Background: Unilateral vocal fold paralysis (UVFP) often results from neoplastic or iatrogenic damage to the recurrent laryngeal nerve or vagus nerve. It can have harmful effects on the patient's quality of life owing to dysphonia and aspiration. The configuration of glottic closure in patients with UVFP is variable and unique in each case depending on the position of the immobile vocal fold, which is determined by factors such as intact nerve supply to the muscles, the extent of reinnervation, synkinesis, and compensatory laryngeal postures. Medialization thyroplasty and arytenoid adduction (AA) are effective treatments for medializing the paralyzed vocal cord; nevertheless, the indications and benefits of each procedure remain controversial. Historically, AA has been indicated for patients with vertical height mismatch and those with a maximum phonatory duration of <6 seconds. The success of laryngeal framework surgery largely depends on achieving an excellent phonatory closure. Pathophysiologically, AA stimulates the action of lateral cricoarytenoid muscle (LCA). Objectives: (1) To study the prevalence of different types of phonatory gaps in patients presenting with unilateral vocal fold palsy; (2) to identify whether a gap at the vocal process level is the most predictive factor preoperatively regarding whether AA is required or not. Materials and methods: The retrospective cohort study was done from the digital data archives of the senior author containing the laryngoscopic findings of unilateral vocal fold palsy patients in whom type I thyroplasty with or without arytenoid rotation was done during a period of 2021–2022. The laryngoscopic findings of these patients were compared both pre- and postoperatively to assess for the closure of phonatory gap at different levels. Results: Of the 30 study subjects, males were 40% and females were 60%. In most cases, 73.3% had a phonatory gap at the thyroarytenoid (TA) and vocal process level, followed by 16.7% having a gap at the TA level, and 6.7% gap at the vocal process level only and 3.3% gap at the body of arytenoid level only. Around 66.7% of the subjects underwent arytenoid rotation and medialization thyroplasty, whereas 33.3% underwent type I thyroplasty alone. Out of the 19 patients who underwent AA, the gap at the vocal process level was closed in 17 patients with a p-value of 0.006, which is statistically significant (Fischer's exact test). Conclusion: The gap at the level of the vocal process of arytenoid may predict the patients who require AA and help in the preoperative planning of patients regarding the type of laryngeal framework surgery to be selected.

Introduction: Tonsillectomy, or excision of palatine tonsils situated in the oropharynx, is a surgical procedure executed on modulation structures of the vocal tract and may produce substantial changes in voice quality. Potential changes in the voice may be of great importance if the patient is a singer or a performing artist, and also in the present setting where global voice biometrics is gaining momentum as a person's voice is as unique as a fingerprint. Therefore, it seems purposeful to determine objectively the changes in voice characteristics resulting from tonsillectomy. Aim: To determine if vocal resonance changes after tonsillectomy. Materials and methods: A prospective descriptive study of postoperative voice change in 31 tonsillectomy cases was done over a period of 1 year. Preoperative and postoperative voice was recorded, and formant frequencies were obtained and compared. Results: The first and second formants increased postoperatively, but only the change in the second formant was found to be statistically significant. Conclusion: As expected, the voice changed after tonsillectomy but was barely perceptible to the patients, except in the case of voice professionals, where it can have a significant impact because of the change in signature voice.

Laryngeal herpes is a rare entity. Varicella zoster virus (VZV) can involve the pharyngolaryngeal region and cranial nerves. The first contact with this virus, transmitted by airborne particles shed from the skin of an infected person, produces symptoms. After resolution of symptoms, VZV travels to the dorsal root ganglia of the spinal cord, where it remains dormant for years. Reactivation of the virus occurs secondary to impaired cellular immunity. A case of a 60-year-old man presented with a change in voice and difficulty in swallowing. Another case of a 75-year-old woman presented with a change in voice, sore throat, and right facial palsy. In both cases, flexible laryngoscopy showed vesicles on the right side of the larynx. Cases were confirmed by laryngeal swab PCR testing. Both cases were treated with oral steroids and oral antiviral valacyclovir 500 mg three times a day for 10 days. This clinical condition should be kept in mind when a patient presents with unilateral sore throat and voice change.

We report a case of an 88-year-old female who presented to us with dysphagia, change in voice, and stridor, the diagnosis of which turned out to be primary laryngeal lymphoma. It is a rare condition, and repeated biopsies are needed in most of the cases. It has a very good response to radiotherapy and chemotherapy.

Background: Inflammatory myofibroblastic tumor (IMT) is an uncommon lesion that usually involves the lungs and mostly affects young adults. Head and neck IMTs account for 14–18%. These benign tumors are locally aggressive; hence, an accurate diagnosis is vital for the treatment plan. Case description: A young male presented with hoarse voice for 9 months with a history of three previous laryngeal surgeries. Stroboscopy revealed a multilobulated vascular lesion, attached to the left vocal process. Laser-assisted wide excision of the lesion with an adjuvant treatment of botulinum toxin injection was performed. Histopathology revealed spindle cell tumor, immunohistochemistry was suggestive of myoepithelioma. On 6-month postoperative follow-up, stroboscopy revealed good healing. Conclusion: Laryngeal IMTs have a tendency to recur unless excised with a wide margin. Histopathology along with immunohistochemistry is essential for diagnosis. Tumors attached to the vocal process may benefit from botulinum toxin injection. The patient is advised for a close and prolonged follow-up.

Context: Osteoblastoma is a benign, slow-growing, but locally aggressive bone tumor. It is usually localized in the cervical vertebra but may rarely involve the laryngeal cartilage. Case description: We report a case of osteoblastoma hypopharynx in a 10-year-old boy who presented with snoring and mouth breathing. His video laryngoscopic examination showed a mass in the pyriform fossa, which could not be excised by endoscopic excision technique and hence, was referred to our center for external approach excision. The whole mass was excised en bloc via an external approach, and a Ryles tube was inserted for 10 days. Histopathological examination (HPE) report came as Osteoblastoma. Ryles tube was removed after doing a fluoroscopy to confirm normal swallowing. Conclusion: Osteoblastoma hypopharynx which has never been reported before in the literature can be treated completely by surgical excision via an open approach.