MyMedR

Fulltext Epiglottic abscess: a rare cause of odynophagia

Irfan M, Fariza NH

Med J Malaysia, 2012 Oct;67(5):545-6.

Epiglottic abscess is rare sequelae of acute epiglottitis. It occurs commonly in adult although acute epiglottitis commonly occur in children. The presentation includes fever with odynophagia. The diagnosis is based on high index of suspicion especially when oral examinations reveal normal findings. We report a case of adult epiglottic abscess which was treated with incision and drainage. The outline of management was discussed.

Matched MeSH terms: Epiglottis*; Epiglottitis

Fulltext Carbon dioxide laser excision of a big epiglottic cyst

Baharudin A, Hazama M

Med J Malaysia, 2006 Dec;61(5):636-7.

PMID: 17623969 MyJurnal

Epiglottic cyst is usually asymptomatic and the commonest presentation is foreign body sensation in the throat. Treatment of epiglottic cysts depends on their size and on the clinical symptoms. Surgery is necessary for large ones. Various modalities of therapy include endoscopic excision, marsupialization and deroofing with or without a carbon dioxide laser. We report our experience of managing a case of a large epiglottic cyst with a carbon dioxide laser.

Matched MeSH terms: Epiglottis/pathology*; Epiglottis/surgery

Fulltext Brachytherapy of tongue carcinoma in a patient with difficult airway: anesthetic considerations

Ghaffar ZA, Chong SE, Tan KL, Appalanaido GK, Musa MY, Hussin HB, et al.

J Contemp Brachytherapy, 2018 Dec;10(6):573-576.

PMID: 30662482 DOI: 10.5114/jcb.2018.79856

The practice of brachytherapy in unresectable tongue carcinoma is gaining popularity. However, this procedure poses specific anesthetic challenges, particularly challenges of airway sharing and a higher rate of difficult airway. We report a 74-year-old chronic smoker, chronic alcoholic with history of stroke, who had undergone brachytherapy for tongue carcinoma. Apart from a huge tongue tumor, he had an epiglottic mass but refused elective tracheostomy. This had led to a few critical states throughout the process of treatment, including a metabolic crisis due to thiamine deficiency and difficult airway crisis. To our best knowledge, there have been no reported case on a patient with vocal cord mass undergoing tongue brachytherapy. We hope sharing of this experience may aid the management of similar patients in future.

Matched MeSH terms: Epiglottis

Fulltext Sound frequency spectra of snore in relation to the site of obstruction among snorers

Qualickuz Zanan NH, Azman M, Zainuddin K, Wan Puteh SE, Mohamed AS, Mat Baki M

Acta Otorhinolaryngol Ital, 2021 Aug;41(4):348-355.

PMID: 34533538 DOI: 10.14639/0392-100X-N1202

Objective: This study aimed to describe the sound frequency of snoring in relation to the site of upper airway vibration among snorers.

Methods: 383 snores from 40 participants who complained of snoring were digitally recorded during natural and induced sleep using a level III polysomnography monitor with a built-in microphone. During drug-induced sleep endoscopy (DISE), the real-time site of upper airway obstruction was assessed, and the sound frequency of snoring was recorded synchronously.

Results: The mean peak of snoring frequency for unilevel palatal, oropharynx and epiglottis obstruction were 522.5, 482.4 and 300.0 Hz, respectively. Most participants showed multilevel obstruction at the palate and oropharynx, in which the mean for bi-peak snoring frequency were 402.90 Hz and 1086.96 Hz, respectively. Severity of OSA was significantly associated with multilevel obstruction.

Conclusions: There was a significant association between the snoring sound frequency and site of unilevel obstruction. Palatal or oropharyngeal obstruction produced sound at mid-frequency range, while the epiglottis produced a low frequency range. Multilevel obstruction documented a bi-peak snoring frequency.

Matched MeSH terms: Epiglottis

Basaloid Squamous Cell Carcinoma: An Unusual Ball-Valve Laryngeal Obstruction

Tan SH, Hindi KW, Chandran PA, Chong AW

Iran J Otorhinolaryngol, 2015 May;27(80):243-6.

PMID: 26082908

INTRODUCTION: A rare case of basaloid squamous cell carcinoma (BSCC) of the larynx, which has not been previously reported, is described.

CASE REPORT: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords.

CONCLUSION: Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

Matched MeSH terms: Epiglottis

Fulltext An adult with thumb sign In the lateral neck radiograph

Irfan Mohamad, Mohd Syafwan Mohd Soffian, Amran Mohamad

Malaysian Journal of Medicine and Health Sciences, 2015;11(1):85-88.

MyJurnal

Acute epiglottitis though relatively common in pediatric patients as compared to adults, present with almost similar clinical presentations. They include voice change, difficulty or painful swallowing and sometimes with upper airway obstruction. Physical finding of swollen epiglottis is difficult to be obtained owing to the danger of introducing laryngeal mirror into the oropharynx as to avoid contact spasm. The diagnostic thumb sign appearance on lateral neck radiograph is considered pathognomonic of epiglottitis. We report a case of an adult with clinical features and radiological finding of an acute epiglottitis, which did not resolve with antibiotic treatment. Subsequent imaging confirmed the presence of an abscess in the epiglottic mucosa.

Matched MeSH terms: Epiglottis

Fulltext Partial epiglottic edema post fish bone ingestion

Irfan, M., Ali, A.Y., Rohaizan, Y.

Malaysian Journal of Medicine and Health Sciences, 2012;8(2):69-71.

MyJurnal

A fish bone (foreign body) in the throat is a common presentation in an otolaryngology practice. Commonly the fish bone can be visualized and removed in a clinic setting. More distal foreign body impaction such as at the cricopharyngeus level will need direct laryngoscopy and removal under general anesthesia. It is not uncommon to have patient presented with residual symptom of post foreign body ingestion. Findings such as traumatized mucosa and embedded bone with slough on the mucosal surface are commonly encountered. We report a case of post foreign body ingestion presented with odynophagia and laryngoscopy showed a partially swollen epiglottis. The symptom recovered with conservative management.

Matched MeSH terms: Epiglottis

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