Primidone therapy was an effective pharmacologic treatment for essential vocal tremor in 14 of 26 patients in this case series, providing an alternative to botulinum neurotoxin therapy.
A 77-year-old female with bilateral vocal cord paralysis and dependent tracheostomy status after total thyroidectomy presented to clinic for evaluation of decannulation via arytenoidectomy. Preliminary data suggests coblation versus standard CO2 laser ablation in arytenoidectomy may provide benefits in terms of decreased tissue necrosis and patient outcome. The patient elected to proceed with arytenoidectomy by coblation. The initial procedure went well but postoperative bleeding required a return trip to the operating room for hemostasis. In the coming months the patient's tracheostomy tube was gradually downsized and eventually capped. She was decannulated eight months after surgery, speaking well and without complaints. Details of the surgical procedure and outcome will be discussed.
Actinomyces-related osteomyelitis of the face and jaw is an uncommon complication following invasive dental procedures or trauma, but can have an idiopathic etiology. This case involved a 71-year-old woman who presented to her primary physician for acute sinusitis over a two-week period. CT scan revealed sinusitis with associated bony destruction of the hard palate. She was subsequently referred over concern for invasive fungal sinusitis. She underwent biopsy and debridement yielding a diagnosis of Actinomycesrelated osteomyelitis of the hard palate. Debridement and intense antimicrobial therapy for several months eventually resolved her infection. Though her outcome was favorable, patients with this disease can present after this invasive and aggressive bacteria has already caused irreversible damage.
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