Background: Spectra-A(S) is a part of a novel endoscopic imaging technique based on color tone shift algorithm to increase contrast based mainly on the green (540 nm) and blue (415 nm) light spectral signals designed for the visualization of abnormal microvasculature on the mucosal surface such as intraepithelial papillary capillary loop pattern (IPCL). Transoral laser microlaryngeal cordectomy (TLMC) surgery is performed using a laser with the microscope and the histopathology report is the gold standard in deciding the free margins. Aim: To assess the accuracy of the combined findings of S light, subepithelial infiltration (I), and palpation (P) of the vocal fold lesion in deciding the margins in TLMC for early glottic cancer, considering the final histopathology report as the gold standard. Results: Out of a total of 35 study patients, the results of specimen identification protocol (SIP) in deciding free margins were in concordance with the histopathological report (HPR) in 26 patients. Since using a combination of SIP is less resource intensive than frozen section (FS), it may be useful in places where intraoperative FS is not available. Conclusion: The accuracy of the combined findings of SIP in deciding the margins in TLMC for early glottic cancer was 74%. The gold standard was taken as the final histopathology report.

Background: Bilateral vocal cord palsy (BVCP) continues to be a challenge for laryngologists. The cause varies from idiopathic to trauma. At present, there are many static surgical treatments available for BVCP, which improve airway at the expense of voice. More than 75% of nerve fibers goes to adductors. Bilateral adductor involvement is rare in BVCP. For improving the airway without compromising the voice a dynamic procedure is needed. Two such procedures at experimental stages are total selective reinnervation and posterior crico arytenoid (PCA) pacemaker. Here, we are analyzing our experience with eight such cases of total selective reinnervation. Aim: To assess the efficacy of total selective reinnervation in cases of BVCP. Objectives: (1) To assess the improvement in airway post total selective reinnervation; (2) To assess the improvement in voice post total selective reinnervation; (3) To assess the involvement of swallowing function in total selective reinnervation. Methodology: This is a prospective study of 8 cases of BVCP who had undergone total selective reinnervation during a period of 9 years. Among the eight cases, two cases had idiopathic BVCP and six cases were post total thyroidectomy. All patients had a minimum follow-up period of 12 months except the last case which was in 7th postoperative month. Patient selection: all cases were seen within 2 years of their complaint except the child with congenital bilateral vocal cord palsy which was done at 4 years. Examination under anesthesia was done in all cases to rule out cricoarytenoid joint fixity. Electromyography (EMG) was not done. Pre-op assessment of quality of voice in each of these patients was done with Voice Handicap Index (VHI-10). Glottic space assessment was done with dyspnoea index score and flexible endoscopy. None of the patients had swallowing dysfunction at presentation. A repeat assessment was done at 6 and 12 months post-op and the results were compared. Results: In the immediate post-op period, all the patient had worsened voice quality. However, voice improved by 4 months and by 12 months all patients had better voice and lower VHI. Regarding airway: six patients were decannulated in 2 weeks, one patient was decannulated after 4 months and the youngest one after 1 year. By 6 months all patients had improved their dyspnea index by 1. However, between 8 and 12 months four patients had worsening dyspnea index requiring static procedures. Out of the four patients who did not require static procedures, one has completed only 6 months. The immediate swallowing dysfunction following the procedure improved within a period of 2 weeks. Conclusion: Total selective reinnervation improved the voice in all cases and it did not have any adverse effect on swallowing; however, the long-term effect in improving the airway was only in 50% of patients. The best results were obtained in younger patients. This is in sharp contrast with nonselective reinnervation for unilateral vocal cord palsy, whose success rate is as high as as 95%. This suggests that total selective reinnervation is to be taken up only in selected patients and that too only after detailed discussion about the final outcome and possible need for further surgical procedures.

Objective: The present study investigates the prevalence of various speech and swallowing deficits in head and neck cancer (HNC) patients following radiotherapy (RT). Method: A total of 140 patients diagnosed with stage I and II head and neck cancers participated in the present study. To assess the speech, language and communication skills post-RT, a complete speech, and language test battery was administered. Results: The results of the present study revealed that after completion of radiotherapy, swallowing dysfunction increased to 59% from 15% pre-RT. Postradiotherapy intervention participants presented with various speech disorders, such as slurred speech (13%), voice disorder (26%), stuttering (1%), and trismus (1%). Conclusion: This is a preliminary study, which will serve as an eye-opener for the specialists in a multidisciplinary set-up to appropriately intervene the patients that will save the structures of swallowing, speech, and voice, thereby offering a better quality of life.

Inflammatory pseudotumor is a benign, tumor-like lesion of reactive nature. Its basic morphologic characteristic is spindle cell (myoblasts and fibroblasts) proliferation with a variable number and type of inflammatory cells. The newer terminology is inflammatory myoblastic tumor. Although they are mostly reported in the lung parenchyma, tracheal involvement is not unknown. In the past, it was considered benign, but with recent evidence of local recurrence after surgical resection, cases of metastatic spread, and advances in cytogenetic analysis, they are now categorized as tumors with malignant potential. This paper aims to describe a rare case of laryngotracheal inflammatory myoblastic pseudotumor in a young female who had to undergo tracheostomy due to acute airway obstruction, after which the patient underwent complete excision of the tumor along with expansion laryngoplasty.

Adult epiglottitis is inflammation of the epiglottis and adjoining supraglottis. Many times, it is misdiagnosed or diagnosed late. We present a 50-year-old male who presented with chief complaints of fever, difficulty in swallowing, and change in voice for 2 days. He was diagnosed with epiglottitis and managed with intravenous antibiotics, analgesics, and steroids. Oxygen supplementation was done. Airway intervention was avoided by vigilant monitoring and timely intervention. Patients presenting with airway risk factors such as tachypnea, tachycardia, decreased oxygen saturation, the “double thumb sign” on X-ray, and epiglottic abscess must be carefully monitored, and an airway management plan must be made. Because of its rapid progression and potential threat to airway, it is important for otolaryngologists to be familiar with this condition.

Aims and background: To cross-culturally adapt and translate the Australian English version of the “Evaluation of Ability to Sing Easily” (EASE) scale and to find the validity and reliability of the Gujarati version of “EASE” for the Gujarati singers. Materials and methods: Permission for cross-cultural adaptation and translation of the Australian English version of the “EASE” scale into the Gujarati language for Gujarati singers was obtained from the author and it was translated with methods directed by the World Health Organization (WHO). For evaluation of psychometric properties, 10 Gujarati professional voice teachers and 13 vocal students were recruited for validity and reliability, respectively. Result: Content validity index for EASE-G item no. 1-22 was 1 as all experts had agreed for relevance of all the voice descriptors asked in **image;. The interclass correlation [ICC] was 0.89 which showed good reliability and almost perfect agreement as repeatability and coefficient of Cronbach's alpha for internal consistency was 0.94 which showed excellent reliability level for overall EASE -G scale scores. Conclusion: Analysis of psychometric properties has shown that the Gujarati version of “EASE” is a valid and reliable self-administered tool to assess vocal loading as an ability to sing for Gujarati singers. Clinical significance: The Gujarati version of the “EASE” scale can be used for assessing perceptual singing function specifically for Gujarati singers who know the Gujarati language only.