<p class="abstract">Amyloidosis is a rare, benign, slowly progressive disease characterized by extracellular accumulation of<strong> </strong>amyloid in different tissues of the body. It accounts for 0.2-1.2% of benign laryngeal tumors and usually presents as an isolated localized laryngeal amyloidosis, but can also be part of systemic amyloidosis. A 26 years old female with history of gradually developing, persistent hoarseness, and progressive<strong> </strong>dyspnea since 1 year, worsened over the past three days. Outpatient Department based endoscopy showed bilateral mobile, thickened vocal cords with subglottic edematous thickness. Computed tomography scan showed symmetrical thickening of bilateral vocal cord, causing glottic narrowing about 70% on the AP view and about 50% on the lateral view and no cartilage invasion or lymphadenopathy. Microlaryngoscopy and biopsy of the specimen were performed and histopathology confirmed the diagnosis of amyloidosis with Congo red stain. Patient was managed by surgical excision of the mass and long term follow-up. To rule out systemic amyloidosis patient is referred to rheumatology clinic and hematology clinic for further evaluation and management. Histopathological examination of the involved tissue confirms the diagnosis, and long term follow up is mandatory in the management of amyloidosis.</p>

<p class="abstract"><strong>Background: </strong>The two important principles in Reinke’s edema treatment are minimal intervention and superficial resection with evacuation the edema and preservation the medial edge of the vocal fold to improve the voice quality. The aim of this study was to evaluate a novel surgical technique in treatment of Reinke’s edema and its effect on subjective and quantitative voice characteristics. The study design was a prospective clinical series.</p><p class="abstract"><strong>Methods: </strong>We evaluated 67 patients from 19 to 73 years (mean, 47.7 years) with Reinke’s edema. The patients were divided into 3 types, mild, moderate and sever. Clinical voice assessment was composed of stroboscopy, subjective voice evaluation (GRBAS hoarseness scale) and quantitative voice evaluation were evaluated pre- and postoperatively. All patients underwent endolaryngeal CO2 laser puncturing for treatment of Reinke’s edema.</p><p class="abstract"><strong>Results: </strong>67 patients diagnosed as Reinke’s edema were classified by H. Yonekawa classification into three types. Type I 25 (37.3%) patients, type II 30 (44.8%), type III 12 (17.9%). Out of 67 patients, fifty two (77.6%) were smoker. In all the patients, the laryngostrobscopic findings showed an improvement of mucosal wave patterns with little vocal fold scaring. Significant vocal improvement was also noted in subjective and objective voice assessments.</p><p class="abstract"><strong>Conclusions: </strong>The laser puncture technique is safe, effective and less invasive to treat Reinke’s edema with significant improvement in vocal performance after surgery.</p>

<p class="abstract">In developing countries, head and neck penetrating injuries from construction nails are rare can be dangerous or fatal. The use of nail guns in the construction industry gained popularity during the 1990s and is now widespread. In majority of nail gun injuries, the extremities are involved, although injuries to the head and neck region have also been described with approximately 45 cases of cranium penetrating nail gun injuries published in the literature. The management of such cases includes a neurological examination, systemic physical examination, and determination of the optimal surgical method to approach and remove the foreign body. we report a case of penetrating skull base injury caused by a nail gun in a 46-year-old man that was successfully managed by a transnasal endoscopic approach. The patient recovered completely and was discharged. To prevent complications and achieve the best outcomes in such cases, careful diagnosis and assessment are necessary.</p>