Vocal process granuloma is an uncommon occurrence which is possibly related to endotrachial intubation. Despite its infrequent occurrence, intubation vocal granuloma has received considerable attention in the literature on account of its versatile clinical managements and various results. We presented a series of cases afflicted with intubation vocal granuloma and documented the promising effect of potassium titanyl phosphate (KTP) laser ablation. Twelve patients of intubation vocal granuloma had been retrospectively reviewed at Tri-Service General Hospital from January 1999 to June 2006. Detailed history taking, physical examination, and voice analysis were conducted in all patients before and after this surgical intervention. They all underwent KTP laser ablation of vocal granuloma. Patients were 7 females and 5 males with a mean age of 46.8 years. The grade of hoarseness, roughness, breathiness, asthenia, and strain (GRBAS) scale and maximum phonation time (MPT) showed significant different before and after this surgical intervention (P < 0.05). There was no recurrence in all patients for at least 14 months in the follow-up. We have found that KTP laser microlaryngosurgery can be a useful therapy and can lead avoidance of repetitive surgical procedures.
Adenocarcinoma of the prostate (CAP) is a rare diagnosis in men younger than 50 years of age; this age group accounts for less than 0.1% of all patients with prostatic cancer. Left supraclavicular lymphadenopathy (LSCL) as the presenting symptom of metastatic CAP is even rarer. No cases of CAP presenting as LSCL in men younger than 45 years have been reported in the literature. Here we report a 42-year-old male with the uncommon presentation of CAP as LSCL. In adult males with persistent LSCL, even if younger than 45 years, measurement of serum prostate specific antigen is warranted at the time of initial presentation, and the lymph node biopsy should be subsequently stained for prostate specific antigen immunohistochemically. These examinations are crucial to establish a definitive diagnosis of CAP and, in turn, to institute appropriate management and achieve the best possible outcome.
This study reported our experience of the clinical characteristics of periparotid recurrence of nasopharyngeal carcinoma (NPC) after parotid-gland-sparing radiotherapy. We retrospectively reviewed the charts of 296 patients with NPC who underwent parotid-gland-sparing radiotherapy at the Tri-Service General Hospital from 1998 to 2008. Eighty-three patients underwent three-dimensional conformal radiotherapy, and 205 patients underwent intensity-modulated radiotherapy; parotid glands were spared bilaterally in all patients. None of these patients had undergone previous radiotherapy or surgical treatment of the head and neck. Disease recurred in a spared parotid gland in three patients (1.04%). Two of these patients had undergone three-dimensional conformal radiotherapy and the third underwent intensity-modulated radiotherapy. All three patients had undergone parotidectomy. Adjuvant radiotherapy or concurrent chemoradiation was administered. One patient died of metastatic disease 26 months after diagnosis of recurrence; the others were well with no evidence of disease at 63 and 6 months after initial recurrence. Periparotid recurrence is an uncommon pattern of locoregional failure after parotid-gland-sparing radiotherapy for NPC. Early diagnosis and aggressive therapy for patients with periparotid recurrence may improve outcomes.
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