Vocal fold pseudocysts. (Laryngoscopic Clinic).A 19-year-old vocal arts student sought evaluation after she had developed bronchitis and laryngitis laryngitis, inflammation of the mucous membrane of the voice box, or larynx, usually accompanied by hoarseness, sore throat, and coughing. Acute laryngitis is often a secondary bacterial infection triggered by infecting agents causing such illnesses as colds, . Her voice had returned to normal for a short period, but eventually it worsened. The patient noted a "permanent gap" in her upper range (mezzo-soprano) with fatigue, hoarseness, and breathiness. Strobovideolaryngoscopy revealed the presence of bilateral pseudocysts of the vocal folds, which had impaired the glottic glot·tic adj. 1. Of or relating to the tongue. 2. Of or relating to the glottis. glottic pertaining to (1) the glottis, or (2) the tongue. closure. Pseudocysts are localized collections of fluid in Reinke' s space; they do not form a capsule, as is seen in a true cyst. Additional findings included right superior laryngeal nerve superior laryngeal nerve n. A branch of the vagus nerve at the inferior ganglion. At the thyroid cartilage, it divides into two branches, the internal, which supplies the mucous membrane of the larynx above the vocal cords; and the external, which paresis paresis /pa·re·sis/ (pah-re´sis) slight or incomplete paralysis. general paresis paralytic dementia; a form of neurosyphilis in which chronic meningoencephalitis causes gradual loss of cortical , laryngopharyngeal reflux, and muscle tension dysphonia dysphonia /dys·pho·nia/ (-fo´ne-ah) a voice impairment or speech disorder.dysphon´ic dys·pho·ni·a n. Difficulty in speaking, usually evidenced by hoarseness. . Laryngeal electromyography confirmed the right superior laryngeal nerve paralysis. Findings on thyroid ultrasound and selected blood tests were normal. Despite good vocal hygiene, voice therapy, and protonpump inhibitor therapy, the patient's pseudocysts did not resolve. She was taken to the operating room, where a 00 endoscope detected bilateral pseudocysts (figure 1). The left pseudocyst pseudocyst /pseu·do·cyst/ (soo´do-sist) 1. an abnormal or dilated space resembling a cyst but not lined with epithelium. 2. was softer than the right, and its fluid component was more defined. A 70[degrees] endoscope demonstrated the vertical extent and inferior limit of the masses (figure 2). The pseudocysts were evacuated, and fat was injected into the vocal folds. The patient's symptoms improved postoperatively. From the Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson Univesity, Philadelphia. |
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