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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  ORIGINAL ARTICLE
Voice Therapy in Muscle Tension Dysphonia Cases
Sachender Pal Singh, Smrity Rupa Borah Dutta
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:38] [Pages No:20-24] [No of Hits : 1228]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1097 | FREE

ABSTRACT

Muscle tension dysphonia (MTD) is a condition where phonation is associated with excessive muscular tension or muscle misuse. It has multifactorial etiologies. It can be a primary or secondary MTD. While it can affect anyone, sufferers usually belong to a particular group. It has very serious impact on sufferer’s personal, social and professional life.
We are presenting here, our 20 months prospective study done in the department of otorhinolaryngology, Silchar Medical College and Hospital from June 2012 to July 2013.
Voice therapy was given to every patient, whether primary or secondary MTD. Pre-therapy vs post-therapy comparisons were made of self-ratings of voice handicap index, auditoryperceptual ratings as well as visual-perceptual evaluations of laryngeal images.
Outcome of voice therapy results (Graphs 1 and 2) in such patients were found to be very good. As the disease is multifactorial, treatment approach should be broad-based involving multidisciplinary team.

Keywords: Circumlaryngeal massage, Dysphonia plica ventricularis, GRABS score.

Abbreviations: Vocal Cord Nodule (N), Vocal Polyp (P), Laryngopharyngeal Reflux (LPR), Presbylaryngis (PL), Cut Throat injury (CT), Primary Muscle Tension Dysphonia (PMTD), Dysphonia Plica ventricular (DPV).

How to cite this article: Singh SP, Dutta SRB. Voice Therapy in Muscle Tension Dysphonia Cases. Int J Phonosurg Laryngol 2015;5(1):20-24.

Source of support: Nil

Conflict of interest: None

 
2.  Original Article
Diagnostic Challenge of Sulcus Vocalis Made Easier
Nupur Kapoor Nerurkar, Harsh Karan Gupta, Ajay Eknath Shedge
[Year:2015] [Month:July-December] [Volume:5 ] [Number:2] [Pages:33] [Pages No:39-41] [No of Hits : 630]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1102 | FREE

ABSTRACT

Objectives: To introduce a simple diagnostic test performed with white light laryngoscopy for the diagnosis of sulcus vocalis.

Materials and methods: This is a retrospective observational study. A total of 14 patients with voice-related complaints and a phonatory gap on examination were included. Obvious structural and neuromuscular glottic pathologies were excluded. Phonatory gap was measured using white light rigid laryngoscopy with the technique described here. Findings were then correlated with stroboscopy.

Results: All 14 patients (10 U/L and 4 B/L), observed to have an asymmetric phonatory gap on white light rigid laryngoscopy, were diagnosed with sulcus vocalis.

Conclusion: An asymmetric phonatory gap, as seen on white light laryngoscopy and measured with the simple technique mentioned here, should make the laryngologist suspect a sulcus vocalis. However, the diagnosis needs to be confirmed by stroboscopy.

Keywords: Phonatory gap, Stroboscopy, Sulcus.

How to cite this article: Nerurkar NK, Gupta HK, Shedge AE. Diagnostic Challenge of Sulcus Vocalis Made Easier. Int J Phonosurg Laryngol 2015;5(2):39-41.

Source of support: Nil

Conflict of interest: None

 
3.  Original Article
Gastroesophageal Reflux Disease in Patients with Eustachian Tube Catarrh
Anuja Bhargava, Meenu Cherian, Tambi A Cherian, Sanjay Gupta
[Year:2015] [Month:July-December] [Volume:5 ] [Number:2] [Pages:33] [Pages No:61-66] [No of Hits : 582]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1107 | FREE

ABSTRACT

Background: Eustachian tube catarrh could be due to laryngopharyngeal reflux besides other causes.

Objectives: To assess gastroesophageal reflux disease (GERD) in patients with Eustachian tube catarrh and the effect of proton pump inhibitors on symptoms of Eustachian tube disease.

Methodology: A total of 50 patients were selected with symptoms of Eustachian tube catarrh and evaluated prospectively in the ENT Outpatient Department of the Pondicherry Institute of Medical Sciences, Puducherry.

Results: The group consisted of 15 (30%) males and 35 (70%) females. The largest group was of the age of 45 years and above (44%). The most common symptom of Eustachian tube catarrh was itching (84%), followed by otalgia (76%) and popping sensation on swallowing (74%). On otoscopic examination, the commonest grade of tympanic membrane retraction was grade I (57%), on tympanometry 90% of cases had middle ear pressure in range -100 to +100. The middle compliance ranged from 0.5 to 1.75 (normal) in 86% of the cases. The tympanomeric curve was type A (normal) in 78% of the cases and type C in 8% of the cases. At the end of 4 and 8 weeks, the response of treatment to proton pump inhibitors was significantly higher (z = 3.53, p < 0.05) in the studied group.

Conclusion: Laryngopharyngeal reflux (LPR) could be an important etiological factor in Eustachian tube catarrh. The treatment, with proton pump inhibitors, of Eustachian tube catarrh with no local identifiable cause, could be very useful to this subsect of patients.

Keywords: Eustachian tube catarrh, Gastroesophageal reflux, Laryngopharyngeal reflux, Proton pump inhibitors.

How to cite this article: Bhargava A, Cherian M, Cherian TA, Gupta S. Gastroesophageal Reflux Disease in Patients with Eustachian Tube Catarrh. Int J Phonosurg Laryngol 2015;5(2): 61-66.

Source of support: Nil

Conflict of interest: None

 
4.  ORIGINAL ARTICLE
Role of Voice Therapy in Patients with Mutational Falsetto
Arvind Varma, Alok Kumar Agrahari, Raj Kumar, Vijay Kumar
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:38] [Pages No:25-27] [No of Hits : 560]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1098 | FREE

ABSTRACT

Background: Mutational falsetto is the most common mutational voice disorder, found in all ages. Clinicians often miss this diagnosis due to unfamiliarity with the condition. The voice of a person with mutational falsetto is high pitched, weak, thin, breathy, hoarse and monopitched.

Objective: This study was carried out to evaluate the efficacy of voice therapy in persons with mutational falsetto.

Methods: Eleven male patients with ages between 18 and 26 years (mean age 22.18 years, SD 2.52) diagnosed with mutational falsetto underwent acoustical analysis using Praat Software, perceptual analysis using grade, roughness, breathiness, asthenia and strain (GRBAS) scale and psychosocial analysis using emotional component of voice handicap index (VHI). All the components were analyzed pre- and postvoice therapy.

Results: Improvement in acoustic analysis parameters was statistically significant with p-value less than 0.0001(pretherapy mean of fundamental frequency (F0) was 217.45 with SD 8.68, whereas post-therapy mean of F0 was 127.50 with SD 5.32). Significant improvement in perceptual analysis was seen post-therapy on GRBAS scale. Improvement in psychosocial aspect was also statistically significant with p-value less than 0.0001 (pre-therapy mean 26.18, SD 1.72 post-therapy mean 7, SD 1.15).

Conclusion: Voice therapy plays an important role in lowering F0 and alleviation mental agony of the patients with mutational falsetto.

Keywords: Fundamental frequency, Mutational falsetto, Voice therapy.

How to cite this article: Varma A, Agrahari AK, Kumar R, Kumar V. Role of Voice Therapy in Patients with Mutational Falsetto. Int J Phonosurg Laryngol 2015;5(1):25-27

Source of support: Nil

Conflict of interest: None

 
5.  CASE REPORT
Suspecting Airway Foreign Body in Agenesis of the Lung: A Rare Incidence of Misdiagnosis
Santosh Kumar Swain, Sidarth Mohanty, Neha Singh, Jashashree Choudhury, Mahesh Chandra Sahu
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:38] [Pages No:32-34] [No of Hits : 536]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1100 | FREE

ABSTRACT

Agenesis of the lung is an extremely rare condition. Suspecting foreign body in agenesis of the lung is a diagnostic dilemma. We report the case of an 11 months old boy who presented with cough and cold; examination showed decreased air entry on the right side and investigations reported collapse on chest X-ray and plain computed tomography (CT) scan of thorax. Pediatrician suspected airway foreign body. Rigid bronchoscopy was done to confirm the diagnosis, but there was blind end in the right bronchus with no foreign body seen. Contrast-enhanced CT scan (CECT) of the neck and chest confirmed the aplasia of right lung. Agenesis of the lung should be kept in the mind by the clinician when dealing with foreign body in airway. This can prevent unnecessary intervention like rigid bronchoscopy.

Keywords: Agenesis of the lung, Airway foreign body, Bronchoscopy.

How to cite this article: Swain SK, Mohanty S, Singh N, Choudhury J, Sahu MC. Suspecting Airway Foreign Body in Agenesis of the Lung: A Rare Incidence of Misdiagnosis. Int J Phonosurg Laryngol 2015;5(1):32-34.

Source of support: Nil

Conflict of interest: None

 
6.  Original Article
Posterior Commissure Hypertrophy as Diagnostic and Prognostic Indicator for Laryngopharyngeal Reflux
Anagha Atul Joshi, Bhagyashri Ganesh Chiplunkar, Renuka Anil Bradoo, Kshitij Dhaval Shah
[Year:2015] [Month:July-December] [Volume:5 ] [Number:2] [Pages:33] [Pages No:57-60] [No of Hits : 533]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1106 | FREE

ABSTRACT

Purpose: To establish posterior commissure hypertrophy as tool to diagnose laryngopharyngeal reflux (LPR) and to determine whether it can be used as a reliable marker for response to treatment.

Materials and methods: A prospective study of 100 patients with voice disorder was conducted. Patients were evaluated using reflux symptom index (RSI) and reflux finding score (RFS) by 70° Hopkins’ rigid laryngoscope. Those patients in whom RFS score was 7 or more were diagnosed to have LPR. These patients were then started on antireflux therapy along with lifestyle modification and were evaluated regularly over a period of 6 months.

Results: The prevalence of LPR in patients with voice disorders was found to be 25%. Mean age was 41.48 years and the male and female ratio was 0.85:1. Posterior commissure hypertrophy was present in 60 out of 100 patients (60%). Among laryngopharyngeal reflux disease (LPRD), 23 out of 25 patients (92%) had posterior commissure hypertrophy, out of which only 2 (8.6%) patients showed complete resolution of posterior commissure hypertrophy after 6 months of treatment. A total of 10 patients (43.47%) did not show any change in grading of posterior commissure hypertrophy. And 11 patients (47.82%) showed downgrading of posterior commissure hypertrophy. Sensitivity of posterior commissure hypertrophy for diagnosis of LPR was found to be 92%, whereas specificity was 50.66%.

Conclusion: Posterior commissure hypertrophy can be used as a screening tool for diagnosis of LPR but cannot be used reliably as a clinical marker for response to therapy.

Keywords: Laryngopharyngeal reflux, Posterior commissure hypertrophy, Reflux finding score.

How to cite this article: Joshi AA, Chiplunkar BG, Bradoo RA, Shah KD. Posterior Commissure Hypertrophy as Diagnostic and Prognostic Indicator for Laryngopharyngeal Reflux. Int J Phonosurg Laryngol 2015;5(2):57-60.

Source of support: Nil

Conflict of interest: None

 
7.  ORIGINAL ARTICLE
Elongated Styloid Process Revisited
Anand Acharya
[Year:2015] [Month:January-June] [Volume:5 ] [Number:1] [Pages:38] [Pages No:15-16] [No of Hits : 505]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1095 | FREE

ABSTRACT

Elongated styloid process is one of the many causes of pain in throat. Yet, it is often overlooked. When the throat looks normal on examination, the entity should be kept in mind, to clinch the diagnosis. Management and review of literature are discussed.

Keywords: Eagle syndrome, Elongated styloid process, Foreign body sensation, Stylalgia.

How to cite this article: Acharya A. Elongated Styloid Process Revisited. Int J Phonosurg Laryngol 2015;5(1):15-16.

Source of support: Nil

Conflict of interest: None

 
8.  CASE SERIES
Salvaging a Shattered Larynx: A Challenge in Clinical Otorhinolaryngology
Sanjeev Mohanty, Shameena Shinaz, Gopinath Maraignanam, John Samuel
[Year:2014] [Month:January-June] [Volume:4 ] [Number:1] [Pages:44] [Pages No:13-16] [No of Hits : 1433]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1071 | FREE

ABSTRACT

Laryngotracheal trauma is a life-threatening clinical scenario at times. Although considered rare, it is on the rise due to high speed vehicular accidents. Failure to recognize such injuries and promptly secure an airway may have fatal consequences.1 We are reporting three cases of laryngotracheal blunt trauma, all of whom subsequently developed absolute dysphagia, difficulty in breathing and difficulty in phonation. These patients were appropriately managed in the critical time period. Two patients were surgically managed and one patient was treated conservatively. They are on regular follow-up and are physiologically stable. In this report, the treatment strategies adopted leading to good clinical outcomes are highlighted.

Keywords: Laryngeal trauma, Dysphonia, Emphysema, Odynophagia, Counter tracheostomy, False passage, Laryngeal stabilization.

How to cite this article: Mohanty S, Shinaz S, Maraignanam G, Samuel J. Salvaging a Shattered Larynx: A Challenge in Clinical Otorhinolaryngology. Int J Phonosurg Laryngol 2014;4(1):13-16.

Source of support: Nil.

Conflict of interest: None

 
9.  CASE REPORT
A Rare Cause of Hoarsness of Voice: Lipoid Proteinosis of the Larynx
Santosh Kumar Swain, Maitreyee Panda, Nibedita Patro, Mahesh Chandra Sahu
[Year:2014] [Month:January-June] [Volume:4 ] [Number:1] [Pages:44] [Pages No:23-26] [No of Hits : 1284]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1074 | FREE

ABSTRACT

Lipoid proteinosis (LP) is a rare genetic disease with autosomal recessive inheritance. It most often involves deposition of periodic acid Schiff positive hyaline material in skin, oral mucosa, larynx and other tissues. But it also involves the central nervous system, lungs, lymph nodes and striated muscles. Hoarseness, small papules on the eyelid border (moniliform blepharosis), enlarged tongue, waxy skin, and diffuse verrucous skin colored or yellowish papules and plaques on traumatized areas and oral mucosa are the most common features leading to the clinical diagnosis of LP. We present the case report of a 12-year-old boy with significant hoarseness, inability to protrude the tongue, beaded papules along the eyelid margins, and scarring of the skin. Of his two sisters, one had the same symptoms but with less clinical severity and the other had no features of LP.

Keyword: Consanguinity, Laryngeal manifestation, Hoarseness, Lipoid proteinosis, Urbach-Wiethe disease.

How to cite this article: Swain SK, Panda M, Patro N, Sahu MC. A Rare Cause of Hoarseness of Voice: Lipoid Proteinosis of the Larynx. Int J Phonosurg Laryngol 2014;4(1):23-26.

Source of support: Nil.

Conflict of interest: None

 
10.  ORIGINAL ARTICLE
Does Voice Therapy Cure All Vocal Fold Nodules?
Baisakhi Bakat, Abhishek Gupta, Arunima Roy, Amitabha Roychoudhury, Barin Kumar Raychaudhuri
[Year:2014] [Month:July-December] [Volume:4 ] [Number:2] [Pages:38] [Pages No:55-59] [No of Hits : 1280]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1083 | FREE

ABSTRACT

Introduction: Vocal nodules are known to be one of the most common benign lesions, commonly situated at the junction of anterior one third and posterior two third of vocal folds. Voice therapy is considered to be the gold standard of treatment of vocal fold nodule.

Objectives: To determine the efficacy of voice therapy in the treatment of vocal fold nodules and to identify any possible reason for failure to voice therapy in managing vocal fold nodules.

Materials and methods: A prospective study, conducted over a period of 6 months. Eighteen adult patients diagnosed with vocal fold nodules at a tertiary care hospital were subjected to 6 weeks of voice therapy. Pre and post therapy subjective (Voice Handicap Index-10) and objective (Rigid fiber optic laryngoscopy) evaluation was done. Patients with no improvement after 6 weeks of voice therapy underwent micro laryngeal surgery. All patients were followed up at 3 months and 6 months.

Results: In majority of patients, objective and subjective voice outcome parameters were significantly improved after voice therapy. Although a few cases showed no significant improvement after therapy, they recovered completely after microlaryngoscopic surgery. It was found that patients who required surgery even after voice therapy had hard nodules.

Keywords: Vocal fold nodule, Voice therapy, Microlaryngoscopic surgery.

How to cite this article: Bakat B, Gupta A, Roy A, Roychoudhury A, Raychaudhuri BK. Does Voice Therapy Cure All Vocal Fold Nodules? Int J Phonosurg Laryngol 2014;4(2):55-59.

Source of support: Nil

Conflict of interest: None

 
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