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Ozljeda nagnječenjem ishijadičnog živca kod štakora i praćenje oporavka istog putem plantarnog testa i imunohistokemijskim putem
No full textAn experimental crush injury to the sciatic nerve, with a crush force of 49.2 N (pressure p=1.98x108 Pa), was inflicted in 30 male rats (Wistar). A control group (sham), with the same number of rats, was also operated upon exactly as the experimental group but without the crush injury. We tested the sensory and motor recovery of the sciatic nerve with Hargreaves method, using an apparatus from Ugo Basile, Italy. Testing was continued for both legs of each rat, injured and uninjured, starting preoperatively (0 day), and then 1, 7, 14, 21, and 28 days postoperatively. The same experiment was run simultaneously with the sham group. The Plantar test showed recovery of the sensory and motor function of the sciatic nerve, though not complete recovery, by 28 days. An immunohistochemical experiment was run in parallel with the plantar test on L3-L6 segments of the spinal cord from where the sciatic nerve extends. We used antibodies for Myelin-associated glycoprotein (MAG), and gangliosides GD1a and GT1b on the aforesaid part of the spinal cord. The immunohistochemical methods showed changes in sensory and motor axons in the spinal cord segment L3-L6 which suggest correspondence with the results of the Plantar test, in terms of recovery of the sensory and motor function after injury of the sciatic nerve. The immunohistochemical results also show ipsilateral and contralateral changes following injury. Results of the plantar test are suggestive that the rat shows compensation for an injury in its contralateral leg.Na 30 muških štakora (Wistar) učinjeno je eksperimentalno ozljeđivanje ishijadičnog živca nagnječenjem, upotrebnom sile od 49,2 N (tlak p=1.98x108 Pa). Također je na jednakom broju štakora učinjen kontrolni dio pokusa (sham) gdje je prikazan neozlijeđeni ishijadični živac uz prethodno razmicanje muskulature. Iza toga smo ispitivali osjetilni i motorički oporavak ozlijeđenog živca upotrebom Hargreavesove metode plantarnog testa, uz upotrebu aparata Ugo Basile, Italija. Testiranje je vršeno kontinuirano za obje noge štakora, ozlijeđenu i neozlijeđenu, prijeoperacijski (0 dan), prvi dan nakon ozljede, 7, 14, 21 i 28 dan poslije ozljede. Istovjetno je učinjeno i za kontrolnu skupinu životinja (sham). Plantarni test je pokazao oporavak motoričke i osjetilne funkcije ozlijeđenog ishijadičnog živca 28 dan ali nije u potpunosti dosegao prijeoperacijske vrijednosti. Paralelno sa plantarnim testom radili smo imunohistokemijski pokus na dijelu kralježnične moždine L3-L6, gdje je polazište ishijadičnog živca. Koristili smo protutijela na mijelinom udruženi glikoprotein (MAG), i gangliozide GD1a i GT1b u navedenom dijelu kralježnične moždine. Imunohistokemijskom metodom pokazali smo promjene na motoričkim i osjetilnim aksonima u kralježničnom dijelu L3-L6 i usporedili sa rezultatima plantarnog testa, u smislu oporavaka motorike i osjeta nakon ozljede ishijadičnog živca. Imunohistokemijskom analizom dobiveni rezultati također pokazuju ipsilateralne i kontralateralne promjene nakon ozljede. Rezultati plantarnog testa pokazuju motoričku kompenzaciju ozlijeđene noge štakora neozlijeđenom
Chronical Problems of Prematures and Discharge Planing
No full textNapretkom porodničarske i perinatalne skrbi za majku i dijete, danas preživljavaju djeca veoma kratke gestacijske dobi i male rodne mase. Sve je veći broj djece koja zbog preranog rođenja kasnije u životu imaju kronične probleme. Takva se djeca često rađaju slabije vitalna, u njih često nalazimo i kliničke znakove intraamnijske infekcije. Pri liječenju takve djece često provodimo agresivne medicinske postupke (mehaničku ventilaciju, parenteralnu prehranu, dugotrajnu intravenoznu primjenu elektrolitskih otopina i antibiotika, mikrotransfuzije, potpune izmjene krvi). Prerano rođena djeca preosjetljiva su na nagle promjene krvnog tlaka, hipoksiju, hiperoksiju, hipo i hiperkapniju. Sve to može dovesti do trajnih posljedica. Kronični problemi nedonoščadi koji mogu nastati su: bronhopulmonalna displazija, retinopatija nedonoščeta (sljepoća, refrakcijske mane, slabovidnost, glaukom), osteopenija, epilepsija, cerebralna paraliza, slabo napredovanje na težini (anemija), nagluhost i gluhoća, traheomalacija, malformacije zuba, nosa i usne šupljine. Pomno odabranim terapijskim, a kasnije rehabilitacijskim postupcima i kliničkim praćenjem, nastojimo u te djece spriječiti nastanak oštećenja, invalidnosti i ometenosti.Advances in obstetrical and perinatal care for mother and child, causes survival of prematures with very short gestation and very low birth weight. We see today an increasing number of children born prematurely with chronical problems later in life. Prematures are often born in asphyxia, with clinical signs of intraamiotic infection. Treating of such children frequently conducting aggressive medical procedures (mechanical ventilation, parenteral nutrition, long-term intravenous electrolyte replacement and antibiotics, microtransfusiones, complete blood exchange). Prematures are sensitive to sudden changes in blood pressure, hypoxia, hiperoxia, hypo and hypercapnia. All this conditions can lead to permanent consequences. Chronic problems of prematures that can occur are: bronchopulmonary dysplasia, retinopathy (blindness, refractive defects, visual impairment, glaucoma), oteopenia, epilepsy, cerebral paralysis, poor progress in weight (anemia), hearing loss and deafness, traheomalation, malformations of teeth, nose and oral cavity. By carefully selected treatment, later rehabilitation procedures and clinical follow-up, we are trying to prevent damage, disability and disability in these children
Cjelovitost sluznice tankog crijeva tijekom anestezije kod velikih kirurških zahvata trbuha
No full textThe aim of the study was to examine a perfusion and integrity of small bowel in 60 subsequent patients during the major open abdominal surgery which lasted from 2 to 7 hours. Two samples of the intestinal mucosa were removed: at the beginning, and at the end of the surgical procedure in general anaesthesia. A mucosal injury was classified into 4 grades. pH, PCO2 and lactate level were measured in the blood samples from the arterial and mesenteric vein in one hour time intervals. The changes of intestinal mucosa were found in 31 patients (51.7%): in 19 patients (31.7%) grade 1 changes were recorded, in 10 patients (16.7%) grade 2, and in 2 patients (3.3%) grade 3. Grade 4 lesions were not recorded.
There was a statistically significant correlation between grades of the mucosal damage and the surgery duration (p=0.001). Analysis during the one hour intervals showed that there was no exact time point when the significant aggravation of the pathohistological changes in intestinal mucosa occurred. However, when patients were allocated into two subgroups with surgical procedures lasting less than 4 hours and more than 4 hours, there was a statistically significant difference in the grades of mucosal damage between subgroups (p<0.05). More biopsies without pathohistological changes were observed in the patients whose procedure duration was < 4 hours. A significantly higher lactate concentrations in arterial and mesenteric venous blood were observed in the patients with pathohistological changes at 6 hours time point as compared to 2 hour time point in the patients without pathohistological changes (p<0.05). During the open abdominal surgery in general anaesthesia, the length of the procedure influences the grade of the intestinal mucosa injury. Deterioration of the pathohistological findings in the intestinal mucosa correlates with high lactate blood level, suggesting that the cause of these changes may result from tissue hypoxia.Cilj studije je bio ispitati perfuziju i cjelovitost sluznice tankog crijeva tijekom anestezije i kirurškog zahvata na otvorenom trbuhu kod 60 bolesnika u postupcima razli~itog trajanja. Tijekom operacije uzeta su dva uzorka crijevne sluznice: T0 na početku postupka i TN na kraju postupka (N=trajanje postupka u satima, od 2 do 7 sati). Svi bioptički uzorci su pregledani a uočena oštečenja sluznice klasificirana u 4 stupnja. Promjene crijevne sluznice su nađene u 31 bolesnika (51,7%): u 19 bolesnika (31,7%) zabilježene su promjene 1. stupnja; u 10 bolesnika (16,7%) promjene 2. stupnja; u 2 bolesnika (3,3%) promjene 3. stupnja. Oštečenja 4. stupnja nisu zabilježena. Postojala je povezanost između stupnjeva o{te}enja i trajanja operacije (p=0,001). Analiza tijekom jednosatnih vremenskih intervala je pokazala da ne postoji odre|eno vrijeme kada nastupa značajno pogoršanje patohistološkog nalaza sluznice crijeva. Zatim su bolesnici podijeljeni u 2 skupine: bolesnici kod kojih su operacije trajale manje od 4 sata i oni kod koji su operacije trajale 4 i vi{e sati. Postojala je statistički zna~ajna razlika u stupnjevima oštečenja sluznice između ovako podijeljenih skupina (p<0,05). Skupina bolesnika kod kojih je operacija trajala manje od 4 sata imala je vi{e uzoraka biopsije crijeva u kojima nije bilo patohistoločkih promjena. Tijekom operacije, u jednosatnim intervalima, uzimani su uzorci krvi iz arterije i mezenterične vene za odre|ivanje pH, koncentracije ugljičnog dioksida i laktata. Razlike u koncentraciji laktata u arterijskoj i mezenteričnoj venskoj krvi nakon 2 i 6 sati postupka između skupine sa i one bez patohistoločkih promjena bile su značajne (p<0,05). Prema tome, za vrijeme anestezije i operacija na otvorenom trbuhu, du`ina postupka utje~e na stupanj oštečenja sluznice tankog crijeva. Pogoršanje patohistoločkih promjena crijevne sluznice povezano je sa visokom razinom laktata u krvi, dokazuju}i tako da je uzrok ovih promjena povezan sa tkivnom hipoksijom
Epidemiološki podaci o malignom melanomu u Osječko-baranjskoj županiji (Istočna Hrvatska) u razdoblju od 2000–2008. godine
No full textDuring the past several decades there has been a substantial increase in the incidence of malignant melanoma worldwide. The highest incidences were reported in New Zealand and Australia. In Europe the northern countries generally have a higher incidence. The aim of this retrospective study was to provide the incidence and mortality for all patients with malignant melanoma diagnosed in Osijek-Baranya County, Eastern Croatia, during 2000–2008. In the past 30 years in the Republic of Croatia the incidence of melanoma increased by 337%. During the period of 2000–2006 in Osijek-Baranja County, the incidence of melanoma increased by 13%. The incidence of melanoma increases with age, but in past decades melanoma is more often diagnosed in people aged 25–40. The mortality between 2000 and 2008 increased by 18%. The incidence of melanoma generally increases equally in men and women. The most common localization of skin melanoma in males was trunk and in females the lower extremities. Presently, in Osijek-Baranya County melanoma is 15th on the list of malignant tumors and represent 2% of all malignant tumors. In New Zealand, Australia and European northern countries mortality is reduced, as result of earlier diagnosis and education of risk groups. Unfortunately, in Osijek-Baranya County, in a comparison with these countries, the mortality is higher although incidence is the same or lower.Posljednjih se desetljeća bilježi značajan porast incidencije malignog melanoma u žitavom svijetu. Najviša incidencija bilježi se u Novom Zelandu i Australiji. U Europi sjeverne zemlje imaju najveću incidenciju. Cilj ove retrospektivne studije bio je prikazati incidenciju i smrtnost kod svih bolesnika kojima je na području Osječko-baranjske županije dijagnosticiran maligni melanom u razdoblju od 2002. do 2008. godine. Posljednjih 30 godina incidencija malignih melanoma u Republici Hrvatskoj porasla je za 337%. U razdoblju od 2000. do 2006. godine u Osječko-baranjskoj županiji incidencija malignog melanoma porasla je za 13%. Incidencija melanoma raste s dobi, no u posljednje vrijeme sve se češće dijagnosticiraju u dobnoj skupini između 25-te i 40-te godine. U razdoblju od 2000. do 2008. godine smrtnost je porasla za 18%. U~estalost pojavljivanja melanoma gotovo je podjednaka u muškaraca i žena. Najčešća lokalizacija kožnog melanoma kod muškaraca je trup, a kod žena donji ekstremiteti. Melanom se u Osječko-baranjskoj županiji po učestalosti nalazi na 15. mjestu i predstavlja oko 2% svih malignih tumora. U Novom Zelandu, Australiji i zapadnoeuropskim zemljama smrtnost je smanjena, i to kao rezultat rane dijagnostike i edukacije rizičnih skupina. Nažalost, u Osječko-baranjskoj županiji, u usporedbi s ovim zemljama, smrtnost je veća iako je incidencija jednaka ili niža
Phenotype and Natural History in Marshall–Smith Syndrome
No full textMarshall-Smith syndrome (MSS) is a distinctive entity of unknown etiology with fewer than 50 patients described in the medical literature to date. Through an International collaboration and use of an online wiki to facilitate data collection and sharing, we further delineate the phenotype and natural history of this syndrome. We present 15 new patients, the oldest being 30 years, provide an update on four previously published cases, and compare all patients with other patients reported in literature. Main clinical features are moderate to severe developmental delay with absent or limited speech, unusual behavior, dysharmonic bone maturation, respiratory compromise secondary to upper airway obstruction, short stature, and kyphoscoliosis. Facial features are characteristic with high forehead, underdeveloped midface, proptosis, anteverted nares, and everted lips. Minor abnormalities of brain morphology such as hypoplasia of the corpus callosum are common. Mortality from respiratory complications is high, but airway support increasingly allows survival into adulthood. Array-CGH was performed on 12 of the cohort and no copy number variants of clear clinical relevance were identified. The present study is the first reported use of an online wiki to aid delineation of a genetic syndrome, and illustrates its value in collecting detailed data in rare conditions
Granular cell tumor
No full textGranular cell tumors are relatively uncommon benign lesions occurring in almost any part of the body. We report the cytological diagnosis of granular cell tumor in 25-year-old male patient who presented with an inguinal mass clinically suspected to be a lymphadenopathy. Fine needle aspiration revealed polygonal cells with abundant, granular cytoplasm and eccentrically located vesicular nuclei and inconspicuous nucleoli. The histopathological examination of the surgical excision confirmed the diagnosis. If resection is complete, local surgical excision is curative for benign granular cell tumors. Granular cell tumor has a characteristic cytological appearance, and fine-needle aspiration cytology has been suggested to be diagnostic modality of choice.Granular cell tumor je relativno neuobičajena dobročudna promjena koju je moguće naći na bilo kojem dijelu tijela. Autori prikazuju bolesnika sa tvorbom u preponi za koju se posumnjalo da je povećani limfni čvor. Citološkom punkcijom su nađene poligonalne stanice obilne zrnate citoplazme sa ekscentrično smještenim vezikularnim jezgrama i nezamjetnim nukleolima. Histopatološki pregled odstranjene tvorbe je potvrdio citološku dijagnozu. Resekcija tvorbe je i jedini terapijski postupak za dobročudne granular cell tumore. Zbog karakteristične citološke slike granular cell tumora, citološka punkcija je metoda izbora u njegovoj dijagnostici
Papa test - Sa ili bez vaginalnog razmaza?
No full textThe aim of this study was to evaluate medical and economic justification of vaginal smears as a part of primary screening for cervical carcinoma and its precursors. Study included 245.048 participants whose VCE (vaginal, cervical, endocervical) smears were examined at Department of clinical cytology of University Hospital Center Osijek from 2003 till 2008. There were 12.639 (5.2%) abnormal findings, and they were divided into three groups: abnormal cells found only in vaginal smear (V), abnormal cells found in vaginal and in at least one other smear (V+) and abnormal cells not found in vaginal smear (C/E). These three groups were analysed in respect to cytological differential diagnosis and age of participants. It was estimated how many women could be additionally included in the screening, if vaginal smear would be included in the Pap test only after 50 years of age. In 6.9% of cytologically diagnosed lesions abnormal cells were found exclusively in vaginal smears (0.35% of all findings). As for squamous cell lesions, 91.2% were mild lesions (ASC and LSIL). Invasive squamous cell carcinoma was not diagnosed exclusively by vaginal smear in either woman under 50 years of age, while in women over 50 years of age it was diagnosed in 2.3% of cases. Exclusively by vaginal smear was diagnosed 3.9% of all AGC and 6.3% of adenocarcinoma, while in 85.0% of glandular epithelium lesions abnormal cells were not found in vaginal smears. Two thirds of adenocarcinoma diagnosed exclusively by vaginal smears were endometrial adenocarcinoma, but that is only 10.3% of all endometrial carcinoma diagnosed by Pap test. Obtained results show that taking of vaginal smears along with cervical and endocervical smears as a part of primary screening for cervical carcinoma and its precursors in women under 50 years of age is not justifiable, since vaginal smear only has a role in detection of endometrial carcinoma that are extremely rare in younger age groups. If vaginal smear would be taken only in women over 50 years of age, additional 37.7% of women under 50, or 25.1% women over 50 years of age could be included in the screening.Cilj ove studije bio je procijeniti medicinsku i ekonomsku opravdanost uzimanja vaginalnog razmaza u sklopu primarnog probira cervikalnog karcinoma i njegovih prekursora. U studiju je uključeno 245.408 ispitanica čiji su VCE (vaginalni, cervikalni, endocervikalni) razmazi bili pregledani na Odjelu za kliničku citologiju Kliničkog bolničkog centra Osijek od 2003. do 2008. godine. Abnormalnih je nalaza bilo 12.639 (5,2%), a podijeljeni su u tri skupine: abnormalne stanice nađene samo u vaginalnom razmazu (V), abnormalne stanice nađene u vaginalnom i bar u još jednom razmazu (V+) i abnormalne stanice nisu nađene u vaginalnom razmazu (C/E). Te su tri skupine analizirane u odnosu na citološku diferencijalnu dijagnozu i životnu dob ispitanica. Procijenjeno je koliko bi se `ena moglo dodatno obuhvatiti probirom ukoliko bi se vaginalni razmaz uključio u PAPA test tek nakon pedesete godine života. U 6,9% citološki dijagnosticiranih lezija abnormalne su stanice nađene isključivo u vaginalnim razmazima (0,35% svih nalaza). Kod lezija pločastog epitela u 91,2% slučajeva radilo se o lakšim lezijama (ASC i LSIL). Invazivni pločasti karcinom isključivo vaginalnim razmazom nije dijagnosticiran niti u jedne žene mlađe od 50 godina, dok je u žena starijih od 50 godina dijagnosticiran u 2,3% slučajeva. Isključivo vaginalnim razmazom otkriveno je 3,9% svih AGC i 6,3% adenokarcinoma, dok kod 85,0% lezija žljezdanog epitela abnormalne stanice nisu nađene u vaginalnim razmazima. Dvije trećine adenokarcinoma dijagnosticiranih isključivo vaginalnim razmazom čini adenokarcinom endometrija, no to je samo 10,3% svih PAPA testom dijagnosticiranih endometralnih karcinoma. Iz navedenih se rezultata može zaključiti da čenama mlađim od pedeset godina nema opravdanja uz cervikalni i endocervikalni uzeti i vaginalni razmaz u sklopu primarnog probira cervikalnog karcinoma i njegovih prekursora, budući da vaginalni razmaz ima ulogu jedino u detekciji endometralnih karcinoma koji su u mlađim dobnim skupinama izuzetno rijetki. Ukoliko bi se vaginalni razmaz uzimao samo ženama starijim od 50 godina moglo bi se dodatno pregledati još 37,7% žena mlađih od 50 godina, ili 25,1% žena starijih od 50 godina
Citodijagnostika folikularnih tumora štitnjače
No full textUS-guided fine needle aspiration cytology is currently the best diagnostic tool for thyroid nodules. The aim of this research was to make a detailed and objective determination of the morphological characteristics of cells in cytological smears in an attempt to distinguish benign from malignant follicular tumors. The research included 62 patients with cytologically diagnosed follicular or oncocytic tumors, and 15 patients with nodular hyperplasia. Echographic findings were divided into three groups: isoechogenic, hypoechogenic and hyperechogenic nodules. We analyzed the cellularity of the smear, cohesion between follicular cells, acinar formations, bare nuclei, characteristics of the nucleus and the cytoplasm, and the presence of colloid. The statistical analysis of cytological parameters has indicated that none of the cytological parameters alone is discriminating enough between non-tumor and tumor changes, or benign and malignant follicular thyroid nodules. The analysis of age, sex, nodule size and ultrasound findings has not shown the correlation between any of these parameters with the malignant or benign follicular tumors. The cytological analysis of the smears for patients with follicular tumors, in combination with clinical data and other diagnostic methods, contributes to more precise diagnostics, but is not sufficient for the differentiation between benign and malignant follicular tumors.Citološka punkcija pod kontrolom ultrazvuka je nedovoljno osjetljiva i specifična za razlikovanje benignih i malignih folikularnih tumora. Cilj istraživanja je bio utvrditi citomorfološke karakteristike stanica punktata histološki verificiranih folikularnih i onkocitnih tumora te odrediti vrijednost pojedinih citoloških parametara u diferencijaciji benignih i malignih tumora. U istraživanje je uključeno 62 ispitanika s citološkom dijagnozom folikularnog ili onkocitnog tumora te 15 ispitanika s čvorastom hiperplazijom. Ehografski, čvorovi su bili izoehogeni i hipoehogeni, a prema veličini su podijeljeni u skladu sa pT klasifikacijom SZO. Semikvantitativno je analizirana celularnost uzorka, kohezija me|u stanicama, morfologija nakupina, gole jezgre, karakteristike jezgre i citoplazme te koloid. Statisti~ki, ni jedan od citolo{kih parametara sam za sebe nije dovoljan diskriminirajući faktor između netumorskih i tumorskih promjena, kao ni između benignih i malignih folikularnih tumora štitnjače. Analizom dobi, spola, veličine čvora ni UZV nalaza nije dokazana povezanost bilo kojeg od ovih parametara s malignim ili benignim folikularnim tumorom. Citološka analiza punkata u kombinaciji sa kliničkim podacima i drugim dijagnostičkim metodama doprinosi preciznijoj dijagnostici, ali sama za sebe nije dostatna za diferencijaciju benignih i malignih folikularnih tumora
Vaginal Colonization with Streptococcus Group B as Risk Factor in Pregnancy and Early Naonatal Period
No full textKolonizacija rodnice streptokokom grupe B u trudnoći predstavlja rizični čimbenik za razvoj rane neonatalne bolesti novorođenčadi. BHS-B neonatalna infekcija zauzima važno mjesto u morbiditetu novorođenčadi, a može biti uzrok i trajnih oštećenja. Većina zemalja je na osnovi vlastite epidemiološke situacije izradila postupnike za prevenciju infekcije koji su temeljeni na probiru vaginalne kolonizacije streptokokom grupe B u trudnoći u 35–37 tjednu te na osnovi rizičnih faktora. Za sada jedina dostupna metoda za prevenciju rane neonatalne bolesti novorođenčadi je pravilna primjena intrapartalne antibiotske profilakse. Sljedeći u svijetu formirane i prihvaćene postupnike o adekvatnom probiru, evaluaciji rizičnih faktora te o antibiotskoj intrapartalnoj profilaksi, pojava rane neonatalne bolesti novorođenčadi prouzročene streptokokom grupe B svodi se na minimum.Colonization of vagina during pregnancy by streptococcus group B represents the risk factor for the development of early neonatal disease in newborn population. GBS neonatal infection is very important for the newborn morbidity, possibly causing even permanent defects. Based on the specific epidemiologic situation, most countries made the protocols for the prevention of infection. These protocols were based on the detection of vaginal colonization with the streptococcus group B, during the 35th till 37th week of pregnancy, as well as on the various risk factors. The only available method up till now has been the correct application of intrapartal antibiotic prophylaxis. Following the worldwide formed and recognized protocols about the adequate screening, risk factor evaluation and about the antibiotic prophylaxis, the appearance of neonatal desease in newborn population, caused by streptococcus group B, can be minimised significantly
Obostrane laringokele udružene s planocelularnim karcinomom: prikaz slučaja i osvrt na literaturu
No full textCoexistence of laryngoceles and laryngeal carcinoma is still being debated, and there are several suggested theories about the pathophysiological relationship between these two entities. We present the case of a 66-year-old male patient with bilateral laryngomucoceles and laryngeal squamos cell carcinoma. A systematic hystological examination of whole organ sections showed that the submucosal spreading of cancer around the saccular necks on both sides caused stenosis which probably created a one-way valve mechanism allowing air to enter the saccule but not to exit. Progression of the tumor completely obstructed the laryngeal opening, leading to glandular secretion stagnation and formation of laryngomucocelesO istovremenom postojanju laringokela i karcinoma larinksa se još uvijek raspravlja. Postoji nekoliko predloženih teorija o patofiziološkim odnosima između ova dva entiteta. Predstavljamo slučaj 66-godišnjeg muškarca s bilateralni laringomukokelama i planocelularnim karcinomom larinksa. Patohistološka analiza pokazala je submukozno širenje karcinoma oko vrata mukokele na obje strane što je vjerojatno prouzročilo stenozu i stvorilo jednosmjerni ventil mehanizam koji omogućava ulaz zraka u laringokelu, ali ne i izlaz. Progresija tumora potpuno zatvara laringealni otvor, a što dovodi do stagnacije žljezdane sekrecije i stvaranja laringomukokele