American journal of otolaryngology
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Comparative Study
Arytenoid adduction combined with medialization laryngoplasty under general anesthesia using a laryngeal mask airway.
Laryngeal framework surgery is usually performed under local anesthesia but cannot be tolerated by some patients. To develop a new procedure for these patients, we evaluated voice outcomes after arytenoid adduction combined with medialization laryngoplasty under general anesthesia using a laryngeal mask airway (LMA) for unilateral vocal cord paralysis. ⋯ These results were equivalent to those of previous reports of surgeries performed under local anesthesia. Intraoperative endoscopic vocal cord observation through the LMA may have contributed to the positive results.
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Korman et al (Laryngoscope.1973;83:683-690) first reported arytenoid dislocation as a rare and unusual complication of intubation. Since then, the terms arytenoid dislocation and arytenoid subluxation (AS) have been used interchangeably to describe disruption of the cricoarytenoid joint. Only 74 cases of AS have been reported in the literature to date. ⋯ Arytenoid subluxation cases are often misdiagnosed as vocal fold paralysis. A high index of suspicion based on the history, examination findings, and objective tests helps in early diagnosis and, thus, early surgical intervention. We present a rare etiology of AS due to a bout of coughing, which was diagnosed early and reduced under general anesthesia with complete reversibility of vocal fold motion, thus restoring normal voice function.
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Lemierre syndrome, also known as postanginal sepsis, is caused by Fusobacterium necrophorum. This rare disease is usually characterized by thrombophlebitis of the jugular vein and septic embolism after a history of sore throat. ⋯ Severe facial infection with high fever and a general feeling of malaise after a history of sore throat should raise the diagnostic possibility of facial vein thrombophlebitis due to F. necrophorum infection.
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Case Reports
Aggressive sinonasal natural killer/T-cell lymphoma with hemophagocytic lymphohistiocytosis.
Extranodal natural killer/T-cell lymphoma of the nasal cavity is a rare malignancy with poor overall prognosis. We report the case of a rapidly fatal natural killer/T-cell lymphoma of the nasal cavity complicated by the concominant development of hemophagocytic lymphohistiocytosis. ⋯ Left untreated, multi-organ failure and death are common. Prompt diagnosis is essential to the successful management of this disorder and for subsequent recovery.
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Randomized Controlled Trial Comparative Study
Does extensive dissection of recurrent laryngeal nerve during thyroid operation increase the risk of nerve injury? Evidence from the application of intraoperative neuromonitoring.
Extensive dissection of recurrent laryngeal nerve (RLN) is inevitable in some complicated thyroid operations. The study aimed to determine whether extensive dissection of RLN increases the risk of nerve injury. ⋯ The results of this study suggest that careful surgical dissection is well tolerated by the RLN.