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Tritter AG, Sadoughi B. Transoral Laser Microsurgical Excision of a Laryngeal Schwannoma Located in the Paraglottic Space. Laryngoscope 2021; 131:2729-2731. [PMID: 34014564 DOI: 10.1002/lary.29624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/07/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To report the first case of transoral excision of a paraglottic laryngeal schwannoma. METHODS Case report. RESULTS Laryngeal schwannomas are rare tumors, with approximately 75 cases reported to date worldwide. Most cases involve superficial supraglottic tumors excised transorally, and some have been found in deeper compartments and treated using transcervical approaches. This report describes the first excision of a schwannoma of the paraglottic space via endoscopic laser laryngotomy. The procedure allowed return to normal function, without recurrence within 8 months, after which the patient was lost to follow-up. CONCLUSIONS Transoral excision of benign paraglottic tumors is safe and feasible. LEVEL OF EVIDENCE N/A. Laryngoscope, 2021.
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Affiliation(s)
- Andrew G Tritter
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, New York, U.S.A
| | - Babak Sadoughi
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, U.S.A
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Tritter AG, Spiller PT, Brown ML, Weinberger PM, Nathan CAO. Pilot Study: Pneumatic Compression Garment Therapy for Postradiotherapy Laryngopharyngeal Edema. Ear Nose Throat J 2020; 101:54-58. [PMID: 32687411 DOI: 10.1177/0145561320942362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Pneumatic compression garment therapy (PCGT) has been established as treatment for postradiotherapy lymphedema, and its use in head and neck patients is becoming more common. Although effects on interstitial edema of the cervical soft tissues have been studied, effects on internal laryngopharyngeal edema, as well as associated symptoms of dysphagia and dysphonia, have yet to be published. METHODS We surveyed 7 patients treated with radiation for head and neck cancer (HNC) who had also been prescribed PCGT for cervical lymphedema. Patients were asked about subjective experience with the device, and also administered the Eating Assessment Tool-10 (EAT-10) and Voice Handicap Index-10 (VHI-10) surveys regarding their symptoms after using PCGT. Laryngoscopy videos from these same periods were also reviewed and scored using a validated tool for assessing laryngopharyngeal edema. RESULTS 85% of patients reported at least some improvement in dysphagia and dysphonia following PCGT. Average EAT-10 score after PCGT was 11.4 and average VHI-10 score after PCGT was 8.7. These compare more favorably to historical scores for the same questionnaires in similar patient populations. Laryngeal edema scores on endoscopic examination were not significantly different after at least 3 months of therapy (pre: 20.15, post: 20.21, P = .975); however, the utility of this result is limited by a low inter-rater reliability (Krippendorff α = .513). CONCLUSIONS While we are unable to show any difference in objective assessment of laryngopharyngeal edema on endoscopic examination in this small pilot study, patients report substantial subjective improvement in postradiotherapy dysphagia and dysphonia following cervical PCGT that warrants more formal investigation.
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Affiliation(s)
- Andrew G Tritter
- Department of Otolaryngology, Louisiana State University Health Science Center, Shreveport, LA, USA
| | - Patrick T Spiller
- Department of Otolaryngology, Louisiana State University Health Science Center, Shreveport, LA, USA
| | | | - Paul M Weinberger
- Department of Otolaryngology, Louisiana State University Health Science Center, Shreveport, LA, USA.,Ochsner LSU Hospital, Shreveport, LA, USA
| | - Cherie-Ann O Nathan
- Department of Otolaryngology, Louisiana State University Health Science Center, Shreveport, LA, USA.,Department of Otolaryngology, Overton Brooks VA Medical Center, Shreveport, LA, USA
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Tritter AG, Mehta V, Samuelson M, deGravelle G, Ma X, Medlin-Moore T, Takalkar A, Caldito G, Nathan CAO. Incidence of contralateral-bilateral nodes in the human papillomavirus era. Laryngoscope 2016; 127:1328-1333. [DOI: 10.1002/lary.26439] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/22/2016] [Accepted: 11/02/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Andrew G. Tritter
- Department of Otolaryngology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Vikas Mehta
- Department of Otolaryngology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
- Department of Surgery; Overton-Brooks VA Medical Center; Shreveport Louisiana U.S.A
| | - Madeleine Samuelson
- Department of Otolaryngology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Ginger deGravelle
- School of Medicine; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Xiaohui Ma
- Department of Otolaryngology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Tara Medlin-Moore
- Department of Otolaryngology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Amol Takalkar
- Department of Radiology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Gloria Caldito
- School of Medicine; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
| | - Cherie-Ann O. Nathan
- Department of Otolaryngology; Louisiana State University Health Sciences Center; Shreveport Louisiana U.S.A
- Department of Surgery; Overton-Brooks VA Medical Center; Shreveport Louisiana U.S.A
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Kwak PE, Tritter AG, Donovan DT, Ongkasuwan J. Long-term Voice Outcomes of Early Thyroplasty for Unilateral Vocal Fold Paralysis Following Aortic Arch Surgery. Ann Otol Rhinol Laryngol 2016; 125:559-63. [DOI: 10.1177/0003489416636127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To describe this institution’s experience with and the long-term outcomes of early type 1 thyroplasty for unilateral vocal fold paralysis (UVFP) following surgery on the aortic arch. Study Design: Retrospective chart review with telephone questionnaire. Setting: Academic tertiary care center. Subjects and Methods: Three hundred forty-eight patients with UVFP following surgery on the aortic arch since 1999 were identified; 40 were available for follow-up. The number of revision procedures following initial thyroplasty was ascertained, and the Voice Handicap Index (VHI) was administered by telephone. The hypothesis that early thyroplasty produced voice outcomes and revision rates comparable to injection laryngoplasty was established prior to the initiation of data collection. Results: Six out of the 40 patients (15%) required revision thyroplasty following their initial procedure. Mean VHI of all patients was 36.0 (SD, 27.2). Mean VHI was significantly different in the 18 to 39 age group (13.1) when compared to the 40 to 59 (51.8) and 60+ (37.7) age groups ( P = .013). Mean follow-up since initial thyroplasty was 46.5 months (SD, 42.2). Conclusions: In the setting of aortic arch surgery with injury to the recurrent laryngeal nerve, early thyroplasty produces voice outcomes comparable to those achieved in the literature with repeated injection and delayed thyroplasty and can be considered in select populations.
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Affiliation(s)
- Paul E. Kwak
- Division of Laryngeal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew G. Tritter
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University-Shreveport, Shreveport, Louisiana, USA
| | - Donald T. Donovan
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Julina Ongkasuwan
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
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Tritter AG, Selber J, Kupferman ME. Surgical Management of a Functional Paraganglioma of the Infratemporal Fossa. J Neurol Surg Rep 2015; 76:e1-7. [PMID: 26251781 PMCID: PMC4520974 DOI: 10.1055/s-0034-1383860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 05/07/2014] [Indexed: 12/01/2022] Open
Abstract
Background Paragangliomas are rare neural crest tumors that can manifest in the head and neck as either functional or more commonly as nonfunctional lesions. Paragangliomas of the infratemporal fossa are exceedingly rare, with no more than a handful of documented cases. Like other tumors of this space, surgical management is challenging on account of complex anatomy and nearby critical structures. Methods A 44-year-old man presented with a right infratemporal fossa functional paraganglioma. Following preemptive embolization and autonomic pharmacotherapy, his tumor was successfully resected via a transfacial maxillary swing approach. Results This case highlights the surgical management of a functional paraganglioma of the infratemporal fossa while demonstrating the effectiveness of a transfacial maxillary swing approach for both exposure and resection. Conclusion Although this report summarizes much of the literature on paragangliomas, there is still much to uncover regarding the fundamental features and genetic etiology of these lesions.
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Affiliation(s)
- Andrew G Tritter
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States ; Baylor College of Medicine, Houston, Texas, United States
| | - Jesse Selber
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Michael E Kupferman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
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Rousseau B, Cohen SM, Zeller AS, Scearce L, Tritter AG, Garrett CG. Compliance and Quality of Life in Patients on Prescribed Voice Rest. Otolaryngol Head Neck Surg 2010; 144:104-7. [DOI: 10.1177/0194599810390465] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives. To determine patient compliance with voice rest and the impact of voice rest on quality of life (QOL). Study Design. Prospective. Setting. University hospital. Subjects and Methods. Demographics, self-reported compliance, QOL impact on a 100-mm visual analog scale (VAS), and communication methods were collected from 84 participants from 2 academic voice centers. Results. Of 84 participants, 36.9% were men, 63.1% were women, and 64.3% were singers. The mean age of participants was 47.2 years. The mean duration of voice rest was 8.8 days (range, 3-28), and the median was 7 days. Overall compliance was 34.5%. Postoperative voice rest patients were more compliant than non-postoperative patients (42.4% vs 16.0%, P = .04, χ2). Voice rest had an impact on QOL (mean ± SD, 68.5 ± 27.7). Voice rest also had a greater impact on singers than nonsingers (mean VAS 77.2 vs 63.6, P = .03, t test) and on those age <60 years than those age ≥60 years (mean VAS 74.4 vs 46.7, P < .001, t test). More talkative patients and those with longer periods of voice rest had worse QOL scores (Spearman correlation = 0.35, P = .001 and Spearman correlation = 0.24, P = .03, respectively). Restrictions in personal and social life were noted in 36.9% of patients, 46.4% were unable to work, 44.0% felt frustrated, and 38.1% reported feeling handicapped while on voice rest. Conclusions. Given poor patient compliance and the significant impact of voice rest on QOL, further studies are warranted to examine the efficacy of voice rest and factors that may contribute to patient noncompliance with treatment.
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Affiliation(s)
- Bernard Rousseau
- Department of Otolaryngology, Vanderbilt University, Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, TN, USA
| | - Seth M. Cohen
- Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, Duke Voice Care Center, Duke University Medical Center, Durham, NC, USA
| | - Amy S. Zeller
- Department of Otolaryngology, Vanderbilt University, Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, TN, USA
| | - Leda Scearce
- Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, Duke Voice Care Center, Duke University Medical Center, Durham, NC, USA
| | - Andrew G. Tritter
- Department of Otolaryngology, Vanderbilt University, Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, TN, USA
| | - C. Gaelyn Garrett
- Department of Otolaryngology, Vanderbilt University, Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, TN, USA
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