The otolaryngologic manifestations of multiple myeloma.

Abstract

The purpose of this paper is to present the precursors and complications of multiple myeloma as manifested in Otolaryngology. The modern Otolaryngologist is well aware that systemic disease may manifest itself in our specialty. Multiple myeloma is a distinctive form of plasma cell dyscrasia which often manifests itself in Otolaryngology. For example, patients may present with epistaxis, hoarseness, asymmetry of the face, swelling of the palate, nasal obstruction and a multiplicity of other symptoms. Therefore, the practicing Otolaryngologist must maintain a high index of suspicion that a seemingly simple sign or symptom may represent one small facet of a generalized condition. The paper emphasizes that in many instances a slight extension of our history taking may provide us with information leading to the diagnosis of this systemic disease. Cases seen by the author are reviewed and the relevant clinical features are presented.

Vocal Fold Wound Healing: A Review for Clinicians

“…For example, the foreign body response to Teflon injection into the vocal fold has been well documented. 71 However, the use of autologous fat seems to elicit a minimal inflammatory response, little epithelial reaction, and minimal unexpected fibrosis. 72 Numerous augmentation materials have been described in the literature.…”

Histologic Evaluation of Teflon Granulomas of Human Vocal Cords:A Light and Electron Microscopic Study

“…Even after this short time interval the author reported numerous multinucleated giant cells of the foreign body type. The tissue response 48 hours after Teflon injection, has recently been documented by Lewy & Millet (1978). These authors described a heavy infiltration of leukocytes as well as marked hyperemia and interstitial tissue edema around the foreign material of the vocal cord.…”

A Delayed Tef lonoma of the Neck Simulating a Thyroid Neoplasm

“…the intensity of the tissular reaction and the relative amounts of giant cells and fibrous tissue) varies, depending on the interval between injection and histologic evaluation [9,[11][12][13][14][15][16][17][18][19][20][21][22] and from case to case [17,21], probably due to interindi vidual differences in the susceptibility or reactivity to Teflon. Modifications of individual susceptibility may also occur with time, and may be an explanation for the long interval (3 years) between Teflon paste injection and clinical manifestations in our patient, the initial bland or mild tissular reaction being followed by a secondary more active foreign body granuloma, with delayed clinical man ifestations.…”

“…It gives a medialization of the paralyzed cord so that the functional contralateral vocal cord can more easily approximate it, allowing a better voice and glottic competence. The results are generally good and adverse reactions and com plications are usually limited to transient edematous swelling of the vocal cord, sometimes with cervical lym phadenitis [9], However, overinjection of the material or injection in an improper site may result in the delayed production of a mass in the larynx or in the neck, simulat ing a laryngeal or thyroid neoplasm.…”