Laryngeal amyloidosis: diagnosis, pathophysiology and management

2017 ◽  
Vol 131 (S2) ◽  
pp. S41-S47 ◽  
Author(s):  
N M Phillips ◽  
E Matthews ◽  
C Altmann ◽  
J Agnew ◽  
H Burns
Keyword(s):  
Carbon Dioxide Laser ◽  
Case Series ◽  
Anatomical Location ◽  
Amyloid Deposits ◽  
Laryngeal Amyloidosis ◽  
Laryngeal Lesions ◽  
Laser Excision ◽  
Endoscopic Microsurgery ◽  
The One ◽  
Benign Laryngeal Lesions

AbstractBackground:Laryngeal amyloidosis represents approximately 1 per cent of all benign laryngeal lesions, and can cause variable symptoms depending on anatomical location and size. Treatment ranges from observation through to endoscopic microsurgery, laser excision and laryngectomy.Objectives:To highlight the diversity of presentations, increase awareness of paediatric amyloidosis and update the reader on current management.Case series:Five cases are illustrated. Four adult patients were female, and the one child, the second youngest in the literature, was male. Amyloid deposits were identified in all laryngeal areas, including the supraglottis, glottis and subglottis. Treatment consisted of balloon dilatation, endoscopic excision, laser cruciate incision, and resection with carbon dioxide laser, a microdebrider and coblation wands.Conclusion:Laryngeal amyloidosis remains a rare and clinically challenging condition. Diagnosis should be considered for unusual appearing submucosal laryngeal lesions. Treatment of this disease needs to be evaluated on a case-by-case basis and managed within an appropriate multidisciplinary team.

scholarly journals Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 105S-112S
Author(s):  
Benjamin John Miller ◽  
Amr Abdelhamid ◽  
Yakubu Karagama
Keyword(s):  
Laser Surgery ◽  
Case Reports ◽  
Case Series ◽  
Primary Outcome Measure ◽  
Blue Laser ◽  
Current Evidence ◽  
Future Research ◽  
Retrospective Case ◽  
Laryngeal Lesions ◽  
Benign Laryngeal Lesions

Background: The recent introduction of 445 nm blue laser to office-based laryngology presents potential advantages. These include a desirable combination of cutting and photoangiolytic qualities and a lightweight, shock-resistant design. Despite its increasing use, current evidence is limited to experimental data and case reports. Objectives: The authors present a case series and overview of office blue laser transnasal flexible laser surgery (TNFLS), considering indications, patient selection, safety, technique, and surgical outcomes. We also review the safety and relevance of TNFLS to the ongoing coronavirus pandemic. Methods: Retrospective case series and narrative review. Our primary outcome measure was preoperative and postoperative Voice Handicap Index (VHI-10) score. Complications were documented by nature and severity. Results: Thirty-six cases of office blue laser TNFLS were performed. A statistically significant improvement in VHI-10 score was demonstrated in cases of recurrent respiratory papillomatosis (RRP) and benign laryngeal lesions causing dysphonia ( P < 0.01 and 0.045). Blue laser also proved effective in assisting office biopsy procedures. A minor and self-limiting complication was reported. Conclusions: Office blue laser TNFLS is safe and effective in the treatment of RRP and a range of benign laryngeal lesions. Future research should compare the efficacy and safety of blue laser with potassium titanyl phosphate laser in office-based treatment of these conditions. Further assessment of the cutting qualities of blue laser, initially in the theater environment, is necessary to refine our understanding of future applications.

Excision of benign larygeal lesions: comparison of carbon dioxide laser with conventional surgery

1987 ◽  
Vol 101 (12) ◽  
pp. 1254-1257 ◽  
Author(s):  
P. M. Robinson ◽  
A. M. Weir
Keyword(s):  
Carbon Dioxide ◽  
Carbon Dioxide Laser ◽  
Voice Quality ◽  
Length Of Hospital Stay ◽  
Conventional Surgery ◽  
Analgesic Requirement ◽  
Significant Difference ◽  
Laser Excision ◽  
Benign Laryngeal Lesions ◽  
Age And Sex

AbstractTwenty-six cases of patients presenting with benign laryngeal lesions treated by laser excision were compared with age and sex matched controls treated by conventional surgery. There was no statistically significant difference post-operatively between the groups in analgesic requirement, length of hospital stay, voice quality or laryngoscopic appearance.

scholarly journals Acute bilateral foot drop with or without cauda equina syndrome—a case series

2021 ◽  
Vol 163 (4) ◽  
pp. 1191-1198
Author(s):  
Andreas K. Demetriades ◽  
Marco Mancuso-Marcello ◽  
Asfand Baig Mirza ◽  
Joseph Frantzias ◽  
David A. Bell ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Case Series ◽  
Foot Drop ◽  
Spinal Disease ◽  
Full Resolution ◽  
Degenerative Spinal Disease ◽  
The Mean ◽  
The One

Abstract Introduction Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded. Methods Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery. Results Seven patients are presented. The mean age at presentation was 52.1 years (range 41–66). All patients but one were male. All had a painful radiculopathic presentation. Relevant discopathy was observed from L2/3 to L5/S1, the commonest level being L3/4. Five were treated within 24 h of presentation, and two within 48 h. Three had concomitant cauda equina syndrome; of these, the first two made a full motor recovery, one by 6 weeks follow-up and the second on the same-day post-op evaluation. Overall, five out of seven cases had full resolution of their ankle dorsiflexion pareses. One patient with 1/5 power has not improved. Another with 1/5 weakness improved to normal on the one side and to 3/5 on the other. Conclusion When bilateral foot drop occurs acutely, we encourage the consideration of degenerative spinal disease. Relevant discopathy was observed from L2/3 to L5/S1; aberrant innervation may be at play. Cauda equina syndrome is not necessarily associated with acute bilateral foot drop. The prognosis seems to be pretty good with respect to recovery of the foot drop, especially if partial at presentation and if treated within 48 h.

Benign Laryngeal Lesions

2022 ◽  
Author(s):  
Jeffrey Straub ◽  
Brandon Kim
Keyword(s):  
Laser Therapy ◽  
Vocal Fold ◽  
Clinical Presentation ◽  
Benign Tumors ◽  
Vocal Hygiene ◽  
Laryngeal Lesions ◽  
Benign Laryngeal Lesions ◽  
Vocal Fold Nodules

Benign laryngeal lesions represent a diverse set of pathologies whose clinical presentation may range from no symptoms to dyspnea and/or dysphonia. Flexible fiberoptic laryngoscopy and videolaryngostroboscopy are important in distinguishingdifferent types of lesions, and management and treatment are dependent on the identification of these lesions, as they have different etiologies. Some lesions such as vocal fold nodules and polyps are primarily phonotraumatic and may benefit fromspeech therapy and vocal hygiene as initial approaches. Vocal fold cysts and benign tumors may benefit from microlaryngeal approaches, while capillary ectasias, polypoid corditis, laryngoceles, saccular cysts, and papilloma may benefit from laser therapy. Vocal fold granulomas may arise from various etiologies such as intubation, traumatic behaviors, or reflux. Polypoid corditis arises from smoking. This review is intended to provide an overview of the variety of lesions that encompass non-malignant laryngeal lesions that is both suitable for junior and senior residents. This review contains 12 figures, 5 tables, and 64 references Keywords: Benign laryngeal lesions, Laryngocele, Polyp, Cyst, Polypoid Corditis, Papilloma

scholarly journals One-Time Cortical Lamina: A New Technique for Horizontal Ridge Augmentation. A Case Series

2021 ◽  
Vol 8 (6) ◽  
pp. 22-30
Author(s):  
Vincenzo Foti ◽  
Davide Savio ◽  
Roberto Rossi
Keyword(s):  
Fibrin Sealant ◽  
Case Series ◽  
X Rays ◽  
Marginal Bone Loss ◽  
Ridge Augmentation ◽  
Keratinized Tissue ◽  
A New Technique ◽  
The One ◽  
Hard Consistency

The aim of this case series is to introduce the One-Time Cortical Lamina Technique, a simplification of the F.I.R.S.T. (Fibrinogen-Induced Regeneration Sealing Technique) in cases where only horizontal augmentation is needed. The indications for this technique are ASA2 and ASA1 anxious patients. Pre-requisites for this surgical technique are: a good amount of keratinized tissue, sufficient alveolar ridge width for placement of implants, thickness of vestibular bone at CBCT planning less than 1 mm with risk of threads exposure. Five patients with horizontal deficiencies were selected to test the efficacy of this approach. The defects were augmented using a porcine cortical bone lamina in combination with collagenated porcine bone mixed with fibrin sealant. The cortical lamina was placed only buccal to the implants and stabilized with fibrin sealant, without pins or screws. Upon completion of the implant surgery, healing abutments were connected to the implants and the soft tissue sutured around them. The healing was uneventful in all cases. Six months after surgery impressions for final restorations were taken and screwed crowns delivered. The new volume had hard consistency and the follow-up CBCT measured an average of 4.17 mm of horizontal bone augmentation. One to three years of follow up demonstrated the maintenance of vestibular volume, hard consistency and clinical stability. Intraoral X-rays showed no marginal bone loss. An advantage of this technique could be the one stage surgery that creates a stable environment for regeneration from day one.

scholarly journals A Study of Management of Benign Lesions of the Larynx

2011 ◽  
Vol 1 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Pankaj Kumar Doloi ◽  
Swagata Khanna
Keyword(s):  
Cost Effective ◽  
Clinical Findings ◽  
Benign Tumors ◽  
Complete Relief ◽  
Vocal Rehabilitation ◽  
Body Sensation ◽  
Laryngeal Lesions ◽  
Endolaryngeal Surgery ◽  
Microlaryngeal Surgery ◽  
Benign Laryngeal Lesions

ABSTRACT A two-year prospective study was conducted from June 2008 to May 2010. A total of 80 patients with benign laryngeal lesions were included in the study based on symptoms, such as hoarseness of voice, foreign body sensation, vocal fatigue, dyspnea and cough and with positive clinical findings on indirect laryngoscopy. Diagnostic and therapeutic laryngoscopic and microlarygoscopic procedures were employed. Vocal cord polyps were observed to be the commonest type of lesions. Out of the 80 patients in the study group, 40% patients got complete relief with voice rest and vocal rehabilitation; 60% patients required surgery, which included endoscopic/microlarygoscopic endolaryngeal surgery and external approaches. There was no recurrence in cases of vocal polyps and nodules during the period of observation. Endolaryngeal surgery and voice rest offer a cost-effective, useful and safe method for the management of benign laryngeal lesions. With the inclusion of lasers, they can be more precisely operated. As such, the standard treatment of choice in all types of benign tumors of the larynx should consist of a triad of approach by microlaryngeal surgery (either microscopic or endoscopic, with or without use of lasers), voice rest and vocal rehabilitation.

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