Objective: To investigate by means of videostoboscopy the characteristics of the neoglottis after total laryngectomy with primary or secondary voice reconstruction using a non-prosthetic tracheoesophageal fistula technique. Methods: Design: Cross-Sectional Study Setting: Tertiary Public Hospital Subjects: Twenty alaryngeal patients Results: Videostroboscopy enabled evaluation of the neoglottis in all but two patients with a pectoralis major myocutaneous flap reconstruction of the pharyngoesophageal segment. Pooling of saliva was present in the cranial neoglottic opening in all subjects, but obscured visualization in these two. A circular neoglottic shape was most commonly seen. Vibration of the neoglottis was noted in 90% of all alaryngeal patients and was associated with a regular mucosal wave. Pharyngoesophageal vibration was noted in two thirds of patients. It was associated with a strong mucosal wave, regular vibration and a longer open phase. Conclusion: Videostroboscopy confirmed that neoglottic vibration accompanies sound production while pharyngoesophageal vibration may reinforce and enhance voice production in alaryngeal patients with non-prosthetic TE voice reconstruction.
LARYNX SPEECH ; ALARYNGEAL

OBJECTIVE: To present a function-preserving surgical technique of post-laryngotracheal resection reconstruction of the subglottic airway using autologous tracheal cartilage composite graft.

METHODS:

     Design:            Case Report

     Setting:           Tertiary Government Training Hospital

     Participants:   One

RESULT: A 77-year-old woman diagnosed with papillary thyroid carcinoma with laryngotracheal invasion underwent total thyroidectomy with laryngotracheal resection. The tracheal defect was reconstructed using end-to-end anastomosis of the trachea to the remaining cricoid. The cricoid (subglottic) defect was repaired using the harvested tracheal cartilage with mucosa. Post-operatively, the patient was maintained on nasogastric tube feeding and tracheostomy tube for 2 weeks. Subsequently, the nasogastric tube and tracheostomy tube were removed and the patient tolerated oral feeding without any airway problem. The last follow-up of the patient was 6 months post-operatively without complications.

CONCLUSION: Autologous tracheal cartilage may be a potentially promising composite graft for reconstruction of the cricoid (subglottic) defect in a patient following laryngotracheal resection for invasive papillary thyroid carcinoma of the larynx and trachea.

 

Human ; Carcinoma ; Thyroid Gland

OBJECTIVE: To evaluate the association of salivary pH and taste sensitivity among geriatric and non-geriatric patients in an otorhinolaryngology - head and neck surgery out-patient clinic.

METHODS:

Design:           Cross-Sectional Study

Setting:           Tertiary Government Training Hospital

Participants: 40 otorhinolaryngology out-patients

 

RESULTS: Of the 40 patients aged 24 to 92-years-old (mean age 59.8 years), 21 were geriatric and 19 were non-geriatric. The mean salivary pH was 6.66 (range 5 to 8) and 6.63 (range 5 to 7) for geriatric and non-geriatric groups; the difference in mean salivary pH was not statistically significant (p = .87). The salivary pH in the geriatric group showed a negative correlation with age (r=0.06), while the salivary pH in the non-geriatric group had a positive correlation with age (r=0.14). Overall, increases in age among the non-geriatric group were correlated with increase in salivary pH which were not observed in the geriatric patients. In the geriatric group, among the 4 tastants, the strongest correlation between taste sensitivity and salivary pH was observed for quinine followed by sucrose and NaCl, but no correlation for citric acid. In the non-geriatric group, the strongest correlation between taste sensitivity and salivary pH was observed for NaCl, followed by quinine, citric acid and sucrose.

CONCLUSION: There was no significant difference between the mean salivary pH of geriatric and non-geriatric patients, and both means were within normal. There was a negative correlation between age and salivary pH in the geriatric group, and a positive correlation in the non-geriatric group.  Salivary pH had the strongest correlation with taste sensitivity for quinine and NaCl among geriatric and non-geriatric participants, respectively, but the reasons for, and significance of this cannot be inferred from the present study.

KEYWORDS: salivary pH; taste sensitivity; gustatory function; geriatric

Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Middle Aged (a Person 45-64 Years Of Age) ; Taste

OBJECTIVES: To  present  a  rare  case  of  primary  parathyroid  carcinoma  and  discuss  its  clinical findings and management.
METHODS:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
RESULTS: A 54-year-old woman presented with a 3-year history of recurrent nephrolithiasis despite several  courses  of  shock  wave  lithotripsy.  She  had  persistent  hypercalcemia  and  parathyroid hormone levels were noted to be elevated. Neck ultrasound showed a hypoechoic solid nodule measuring  approximately  1.7  x  1.6  cm  in  the  lateral  inferoposterior  aspect  of  the  left  thyroid lobe. Parathyroid scintigraphy revealed a focal uptake on the left lower thyroidal bed. The patient underwent  left  inferior  parathyroidectomy  with  subtotal  thyroidectomy  and  isthmusectomy Frozen  section  reported  a  parathyroid  tumor  and  the  final  histopathologic  results  revealed  a parathyroid carcinoma.
CONCLUSION: A  rare  case  of  parathyroid  carcinoma  was  presented  manifesting  with  recurrent nephrolithiasis.  Elevated  serum  calcium  and  intact  parathyroid  hormone  (iPTH)  can  confirm  a primary  hyperparathyroid  problem.  Neck  ultrasound  and  parathyroid  scintigraphy  help  in  the localization of a parathyroid tumor. Only final histopathologic results can confirm the diagnosis of parathyroid carcinoma. Complete surgical excision is the treatment of choice and offers a good prognosis.

Human ; Female ; Middle Aged ; Parathyroid Neoplasms ; Parathyroidectomy ; Thyroidectomy ; Hypercalcemia ; Thyroid Gland ; Calcium ; Parathyroid Glands ; Lithotripsy ; Kidney Calculi ; Parathyroid Hormone

Objective: To determine the validity and reliability of the Filipino Dizziness Handicap Inventory (FDHI) questionnaire among geriatric patients with dizziness. Methods: Design: Linguistic Validation Setting: Tertiary Government Training Hospital Participants: Twenty-five (25) patients Results: The dizziness handicap inventory was translated into Filipino by a Filipino language specialist and an ENT specialist who are experts in their field. The translated version was easily understood by the 25 geriatric patients with Cronbach α scores of .957 overall [M = 2.16; SD = 1.93]. Sub-domain item-total correlation scores (physical M = 2.6, SD = 1.90, Cronbach α = .860; emotional M = 1.66, SD = 1.84, Cronbach α = .901; and functional M = 2.5, SD = 1.97, Cronbach α = .902) demonstrated validity of the respective subdomains. Conclusion: The Filipino Dizziness Handicap Inventory questionnaire is an internally valid tool for assessment of dizziness among geriatric patients. External validity and reliability can be evaluated in future studies employing corroborative measures and repeated testing.
dizziness