Pulmonary hyalinizing granuloma with laryngeal and subcutaneous involvement: report of a case successfully treated with glucocorticoids.
We report a case of pulmonary hyalinizing granuloma (PHG) with laryngeal and subcutaneous involvement. A 43-year-old man was admitted to our hospital for assessment of hoarseness. Cervical and chest computed tomography, respectively, revealed a laryngeal tumor and two pulmonary masses. Specimens obtained from the pulmonary masses were compatible with PHG. The histopathology of biopsy specimens from both the laryngeal tumor and a subcutaneous tumor resembled that of the resected lung masses. Although there is no established treatment for PHG, the laryngeal tumor was diminished and all other lesions disappeared with glucocorticoid treatment. (+info)
Vocal process granuloma: clinical characterization, treatment and evolution.
Vocal process granuloma is a disease whose etiopathogenesis is not well defined. Therefore, its clinical and surgical treatment is not standardized and its therapeutic results depend on the hospital where it is seen. AIM: Aiming to characterize patients with vocal process granuloma treated in our hospital, the therapeutic approach used and clinical evolution. MATERIAL AND METHOD: We performed a retrospective review of records. RESULTS: We found more male vocal process granuloma, except when associated with laryngeal intubation. The most frequent related etiopathogenic factor was laryngeal-pharynx reflux, followed by laryngeal intubation and vocal abuse. Clinical management with proton-pump inhibitor (PPI), topical inhalant steroid and phonotherapy was enough for remission on 48.6% of the patients. Surgery for removal of the granuloma associated with clinical management was effective in 90% of the events. Later recurrences (more than one year) were noticed in five patients, suggesting that associated etiopathogenic factors should be held for a long time. (+info)
Obstructive subglottic granuloma after removal of a minitracheostomy tube.
We report herein a patient with subglottic granuloma after removal of a minitracheostomy tube (Minitrach II, SIMS Portex Inc., Hythe, Kent, UK). The patient underwent pulmonary resection for lung cancer followed by insertion of the minitracheostomy tube for prevention of sputum retention. The tube was removed 4 days after insertion. Twelve weeks later, the patient developed severe dyspnea and stridor. Bronchoscopy showed an obstructive subglottic granuloma arising from the anterior wall. The granuloma was removed by coring out using a conventional tracheal tube, followed by local injection of methylprednisolone acetate. The patient is now asymptomatic without regrowth of the granulation tissue 12 weeks after the treatment. With complication in mind, attention should be paid to patients suffering dyspnea or stridor after removal of a minitracheostomy tube. (+info)
Laryngeal granuloma: a complication of prolonged endotracheal intubation.
Laryngeal granuloma is an uncommon complication arising from irritation of the laryngeal structures. 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. Excision of the lesions under endotracheal general anesthesia led to an uneventful outcome. The causes, predisposing factors, diagnostic features, and treatment of laryngeal granuloma are reviewed. (+info)
Clinical, histological and electron microscopic aspects of vocal fold granulomas.
Peptic (contact ulcer) granuloma of the larynx.
Review of published work and analysis of clinical data and pathology of four biopsy specimens from two patients with laryngeal contact granuloma showed that its peptic origin was derived from a gastro-oesophago-laryngeal reflux. It is proposed that the term "peptic granuloma" should be given to this phenomenon. This term is given further support on account of the spectacular recovery of the laryngeal lesion following antacid and antireflux treatment, rather than the traditional method of using vocal rest and speech therapy, assumed to be the best way of treating a result of mechanical irritation, the previously accepted cause of laryngeal contact granuloma. (+info)