Congenital laryngeal cyst causing respiratory distress in a neonate: a rare case report

Congenital laryngeal cyst is a rare but responsible of upper airway obstruction which can be potentially life-threatening. The most common symptoms are inspiratory stridor, dyspnea, cyanosis, abnormal voice and difficulty with feeding. It should be differentiated from laryngomalacia. It is diagnosed by flexible fibro-optic laryngoscopy. Surgical options are endoscopic excision, needle aspiration, de-roofing, external laryngo-fissure and lateral pharyngotomy. The best treatment consists in the entire removal of the cyst. This case report described the case of 28 days old neonate with a severe airway distress and stridor caused by a congenital laryngeal cyst which has been managed by de-roofing of the cyst entirely with flexible laryngoscope.

Post-operative outcomes of different surgical approaches to oropharyngeal squamous cell cancer: a case-matched study

Objective To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management. Methods Records of 162 patients treated with transmandibular surgery, transoral laser microsurgery or lateral pharyngotomy were reviewed. The transoral laser microsurgery cohort was matched with the lateral pharyngotomy and transmandibular surgery cohorts for tumour stage, tumour subsite and human papilloma virus status, and the intra- and post-operative outcomes were compared. Results Duration of surgery and hospital stay were significantly longer for transmandibular surgery. Tracheostomy and nasogastric feeding tube rates were similar, but time to decannulation and to oral feeding were longer in the transmandibular surgery group. Transmandibular surgery more frequently required flap reconstruction and had a greater complication rate. Negative margins were fewer in the lateral pharyngotomy group than in the transoral laser microsurgery and transmandibular surgery groups. Conclusion In comparison with transmandibular surgery, transoral laser microsurgery and lateral pharyngotomy were associated with fewer complications and faster functional recovery. Lateral pharyngotomy had a higher rate of positive margins than transoral laser microsurgery, with a consequently greater need for adjuvant therapy. Many patients are nonetheless unsuitable for transoral surgery. All these factors should be considered when deciding on oropharyngeal cancer surgical treatment.

Resection of a Giant Hypopharyngeal Liposarcoma Invading the Esophagus by Lateral Pharyngotomy: A Case Report

Hypopharyngeal liposarcomas are extremely rare. Due to the lack of experience, pathologists and surgeons find it difficult to make a clear diagnosis and provide accurate, timely treatment. A 43-year-old man with a complaint of foreign body sensation in the throat for 6 months and swallowing difficulty for 2 months was admitted to our department. Contrast-enhanced computed tomography of the chest and larynx revealed a lesion with smooth surface in the esophagus, connected by a pedicle to the hypopharyngeal lesion. The same result was found by gastroscopy. Lateral pharyngotomy was performed for tumor removal, and after 3 weeks, the patient showed good movement of bilateral vocal cords, without dysphagia, choking cough, or hoarseness. This is the first case report of hypopharyngeal liposarcoma invading the esophagus. A thorough preoperative evaluation may be required for the proper diagnosis, prevention, and treatment.

Presentation and Management of Giant Fibrovascular Polyps of the Hypopharynx and Esophagus

Objective: Fibrovascular polyps of the hypopharynx and esophagus are rare, with few case reports in the literature. In this article, we present our institutional experience with a focus on airway and surgical management. Study Design: Case series. Setting: Tertiary academic institution. Methods: A retrospective review was conducted of 4 patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012. Patient demographics, clinical presentation, diagnostic studies, and surgical approaches were reviewed. A review of the published literature was also performed. Results: The average age at presentation was 72 years (range, 59-85 years). Among the 4 patients, 2 presented with airway compromise requiring tracheotomy. All patients had removal of the polyp shortly after presentation; 2 underwent transcervical approaches with lateral pharyngotomy/esophagotomy, and the other 2 had endoscopic removal. The polyps arose from the hypopharynx in 3 patients and upper esophagus in 1. Three patients had complete resolution of their symptoms and remained disease free. One patient had recurrence of the polyp 2 years later and is currently being observed. Conclusion: Fibrovascular polyps are rare tumors of the hypopharynx/esophagus that present in older adults. Although benign, they can cause life-threatening airway compromise that may necessitate tracheotomy. We present 4 cases of fibrovascular polyps and discuss our evolving surgical management, including endoscopic removal.

Double nail in Hypopharynx- A rare presentation

Introduction An extremely rare case of a pair of nails impacted in the right pyriform sinus, presenting 72 hours after the incident, is reported. Case Report X-ray soft tissue neck revealed the presence of a pair of nails in the neck at C4-C5 vertebral level. The foreign bodies could not be seen on hypopharyngoscopy due to severe mucosal oedema. Lateral pharyngotomy was done to remove the nails with C-arm guidance. Discussion Retained foreign bodies in the aerodigestive tract are known to produce complications. Delayed presentation makes the management difficult. C-arm guidance during surgical exploration is helpful to locate a radiopaue foreign body in difficult situations.