Search

Alveolar soft part sarcoma (ASPS) is a rare malignant neoplasm that tends to occur in the deep soft tissues of both adults and children. ASPS has a progressive clinical course that is unfortunately characterised by late metastases and an overall poor prognosis. Although the tumour has been reported in a wide range of anatomic sites, few cases of primary laryngeal ASPS are reported in the literature. Here, we report the case of a 24-year-old man with no significant medical history who presented with progressive mild dysphonia and hoarseness. Imaging studies revealed a well-circumscribed, partially cystic submucosal mass with involvement of the right vocal fold and other local structures, and the patient was referred for surgical excision. Morphological and immunohistochemical examination of the excised lesion revealed ASPS. The findings of this case are compared with those of seven additional cases of primary laryngeal ASPS, which were found following literature review.

El presente artículo presenta la evaluación y rehabilitación vocal en un caso de parálisis laríngea unilateral; se comparan parámetros vocales objetivos pre y postratamiento y se aplican estrategias y actividades de intervención, basadas en los principios de aprendizaje sensoriomotor. Método: Paciente masculino de 69 años con diagnóstico de parálisis de pliegue vocal derecho en posición paramediana. Se realiza evaluación pre y post rehabilitación vocal, incluyendo parámetros objetivos a nivel acústico, electroglotografíco, videoestroboscopico. El plan de tratamiento incluyó 5 sesiones de intervención. Resultados: cambios objetivos en tiempo máximo de fonación, cualidades acústicas de la voz, parámetros acústicos (de frecuencia, perturbación, relación armónico- ruido y características espectrales a largo plazo), grado de aducción de los pliegues vocales y competencia glótica. Adherencia del tratamiento a los contextos reales de desempeño del paciente, permitiéndole un habla espontánea con audibilidad, naturalidad e inteligibilidad; interacciones comunicativas efectivas con familia, amigos y compañeros de trabajo. Conclusión: La parálisis de pliegue vocal unilateral es una deficiencia donde el tratamiento terapéutico se convierte en el principal recurso para fortalecer la calidad de vida del paciente con este diagnóstico; los principios de aprendizaje sensorio-motor fueron un aspecto esencial para los cambios reportados en la voz del paciente

OBJECTIVES The primary objective was to investigate the left-right vocal fold symmetry in rheological and histological properties using a rabbit model. The other objective was to develop statistical models for the comparison of rheological properties between paired vocal folds. METHODS Viscoelastic shear properties of six pairs of vocal fold lamina propria specimens were measured over a frequency range of 1 to 250 Hz by a linear, controlled-strain, simple-shear rheometer. The rheological data of the left and right vocal folds was statistically compared using the mixed-effects model approach. Six additional rabbit larynges were histologically analyzed for left-right symmetry in distribution patterns and relative densities of major extracellular matrix constituents. RESULTS There were no significant differences in elastic shear modulus (P = 0.1069) and dynamic viscosity (P = 0.944) of the lamina propria between the two vocal folds of the same larynx. Left-right vocal fold symmetry in densities and distribution patterns of the key molecular constituents was also demonstrated in histological results. CONCLUSION By showing that the left and right vocal folds were rheologically and histologically symmetrical in rabbit, this study validated an underlying assumption made in many previous reports. Statistical models for the analysis of hierarchically correlated left-right vocal fold rheological data were also presented. LEVEL OF EVIDENCE NA. Laryngoscope, 128:E359-E364, 2018.

In the structure of oncological morbidity of the upper respiratory tract, malignant tumors of the larynx, including tumors of mesenchymal origin, are the most common. From 1959 to 2013, 55 cases of laryngeal leiomyosarcoma were described in scientific literature. Rarity of this localization of the tumor was the reason for publication of a clinical observation of a patient with endophytic tumor of the right vocal fold. Differential diagnosis for myofibro-, fibro-, and leiomyosarcoma was conducted. Based on immunohistological examination, well-differentiated laryngeal leiomyosarcoma was diagnosed.

Background: Laryngeal mask airway (LMA) insertion contributes to airway protection in patients with a laryngeal tumor around the glottis. There has been no report of LMA insertion itself exacerbating airway obstruction in such patients. Case presentation: A 62-year-old male underwent elective surgical resection of a large laryngeal polyp. The polyp was attached to the right vocal fold and synchronously swung inward into the trachea and outward to the larynx with inspiration and expiration, respectively. Although manual positive pressure ventilation was easily achieved without any airway obstruction after anesthetic induction, the airway was completely obstructed by the polyp lodged between the vocal cords immediately after LMA insertion. Soon after removal of the LMA, patency of the airway was dramatically improved. Conclusion: Our experience indicates that we should pay attention to airway obstruction due to lodging of the polyp between the vocal cords after LMA insertion in patients with a laryngeal polyp., Article, JA CLINICAL REPORTS.4:43(2018)

BACKGROUND Vocal fold injury results in severe voice alteration that limits occupational function and social interaction. An ovine model of laryngeal injury has been developed, validated and utilized to examine laryngeal wound healing and the effect of a novel collagen inhibitor (halofuginone) on surgical wound healing. The study design includes basic research and animal model. METHODS An ovine laryngeal model was utilized to study controlled vocal fold injury and healing. Twenty-five sheep were divided into five groups. Sheep underwent right vocal fold injury preceded or followed by administration of halofuginone orally, topically or intralesionally. Biopsies were taken at commencement, 1 month and larynges explanted at 3 months. Specimens were examined for elastin and collagen density and epithelial changes. Pearson correlation statistics and Student's t-tests were used to assess inter-relationships. RESULTS All sheep tolerated halofuginone. One sheep death occurred in an untreated sheep. Vocal fold tissue demonstrated a predictable histological response to injury. Elastin was significantly reduced post-injury in the glottis. Halofuginone administered orally for 10 weeks prevented elastin loss and demonstrated a trend of reducing collagen density post-injury. CONCLUSION In an ovine laryngeal injury model, administration of a fibrosis inhibitor resulted in altered elastin and collagen deposition after injury in the glottis. Further investigation is warranted to examine whether these tissue changes affect vocal fold dynamics.

Summary Objectives A single case study is reported of a child who underwent several surgical procedures as result of congenital grade III subglottic stenosis. The anterior aspect of the right vocal cord was damaged and underwent atrophy during one of these procedures. Now, an active 10-year-old, the patient has become increasingly aware of his vocal limitations on functional activities. Injection of hyaluronic acid into the vocal folds has been known to provide improved voice quality in adults although there are no known cases reported of this procedure in children. Methods This article reports voice outcomes after injection of hyaluronic acid into the Reinke's space in a single case study. Voice recordings were made before, after, and 1 month after injection. The voice recordings were subject to acoustic and perceptual analysis. Results Post and follow-up voice recordings demonstrate decreased jitter, shimmer, and harmonics-to-noise ratio. Perceptual evaluation indicates improved voice quality. Conclusion Injection of hyaluronic acid in children who require voice augmentation is possible and may contribute to increased vocal function and improved voice outcomes.