Ancient schwannoma of the parapharynx causing dysphagia: a rare entity.

A schwannoma is a benign, encapsulated tumour that is derived from neural sheath (Schwann) cells. Approximately 25-40% of schwannomas occur in the head and neck. The most common site is the parapharyngeal space of the neck; oropharyngeal occurrence is extremely rare. Among the various histological types of schwannomas reported to date, the ancient (degenerative) variant is the most rare. To our knowledge, this is the first report of an ancient schwannoma in the parapharynx with an extensive oropharyngeal component causing dysphagia. Dysphagia was the prominent symptom because of the location and volume of the lesion. The tumour was excised via a transcervical approach.

Acoustic analysis of tracheo-oesophageal voice in male total laryngectomy patients.

INTRODUCTION: The aim of this study was to test the null hypothesis that voice parameters of post-laryngectomy patients using tracheo-oesophageal (TO) prosthetic valves are similar to those of normal laryngeal subjects. METHODS: Thirty total laryngectomy patients and thirty normal controls were subjected to acoustic analysis of single voice recordings using a sustained vowel. Acoustic parameters including fundamental frequency, jitter, shimmer, harmonics-to-noise ratio and maximum phonation time were analysed. RESULTS: Poorer values were found as well as larger variability for all the voice parameters for the total laryngectomy patients using TO voice compared with those of normal subjects. There were statistically significant differences (p<0.05) for all studied parameters between the TO and normal speech. CONCLUSIONS: Alaryngeal speech with TO voice prosthesis is not yet comparable to laryngeal speech.

Perspectives on quality of life following total laryngectomy.

Quality of life (QOL) considerations are uniquely important in head and neck oncology outcomes research due to the multidimensional impact of these tumors and their treatment. The impact of a head and neck cancer diagnosis on the person and the consequences of its treatment cross multiple functional domains that have a clear and direct influence on one's post-treatment well-being and associated QOL. Total laryngectomy can result in significant alterations in the physical, psychological, social, and emotional domains with an ultimate influence on the individual's judgment of his or her own QOL. Loss of voice, altered swallowing and a permanent tracheostoma, together with the uncertainty of cure, have a profound effect on the patient's physical and psychological rehabilitation. The evaluation of QOL and performance outcome in laryngectomees remains critical to optimal patient care, comprehensive evaluation of treatment alternatives, and the development of informed rehabilitative services and patient education.