Abstract

The most frequent cause of laryngeal aspergillosis in immunocompromised hosts is secondary invasion from the lungs and tracheobronchial tree. However, there have only been a few cases of primary aspergillosis of the larynx reported in the past fifty years. We describe the example of a 73-year-old woman who complained of on-going hoarseness. She is a non-smoker who has been treated with nebulized tobramycin, inhaled and oral corticosteroids, bronchodilators, and other medications for her history of asthma and chronic bronchiectasis. It was determined via direct laryngoscopy and vocal cord stripping that the patient had invasive aspergillosis with no other symptoms.

With oral voriconazole, the patient was successfully treated and showed no symptoms of recurrence. To the best of our knowledge, no reference of inhaled antibiotics producing this uncommon presentation has been made in the literature, despite the fact that a number of significant risk factors for the development of primary aspergillosis of the larynx have been documented. Therefore, we emphasise the role of inhaled tobramycin as a special initiator of this unusual appearance.

Though uncommon, laryngeal trauma is a serious and sometimes fatal injury. Since the clinical appearance of acute laryngeal trauma varies depending on the location, intensity, and mode of injury, rapid diagnosis and treatment are required. There are provided two case studies: (1) Case history A describes a 53-year-old man who fractured the mid anterior thyroid cartilage and both aspects of the cricoid cartilage after a motor vehicle accident; however, this patient was asymptomatic from the above fractures; and (2) Case history B describes a 41-year-old man who suffered trauma to the chest, neck, and left arm after being struck by a large lead pipe, which fractured the left aspect of the cricoid cartilage; this patient was symptom. Symptomatology may be connected to the type of acute laryngeal injury rather than the severity of the injury as well as the mode of injury. Emergency department physicians and trauma radiologists should be able to identify acute laryngeal trauma. Acute laryngeal trauma may not require unnecessary expert consultations and long-term problems if it is identified and treated quickly.