Hoarseness in an older adult: Ortner syndrome

A detailed examination in an older adult presenting with chronic hoarseness is mandatory to exclude an upper aerodigestive tract malignancy. We describe a 71-year-old chronic smoker with essential hypertension who presented with hoarseness and vocal fatigue for 5 months. Laryngoscopic examination showed left vocal fold paralysis with phonation gap. No growth was seen at all laryngeal and hypopharyngeal subsites. The rest of the head and neck, chest, upper limbs and neurovascular examination were unremarkable. A plain chest radiograph demonstrated a cause for the left recurrent laryngeal nerve palsy. The diagnosis, complications and definitive management of the underlying cause and resultant voice problem will be discussed.

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Regenerative medicine for end-stage fibrosis and tissue loss in the upper aerodigestive tract: a twenty-first century review

The Journal of Laryngology & Otology ◽

10.1017/s002221512100092x ◽

2021 ◽

pp. 1-13

Author(s):

F R Green ◽

N M Shubber ◽

F S Koumpa ◽

N J I Hamilton

Keyword(s):

Salivary Gland ◽

Regenerative Medicine ◽

Vocal Fold ◽

Aerodigestive Tract ◽

First Century ◽

Tissue Loss ◽

Cochrane Library ◽

Upper Aerodigestive Tract ◽

Twenty First Century ◽

End Stage

Abstract Objective This review assesses regenerative medicine of the upper aerodigestive tract during the first two decades of the twenty-first century, focusing on end-stage fibrosis and tissue loss in the upper airways, salivary system, oropharynx and tongue. Method PubMed, Embase, Google Scholar, Cochrane Library, Medline and clinicaltrials.org were searched from 2000 to 2019. The keywords used were: bioengineering, regenerative medicine, tissue engineering, cell therapy, regenerative surgery, upper aerodigestive tract, pharynx, oropharynx, larynx, trachea, vocal cord, tongue and salivary glands. Original studies were subcategorised by anatomical region. Original human reports were further analysed. Articles on periodontology, ear, nose and maxillofacial disorders, and cancer immunotherapy were excluded. Results Of 716 relevant publications, 471 were original studies. There were 18 human studies included, within which 8 reported airway replacements, 5 concerned vocal fold regeneration and 3 concerned salivary gland regeneration. Techniques included cell transplantation, injection of biofactors, bioscaffolding and bioengineered laryngeal structures. Conclusion Moderate experimental success was identified in the restoration of upper airway, vocal fold and salivary gland function. This review suggests that a shift in regenerative medicine research focus is required toward pathology with a higher disease burden.

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The Plain Chest Radiograph

Pulmonary Embolism ◽

10.1002/9780470692042.ch46 ◽

2008 ◽

pp. 216-220

Keyword(s):

Chest Radiograph ◽

Plain Chest Radiograph ◽

Plain Chest

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The Plain Chest Radiograph in the Assessment of Cardiac Disease

Integrating Cardiology for Nuclear Medicine Physicians ◽

10.1007/978-3-540-78674-0_6 ◽

2008 ◽

pp. 65-75

Author(s):

Nicola Mulholland

Keyword(s):

Chest Radiograph ◽

Cardiac Disease ◽

Plain Chest Radiograph ◽

Plain Chest

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Neurosarcoidosis Directly Involving the Cervical Vagus Nerve

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420942546 ◽

2020 ◽

pp. 000348942094254

Author(s):

Jason R. Crossley ◽

Nathan Aminpour ◽

Jonathan P. Giurintano ◽

Ann K. Jay ◽

Brent T. Harris ◽

...

Keyword(s):

Vagus Nerve ◽

Vocal Fold ◽

Granulomatous Inflammation ◽

Nerve Biopsy ◽

Jugular Foramen ◽

Vagus Nerves ◽

Vocal Fold Paresis ◽

Nerve Tumor ◽

Left Recurrent Laryngeal Nerve ◽

Cranial Neuropathies

Objectives: To present a novel location in which neurosarcoidomatous inflammation is identified and its accompanying presentation. Methods: The authors present a case of bilateral vocal fold paresis associated with non-caseating granulomatous inflammation of the cervical and intra-axial portions of the vagus nerve masquerading as a cranial nerve tumor. Results: Examination revealed bilateral vocal fold paresis and asymmetric palate elevation. MRI demonstrated enhancing bilateral jugular foramen masses, and neck ultrasound demonstrated bilateral thickened appearance of the vagus nerves. Vagus nerve biopsy demonstrated non-caseating granulomas. Conclusions: Neurosarcoidosis may contribute to variable cranial neuropathies. Vocal fold paresis is usually thought to arise from mediastinal compression of the left recurrent laryngeal nerve. Rarely, though, lesions may arise in other parts of the vagus nerve. Failure of response to steroids does not rule out the diagnosis, making tissue diagnosis important in some cases.

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The plain chest radiograph after acute smoke inhalation

Clinical Radiology ◽

10.1016/s0009-9260(88)80334-9 ◽

1988 ◽

Vol 39 (1) ◽

pp. 33-37 ◽

Cited By ~ 36

Author(s):

Michael J. Lee ◽

Denis J. O'Connell

Keyword(s):

Chest Radiograph ◽

Smoke Inhalation ◽

Plain Chest Radiograph ◽

Plain Chest

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Computed Tomagraphic Scan Features Of An Arterio- Venous Malformation Which Presented As a SolitaryPulmonary Nodule On Plain Chest Radiograph

Nigerian Quarterly Journal of Hospital Medicine ◽

10.4314/nqjhm.v9i1.12347 ◽

1999 ◽

Vol 9 (1) ◽

Author(s):

KO Soyebi ◽

TA Ali

Keyword(s):

Chest Radiograph ◽

Venous Malformation ◽

Plain Chest Radiograph ◽

Plain Chest ◽

Arterio Venous Malformation

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Autologous Fat Injection for Vocal Fold Paralysis: Long-Term Histologic Evaluation

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949510400101 ◽

1995 ◽

Vol 104 (1) ◽

pp. 1-4 ◽

Cited By ~ 61

Author(s):

Lauren S. Zaretsky ◽

Michael deTar ◽

Maisie L. Shindo ◽

Dale H. Rice

Keyword(s):

Vocal Fold ◽

Vocal Fold Paralysis ◽

Laryngeal Nerve ◽

Fat Injection ◽

Autologous Fat ◽

Alloplastic Materials ◽

Histologic Evaluation ◽

Left Recurrent Laryngeal Nerve ◽

Thyroarytenoid Muscle

Many techniques have been developed for medialization of the paralyzed vocal fold. The purpose of this study is to evaluate autologous fat as an alternative to alloplastic substances for use in vocal fold medialization. Eight dogs underwent left recurrent laryngeal nerve sectioning. Autologous fat was harvested, and the paralyzed vocal fold was medialized by injecting the fat into the thyroarytenoid muscle. The animals were divided into three groups for evaluation at 1, 3, and 6 months. Videolaryngoscopy was performed prior to sacrificing the animals. The larynges were sectioned coronally, and histologic studies were performed. The studies confirmed the preservation of viable fat at the injected site in all animals. Only a minimal inflammatory response was observed in the 1-month group. It would appear that fat injection is a viable alternative to Teflon injection and thyroplasty; it eliminates the need for alloplastic materials, does not appear to migrate, and does not require an open procedure.

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