International Journal of Phonosurgery & Laryngology

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2022 | January-June | Volume 12 | Issue 1

Original Article

Jijo George, Unnikrishnan K Menon, Archana M Varghese

The Effect of Short Duration vs Long Duration Voice Rest on the Outcome of Phonosurgery for Benign Vocal Fold Lesions: A Pilot Study

[Year:2022] [Month:January-June] [Volume:12] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Benign vocal fold lesion, Hoarseness, Phonomicrosurgery, Voice rest

   DOI: 10.5005/jp-journals-10023-1232  |  Open Access |  How to cite  | 

Abstract

Background: Patients with benign vocal fold lesions often present with hoarseness. The mainstay of treatment is precise excision, termed phonomicrosurgery, and voice rest is recommended afterward to promote wound healing and better voice outcomes in the postoperative phase. However, there is no general consensus among the clinicians about the type and duration of voice rest needed. This study is an initial attempt to compare the effect of strict voice rest of short duration (1 day) vs long duration on the voice outcome postsurgery. Materials and methods This being a pilot study, 10 patients undergoing phonomicrosurgery for benign vocal fold lesions, were chosen. They were alternately divided into two groups of short duration and long duration strict voice rest. Five patients were advised to follow 1 day's strict voice rest and other five, 7 days’ voice rest. Pre and postoperative voice parameters of each patient were recorded, analyzed, and compared. To compare the pre and postchanges of voice parameters, Wilcoxon signed-rank test was applied and to compare the median difference of numerical variables between groups, Mann–Whitney U test was applied. Results: While comparing the difference in voice parameters between the preoperative and postoperative periods in each group separately, almost all voice parameters showed statistically significant association. However, when comparing the changes between the groups, Voice Handicap Index (VHI) score was the only voice parameter which showed significant association (p-value 0.047). Conclusion: In this pilot study, voice rest has positive impact on voice outcome postsurgery; and longer duration of absolute voice rest was found to give more subjective satisfaction regarding voice quality, based on the VHI score.

Original Article

Sujata Mulia, Indranil Chatterjee, Sujoy K Makar, Vijaya Sinha

A Comparative Study among Trained Hindustani Classical Singers, Untrained Singers and Non-singers through Cepstral Analysis

[Year:2022] [Month:January-June] [Volume:12] [Number:1] [Pages:7] [Pages No:5 - 11]

Keywords: Cepstrum, Hindustani classical singers, PRAAT, Singing

   DOI: 10.5005/jp-journals-10023-1234  |  Open Access |  How to cite  | 

Abstract

Aim: The present study had the aim to obtain the cepstral measure [Cepstral peak (CP), Cepstral peak prominence (CPP), Cepstral peak prominence smoothed (CPPS)] of trained singers, untrained singers, and non-singers for the sustained vowel /a/, oral passage reading, and singing of the national anthem. Materials and methods: A total of 180 normal-speaking adults within the age range of 20–45 years were considered for the study, and they were divided into three groups: trained Hindustani classical singers (30 males and 30 females), untrained singers (30 males and 30 females), non-singers (30 males and 30 females). The subjects were screened for speech, language, and hearing defects or any other abnormalities. They were asked to undergo three tasks: sustained vowel /a/, oral passage reading, and singing task. Recordings were done, and then acoustic (cepstral) analyses were done through PRAAT software. Statistical analyses were done for the analyzed data. Statistical Package for Social Sciences (SPSS), version 16.0 was used. Results: Significant differences were obtained at p < 0.05 between the genders (male and female) for different tasks and different cepstral parameters. Trained singers were found to have greater means than untrained singers and non-singers. Female participants were found to have a greater mean than the male participants. Significant differences were obtained for CPPS measures in sustained vowel tasks. For oral passage reading, trained singers and non-singers have significant differences for CP measure, no significant difference between trained singers, untrained singers, and non-singers were observed for CPP, and significant differences between non-singers and untrained singers, trained singers and untrained singers were found for CPPS measure. Conclusion: From the present study, it can be concluded that the Hindustani classical trained singers have better harmonic organization and periodicity in their voices when compared with untrained singers and non-singers. Clinical significance: This study provides an insight into the acoustical measure through cepstral analysis of Hindustani classical trained singers when compared to untrained singers and non-singers, which will provide a base for the disordered singing population.

Original Article

Nupur K Nerurkar, Trishna Akshay Chitnis, Jarvis Pereira

Presence and Pattern of Chromesthesia in 200 Individuals: An Experiment Performed on World Voice Day

[Year:2022] [Month:January-June] [Volume:12] [Number:1] [Pages:4] [Pages No:12 - 15]

Keywords: Chromesthesia, Music therapy, Phonosurgery, Synesthesia

   DOI: 10.5005/jp-journals-10023-1235  |  Open Access |  How to cite  | 

Abstract

Aim: To study the presence and pattern of chromesthesia. Chromesthesia is the eliciting of visual images (Color) by aural stimuli (music). It is a type of synesthesia which is a phenomenon where one type of sensory stimulus evokes a response in another sense. Materials and methods: We conducted an experiment on World Voice Day in which 200 participants were made to listen to five songs/tracks and were asked to think of a color. Results: The colors chosen by them were categorized as ‘bright’ or ‘dull’ and data was presented as pie charts. Conclusion: Based on whether the colors chosen were ‘bright’ or ‘dull’ and whether the song was ‘upbeat’ or ‘slow’, we recommend that ‘happy’ or ‘upbeat’ music could be included as part of regular treatment in patients especially those who are singers or musicians as it brings about a positive mood change and helps in the recovery of the patients especially in the postoperative period when they are usually on voice rest.

CASE REPORT

S Vivek, Jayakumar R Menon, Manju E Issac, Jayanthy Pavithran

Congenital Cricopharyngeal Achalasia in an Infant Treated by External Cricopharyngeal Myotomy: A Case Report

[Year:2022] [Month:January-June] [Volume:12] [Number:1] [Pages:3] [Pages No:16 - 18]

Keywords: Achalasia, Aspiration, Cricopharyngeus, Dysphagia, Myotomy

   DOI: 10.5005/jp-journals-10023-1230  |  Open Access |  How to cite  | 

Abstract

Congenital cricopharyngeal atresia is a rare but serious cause of dysphagia in infants. The failure of the cricopharyngeus muscle (CPM) to adequately relax on food intake is considered as the cause. This condition usually presents early in life with symptoms that include regurgitation, nasopharyngeal reflux, aspiration, choking episodes, and failure to thrive. Videofluoroscopy helps to clinch the diagnosis, demonstrating a prominent cricopharyngeal bar in most cases. This describes the case report of a male infant who presented with cricopharyngeal achalasia (CPA) and underwent open cricopharyngeal myotomy at 6 months of age, leading to the resolution of symptoms.

CASE REPORT

Rafees H Palliyalthodi, Suma S Mathews

Neurofibroma of Glottis: A Case Report

[Year:2022] [Month:January-June] [Volume:12] [Number:1] [Pages:3] [Pages No:19 - 21]

Keywords: Benign lesions, Larynx, Microlaryngeal surgery, Neurofibroma, Neurofibroma larynx, Nonplexiform neurofibroma, Plexiform neurofibroma, Surgery larynx

   DOI: 10.5005/jp-journals-10023-1233  |  Open Access |  How to cite  | 

Abstract

Neurofibroma is a benign tumor rarely seen in the larynx. It is a peripheral nerve sheath tumor arising from the fibrous covering of peripheral nerve. Peripheral nerve sheath tumors include schwannomas (neuromas or neurilemmomas) and neurofibromas. The presenting symptoms in laryngeal neurofibroma may be a change in voice, dysphagia, dyspnea, or globus sensation depending on the site and size of the tumor. The most common site of neurofibroma reported in the larynx is the supraglottis. We report a case of neurofibroma of the glottis, which is an uncommon location for this rare tumor. The patient underwent microlaryngoscopic excision of the tumor and histopathological examination including immunohistochemistry which confirmed the diagnosis of neurofibroma.

CLINICAL TECHNIQUE

Gopishankar Subramaniasamy, Anagha Atul Joshi, Pushkaraj Kulkarni, Renuka A Bradoo, Madhu S Velecharla

Injection Laryngoplasty with Hyaluronic Acid: A Study to Analyze the Quality and Longevity of Voice Improvement in Unilateral Vocal Cord Palsy

[Year:2022] [Month:January-June] [Volume:12] [Number:1] [Pages:9] [Pages No:22 - 30]

Keywords: Hyaluronic acid, Injection laryngoplasty, Techniques of injection laryngoplasty, Vocal cord palsy, Voice improvement

   DOI: 10.5005/jp-journals-10023-1231  |  Open Access |  How to cite  | 

Abstract

Purpose: To study the efficacy of injection laryngoplasty with hyaluronic acid in unilateral vocal cord palsy with respect to the quality of voice, symptomatic relief, and longevity of treatment outcome. Materials and methods: A prospective study was conducted, including 20 patients with unilateral vocal cord palsy. Injection laryngoplasty with hyaluronic acid was done as an office-based procedure by different approaches. Patients were assessed before the procedure and at regular intervals for 6 months after the procedure using various voice parameters, viz. GRBAS scale, maximum phonatory time, voice handicap index, and voice analysis by Dr. Speech voice analyzer software. Laryngoscopy was also done at each follow-up to check for the phonatory gap. Results: Injection laryngoplasty with hyaluronic acid was done successfully in all 20 patients with complete glottal closure. The thyrohyoid percutaneous technique was the most preferred approach. All voice parameters showed statistically significant improvement for 6 months. The phonatory gap closure was almost maintained throughout the period of 6 months, with none having symptoms of aspiration. No side effects were noted in our study. Conclusion: Injection laryngoplasty with hyaluronic acid is an effective temporary treatment modality in cases of unilateral vocal cord palsy, which can give good quality of voice and overcome aspiration for at least a period of 6 months.

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