (35% of the general population) and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of laser-assisted uvulopalatoplasty (LAUP). However, acceptable studies on its effectiveness are lacking. The present randomised, placebo-controlled study included 25 nonapnoeic and mild obstructive sleep apnoea snorers to evaluate LAUP effectiveness for snoring. Group I received a one-stage LAUP treatment and group II a placebo (simulated snore surgery followed by an oral placebo). Before each treatment and 3 months after, the variables and procedures assessed were: body weight; sleepiness (Epworth sleepiness scale); quality of life (SF-36); subjective snoring intensity (0-10 analogue scale); objective snoring intensity (average decibel intensity); snoring index (number of snores per hour); and apnoea/hypopnea index. No differences were observed in body weight, sleepiness, quality of life, subjective and objective intensity, and frequency of snoring, and apnoea/hypopnea index between the groups before and 3 months after treatment. In conclusion, this study provides evidence of the lack of effectiveness of one-stage laser-assisted uvulopalatoplasty for snoring in nonapnoeic and mild obstructive sleep apnoea patients, with the result that it does not meet the expectations generated by the procedure.

[Results of using botulism toxin in the treatment of spasmodic dysphonia]. / Resultados de la aplicación de toxina botulínica en el tratamiento de la disfonía espasmódica.

Spasmodic Dysphonia (SD) is a dystonia involving laryngeal musculature thus causing a characteristic voice disorder. Two main types of SD have been described. The adductor type is the commonest and it is characterized by a strain-strangle, choked voice. The abductor type can be distinguished from the previous one by episodes of a blown and whispering voice, interrupting speech. Botulism toxin (BTX) has demonstrated to be the most effective treatment for this condition. Thirty patients diagnosed of SD (twenty-nine adductor type/one abductor type) were included. Their degree of dysphonia was evaluated using both functional and visual-analogue scales. They were treated with BTX vocal cord injections using a percutaneous technique under EMG guidance. Improvements up to a 100% of the normal vocal function were obtained, with an average of 82% in the adductor type. The adverse effects were mild and transient. Hypophonia affected 61.3% of patients lasting an average of 11.3 days. Dysphagia was reported in 44.1% of cases lasting an average of 5.8 days.

Resultados de la aplicación de toxina botulínica en el tratamiento de la disfonía espasmódica / Results of using botulism toxin in the treatment of spasmodic dysphonia

La disfonía espasmódica (DE) es una distonía que afecta a la musculatura laríngea, causando un transtorno característico de la voz. Se han descrito dos tipos principales de DE. La DE de tipo abductor es la más común y se caracteriza por una voz entrecortada, tensa y estrangulada. La DE de tipo abductor se distingue de la anterior por la presencia de un habla interrumpida por episodios de voz soplada y de baja intensidad. La toxina botulínica (TOXBA) ha demostrado ser el tratamiento más efectivo para esta patología. Treinta pacientes afectos de DE (veintinueve DE tipo adductor/una DE tipo abductor), cuyo grado de disfonía fue valorado mediante escalas de incapacidad y analógica-visual, fueron tratados mediante infiltración de TOXBA en cuerdas vocales, por vía transcutánea con guía EMG. Se obtuvieron mejorías de hasta el 100 por ciento de la función fonatoria normal, con una media del 82 por ciento en la DE tipo adductor. Los efectos secundarios fueron leves y de corta duración. Apareció hipofonía en el 61,3 por ciento con una duración media de 11,3 días y disfagia en el 44,1 por ciento, durante 5,8 días (AU)

Spasmodic Dysphonia (SD) is a dystonia involving laryngeal musculature thus causing a characteristic voice disorder. Two main types of SD have been described. The adductor type is the commonest and it is characterized by a strain-strangle, choked voice. The abductor type can be distinguished from the previous one by episodes of a blown and whispering voice, interrupting speech. Botulism toxin (BTX) has demonstrated to be the most effective treatment for this condition. Thirty patients diagnosed of SD (twenty-nine adductor type/one abductor type) were included. Their degree of dysphonia was evaluated using both functional and visual-analogue scales. They were treated with BTX vocal cord injections using a percutaneous technique under EMG guidance. Improvements up to a 100% of the normal vocal function were obtained, with an average of 82% in the adductor type. The adverse effects were mild and transient. Hypophonia affected 61.3% of patients lasting an average of 11.3 days. Dysphagia was reported in 44.1% of cases lasting an average of 5.8 days (AU)

[Variation over two years of cardiovascular risk in patients cared for at primary care services for hypertension, diabetes and dyslipidemia]. / Variación bienal del riesgo cardiovascular en los pacientes atendidos en los servicios de atención primaria: hipertensión, diabetes y dislipemias.

OBJECTIVE: To analyse the modifications in cardiovascular risk in patients seen over two years in adult services for dyslipaemia, diabetes mellitus or hypertension. DESIGN: Observational, retrospective study with repeated measurement tests. SETTING: Two health centres. PATIENTS: 265 patients attended by the above services who were free of cardiovascular disease at the start of the study. MEASUREMENTS AND RESULTS: During the study period, the cumulative incidence of cardiovascular morbidity was 4.2% (1.8-6.6%). Patients, without events, underwent a mean reduction in overall cardiovascular risk of -1.6% (p < 0.001). In patients classified as high-risk at the start of the study, the mean reduction was much greater: -3.7% (p < 0.001). Giving up smoking and controlling dyslipaemia brought about the greatest reductions in cardiovascular risk. CONCLUSIONS: Monitoring of cardiovascular risk in patients attended for conditions in the INSALUD portfolio of services, i.e. hypertension, dyslipaemia, diabetes mellitus, enables this risk to be reduced and priority to be given to health care delivery to more vulnerable groups.

Variación bienal del riesgo cardiovascular en los pacientes atendidos en los servicios de atención primaria: hipertensión, diabetes y dislipemias / Variation over two years of cardiovascular risk in patients attended in primary care services for hypertension, diabetes and dyslipaemia

Objetivo. Analizar las modificaciones del riesgo cardiovascular a lo largo de 2 años en pacientes atendidos en los servicios de adultos: dislipemia, diabetes mellitus e hipertensión. Diseño. Observacional, retrospectivo, pruebas de medidas repetidas. Emplazamiento. Dos centros de salud. Pacientes. Doscientos sesenta y cinco pacientes atendidos en los citados servicios, libres de enfermedad cardiovascular al inicio del estudio. Mediciones y resultados. Durante el período de estudio, la incidencia acumulada de morbilidad cardiovascular fue del 4,2 por ciento (1,8-6,6 por ciento). Los pacientes, sin episodios, experimentaron una reducción media del riesgo cardiovascular global de -1,6 por ciento (p < 0,001). En los pacientes clasificados de alto riesgo al comienzo del estudio, la reducción media fue mucho mayor -3,7 por ciento (p < 0,001). El abandono del hábito tabáquico y el control de las dislipemias ha proporcionado la mayor reducción del riesgo cardiovascular. Conclusiones. La monitorización del riesgo cardiovascular en los pacientes atendidos en la cartera de servicios del INSALUD: hipertensión arterial, dislipemia, diabetes mellitus, permite incidir en la reducción de dicho riesgo, facilitando la priorización de la asistencia hacia los grupos más vulnerables (AU)

[Ethmoidal metastasis of renal adenocarcinoma]. / Metástasis etmoidal de adenocarcinoma renal.

The sinonasal tract and, more specifically, the ethmoid sinus, are uncommon sites for metastatic tumors. Fewer than 100 cases have been reported in the world literature. We report the case of a 65-year-ol woman who underwent nephrectomy and adrenalectomy for renal cell carcinoma (hypernephroma) with adrenal metastasis. Four months later the patient was seen for repeated epistaxis and nasal obstruction, which was diagnosed as ethmoidal metastasis of renal adenocarcinoma in a second biopsy. The second metastasis was removed by lateral rhinotomy but recurred six months later. Palliative surgery was performed and the patient died eight months later from brain metastases. Therapeutic strategies for metastatic nasal tumors are reviewed.

Metástasis etmoidal de adenocarcinoma renal / Ethmoidal metastasis of renal adenocarcinoma

La región naso-sinusal y el etmoides en concreto, son localizaciones excepcionales para tumores metastásicos. Menos de 100 casos han sido descritos en la literatura mundial. Presentamos el caso de una mujer de 65 años intervenida de nefrectomía con suprarrenalectomía por un adenocarcinoma renal (hipernefroma) con metástasis suprarrenal. Cuatro meses después la paciente consultó por epistaxis de repetición y obstrucción nasal, siendo diagnosticada de metástasis etmoidal de adenocarcinoma renal en una segunda biopsia. Esta segunda metástasis fue extirpada por vía para- látero-nasal con recidiva local a los seis meses. Se realizó cirugía paliativa y la paciente falleció a los ocho meses por metástasis cerebrales. Se revisan las estrategias terapéuticas para los tumores nasales metastásicos (AU)

The sinonasal tract and, more specifically, the ethmoid sinus, are uncommon sites for metastatic tumors. Fewer than 100 cases have been reported in the world literature. We report the case of a 65-year-old woman who underwent nephrectomy and adrenalectomy for renal cell carcinoma (hypernephroma) with adrenal metastasis. Four months later the patient was seen for repeated epistaxis and nasal obstruction, which was diagnosed as ethmoidal metastasis of renal adenocarcinoma in a second biopsy. The second metastasis was removed by lateral rhinotomy but recurred six months later. Palliative surgery was performed and the patient died eight months later from brain metastases. Therapeutic strategies for metastatic nasal tumors are reviewed (AU)

[Psammomatoid ossifying fibroma. Apropos a case]. / Fibroma osificante psamomatoide. A propósito de un caso.

A 41-year-old woman had a left palatal tumor diagnosed as psammomatoid ossifying fibroma. This tumor is a rare subtype of benign fibro-osseous craniofacial lesion that occurs mainly in women, younger age groups, and the sinonasal tract. It has distinctive histomorphological features. The tumor is slow-growing but tends to be locally aggressive and to destroy adjacent anatomic structures. Surgical excision with broad margins is the treatment of choice.

[Evaluation of factors related with glycemia control in type-2 diabetes mellitus]. / Valoración de los factores relacionados con el control de la glucemia en la diabetes mellitus tipo 2.

OBJECTIVES: To analyse factors characteristic of the patient, supplier and process relating to Glucaemia control in type-2 Diabetes Mellitus (DM). DESIGN: A retrospective, observational study. SETTING: Semi-rural Health Centre. PATIENTS AND OTHER PARTICIPANTS: 162 patients, the whole of the sample selected at random from the list of the DM programme. 32 patients who did not meet the study's inclusion criteria were excluded. MEASUREMENTS AND RESULTS: Compliance with the different technical standards, with other variables relating to the patient (sex, age, BMI, year of diagnosis) and with doctor's training were measured. Also recorded was Glucaemia control through the Glycosilate Haemoglobin (HbA1c)level, with good and acceptable control defined as HbA1c less than 7.6%, and poor HbA1c control the same as or over 7.6%. There was highly significant correlation between the year of diagnosis of type-2 DM and HbA1c (r = 0.34). Patients with late DM complications also had higher HbA1c levels. In the disease's first five years of evolution, there was quite significant correlation (p = 0.034) between overall compliance with different technical standards and the HbA1c level. CONCLUSIONS: The variable most closely related to the level of metabolic control was the duration of the disease. The improvement in compliance with procedures in the first years of Diabetes diagnosis favours the patient's metabolic control.

[Otoneurological manifestations of Lyme's disease]. / Manifestaciones otoneurológicas de la borreliosis de Lyme.

Infection with Borrelia burgdorferi is responsible for Lyme disease, an uncommon disorder in our country. It should be stressed that any of the neurologic manifestations of this disease may occur alone and may be the presenting manifestation of the illness. Several reports suggest that 1/4 of idiopathic Bell's palsies can be associated with this infection and in Europe is the most common cause of childhood facial nerve paresis. The same disease has been related to sudden deafness and vertigo cases. For its important therapeutic and prognostic implications the diagnosis of a Lyme disease must be taken into account in every case of peripheral facial nerve palsy, specially in children, in bilateral or recurrent cases and in those cases associated to other cranial neuritis or general manifestations.

[Phyolaryngocele: a case report and review of literature]. / Piolaringocele. Presentación de un caso y revisión de la literatura.

A case of pyolaryngocele presented as a lateral cervical mass that produced acute dyspnea requiring tracheotomy. The diagnosis was by direct laryngoscopy, which revealed outflow of purulent material with pressure on the tumor, and was confirmed by CT. Broad-spectrum antibiotic treatment was given and the pyolaryngocele was excised by lateral extramucosal tyrotomy. The literature on laryngocele and pyolaryngocele was reviewed.