A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient’s subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.
Ambulatory Care Facilities ; Biopsy ; Endoscopy ; Foreign Bodies ; Fresh Water ; Humans ; Hyperemia ; Korea ; Laryngeal Mucosa ; Laryngitis ; Parasites ; Pharyngitis ; Pharynx ; Sensation ; Surgical Instruments

BACKGROUND AND OBJECTIVES: The aim of this study is verify the correlation between benign laryngeal mucosal disease and metabolic syndrome. MATERIALS AND METHOD: Data for patients diagnosed with benign laryngeal mucosal disease and metabolic syndrome from 2006 to 2015 were selected for analysis from the National Health Insurance Service database. RESULTS: The prevalence of Metabolic syndrome was 2,179,785 out of 6,437,051 patients (33.86%). The prevalence of benign laryngeal mucosal disease was 516,594 out of 6,437,051 patients (8.03%). Metabolic syndrome was a risk factor for benign laryngeal mucosal disease [hazard ratio: 0.99, 95% confidence interval: 0.984–0.997] after adjusting for age and other variables including age, gender, smoking status, alcohol intake, exercise, body mass index, and diabetes. The number of metabolic syndrome components was also risk factor. CONCLUSION: Metabolic syndrome was related to the incidence of benign laryngeal mucosal disease. However this correlation did not seem to be high.
Body Mass Index ; Epidemiology ; Humans ; Incidence ; Laryngeal Mucosa ; Methods ; National Health Programs ; Prevalence ; Republic of Korea ; Risk Factors ; Smoke ; Smoking ; Vocal Cords

BACKGROUND: Endotracheal intubation can cause focal ischemia, damage or edema to the laryngeal mucosa, and may be followed by serious complications such as vocal cord paralysis, ulcers, and granulation tissue formation. Laryngeal granuloma is rare but also a significant late complication of endotracheal intubation, and anesthesiologists should be concerned about it.CASE: We experienced four cases of laryngeal granuloma that developed after two-jaw surgery January 2017–December 2018 in our hospital and would like to report these cases with brief review of literature.CONCLUSIONS: There are frequent movements on the head and neck in maxillofacial surgery and the nasotracheal intubation should be prolonged after bimaxillary osteotomy surgery because of post-operative airway problems. This may be why two-jaw surgery may have higher occurrence of laryngeal granuloma than others.
Edema ; Granulation Tissue ; Granuloma, Laryngeal ; Head ; Humans ; Intubation ; Intubation, Intratracheal ; Ischemia ; Laryngeal Mucosa ; Neck ; Osteotomy ; Surgery, Oral ; Ulcer ; Vocal Cord Paralysis

Laryngeal neoplasm is the second most common malignancy of the upper aerodigestive tract. About 85% to 95% of laryngeal malignancies are squamous cell carcinoma that arises from the epithelial lining of the larynx. The exact cause of laryngeal neoplasm is unknown, but certain risk factors can affect the chances of developing it. Chronic inflammation is a mutagen factor confirmed in the carcinogenesis of various tumor. Inhalation injuries cause histopathologic damage to laryngeal mucosa and inflammation change. This long term inflammation may leads to the development of dysplasia and malignant transformation. Recently, we experienced a case of malignant transformation of laryngeal mucosa after inhalation injury patient 25 years ago. Herein, we reported this rare case and review the relevant literature.
Burns ; Carcinogenesis ; Carcinoma, Squamous Cell ; Humans ; Inflammation ; Inhalation* ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Larynx ; Mucous Membrane* ; Risk Factors

The superior laryngeal artery is the principal artery supplying the laryngeal mucosa, musculature, and glands. Knowledge of variations in the origin of superior laryngeal artery could prove to be very useful during reconstructive surgeries of the larynx, partial laryngectomy, laryngeal transplantation, and also during procedures like super-selective intra-arterial chemotherapy for laryngeal and hypolaryngeal cancers. However, relatively few studies have been done on the superior laryngeal artery in comparison to its clinical importance. The present study was aimed at documenting the prevalence of variable origin of the superior laryngeal artery within the carotid triangle. Sixty hemi-necks obtained from 30 South Indian cadavers were dissected and studied for variations in the origin of superior laryngeal artery. It was observed that the superior laryngeal artery took origin from superior thyroid in 91.7% cases. Variable origin from the external carotid artery was noted in 5% cases. The superior laryngeal artery was found to arise from the lingual artery in one case alone (1.7%). In addition to the above findings, a very rare variation of superior laryngeal artery arising from the ascending pharyngeal (1.7%) was also observed in the hemi-neck of one cadaver. All the variations that were observed were unilateral and on the left side. These findings may help provide further insight to the anatomists, radiologists and surgeons and can help improve performances during surgical manipulations of the larynx.
Anatomists ; Arteries* ; Cadaver ; Carotid Artery, External ; Drug Therapy ; Humans ; Laryngeal Mucosa ; Laryngectomy ; Larynx ; Prevalence ; Surgeons ; Thyroid Gland

OBJECTIVE: To investigate the expression of B-cell translocation gene 1 (BTG1) and to determine the relationship between BTG1 expression and clinicopathological features, biological behaviors in laryngeal squamous cell carcinoma. METHOD: Immunohistochemistry and Western blot were used to analyze BTG1 protein expression in 70 cases of laryngeal cancer and 35 cases of adjacent corresponding laryngeal mucosal tissues to illuminate the relationship between BTG1 expression and clinical factors. RESULT: The positive rate of BTG1 protein expression was 31.43% in laryngeal carcinoma tissues, significantly lower than 91.43% in the adjacent laryngeal tissues (P < 0.05). Western blot showed the relative expression of BTG1 protein between cancer lesion and adjacent tissue were 0.217 ± 0.032 and 0.918 ± 0.081, showing the difference with statistical significance (P < 0.05). The expression of protein was significantly correlated with the tumor invasion, lymph node metastasis, clinic stage and histological grade (P < 0.05 or P < 0.01), but not with sex, age and tumor location (P > 0.05) of patients with laryngeal cancer. CONCLUSION The expression of BTG1 protein was decreased in laryngeal squamous cell carcinoma, suggesting that BTG1 gene may be closely associated with the carcinogenesis and the degree of malignancy. Detection of BTG1 expression may be useful in diagnosis, treatment and prognosis of laryngeal carcinoma.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Mucosa ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Neoplasm Grading ; Neoplasm Proteins ; metabolism ; Neoplasm Staging ; Prognosis ; Squamous Cell Carcinoma of Head and Neck

OBJECTIVE: To study the efficacy of treatment with microsurgery in combination with local injection of type A botulinum toxin for vocal process granuloma. METHOD: 28 patients with vocal process granuloma received endotracheal intubation under general anesthesia. The lesion was removed with micro-scissor and CO2 laster under a self-retaining laryngoscope and microscope. The incision and mucous membrane surrounding the wound was closed with 8-0 absorbable suture. 4-point injection of botulinum toxin type A 8-15 u was then performed along the thyroarytenoid muscle and arytenoid muscle of the same side. Postoperative medication was administered based on disease causes. RESULT: All patients experienced vocal cord dyskinesia of the injected side 2-3 days after surgery. At 1 month after the surgery, wound healing was good in all the 28 patients, and the vocal cord movement was limited at the injected side. At 3 months, movement of the bilateral vocal cords was normal, and the vocal cord process mucosa was smooth. Patients were followed up for more than a year, and only one patient had recurrence in 2 months after surgery. The cure rate was 96. 4%. CONCLUSION Combination of laryngeal microsurgery and type A botulinum toxin local injection can shorten the treatment course of vocal process granuloma.
Anesthesia, General ; Botulinum Toxins ; administration & dosage ; Granuloma ; drug therapy ; surgery ; Humans ; Injections ; Intubation, Intratracheal ; Laryngeal Mucosa ; Laryngeal Muscles ; Laryngeal Neoplasms ; drug therapy ; surgery ; Laryngoscopes ; Larynx ; Microsurgery ; Postoperative Period ; Recurrence ; Vocal Cords ; Wound Healing

A 13-year-old female patient visited the otolaryngology clinic with complaints of a moving foreign body sensation in her throat. The patient used to eat raw fish and she had eaten mullet sashimi a week before. During laryngoscopy for the pharynx and larynx, a motile fluke was found attached to the posterolateral nasopharyngeal wall. The worm was easily removed and identified as Clinostomum complanatum (C. complanatum) after morphological observation. C. complanatum is a digenetic trematode which usually infects fish-eating birds. Human infection by C. complanatum is very rare, and if a human eats infected raw fish, the worm can be on the pharyngeal or laryngeal mucosa. Human cases of parasitic C. complanatum infection have been reported twice in Korea, with the present report being the first case in the otolaryngology field.
Adolescent ; Birds ; Female ; Foreign Bodies ; Humans ; Korea ; Laryngeal Mucosa ; Laryngoscopy ; Larynx ; Otolaryngology ; Pharyngitis* ; Pharynx ; Sensation ; Smegmamorpha ; Trematoda

OBJECTIVE: To study the expression of DNA-dependent protein kinase (DNA-PK) in human laryngeal squamous cell carcinoma (LSCC) and normal laryngeal mucosa (NLM), and to analysize the relationship between the expression and the clinicopathologic parameters of LSCC. METHOD: Immunohistochemical technique (Envision) was used to detect the expression of DNA-PK in 64 cases of LSCC and 15 cases of NLM. To investigate an investigation was conducted on the relationship between the expression and clinico-pathological features of LSCC. RESULT: DNA-PK was lowly expressed in NLM and highly expressed in LSCC,the positive rate of DNA-PK expression was 26.67% (4/15), 78.13% (50/64), respectively, and there was significant different difference between the two groups (P < 0.05). Its expression was correlated with the level of histodifferentiation (P < 0.05), but not with TNM stages and neck lymph node metastasis (P > 0.05). CONCLUSION DNA-PK may be involved in disease development of LSCC.
Aged ; Carcinoma, Squamous Cell ; enzymology ; pathology ; DNA-Activated Protein Kinase ; metabolism ; Female ; Head and Neck Neoplasms ; enzymology ; pathology ; Humans ; Laryngeal Mucosa ; enzymology ; Laryngeal Neoplasms ; enzymology ; pathology ; Larynx ; enzymology ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Squamous Cell Carcinoma of Head and Neck

OBJECTIVE: To explore new hallmarks affecting the prognosis of patients with laryngeal squamous cell carcinoma (LSCC) via investigating the expression of CyclinE and p27 in LSCC tissues. METHOD: The expression of CyclinE and p27 was detected via Elivision immunohistochemical staining in 160 LSCC tissues and 20 normal laryngeal tissues (NLT). The relationship between CyclinE/ p27 and LSCC/ NLT was analyzed via Log-rank analysis. The relationship of CyclinE and p27 protein was statistically analyzed by spearman correlation analysis. The relationship between CyclinE/p27 and clinical-pathology-factors of patients with LSCC, such as age, gender, tumor site, diameter, differentiation, lymph node metastasis and PTNM stage were analyzed by Chi-square test. The relationship between clinical-pathology-factors, CyclinE, p27 and overall survival time of patients with LSCC was analyzed via Cox multiplicity and Kaplan-Meier survival analysis. A significant difference was recognized by P<0.05. RESULT: In LSCC the positive rates of CyclinE and p27 protein was 62.50% and 41.25% respectively (P<0.05). In NLT the positive rates of CyclinE and p27 protein was 35% and 70% respectively (P<0.05). The expression of CyclinE or p27 protein was closely correlated with lymph node metastasis, PTNM stage of patients with LSCC (P<0.05). The expression of CyclinE and p27 had no significant correlations with patients' gender, age and tumor site, diameter differentiation (P>0.05 for all). A negative correlation was found between the expression of CyclinE and p27 protein, r= -0.767(P<0.05). Kaplan-Meier survival analysis showed that the overall survival rate of patients with LSCC was 36.9% (P<0.05). The 5-year survival rate in positive group of CyclinE was 8%, in negative group was 80% (P<0.05). On the contrary, the 5-year survival rate of patients with LSCC in positive group of p27 protein was 77.27%, the rate was 5.32% in negative group (P<0.05). Cox multivariate regression analysis revealed that lymph node metastasis, PTNM stage, CyclinE and p27 were independent risk factors of prognosis for patients with LSCC. CONCLUSION It is the molecular basis underlying the development and invasion/ metastasis of LSCC that activation of CyclinE gene accompanying inactivation of p27 gene. It is very important of co-detecting CyclinE and p27 protein to predict the prognosis of patients with LSCC.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Cyclin E ; metabolism ; Cyclin-Dependent Kinase Inhibitor p27 ; metabolism ; Female ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Laryngeal Mucosa ; metabolism ; pathology ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Oncogene Proteins ; metabolism ; Prognosis ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate