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Brazilian Journal of Otorhinolaryngology 2023Ectopic thymic tissue in the subglottis is an extremely rare disease that causes airway obstruction. Few cases reported were accurately diagnosed before surgery. (Review)
Review
OBJECTIVES
Ectopic thymic tissue in the subglottis is an extremely rare disease that causes airway obstruction. Few cases reported were accurately diagnosed before surgery.
METHODS
A case of a 2-year-old boy with airway obstruction caused by a left subglottic mass was reported. The presentation of radiological imaging, direct laryngoscopy and bronchoscopy, pathology, and surgical management were reviewed. An extensive search in PubMed, EMBASE, Web of Science, Google Scholar, and EBSCO of English literature was performed without a limit of time.
RESULTS
Besides our case, only six cases were reported since 1987. The definitive diagnosis on these patients were made with the findings of pathology, of which, five were ectopic thymus and two were ectopic thymic cysts. Our case was the only one with a correct suspicion preoperatively. Four cases underwent open surgical resection, and two cases underwent microlaryngeal surgery, while one deceased after emergency tracheostomy. No recurrences were found by six patients during the follow-up after successful treatments.
CONCLUSION
Ectopic thymus is a rare condition, infrequently considered in the differential diagnosis of subglottic masses. Modified laryngofissure may be an effective approach to removing the subglottic ectopic thymus and reconstructing the intact subglottic mucosa.
Topics: Male; Humans; Child; Child, Preschool; Larynx; Laryngoscopy; Laryngeal Diseases; Airway Obstruction; Diagnosis, Differential
PubMed: 34840123
DOI: 10.1016/j.bjorl.2021.10.001 -
Neuroimaging Clinics of North America Nov 2022The larynx serves as the gateway between the upper and lower respiratory tracts and is involved in the tasks of phonation, deglutition, and airway protection.... (Review)
Review
The larynx serves as the gateway between the upper and lower respiratory tracts and is involved in the tasks of phonation, deglutition, and airway protection. Familiarity with the complex anatomy of the larynx is critical for detecting and characterizing disease in the region, especially in cancer staging. In this article, we review the anatomy of the larynx and cervical trachea, including an overview of their cartilages, supporting tissues, muscles, mucosal spaces, neurovascular supply, and lymphatics, followed by correlation to the clinically relevant anatomic sites of the larynx. Imaging techniques for evaluating the larynx and trachea will also be discussed briefly.
Topics: Humans; Larynx; Neck; Trachea
PubMed: 36244725
DOI: 10.1016/j.nic.2022.07.011 -
Ear, Nose, & Throat Journal May 2022Inflammatory myofibroblastic tumor (IMT) is a very rare mesenchymal tumor that can behave as a locally benign or aggressive lesion. Here, we present an extremely rare...
Inflammatory myofibroblastic tumor (IMT) is a very rare mesenchymal tumor that can behave as a locally benign or aggressive lesion. Here, we present an extremely rare case of IMT involving the subglottic of a middle-aged male. Steroid therapy treatment alleviated dyspnea, but the recurrence of dyspnea was reported two months later. Both sides of the subglottic tumor were excised following treatment, and the surgical specimens were subjected to histopathological evaluation and diagnosis for IMT. At 4 years after excision, follow-up laryngoscopy revealed symmetric vocal cords without evidence of any subglottic mass. Subglottic mass is often asymptomatic until it presents with hoarseness or dyspnea, and subglottic IMT is rare. Based on the successful treatment of our case, complete surgical excision is highly recommended for this rare tumor. However, further research is needed to discover a more effective and cost-effective treatment approach.
PubMed: 35533683
DOI: 10.1177/01455613221083810 -
Ear, Nose, & Throat Journal Mar 2022
PubMed: 35324324
DOI: 10.1177/01455613221086528 -
Thoracic Surgery Clinics Nov 2007Anatomically, the larynx presents several unique features that account for the difficulties in the surgical management of pathologies, such as benign strictures located... (Review)
Review
Anatomically, the larynx presents several unique features that account for the difficulties in the surgical management of pathologies, such as benign strictures located in the area. These features include its unique cartilaginous support, its short length, its intrinsic and extrinsic musculatures, and its innervation, all of which are fundamental for the function of breathing, phonation, and swallowing. It is important that the thoracic surgeon operating on the larynx understand this particular anatomy, the limits of surgery, and most importantly the steps to be taken to avoid catastrophic complications.
Topics: Glottis; Humans; Laryngeal Diseases; Thoracic Surgery
PubMed: 18271169
DOI: 10.1016/j.thorsurg.2006.11.001 -
Thoracic Surgery Clinics Nov 2007The complexity of the glottic and subglottic region in terms of anatomy and function make this region challenging in evaluation and treatment. A thorough understanding... (Review)
Review
The complexity of the glottic and subglottic region in terms of anatomy and function make this region challenging in evaluation and treatment. A thorough understanding of the complex anatomy is necessary for the management of patients who have dysphonia, vocal fold paralysis, glottic or subglottic stenosis, or complications, which may present after prolonged intubation or surgical interventions in the upper airway and the thorax.
Topics: Glottis; Humans; Laryngeal Diseases; Otolaryngology
PubMed: 18271168
DOI: 10.1016/j.thorsurg.2006.11.002 -
Clinics in Perinatology Dec 2018The subglottis is a narrow region of the pediatric airway that is exquisitely susceptible to the development of airway stenosis. The incidence of acquired subglottic... (Review)
Review
The subglottis is a narrow region of the pediatric airway that is exquisitely susceptible to the development of airway stenosis. The incidence of acquired subglottic stenosis in the setting of prolonged intubation has significantly decreased because of improved endotracheal tube management protocols. Advances in otolaryngology interventions, such as balloon dilation and endoscopic cricoid split techniques, may allow the avoidance of tracheostomy in patients with mild to moderate subglottic stenosis. However, patients with severe subglottic stenosis are often tracheostomy dependent. Open surgical techniques to treat severe disease, such as laryngotracheal reconstruction and cricotracheal resection, offer high rates of tracheostomy decannulation.
Topics: Bronchoscopy; Cricoid Cartilage; Dilatation; Female; Humans; Infant, Newborn; Intubation, Intratracheal; Laryngoscopy; Laryngostenosis; Male; Plastic Surgery Procedures; Recovery of Function; Risk Assessment; Treatment Outcome
PubMed: 30396418
DOI: 10.1016/j.clp.2018.07.013 -
Journal of Medical Case Reports Feb 2016Epithelial-myoepithelial carcinoma is an extremely rare disease that usually occurs in the parotid gland but can occur in a variety of sites such as the nasal cavity,... (Review)
Review
BACKGROUND
Epithelial-myoepithelial carcinoma is an extremely rare disease that usually occurs in the parotid gland but can occur in a variety of sites such as the nasal cavity, paranasal sinus, and base of the tongue.
CASE PRESENTATION
We report a rare case of epithelial-myoepithelial carcinoma, which developed in the subglottic region. A 78-year-old Korean woman visited our hospital complaining of hoarseness, which had developed 1 month previously. Flexible laryngoscopy showed a round mass that blocked approximately 80 % of the tracheal diameter. Complete excision of the mass was carried out under general anesthesia, using a transoral approach. Epithelial-myoepithelial carcinoma was diagnosed following immunohistochemical analysis.
CONCLUSIONS
We report a rare case of epithelial-myoepithelial carcinoma that occurred in the subglottic region. To the best of our knowledge, only one other case has been reported since this disease was first identified approximately 40 years ago.
Topics: Aged; Carcinoma; Female; Humans; Laryngeal Neoplasms; Myoepithelioma
PubMed: 26922486
DOI: 10.1186/s13256-016-0824-8 -
Seminars in Fetal & Neonatal Medicine Oct 2023Safe and effective management of the neonatal airway requires knowledge, teamwork, preparation and experience. At baseline, the neonatal airway can present significant... (Review)
Review
Safe and effective management of the neonatal airway requires knowledge, teamwork, preparation and experience. At baseline, the neonatal airway can present significant challenges to experienced neonatologists and paediatric anaesthesiologists, and increased difficulty can be due to anatomical abnormalities, physiological instability or increased situational stress. Neonatal airway obstruction is under recognised, and should be considered an emergency until the diagnosis and physiological implications are understood. When multiple types of difficulties are present or there are multiple levels of anatomical obstruction, the challenge increases exponentially. In these situations, preparation, multi-disciplinary teamwork and a consistent hospital-wide approach will help to reduce errors and morbidity.
Topics: Humans; Infant, Newborn; Airway Obstruction; Neonatology
PubMed: 38030433
DOI: 10.1016/j.siny.2023.101483