International journal of phonosurgery and laryngology最新文献

{"title":"A Curious Case of Laryngeal Stridor","authors":"A. Agarwal, Shruti Dhingra","doi":"10.5005/JP-JOURNALS-10023-1184","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1184","url":null,"abstract":"Ab s t r Ac t Aim and objective: To present a case of acute respiratory obstruction due to isolated hemorrhage in the larynx in a patient with coagulation disorder, which is a very rare presentation. Background: Acute upper airway obstruction can occur due to various causes. Spontaneous, unprovoked hemorrhage in the larynx can be a significant and potentially life-threatening complication. Coagulation disorders constitute a small percentage of such cases. An accurate initial assessment of a struggling, dyspneic patient can make the diagnosis challenging. Case description: Here, we describe a case of spontaneous internal hemorrhage in the larynx leading to upper airway obstruction in a patient with hemophilia A. The patient was admitted to an intensive care unit for airway observation and treatment with factor VIII supplementation. In the first 24 hours, there was a rapid respiratory improvement. The laryngeal hematoma gradually resolved by the 5th day. Conclusion: The patient was managed conservatively, and no intubation or tracheostomy was needed. Clinical significance: Hemophilia A can lead to life-threatening airway obstruction due to isolated laryngeal hemorrhage. Examination and diagnosis can be challenging if the prior history is not known as the condition mimics various other conditions. We need to keep an eye on subtle pointers that instigate an episode of bleeding. Keeping a high index of suspicion with prompt airway control and rapid reversal of coagulopathy can be lifesaving.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127336569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Thyrotomy Approach in the Era of Transoral Laser Surgeries","authors":"R. Kamala, R. Vaishnavi, B. Manjula, Brinda A. Poojari","doi":"10.5005/JP-JOURNALS-10023-1187","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1187","url":null,"abstract":"Ab s t r Ac t Background: Laryngeal lipomas are rare benign lesions and are usually asymptomatic till they grow in size to become obstructive. Excision of a laryngeal submucosal lesion presents with the dilemma of an external or an endoscopic approach. The transoral endoscopic approach is preferred for smaller lesions and external approach for large tumors. This report introduces the external lateral thyrotomy approach for excision of a paraglottic space lipoma. Case description: A 33-year-old female patient, teacher by profession, presented with complaints of voice change and choking sensation for 3 months. Flexible laryngoscopy revealed a smooth submucosal swelling of the right false cord and aryepiglottic (AE) fold with fullness in the right pyriform fossa and bilateral mobile vocal cords. Contrast-enhanced computed tomography (CECT) scan of neck was suggestive of a right paraglottic 5 × 3 cm dumbbell-shaped lipoma that was excised by the lateral thyrotomy approach. Conclusion: The lateral thyrotomy approach provided adequate exposure of the tumor and excellent visibility of the entire paraglottic space under direct vision. A complete excision could be performed without any breach of the laryngeal mucosa or tracheostomy and with preservation of voice and laryngeal framework. Clinical significance: An individualized approach is needed for rare tumors and sometimes a simple procedure may outweigh the benefits of an advanced technique.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131768501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Commissure Granuloma with Chondronecrosis: A Late Complication of Type I Thyroplasty","authors":"N. Nerurkar, D. Agrawal, R. Krishnan","doi":"10.5005/JP-JOURNALS-10023-1186","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1186","url":null,"abstract":"Ab s t r Ac t Aim and objective: The development of an anterior commissure granuloma following medialization of the vocal fold with a silicone implant is a rare complication as silicone is a relatively inert material. However, when such granulomas do develop, they are often picked up late due to slow progression over years. Case description: Our article focuses on the clinical presentation, evaluation, and management of a patient with an anterior commissure granuloma and thyroid cartilage chondronecrosis who presented to us with a history of multiple medialization laryngoplasties in the past, following an immobile vocal fold which was after a parapharyngeal tumor excision. Conclusion: Though anterior commissure granulomas following medialization laryngoplasty are not frequently seen currently due to the use of implants that produce minimal foreign body reaction and sterile conditions, we believe that in our case the etiology of the granuloma formation with chondronecrosis of the thyroid cartilage may be due to the very large size of the revision implant with resultant extrusion with foreign body reaction leading to long-standing infection. Clinical significance: Any implant however inert, runs a small risk of infection with granuloma formation which is more likely with large implants and multiple surgeries causing devascularization of tissues. Close observation following thyroplasty with stroboscopy and imaging when needed may help pick up complications early, avoiding progression to chondronecrosis and possibly respiratory distress.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123500881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transtracheal Approach for Tracheobronchial Surgery: Our Experience with This Novel Technique","authors":"G. Khaund, B. Gogoi, S. Kalita, Keshavanand Konwar, U. Barman, D. Gogoi, P. Bora, N. Deka","doi":"10.5005/JP-JOURNALS-10023-1188","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1188","url":null,"abstract":"Working field being the same, airway surgery becomes a challenging domain for surgeons as well as the anesthesiologists. In our study, we are highlighting the endoscopic transtracheal approach for tracheobronchial surgery (ETATS) as a novel technique to access tracheal and bronchial pathology. Diagnostic bronchoscopy and imaging aiding in preoperative planning, in conjunction with the anesthesiology team, this technique could aid in the management of airway cases, which might otherwise not be possible by conventional approaches. We have shared our experience with ETATS in three emergency airway cases as the outcome of management has been favorable.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116189702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consequences of Intubation in COVID-19 Patients: Are We Ready?","authors":"P. Dehgani-Mobaraki, A. Zaidi","doi":"10.5005/JP-JOURNALS-10023-1185","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1185","url":null,"abstract":"Ab s t r Ac t Aim and objective: We report a case of a 61-year-old man, still recovering from COVID-19, who developed acute respiratory distress syndrome (ARDS) requiring hospitalization and intubation in early March 2020. Consequently, he developed post-intubation bilateral massive vocal fold granulomas. To date, this is the first case report of laryngeal granulomas following intubation since the outbreak. Background: Clinical presentation of COVID-19 ranges from being asymptomatic to mild symptoms while a fraction of them develop ARDS. There is a need to highlight the probability of a rise in the number of patients with complaints of voice change and laryngeal lesions in the coming months. More specifically, post-intubation laryngeal granulomas. Case description: The patient timeline, blood exams, serological tests, radiological examination, voice evaluation, and videolaryngoscopy of a 61-year-old recovered COVID-19 patient with bilateral vocal fold granulomas have been described in detail that would assist in clinical decision-making. Conclusion: A significant number of patients underwent intubation at the beginning of the pandemic. These patients can be expected to be frequent visitors at the outpatient clinic and emergency rooms in the future with complaints of change in voice and laryngeal lesions. The question of whether we are ready for it needs to be assessed. Clinical significance: Patients who underwent long-term intubation following ARDS after contracting COVID-19 infection need to be further evaluated and kept on a regular follow-up. Conclusion: Information regarding intubation granuloma risk, breathing exercises, and speech therapy might be beneficial to such patients. We need to be well prepared to expect a surge in the number of cases reporting with voice disorders shortly.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129168282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of USG-guided 95% Ethanol Sclerotherapy in Solitary Benign Thyroid Cysts","authors":"R. Nishad, A. Jain, Ashwani Kumar, Rajesh Kumar, Mangal Singh","doi":"10.5005/jp-journals-10023-1181","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1181","url":null,"abstract":"Thyroid nodule is frequently encountered thyroid diseases and is characterized by growth of abnormal tissues into the thyroid gland. Solitary nodule, defined as palpable, clinically detectable single nodule in otherwise normal thyroid gland, usually presents as asymptomatic mass that is discovered either by patient or clinician. Materials and methods: Twenty patients meeting inclusion criteria were included in study. Under strict aseptic conditions, using ultrasonographic guidance, fluid from cyst was aspirated and 95% ethanol was slowly (approximately 1 mL/minute) instilled into cavity to a volume of approximately 50% of volume of aspirated fluid. Patients were called for follow-up at an interval of 1 month for 3 months. Ultrasound was done to document volume of cyst, intracystic fibrosis and vascularity. Results: The mean pre-procedure volume of cysts was 3.605 cm3. After instillation of ethanol, the mean volumes at the end of 1st, 2nd and 3rd month of treatment were respectively 1.665 cm3, 0.9585 cm3 and 0.442 cm3. The mean volume reduction rates were calculated. Smaller cysts demonstrate better results than the larger cysts i.e., cyst size in range of 2.1–2.5 cm3 shows 97.14% reduction after 3 months, while cysts of >4.1 cm3 had mean reduction of 71.79% only. Conclusion: In the management of benign euthyroid cysts, USG-guided percutaneous ethanol injection is a cost-effective and efficient nonsurgical treatment modality with higher success rates. It is a relatively safe procedure with very low or no complication rates and has better patient compliance. Clinical significance: A non-surgical and cost-effective procedure can be treatment of choice for appropriately selected patient thus beneficial to greater majority of society.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115571890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Laryngology due to COVID-19","authors":"Michael J Pitman","doi":"10.5005/jp-journals-10023-1183","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1183","url":null,"abstract":"","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132199867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal of a Classification for Sulcus Following Microlaryngoscopy with a Retrospective Study of the Results of a Laser-assisted Sulcus Release Surgery","authors":"N. Nerurkar, Zainab Nagree, D. Agrawal","doi":"10.5005/jp-journals-10023-1180","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1180","url":null,"abstract":"Ab s t r Ac t Background: Sulcus vocalis has historically remained challenging in terms of both diagnosis and management. The problem is further compounded by a lack of clarity in its classification as an accurate estimation of its presence and depth can be established only during microlaryngoscopy (MLS). We have thus proposed a classification of sulcus following MLS, which would allow for uniform grading. A laserassisted sulcus release (LASR) technique is described which was performed in 7 patients and 10 vocal folds of isolated sulcus cases with outcome measures studied retrospectively. Materials and methods: The classification proposed of sulcus following MLS is based on depth of invagination of the sulcus, length of the sulcus, presence of keratin debris within, and associated presence of mucosal bridges, polyps and cysts. A LASR technique was performed for type A and D sulci (based on proposed classification) where the multiple points of release were made with a CO2 laser Acublade perpendicular to the lips of the sulcus. All patients received preand postoperative voice therapy. Preoperative and 3 months’ postoperative stroboscopy and vocal outcome measures were reviewed retrospectively. Results: Stroboscopic improvement of the mucosal wave and amplitude with decreased phonatory gap and decreased ventricular hyperadduction was observed in all patients postoperatively. There was a significant improvement of grade, roughness, breathiness, asthenia, strain (GRBAS) and maximum phonatory time (MPT) (p < 0.05). Conclusion: The LASR technique performed for type A and D sulci in our limited case series revealed 3-month postoperative stroboscopic improvement along with improvement in vocal parameters. We plan to continue this study to include a larger sample size.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124375531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Speech Range Profile in Hindi in Hyperfunctional Voice Disorders: A Case-controlled Observational Study","authors":"Raj Kumar, N. Panda, Noorain Alam, S. Munjal, Diya Nair","doi":"10.5005/jp-journals-10023-1177","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1177","url":null,"abstract":"Ab s t r Ac t Background: Speech range profile (SRP) is defined as the graphical plot of an individual’s frequency–intensity interactions occurring during connected speech production. As speech stimuli are better method to assess the functional limit of voice, SRP has advantage over voice range profile (VRP) in terms of application, easiness to administer the test, and duration needed to complete the test. There is a need for a simple tool to measure the physiologic limit of phonatory system in Hindi for Indian population. Objective: The objectives of the present study were to (1) measure SRP in persons with hyperfunctional voice disorders and to compare the findings with persons with normal voice in both male and female groups and (2) find whether SRP measure can be used to differentiate between the hyperfunctional voice disorder and normal voice. Design: A case-controlled observational study. Setting: The study was conducted at speech and hearing unit at the Postgraduate Institute of Medical Education and Research, Chandigarh. The data were collected during 6 months between January and June 2019. Patients: The subject group (n = 70) comprised 35 male and 35 female participants with hyperfunctional voice disorders, while the control group (n = 70) comprised ageand gender-matched participants with normal voice quality. Measurements: After the videolaryngostroboscopy examination, SRP was obtained using the VRP module in Computerized Speech Lab software from Pentax Medical. The parameters analyzed were the lowest frequency (Fmin, Hz), highest frequency (Fmax, Hz), minimum intensity (Imin, dB SPL–sound pressure level), and maximum intensity (Imax, dB SPL). Results: The SRP values were compared between the two groups using Mann–Whitney U test. A significant difference was found between the subject group and the control group in mean values of minimum frequency and maximum frequency in female groups. In male groups, significant difference was seen in values of minimum frequency, maximum frequency, Imax, as well as intensity range. Subject group with hyperfunctional voice disorder had significantly lower values (p < 0.05). Limitations: The number of subjects is less. There is a need to perform SRP in a larger population and across various voice disorders. Effect of smoking habit was not considered in the study. Also, it is difficult to measure Fmax especially in early post-phonosurgery assessment. Conclusion: Our study shows that SRP can be used clinically to differentiate the hyperfunctional voice disorders from normal voice in both male and female groups.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"03 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130244533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Tubercular Upper Airway Stenosis: Our Experience","authors":"R. Srivastava, A. Agarwal, Issac M Macharia","doi":"10.5005/jp-journals-10023-1182","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1182","url":null,"abstract":"Ab s t r Ac t Aim: This study describes the findings seen in patients suffering from stenosis of the upper airway secondary to tuberculosis (TB) and its management. Materials and methods: A prospective study was done at a tertiarycare hospital between August 2017 and April 2019 on four patients diagnosed with airway stenosis secondary to TB. Results: There were three males and one female, and the age ranged from 18 to 38 years. Rechanneling of the stenosed segment was done using cold instruments and CO2 laser, used alone or in combination. One patient developed recurrence even after undergoing two procedures which had to be eventually treated by resection anastomosis. Conclusion: Early diagnosis and treatment with antitubercular medications is the key to prevent the development of airway stenosis. The treatment of stenosis involves surgical intervention using cold instruments and laser, and the chances of getting satisfactory results are good. Regular follow-up of such patients is extremely important. Clinical significance: Development of airway stenosis secondary to TB is a dreaded sequelae of the disease pathogenesis. This entity should be kept as one of the differential diagnoses while evaluating patients with upper airway stenosis in whom the etiology of the condition remains elusive.","PeriodicalId":258448,"journal":{"name":"International journal of phonosurgery and laryngology","volume":"6 16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116869786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}