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P076
P238
Otolaryngology-Head and Neck Surgery, Vol 135, No 2S, August 2006
CONCLUSIONS: Olfactory impairment is common in laryngectomized patients. The NAIM method is easy to learn and rapidly improves smell and taste. One single intervention session is sometimes sufficient but many patients benefit from repeated training. The SOIT odor-differentiation test is an effective and simple test for the assessment of olfaction acuity after laryngectomy.
P075 Osteoma of the Larynx: A Case Report Ritvik Prakash Mehta, MD (presenter); William Faquin, MD PhD; Ramon A Franco, Jr, MD Boston MA; Framingham MA OBJECTIVES: 1. To present the second reported case of an osteoma of the larynx. 2. To review the pertinent literature on bony lesions of the larynx. METHODS: Case report and review of the literature. RESULTS: The team presents the case of a 48-year-old man who presented for evaluation of worsening dysphonia and dysphagia over one year. He had limited exercise tolerance secondary to dyspnea and had symptoms of aspiration with thin liquids. On flexible fiberoptic laryngoscopy, a mass was seen spanning the interarytenoid region and causing impairment of vocal fold mobility with a persistent glottic gap. On operative microlaryngoscopy, a firm calcified mass was encountered in the interarytenoid region. This was essentially chiseled out using laryngeal instruments. The patient’s vocal fold mobility was normal on his postoperative evaluation. His dysphonia and dysphagia resolved completely. Histopathologic evaluation revealed lamellar cortical and trabecular bone with a fatty and hematopoietic marrow consistent with an osteoma. This case represents the second reported case of a laryngeal osteoma. Bony tumors of the larynx are extremely rare. Typically, osteomas are firm, nodular masses of bone. Histologically, they are characterized by trabeculae of lamellar bone. A fibrofatty marrow space may be seen. Radiographically, they appear as well-defined calcific masses. The etiology of osteomas is unknown although trauma and infection have been proposed as inciting factors. The primary therapy for symptomatic osteomas is surgical excision. CONCLUSIONS: Osteomas of the larynx are extremely rare but can cause significant functional impairment. Surgical excision is the mainstay of therapy for these rare lesions.
P076 Multilocular Extranodal MALT-Lymphoma Affecting the Larynx Susan Arndt, MD (presenter); Ariane Julia Zimmer, MD; Joerg Schipper, MD; Antje Aschendorff, MD; Wolfgang Maier, MD; Bernhard Richter, PD MD Freiburg Germany
OBJECTIVES: B-cell-lymphoma of the mucosa-associated lymphoid tissue (MALT) accounts for about 7-8% of all B-cell lymphomas and 50% of all gastric lymphomas. Long-term localized growth is typical for MALT-lymphoma. Multifocal affections are possible in advanced stages. MALT-lymphoma of the larynx is a very rare disease with no more than 15 cases reported in literature. This presentation reports on one case of this disease. METHODS: A 34-year-old woman presented with hoarseness in the presenters’ department during the 25th week of pregnancy. The physical examination revealed a submucosal mass of both false vocal folds. There was a Helicobacter pylorirelated MALT-lymphoma of the stomach in her medical history seven years ago, regressing after eradication treatment. Tumor reduction of the intralaryngeal mass was performed after delivery at term. Histological and immunohistochemical analyses proved the presence of an extranodal MALT-lymphoma of the supraglottis. The following staging revealed a recurrent tumor of the MALT-lymphoma in the stomach and an affection of the right conjunctiva. RESULTS: Following recent reports on successful treatment of MALT-lymphoma with antibiotics, therapy with Doxicyclin was initiated leading subjectively to a decline of the complaints which could not be objectified in MRI control of the larynx. Because of the expansive systemic affection of the original MALT-lymphoma of the stomach, chemoimmunotreatment was indicated according to the FCR protocol (Fludara-bin/ Cyclophosphamid/Rituximab). CONCLUSIONS: In the rare diagnosis of MALT-lymphoma of the larynx, comprehensive staging is indispensable to exclude multifocal affections. Treatment of the primarily localized MALT-lymphoma differs from the procedure in patients with systemic affection.
P077 Age-Related Changes in Human Laryngeal Nerves Romualdo Suzano Louzeiro Tiago, MD PhD (presenter); Osiris O C Brasil, PhD Sao Paulo Brazil OBJECTIVES: Perform a morphometric analysis of myelin fibers from laryngeal nerves aiming at verifying quantitative changes due to aging process. METHODS: A 1cm fragment was collected from the superior laryngeal nerves (SLN) and recurrent laryngeal nerves (RLN). The sample was divided in two age groups: adult group aged under sixty years old (six corpses) and elderly group aged sixty years or older (six corpses). The material was fixed in glutaraldehyde and paraformaldehyde solution, postfixed in osmium tetroxide, dehydrated in increasing concentrations of ethanol and included in epoxy resin. The blocks were cut in order to obtain 0.3m semithin cuts and analyzed under light microscope coupled with an image analyzing system. RESULTS: The total number of myelin fibers from SLN was similar in both groups (p⫽0.1188), but with the adult group
Otolaryngology-Head and Neck Surgery, Vol 135, No 2S, August 2006
CONCLUSIONS: Olfactory impairment is common in laryngectomized patients. The NAIM method is easy to learn and rapidly improves smell and taste. One single intervention session is sometimes sufficient but many patients benefit from repeated training. The SOIT odor-differentiation test is an effective and simple test for the assessment of olfaction acuity after laryngectomy.
P075 Osteoma of the Larynx: A Case Report Ritvik Prakash Mehta, MD (presenter); William Faquin, MD PhD; Ramon A Franco, Jr, MD Boston MA; Framingham MA OBJECTIVES: 1. To present the second reported case of an osteoma of the larynx. 2. To review the pertinent literature on bony lesions of the larynx. METHODS: Case report and review of the literature. RESULTS: The team presents the case of a 48-year-old man who presented for evaluation of worsening dysphonia and dysphagia over one year. He had limited exercise tolerance secondary to dyspnea and had symptoms of aspiration with thin liquids. On flexible fiberoptic laryngoscopy, a mass was seen spanning the interarytenoid region and causing impairment of vocal fold mobility with a persistent glottic gap. On operative microlaryngoscopy, a firm calcified mass was encountered in the interarytenoid region. This was essentially chiseled out using laryngeal instruments. The patient’s vocal fold mobility was normal on his postoperative evaluation. His dysphonia and dysphagia resolved completely. Histopathologic evaluation revealed lamellar cortical and trabecular bone with a fatty and hematopoietic marrow consistent with an osteoma. This case represents the second reported case of a laryngeal osteoma. Bony tumors of the larynx are extremely rare. Typically, osteomas are firm, nodular masses of bone. Histologically, they are characterized by trabeculae of lamellar bone. A fibrofatty marrow space may be seen. Radiographically, they appear as well-defined calcific masses. The etiology of osteomas is unknown although trauma and infection have been proposed as inciting factors. The primary therapy for symptomatic osteomas is surgical excision. CONCLUSIONS: Osteomas of the larynx are extremely rare but can cause significant functional impairment. Surgical excision is the mainstay of therapy for these rare lesions.
P076 Multilocular Extranodal MALT-Lymphoma Affecting the Larynx Susan Arndt, MD (presenter); Ariane Julia Zimmer, MD; Joerg Schipper, MD; Antje Aschendorff, MD; Wolfgang Maier, MD; Bernhard Richter, PD MD Freiburg Germany
OBJECTIVES: B-cell-lymphoma of the mucosa-associated lymphoid tissue (MALT) accounts for about 7-8% of all B-cell lymphomas and 50% of all gastric lymphomas. Long-term localized growth is typical for MALT-lymphoma. Multifocal affections are possible in advanced stages. MALT-lymphoma of the larynx is a very rare disease with no more than 15 cases reported in literature. This presentation reports on one case of this disease. METHODS: A 34-year-old woman presented with hoarseness in the presenters’ department during the 25th week of pregnancy. The physical examination revealed a submucosal mass of both false vocal folds. There was a Helicobacter pylorirelated MALT-lymphoma of the stomach in her medical history seven years ago, regressing after eradication treatment. Tumor reduction of the intralaryngeal mass was performed after delivery at term. Histological and immunohistochemical analyses proved the presence of an extranodal MALT-lymphoma of the supraglottis. The following staging revealed a recurrent tumor of the MALT-lymphoma in the stomach and an affection of the right conjunctiva. RESULTS: Following recent reports on successful treatment of MALT-lymphoma with antibiotics, therapy with Doxicyclin was initiated leading subjectively to a decline of the complaints which could not be objectified in MRI control of the larynx. Because of the expansive systemic affection of the original MALT-lymphoma of the stomach, chemoimmunotreatment was indicated according to the FCR protocol (Fludara-bin/ Cyclophosphamid/Rituximab). CONCLUSIONS: In the rare diagnosis of MALT-lymphoma of the larynx, comprehensive staging is indispensable to exclude multifocal affections. Treatment of the primarily localized MALT-lymphoma differs from the procedure in patients with systemic affection.
P077 Age-Related Changes in Human Laryngeal Nerves Romualdo Suzano Louzeiro Tiago, MD PhD (presenter); Osiris O C Brasil, PhD Sao Paulo Brazil OBJECTIVES: Perform a morphometric analysis of myelin fibers from laryngeal nerves aiming at verifying quantitative changes due to aging process. METHODS: A 1cm fragment was collected from the superior laryngeal nerves (SLN) and recurrent laryngeal nerves (RLN). The sample was divided in two age groups: adult group aged under sixty years old (six corpses) and elderly group aged sixty years or older (six corpses). The material was fixed in glutaraldehyde and paraformaldehyde solution, postfixed in osmium tetroxide, dehydrated in increasing concentrations of ethanol and included in epoxy resin. The blocks were cut in order to obtain 0.3m semithin cuts and analyzed under light microscope coupled with an image analyzing system. RESULTS: The total number of myelin fibers from SLN was similar in both groups (p⫽0.1188), but with the adult group