1,720,977 research outputs found
Cobblestoning soft palate lesion: case report of a difficult diagnosis
Full text linkOral lesions are often the first sign of an Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and
ulcerative colitis (UC). Oral manifestations are not always accompanied by intestinal inflammation’s symptoms. For this
reason, many times, ENT specialist is the first doctor who receives the patient. Diagnosis and treatment of the patients
affected by IBD associated with several extra-intestinal manifestations requiring a multidisciplinary management. Endoscopic examination allows us to diagnose the disease but non-invasive markers of intestinal inflammation, like fecal
calprotectin, may be used to select which patients need to undergo endoscopic examination; thereby avoiding unneces- sary investigations. The therapeutic choice, currently available, to treat oral lesions associated with IBD includes topical
or systemic corticosteroids, immunosuppressive agents, and biologic drug
Strategies and Controversies in the Treatment With Carbon Dioxide Laser of Laryngeal Hemangioma: A Case Series and Review of the Literature
Full text linkThe hemangioma is the most common vascular tumor, involving the head and neck in 60% of cases. It is rare in the larynx. In children, hemangiomas are more frequent on the subglottis, whereas in adults the most common site is the supraglottis. Laryngeal hemangioma with cavernous features isolated to the free edge of the vocal fold is a very rare clinical finding. We present 2 cases of glottic hemangioma. Both patients reported severe hoarseness
New Therapeutic Strategies in the Treatment of Stomal Recurrence After Total Laryngectomy: Role of Immunotherapy
Full text linkObjective: The aim of this study was to investigate the incidence of stoma recurrence and the therapeutic strategy outcomes in relation to survival that have been adopted over the past few decades using a monoclonal antibody, specifically nivolumab. Methods: This study included a total of 487 patients diagnosed with laryngeal carcinoma undergoing either a laryngectomy or salvage surgery after conservative interventions at the ENT Unit of Federico II University in Naples, Italy, between 2011 and 2021. Following a minimum 2.5-year follow-up and a maximum 21-year follow-up, the results revealed that only 38 patients suffered a stomal recurrence. Results: Despite various adopted treatment strategies, the literature reports lower patient survival rates. Following a total laryngectomy, stomal recurrence represents a therapeutic management challenge due to a poor prognosis for nearly every treated case. According to the literature, in fact, despite a low incidence (ie, 0.8–31.3%), the overall mortality rate increases from 77% to 100% after three years. Nevertheless, introducing immunotherapy into cancer treatment has resulted in an observable revolution in the treatment of different types of cancers over the years. Conclusion: In light of recorded data on survival following the use of the nivolumab, the case presented in this study allows a new perspective of successfully treating recurrences of squamous carcinoma of the head and neck. © The Author(s) 2022
Sport in the Laryngectomized Patient: A Literature Review and Single Case Presentation
Full text linkBackground: Total laryngectomy is an operation that involves numerous problems for the patient, especially in daily life: loss of the fact, loss of voice, evident scars and persistence of the tracheostoma. Much is known about rehabilitation programs involving the voice, swallowing, shoulder girdle rehabilitation; less explored is the field of sport and sports rehabilitation in the laryngectomized patient. Methods: We conduced systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in order to evaluate the possibilities of practicing sports for the patient after total laryngectomy. Results: From an initial search of 4191 papers, we have come to include six papers for this literature review. We have also reported one of our clinical cases referring to a laryngectomized patient who swims competitively at an amateur level even after surgery with a particular device. The purpose of this work is to understand the role and importance of sport in rehabilitation and the possibilities that a frail patient like the laryngectomized patient has in practicing sport. Surely the best results are obtained in subjects who practiced sports before surgery. Conclusion: It is evident that sport is important in the psychological and motor recovery of the laryngectomized patient. There is still a lack of clear rehabilitation protocols, especially for water sports, which allow all laryngectomized patients to return to sports. We believe that early resumption of physical activity makes the experience of the disease less dramatic
Subglottic Mass as Isolated Manifestation of Relapsing Polychondritis at Presentation
Full text linkRelapsing polychondritis (RP) is a rare systemic disease that is characterized by recurrent episodic inflammation of the cartilaginous structures of the body, resulting in their progressive destruction and subsequent replacement with fibrotic scar. We present a case of RP that initially manifested with subglottic involvement and we propose an innovative strategy for the treatment for laryngeal RP in phase of active inflammation. A multidisciplinary approach (rheumatologist, otolaryngologist, immunologist, internist, cardiologist, etc) and adequate follow-up are essential. The timeliness of the diagnosis is fundamental to contain the destructive effects on the cartilages involved
Effects of Adenotonsillectomy on Vocal Function
Full text linkIntroduction: Correct breathing is a fundamental condition for adequate vocal production. Respiratory dynamics are able to modify the growth of facial mass and lingual posture, i.e., of the skull, the mandibular one. For this reason, infant mouth breathing can cause hoarseness. Materials and methods: We evaluated the actual changes in the characteristics of the voice and articulation of language in a group of subjects affected by adenotonsillar hypertrophy (grade 3-4), with frequent episodes of pharyngo-tonsillitis who underwent adenotonsillectomy. Our study included 20 children-10 boys and 10 girls-aged 4 to 11 years who had adenotonsillar hypertrophy and pharyngotonsillitis episodes exceeding 5-6 per year in the previous 2 years. The control group (Group B) included 20 children-10 boys and 10 girls-aged 4 to 11 years (average age of 6.4 years) who had not undergone surgery and shared the same degree of adenotonsillar hypertrophy as those in Group A but who did not experience recurrent pharyngotonsillitis episodes. Discussion: The hypertrophy of adenoids and tonsils significantly impacted breathing, vocal function, and speech articulation. All this is responsible for a state of tension in the neck muscles, which at the level of the vocal tract causes hoarseness. The changes objectively observed in our study in the pre- and post-operative phase demonstrate how adenotonsillar hypertrophy is responsible for an increase in resistance to the passage of air at the glottic level. Conclusions: For this reason, adenotonsillectomy has an impact on recurrent infections and can also lead to an improvement in speech, breathing, and posture
Neuroendocrine carcinoma of the larynx with Lambert-Eaton myasthenic syndrome: a rare case report and literature review
Full text linkThis current report describes a rare clinical case of neuroendocrine carcinoma (NEC) of the larynx with associated Lambert-Eaton myasthenic paraneoplastic syndrome (LEMS). A 68-year-old male patient presented with severe dysphonia and dysphagia. He underwent a total laryngectomy and the excised lesion was extremely large. A pathological examination demonstrated ‘morphological findings of a poorly differentiated carcinoma (G3) with aspects of neuroendocrine differentiation’ (i.e. a poorly differentiated neuroendocrine carcinomas [PD-NEC]). Based on the patient’s medical history and the immunohistochemical findings, he was treated with three cycles of neoadjuvant chemotherapy (cisplatin–etoposide) and then radiotherapy with a total dose of 70 Gy. Of the 10 cases of paraneoplastic syndrome (PNS) related to laryngeal NEC reported in the literature, nine of these syndromes were of an endocrine type. Only one case of PNS associated with laryngeal cancer had a neurological manifestation, which was LEMS. To the best of our knowledge, this current case has only one similar precedent in the literature and it is the second report of an association between a PD-NEC and LEMS. Laryngeal NECs are rare lesions with different prognostic characteristics. The diagnosis should be made using an endocrinological, neurological, radiological and histological multidisciplinary approach. A radical surgical approach is recommended
Small-Cell Carcinoma of Nasopharynx: A Case Report of Unusual Localization
Full text linkNeuroendocrine tumors are a spectrum of rare and highly heterogeneous neoplasms with distinct functional and biological behavior in relation to location, tumor size, and histological differentiation. Neuroendocrine tumors arise from the neuroendocrine cells of the diffuse neuroendocrine system located in almost every organ. Neuroendocrine tumors in the head and neck district are usually reported in sinonasal cavities and larynx. We present the case of a nasopharyngeal small-cell neuroendocrine carcinoma, which, as far as we know, is the 16th case reported in literature
Intralabyrinthine Schwannoma of the Intravestibular Subtype: A Difficult Diagnosis
Full text linkIntralabyrinthine schwannoma is a rare, slow-growing, benign
tumor that affects the most terminal portions of the vestibular
and cochlear nerves. It can be located in the vestibule, cochlea,
or semicircular canals.
In 2004, Kennedy et al proposed a classification system
which recognized 7 subtypes of intralabyrinthine schwannoma;
in 2013, Abel et al1 modified the Kennedy classification,2
which included intracochlear, intravestibular (IV), intravestibulocochlear, transmodiolar, transmacular, transotic, and tympanolabyrinthine, to also include translabyrinthine, tumors
extending into the CPA, and tumors not otherwise specified.
They also proposed to rename intralabyrinthine schwannoma
as primary inner ear schwannoma to permit clear subsite
categorization.
Patients usually have nonspecific symptoms, including hearing loss, tinnitus, and only single episode of vertigo. Among the
resulting symptoms, the most frequent is hearing loss, which
affects 95% of the patients. Most times, this loss is slow and
progressive, but it may be sudden or fluctuating. Less common
symptoms include tinnitus (51%), imbalance (35%), vertigo
(22%), and ear fullness (2%), which may be present alone or
in combination.3-7 We report a rare case of a patient with hearing
loss and single episode of vertigo secondary to the intralabyrinthine schwannoma of the IV subtype
New Therapeutic Strategies in the Treatment of Stomal Recurrence After Total Laryngectomy: Role of Immunotherapy
No full textObjective The aim of this study was to investigate the incidence of stoma recurrence and the therapeutic strategy outcomes in relation to survival that have been adopted over the past few decades using a monoclonal antibody, specifically nivolumab. Methods This study included a total of 487 patients diagnosed with laryngeal carcinoma undergoing either a laryngectomy or salvage surgery after conservative interventions at the ENT Unit of Federico II University in Naples, Italy, between 2011 and 2021. Following a minimum 2.5-year follow-up and a maximum 21-year follow-up, the results revealed that only 38 patients suffered a stomal recurrence. Results Despite various adopted treatment strategies, the literature reports lower patient survival rates. Following a total laryngectomy, stomal recurrence represents a therapeutic management challenge due to a poor prognosis for nearly every treated case. According to the literature, in fact, despite a low incidence (ie, 0.8-31.3%), the overall mortality rate increases from 77% to 100% after three years. Nevertheless, introducing immunotherapy into cancer treatment has resulted in an observable revolution in the treatment of different types of cancers over the years. Conclusion In light of recorded data on survival following the use of the nivolumab, the case presented in this study allows a new perspective of successfully treating recurrences of squamous carcinoma of the head and neck
- …
