Extended Neuralgic Amyotrophy Syndrome: voice therapy in one case of vocal fold paralysis / Amiotrofia Nevrálgica Estendida: fonoterapia em um caso de paralisia de prega vocal

Neuralgic Amyotrophy (NA) is a rare disturb of the peripheral nervous system that can include extreme pain, multifocal paresis and atrophy of the muscles of the upper limbs. When the nerves located outside of the brachial plexus are involved, the term Neuralgic Amyotrophy Extended (ANE) is used. Diagnosis of NA is clinical and has a series of inclusion and compatibility criteria established by the European CMT Consortium. On this study the clinical history, multidimensional vocal assessment data and the vocal techniques used in five-weeks voice therapy for one patient, professional voice, with ANE are presented. In this case, sudden and recurrent paralysis of his right vocal fold was the only manifestation of the disease. At the end of the fifth week the patient's voice was normal, the spoken and sung vocal ranges were same as before the current episode of ANE and scores of his vocal self-assessment were appropriate.

A Amiotrofia Nevrálgica (AN) é um distúrbio raro do sistema nervoso periférico que pode incluir dor extrema, paresia multifocal e atrofia dos músculos dos membros superiores. Quando há o envolvimento de nervos localizados fora do plexo braquial, o termo Amiotrofia Nevrálgica Estendida (ANE) é utilizado. O diagnóstico da AN é clínico e possui uma série de critérios de inclusão, bem como critérios de compatibilidade estabelecidos pelo European CMT Consortium. Neste estudo são apresentados a história clínica, os dados da avaliação vocal multidimensional e as técnicas vocais utilizadas na terapia vocal de cinco semanas de um paciente, profissional da voz, com ANE. A paralisia súbita e recorrente da prega vocal direita foi a única manifestação da doença. Ao término da quinta semana, a voz do paciente estava adaptada, as extensões de voz falada e cantada eram as mesmas de antes da lesão e os escores de sua autoavaliação vocal estavam adequados.

Adult Rhabdomyoma of the Larynx

Rhabdomyoma is a rare benign tumor derived from skeletal muscles. Laryngeal rhabdomyomas are even rarer, with only approximately 40 reported cases in world literature. Laryngeal rhabdomyomas usually are seen as masses covered by mucosa. They are often solitary asymptomatic tumors, but symptoms such as hoarseness can occur. The radiologic features are usually those typical of benign neoplasms, showing well-delineated borders. The differential diagnoses for laryngeal masses include cysts, laryngoceles, and benign and malignant neoplasms. The diagnosis is usually made using histopathologic findings, but in some cases some difficulties can be found. Immunohistochemical staining is of great value in the differentiation of similar tumors. Treatment of rhabdomyoma is surgical excision. Objective  To describe a case of rhabdomyoma of the larynx attended at Santa Casa de Misericórdia do Rio de Janeiro. Case Report: A 35-year-old man presented with progressive hoarseness in the preceding year. Laryngoscopy showed a large submucosal tumor at the supraglottic region of the larynx. The neck computed tomography scan confirmed the submucosal mass, with distinct borders. The patient was taken to the operating suite, where endoscopic extirpation of the mass was performed. Initial histologic diagnosis was suggestive of paraganglioma, which was not confirmed by studies with immunohistochemical markers, and diagnosis was changed to adult-type rhabdomyoma. The patient recovered well. His voice returned to normal after 3 months. Discussion: Although muscle tumors of the larynx are very rare, rhabdomyoma should be considered when there is a submucosal mass in the larynx...