Contact ulcer granuloma has a multifactorial etiology but vocal abuse is considered the most important etiological factor. Some other possible factors are well-known: tuberculosis, allergies, hormonal or autonomic imbalance, psychosomatic influences, reflux-esophagitis, pathological conditions of the nose, nasal accessory sinus, tonsils. Constitutional factors play also an important role. The symptoms range from mild huskiness to severe hoarseness with pain extending to the ear, dysphagia, sometimes hemoptysis and chronic cough. Failure to recognize the pathological features of this frequently overlooked lesion leads to diagnosis of larynx cancer, angiosarcoma or hemangioma. Indication for microsurgical removal is only severe dyspnea by size of mass or if the dignity is not clear, because any surgical procedure has only temporary value and does not eliminate the etiological factors. The dignity can normally be proved by stroboscope. Vocal rehabilitation and re-education are an essential appropriate means of treatment for this disease if other causative factors are excluded.

A case of trichoadenoma Nikolowski in a 74-year-old woman is reported. The tumour invaded the upper lip, the base of the columella and the left nasal entrance. The tumour was cured by surgery and plastic reconstruction of the defect. This benign lesion of the hair follicles is rare and therefore often misdiagnosed as basal cell carcinoma or seborrheic keratosis. Examination of tumour cells by DNA-flow cytophotometry showed a normal diploid DNA-content of the tumour cells.

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Während Störungen der Stimmfunktion bei Patienten mit Sprechapraxie wiederholt beschrieben wurden und obwohl theoretisch das Auftreten von Apraxien der Stimmgebung postuliert wird, liegt bisher erst eine Falldarstellung eines Patienten mit einer Kehlkopfoder Phonationsapraxie vor. Hier wird ein 51 jähriger Patient mit ausgedehnter rechts-temporoparietaler intrazerebraler Blutung beschrieben, der bei weitgehend ungestörter Artikulation und fehlenden Zeichen einer Dysarthrie und einer Aphasie eine Aphonie und eine fehlende Sprechatmung hat. Diese Störung wird nach differentialdiagnostischem Ausschluss anderer zentral bedingter Stimmstörungen als Kehlkopfapraxie eingeordnet.