To evaluate the role of narrow band imaging (NBI) in detecting benign nonvascular glottic lesions.

Our study is a retrospective and prospective analysis of 247 patients with suspected benign glottic lesions who presented to our voice clinic over a 6-month duration. Patients were diagnosed on stroboscopy (by the first author) and divided into three groups consisting of leukoplakia, sulci, and cysts. A white light (WL) laryngoscopy and NBI examination was performed by an independent laryngologist (not an author) followed by a comparative analysis. The final gold standard for diagnosis was microlaryngoscopy with or without histopathology. Sensitivity of each modality for diagnosis of the three groups was calculated.

The NBI is more sensitive for diagnosing leukoplakia. Stroboscopy is more sensitive for diagnosing sulcus.

Small vocal fold lesions may be missed on WL laryngoscopy. Stroboscopy helps in the diagnosis of structural glottic lesions affecting mucosal wave pattern. Many studies have shown that NBI light highlights the vasculature in superficial mucosal and subepithelial layers. This study is an analysis of the value of NBI in detecting relatively avascular glottic lesions, such as leukoplakia, sulci, and cysts.

Nerurkar NK, Shedge AE, Gupta HK, Arya AA. Role of Narrow Band Imaging in Relation to Stroboscopy and White Light Laryngoscopy in Diagnosis of Benign Nonvascular Glottic Lesions. Int J Phonosurg Laryngol 2017;7(1):1-5.

The aim of this study is to evaluate the role of laryngopharyngeal reflux (LPR) in patients with laryngeal complaints and study the correlation between reflux symptom index (RSI) and reflux finding score (RFS).

This is a study of 104 patients, who presented in the ear, nose, and throat outpatient department at the Civil Hospital, Ahmedabad, India, from April 2015 to April 2016, with complaints like change of voice, chronic cough, foreign body sensation, throat clearing, difficulty swallowing, and regurgitation.

All the patients were examined with 90° endoscope by a single examiner, and an RSI ≥13 was considered as indicative of reflux.

The mean age of the 104 patients was 47.2 years. The male-female ratio was 1:1.8. The RSI ranged from 5 to 44, with a mean of 22.99 and standard deviation (SD) of 7.43. The RFS ranged from 4 to 22, with a mean of 11.04 and SD of 3.07. Both the parameters showed high correlation (correlation coefficient 0.98).

The LPR plays an important contributory role in patients with laryngeal complaints. The RFS and RSI can be used as routine parameters in establishing the diagnosis of reflux.

Shah RV, Vishwakarma R. Laryngopharyngeal Reflux: Is It the Real Culprit in Patients with Laryngeal Complaints? Int J Phonosurg Laryngol 2017; 7(1):6-9.

Bilateral abductor palsy is treated by tracheostomy or any lateralization procedure. Kashima's surgery is a lateralization procedure introduced by Kashima in 1989.

To evaluate the effect of Kashima's surgery using subjective measures of breathing quality in patients with bilateral abductor palsy.

This is a prospective study with 31 patients (3 men, 28 women) who underwent Kashima's surgery between January 2013 and December 2015 in the Laryngology department. Subjective evaluation was done by using dyspnea index score in the pre- and postoperative periods. Dyspnea index score is calculated based on answers given to a 7-point questionnaire and assessed by Likert scale, a self-assessment scale. For each point, the scores range from 0 to 3, and the maximum score is 21. Patients who already had tracheotomy were given a score of 14. This score was calculated again using the same questionnaire in the pretracheostomy scenario.

There is significant reduction in the dyspnea index score with a median reduction score of 9 and improvement of quality-of-life after Kashima's surgery.

Dyspnea index score is easy to administer. Considering the cost of treatment and high success rate of decannulation, it is obvious that Kashima's surgery is effective and affordable in bilateral abductor palsy.

Issac ME. Effect of Kashima's Surgery in Bilateral Abductor Vocal Cord Palsy. Int J Phonosurg Laryngol 2017;7(1):10-12.

To study the outcome of microlaryngeal surgery for vocal fold polyp on quality of voice with voice handicap index-10 (VHI-10).

Microlaryngeal surgery for vocal fold polyp will improve the quality of voice.

This is a nonrandomized prospective study with a quasi-experimental design. A total of 36 patients presenting with vocal cord polyp and who underwent a microlaryngeal surgery for the same from March 2016 to August 2016 were included in the study. All the patients were given a self-reporting questionnaire consisting of 10 questions — VHI-10 — and asked to score it. The same questionnaire was given 6 weeks postmicrolaryngeal surgery to these patients and both scores were compared.

The mean age of the study population was 44.67 ± 0.34 with the maximum number of patients in the age group 31 to 50. Out of the 36 patients, 27 were males and 9 females. A total of 22 (61%) patients had right-sided polyp and 14 (39%) had left-sided polyp. The majority of the patients were voice professionals, with the maximum number being that of teachers. The mean preoperative and postoperative VHI-10 was 30.36 ± 6.42 and 1.11 ± 1.76 respectively. The reduction in preoperative and postoperative scores gave a p-value of <0.05 at a confidence interval of 95%.

Nath HSS, Menon JR, Issac ME, Binukrishnan R, Sebastian A. Outcome of Microlaryngeal Surgery for Vocal Fold Polyp on Quality of Voice. Int J Phonosurg Laryngol 2017;7(1):13-15.

Though fine needle aspiration cytology (FNAC) for thyroid is acclaimed as a gold standard before going for intervention, there are some limitations with respect to tissue availability, technique, skill of performer, etc. So, a cross-sectional study was conducted to determine the accuracy of FNAC in diagnosis of thyroid swelling and to assess the correlation between preoperative cytopathological diagnosis and postoperative histopathological diagnosis.

Data collected from records in the time period of 3 years, i.e., from August 2012 to August 2015, were evaluated and analyzed.

A total number of 93 cases were included in the study of which majority were females with frequency of 84.94%, most of the incidence of thyroid swellings occur in the age group of 40 to 50 years. Overall mismatch between histopathological examination and FNAC was 43 out of 93 and of which 7 were major and 36 were minor mismatch. Sensitivity of patients having malignancy with positive FNAC is 82.35% from the study and specificity of patients with nonmalignant thyroid disease and positive cytology is 95.18%.

It was observed that FNAC is a reliable, safe, and accurate method as a first line of evaluation in thyroid swelling before the surgery. Fine needle aspiration cytology is more sensitive in detecting thyroid gland malignancy but still correlation is always necessary and therefore, histopathological analysis still remains essential for final diagnosis.

Bodepudi SL, Kalyan KASSN, Peddi R. Study of Correlation of Preoperative Fine Needle Aspiration Cytology with Histopathological Examination in Thyroid Swellings. Int J Phonosurg Laryngol 2017;7(1):16-19.

Bradoo R, Dave VJ, Joshi A, Shah K. False Cord Retractor: An important Tool in diagnosing Posterior Laryngeal Cleft. Int J Phonosurg Laryngol 2017;7(1):20-22.

Gupta R, Mohindroo NK, Azad R, Thakur JS. Thyroglossal Cyst Papillary Carcinoma: What Next Step must be done? Int J Phonosurg Laryngol 2017;7(1):23-26.

To investigate the changes in the vibratory function of the vocal cords in two diagnosed cases of tuberculosis during and after completion of treatment.

Laryngeal tuberculosis is one of the most common granulomatous diseases of the larynx. Patients present with hoarseness, irritation in throat, dysphagia, and breathlessness. The hoarseness occurs due to the granulomatous reaction involving the subepithelial layer of the vocal cords, which heal with fibrosis.

A 56-year-old male presented with a 2-month history of cough, hoarseness allegedly precipitated by vocal abuse, dysphagia, weight loss, and evening rise of temperature. There was associated history of tobacco and betel nut intake. A 50-year-old female patient presented with complaints of hoarseness of 3 months duration not associated with any cough, dysphagia, fever, weight loss, or breathlessness. Clinical examination showed whitish lesions in the vocal cords. Microlaryngeal surgery done in both cases for collecting biopsy specimen showed a chronic inflammatory process with granuloma. Antitubercular treatment consisting of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol was given for a period of 6 months. The patients were assessed at the end of 2 and 6 months of treatment symptomatically and clinically with fiber-optic laryngoscopy and stroboscopy. Significant improvement in the vibratory pattern of vocal cords and voice quality was noted in both the patients.

Early recognition of the disease and initiation of treatment are necessary for a desirable outcome of vibratory function of the vocal cords.

As patients present with nonspecific symptoms, an accurate diagnosis of laryngeal tuberculosis can be made by a proper histopathological examination and acid-fast staining of specimen obtained by microlaryngeal surgery. Early initiation of treatment is the key to better outcome.

Roy KP, Datta DJ, Madam S, Koduru PK. Tuberculosis of the Larynx: A Review of Two Cases. Int J Phonosurg Laryngol 2017;7(1):27-30.

Dandala SR, Panuganti A, Kumuda P. Atypical Spindle Cell Lesion of Larynx: A Rare Benign Condition mimicking Malignancy. Int J Phonosurg Laryngol 2017;7(1):31-35.

Nerurkar NK, Desai BH, Jain A. Mishaps of Larynx in Pregnancy. Int J Phonosurg Laryngol 2017;7(1):36-38.