Introduction: Oncocytic cysts of the larynx are benign, uncommon, and slow-growing lesions that usually occur in elderly people, especially in those with a history of smoking and chronic irritation. These lesions cause various clinical symptoms depending on their location and size, requiring physicians to consider a wide range of symptoms. Case Presentation: Here we present two men who were referred to us because of prolonged voice hoarseness. Conclusions: Medical assessments led us to the diagnosis of oncocytic cysts in the false and TRUE VOCAL CORDS. Both patients were followed up after removing their laryngeal cysts and have had no clinical complaints since then.

Foreign body (FB) aspiration is a rare event in adults and can mimic other pathologies such as refractory asthma. Most of the objects can be removed using a bronchoscope. Herein, we present a unique case of aspiration of a FB stocked between VOCAL CORDS for one week and the anesthetic considerations.

Hyperimmunoglobulin E syndrome (HIGE) is considered as a phagocytic or a newly classified complex and heterogeneous primary immunodeficiency disease with symptoms such as increased levels of immunoglobulin E, eczema, and, recurrent lung and skin infections. In this paper, we have presented a rare case of this syndrome. A 9-year-old Iranian girl presented with a history of pruritic maculopapular rash who was eventually diagnosed as a case of HIGE. In her recent admission, she had dysphonia, stridor and huge cauliflower cutaneous lesions on her neck, finger and VOCAL CORDS, which did not respond to intravenous antibiotics, and ultimately required surgical removal.

In this study, the samples were the patients who underwent direct laryngoscopy of chronic hoarseness in Isfahan Ayatollah Kashani Hospital, from April 1991 to December 1998. Hoarseness is the most prevalent and important symptom of laryngeal disorders; and it is sometimes the only complaining symptom of this organ s dysfunction. In differential diagnosis of chronic pathologies involving larynx, a neoplastic process must be ruled out. Therefore, endoscopy and biopsy are required to detect carcinoma. This project is a cross sectional descriptive study Population, were all the patients underwent direct laryngoscopy due to chronic hoarseness in Isfahan Ayatollah Kashani hospital from April 1991 to December 1998. Sampling was in census, by means of files existing in the hospitals archive. Cases that laryngoscopy were due to causes other than hoarseness, such as foreign body, or trauma, or in cases that the files were incomplete were excluded from the study. Totally 408 files were evaluated: 54 excluded due to above reasons, and research continued on 363 cases. Average age of evaluated patients was 42.6 years and standard deviation was 18.9. The most abundant was in the 31-40 year group, 67.2% of patients were male. In 63.9% of all patients, definite diagnosis was as certained only by laryngoscopy, and 36.1% were biopsied. On the whole: 36.9% of cases were intact, 9.6% TRUE VOCAL cord paralysis, 20.1% tumor, and 33.4%inflammation. At least 20% of cases were defined as Tumors. That is a high ratio; and this group needs quick diagnostic and therapeutic measures. Our aim of direct laryngoscopy in patients with chronic hoarseness is `

Background: The insertion of endotracheal tube is essential for most surgical operations, mechanically ventilated patient in ICU wards, During cardiopulmonary resuscitation and so for transport of patients. The aim of this study was determination of airway related distances in Iranian patients.Methods: In a cross- sectional study during year 2007 in Imam Khomeini university Hospital a total of 75 ASA class I and II patients who were admitted to pulmonary ward evaluated for determination of incisor-VOCAL cord and incisor- carina distances. The nasal nare- VOCAL cord distance was determined too.Results: A total of 71 patients, 45(63%) male and 26(36.6%) female were evaluated. The Incisor-VOCAL cord distance in males and females was 16.83±0.75mm against 15.04±1.12mm (P=0.03). The difference of nare-VOCAL CORDS and Incisor- VOCAL cord distances was 2-3Cm.Conclusions: There was direct association between height and tracheal length in the study patients. The tracheal length (suitable insertion depth) in our patients was different from the recommendations (23 & 21 Cm for men and women) for non- Iranian, 25.9 versus 22.6 for Iranian men and women respectively. The difference of nasal nare-VOCAL cord and upper incisor-VOCAL cord distances in our patients was 2-3 cm, the lower range of accepted or reported one. We offer to do another experience with larger study group to apply the data to Iranian population.

Introduction: Varicella-zoster virus may cause an infectious disease called Ramsay Hunt syndrome. The related symptoms include facial nerve palsy (FNP), otalgia, the vesicular eruptions of the auricle and external auditory canal, less common ocular movement disorder, facial hypoesthesia, myofascial pain, vestibular symptoms, hearing loss, dysphasia, VOCAL cord paralysis, as well as tongue paralysis due to cranial neuropathies. Case Report: Herein, we presented the case of a 55-year-old man with left peripheral facial nerve palsy, profound hearing loss, and TRUE VOCAL cord paralysis. The FNP recovered after 2 weeks and synkinesis totally improved after 4 weeks. Conclusion: Ramsay Hunt syndrome may present as cranial polyneuropathy; therefore, accurate history taking and physical examinations are necessary in this regard. The recovery rate of the vagus nerve is probably fair without polyneuropathy; however, it seems to be poor in cases suffering from polyneuropathy.

VOCAL cord palsy (VCP) is the most serious complication as aspiration, and dysphagia after neck surgeries. Therefore, various methods are available to assess the immobilization of the VOCAL cord. Intraoperative neuromonitoring has been the usual method to check the efficient integrity of the recurrent laryngeal nerve. In recent years, transcutaneous laryngeal ultrasonography (TLUS) has appeared as an alternative method. Sixty-four patients underwent thyroid surgery, group I (32 patients) IONM examined by electromyography to evaluate the VC functions, and group II TLUS (32 patients) using a superficial liner ultrasound probe. Complications, patient satisfaction, enhanced recovery, extubation time, and long stay in hospitals and ICU were recorded. Statistically highly significant enhanced recovery time in IONM group was 29.58±9.86 and TLUS group was 2.75±0.81, p<0.001. No significant difference in patients' satisfaction, (p>0.05). In the IONM group, 5 patients (15.6%) had decay signals, 2 patients (6.3%) had hematoma formation, 8 patients (25.0%) had unilateral VOCAL cord palsy, and 2 patients (6.3%) had delayed extubation and long stay time in the ICU. TLUS group, 2 patients (6.3%) had decay signals, 2 patients (6.3%) had hematoma formation, 5 patients (15.6%) had unilateral VOCAL cord palsy, and 1 patient (3.1%) had delayed extubation and long time in the ICU. Given the risk of injury RLN during thyroid and neck surgeries, the lateral approach of TLUS had a significantly better overall VC visualization rate than the classic midline approach in peri-operative patients, and IONM can be useful in difficult cases.

Mycosis fungoides is the most common type of cutaneous malignant T cell lymphoma which primarily affects skin. However, extracutaneous manifestation may occur in advanced stages, mostly observed in postmortum studies. We present a case of mycosis fungoides that disseminated to the TRUE VOCAL cord of a 48 year-old African American man who presented with hoarseness. Only two cases that have also demonstrated a rare involvement of the TRUE VOCAL cord have been reported in the English literature. In both cases, mycosis fungoides infiltration of the TRUE VOCAL cord was seen postmortem, along with visceral dissemination of mycosis fungoides. We herein describe a single extracutaneous manifestation of mycosis fungoides in the TRUE VOCAL cord of a living patient with a 21-year diagnosis of mycosis fungoides. VOCAL cord involvement by mycosis fungoides must be considered as one of the differential diagnoses in any mycosis fungoides patients who complain of persistent hoarseness. Awareness of this entity is clinically important due to the necessity of a different management.

Introduction: The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and VOCALly healthy controls. Materials and Methods: This case-control descriptive study was performed on 113 people, including 50 patients with rheumatoid arthritis and 63 controls. The participants were subjected to videolaryngostroboscopic examinations in order to evaluate fundamental frequency, different structural VOCAL lesions, patterns of glottal closure, subglottal changes, supraglottis appearance, and movement patterns of the arytenoid cartilage. The obtained results were compared between the two research groups. Data analysis was performed in the Statistical Package for the Social Sciences, version 24. 0. A p-value less than 0. 05 was considered statistically significant. Results: The results revealed a statistically significant difference between the two groups in terms of the complete pattern (P=0. 00) and strained state of glottal closure (P=0. 00), pattern of subglottal changes (χ 2=25. 98, df=2; P<0. 001), and movement patterns of the arytenoid (χ 2=21. 16, df=1; P<0. 001). Additionally, based on the obtained frequencies, the two groups showed significant differences regarding the normal state of the larynx (P=0. 00), hypertrophy of VOCAL fold (P=0. 007), epithelial change (P=0. 007), and Reinke's edema (P=0. 001). However, the videolaryngostroboscopic examination results revealed no significant difference between the two groups in terms of polyp (P=0. 20), nodule (P=0. 57), sulcus VOCALis (P=0. 08), cyst (P=0. 45), and atrophy of VOCAL folds (P=0. 45). Conclusion: It seems that rheumatoid arthritis affects the patterns of arytenoids movement, some kinds of glottal closure patterns, and subglottal changes. As the results indicated, the occurrence of some laryngeal structural changes was higher in patients with rheumatoid arthritis than in individuals without this disorder.