Cricoarytenoid joint abscess associated with rheumatoid arthritis

Foggia, Megan J.; Hoffman, Henry T.

doi:10.1016/j.amjoto.2019.03.013

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…There were 7 cases of spontaneous laryngeal abscess identified in the literature since 1985. [7][8][9][10][11][12][13] In total, 8 cases (inclusive of current case) are included for analysis. Six of 8 had some form of immunocompromise (75%).…”

Section: Resultsmentioning

confidence: 99%

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

Rohlfing

Kan

Tierney

et al. 2022

Ann Otol Rhinol Laryngol

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Objective: Laryngeal abscesses are rare in the modern antibiotic era. Historically, they were associated with systemic infections including typhoid fever, measles, gonorrhea, syphilis, and tuberculosis. More recent authors have described cases resulting from iatrogenic injury and immunosuppression. This report presents a novel case of laryngeal abscess in the setting of uncontrolled diabetes and a detailed review of modern, reported cases of spontaneous laryngeal abscess. Methods: Report of a single case. Also, PubMed was queried for cases of laryngeal abscess since 1985. Case report: A 58-year-old male with poorly controlled diabetes presented with odynophagia, dysphagia, and dyspnea. He had biphasic stridor, and flexible laryngoscopy showed reduced mobility of bilateral vocal folds and narrowed glottic airway. He was taken urgently for awake tracheostomy and microdirect laryngoscopy. Laryngoscopy demonstrated fullness and fluctuance of the right hemilarynx. The abscess cavity was entered endoscopically via paraglottic incision extending into the subglottis. The patient was treated with an 8-week course of ampicillin-sulbactam with resolution of infection. Results: Seven additional cases of spontaneous laryngeal abscesses published after 1985 were identified. In total, 6 of 8 had some form of immunodeficiency (75%). The most common presenting symptoms were dysphonia (8/8, 100%), odynophagia (5/8, 62.5%), and dyspnea/stridor (4/8, 50%). All cases were treated with surgical incision and drainage. Conclusions: Laryngeal abscesses are rare in the era of modern antibiotics. This review confirms that the majority of recent episodes occurred in the setting of immunodeficiency and are caused by non-tubercular bacteria. These infections are commonly associated with impaired vocal fold mobility which may contribute to dyspnea, stridor, and airway compromise. Surgical intervention is necessary for treatment and culture-directed antimicrobial therapy. Poorly controlled diabetes is a newly described context for development of spontaneous laryngeal abscess.

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Section: Resultsmentioning

confidence: 99%

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

Rohlfing

Kan

Tierney

et al. 2022

Ann Otol Rhinol Laryngol

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“…An important stage in diagnostics is the differentiation of this pathology from the palsy of the recurrent laryngeal nerve. The therapy is mainly based on treatment of the underlying disease causing the joint dysfunction [23][24][25]. Another related aspect is the pathological asymmetry of the movement of the tincture cartilages, of which their non-linear adduction is of the greatest importance.…”

Section: State Of Knowledgementioning

confidence: 99%

Influence of selected autoimmunological diseases on phonation devices, diagnostics and treatment

Markowska¹,

Jurkiewicz²

2023

J Pre Clin Clin Res.

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Introduction and Objective. Many autoimmune diseases correlate with phonatory disorders which significantly reduce the well-being and quality of life of patients due to difficulties in verbal communication. The aim of the review is to present the current medical knowledge on ENT complications in patients suffering from selected autoimmune diseases. The text is partially supplemented with the possibilities of diagnosis and treatment of these disorders. Review Methods. PubMed, PubMed Central, and printed literature were searched using key words related to phoniatrix, larynx, immunology, voice, thyroid and dysphonia. Articles in Polish, German and English were searched. Bibliographies with outdated data and those that did not have the latest update or did not meet the selected criteria were excluded. Exclusions were most often due to an incomplete topic as well as results reported by an unrepresentative group of patients. The review was supported by an additional case study included as relevant to add significant clinical and imaging value to the work. Brief description of the state of knowledge. Autoimmune diseases are manifested in various body systems, including the phonational system. Both patients and doctors often do not expect that symptoms such as hoarseness, dysphonia, low voice or sore throat may be caused by an underlying disease. The list of ailments, diagnostic options and treatment is intended to present this problem and to increase medical awareness. Summary. Tthe presented diseases have been shown primarily from the side of disorders in phonation which accompany them. Despite the apparent unrelatedness of the disease with the production of sound, the clinical picture often shows ENT symptoms that are significant for the patient.

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“…Patients with rheumatoid arthritis (RA), an autoimmune disease, are vulnerable to infection due to the immunocompromised status or concomitant use of immunosuppressants such as methotrexate (MTX), disease‐modifying antirheumatic drugs (DMARDs), or biologics . A correlation between RA and DNI was proposed as a hypothesis, but few relevant case reports were published after global review . Consequently, we conducted the study to investigate the effects of RA on DNI occurrence, treatment, and prognosis.…”

Section: Introductionmentioning

confidence: 99%

Real‐world evidence for increased deep neck infection risk in patients with rheumatoid arthritis

et al. 2019

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Objective To investigate the association between rheumatoid arthritis (RA) and deep neck infection (DNI). Study Design Retrospective cohort study. Methods Patients newly diagnosed with RA between 2000 and 2011 were identified from the National Health Insurance Research Database in Taiwan. Moreover, patients without RA were randomly selected and matched at a 1:4 ratio by age, sex, urbanization level, income, and diabetes mellitus. The patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of DNI. Results In total, 30,207 patients with RA and 120,828 matched patients without RA were enrolled. Patients with RA had a significantly higher cumulative incidence of DNI than those without RA (P < 0.001). The adjusted Cox proportional hazard model demonstrated that RA was significantly associated with a higher incidence of DNI (hazard ratio: 2.80, 95% confidence interval: 2.26–3.46, P < 0.001). Therapeutic methods (surgical or nonsurgical) did not differ significantly between the patients with RA‐DNI and with non–RA‐DNI. Patients with RA‐DNI had higher rates of tracheostomy, mediastinitis, mediastinitis‐related mortality, and mortality than patients with non–RA‐DNI, although these differences were without statistical significance. RA patients receiving no therapy experienced higher rates of DNI compared with those receiving methotrexate alone, disease‐modifying antirheumatic drugs, or biologic therapies. Conclusion This study is the first to investigate the association between RA and DNI. We conclude RA is an independent predisposing factor for DNI. Level of Evidence 4 Laryngoscope, 130:1402–1407, 2020

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Cricoarytenoid joint abscess associated with rheumatoid arthritis

Cited by 5 publications

References 13 publications

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

Influence of selected autoimmunological diseases on phonation devices, diagnostics and treatment

Real‐world evidence for increased deep neck infection risk in patients with rheumatoid arthritis

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