[Obese woman presenting as vocal cord abductor paralysis and floppy arytenoid associated with early signs of multiple system atrophy].

In multiple system atrophy (MSA), sleep-related breathing disorders are commonly observed, including vocal cord abductor paralysis (VCAP), which can cause sudden death. In its early stage, VCAP occurs only during sleep, but as the disease progresses, it appears when both awake and asleep. We encountered a 59-year-old obese woman who had been under continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea syndrome (OSAS) for approximately one year but later developed acute respiratory failure because of VCAP. VCAP was the predominant finding that led to the diagnosis of MSA in our patient. On laryngoscopic examination, the movement of the patient's larynx was normal during wakefulness, but VCAP, paradoxical movements of the vocal cord and a floppy arytenoid were observed during drug-induced sleep. We suggest that detection of VCAP and laryngopharyngeal abnormalities such as floppy arytenoid in the early stage of MSA is important for determining treatment options.

Síndrome de Eagle: relatos de caso

Introdução: O processo estilóide do osso temporal é uma projeção óssea que corresponde à origem dos músculos estilo-faríngeo, estilo-hiódeo e estiloglosso. A síndrome de Eagle se caracteriza pela presença de sintomas, como otalgia, disfagia, odinofagia e dor facial, associados ao aumento do processo estilóide maior que 30 mm. Objetivo: Apresentar três casos clínicos de pacientes com diagnóstico de síndrome de Eagle e discutir a apresentação clínica e o tratamento desta doença. Conclusão: O tratamento cirúrgico com ressecção de parte do processo estilóide está relacionado à remissão dos sintomas nos pacientes com diagnóstico de síndrome de Eagle. A abordagem a partir de cervicotomia alta determina boas condições de exposição do processo estilóide, com ressecção mais ampla e preservação de estruturas vasculonervosas.

Distúrbios do fechamento velofaríngeo e alteraçöes laríngeas / Disorders of the velopharyngeal and laryngeal dysfunction

This article shows evidences that laryngeal and respiratory compensations due to poor velopharyngeal closure can develop vocal symptoms

Cleft larynx: management and one-stage surgical repair by anterior translaryngotracheal approach in two children.

Cleft larynx is a rare congenital anomaly which is now being reported with increasing frequency. It is characterized by a midline posterior defect. Two children underwent laryngeal cleft repair by an anterior translaryngeal approach. Tracheotomy was avoided and closure of the anterior laryngofissure was carried out over the nasotracheal tube. The patients were cared for in a pediatric intensive care unit until extubation. Extubation was performed on day 8. The older child had few functional problems and did well whereas the younger child did poorly. In this latter case, the initially successful surgical result was impaired by post-operative aspiration, due to numerous possible factors: gastroesophageal reflux secondarily controlled by Nissen fundoplication, disturbed swallowing as a result more of the cleft repair work than of the surgical approach, or else immaturity of the suction-swallowing reflex.

Congenital laryngeal anomalies associated with tracheal agenesis.

Forty-eight cases of tracheal agenesis have been reported to date. Previous authors have studied gross postmortem laryngeal specimens. Of 37 cases wherein laryngeal findings were mentioned, only 14 were reported to be abnormal. This report details two more cases of tracheal agenesis and includes a detailed histopathologic study of the laryngeal anomalies by serial horizontal section. Although one of these specimens appeared normal at autopsy, both were found to have several abnormalities when studied microscopically in horizontal section. Both have an elliptical cricoid cartilage, an abnormality originally discovered by one of us (G.F.T.) using the same technique.