We herein report a case of life-threatening invasive fungal sinusitis following allogeneic hematopoietic stem cell transplantation. Since the infection could not be controlled by endoscopic sinus surgery or drainage of the infratemporal fossa and orbit, we performed enucleation of the left eye. Although recent case reports have described the successful preservation of eyes with invasive fungal sinusitis, we should consider orbit evisceration to save the patient's life in cases of severe immunodeficiency, such as in patients receiving multiple immunosuppressive treatments.

Hyalinizing trabecular tumor (HTT) is a rare thyroid tumor of follicular cell origin with a trabecular pattern of growth and marked intertrabecular hyalinization. We herein report a case of HTT in a 26-year-old man with a thyroid goiter. Since the clinical and ultrasonographic features were nonspecific, fine-needle aspiration was performed, which resulted in an indeterminate cytologic diagnosis (category 3). After partial thyroidectomy was performed, an operative rapid pathologic diagnosis revealed that the goiter was a hyalinizing trabecular tumor. The patient therefore did not undergo paratracheal lymph node dissection. There is no unified treatment policy for HTT. If we treat cases of HTT using the protocol for a benign tumor, an operative rapid pathologic diagnosis can provide effective information on whether or not to perform paratracheal lymph node dissection. If we cannot determine the malignancy before the operation, we may still be able to prevent unnecessary paratracheal lymph node dissection by an operative rapid pathologic diagnosis.

Most cases of unilateral vocal cord paralysis exhibiting severely insufficient glottic closure can be improved by functional surgery of the larynx. However, in cases with an unsatisfactory improvement, voice therapy may be required after surgery. We examined the effects of voice therapy after functional surgery of the larynx in cases of unilateral vocal cord paralysis. Among 12 patients with unilateral vocal cord paralysis who underwent functional surgery of the larynx at our hospital, five required voice therapy after surgery because of muscle tension dysphonia and atrophy of the vocal cord on the healthy side. Following voice therapy, four of these five patients showed improvements in subjective and objective evaluations. Our results indicate that post-surgery voice therapy may be necessary for patients who suffer from muscle tension dysphonia due to the compensatory use of the vocal cord on the healthy side during dysphonia or when the patient suffers from sulcus vocalis.

We encountered a 24-year-old female patient who had been born at 752g and intubated immediately after birth. She had been treated under intubation for seven months. After extubation, her crying voice sounded soft, and from childhood, her voice sounded hoarse . An examination of the larynx revealed a glottis posterior gap and the arytenoid mucous membrane touching the epiglottis laryngeal surface, along with hyper-closure of the vestibular folds on both sides. Computed tomography showed calcification of the thyroid cartilage from the rear end to the lower end on both sides. At the level of the thyroid cartilage, the cricoid cartilage showed calcification and advanced distortion. Long-term endotracheal intubation during the neonatal period appeared to have altered the layer structure of the vocal cords, causing structural changes in the cricoarytenoid joints. The supraglottic hyper-closure during vocalization was thought to have occurred as compensation for the mucosal wave disturbance of the vocal cords and glottic insufficiency during vocalization.

Thyroplasty type Ⅰ and Ⅲ (TP Ⅰ + Ⅲ) has improved dysphonia with severe vocal fold atrophy in cases of oculopharyngeal muscular dystrophy (OPMD). The patient was a 68-year-old man who had been diagnosed with OPMD 10 years before the operation. He underwent cricopharyngeal myotomy three years after the diagnosis, and his swallowing function improved. Three years later, he became annoyed by his altered voice. Autologous fat injections twice and collagen injections twice to the right vocal cord were performed over the subsequent few years;however, his voice quality was not improved due to the absorption of fat and collagen and the marked progression of vocal fold atrophy. TP Ⅰ + Ⅲ was performed to improve his breathy voice, while an endoscopic examination of swallowing showed that his swallowing function had deteriorated steadily. After the operation, each vocal cord was shifted toward the midline successfully, although the vocal cord closure was not perfect. TP Ⅰ + Ⅲ seems to be an effective phonosurgical technique for the treatment of dysphonia due to severe vocal fold atrophy.