Our results suggest VM disease is more common than previously thought. We believe that further EcochG-based studies would shed light on the controversial topic on the intersection and disjunction sets of MD and VM diseases. Although the results of the present study are compatible with peripheral vestibular effects, it is not possible to rule out another central mechanism at some other level.
A 58-year-old man was admitted to our department with complaint of hoarseness. On endoscopical examination, a partially ulcerated lesion of the right vocal cord extending to the anterior commissure was detected. The vocal cords were symmetrically mobile. Head and neck examination revealed no palpable neck masses, and the remainder of the otorhinolaryngologic examination was normal. He had no smoking history, and medical history was unremarkable.Magnetic resonance imaging (MRI) of the neck showed a mass involving the right vocal cord extending the anterior commissure. In addition, there was no pathologic lymph node in the MRI scans of the neck (Fig. 1).To gain additional information about the mass and to perform a biopsy for histopathological investigation, the patient underwent direct microlaryngoscopy under general anesthesia. Fragmented tissue biopsies were histologically investigated. Histologically, the surface epithelium is ulcerated by a tumor and infiltrated lesion is present in the subepithelial tissue. The tumor formed syncytial sheets and nests without evidence of squamous or glandular differentiation, and is densely surrounded by inflammatory cells, largely lymphocytes and plasma cells. Tumor cells are composed of epithelial cells, containing large central nuclei with prominent nucleoli and a large eosinophilic cytoplasm. Pathological study of the surgical specimen revealed an undifferentiated carcinoma with aspects of lymphoepithelioma (Fig. 2). The patient was treated with frontolateral laryngectomy. Right vocal cord and anterior commissure including cartilage piece of the left thyroid cartilage lamina as well as one-third anterior part of the left vocal cord were removed.Definitive histopathological diagnosis was a poorly differentiated squamous cell carcinoma with aspects of lymphoepithelioma. In situ hybridization for Epstein-Barr virus (EBV) and PCR EBVspecific amplification proved to be negative. At that time, after 18 months of follow-up, there was no evidence of recurrence.Lymphoepithelial carcinoma of the larynx accounts for 0.2% of all laryngeal cancers. 1 These tumors are an exceedingly rare and aggressive neoplasm with a propensity for early cervical lymph node and distant metastasis. The most common site of development of primary laryngeal lymphoepithelial carcinoma is the supraglottic region. 2 The relationship between EBV and lymphoepithelial carcinoma of the larynx remains controversial. Despite the small number of cases, the initial results suggest that EBV plays a limited role in the etiology of lymphoepithelial carcinoma of the larynx. The clinical course and optimal treatment of nonnasopharyngeal lymphoepithelioma of the head and neck have not been well described. Although most patients have been treated surgically, this tumor is radiosensitive and radiotherapy should be considered as the main treatment. Neoadjuvant chemotherapy may be recommended in patients with early regional adenopathy in order to decrease the distant metastasis rate.
The patients with total laryngectomy seem to have more psychological problems that must be addressed in the postoperative period.
The Journal of International Advanced Otology (J Int Adv Otol) is an international, peer reviewed, open access publication that is fully sponsored and owned by the European Academy of Otology and Neurotology and the Politzer Society. The journal is published triannually in April, August, and December and its publication language is English.The scope of the Journal is limited with otology, neurotology, audiology (excluding linguistics) and skull base medicine.The Journal of International Advanced Otology aims to publish manuscripts at the highest clinical and scientific level. J Int Adv Otol publishes original articles in the form of clinical and basic research, review articles, short reports and a limited number of case reports. Controversial patient discussions, communications on emerging technology, and historical issues will also be considered for publication.Target audience of J Int Adv Otol includes physicians and academics who work in the fields of otology, neurotology, audiology and skull base medicine.
Objectives To compare voice parameters in subjects with different hearing level.Methods The evaluation consisted of Multi-Dimensional Voice Program (MDVP) and electroglottography. Group 1 consisted of normal hearing subjects which is bilateral average hearing better than 25 decibels (dB) whereas group 2 consisted of patients who have bilateral average hearing between the 25 and 60 dB and group 3 consisted of patients who have bilateral average hearing between the 60 and 90 dB. The evaluations were performed on males and females separately.Results In female subjects, fundamental frequency (F0), absolute jitter, %jitter and soft phonation index (SPI) were significantly different between the group 1 and group 2. Also, we detected significant difference on maximum phonation time (MPT), fundamental frequency, absolute jitter and %jitter, and variable F0 (vF0) values between group 1 and group 3. Male subjects demonstrated significant difference between the group 1 and group 2 in MPT, absolute jitter, %jitter, vF0, and SPI parameters. Between the group 3 and group 1; differences in absolute jitter, %jitter, shimmer, %shimmer, vF0, and SPI were also significant.Conclusion This study concluded that even mild to moderate hearing losses may affect voice patterns in adults and also females and males react differently to hearing loss in some parameters.
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