Injection laryngoplasty through a transoral approach using the Guedel oral airway.

Injection laryngoplasty has gained popularity as a treatment modality for glottal insufficiency. Several approaches have been described, specifically transcutaneous, transoral and transnasal. The authors describe a novel technique performed successfully on three subjects, namely endoscopic injection laryngoplasty using the modified Guedel oral airway. There was marked improvement in dysphonia, maximum phonation time and closed quotient in all three subjects with a decrease in the Voice Handicap Index-10 score. This new approach is a viable approach for the treatment of glottal insufficiency.

Late pneumolabyrinth after stapedectomy.

INTRODUCTION: Pneumolabyrinth is defined as the presence of air within the inner ear causing cochleovestibular signs and symptoms. Twenty-seven cases of pneumolabyrinth are published in the literature of which only two were described as delayed pneumolabyrinth as a complication of stapes surgery. CASE REPORT: A 45-year-old male patient presented with vertigo after Valsalva maneuver 12 years after stapedectomy. He was diagnosed with delayed pneumolabyrinth on high resolution computed tomography and underwent an exploratory tympanotomy with surgical repair. DISCUSSION: Delayed pneumolabyrinth is a rare complication of stapes surgery and should be considered in patients presenting with vestibulocochlear symptoms even many years later. An exploratory tympanotomy is recommended for patients diagnosed with pneumolabyrinth and having a sensorineural hearing loss and/or persistent vertigo.

Spontaneous Transethmoidal Meningoceles in Adults: Case Series with Emphasis on Surgical Management.

BACKGROUND: Spontaneous onset transethmoidal meningocele is a rare entity among the adult population. METHODS: A retrospective chart review was performed and cases of adults diagnosed with spontaneous transethmoidal meningoceles from November 2000 till February 2014 were reported. Data collected included demographics, clinical presentation, diagnostic modalities, and results. Intraoperative findings, the type of surgical reconstruction performed, and the percentage of recurrence, if present, were also reported. RESULTS: Ten cases of spontaneous transethmoidal meningoceles in adults were diagnosed. Eight were females and two males with a mean age of 47.5 years. All patients presented with CSF leakage with or without meningitis. They underwent a reconstruction of the base of skull defect using the temporalis fascia graft in addition to fibrin glue (Tissucol) and Surgicel (Ethicon). In two cases with a larger defect, a piece of septal bone and turbinate mucosa were applied achieving a watertight seal in all cases. CONCLUSION: Spontaneous transethmoidal meningocele in adults is a rare condition. It usually presents with clear rhinorrhea with or without meningitis and an endoscopic multilayer reconstruction is advocated for treatment of such conditions.

Laryngopharyngeal symptoms in patients with chronic obstructive pulmonary disease.

UNLABELLED: The aim of the study was to report on the prevalence and severity of laryngopharyngeal symptoms in patients with COPD compared to controls. A total of 27 patients with COPD and 13 controls matched according to age and gender were included. Demographic data included age, gender, history of smoking and history of allergic rhinitis. The Reflux symptom Index described by Belafsky et al. was used. The frequency and average score of each of the laryngopharyngeal symptoms were computed. The mean age of patients was 61.67 ± 11.09 years. Ninety-two percent were smokers and 11.1 % had allergy rhinitis. The mean of Total Reflux Symptom index in patients was significantly higher compared to controls (12.70 ± 7.06 vs. 3.00 ± 2.94). In the COPD group, 18 subjects had a positive Reflux symptom index (>11) compared to one in the control group (p value <0.05). There was also a significant difference between the means of six laryngopharyngeal symptoms in patients vs. CONTROLS: COPD patients had higher degree of hoarseness, throat clearing, excessive throat mucus, cough and sticking sensation in the throat. Laryngopharyngeal reflux is more prevalent in patients vs. CONTROLS: The frequency and severity of laryngopharyngeal symptoms is significantly higher in COPD patients.