ABSTRACT
Voice rehabilitation in the laryngectomy patient has been a major goal of reconstructive laryngeal surgery. A series of ten patients underwent laryngectomy and creation of a phonatory neoglottis as outlined by Staffieri. Speech and swallowing were evaluated postoperatively. Functional speech was achieved in 9 out of 10 patients. Swallowing difficulties did not present a serious problem. Voice production utilizing the neoglottic technique was found to be superior to esophageal speech. From this preliminary series, the phonatory shunt operation of Staffieri appears to offer much potential and deserves further study.
Subject(s)
Larynx, Artificial , Speech Disorders/rehabilitation , Aged , Deglutition , Glottis/surgery , Humans , Laryngectomy , Larynx/diagnostic imaging , Male , Middle Aged , RadiographyABSTRACT
Three related disorders in the same patient, namely bilateral primary intracranial cholesteatomas, an "empty sella" syndrome, and a cerebrospinal rhinorrhea are reported. No previous report of bilateral symmetrical cholesteatomas has been made, though single intracranial cholesteatomas have frequently been recorded in medical literature. The "empty sella" syndrome is generally considered to be from a herniation of the subarachnoid into the sella through a deficient diaphragma sella, and was first defined by Ommaya in 1968. Non-traumatic (spontaneous) rhinorrhea remains an uncommon disease initially described in 1826. Experience of the individual otolaryngologist is limited in this region because of infrequent occurrence and because definitive treatment is directed to other specialties. On the other hand, the ear, nose and throat physician may be the first to interpret a drainage from the nose. With this in mind, the etiologic, clinical and management factors in the present case are discussed.
Subject(s)
Brain Diseases/complications , Cerebrospinal Fluid Rhinorrhea/etiology , Cholesteatoma/complications , Empty Sella Syndrome/complications , Brain Diseases/surgery , Cerebrospinal Fluid Rhinorrhea/surgery , Cholesteatoma/surgery , Empty Sella Syndrome/surgery , Humans , Male , Middle AgedABSTRACT
A neuroendocrine secreting tumor, initially presenting as a laryngeal problem, is reported. Subglottic biopsy, first interpreted as paraganglioma, was finally diagnosed as medullary carcinoma of the thyroid. The complex testing required to arrive at an accurate diagnosis of this uncommon thyroid malignancy is discussed. The sparse occurrence of the neoplasm in the laryngologic field, as well as the necessity for differentiating it from other neuroendocrine tumors, bear consideration.
