Sarcoidosis is a systemic inflammatory granulomatous disease that affects multiple organs in the body; however, dysphagia is a relatively rare manifestation at early stages. Dysphagia in sarcoidosis is attributed to many mechanisms, such as mediastinal lymphadenopathy, esophageal or laryngeal involvement, cranial neuropathy, and brainstem infiltration. In this article, we report an extremely rare case with sarcoidosis who presented with dysphagia due to isolated cricopharyngeal myopathy. The 75-year-old woman presented with slowly progressive swallowing difficulty and videofluorography showed insufficient opening of the upper esophageal sphincter. On presentation, she had no cranial nerve or central nervous system impairments. A cricopharyngeal myotomy was performed, and histopathological study revealed a significant inflammatory change with non-necrotizing granulomas within the muscle tissue. We concluded that this was a very rare case of sarcoidosis presenting with localized cricopharyngeal myopathy. Postoperatively, a contracture of the esophageal entrance was successfully released and the dysphagia was alleviated.
Laryngomalacia is one of the most common diseases of laryngeal stenosis in newborns and infants. In contrast, adult-onset laryngomalacia cases are rare and the majority of them are classified as an epiglottic type. We report on a case of 20 -year old female with arytenoid type laryngomalacia who presented with an intermittent inspiratory stridor after catching a cold. Her pulmonary function was normal; however, endoscopic examination showed an inward prolapse of the bilateral flaccid arytenoid mucosa during strained inspiration resulting in supraglottic stenosis. She underwent a resection of the flaccid mucosa bilaterally with the use of CO 2 laser. Postoperatively, her inspiratory dyspnea had been successfully relieved for over a year. The rarity of adult-onset laryngomalacia may lead to overlooking the possibility of this disease. Physicians treating dyspneic patients should be aware of laryngomalacia even in adults and thorough endoscopic observation of the larynx should be mandatory.
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