This study was aimed at investigating the impact of the passive gliding movement (PGM) of the arytenoid cartilage on the postoperative voice outcomes in patients undergoing type I thyroplasty (TPI) alone for unilateral vocal fold paralysis. A total of 15 patients who underwent TPI between 2017 and 2022 were identified, and 8 cases with available pre- and postoperative data were selected for the analysis. The patients were divided into two groups based on the presence or absence of PGM, and the laryngeal endoscopic findings and results of voice assessment were compared between the two groups. In the PGM-positive group, there was a residual gap between the vocal processes and the posterior glottis, and voice evaluation revealed minimal improvement. In contrast, in the PGM-negative group, voice assessment showed clear improvements in all cases. We further investigated the effect of adding arytenoid adduction (AA) to TPI in patients with PGM. While TPI alone did not sufficiently correct the PGM of the arytenoid and the voice improvement remained inadequate, when AA was added, the PGM of the arytenoid was suppressed, resulting in more significant improvements in the voice outcomes. PGM refers to the passive upward and outward movement of the paralyzed vocal fold due to contact with the healthy side. This movement is difficult to correct by TPI alone. Therefore, in cases where PGM is present, the addition of AA appears to be an effective intervention to improve the postoperative voice quality. The results of this study suggest that evaluating the presence or absence of PGM should be incorporated into the decision-making process for selecting the appropriate surgical procedure. This approach could potentially lead to better voice outcomes and enhanced quality of life for patients with unilateral vocal fold paralysis.

　　Pneumatosis intestinalis (PI) is a rare and severe disease characterized by the presence of gas within the gastrointestinal tract wall. There are numerous reports of the condition developing during treatment for head and neck carcinoma (HNC). Herein, we report cases of PI developing during treatment for HNC. Patients who were diagnosed as having PI while undergoing treatment for HNC at Nagoya City University Hospital between April 2014 and December 2023 were included in this study. We conducted a retrospective review of the patient background characteristics, symptoms, and treatment. During the study period, 9 cases who were undergoing treatment for HNC were diagnosed as having PI. The median age was 69 years old (range: 64-79 years). Six cases were male and 3 were female. The primary site of the cancer was the hypopharynx in 4 cases, oropharynx in 3 cases, and the oral cavity and maxillary sinus in 1 case, vespectively. As the treatment for HNC, 5 cases were receiving chemoradiotherapy (with cisplatin in 4 cases and cetuximab in 1 case), 2 cases were receiving treatment with paclitaxel and cetuximab, 1 case was receiving chemotherapy with 5-fluorouracil and cisplatin, and 1 case was receiving treatment with a cetuximab, 5-fluorouracil plus cisplatin regimen. A nasogastric tube was placed in 5 cases and gastrostomy had been performed in 1 case. As treatments for PI, 5 cases received antibiotic therapy while fasting and the remaining 2 cases were only fasting. None of the cases needed surgical treatment. There was no significant difference in the fasting or antibiotic treatment duration according to the presence or absence of portal venous gas. Although PI is a rare disease, special attention should be paid to cases undergoing treatment for HNC, including chemotherapy or molecular-targeted therapy, fasting for an extended period of time, and/or with implanted nasogastric tubes or gastrostomy devices. PI should be kept in mind as one of the adverse events that may have serious outcomes.

　　We report a rare case of acute epiglottitis developing in a 27-year-old man following brief, but high-level exposure to concrete dust at a construction site in the absence of appropriate respiratory protection. The patient presented with severe sore throat and dyspnea; flexible fiberoptic laryngoscopy revealed marked epiglottic edema. An emergency tracheotomy was performed, followed by systemic corticosteroid and antibiotics therapy, which resulted in rapid clinical improvement. Although laboratory tests showed leukocytosis and an elevated serum CRP level, imaging revealed no abscess, there were no systemic signs of infection, and the patient responded promptly to corticosteroid therapy. These features strongly suggest a non-infectious, possibly chemically-induced epiglottitis. To the best of our knowledge, this is the first reported case of acute epiglottitis precipitated by short-term inhalation of cement dust, suggesting the need to include occupational exposure as a potential cause of non-infectious epiglottitis.