Atypical and Disparate Presentations of Laryngeal Sarcoidosis

Mayerhoff, Ross; Pitman, Michael J.

doi:10.1177/000348941011901004

Cited by 15 publications

(14 citation statements)

References 11 publications

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“…Of the three patients who underwent VFS, two showed a slightly reduced cricopharyngeal opening, likely as a result of reduced hyolaryngeal movement. There was no evidence of a cricopharyngeal bar, which was the main physiological manifestation of dysphagia in the single paper in the literature that gives details on the nature of the dysphagia [8].…”

Section: Resultsmentioning

confidence: 96%

“…Five papers (29%) alluded to dysphagic symptoms which resolved following medical treatment. Only one paper gave any details about the dysphagia, and how it was assessed and treated [8]. The authors reported on a case of a 43-year-old woman with progressive dysphagia, who was found to have a cricopharyngeal bar and oesophageal issues on a barium swallow study.…”

Section: Resultsmentioning

confidence: 99%

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Laryngeal Sarcoidosis and Swallowing: What Do We Know About Dysphagia Assessment and Management in this Population?

et al. 2021

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Introduction Sarcoidosis is a chronic granulomatous disease of unknown aetiology and laryngeal involvement is seen in a small percentage of cases. Dysphagia is a common but under-reported symptom. Little is known about how dysphagia typically presents or is managed in the context of this fluctuating disease. We present our case series using an SLT-led model of assessment and management. Methods A literature search was conducted for any articles that reported both laryngeal sarcoidosis and dysphagia. We then analysed a case series of laryngeal sarcoidosis patients treated at Charing Cross Hospital. We report on multidimensional swallowing evaluation and rehabilitative interventions. Results Seventeen papers report both laryngeal sarcoidosis and dysphagia, with only one paper giving details on the nature of the dysphagia and the treatment provided. In our case series (n = 7), patients presented with FOIS Scores ranging from 5 to 7 pre-operatively (median = 6). Aspiration (median PAS Score = 6 and Range = 3–8) and pharyngeal residue were common. Sensory issues were also prevalent with most unaware of the extent of their difficulties. Management interventions included safe swallowing advice, compensatory strategies, exercises and close surveillance given their potential for repeated surgical interventions. Conclusion Laryngeal sarcoidosis is a rare condition. Dysphagia is under-reported and our experience highlights the need for specialist dysphagia intervention. Further research is required to understand dysphagia management requirements in the context of this fluctuating disease process.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Laryngeal Sarcoidosis and Swallowing: What Do We Know About Dysphagia Assessment and Management in this Population?

et al. 2021

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“…7 A review of the medical literature revealed 53 previous reports describing laryngeal sarcoidosis and four reports of laryngeal edema that showed signs of exacerbation or recurrence after therapy. [2][3][4][5] In ►Table 1, we summarize case reports of laryngeal edemas that showed relatively long remissions of 6 months or longer. Of these, the laryngeal edemas that showed signs of exacerbation or recurrence were found in only two cases, one after 15 months 4 and the other after 46 months.…”

Section: Discussionmentioning

confidence: 99%

“…1 There are conditions of the cases that are treated but also exacerbate or recur. [2][3][4][5] In clinical practice, laryngeal edema is frequently seen in acute epiglottitis, laryngitis, and laryngeal allergy. In the case of acute epiglottitis or laryngitis, it is particularly necessary to pay attention to acute airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Intractable Laryngeal Sarcoidosis: A Case Report

Miyazaki

Haraoka

Sakata

et al. 2020

International Journal of Practical Otolaryngology

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Laryngeal sarcoidosis is rare, and reports of recurrences after treatment are even rarer. A 49-year-old Japanese female patient visited our clinic with a 7-day history of dysphagia. Her medical history included sarcoidosis involving the cervical lymph nodes. Endoscopic examination revealed a diffusely swollen epiglottis and bilateral edema of the arytenoids. Corticosteroids and antibiotics were administered, but the laryngeal edema did not subside. Contrast-enhanced computed tomography imaging revealed bilateral low-density areas in the arytenoids. Therefore, we performed bilateral arytenoid biopsy under direct laryngoscopic guidance. The histopathology showed noncaseating epithelioid cell granulomas with moderate to severe chronic inflammatory infiltration; based on these findings, we diagnosed the patient as having laryngeal sarcoidosis. While the laryngeal edema did not recur for several months, arytenoid edema recurred 9 months after systemic steroid therapy. The patient's medical history of sarcoidosis of other organs as well as the presentation of edema of a supraglottic lesion and histopathological findings of noncaseating epithelioid cell granulomas led us to make the diagnosis of laryngeal sarcoidosis again. Laryngeal sarcoidosis is an important consideration in the differential diagnosis of laryngeal edema, as its therapy and clinical course are different from those for other diseases that present with laryngeal edema. A cautious follow-up of patients diagnosed as having laryngeal sarcoidosis is needed, because in rare cases, the laryngeal edema can become worse over time even after therapy.

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“…These conditions share many of the manifestations of laryngeal sarcoidosis and require exclusion [1]. However, it is important to establish an early diagnosis to prevent potential complication such as airway obstruction [11].…”

Section: Discussionmentioning

confidence: 99%