ABSTRACT
Angioleiomyoma is an uncommon benign tumor composed of smooth muscle cells and vascular endotheliums. It is common in the uterus and the gastrointestinal tract but rare in the head and neck. This neoplasm is extremely rare in the nasal cavity, accounting for less than 1% of all vascular leiomyomas. The tumor has a benign nature and the recurrence of tumor is rare and complete removal is the treatment of choice. We present a case of angioleiomyoma which involves the nasal vestibule and was excised by a sublabial approach.
Subject(s)
Accounting , Angiomyoma , Endothelium, Vascular , Gastrointestinal Tract , Head , Myocytes, Smooth Muscle , Nasal Cavity , Neck , Recurrence , UterusABSTRACT
BACKGROUND AND OBJECTIVES: Reflux laryngitis gives rise to inflammatory change in the pharyngolaryngeal tissue with various otolaryngologic and respiratory symptoms. Histamine H2 receptor antagonists and H(+)-K(+)-Exchanging ATPase are currently used as therapeutic medications. However, the efficacy of those two drugs on reflux laryngitis has never been proven yet. Therefore, we intended to analyze and compare the efficacy of the two drugs on reflux laryngitis. MATERIALS AND METHOD: Among the patients who had visited the Department of Otolaryngology, those with the total score of greater than 6 and having more than 2 symptoms that score greater than 2, had undergone laryngoscopy. Of these, the patients who had shown greater than 7 on the Belafsky's Reflux Finding Score (RFS) were studied. The RAN (Ranitidine) group (59 subjects) with Ranitidine administered and RAB (Rabeprazole)group (66 subjects) with Rabeprazole were followed up for 12 weeks, and then the efficacy of each drug was evaluated at 2nd, 4th, and 12th week. Then, the Symptom Score Improvement (SSI) and RFS were compared and analyzed. RESULTS: In comparison the RAN group that had Histamine H2 receptor antagonists and prokinetic agents administered to the RAB group that had H(+)-K(+)-Exchanging ATPase and prokinetic agents administered for the improvement of symptoms caused by reflux laryngitis, no difference was observed till after the first 2 weeks. On the evaluation at 4th and 12th week, statistically higher therapeutic efficacy was shown to a great extent in the RAB group. The findings of laryngoscopy at the 12th week also showed higher therapeutic efficacy in the RAB group. In comparison of symptoms between the groups, there were significant differences in pharyngolaryngeal foreign body sense and chronic throat clearing, and laryngeal edema and injection as well. CONCLUSION: For therapy of reflux laryngitis patients with moderately severe symtpoms, the use of H(+)-K(+)-Exchanging ATPase and prokinetic agents were superior in improving symptoms and clinicopathologic findings of larynx than Histamine H2 receptor antagonists and prokinetic agents.
Subject(s)
Humans , Foreign Bodies , H(+)-K(+)-Exchanging ATPase , Histamine H2 Antagonists , Laryngeal Edema , Laryngitis , Laryngoscopy , Larynx , Otolaryngology , Pharynx , Rabeprazole , RanitidineABSTRACT
BACKMROUND AND ackground and Objectives: Voice is produced by the vibration of the vocal fold mucosa and laryngeal movements affect its vibration. It is speculative that asymmetric laryngeal movements might be the cause of inadequate vibration of the vocal fold mucosa. Using the pharyngogram, authors studied the relation between the asymmetric laryngeal movements and laryngeal nodule in functional voice disorders. MATERIALS AND METHOD: Thirty patients with laryngeal nodule and thirty normal subjects were evaluated. All subjects were evaluated by an acoustic analysis and maximum phonation time. Laryngeal movements were investigated with a laryngostroboscopy. And we investigated the asymmetric movement of larynx and perilarynx using /i/ phonation pharyngogram. RESULTS: Acoustic analysis and maximum phonation time of the patients with laryngeal nodule were different with that of normal subjects. Asymmetry of arytenoid movements and asymmetry of thyroid cartilage protrudings were more common in patients with laryngeal nodule during the examination of the laryngostroboscopy. Asymmetry of pyriform sinus was more common in the patients with laryngeal nodule in the examination of the /i/ phonation pharyngogram. CONCLUSION: Laryngeal asymmetry might affect more commonly the vibration of the vocal fold mucosa in the patients with laryngeal nodule.
Subject(s)
Humans , Acoustics , Larynx , Mucous Membrane , Phonation , Pyriform Sinus , Thyroid Cartilage , Vibration , Vocal Cords , Voice , Voice DisordersABSTRACT
BACKGROUND AND OBJECTIVES: The esophageal voice can be a choice for alaryngeal patients. However, many patients fail to get a esophageal voice, because there are no known systematic principles nor specific training methods of producing the esophageal voice. We evaluated the difference between two vowels of the esophageal voice that have different shapes and movements of the speech apparatus. We also tried to find a relationship between the speech apparatus and the esophageal voice. MATERIALS AND METHODS: Alaryngeal patients were investigated with acoustic analysis, aerodynamic analysis and pharyngoesophagogram. We used the vowel /a/ in which the mouth is widely open and the tongue is posteriorly positioned and vowel /i/ in which the mouth is less widely open and the tongue is anteriorly positioned. We compared the results of analytic studies between two vowels. RESULTS: The esophageal voice has a higher pitch and a lower sound in the /i/ vowel. The hypopharyngeal space above the neoglottis was extended more anteriorly. The /i/ vowel made a more tight contact with the neoglottis to the anterior wall and the short length of the neoglottis. CONCLUSIONS: The results of acoustic analysis and pharyngoesophagogram showed that there were differences between the /a/ vowel and the /i/ vowel of the esophageal voice.
Subject(s)
Humans , Acoustics , Mouth , Tongue , VoiceABSTRACT
BACKGROUND AND OBJECTIVES: Non-organic voice disorders are very difficult to diagnose. The authors attempted to find out the efficiency of videokymography (VKG) which has been newly developed to evaluate the vibratory characteristics of the vocal folds in non-organic voice disorders. MATERIALS AND METHODS: Eighty-seven patients who had voice changes without organic laryngeal pathology were evaluated. We ascertained the larynx to be free of organic disorders using the stroboscopy, following which the VKG examination was performed. The results of VKG were classified according to the common features. RESULTS: Type I showed the normal findings. Asymmetry in the amplitude of upper lips was seen in the type II. Type III showed thick glottal contact. Type IV showed level difference, thick glottal contact and asymmetry in the amplitude of upper lips. Type V had several different amplitudes of the upper lip seen in one cycle of the mucosal wave. Type VI had level difference with thin glottal contact and asymmetry in the amplitude of upper. CONCLUSIONS: Based on these results, we were able to see the different types of VKG and that VKG could be used as a supplementary diagnostic tool in the non-organic voice disorders.
Subject(s)
Humans , Kymography , Larynx , Lip , Pathology , Stroboscopy , Vocal Cords , Voice Disorders , VoiceABSTRACT
BACKGROUND AND OBJECTIVES: Voice quality is determined by the vibration of the vocal cord. Therefore, visualization of the vibratory characteristics of the vocal cord is very important in patients with voice changes. Several methods for directly visualizing the vibrations of the vocal cord have been developed, although none have been commercially available or widely used. Recently, videokymography (VKG) has been developed for direct observation of vibratory characteristics in the vocal cord. VKG achieves a frequency of 7812.5 Hz, which is enough to cover the whole frequency range of the human vocal cord. However, there have been no useful parameters for interpretation of the VKG findings. MATERIALS AND METHODS: We evaluated the vocal cord vibration of 92 subjects (23 of normal, 69 of benign laryngeal lesion) and suggested 9 parameters. We analyzed VKG recordings of subjects using these parameters and interpreted the typical and common VKG findings in each case. RESULTS: There were typical differences in glottal contact, site of glottal contact, shape of glottal contact, mucosal wave, periodicity and symmetry between two groups. Amplitude of upper lip and contact quotient had a highly significant correlation between them. CONCLUSIONS: The authors suggest that these parameters would be useful to quantify the VKG findings.
Subject(s)
Humans , Kymography , Lip , Periodicity , Vibration , Vocal Cords , Voice , Voice QualityABSTRACT
BACKGROUND AND OBJECTIVE: Endoscopic sinus surgery (ESS) is the choice of paranasal sinus surgery, hut its major complication (blindness, CNS trauma) can occur because of the dysharmony between preoperative CT images and perioperative endoscopic findings. Recently, Computer Aided Endoscopic Sinus Surgery (CAESS) reduced complications dramatically and the preoperative images of the surgical field of bony structures match exactly with the perioperative findings. We wanted to find ways to visualize the surgical anatomy and to operate exactly in the key area (frontal recess, natural osteum, sphenoid sinus) with CAESS. MATERIALS AND METHODS: Forty patients (30 patients without history of sinus surgery and 10 returning patients who had history of sinus surgery) with nasal polyp were included for the study. Preoperative coronal CT and axial CT were checked. The first operation was classical ESS, the second operation was CAESS, and we compared the accuracy between them. RESULTS: Of 60 patients with nasal polyp, 45 (75%) were identified with frontal recess, 52 (87%) were identified with natural osteum, and 52 (87fo) were identified with sphenoid sinus. Of the patients returning for surgery (N=20), 9 (45%), 14 (70%), 11 (55%) were identified with Frontal recess, natural osteum, sphenoid sinus, respectively. When CAFSS was used, all key areas were identified. CONCLUSION: Frontal recess is the most difficult site to identify during ESS, and CAESS is very useful in cases which show distorted normal anatomy during frontal recess and sphenoid sinus operation.
Subject(s)
Humans , Endoscopes , Nasal Polyps , Sphenoid SinusABSTRACT
Even for experienced surgeons, it is possible that the complex and variable anatomy and the proximity of important structures make endoscopic sinus surgery a tough job. The main cause of surgical complications is that the image of two dimensional computed tomography scan is not correlated with the endoscopic view during operation. Recently developed computer aided endoscopic sinus surgery(CAESS) may be an important step in reducing the incidence of complications. Authors used the CAESS in 3 cases. The first was the case of huge multiple polyps and needed the revision of surgery. The second was the case of multiple polyps and cleft palate which was operated previously. The last was the case of pituitary cyst. Surgery of the extensive sinus disease or the causes with surgically-congenitally altered anatomical landmarks was safe and easy when CAESS was utilized.
Subject(s)
Cleft Palate , Incidence , PolypsABSTRACT
BACKGROUND AND OBJECTIVES: Examining vibrations of the vocal fold is very important in patients with voice changes. The newly developed videokymography (VKG) takes images in real time and records irregular vibrations of the vocal fold. However, there are few data on VKG findings. We studied VKG to evaluate the vibratory characteristics of the vocal fold in benign vocal fold lesions and normal subjects. MATERIALS AND METHODS: Normal subjects (N=20) and patients (N=100) with laryngeal lesions were evaluated. Unique vibratory patterns, blurred demarcation of the mucosal propagation, decreased margin amplitudes, asymmetry in phase or amplitude, and different contact sites were observed in each benign vocal-fold lesion. RESULTS: There were several differences between subjects with normal and with laryngeal lesion. VKG depicted the tiny difference which were not exactly found by the stroboscope. CONCLUSIONS: We found that each type of laryngeal lesion has specific characteristics which can be revealed by VKG examination. These characteristics could be quantified and used to objectively evaluate VKG findings. This research shows that VKG can be used as a supplementary diagnostic tool.
Subject(s)
Humans , Vibration , Vocal Cords , VoiceABSTRACT
BACKGROUND AND OBJECTIVES: Benign vocal fold lesions are a common cause of voice dysfunction. Successful treatment of these diseases is primarily accomplished through voice therapy and surgical treatment. But many clinicians are faced with cases where problems persist in spite of treatment. The one cause of treatment failure in benign vocal fold lesions may be the bilateral lesions each vocal fold has different lesion. Authors studied to evaluate the possibility of persisted voice dysfunction in bilateral benign vocal fold lesions. MATERIALS AND METHODS: Strobovideolaryngoscopy findings of 128 patients with bilateral benign vocal fold lesions were reviewed. We evaluate to see if lesions in each vocal fold of one patient were the same or not. The treatment methods for each lesion were classified. We compare the treatment methods for each lesion with those already performed on the patients. RESULTS: In cases with nodule in one vocal fold, we observed 8 edema, 2 epidermoid cyst in the opposite vocal fold. In cases with reinke's edema on both vocal fold, we observed combined lesion, such as 1 epidermoid cyst, 1 hyperkeratosis. In cases with sulcus vocalis on both vocal fold, we observed combined lesion, such as 3 nodules, 4 polyps, 6 edema. We observed 2 cases with epidermoid cyst in one side and edema in opposite vocal fold, 5 cases with bilateral vocal nodule and combined varices in one side, 2 cases with bilateral laryngeal edema and combined hyperkeratosis in one side. CONCLUSION: Bilateral benign vocal fold lesions sometimes have more than 2 laryngeal diseases for which the treatment modality is different. Clinician should know the lesion precisely in each vocal fold, and treatment plan should be also made in according to the lesion in each vocal fold.
Subject(s)
Humans , Edema , Epidermal Cyst , Laryngeal Diseases , Laryngeal Edema , Polyps , Treatment Failure , Varicose Veins , Vocal Cords , VoiceABSTRACT
BACKGROUND AND OBJECTIVES: The various types of varix which has a dilated, tortous, elongated blood vessel arising from the microcirculation of the vocal folds may cause different types of dysphonia. There have not been many specific studies on the characteristics of microvascular lesions of the vocal folds, so authors tried to evaluate the shapes, traveling pathway, and predilection site of the microvascular lesions. MATERIALS AND METHODS: A retrospective review of 119 patients with dysphonia was undertaken. All findings of videotapes were evaluated according to the shapes, the traveling pathway, the predilection sites and accompanying disorders of the microvascular lesions. RESULTS: The most common shapes of the microvascular lesions were the abrupt developed type and the multiple dilated type. The longitudinal type was the most common traveling type. The superolateral surface of the vocal folds was the predilection site of the microvascular lesions. Functional voice disorders, such as laryngeal nodule, laryngeal polyp, laryngeal edema, were more common as accompanying disorders. CONCLUSION: Authors found that there were a variety of types of microvascular lesions.
Subject(s)
Humans , Blood Vessels , Dysphonia , Hoarseness , Laryngeal Edema , Microcirculation , Polyps , Retrospective Studies , Varicose Veins , Videotape Recording , Vocal Cords , Voice DisordersABSTRACT
Interdigitating reticulum cell sarcoma is a neoplasm that shows differentiation similar to that of non-neoplastic interdigitating reticulum cells, which normally reside in the paracortical region of the lymph node. Interdigitating reticulum cell sarcoma is extremely rare and its definite identification requires a multiparameter study, including microscopic, enzymatic histochemical, immunophenotypic and molecular findings of the tumor cells. We report a case of interdigitating reticulum cell sarcoma in the right upper jugulodigastric lymph node of a 42-year-old male. The patient wad initially diagnosed as metastatic undifferentiated carcinoma, so we tried to find primary site but failed. The patient was treated by radiation therapy under the diagnosis of metastatic neck node. Two years later, the patient was finally diagnosed to interdigitating reticulum cell sarcoma by pathological review and immunohistochemical studies. The patient has been alive well at 55 month of follow-up.
Subject(s)
Adult , Humans , Male , Carcinoma , Diagnosis , Follow-Up Studies , Lymph Nodes , Lymphoma, Non-Hodgkin , Neck , ReticulumABSTRACT
BACKGROUND: The nasal mucosa is degenerated by inflammations, physical stimulations such as cessation of air flow, and other chemical stimulations. And it is regenerated regularly by newly differentiated cells. OBJECTIVES: In order to investigate the morphologic changes of the nasal mucosa and regenerating activities in sinusitis. MATERIALS AND METHODS: The authors made animal models of acute maxillary sinusitis by obstructing the natural ostium of maxillary sinus of rabbit and inoculating Staphylococcus aureus colonies. Each contralateral side was used as control. The rabbits were sacrificed after 1, 2, and 3 weeks. Morphologic changes of the nasal mucosa and regenerating activities of the olfactory mucosa were observed with Hematoxylin-eosin staining and immunohistochemistry using BrdU. RESULTS: Purulent sinusitis was developed in all rabbits. Light microscopy showed that nasal mucosa revealed inflammatory changes such as edema, inflammatory cell infiltration, goblet cell metaplasia, polypoid change, epithelial ulceration, and submucosal connective tissue proliferation. BrdU-labelled cells were observed mainly in the basal cell layer of the olfactory mucosa, and their numbers in the control sides were significantly higher than in the experimental sides. CONCLUSION: These results indicate that acute infection of the maxillary sinus induces inflammatory changes of both respiratory and olfactory mucosa of the nose and decreases the regenerating activity of olfactory mucosa.
Subject(s)
Rabbits , Bromodeoxyuridine , Connective Tissue , Edema , Goblet Cells , Immunohistochemistry , Inflammation , Maxillary Sinus , Maxillary Sinusitis , Metaplasia , Microscopy , Models, Animal , Nasal Mucosa , Nose , Olfactory Mucosa , Physical Stimulation , Sinusitis , Staphylococcus aureus , Stimulation, Chemical , UlcerABSTRACT
No abstract available.