Laryngeal tuberculosis: A review of 26 cases

Objectives To review the clinical characteristics of laryn-geal tuberculosis. Study Design Retrospective case series. Subjects and Methods Medical records of 26 histopa-thology-confirmed cases in a tertiary medical center from 1992 to 2006. Results The female patients were significantly younger than male patients. Hoarseness is the most common symptom (84.6%) because true vocal fold is most commonly involved (80.8%). Infection usually involves unilateral (66.7%) and right-side larynx but multiple subsites of the larynx (57.7%). The appearance of the affected larynx may have mixed features and change before diagnosis. Laryngeal tuberculosis is usually misdiagnosed as laryngeal cancer, especially in patients with malignant signs such as enlarged cervical lymph nodes and vocal fold immobility. Chest film is better than sputum examinations for screening. Conclusion We should be especially alert about TB infection when facing young female patients with unusual laryngeal lesions. Extensive laser excision before diagnosis should be avoided because after antituberculous treatment, prognosis is usually good and vocal fold immobility could be reversible.

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Candidiasis Causing Vocal Fold Leukoplakia: Review of Clinical and Pathological Results of 289 Cases With Vocal Fold Leukoplakia

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419848792 ◽

2019 ◽

Vol 128 (10) ◽

pp. 903-910 ◽

Cited By ~ 1

Author(s):

Murat Gumussoy ◽

Ulku Kucuk

Keyword(s):

Vocal Fold ◽

Inhaled Corticosteroids ◽

Medical Center ◽

Age Groups ◽

Significant Risk ◽

Case Series ◽

Predisposing Factors ◽

Retrospective Case ◽

Vocal Fold Leukoplakia

Objective: In laryngology practice, vocal fold leukoplakia is frequently evaluated by suspension laryngoscopy and biopsy examination upon the patient’s complaints of hoarseness and dysphonia. The purpose of the present study is to investigate and analyze risk factors, diagnosis, treatment, and follow-up results of cases with Candida leukoplakia. Study Design: Retrospective case control study. Setting: Tertiary medical center. Subjects and Methods: Patients with a diagnosis of vocal fold leukoplakia who underwent direct laryngoscopy and biopsy between 2007 and 2017 and diagnosed as candida or noncandida in their histopathology were assigned into 2 groups. Then they were compared in terms of their demographic characteristics, predisposing factors, diagnosis, treatment, and follow-up results. Results: Of the 289 vocal fold leukoplakia cases, 36 were candida, and 253 were noncandida. The mean age of the patients with Candida leukoplakia was 60.86 years. As for the age groups, the largest group (26.1%) was in the seventh decade ( P < .001). The use of inhaled corticosteroids was a significant risk factor ( P < .001). For their medical therapy, the patients were administered fluconazole 200 mg per day for 3 weeks, and the treatment yielded successful results in 91.66% of them. In 5 of the patients, candida leukoplakia and superficial epithelial dysplasia were observed, and no malignant transformation was observed during a mean follow-up of 28 ± 13 months. Conclusion: Candidiasis causing vocal fold leukoplakia is rare, and we report the findings of the largest published case series to date. Eliminating predisposing factors and administrating oral fluconazole 200 mg for 3 weeks are sufficient for medical treatment.

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Demographic Profile and Risk Factors of Patients with Benign Vocal Fold Lesions Diagnosed through Laryngeal Videoendoscopy and Stroboscopy

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v32i1.179 ◽

2017 ◽

Vol 32 (1) ◽

pp. 27-29

Author(s):

Tracy Camille P. Chan ◽

Ma. Clarissa S. Fortuna ◽

Patric S. Enriquez

Keyword(s):

Risk Factors ◽

Vocal Cord ◽

Associated Factors ◽

Vocal Fold ◽

Case Series ◽

Caffeine Intake ◽

Sample Population ◽

Common Symptom ◽

Retrospective Case ◽

Benign Vocal Fold Lesions

Objective: To determine the prevalence of benign vocal cord lesions among Filipino patients in a tertiary institution and identify the demographic characteristics and possible risk factors found among these patients. Methods Study Design: Retrospective case series Setting: Private tertiary hospital Subjects: Records of 2,375 patients who underwent laryngeal video endoscopy and stroboscopy from 2012-2014 were reviewed. Results: There were 632 records of patients with benign vocal fold lesions, of which nodules were most common (211, 33.38%), followed by Reinke’s edema (165, 26.10%), cysts (122, 19.30%), and polyps (74, 11.70%), with hoarseness as the most common symptom (542, 85.76%). More than half (336, 53.16%) were aged 21-40 years, and almost two-thirds (469, 74.21%) were female. The most common associated factors were caffeine intake (445, 70.41%) and inadequate water intake (370, 58.54%), followed by alcohol (253, 40.03%). Smoking was only present in 146 (23.19%). Conclusion: Baseline evidence on the prevalence of benign vocal fold lesions in this institution as well as baseline data on the common characteristics and associated factors seen in the sample population may assist us in current practices and guide future studies directed toward treatment and prevention. Keywords: Vocal Cord; Stroboscopy; Vocal Cord Nodules; Benign Vocal Cord; Stroboscopy/Benign; Stroboscopy/Nodules

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Laser arytenoidectomy in children with bilateral vocal fold immobility

The Journal of Laryngology & Otology ◽

10.1017/s0022215106001794 ◽

2006 ◽

Vol 121 (1) ◽

pp. 25-27 ◽

Cited By ~ 11

Author(s):

G Worley ◽

Y Bajaj ◽

L Cavalli ◽

B Hartley

Keyword(s):

Vocal Fold ◽

Voice Quality ◽

Case Series ◽

Challenging Problem ◽

Retrospective Case ◽

Voice Outcome ◽

Vocal Fold Immobility ◽

The Voice ◽

Bilateral Vocal Fold Immobility ◽

Better Than

Bilateral vocal fold immobility in children is a challenging problem because a balance between good airway and voice quality has to be achieved. Surgery to improve the airway is often postponed or avoided because of fear of losing the voice. In this study our results of laser arytenoidectomy in children are described. This was a retrospective case notes review at a tertiary level paediatric ENT department. The six patients in this case series ranged from nine to 16 years old at the time of laser arytenoidectomy. Post-operative airway and voice quality were assessed. All children in the series had an adequate post-operative airway. Four of these patients had tracheostomies pre-operatively and achieved decannulation. All six patients rated their post-operative voice as better than pre-operatively. This is principally due to increased loudness associated with increased airflow through the larynx, particularly after tracheostomy decannulation. It is recommended that special care should be taken not to disturb the anterior two thirds of the vocal fold during the surgery in order to achieve a good post-operative voice outcome.

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Characteristics and Outcomes Among Hospitalized COVID-19-Positive Patients in a Nonurban Environment

Military Medicine ◽

10.1093/milmed/usab044 ◽

2021 ◽

Author(s):

Robert P Lennon ◽

Theodore J Demetriou ◽

M Fahad Khalid ◽

Lauren Jodi Van Scoy ◽

Erin L Miller ◽

...

Keyword(s):

New York ◽

Medical Center ◽

Academic Medical Center ◽

Military Medicine ◽

Case Series ◽

Outcome Data ◽

Urban Environments ◽

Urban Setting ◽

Published Data ◽

Retrospective Case

ABSTRACT Introduction Virtually all hospitalized coronavirus disease-2019 (COVID-19) outcome data come from urban environments. The extent to which these findings are generalizable to other settings is unknown. Coronavirus disease-2019 data from large, urban settings may be particularly difficult to apply in military medicine, where practice environments are often semi-urban, rural, or austere. The purpose of this study is compare presenting characteristics and outcomes of U.S. patients with COVID-19 in a nonurban setting to similar patients in an urban setting. Materials and Methods This is a retrospective case series of adults with laboratory-confirmed COVID-19 infection who were admitted to Hershey Medical Center (HMC), a 548-bed tertiary academic medical center in central Pennsylvania serving semi-urban and rural populations, from March 23, 2020, to April 20, 2020 (the first month of COVID-19 admissions at HMC). Patients and outcomes of this cohort were compared to published data on a cohort of similar patients from the New York City (NYC) area. Results The cohorts had similar age, gender, comorbidities, need for intensive care or mechanical ventilation, and most vital sign and laboratory studies. The NYC’s cohort had shorter hospital stays (4.1 versus 7.2 days, P < .001) but more African American patients (23% versus 12%, P = .02) and higher prevalence of abnormal alanine (>60U/L; 39.0% versus 5.9%, P < .001) and aspartate (>40U/L; 58.4% versus 42.4%, P = .012) aminotransferase, oxygen saturation <90% (20.4% versus 7.2%, P = .004), and mortality (21% versus 1.4%, P < .001). Conclusions Hospitalists in nonurban environments would be prudent to use caution when considering the generalizability of results from dissimilar regions. Further investigation is needed to explore the possibility of reproducible causative systemic elements that may help improve COVID-19-related outcomes. Broader reports of these relationships across many settings will offer military medical planners greater ability to consider outcomes most relevant to their unique settings when considering COVID-19 planning.

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The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a retrospective case-series analysis

Libyan Journal of Medicine ◽

10.3402/ljm.v6i0.6283 ◽

2011 ◽

Vol 6 (1) ◽

pp. 6283 ◽

Cited By ~ 4

Author(s):

Abdulbaset Elghuel

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Medical Center ◽

Case Series ◽

Retrospective Case ◽

Series Analysis ◽

Retrospective Case Series ◽

Upper Gastrointestinal

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Outcomes in Bilateral Vocal Fold Immobility: A Retrospective Cohort Analysis

Otolaryngology ◽

10.1177/0194599818800462 ◽

2018 ◽

Vol 159 (6) ◽

pp. 1020-1027 ◽

Cited By ~ 4

Author(s):

Shekhar K. Gadkaree ◽

Alexander Gelbard ◽

Simon R. Best ◽

Lee M. Akst ◽

Martin Brodsky ◽

...

Keyword(s):

Risk Factor ◽

Retrospective Cohort ◽

Vocal Fold ◽

Medical Center ◽

Cohort Analysis ◽

Multiple Logistic Regression Analysis ◽

Case Series ◽

Patient Specific ◽

Bilateral Vocal Fold Paralysis

Objective To test the hypothesis that the etiologies of bilateral vocal fold mobility impairment (BLVFI), bilateral vocal fold paralysis (BVFP), and posterior glottis stenosis (PGS) have distinct clinical outcomes. To identify patient-specific and procedural factors that influence tracheostomy-free survival. Study Design Retrospective cohort study. Setting Johns Hopkins Medical Center from 2004 to 2015. Subjects and Methods Case series with chart review of 68 patients with PGS and 17 patients with BVFP. Multiple logistic regression analysis determined factors associated with airway prosthesis dependence at last follow-up and the procedural burden (defined as number of operative procedures per year). Results PGS comprised the majority of BLVFI (76%). PGS injury arose primarily after endotracheal intubation (91%), while BVFP most commonly was due to iatrogenic surgical injury to bilateral recurrent laryngeal nerves (88%, P < .001). Overall in BLVFI, 66% were tracheostomy free at last follow-up (62% in PGS, 82% in BVFP). Of those who underwent an operative intervention to be decannulated, 88% were decannulated (90% PGS, 80% BVFP). Patients with PGS required higher procedural burden to achieve decannulation compared with the BVFP cohort (3.1 ± 5.2 vs 0.71 ± 1.4, P = .002). In multivariate analysis of PGS, smoking was a risk factor for tracheostomy dependence ( P = .026). Conclusions BLVFI is primarily an iatrogenic complication. There are high rates of tracheostomy dependence in BLVFI, with procedural intervention needed for decannulation. Compared with BVFP, patients with PGS had a higher procedural burden overall and to achieve decannulation. Patients with PGS should be counseled that smoking, a modifiable risk factor, may increase the risk of tracheostomy dependence.

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NEAR FATAL AMITRAZ: A NOT SO UNCOMMON POISONING

10.36106/gjra/5601517 ◽

2021 ◽

pp. 42-43

Author(s):

Rohan J Desai ◽

Prasad Ugargol

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Clinical Features ◽

Case Series ◽

Agricultural Product ◽

Common Symptom ◽

Retrospective Case ◽

Case Series Study ◽

Cns Depression ◽

Series Study

Background: Amitraz is a pharmaceutical, veterinary, and agricultural product which is used worldwide to control ectoparasites in animals. Its widespread use has led to increased cases of poisoning in rural parts of India. Aim: To study the clinical features, complications, laboratory abnormalities and outcome of the patients with acute amitraz intoxication. Methodology: The study is a retrospective case series study conducted in HSK hospital between the period of Feb 2019 and May 2020. Results: A total of 11 patients were analysed and results revealed CNS depression and vomiting in 8 of those patients with 1 patient with respiratory failure requiring mechanical ventilation. Conclusion: Amitraz poisoning appears to be severe with CNS depression being the most common symptom. But most patients stabilise and recover quickly. Patients should be monitored for respiratory failure as it is a dreadful complication. Treatment is symptomatic as no antidote is available.

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Risk factors for corneal epithelial wound healing: Can sex play a role?

European Journal of Ophthalmology ◽

10.1177/11206721211066705 ◽

2021 ◽

pp. 112067212110667

Author(s):

Giulia Coco ◽

Kevin J. Hamill ◽

Lee D. Troughton ◽

Stephen B. Kaye ◽

Vito Romano

Keyword(s):

Risk Factors ◽

Wound Healing ◽

Treatment Strategies ◽

Case Series ◽

Healing Time ◽

Retrospective Case ◽

Corneal Epithelial ◽

Female Patients ◽

Epithelial Wound Healing ◽

Wound Healing Time

Purpose To determine if sex is associated with corneal epithelial wound healing time in patients with persistent corneal epithelial defects (PCEDs). Methods Retrospective case series on patients with PCED from November 2014 to January 2019. Records of 127 patients with diagnosis of PCED were reviewed. Patients with an epithelial defect that lasted more than two weeks in the absence of an active corneal infection were included. Main outcome was corneal epithelial wound healing time. Results 55 patients (29 males) with a mean age of 65.3 ± 16.5 years were included. No difference was found between female and male patients in terms of risk factors, age, treatment strategies or intervals between visits (median of 15 days in females and 12 days in males; p = 0.24). Median duration of the PCED was 51 days (IQR 32-130), with a median number of 5 clinical visits (IQR 4-8). Female patients had significantly longer healing times (p = 0.004) and a corresponding increase in the number of clinical visits (median of 7 visits vs. 5 clinical visits in males, p = 0.012). Conclusion Results from this study suggest female patients with PCED might have a longer corneal epithelial wound healing duration and may therefore require earlier intervention.

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P108 TEDUGLUTIDE USE IN CROHN’S DISEASE: A CASE SERIES

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.053 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S23-S23

Author(s):

Adeeti Chiplunker ◽

Christina Ha ◽

Shirley Paski

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Median Duration ◽

Dose Adjustment ◽

Medical Center ◽

Case Series ◽

Dose Interval ◽

Retrospective Case ◽

Inflammatory Bowel

Abstract Background Teduglutide is a glucagon-like peptide-2 (GLP-2) analogue with trophic effects on the intestinal mucosa to increase the absorptive surface area and enhance nutrient and fluid absorption of the small bowel (SB).1 It has been shown to reduce parenteral nutrition (PN) and intravenous fluid (IVF) requirements and is an important adjunct in the medical management of short bowel syndrome (SBS).1–2 Crohn’s disease (CD) is an important etiology of SBS but use of teduglutide in this population can be challenging. Aim The aim of this case series was to describe the use of teduglutide in CD patients. Methods A retrospective case series of all CD patients with SBS who used teduglutide at the Inflammatory Bowel Disease Center at Cedars-Sinai Medical Center. Age, duration of SBS, length of remaining SB and colonic continuity status were recorded. BMI, average daily PN kilocalories (kcal), and IVF requirements were recorded at the time of teduglutide initiation. The duration of teduglutide use was calculated. Teduglutide dose, dose adjustment history, reason for dose adjustment, and therapy complications were noted. Results 9 patients were included (5 male/4 female). Median age was 57 years (IQR 32). Median length of remaining small bowel was 60cm (IQR 27.5) and median duration of SBS was 8 years (IQR 9.83). Median BMI at teduglutide initiation was 18.66 (IQR 4.29) with a median duration of PN of 4.5 years (IQR 9.42) and median PN kcal/day of 971.43 (IQR 518). The median duration of teduglutide was 1.1 years (IQR 3.4). 4 patients (44%) had a teduglutide dose change. 2 patients had dose interval extended from daily to every other day to reduce injection burden. 1 patient developed obstructive symptoms on daily dosing, which resolved when the dose interval was extended to every other day. 1 patient had to stop therapy due to a small bowel obstruction requiring hospitalization. 8 patients (88%) were able to wean or stop PN/IVF with addition of teduglutide. 1 patient had to restart PN despite teduglutide therapy. Table 1. Discussion Teduglutide is effective in Crohn’s disease patients and facilitates weaning of PN and IVF requirements. Most patients tolerate the recommended dose with daily injections, but the dose interval can be extended to every other day to reduce obstructive symptoms or reduce the injection burden without affecting ability to wean PN/IVF. References

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