There are two distinct forms of laryngeal paraganglioma. The patient with the rare Type II has exquisite throat pain that is often clinically confusing. The small size or submucosal location of the lesion often results in a delay in correct diagnosis and treatment. The lesion is very aggressive, even if tiny, generally with widespread metastasis. This tumor should be considered in the differential diagnosis of severe persistent throat pain, especially in the absence of abnormalities on physical or radiologic examination.
Because antibody titers against Epstein-Barr virus (EBV) antigens often are elevated in patients with active undifferentiated and nonkeratinizing nasopharyngeal carcinoma, anti-EBV serologic tests have been applied as a diagnostic aid in patients who have metastatic lymphadenopathy in the neck without an obvious source. IN this study of 44 patients, the serologic testing procedure proved useful in identifying six patients with nasopharyngeal carcinoma that was initially occult but was eventually confirmed by biopsy.
I n recent years, otolaryngologists have been urged to use video endoscopic laryngoscopy as their standard laryngeal examination. Mirror laryngoscopy, it is pointed out, is subjective, fleeting, and memory-dependent. By contrast, video laryngoscopy is visually and acoustically objective, as well as documentary and archival. Nevertheless, there must be many laryngologists who look for further evidence that the expense of video endoscopic equipment-and the time involved in performing, taping, and retrieving the records of these examinations-is justified. Video laryngoscopy would be the standard procedure if this were not the case. Perhaps it would be useful to itemize the claims for video en-From the Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic-Jacksonville (Dr. Pearson), and the Department of Otolaryngology, Mayo Clinic-Rochester (Dr. Neel).
The three most common types of vertiginous episodes area benign positional vertigo, postural vertigo, and endolymphatic hydrops. One of these conditions will be found in more than 90% of patients who present with vertigo as their main complaint. A clear understanding of the differences among these three entities will enable the physician not only to prescribe appropriate effective medical treatment but also to counsel and educate the patient about his or her particular condition.
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