After the first case of isolated agenesis of epiglottis was diagnosed 2 years ago, five more such cases were treated by the group. These formed the index cases of the cohort.

Decision for surgery was based on an arbitrary 3 ALTEs in 24 hours. All the patients were initially intubated. Supraglottic space was closed using interrupted unabsorbable sutures. Tracheostomy was added. At 3 to 6 months of follow-up, glottis was restored by Nd-YAG laser knife. Five out of six children are alive and thriving well. One child died before he could be actively managed.

Isolated agenesis of epiglottis with ALTE is extremely rare. Supraglottic closure saves lives and gives enough time for pharyngoesophageal coordination to develop.

Prasad RG. Congenital Isolated Agenesis of Epiglottis Presenting with Acute Life-threatening Event Successfully Managed by Temporary Supraglottic Closure and Tracheostomy. Int J Phonosurg Laryngol 2015;5(1):1-3.

To analyze redo thyroidectomies so as to get a possible answer to the controversy surrounding thyroidectomy for benign disease.

This is a retrospective observational cohort. From 1996 to 2010, a total 77 cases of redo thyroidectomies were performed. The data of all patients in the department were maintained on a self developed MS access-based software. The data of redo thyroidectomies were reviewed. These patients were from five districts of Andhra Pradesh, 42 were women and 35 men, 51 underwent subtotal thyroidectomy, 21 had hemithyroidectomy and 5 patients had excision procedure; all were benign. The condition varied from multinodular goiter (MNG) and solitary nodule to follicular neoplasm. There were 44 right-sided, and 43 left-sided surgeries. Recurrence occurred in seven in less than 1 year, in 49 in less than 5 years, in 11 of them in less than 10 years and 10 had recurrence after 10 years. A total thyroidectomy was performed in all. Seventy-five had benign disease. Two had suspected neoplasm; one papillary and one Hurthle cell. One patient had transient recurrent laryngeal nerve palsy.

Seventy-seven redo surgeries for benign thyroid disease were performed. The high rate of referrals for recurrence probably suggests inadequacy of subtotal and hemithyroidectomies for benign thyroid diseases.

The present series of 77 redo thyroidectomies clearly suggests inadequacy of initial subtotal thyroidectomy. Evidence-based analysis of complication rates and surgical feasibility supports total thyroidectomy as the complete safe, scientifically acceptable choice of primary surgical treatment for benign thyroid disease.

Prasad RG. Is it Time to Shift to Total Thyroidectomy for Benign Thyroid Disease: An Analysis of 77 Redo Thyroidectomies. Int J Phonosurg Laryngol 2015;5(1):4-6.

Speech-language pathology is a specialty in the study, assessment, and rehabilitation of speech-language disorders (or communication disorders) which are common problems that may affect both sexes and all age groups.

The aim of this study is to raise the attention in Iraq about the role of certified speech pathologists (or speech therapists) in the treatment of patients with communication disorders according to their age and sex distribution, as seen in the phonetic center of University of Jordan.

Subjects with speech problems, who visited the phonetic center in Jordan University for treatment by certified speech-language pathologists, were analyzed retrospectively during 3 years (1996 to 1998), and it included 731 subjects with speech disorders, consisted of 213 females and 518 males, with a minimum age of 2 years and a maximum age of 72 years.

The most common age presentation of communication disorders varies, and it was found that the major speech and language disorders and their distribution were as follows: delayed language development occurred mainly in age group 3 to 4 years (about 57%), stuttering occurred in 3 to 5 years (about 24%), and in articulation disorder occurred in age group 4 to 6 years with about 42%, and in hearing impaired patients occurred mainly in age group of 2 to 4 years with about 45%, in children with mental retardation occurred in age group of 6 to 8 years with about 29%, voice disorders occurred in age 20 to 29 (25%), nasality problems in age group 3 to 5 years (25%), dyslexia in age group 8 to 10 years (40%), and the cases of apraxia, aphasia, and autism were low in number.

The age and sex distribution of communication disorders varies according to the type of disorder. The speechlanguage pathologists have very important role in the evaluation and treatment of speech language disorders. There is great deficiency of this specialty in this country, and the aim of this article is to ring the bell of attention to these common disorders.

SLP: Speech-language pathologist; CDs: Communication disorders; DLD: Delayed language development; HIP: Hearing impaired patient; MR: Mental retardation; CP: Cerebral palsy.

Al-Dujaily M, Nabàa SJA. Age and Sex Distribution of Speech Disorders. Int J Phonosurg Laryngol 2015;5(1):7-14.

Acharya A. Elongated Styloid Process Revisited. Int J Phonosurg Laryngol 2015;5(1):15-16.

Mehta SP. Innovations in Flexible Endoscopic Evaluation of Swallowing and Laryngeal Sensation Testing. Int J Phonosurg Laryngol 2015;5(1):17-19

Vocal Cord Nodule (N), Vocal Polyp (P), Laryngopharyngeal Reflux (LPR), Presbylaryngis (PL), Cut Throat injury (CT), Primary Muscle Tension Dysphonia (PMTD), Dysphonia Plica ventricular (DPV).

Singh SP, Dutta SRB. Voice Therapy in Muscle Tension Dysphonia Cases. Int J Phonosurg Laryngol 2015;5(1):20-24.

Mutational falsetto is the most common mutational voice disorder, found in all ages. Clinicians often miss this diagnosis due to unfamiliarity with the condition. The voice of a person with mutational falsetto is high pitched, weak, thin, breathy, hoarse and monopitched.

This study was carried out to evaluate the efficacy of voice therapy in persons with mutational falsetto.

Eleven male patients with ages between 18 and 26 years (mean age 22.18 years, SD 2.52) diagnosed with mutational falsetto underwent acoustical analysis using Praat Software, perceptual analysis using grade, roughness, breathiness, asthenia and strain (GRBAS) scale and psychosocial analysis using emotional component of voice handicap index (VHI). All the components were analyzed pre- and postvoice therapy.

Improvement in acoustic analysis parameters was statistically significant with p-value less than 0.0001(pretherapy mean of fundamental frequency (F0) was 217.45 with SD 8.68, whereas post-therapy mean of F0 was 127.50 with SD 5.32). Significant improvement in perceptual analysis was seen post-therapy on GRBAS scale. Improvement in psychosocial aspect was also statistically significant with p-value less than 0.0001 (pre-therapy mean 26.18, SD 1.72 post-therapy mean 7, SD 1.15).

Voice therapy plays an important role in lowering F0 and alleviation mental agony of the patients with mutational falsetto.

Varma A, Agrahari AK, Kumar R, Kumar V. Role of Voice Therapy in Patients with Mutational Falsetto. Int J Phonosurg Laryngol 2015;5(1):25-27

Bist SS, Sandhirr S, Shirazi N, AgrawalV, Bharti B. Primary Histoplasmosis of Larynx Mimicking as Laryngeal Carcinoma. Int J Phonosurg Laryngol 2015;5(1):28-31.

Swain SK, Mohanty S, Singh N, Choudhury J, Sahu MC. Suspecting Airway Foreign Body in Agenesis of the Lung: A Rare Incidence of Misdiagnosis. Int J Phonosurg Laryngol 2015;5(1):32-34.

Matta I, Shukla SC, Karnik P. Endolaryngeal Excision of Recurrent Laryngeal Nerve Neurofibroma. Int J Phonosurg Laryngol 2015;5(1):35-38.