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Laryngeal Granuloma


Presentation

  • A case of Wegener's granulomatosis is reported, which during the first year of illness presented only with signs of a laryngeal granuloma.[ncbi.nlm.nih.gov]
  • We present a case where bilateral laryngeal granulomas became clinically evident 3 mo after orthognathic surgery. The patient, a 19-yr-old female, developed acute dyspnea after experiencing gradual voice loss.[ncbi.nlm.nih.gov]
  • Administration of corticosteroid hormones, proton pump inhibitors, and a subsequent follow-up examination performed in our outpatient clinic showed no evidence of recurrence 10 months after the initial presentation.[ncbi.nlm.nih.gov]
  • First, although a sizable lesion was present initially, presurgical voice measures were largely normal or superior. The exception was elevated phonatory effort during singing.[ncbi.nlm.nih.gov]
  • The purpose of this presentation is to define a recurrent granuloma of the posterior two-thirds of the left vocal cord, which appeared the result of gastro-esophageal reflux, including both bile and acid content.[ncbi.nlm.nih.gov]
Thyroid Nodule
  • METHOD: We present the case of a 48-year-old woman who was diagnosed with a laryngeal neoplasm on integrated positron emission tomography and computed tomography scanning, after a routine ultrasound demonstrated an enlarged thyroid nodule.[ncbi.nlm.nih.gov]
Infertility
  • Zinc may be effective in the treatment of many disorders, based on available scientific evidence: gastric ulcers, leg ulcers, skin conditions (eczema, psoriasis, acne vulgaris), gingivitis, immune disorders, infertility, Wilson’s disease, herpes, taste[ncbi.nlm.nih.gov]
Hoarseness
  • Two days after extubation, the patient complained of hoarseness, sore throat, and dyspnea. When symptoms persisted, she was evaluated in the Otolaryngology Department.[ncbi.nlm.nih.gov]
  • All patients experienced hoarseness secondary to the injections, but voice quality returned to baseline in all patients as the toxin was degraded.[ncbi.nlm.nih.gov]
  • In February 1997, she visited the otorhinolaryngology department in our hospital because of continuous hoarseness.[anesthesiology.pubs.asahq.org]
  • If the granuloma is located on the vocal folds, the patient may present with hoarseness and breathiness, if closure of the folds is impaired.[questia.com]
Laryngeal Disorder
  • Laryngeal disorders. When relaxed, the vocal cords normally form a V-shaped opening that allows air to pass freely through to the trachea. The cords open during inspiration and close during swallowing or speech.[merckmanuals.com]
  • Kuhn Role of refluxed acid in pathogenesis of laryngeal disorders Am J Med, 103 (1997), pp. 100-106 [7.] K.R. DeVault, D.O. Castell Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease [8.] J.A. Wilson, A.[elsevier.es]
  • Forty-one of the cases were diagnosed clinically or pa... more Importance Contact granuloma is a difficult-to-treat laryngeal disorder associated with vocal abuse, habitual throat clearing, and laryngopharyngeal reflux.[scinapse.io]
  • The LPR patients who do not symptomatically improve with antireflux therapy often have another underlying laryngeal disorder such as a vocal fold paresis. Laryngeal examination reveals subtle bowing or hypomobility of one or both vocal folds.[nature.com]
Sneezing
Hematemesis
  • At 26 weeks of gestation, she had another episode of hematemesis, along with feeling short of breath and a globus sensation in her throat. She was referred to otolaryngology, and we evaluated her at 36 weeks of gestation.[consultqd.clevelandclinic.org]
Trismus
  • She presented without trismus and was assessed as Mallampati Class I. Laryngeal endoscopy, performed at the otolaryngology department of our hospital, demonstrated a laryngeal tumour with a diameter of approximately 10 mm (Figure 1 a).[bmcresnotes.biomedcentral.com]
Acne Vulgaris
  • Zinc may be effective in the treatment of many disorders, based on available scientific evidence: gastric ulcers, leg ulcers, skin conditions (eczema, psoriasis, acne vulgaris), gingivitis, immune disorders, infertility, Wilson’s disease, herpes, taste[ncbi.nlm.nih.gov]
Withdrawn
Wide Neck
  • Intraoperative direct laryngoscopy showed that the tumour had a smooth surface with a wide neck, and its stalk adhered to the posterior part of the right vocal fold (Figure 1 d). We saw no bleeding due to tumour involution by the tracheal tube.[bmcresnotes.biomedcentral.com]

Workup

  • […] device and 200-300 nm fibre; Zero degree or 30 degree rod lens telescope  18-30 cm length to permit visualisation of the suprastomal area; Water to use in case of an airway fire; Protection for staff and patient whilst using the KTP laser; Preoperative Workup[csurgeries.com]
  • He was then hospitalized and underwent a general workup that included a com... more Morphology, motility, proliferation rate and markers of oxidative stress in primary human gingival fibroblasts (GF) and periodontal ligamental fibroblasts (PDL-F) grown[scinapse.io]

Treatment

  • This study compared the CR and recurrence rates between conservative treatment and surgery for granuloma.[ncbi.nlm.nih.gov]
  • The optimal treatment dose remains to be determined. SIGNIFICANCE: Percutaneous botulinum toxin injection is helpful in resolving laryngeal granulomas.[ncbi.nlm.nih.gov]
  • The aim of this study was to evaluate the role of 3-dimensional conformal radiation therapy (3DCRT) in the treatment of refractory laryngeal granuloma.[ncbi.nlm.nih.gov]
  • The treatment period until LG resolution was significantly longer among patients with a black spot than those without a spot (P .0372).[ncbi.nlm.nih.gov]
  • FINDINGS: Of the 66 patients diagnosed, 10 did not start the treatment, with only 56 being analyzed, 6 of whom later abandoned the treatment. The cause-oriented treatment showed 100% control in postintubation granulomas.[ncbi.nlm.nih.gov]

Prognosis

  • .• Painless asymptomatic condition may be discovered incidentally• Prognosis is good• Treatment is anti tubercular drugs 21. MYCOSIS OF LARYNX• Following mycosis can occur in the larynx1. Candidiasis2. Coccidioidmycosis3. Paracoccidioidmycosis4.[slideshare.net]
  • ., when factors are eliminated, the contact granuloma resolves independently), because any irritation can cause the contact granulomas to reappear. [2] Prognosis [ edit ] As the masses of granular tissue are most often benign, prognosis is generally positive[en.wikipedia.org]
  • […] strategies for primary lesions and recurrences.Data Sources:The data came from a systematic review of the literature.Methods:Main outcome measures were recurrence rate, reducti... more Summary Objective To assess the clinical profile, presentation, prognosis[scinapse.io]

Etiology

  • AIMS AND BACKGROUND: The etiology of laryngeal granulomas is often multifactorial and the benefit of pharmacological therapy remains unclear. Anti-reflux treatment is only effective in granulomas definitely induced by gastroesophageal reflux.[ncbi.nlm.nih.gov]
  • The most common etiological factor is voice abuse, with predisponing factors such as reflux disease. Postintubation ulcers and granulomas, although of different etiology, according to all the other traits belong to this clinical entity.[ncbi.nlm.nih.gov]
  • Laryngeal granulomas are found most commonly in the posterior larynx involving the region of the arytenoid cartilages; but depending upon the etiology, they may be found anywhere in the larynx.[questia.com]
  • Gastroesophageal reflux (GER), hyperfunctional use of the voice, and intubation injury are etiological factors. Patients usually complain of dysphagia, and dysphonia.[laryngologyandvoice.org]
  • Crit Care Med 1983; 11:362-7 Ward PH, Zwitman D, Hanson D, Berci G: Contact ulcers and granulomas of the larynx: New insights into their etiology as a basis for more rational treatment.[anesthesiology.pubs.asahq.org]

Epidemiology

  • […] isolated LPR are not obese. 4, 5 Unfortunately, the remaining risk factors and patient profiles for LPR are not well established because epidemiologic studies in this area are lacking.[nature.com]
  • […] patients. [3] Surgical solutions are sometimes used, however rates of recurrence are higher. [3] Most recent research suggests that surgical options should only be explored once treatment of reflux with or without voice therapy has been introduced. [3] Epidemiology[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Grasp the nuances of the pathophysiology of today’s major respiratory conditions—including pulmonary hypertension, COPD, asthma, environmental lung disease, sleep disorders, infections of the immunocompromised, neonatal breathing disorders, and drug-resistant[books.google.com]
  • This suggests that differences in pathophysiology between LPR and GERD patients are part of the basis for the contrasting symptomology.[nature.com]
  • Louis, in the mid-19th century, established the correlation between pulmonary and laryngeal tuberculosis and explained the pathophysiology of such laryngeal lesions.[entokey.com]
  • Pathophysiology Contact granulomas are usually pale, pedunculated masses found on the medial or superior edge of the vocal process of the arytenoid cartilage; however, they may also be deep red, lobulated, and sessile.[emedicine.medscape.com]

Prevention

  • After excision, removal of the irritating source is necessary to prevent recurrence. Resources In This Article[merckmanuals.com]
  • She was administered 250 mg methylprednisolone succinate for the prevention of vocal cord edema. Extubation was performed after complete awakening from anesthesia.[anesthesiology.pubs.asahq.org]
  • For most patients with laryngeal granulomas due to LPR, prolonged treatments with high doses of proton pump inhibitors is necessary to reverse tissue damage and prevent recurrence.[questia.com]
  • Awake or semi-awake intubation can be performed to prevent tumour disruption, and intubation can be performed by advancing the endotracheal tube along the opposite side from the tumour under bronchoscopic visualization.[bmcresnotes.biomedcentral.com]

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