A 25-year-old female developed permanent, fluctuating sensorineural hearing loss (SNHL), disabling vertigo, and tinnitus following an uneventful spinal anesthesia for cesarean section. At her first visit to the ear-nose-throat (ENT) department approximately 2 months postoperatively, pure-tone thresholds revealed profound SNHL on the right side whereas thresholds were within normal limits on the left side. The recruitment score (SISI) was 95% at 2000 Hz on the right side. Directional preponderance towards the right and the right canal paresis were evidenced by bithermal caloric testing. At follow ups the pure tone thresholds have shown some improvement, but fluctuating SNHL, disabling vertigo attacks, and tinnitus have remained. These findings imply a cochlear pathology causing endolymphatic hydrops possibly induced by lumbar puncture for spinal anesthesia.
Endoscopic approach for complete removal of the CPs is an extremely safe and effective procedure. It should be focused on the detection of the exact origin and the extent of the polyp to prevent recurrence.
Both laryngocele and laryngeal amyloidosis are uncommon, and simultaneous occurrences of these entities are extremely rare. A case of laryngeal amyloidosis with laryngocele in which the computed tomography (CT) and magnetic resonance (MR) imaging of the larynx, clearly demonstrating both disease processes, is discussed. Diagnosis is confirmed by histopathologic specimens. Only two cases have been reported in the world literature, and this is the third case of laryngeal amyloidosis associated with laryngocele.
According to histopathologic results of this study (tissue compatibility of three materials), silicone is the most suited material among the study materials for medialization. Gore-Tex can also be used for this purpose. Irradiated cartilage, on the other hand, appears not to be a suitable material for medialization laryngoplasty.
The biological mechanisms of cancer and associations with behavior of tumours need to be studied to understand progression and determine appropriate treatments. Here we investigated expression of VEGF, MMP-9 and E-cadherin in laryngeal SCCs and their relations with clinical behavior. This prospective study was based on 38 surgical specimens from patients with primary laryngeal SCC and data recorded in their cards. Expression of the three factors in tumor tissue was examined using immunohistochemistry and correlations with clinical parameters of primary tumors, regional lymph node metastases, stage of disease, histopathologic differentiation, and vascular/cartilage invasion were investigated. Regarding the cases with positive MMP-9 expression, the difference between well and moderately/poorly differentiated tumors was statistically significant. However, differences between early stage (stage I and II) and late-stage (stage III and IV) tumours, and between positive and negative for pLN metastasis were not. No significant relationship between positive VEGF and tumor differentiation or stage was apparent, but E-cadherin levels significantly differed between well and moderately/ poorly differentiated tumours and with the presence of pLN metastasis. E-cadherin staining did not vary between MMP-9 positive and negative cases. In conclusion, MMP-9 may be a negative predictor of differentiation in laryngeal SCC, while E-cadherin is a predictor of differentiation and nodal metastases. Even if the difference between VEGF expression and tumor stage was not statistically significant, it seems that there exists some relationship, which might be clarified with a greater number of cases.
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