Laryngeal schwannoma: a systematic review.

A large proportion of schwannomas are found in the head and neck region. Schwannoma located within the larynx however is uncommon. The characteristic features, clinical presentations, treatment and the outcomes of patients with laryngeal schwannoma are therefore not clearly understood. The aim of this comprehensive review is to compile, analyze and present the details to develop a consensus and augment the available literature on laryngeal schwannoma. A comprehensive literature search on laryngeal schwannoma was performed on PUBMED/MEDLINE, EMBASE, CINAHL and Science Citation Index using MeSH words. A total of 55 patients were reviewed in this study. 40.7 % of the tumours arose from the aryepiglottic fold or arytenoids. Other areas where tumours were found included the false cord, true vocal cord, epiglottis, subglottis, piriform sinus and the post cricoid area. 64.9 % patients presented with dysphonia. Others typically present with multiple symptoms related to the mass effect and location of the tumour. All patients were managed surgically with different techniques and approaches. Majority of patients were alive with no residual disease. There were five recurrences and no mortality to date. Schwannoma within the larynx can present with a variety of symptoms. Surgical excision remained as the treatment of choice with good overall prognosis.

Assessment of upper airway obstruction by measuring peak oral and nasal inspiratory flow.

OBJECTIVE: We wanted to access upper airway obstruction in patients undergoing tonsillectomy by measuring peak oral and nasal inspiratory airflow. METHODS: We recruited study participants from a cohort of patients on the waiting list for tonsillectomy, with or without adenoidectomy, at University Hospital of Wales, Cardiff, UK. Fifty patients enrolled on phase I of the study and underwent pre-operative measurement of the rate of peak oral and nasal inspiratory flow; 25 of these patients returned after one month for phase II of the study and underwent post-operative measurement of the rate of both peak oral and nasal inspiratory flow. RESULTS: Of the 25 participants who completed phase II of the study, 17 (68 per cent) showed an increase in post-operative peak oral inspiratory flow rate by an average of 45 per cent, while 18 (72 per cent) showed an increase in post-operative peak nasal inspiratory flow rate by an average of 22 per cent. CONCLUSION: Both peak oral and nasal inspiratory flow rate measurements may be useful measures of oral and nasal obstruction. Further larger studies are needed to develop these measurements as screening and efficacy measures for adenotonsillectomy to relieve upper airway obstruction.

A review on the mechanism of sore throat in tonsillitis.

BACKGROUND: Sore throat is a common condition associated with acute upper respiratory tract infection, and recurrent episodes of infection may result in chronic tonsillitis. The current UK and USA guidelines for tonsillectomy use the incidence of sore throat episodes as an indication for surgery. However, the mechanism of sore throat is poorly described in the literature. OBJECTIVES: This review will provide basic information for the clinician regarding: the causes, pathophysiology and neurophysiology of sore throat; the mechanism of inflammation; and the role of transient receptor potential ion channels as nociceptors involved in sore throat. The review will present new ideas on the mechanism of ice therapy as an analgesic for post-tonsillectomy pain, and the role of vanilloid and cold receptors.

Case of perilymphatic fistula caused by medially displaced tympanostomy tube.

OBJECTIVE: We present a rare case of perilymphatic fistula which occurred due to bony erosion by a tympanostomy tube that had migrated into and become interred in the middle-ear space. METHOD: We present a case report and a literature review concerning migration of tympanostomy tubes into the middle ear as a complication of tubes insertion. CONCLUSION: Medial migration of tympanostomy tubes into the middle-ear space is a rare complication of tympanostomy tubes insertion. To our knowledge, this is the first report of perilymphatic fistula caused by a tympanostomy tube which had migrated into the middle ear. This case highlights the need for early removal of tympanostomy tubes which migrate into the middle ear.

Chondrosarcoma of larynx: review of literature and clinical experience.

Laryngeal chondrosarcomas are rare, cartilaginous tumours, and around 300 cases have been reported in the literature. They are slow-growing tumours which present difficulties both in diagnosis and treatment. Most patients eventually require radical surgery. However, over the last 10 years, we have diagnosed two cases of laryngeal chondrosarcoma and managed them conservatively by endoscopic debulking and regular follow up. The objective of this article is to highlight the conservative approach in managing these patients, particularly in the presence of co-morbid conditions.