Lymphangiomas of the larynx are quite rare and even rarer in adults. Isolated cavernous lymphangioma in the laryngeal ventricle was diagnosed in a 47-year-old woman. The patient presented with hoarseness with a history of three months. Direct laryngoscopy performed under general anesthesia showed a large, smooth, gray-reddish tumor above the right vocal fold, originating from the right ventricle. The tumor was removed through a micro-laryngoscopic procedure with cold instruments. Histopathologic diagnosis was cavernous lymphangioma. There was no local recurrence a year after the operation.
Cytomegalovirus (CMV) reactivation is a known complication in patients with hematological cancers and those who undergo stem cell transplants, often resembling cancer relapse. CMV lymphadenitis, an infection localized to the lymph nodes, can be difficult to distinguish from lymphoma recurrence based on clinical and radiological findings alone. We report a case of a 40-year-old male treated for Hodgkin lymphoma who presented with cervical lymphadenopathy nine months after treatment. PET-CT showed a hypermetabolic lesion, suggesting relapse, but a biopsy confirmed CMV lymphadenitis. Systemic CMV infection was excluded based on negative PCR results and normal thoracic imaging. This report highlights the importance of histopathological confirmation in patients with a history of lymphoma, as CMV lymphadenitis can mimic relapse. Accurate diagnosis prevents unnecessary treatments and avoids misinterpretation of imaging findings. In isolated lymph node cases without systemic symptoms, observation may be sufficient as the condition can resolve spontaneously. This underscores the need for careful evaluation to ensure correct diagnosis and appropriate management.
Objective: The aim of this study was to analyse factors that predispose patients to pharyngocutaneous fistula (PCF) in total laryngectomy, with a focus on intraoperative primary tracheooesophageal fistula (TEF) with voice prosthesis and anti-reflux prophylaxis.Methods: This retrospective cohort included 77 patients who underwent total laryngectomy (TL). Potential risk factors included intraoperative primary TEF with voice prosthesis, anti-reflux prophylaxis, previous radiotherapy (RT), diabetes mellitus, concurrently neck dissection and tumour stage.Results: The global PCF rate was 46.3%. No statistically significant difference was noted between the fistula positive and negative groups for these parameters, except for hospitalisation time.Conclusion: Anti-reflux prophylaxis was not significantly associated with the incidence of PCF. Primary TEF and voice prosthesis did not increase the incidence of PCF.
Objective To compare the thicknesses of bone beneath the internal receiver stimulator (IRS) with the symmetric contralateral unimplanted side in postoperative temporal high‐resolution computed tomography (CT) and/or cranial CT of the patients for whom cochlear implants were secured by the subperiosteal temporal pocket technique. Study Design Case series with chart review. Setting Tertiary care hospital, cochlear implant referral center. Subjects Cochlear‐implanted pediatric patients with postoperative temporal high‐resolution CT and/or cranial CT were reviewed. The study group included 10 patients with Clarion devices (Advanced Bionics, Valencia, California). Methods Thicknesses of bone were recorded independently by 2 radiologists in the standardized coordinates of proximal, middle, and distal segments of both the IRS bed and the contralateral unimplanted side in each patient. Bone thickness differences in the proximal, middle, and distal segments of IRS were investigated. Any correlation between bone thickness differences and patient age at implantation or duration of implantation was also investigated. Results Mean values of bone thicknesses obtained from the IRS side and contralateral unimplanted side were, respectively, as follows: 2.40 ± 0.80 mm and 4.17 ± 1.10 mm in the proximal segment ( P = . 0001); 1.48 ± 0.33 mm and 3.02 ± 0.85 mm in the middle segment ( P =. 0001); and 2.13 ± 0.41 mm and 3.40 ± 0.61 mm in the distal segment ( P = . 006). Significant positive correlation was found between patient age at implantation and decrement values in the distal segments ( r = 0.681, P =. 03). Conclusion The subperiosteally secured IRS eventually creates its own well on the skull vault. This new radiologic evidence shows that device migration risk decreases over time, and it supports the findings of other clinical series showing device stability using the subperiosteal pocket technique.
Objective The aim of this study was to investigate serum and saliva fetuin‐A, protein, and electrolyte levels in patients with sialolithiasis. Study Design Prospective randomized controlled study. Setting Tertiary center. Subjects and Methods Twenty patients with recurrent sialadenitis secondary to submandibular salivary gland stones and 20 asymptomatic healthy volunteers without salivary gland stones were included in the study. Bimanual palpation and ultrasonography were performed in the patient and control groups. The electrolyte, protein, and fetuin‐A levels of the serum and saliva were measured. Results The serum calcium, phosphorus, and potassium levels of the patients were significantly lower than those of the control group (respectively, P =. 04, P =. 01, P =. 04). There was no statistically significant difference between the serum fetuin‐A levels of the 2 groups ( P =. 06). The saliva phosphorus values of the patients were higher than those of the control group ( P =. 05), as were their saliva fetuin‐A and total protein values ( P =. 001, P =. 01). A positive correlation was determined between the saliva fetuin‐A levels and the saliva phosphorus and potassium levels of the patients ( P =. 04, P =. 02). The magnesium level, which has been argued to be a factor in the prevention of calcification, showed an increased correlation with the total protein in the patient group ( P =. 02). Conclusion It is possible that the high levels of saliva fetuin‐A, total protein, and phosphorus with insufficient of saliva magnesium levels may make a contribution to the formation of sialoliths.
We aimed to compare the effectiveness of wideband absorbance in detecting ossicular chain discontinuity with intraoperative findings.In this study, 58 ears from 38 patients with chronic otitis media (COM) were included. Twenty-six ears with perforation and intact ossicular chain were determined as Group 1, 12 ears with perforation and ossicular chain defects were determined as Group 2, and 20 ears with normal hearing and intact tympanic membrane were determined as Group 3. The comparison of the groups was made considering the static (non-pressure) absorbance analysis performed using wideband tympanometry.When perforation sites were evaluated in Group 1 and Group 2; there were 12 anterior perforations, 7 posterior perforations, and 19 subtotal perforations. Air conduction thresholds in Group 2 were significantly (P<0.05) higher than in Group 1, as expected in pure tone audiometry. When wideband absorbance (WBA) measurements were evaluated in all 3 groups, no significant difference (P>0.05) was found between the frequencies 226 to 1000 Hz. WBA measurements at 8 frequencies between 1888-2311 Hz in Group 1 were significantly lower than Group 3 (P<0.05). WBA measurements at 4 frequencies between 3462-3886 Hz frequencies in Group 2 were significantly lower than Group 1 (P<0.05).Our findings concluded that a significant decrease in absorbance values in the narrow frequency range may be valuable in predicting ossicular chain defects.
Hyponatremia develops as a result of the inappropriate secretion of antidiuretic hormone. In rare cases, it develops as an iatrogenic complication. For example, acute iatrogenic post-tonsillectomy hyponatremia has been described in children following the infusion of hypo- or isotonic fluid. We report a case of rapidly developing post-tonsillectomy iatrogenic hyponatremia in a 5-year-old girl following an excessive infusion of hypotonic fluid. Her signs and symptoms began with nausea and vomiting and progressed to seizures and coma. We corrected the electrolyte disturbance by infusing a 3% sodium chloride solution until her neurologic manifestations disappeared, at which time her serum sodium concentration had risen back to 135 mEq/L. Otolaryngologists are not generally exposed to much information about hyponatremia, so we must be aware of its associated neurologic signs and symptoms.
Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease involving the sacroiliac joint and the vertebral column.It can also affect other organs.We aimed to evaluate the voice quality objectively in patients with AS.Methods: Forty-eight patients who were followed in physical therapy clinic with a diagnosis of AS were enrolled in the study.The control group included 18 healthy volunteers who did not have any voice problems or airway pathology.All patients underwent otorhinolaryngologic examination, laryngostroboscopic evaluation, acoustic voice analysis and pulmonary function test.Results: Of the 48 patients included in the study, 35 were males and 13 were females.Of the 18 healthy volunteers included in the control group, 14 were males and four were females.The mean ages of the patient and control groups were 38.8±9.79 and 44.17±9.85years, respectively.There was no statistically significant difference between the groups in terms of demographic characteristics.No cricoarytenoid joint involvement was observed in the patient group.The mean fundamental frequency (F 0 ) value in the patient group was significantly lower than the control group (p=0.043),while Shimmer values (%) were significantly higher (p=0.008).Additionally, harmonics-to-noise-ratio and signal-to-noiseratio values were significantly lower in the patient group (p=0.032).No statistically significant difference was found in terms of other acoustic parameters. Conclusion:In our study, F 0 in patients with AS was lower than the control group.This may be related to reduced respiratory capacity of patients with AS.
The aims of this study were to evaluate histochemical markers of apoptosis in the cricopharyngeus muscle, which is the gatekeeper of the pharyngoesophageal region during the swallowing process; to investigate the effects of primary aging on this muscle; and to determine whether a relationship exists with gastroesophageal reflux disease.The study included 30 fresh cadavers with a time of death of 12 hours or less obtained from the Turkish Ministry of Justice Forensic Medicine Unit. All cadavers were dissected with routine postmortem skin incisions to extract specimens from the cricopharyngeus muscle and the esophagocardiac junction mucosa. Muscle degeneration and primary aging were demonstrated by immunodetection of Bax, Bcl-2, and Caspase-3 proteins as markers of the apoptosis. Esophageal specimens were examined for the presence of reflux esophagitis.The mean age was 41.5 (14-74) years, and the study included 18 male and 9 female cadavers. Three of them were excluded because of fixation artifacts. The mean Bax, Bcl-2, and Caspase scores showed no statistically significant relationship with age (P = 0.94). The right and left sides of the muscle were investigated separately, and the Bax scores of the right side of the cricopharyngeus muscle showed a statistically significant decrease with age (P = 0.026), whereas the Bax and Bcl-2 scores were increased with age (P = 0.035 and 0.049, respectively) on the left side. Evaluation of the 23 esophagus specimens revealed 10 cases of esophagitis. No relationship was found between the mean of each apoptotic marker and esophagitis.It is histopathologically not possible to demonstrate muscle death due to either primary aging or reflux. This might be attributable to the defensive capability of this unique muscle to maintain the feeding process.
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