International Journal of Phonosurgery & Laryngology

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Volume 11, Number 2, July-December 2021

Original Article

Chandan Biswas, Indranil Chatterjee, Joyanta C Mandal

Trained and Untrained Female Singers Using Electroglottography Parameters: A Comparative Study

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:6] [Pages No:33 - 38]

Keywords: Electroglottography, Trained singer, Untrained singer, Vocal folds, Voice

   DOI: 10.5005/jp-journals-10023-1221  |  Open Access |  How to cite  | 

Abstract

Aim and objective: This study is aimed to evaluate and compare the effect of training on female trained (Hindustani classical) singers and untrained singers using electroglottography (EGG) parameters. Materials and methods: A total of 60 female subjects aged between 18 and 30 years were categorized into two groups: 30 female Hindustani classical singers and 30 untrained female singers. EG-PC3 EGG system of Dr. Speech software, TigerDRS Inc was used for this study. The following five parameters were taken into consideration: contact quotient (CQ), contact index (CI), contact quotient perturbation (CQP), contact index perturbation (CIP), and contact ratio (CR). The recording procedure involved two tasks: singing and speech. Results: By comparing these two groups with t-test, it has been found that p value is less than 0.05 (here α = 0.05 level of significance, 95% confidence level) for all the parameters which revealed significant difference of EGG parameters in trained and untrained singers for singing task as well as for speech task. Conclusion: All the parameters are proved to be useful to show differences. The quantitative parameters with higher significance to differentiate were CQ, CI, CQP, CIP, and CR, which provide information with respect to the glottis contact, the vibratory regularity, the vibration symmetry, and the speed of closing and opening of the vocal folds. Clinical significance: The study would help professional voice users to understand the impact of training on their phonatory capability and on their everyday speech pattern, thereby providing vocal education to the singers to prevent vocal abuse especially in case of untrained singers.

Original Article

Nupur K Nerurkar, Shruti Dhingra, KM Ranjita

A Retrospective Study of Granulomatous Lesions of the Larynx: Decision-making in Malignant Mimickers

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:7] [Pages No:39 - 45]

Keywords: Granulomatous lesions, Hoarseness, Larynx, Subglottic stenosis

   DOI: 10.5005/jp-journals-10023-1225  |  Open Access |  How to cite  | 

Abstract

Granulomatous conditions of the larynx constitute a heterogeneous group of lesions with overlapping symptoms. Many laryngoscopy findings are nonspecific, often confusing, with few systemic manifestations, and sometimes present as acute airway emergencies. It is imperative that the laryngologist suspects the possibility of such lesions when the presentation is atypical and the diagnosis does not “fit” in the classical scheme. Most cases may be managed conservatively avoiding an unnecessary tracheostomy. The correct approach undertaken at this time is crucial in determining the prognosis of the patient. An effective strategy involves multidisciplinary teams and a keen eye for systemic features, before undertaking any surgical intervention. Most granulomatous diseases show a definite regional preponderance but with the increase in immunocompromised conditions and globalization, this trend is changing worldwide. We retrospectively reviewed the data of 252 patients with suspected granulomatous lesions, seen over an 8-year period (2012–2020) at a tertiary care hospital with a voice clinic, in India. The epidemiological details, stroboscopy findings, histopathology, and response to treatment were noted. Some of the interesting cases with atypical presentations, which posed a diagnostic challenge, are discussed.

Original Article

Priyam Sharma, Gautam Khaund, Vivek Agarwal, Surajit Barman, Debika Baruah

Microlaryngeal Surgery—Difficulties Faced in Perioperative and Postoperative Periods: A Prospective Study

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:4] [Pages No:46 - 49]

Keywords: Difficulties, Microlaryngeal surgery, Vocal cords

   DOI: 10.5005/jp-journals-10023-1226  |  Open Access |  How to cite  | 

Abstract

Microlaryngeal surgery is popular among otolaryngologists owing to the increase in the number of patients with laryngeal complaints. Microlaryngeal surgery refers to surgery that is performed on the vocal cords under high magnification with the help of an endoscope or a microscope. In this study, we aim to assess the most common difficulties faced during and after the surgery.

ORIGINAL RESEARCH

Susan P Chacko, Anagha A Joshi, Vaishnavi R Sangle, Devika S Arora, Rishidhar A Dubey

Incidence of Dysphagia in Acute Stroke Patients: An Early Screening and Management

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:4] [Pages No:50 - 53]

Keywords: Dysphagia, FEES, Swallowing therapy

   DOI: 10.5005/jp-journals-10023-1222  |  Open Access |  How to cite  | 

Abstract

Introduction: In acute stroke dysphagia is a common complication associated with a risk of pneumonia and mortality. The primary aim of our study was to assess the incidence of dysphagia in acute stroke patients and analyze the benefits of early screening and management. Materials and methods: A prospective cohort study was conducted in our center. A total of 100 acute stroke patients were seen. All patients were then assessed by Mann assessment of swallowing ability (MASA) for the presence of dysphagia and aspiration. Patients with dysphagia were then further evaluated by fiber-optic-endoscopic evaluation of swallowing (FEES), stroke severity was assessed by National Institutes of Health Stroke Scale (NIHSS) score and location of stroke was done on the basis of CT scan of the brain. Results: Dysphagia was seen in 53 patients of acute stroke. FEES and swallowing therapy were done in 39 of dysphagia patients. The 3 parameters considered in FEES were penetration aspiration scale, secretion rating scale and residue rating scale. In patients with mild dysphagia compensatory strategies were given whereas in patients with moderate to severe dysphagia both compensatory and rehabilitative were given. Improvement was seen in our patients after swallowing therapy. Conclusion: The incidence of dysphagia in acute stroke patients was 53%. MASA scale helped in early detection of dysphagia. FEES and appropriate swallowing therapy played a significant role in improving the outcome of our patients.

ORIGINAL RESEARCH

Anton Dev X, Prithvi Das, Somnath Saha

Evaluation of Language in Post-CVA Patients: A Clinicophonological Study

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:7] [Pages No:54 - 60]

Keywords: Aphasia, Post-CVA, Poststroke, WAB

   DOI: 10.5005/jp-journals-10023-1229  |  Open Access |  How to cite  | 

Abstract

Aims and objectives: • To assess patients with cerebrovascular accidents (CVA), in order to ascertain the presence and types of language deficits. • Assess for any possible association between lesion site and pattern and degree of language impairments. • To determine if the degree of language deficits are more in left hemisphere pathology. Materials and methods: An observational study was conducted over a period of 1 year in the Department of ENT and Head-Neck Surgery and Department of Neuromedicine in a Tertiary Care Hospital. Poststroke patients were evaluated. Stable patients were selected. Both hemorrhagic and ischemic stroke patients were included. We had used the Western Aphasia Battery (WAB) to assess the faculty of Language in the study population and computed the Aphasia Quotient, based on which we categorized language function. Results: In our study, the number of patients with Infarction as the pathologic process was greater than those with hemorrhage. A total of 40% of cases had exclusively subcortical lesions. In our study, young stroke (stroke in patient under 50 years of age), was present in 14%. Aphasia was present in 40% of the patients. Crossed aphasia was seen in one patient (4%). Based on the aphasia quotient obtained from WAB, we categorized the aphasia as mild (4%), moderate (12%), and severe (24%). We had a preponderance of nonfluent aphasia. Conclusion: The frequency of poststroke aphasia was higher in our study (40%) than that seen in earlier studies. We have seen a preponderance of nonfluent aphasia in our study with global aphasia (50%) being the commonest subtype. Significant association (p < 0.05) was found between left-sided lesions and the presence of aphasia.

ORIGINAL RESEARCH

S Vivek, Reshmi M Nair

Decision-making in Arytenoid Granuloma Management: An Insight into the Presentations and Etiology

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:5] [Pages No:61 - 65]

Keywords: Arytenoid granuloma, Interarytenoid pachydermia, Videolaryngoscopy, Vocal process

   DOI: 10.5005/jp-journals-10023-1224  |  Open Access |  How to cite  | 

Abstract

Introduction: Arytenoid granulomas are benign exophytic inflammatory lesions that are found in the posterior glottis. This study aims to address the two presentations of arytenoid granuloma, namely process granuloma (PG) and body granuloma (BG), and to study the etiological factors behind each of these and thereby provide better understanding of the treatment of these two forms. Materials and methods: Descriptive study was performed by analyzing the videolaryngoscopic (VLS) recordings of 80 patients presenting with arytenoid granuloma. The demographic and clinical characteristics were also analyzed. Results: Arytenoid granulomas exhibited a male predominance with male: female ratio being 3.7:1. A total of 73 patients (91.25%) had unilateral granuloma, whereas seven patients (8.75%) had bilateral granuloma. Of the unilateral granulomas, 46 (57.5%) patients presented with left-sided granuloma, and 27 (33.8%) presented with right-side granuloma. The subtype of process granuloma (PG) was seen in 43 patients (53.75%) and BG in 37 patients (46.25%). PG is the commonest type of granuloma in males, and BG is the commonest type of granuloma in females. The association of process granuloma with inter arytenoid pachydermia was statistically significant but not BG. All cases of vocal cord paralysis in our series had BG. The majority of vocal cord paralysis (42.8%) cases with arytenoid granuloma showed severe overriding of arytenoid cartilage on the normal side. Conclusion: Identifying the two subgroups of arytenoid granuloma, namely process and BG, is imperative as they guide the proper management of arytenoid granuloma.

CASE REPORT

Swati Mishra, KKR Ramalingam

Laryngeal Schwannoma and its Management: A Case Report

[Year:2021] [Month:July-December] [Volume:11] [Number:2] [Pages:3] [Pages No:66 - 68]

Keywords: Awake intubation, Laryngeal schwannoma, Neurofibroma, Supraglottis

   DOI: 10.5005/jp-journals-10023-1228  |  Open Access |  How to cite  | 

Abstract

Laryngeal Schwannomas are rare clinical entities that often present with gradually progressing symptoms of hoarseness of voice, dyspnea, globus sensation, and occasionally with a mass in the neck. This most commonly arise in males during the 5th decade of life and is usually supraglottic in location. They are treated surgically. Surgical excision, when done, completely and meticulously prevents recurrence and helps preserve the normal laryngeal function. Schwannomas are amenable to complete surgical resection, unlike neurofibromas which penetrate the nerve fibers and thus have a higher chance of recurrence and malignant transformation. This article talks about a case of laryngeal schwannoma and its management by surgical excision preceded by awake intubation.

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