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Seth C, Dutta M, Kadambott S. Solitary Laryngeal Neurofibroma in an Elderly Patient With von Recklinghausen's Disease. EAR, NOSE & THROAT JOURNAL 2022:1455613221098275. [PMID: 35477284 DOI: 10.1177/01455613221098275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Chandan Seth
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, West Bengal, India
| | - Mainak Dutta
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, West Bengal, India
| | - Sharafali Kadambott
- Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, West Bengal, India
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2
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Bulian A, Couloigner V, Belhous K, Luscan R, Khirani S, Fauroux B. Sleep-disordered breathing in pediatric neurofibromatosis type 1. Am J Med Genet A 2022; 188:1964-1971. [PMID: 35278041 DOI: 10.1002/ajmg.a.62722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/17/2022] [Accepted: 03/01/2022] [Indexed: 11/12/2022]
Abstract
The relationship between neurofibromatosis type 1 (NF1) and sleep-disordered breathing (SDB) has not been widely studied. The aim of the study was to analyze SDB in children with NF1 of the respiratory system. All children with NF1 followed between September 2008 and July 2020 who had a respiratory polygraphy (RP) were included. The clinical charts, cerebral and cervical magnetic resonance imaging (MRI), and RP were analyzed. Twenty-two patients (11 girls, median age at RP 8.3 [0.2-18.2] years) were included in the study. Nine patients (41%) had a NF1 involvement of the upper airways, 13 (59%) patients of the central nervous system (CNS), the cranial nerves (CN) and/or medulla, and 17 (77%) patients had a hypertrophy of the adenoids and/or tonsils. Five patients were treated with Continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) before their first evaluation because of severe obstructive sleep apnea (OSA). Accordingly, 10 (45%) patients had no OSA, one (5%) mild OSA, 2 (9%) moderate OSA, and nine (41%) severe OSA. None of the patients had central sleep apnea. Despite upper airway surgery, three patients required CPAP, two could be weaned and one died after a switch to tracheostomy. None of the patients treated with CPAP/NIV could be weaned, one patient required tracheostomy. Neither the clinical nor the MRI findings were able to predict OSA on a RP. The prevalence of OSA in NF1 is high, regardless of the nature of airway obstruction and the clinical and MRI findings, underlining the value of a systematic RP. CPAP may reduce the need of tracheostomy.
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Affiliation(s)
- Anna Bulian
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.,Department of Medical Sciences, Pediatrics, University of Ferrara, Ferrara, Italy
| | - Vincent Couloigner
- Department of Pediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Kahina Belhous
- Faculté de Médecine, Université de Paris, Paris, France.,Department of Radiology, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | - Romain Luscan
- Department of Pediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France
| | - Sonia Khirani
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.,EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris University, Paris, France.,ASV Santé, Gennevilliers, France
| | - Brigitte Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.,EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris University, Paris, France
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3
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Schuster-Bruce J, Kelly M, Bernic A, Brar S, Barber J, Modayil P. Coblation debulking of a paediatric laryngeal plexiform neurofibroma: a pragmatic response to a rare tumour. J Surg Case Rep 2022; 2022:rjab646. [PMID: 35096374 PMCID: PMC8791663 DOI: 10.1093/jscr/rjab646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/30/2022] [Indexed: 11/15/2022] Open
Abstract
Laryngeal neurofibroma is a rare but important differential diagnosis in a patient presenting with stridor. In paediatric patients, these lesions present a management conundrum: complete surgical resection is the established treatment of choice, but an aggressive approach can be detrimental to developing anatomy. We report the case of a plexiform neurofibroma affecting the right hemilarynx of a 3-year-old boy. Endoscopy revealed a large tumour, involving the right aryepiglottic fold and extending into the piriform sinus, ventricle and the false cord. Given the patient’s young age and the challenging tumour location, the lesion was debulked, rather than resected, using coblation (low-temperature plasma radiofrequency ablation). At 30 months follow-up, the neurofibroma has mildly increased in size—in line with expectations that these lesions exhibit slow growth throughout childhood—but there are no significant respiratory symptoms and there is no functional impairment.
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Affiliation(s)
| | - Mairead Kelly
- Correspondence address. Department of Ear Nose and Throat Surgery, St George’s University Hospitals NHS Foundation Trust, Blackshaw Rd, London, SW17 0QT, UK. Tel: 07779245551; E-mail:
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4
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Pancreatic/peripancreatic neurogenic tumor; little known masses not to be missed. Pancreatology 2021; 21:1386-1394. [PMID: 34446337 DOI: 10.1016/j.pan.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Retroperitoneal neurogenic tumors are extremely rare pathological entities; therefore, few clinical features and natural courses, especially originating from the pancreatic/peripancreatic regions, have been reported. This study aimed to investigate the clinicopathological features of pancreatic and peripancreatic neurogenic tumors and assess the diagnostic value of computed tomography (CT) and endoscopic ultrasound-guided fine needle biopsy (EUS-FNB). METHODS Between 2006 and 2018, patients who were diagnosed with neurogenic tumors were included. In total, 90 histologically confirmed cases of neurogenic tumors located in the pancreatic/peripancreatic regions were selected for analysis. RESULTS The mean age was 49.2 ± 13.1 years. There were no differences in sex distribution of the tumors. Schwannomas (44.4%) and paragangliomas (41.1%) were the most common neurogenic tumors. The sensitivity of CT was 62.2% in 90 cases. EUS-FNB was performed in 30 cases and the sensitivity of it was 83.3%. The diagnosis of neurogenic tumors with EUS-FNB or CT was not significantly associated with tumor location and size. Surgical resection was performed in 78 cases. Of the 12 patients who did not undergo surgery, 10 cases were followed-up without any increase in tumor size. CONCLUSIONS Through the present study, we verified radiological, pathological, and clinical aspects of the pancreatic/peripancreatic neurogenic tumors which little known before, therefore, this study can serve as the basis for research to present an optimal diagnosis and treatment of neurogenic tumors. In addition, EUS-FNB is useful in the diagnosis of pancreatic/peripancreatic neurogenic tumors with relatively high sensitivity and can help establish therapeutic plans before the surgery.
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5
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Hutnik R, Chen PG, Mortensen MM. A solitary supraglottic neurofibroma presenting with obstructive sleep apnea in an adolescent. J Clin Sleep Med 2021; 16:635-638. [PMID: 32022666 DOI: 10.5664/jcsm.8290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
None Obstructive sleep apnea (OSA) is commonly encountered in the pediatric population and has a large differential diagnosis. As clinicians, we must determine who needs to undergo flexible laryngoscopy to rule out potential obstructing lesions causing OSA. This report presents a 16-year-old female who presented with snoring, "asthma," dysphagia, and OSA. Flexible laryngoscopy and computed tomography revealed a neurofibroma of the aryepiglottic fold without associated neurofibromatosis type 1. The patient underwent microlaryngoscopy and the lesion was excised using cold steel and a carbon dioxide laser. At 6 months' follow-up, the patient was breathing without difficulty and had no evidence of recurrence. Solitary laryngeal neurofibromas are extremely rare, and this is the first case of an adolescent with OSA caused by a solitary supraglottic neurofibroma. A supraglottic mass needs to be considered in the differential diagnosis of patients with OSA who fail conservative treatment, even a diagnosis as rare as a solitary laryngeal neurofibroma.
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Affiliation(s)
- Robert Hutnik
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Stony Brook Medicine, Stony Brook, New York
| | - Philip G Chen
- Department of Otolaryngology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Melissa M Mortensen
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Stony Brook Medicine, Stony Brook, New York
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Hackenberg S, Kraus F, Scherzad A. Rare Diseases of Larynx, Trachea and Thyroid. Laryngorhinootologie 2021; 100:S1-S36. [PMID: 34352904 PMCID: PMC8363221 DOI: 10.1055/a-1337-5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review article covers data on rare diseases of the larynx, the trachea and the thyroid. In particular, congenital malformations, rare manifestations of inflammatory laryngeal disorders, benign and malignant epithelial as well as non-epithelial tumors, laryngeal and tracheal manifestations of general diseases and, finally, thyroid disorders are discussed. The individual chapters contain an overview of the data situation in the literature, the clinical appearance of each disorder, important key points for diagnosis and therapy and a statement on the prognosis of the disease. Finally, the authors indicate on study registers and self-help groups.
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Affiliation(s)
- Stephan Hackenberg
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
| | - Fabian Kraus
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
| | - Agmal Scherzad
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
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7
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Cunha B, Pacheco R, Fonseca I, Borges A. Solitary neurofibroma of the larynx: a diagnostic challenge. BMJ Case Rep 2021; 14:14/1/e236682. [PMID: 33461999 PMCID: PMC7813421 DOI: 10.1136/bcr-2020-236682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Solitary neurofibromas of the larynx are extremely rare, with a total of 15 cases described in the literature. Nonetheless, acquaintance with this diagnosis is important, as misdiagnoses can have negative consequences. Presenting symptoms are non-specific and depend on tumour size and location. As well-defined submucosal masses with a broad differential diagnosis, they remain a clinical and radiological challenge. While some characteristics might favour a benign nature and subtle signs might help narrow the differential diagnosis, imaging alone is not sufficient for differentiation and definitive diagnosis requires a biopsy. Complete surgical resection and long-term follow-up is indicated. We share our experience on a case of a solitary laryngeal neurofibroma in a middle-aged woman, presenting with a large well-defined paraglottic lesion.
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Affiliation(s)
- Bruno Cunha
- Neuroradiology Department, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
| | - Ricardo Pacheco
- Otolaryngology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Isabel Fonseca
- Pathology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Alexandra Borges
- Radiology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
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Naunheim MR, Plotkin SR, Franco RA, Song PC. Laryngeal Manifestations of Neurofibromatosis. Otolaryngol Head Neck Surg 2016; 154:494-7. [DOI: 10.1177/0194599815626133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/17/2015] [Indexed: 11/16/2022]
Abstract
Objectives To describe the range of findings in patients with neurofibromatosis (NF) presenting to a laryngology clinic and to analyze the etiologic factors of vocal fold dysfunction in this cohort. Study Design Case series with chart review. Setting Tertiary laryngology practice. Subjects and Methods All cases of NF presenting to an academic laryngology practice were retrospectively reviewed (August 2005 to May 2014), with a total of 34 cases. Demographic data, symptoms, and endoscopic examination findings were reviewed. Etiologic factors of laryngeal complaints were analyzed with reference to NF-associated pathologies and surgical history. Results Thirty-four patients with NF-1 or NF-2 were evaluated, and 28 of these patients (6 NF-1 and 22 NF-2) had laryngeal pathology. The most common presenting symptoms were vocal weakness (n = 21), dysphagia (n = 5), and globus (n = 4). Three patients had NF-related vocal fold masses on examination, including 2 neurofibromas and 1 schwannoma. Unilateral vocal cord paralysis was seen in 17 patients; bilateral paralysis was observed in 5 patients. Of patients with unilateral or bilateral paralysis, 20 had intracranial masses (vestibular schwannoma, meningioma, or skull base tumors), and 16 had previously undergone surgery for these lesions. Of the patients with NF-associated intracranial tumors, 87.0% presented with vocal cord paralysis, whereas only 40.0% of those without intracranial masses had paralysis ( P = .0560). Seven patients underwent medialization procedures. Conclusion Neurofibromatosis patients may present to laryngology clinic with primary laryngeal tumors or, more commonly, unilateral or bilateral paralysis. Otolaryngologists should be keenly aware of vocal fold paralysis caused by the NF-associated tumors, with particular attention to bilateral paralysis in NF-2.
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Affiliation(s)
- Matthew R. Naunheim
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Scott R. Plotkin
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ramon A. Franco
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Phillip C. Song
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
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9
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Rodríguez H, Cuestas G, Cocciaglia A, García de Dávila MT. Neurofibromatosis Type 1 With Laryngeal Involvement in an Infant. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015. [DOI: 10.1016/j.otoeng.2015.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Elluru RG, Friess MR, Richter GT, Grimmer JF, Darrow DH, Shin JJ, Perkins JA. Multicenter Evaluation of the Effectiveness of Systemic Propranolol in the Treatment of Airway Hemangiomas. Otolaryngol Head Neck Surg 2015; 153:452-60. [DOI: 10.1177/0194599815591809] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 05/27/2015] [Indexed: 12/28/2022]
Abstract
Objective To evaluate the effectiveness of systemic propranolol in airway infantile hemangioma (AIH) treatment. Design Case series with chart review. Participants Patients with AIH treated with propranolol between 2009 and 2012 with at least a 1-year follow-up. Outcomes Presenting age, treating institution, syndrome presence, presenting AIH stage, endoscopy status, propranolol initiation location/dose/duration, time to stridor resolution, adjunctive medical and surgical therapy, and treatment-associated complications. Results Twenty-seven patients met inclusion criteria. Average age of diagnosis was 2.3 months (range, 1-5 months). The AIHs were stage 1 in 7 of 27 (26%), stage 2 in 12 of 27 (44%), and stage 3 in 8 of 27 (30%). Propranolol initiation was inpatient in 25 of 27 (93%) and outpatient in 2 of 27 (7%). Propranolol dose was maintained at 2 mg/kg/d in all patients for a minimum of 7 months (range, 7-34 months; median, 15 months). Stridor was eliminated within 24 hours or less of propranolol initiation in 23 of 27 (85%). At diagnosis, staging and propranolol initiation in 11 of 27 (41%) were managed with propranolol alone; the remaining 16 of 27 (59%) also had a steroid injection. The use of adjuvant therapy at the time of propranolol initiation and the size of the AIH were not statistically correlated. Twelve patients had additional treatments after the initiation of propranolol due to recurrence of respiratory symptoms, 1 of 27 (4%) of whom was considered a nonresponder. No complications related to propranolol use were noted. Conclusions This multisite study of AIH treatment with propranolol demonstrates similar effectiveness to surgical treatment modalities. Propranolol therapy for AIH had no complications, had potentially lower resource utilization, and should be considered a first-line AIH treatment.
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Affiliation(s)
- Ravindhra G. Elluru
- Divsion of Pediatric Otolaryngology, Dayton Children’s Hospital, Dayton, Ohio, USA
| | - Melanie R. Friess
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Gresham T. Richter
- Divsion of Pediatric Otolaryngology, Arkansas Children’s Hospital, Little Rock, Arkansas, USA
| | - J. Fred Grimmer
- Divison of Pediatric Otolaryngology, University of Utah Medical Center, Salt Lake City, Utah, USA
| | - David H. Darrow
- Divison of Pediatric Otolaryngology, Children’s Hospital of The King’s Daughter, Norfolk, Virginia, USA
| | - Jennifer J. Shin
- Divison of Pediatric Otolaryngology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Jonathan A. Perkins
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Seattle, Washington, USA
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Setabutr D, Perez MR, Truong MT, Senders CW, Rubinstein BK. Neurofibromatosis of the larynx causing stridor and sleep apnea. Am J Otolaryngol 2014; 35:631-5. [PMID: 24888794 DOI: 10.1016/j.amjoto.2014.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/26/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Neurofibromatosis type 1 can rarely present in the larynx. Patients typically do not present with complete obstructive symptoms, but partial obstruction and stridor. We review our health centers' case series of two patients, the first of whom presented with persistent sleep apnea post tonsillectomy and adenoidectomy, and the second who presented with noisy breathing. Additionally, we will review the literature on the management and treatment options for children with this rare clinical entity. METHODS Retrospective case review. CASE REPORT & RESULTS A two-year old male underwent a sleep endoscopy following persistent evidence of obstructive sleep apnea on polysomnography after initial tonsillectomy and adenoidectomy. Family elicited concerns about noisy breathing at night and an accompanying video documented stridor while sleeping during the monitored polysomnography. Flexible fiberoptic laryngoscopy in the operating room revealed what appeared to be a cystic mass along the right aryepiglottic fold causing deviation of the laryngeal introitus towards the contralateral side. Subsequent direct laryngoscopy and excisional biopsy revealed pathology results consistent with a plexiform neurofibroma. A six-month-old patient with stertor and stridor was found to have a laryngeal mass, subglottic stensosis, and progressive airway obstruction due to plexiform neurofirboma in the supraglottis, subglottis, and trachea. We present a series of two patients incidentally diagnosed with neurofibromatosis type 1 by way of a laryngeal neurofibroma and review the literature on management options. Both patients were found to have accompanying café au lait spots. Both patients required tracheostomy for airway management, and one was successfully decannulated. CONCLUSION Laryngeal neurofibroma is a rare anomaly that can manifest with airway obstruction. Both patients presented here subsequently were noted to have café au lait spots on physical examination. The Otolaryngologist should be reminded of this anomaly when evaluating a child with evidence of a submucosal laryngeal mass. We present our series including that of a patient whose diagnosis was prompted by persistent sleep apnea following adenotonsillectomy tonsillectomy and a patient with airway obstruction and subglottic stenosis due to a neurofibroma. The treatment of choice is complete excision of the neurofibroma while maintaining functionality of the larynx. This can lead to successful decannulation.
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Affiliation(s)
- Dhave Setabutr
- Department of Otolaryngology, UC Davis Medical Center, Sacramento, CA USA.
| | - Myrza R Perez
- Division of Pediatric Pulmonology, Kaiser Permanente, Roseville, CA USA
| | - Mai Thy Truong
- Department of Head & Neck Surgery, Kaiser Permanente, Santa Clara, CA USA
| | - Craig W Senders
- Department of Otolaryngology, UC Davis Medical Center, Sacramento, CA USA
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Rodríguez H, Cuestas G, Cocciaglia A, García de Dávila MT. Neurofibromatosis type 1 with laryngeal involvement in an infant. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2014; 66:299-301. [PMID: 24846563 DOI: 10.1016/j.otorri.2014.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/11/2014] [Accepted: 02/16/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Hugo Rodríguez
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Giselle Cuestas
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.
| | - Alejandro Cocciaglia
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
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Chinn SB, Collar RM, McHugh JB, Hogikyan ND, Thorne MC. Pediatric laryngeal neurofibroma: case report and review of the literature. Int J Pediatr Otorhinolaryngol 2014; 78:142-7. [PMID: 24315214 PMCID: PMC4157055 DOI: 10.1016/j.ijporl.2013.10.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 11/26/2022]
Abstract
Presentation of a case of pediatric laryngeal neurofibroma (LNF) and review of the world literature. Comprehensive review of the world literature using Pubmed and Google scholar. Pediatric LNF was identified in 62 cases reported in the world literature. The most common presenting symptom is stridor and the most common location of the tumor in the larynx is the aryepiglottic fold. Recent reports demonstrate increased utilization of endoscopic resection with reduced need for tracheostomy. Pediatric LNF is a rare disorder. Review of the world literature since 1940 suggests a recent trend away from aggressive open resection and toward more conservative endoscopic resection with excellent functional results.
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Affiliation(s)
| | | | | | | | - Marc C. Thorne
- Corresponding Author: Marc C. Thorne, MD, MPH (); (734)936-9598 (phone); (734)936-4934 (fax); Department of Otolaryngology – Head and Neck Surgery; 1500 E. Medical Center Dr.; Ann Arbor, MI 48109
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Lakshiminarasimhaiah G, Jagannatha AT, Pai KR, Varma RG, Hegde AS. Anaesthetic management of a child with neurofibromatosis type 2 for multiple tumour decompressions. J Clin Diagn Res 2013; 7:3004-5. [PMID: 24551709 PMCID: PMC3919336 DOI: 10.7860/jcdr/2013/6881.3828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/04/2013] [Indexed: 11/24/2022]
Abstract
Neurofibromatosis type 2 is a genetic disorder with autosomal dominant pattern. It can manifest as intracranial, spinal, ocular and cutaneous lesions. The lesions can extend to all the systems. We present an anaesthetic management of a paediatric patient with neurofibromatosis 2 for multiple spinal and thoracic tumour decompression.
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Affiliation(s)
- Geetha Lakshiminarasimhaiah
- Assistant Professor, Department of Neuroanaesthesia, Ramaiah Medical CollegeBangalore-560054, Karnataka, India
| | | | - Kulyadi Raghavendra Pai
- Professor and Head, Department of Neuroanaesthesia, Ramaiah Medical CollegeBangalore-560054, Karnataka, India
| | - Ravi Gopal Varma
- Professor and Head, Department of Neurosurgery, Ramaiah Medical CollegeBangalore-560054, Karnataka, India
| | - Alangar Satyaranjandas Hegde
- Senior Professor, Department of Neuro Surgery & Director, MS Ramaiah Institute of Neurosciences. Bangalore-560054, Karnataka, India
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15
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Son HY, Shim HS, Kim JP, Woo SH. Synchronous plexiform neurofibroma in the arytenoids and neurofibroma in the parapharynx in a patient with non-neurofibromatosis: a case report. J Med Case Rep 2013; 7:15. [PMID: 23305487 PMCID: PMC3551692 DOI: 10.1186/1752-1947-7-15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 11/28/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED INTRODUCTION Plexiform neurofibroma of the larynx is a rare disease. In this report, we present a plexiform neurofibroma in the arytenoids and neurofibroma in the parapharynx detected coincidently. CASE PRESENTATION A 56-year-old Asian woman presented with respiratory distress and episodes of apnea at night. A solitary mass from the left arytenoids was found to be nearly obstructing the airway and causing the sleep apnea. There was also a parapharynx mass protruding into the pharynx. The parapharynx tumor was removed with the lateral incision approach, and the arytenoid tumor was removed with a transoral carbon dioxide laser. The pathologic diagnosis was plexiform neurofibroma for the arytenoid mass and neurofibroma for the parapharynx mass. CONCLUSION We have reported an extremely rare case of plexiform neurofibroma in the arytenoids and neurofibroma in the parapharynx. This entity may be considered in the differential diagnosis of all laryngeal and parapharynx masses.
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Affiliation(s)
- Hee Young Son
- Department of Otolaryngology, Gyeongsang National University, Jinju, Korea.
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Abstract
The majority of neck masses in the pediatric population are congenital or inflammatory in origin requiring a thorough understanding of embryology and anatomy of the cervical region. However, malignancy must always be ruled out as they represent 11%-15% of all neck masses in the pediatric population. The initial history and physical are of utmost important to correctly work-up and eventually diagnose the lesion. This article addresses many aspects of the workup, diagnosis and eventual proper surgical or medical management of pediatric neck masses.
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Abstract
Pediatric respiratory illnesses are a huge burden to emergency departments worldwide. This article reviews the latest evidence in the epidemiology, assessment, management, and disposition of children presenting to the emergency department with asthma, croup, bronchiolitis, and pneumonia.
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Affiliation(s)
- Joseph Choi
- McGill University FRCP Emergency Medicine Residency Program, Royal Victoria Hospital, 687 Pine Avenue West, Room A4.62, Montreal, Quebec, Canada H3A 1A1.
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Voice Characteristics in Adults With Neurofibromatosis Type 1. J Voice 2011; 25:759-64. [DOI: 10.1016/j.jvoice.2010.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 07/20/2010] [Indexed: 01/05/2023]
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19
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Diffuse Subglottic Laryngeal Neurofibroma in an Adult. Otolaryngol Head Neck Surg 2009; 141:545-6. [DOI: 10.1016/j.otohns.2009.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Accepted: 03/12/2009] [Indexed: 11/17/2022]
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20
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Dave SP, Farooq U, Civantos FJ. Management of advanced laryngeal and hypopharyngeal plexiform neurofibroma in adults. Am J Otolaryngol 2008; 29:279-83. [PMID: 18598841 DOI: 10.1016/j.amjoto.2006.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Accepted: 06/26/2006] [Indexed: 11/17/2022]
Abstract
Laryngeal neurofibromas are rare. The plexiform subtype is less common and often presents during childhood in association with neurofibromatosis type I. Because it is unencapsulated and more aggressive, plexiform neurofibroma presents a management dilemma. Imaging, particularly magnetic resonance imaging, can aid in diagnosing neurofibroma, differentiating the nonplexiform and plexiform subtypes, and planning the subsequent operative approach. The importance of conservative surgery to relieve symptoms, but preserve laryngopharyngeal function, and close follow-up are stressed. We report 2 adult cases of plexiform neurofibroma involving the larynx and hypopharynx and discuss the controversies in management.
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Affiliation(s)
- Sandeep P Dave
- Department of Otolaryngology-Head and Neck Surgery, Jackson Memorial Medical Center and Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA
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