Understanding Speech-Language Pathology and Surgical Interventions for Exercise-Induced Laryngeal Obstruction.

This review provides an overview of existing data from the literature summarizing therapies for exercise-induced laryngeal obstruction (EILO) with 2 main areas of focus. We discuss the role of speech-language pathologists in the assessment and treatment of EILO and an overview of different respiratory retraining techniques used in the behavioral management of the disease. We then discuss the role and some of the technical specifics of supraglottoplasty (SGP) for refractory supraglottic EILO, including patient selection and similarities between SGPs performed for EILO and for infants with laryngomalacia.

Airway Biopsy Results From Patients With Suspected Granulomatosis With Polyangiitis (2005-2015): Clinicopathological Correlation and Proposal of an Algorithm to Improve Diagnosis.

Objectives: The aim of this study was to review the histologic diagnostic yield of airway biopsies with a suspected granulomatosis with polyangiitis (GPA) diagnosis at a single center devoted to respiratory diseases using previously published criteria. A secondary aim was to apply the algorithm proposed by the European Medicines Agency to determine whether more biopsies were confidently identified as having GPA diagnoses.

Methods: From a total of 132 airway biopsies (2005-2015), 50 were randomly selected for second review by an expert pathologist, and previously published criteria were applied.

Severe microscopic polyangiitis with unilateral vocal cord paralysis as initial manifestation.

Case Description: A 16 year-old female who presented with initial ear, nose and throat manifestations who later progressed to severe renal disease, requiring hemodialysis after 11 months of unique laryngeal involvement.

Clinical Findings: Unilateral vocal cord paralysis without other symptoms or signs, but with positive perinuclear anti-neutrophil cytoplasmic antibodies (ANCA) and anti-myeloperoxidase autoantibodies, followed an unfavorable course months later with rapidly progressive glomerulonephritis. Renal biopsy confirmed an ANCA-associated vasculitis.