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      Bilateral Vocal Fold Lobular Capillary Hemangioma Mimicking Glottic Carcinoma in a Chronic Smoker

      case-report
      , * ,
      Oman Medical Journal
      OMJ
      Glottis, Lobular Capillary Hemangioma, Pyogenic Granuloma, Adult, Hoarseness

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          Abstract

          Laryngeal hemangioma is a rare benign tumor of the larynx with predilection for a supraglottal subsite. Common presentations include hoarseness, dyspnea, and dysphagia, with a typical appearance of a reddish-purplish mass. A capillary form of the tumor, lobular capillary hemangioma (LCH) is extremely rare in adults and is predominantly unilateral. Diagnosis is made histologically by the distinct lobular growth pattern of capillary proliferation. Here, we report a 50-year-old male chronic smoker who presented with 3-month history of progressive hoarseness, dry cough, and intermittent dyspnea. Flexible endoscopy of the larynx showed irregular pinkish-white masses on the middle third of the bilateral vocal folds. The provisional diagnosis of glottic carcinoma was ruled out by histopathology, and the final diagnosis was bilateral glottic LCH, making it the first recorded case of this condition in literature. The patient underwent endolaryngeal microsurgery with subepithelial excision, a procedure that can be both diagnostic and therapeutic for this rare tumor.

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          Most cited references17

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          Current opinion in diagnosis and treatment of laryngeal carcinoma.

          Laryngeal carcinoma is the 11th commonest form of cancer in men world-wide, with 121,000 new cases in 1985. More than 95% of all laryngeal malignancies are squamous cell carcinomas. Treatment indications in cancer of the larynx are often controversial, since there are few comparative studies of different available therapeutic approaches. Surgery and radiotherapy are both widely used, and the choice between these two procedures is the most common therapeutic decision which has to be taken. Laryngeal function preservation has gained more and more weight in the last decades and chemotherapy is also a significant component of several curative approaches. In the last decades, several organ-preserving surgical techniques have become available and consequently total laryngectomy results less applied. Regardless of the treatment modality, Tis, T1, T2 laryngeal carcinomas have an 80-90% probability of cure, whereas for more advanced tumours this is approximately 60%. The most effective approach to laryngeal cancer remains prevention and early diagnosis when this cancer is curable with function preserving treatments.
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            The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach.

            The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F(0)-High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI = 0.13 x MPT + 0.0053 x F(0)-High - 0.26 x I-Low - 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices -5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.
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              Clinical examination of voice.

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                Author and article information

                Journal
                Oman Med J
                Oman Med J
                OMJ
                Oman Medical Journal
                OMJ
                1999-768X
                2070-5204
                22 March 2022
                March 2022
                : 37
                : 2
                : e355
                Affiliations
                [1]Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
                Author notes
                [* ]Corresponding author: marinamatbaki@ 123456ppukm.ukm.edu.my
                Article
                OMJ-37-02-1900187
                10.5001/omj.2021.49
                8941334
                cde9ab6a-6fd4-4a8e-8ebd-81a65ef63091
                The OMJ is Published Bimonthly and Copyrighted 2022 by the OMSB.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC) 4.0 License. http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 08 December 2019
                : 11 July 2020
                Categories
                Case Reports
                Case Reports

                glottis,lobular capillary hemangioma,pyogenic granuloma,adult,hoarseness

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