We describe a case of non-tuberculous mycobacterial infection of the larynx in a previously well, immunocompetent young woman. Laryngeal mycobacterial infection is rare and currently accounts for less than 1% of all cases. A diagnostic dilemma often occurs because it may mimic laryngeal carcinoma, chronic laryngitis, or laryngeal candidiasis. This case highlights the importance of considering non-tuberculous mycobacterial infection in the differential diagnosis of laryngeal lesions.

Our results suggest that intensive empirical treatment with proton pump inhibitors is effective in diagnosing laryngopharyngeal reflux.

No abstract

BACKGROUND AND OBJECTIVESObstructive sleep apnea (OSA) is a common disease affecting middle-aged patients and is associated with significant cardiovascular, cerebrovascular, and metabolic complications. Current evidences show inconclusive association between OSA and insulin resistance (IR). This study aims to examine the possible correlation between OSA parameters and IR.DESIGN AND SETTINGSThis was a cross-sectional study to examine the association between OSA parameters and IR using homeostasis model assessment (HOMA) on patients who underwent polysomnogram (PSG) in a tertiary center between March 2011 and March 2012 (1 year).PATIENTS AND METHODSA total of 62 patients underwent PSG within the study period, of which 16 patients were excluded due to abnormal fasting blood sugar. Information on patients’ medical illnesses, medications, and Epworth sleepiness scale (ESS) was obtained. Patients’ body mass index (BMI), neck circumference, and waist circumference (WC) were measured. Blood samples were collected after 8 hours of fasting to measure HOMA–IR value. Overnight PSG was performed for all patients. Data was recorded and analyzed using SPSS, version 12.0 (SPSS Inc, Chicago, USA).RESULTSThe prevalence of IR in OSA patients was 64.3%. There was significant correlation between OSA parameters (apnea-hypopnea index, ESS, BMI, and WC) and HOMA–IR with correlation coefficient of 0.529, 0.224, 0.261, and 0.354, respectively.CONCLUSIONA linear correlation exists between OSA parameters and IR concluding a definite causal link between OSA and IR. IR screening is recommended in severe OSA patients.

A pyolaryngocele is an uncommon complication of a laryngocele that has become infected. We present a case of a pyolaryngocele that was probably due to repeated injections in the neck veins. The pathogenesis, clinical features and management are discussed in detail.