Left mixed laryngocele in absence of risk factors: A case report and review of literature.

Laryngocele is an uncommon benign cystic dilatation of the laryngeal saccule that communicates with the laryngeal lumen and contains air. On the basis of its localization, it can be traditionally classified in internal, external, or mixed. Usually unilateral and rarely bilateral, it may be congenital or acquired. It most often appears later in life without important symptoms except for cervical swelling. Here, together with a review of literature, we report the case of a 72-year-old man, smoker but without other specific risk factors, who presented laryngeal dyspnea for about one year. Neck CT scan performed during a previous hospitalization for respiratory failure revealed a left mixed laryngocele that was later surgically removed with cervicotomic access. The patient was discharged after one week. One month after surgery, we confirmed the absence of disease with video laryngoscopy.

Lateralization of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) with the latency test: a pilot study.

Background: The treatments of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) have low remission rates ranging between 60% and 90%, connected to the difficulty in correctly identifying the affected side of HSC-BPPV. Objective: To propose and compare the efficacy of the latency test (LT) in identifying the affected ear in patients with HSC-BPPV. Materials and methods: Twenty-one subjects diagnosed with HSC-BPPV, as ascertained by head rolling test (HRT), were prospectively identified. Lateralization was assessed with pseudo-spontaneous nystagmus, lying-down nystagmus, bow and lean (BLT), HRT and LT tests. LT is a novel technique involving a 180° movement of the head and the analysis of the time required to reverse the nystagmus. Results: About 57% of patients were diagnosed with geotropic, and 43% with apogeotropic type HSC-BPPV. LT achieved a correct side diagnosis in 86%. Efficacy analysis of the tests compared to HRT revealed a substantial fair level of agreement for lying-down test (κ = 0.32, p < .05), a slight level of agreement for BLT (κ = 0.19, p < .05) and a substantial level of agreement for LT (κ = 0.071, p < .001). Conclusions and significance: LT was proven to show a substantial level of agreement compared to HRT in identifying the affected ear in patients with HSC-BPPV in this pilot study.