Primary laryngeal aspergillosis in a postpartum patient

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To present a rare case of primary laryngeal aspergillosis manifesting with hoarseness in a seemingly healthy, immunocompetent, postpartum patient and discuss the probable contributing factors leading to this unusual disease process.</p> <p style="text-align: justify;"><strong>METHODS</strong><br /><strong>Design:</strong> Case Report<br /><br /><strong>Setting:</strong> Tertiary Private University Hospital<br /><br /><strong>Subjects:</strong>  One<br /><br /><strong>RESULTS:</strong> A 28-year-old previously healthy postpartum woman presented with hoarseness of a few weeks duration and recent intake of antibiotics and steroids. Videolaryngoscopy revealed a creamy, exophytic mass overlying both vocal folds. Microscopic examination revealed septated, dichotomously branching hyphae with acute angles characteristic of Aspergillus sp. The patient recovered with anti fungal medications.<br /><br /><strong>CONCLUSION:</strong> The clinical presentation of laryngeal aspergillosis can be very non-specific and should not be disregarded merely on the basis of immune competence. It should be considered, together with other host and environmental factors when a patient responds poorly to conventional treatment. There is a need for quick and accurate diagnosis as the disease responds quite rapidly with appropriate anti fungal medications.</p>

Endoscopic myringotomy and ventilation tube placement: A valuable otolaryngologic procedure under topical anesthesia

@#Dear Editor: Time has proven that endoscopy is generally a safe and effective tool in the diagnosis and treatment of various conditions. It offers superior visualization with markedly decreased morbidity and mortality. In Otolaryngology, otoendoscopy has been gaining acceptance in providing improved otoscopic visualization and video recording of the tympanic membrane. We describe a technique of myringotomy and ventilation tube insertion under endoscopic visualization using a rigid Hopkins rod scope previously described by other authors based on their accepted clinical guidelines for myringotomy. 1,2 The use of rigid endoscopes provides visualization of the entire tympanic membrane with excellent resolution, better fidelity of color with a well-angled or side-to-side vision. The procedure is generally safe, convenient and can be performed in an out-patient setting. Correspondingly, the video recordings could improve disease documentation for baseline and post-myringotomy evaluation. They can also be a tool to enable better understanding for patients.