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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 : 1147]
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 : 585]
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 : 545]
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 : 515]
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 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 : 1383]
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

 
6.  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 : 1252]
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

 
7.  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 : 1229]
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

 
8.  ORIGINAL ARTICLE
Laryngopharyngeal Reflux in Dysphonics-Understanding the Significance and the Efficacy of Clinical Diagnosis: A Case-based Study
Swapna Sebastian, Arif Ali Kolethekkat, John Mathew, Mahasampath Gowri
[Year:2014] [Month:January-June] [Volume:4 ] [Number:1] [Pages:44] [Pages No:5-9] [No of Hits : 1211]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1069 | FREE

ABSTRACT

Objective: To determine the prevalence of laryngopharyngeal reflux (LPR) in patients with voice disorders and to find out the efficacy of reflux symptom index (RSI) and reflux finding score (RFS) in the diagnosis.

Methods: This prospective analytical study was conducted on 554 patients who presented with dysphonia and symptoms suspicious of LPR. They were then subjected to clinical work up based on symptomatic history based RSI and video stroboscopic RFS scoring criteria. The results were analyzed statistically. The differences between RSI and RFS were calculated by Fisher’s two sided test and the comparison between the two is calculated using kappa statistics to check the strength of agreement.

Results: Among 554 patients, 457 (82.4%) patients were diagnosed to have LPR based on RSI score of more than 13. Among 448 (80.8%) patients RFS score was positive. Vocal nodule (23.64%), laryngitis (22.38%) and the vocal polyp (20.03%) constitute the majority, with a female preponderance in vocal nodule. Both RSI and RFS were poor or almost absent in conditions such as spasmodic dysphonia, tremors, vocal cord palsy, hemorrhage, functional aphonia and traumatic conditions. The Pearson correlation coefficient showed a good correlation and agreement between RSI and RFS was statistically significant.

Conclusion: The association of LPR in patients with voice disorders is significantly high. The RSI and RFS based clinical diagnosis is reliable and valid in the diagnosis of LPR as revealed in our study.

Keywords: Dysphonia, Laryngopharyngeal reflux, RSI, RFS, Agreement.

How to cite this article: Sebastian S, Kolethekkat AA, Mathew J, Gowri M. Laryngopharyngeal Reflux in Dysphonics- Understanding the Significance and the Efficacy of Clinical Diagnosis: A Case-based Study. Int J Phonosurg Laryngol 2014;4(1):5-9.

Source of support: Nil.

Conflict of interest: None

 
9.  CASE REPORT
Near-total Laryngectomy: An Oncologically Safe Alternative
Arjun Dass, Surinder K Singhal, Nitin Gupta, Hitesh Verma
[Year:2014] [Month:January-June] [Volume:4 ] [Number:1] [Pages:44] [Pages No:30-32] [No of Hits : 1100]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1076 | FREE

ABSTRACT

Traditional treatment for advanced transglottic laryngeal and hypopharyngeal cancers is wide field laryngectomy. Patients who undergo wide field laryngectomy must also undergo voice rehabilitation with a prosthesis, electrolarynx or esophageal speech. These are associated with complications, such as bloating of the stomach, stenosis, aspiration and difficulty with hygiene of the TEP prosthesis. Near-total laryngectomy is a surgical treatment modality, where speech is maintained by way of a dynamic myomucosal shunt. It was specially designed to overcome the serious complications of adynamic tracheoesophageal shunt methods.

Keywords: Near-total laryngectomy, Myomucosal shunt, Interarytenoid area.

How to cite this article: Dass A, Singhal SK, Gupta N, Verma H. Near-total Laryngectomy: An Oncologically Safe Alternative. Int J Phonosurg Laryngol 2014;4(1):30-32.

Source of support: Nil.

Conflict of interest: None

 
10.  CASE REPORT
Worm in the Throat: Hamartoma Larynx
Sudarshan Loka Reddy, Nagendra Kadapa
[Year:2014] [Month:January-June] [Volume:4 ] [Number:1] [Pages:44] [Pages No:33-35] [No of Hits : 1060]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10023-1077 | FREE

ABSTRACT

Hamartomas of larynx are rare benign lesions which can be a rare cause for respiratory obstruction. This report highlights the case of a young female who presented with foreign body sensation and worm-like mass in throat of 10 years duration. On videolaryngoscopy, a pinkish polypoidal worm like mass was seen arising from the right side of epiglottis on the laryngeal surface. Endoscopic guided excision with cautery was done and the mass revealed hamartoma on histopathology.

Keywords: Hamartoma, Videolaryngoscopy, Epiglottis.

How to cite this article: Reddy SL, Kadapa N. Worm in the Throat: Hamartoma Larynx. Int J Phonosurg Laryngol 2014;4(1):33-35.

Source of support: Nil.

Conflict of interest: None

 
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