International Journal of Phonosurgery & Laryngology

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2023 | January-June | Volume 13 | Issue 1

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Original Article

Deepthi Koganti, Davis T Pulimoottil, Sneha M Joy, Nirmal C Venkataramanujam, Padmanabhan Karthikeyan, Ramiya R Kaipuzha, Neelima Vijayan, Nikhil Sivanand

Is Plummer–Vinson Syndrome Endemic in Puducherry? A Single-center Retrospective Study of this Rare Syndrome

[Year:2023] [Month:January-June] [Volume:13] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Anemia, Dysphagia, Plummer–Vinson syndrome, Postcricoid webs

   DOI: 10.5005/jp-journals-10023-1241  |  Open Access |  How to cite  | 

Abstract

Objective: Although Plummer–Vinson syndrome (PVS) is rare, it is imperative to be aware that this group of patients is at an increased risk of squamous cell carcinoma (SCC) of the pharynx and the esophagus, which can be identified early. The aim of this study was to determine the prevalence of cricopharyngeal webs, iron deficiency anemia (IDA), and dysphagia among individuals diagnosed with PVS in Puducherry. Materials and methods: Over a span of 2 years, a total of 30 patients who were diagnosed with PVS and had presented to the department of ENT at a tertiary care center were included in this single-center study with a review of past events. Dilatation of postcricoid webs was done, followed by a postoperative iron correction. A regular follow-up for 1 year was done to examine the occurrence of cancerous alterations and the reappearance of symptoms. Results: We found the highest incidence (90%) to be in females presenting at the 4th and 5th decades of life, with the most significant presenting complaint in all patients being dysphagia. The majority of them had features of IDA like pallor, koilonychia, glossitis, angular stomatitis, and bald tongue. All patients (100%) showed iron deficiency status in biochemical analysis and postcricoid web in barium swallow. Three patients had associated malignancies, of which two were esophageal and one was hypopharyngeal. Conclusion: Plummer–Vinson syndrome (PVS) is a symptom complex consisting of dysphagia, IDA, and esophageal webs. It is a condition that carries an increased risk for the development of malignancy and has a higher prevalence among people of South Indian descent, especially in the Puducherry region, and comprehensive evaluation should be conducted in these patients to exclude the presence of concomitant malignancy. The esophageal web in PVS can be safely dilated, and the response is sustained during follow-up despite rare recurrences.

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Original Article

Anagha A Joshi, Nishigandha V Nehete, Pushkaraj A Kulkarni, Vaishnavi R Sangle, Renuka A Bradoo, Varun Dave

Assessing the Reliability of a Mobile Phone Recorder in Acoustic Voice Analysis: A Cross-sectional Study

[Year:2023] [Month:January-June] [Volume:13] [Number:1] [Pages:4] [Pages No:5 - 8]

Keywords: Coronavirus disease 2019 infection, Dr Speech software, Microphone, Mobile phone recorder, Voice analysis

   DOI: 10.5005/jp-journals-10023-1243  |  Open Access |  How to cite  | 

Abstract

Aim: To study the variability in acoustic voice parameters captured by different recording devices using the Dr Speech™ software program. Materials and methods: A total of 60 participants were evaluated in a cross-sectional study for a period of 4 months from September to December 2019. A total of 25 of these participants had no voice abnormality, whereas 35 had a known voice disorder. Voices of study participants were recorded using an inbuilt mobile phone and the microphone provided by Dr Speech™ software company. The voice recorded by mobile phone recorder was converted in 16-bit, 44100 Hz, .wav format using Audacity™ software as it was the requirement to analyze voice in Dr Speech™ software. Both sets of voice recordings were then analyzed using the Dr Speech™ software. Results: Voice recordings were made using the microphone provided by Dr Speech software company and compared with the recordings made using the mobile phone recorder. We observed no statistically significant difference between voice parameters from both recordings except in a few parameters like shimmer and harmonic to noise ratio (HNR). We conclude that there is a correlation between the acoustic voice parameters of voices recorded by the microphone of Dr Speech™ software company and the in-built recorder of a mobile phone except few. Using the mobile phone recorder, the voice parameters of study participants with normal voices were compared with those with voice disorders, and the difference was found to be statistically significant. This suggested that mobile phones could differentiate between normal and diseased voices. Conclusion: The result of this cross-sectional study indicated that voices recorded using a mobile phone could be effectively used for voice analysis in certain difficult conditions. Clinical significance: Patients can record their voices on their personal mobile phones and send the recording as an attachment to the treating laryngologist. This will be convenient and cost-saving, with no requirement for a patient to travel to the healthcare center repeatedly; it also helps in reducing the risk of transmission of any infection, especially coronavirus disease 2019 (COVID-19).

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CLINICAL TECHNIQUE

Gopishankar Subramaniasamy, Anagha Atul Joshi, Sneha A Kini, Renuka A Bradoo

Transcutaneous Laryngeal Ultrasonography: A Reliable and Noninvasive Alternative to Laryngoscopy in Diagnosing Vocal Fold Palsy

[Year:2023] [Month:January-June] [Volume:13] [Number:1] [Pages:5] [Pages No:9 - 13]

Keywords: Echolaryngography, Laryngoscopy, Laryngeal ultrasonography, Screening tool, Vocal fold palsy

   DOI: 10.5005/jp-journals-10023-1242  |  Open Access |  How to cite  | 

Abstract

Aim: The aim of this study is to validate the usefulness of laryngeal ultrasonography as a screening tool for vocal fold palsy by correlating it with laryngoscopy findings. Methods: The study includes 60 patients in a tertiary care center over a period of 1 year. Based on the findings of Hopkins 70° rigid laryngoscopy, the patients were categorized into two groups, group I with normal vocal fold mobility and group II with vocal fold palsy. Laryngeal ultrasonography was then done on all the patients by a team of well-trained ultrasonologists, blinded from the laryngoscopy results. These results were then correlated. Result: The vocal folds were appreciated in laryngeal ultrasonography, and the mobility was assessed successfully in 56 of these patients, and results were found to be correlating with the laryngoscopy findings in all these patients. In four patients, the vocal folds could not be visualized by ultrasonography due to severe calcification of the thyroid cartilage. In our study, we noted that as a screening tool, laryngeal ultrasonography has a sensitivity of 90% and a specificity of 96.67%. Conclusion: Laryngeal ultrasonography is a simple, easy, cheap, non-invasive, and easily available tool in diagnosing vocal fold palsy, where laryngoscopy is not possible. Laryngoscopy is an aerosol-generating procedure, hence carries a risk of spread of coronavirus disease 2019 (COVID-19) infection or other similar communicable diseases. Laryngeal ultrasonography circumvents this problem and can be used as a primary diagnostic tool in suspected cases of vocal fold palsy. The utility may be limited to some extent in elderly male patients when the thyroid cartilage is severely calcified.

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BRIEF RESEARCH COMMUNICATION

Nupur K Nerurkar, Gati K Shah, Achala Kamath

The Three Vocal Fold Sign in Laryngology

[Year:2023] [Month:January-June] [Volume:13] [Number:1] [Pages:2] [Pages No:14 - 15]

Keywords: Granulomatous inflammation, Infraglottis, Laryngeal amyloidosis, Laryngeal cancer, Laryngopharyngeal reflux, Pseudosulcus, Subepithelial bulge

   DOI: 10.5005/jp-journals-10023-1244  |  Open Access |  How to cite  | 

Abstract

We are proposing a sign called, “three vocal fold sign” seen on laryngoscopy, which intends to help with the diagnosis of a few clinically challenging conditions like amyloidosis and other granulomatous conditions, laryngopharyngeal reflux, and laryngeal malignancy. This sign is defined as a uniform subepithelial bulge of the undersurface of the vocal folds. This bulge gives an impression of a third vocal fold, the first being the false vocal fold followed by the true vocal fold. A suspicion of amyloidosis or malignancy based on the proposed sign seen on laryngoscopy warrants a contrast-enhanced computed tomography (CT) scan. Any enhancement in the infraglottic region would suggest a possibility of a lesion warranting histopathological confirmation.

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CASE REPORT

Sangineedi Deepthi, Roohie Singh, Sanjay Kumar, Natasha Dogra, Angshuman Dutta

Lobular Capillary Hemangioma at an Unusual Location: A Rare Occurrence

[Year:2023] [Month:January-June] [Volume:13] [Number:1] [Pages:3] [Pages No:16 - 18]

Keywords: Capillary hemangioma, Granuloma, Histopathology, Hypopharynx, Posterior pharyngeal wall, Pyriform sinus

   DOI: 10.5005/jp-journals-10023-1245  |  Open Access |  How to cite  | 

Abstract

Aim: The goal of this study was to document a rare case of lobular capillary hemangioma of the hypopharynx to create awareness among practitioners. Background: Lobular capillary hemangioma (LCH) is a benign, rapidly growing vascular proliferation that presents as a hemorrhagic, red to purple, sessile, or pedunculated mass. They are present most commonly on the cutaneous and mucosal surfaces, such as the gingiva, lips, fingers, and face. It occurs very rarely in the hypopharynx. Case description: We present a case of lobular capillary hemangioma of the left pyriform fossa in a 50 year old female who underwent micro-laryngoscopic excision, with no follow-up complications or recurrence. Conclusion: The present study describes LCH of the hypopharynx, which is an uncommon pathology in terms of the site of lesion in the practice of otolaryngology. Clinical significance: This case study illustrates the importance of documentation of such a rare case of LCH to create awareness among practitioners as surgery in this location is challenging due to the risk of bleeding and airway management and demands surgical expertise.

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Transcutaneous Laryngeal Ultrasonography: A Reliable and Noninvasive Alternative to Laryngoscopy in Diagnosing Vocal Fold Palsy

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