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Laryngoscope Investigative... Feb 2024Patients lose their voice after laryngectomy for laryngeal cancer or aspiration prevention surgery for severe dysphagia. To assist such patients, we developed and...
OBJECTIVE
Patients lose their voice after laryngectomy for laryngeal cancer or aspiration prevention surgery for severe dysphagia. To assist such patients, we developed and verified the utility of a novel vocalization method using a device termed the voice retriever (VR), in which the sound source is placed in the mouth.
METHODS
We investigated the effectiveness of the VR in patients. The VR consists of a mouthpiece with a built-in speaker and a dedicated application that serves as the sound source. We compared the speech intelligibility and naturalness in normal participants using VR and an electrolarynx (EL) for the first time as well as the voice-related quality of life (V-RQOL) in patients with dysphonia before and after using the VR.
RESULTS
The VR produced significantly higher 100-syllable test scores as well as fluency, amount of additional noise, intonation, intelligibility and overall long reading test ratings in the first-time VR and EL users. Furthermore, the VR use significantly improved the V-RQOL of participants with dysphonia.
CONCLUSION
Compared to EL, VR allows more effective speech improvement in participants without experience using an alternative vocalization method and improves the V-RQOL in patients with dysphonia.
LEVEL OF EVIDENCE
Step 4.
PubMed: 38362198
DOI: 10.1002/lio2.1204 -
International Journal of Surgery Case... Mar 2024Primary laryngeal tuberculosis (PLTB) is a rare condition. The symptoms and findings are not specific in most of the cases. Patients are diagnosed essentially based on...
INTRODUCTION AND IMPORTANCE
Primary laryngeal tuberculosis (PLTB) is a rare condition. The symptoms and findings are not specific in most of the cases. Patients are diagnosed essentially based on histopathological examination and mycobacterial culture.
CASE REPORT
We report the case of a 42-year-old woman who presented to our hospital with dysphonia and dysphagia. Direct laryngoscopy revealed a lesion of the supraglottis. CT scan found a diffuse thickening of the entire surface of the larynx. A biopsy confirmed the diagnosis of tuberculosis.
CLINICAL DISCUSSION
Primary laryngeal tuberculosis is a rare clinical entity despite its close anatomical and physiological proximity to the lungs.
CONCLUSION
Clinician should keep in mind the existence of primary laryngeal tuberculosis to avoid delayed diagnosis and treatment, which can lead to high morbidity and mortality.
PubMed: 38350377
DOI: 10.1016/j.ijscr.2024.109376 -
Otolaryngologia Polska = the Polish... Aug 2023<b><br>Introduction:</b> Gastroesophageal Reflux Disease (GERD) is a common disorder in world population. As a result of the regurgitation of acid...
<b><br>Introduction:</b> Gastroesophageal Reflux Disease (GERD) is a common disorder in world population. As a result of the regurgitation of acid content from the stomach to laryngopharynx and larynx, secondary damage of laryngeal mucosa occur, which is highly sensitive to hydrochloric acid, and morphological changes are observed. Symptomatology of laryngopharyngeal reflux is varied which makes differential diagnosis difficult.</br> <b><br>Aim:</b> The aim of the study was the assessment of voice quality, morphological changes in larynx as well as etiology of Laryngopharyngeal Reflux Disease.</br> <b><br>Material and method:</b> The severity of dysphonia was classified using perceptual and acoustic methods as well as RSI. Morphological control was performed using HSDI technique and RFS. Etiological factors were examined basing on barofunction of upper esophageal sphincter and 24-hour pH-metry of air exhaled expressed in Ryan score.</br> <b><br>Results:</b> In the majority of patients with Laryngopharyngeal Reflux, dysphonia was recognized, intensified especially in women (G3R2B0A0S3), which was confirmed in Yanagihara classification (type III) and parameters of acoustic analysis. Voice disorders were the most frequently the result of edema and congestion of interarytenoid area, aytenoids and vocal folds. Those symptoms were caused by the decrease of upper esophageal sphincter tension and acidity of exhaled air which was confirmed in 24-hour pHmetry.</br> <b><br>Conclusions:</b> It is important to educate physicians and patients about the possibilty of negative impact of reflux disease on the occurrence of voice quality disorders. Current diagnostic methods for dysphonia guarantee accurate recognition and therapeutic success improving the prognoses of patients with Laryngopharyngeal Reflux.</br>.
Topics: Humans; Female; Laryngopharyngeal Reflux; Dysphonia; Voice Quality; Larynx; Vocal Cords
PubMed: 38332705
DOI: 10.5604/01.3001.0053.7519 -
Ear, Nose, & Throat Journal Feb 2024Vocal fold process avulsion results from trauma that detaches the vocal process and thyroarytenoid muscle from the body of the arytenoid cartilage. Vocal fold laxity...
Vocal fold process avulsion results from trauma that detaches the vocal process and thyroarytenoid muscle from the body of the arytenoid cartilage. Vocal fold laxity often causes severe dysphonia. Findings can be subtle. A high index of suspicion often permits diagnosis and effective surgical repair.
PubMed: 38323380
DOI: 10.1177/01455613241226860 -
Gland Surgery Jan 2024Primary hyperparathyroidism (pHPT) is an endocrine disorder typically characterized by elevated serum calcium and elevated parathyroid hormone (PTH). While... (Review)
Review
BACKGROUND
Primary hyperparathyroidism (pHPT) is an endocrine disorder typically characterized by elevated serum calcium and elevated parathyroid hormone (PTH). While parathyroidectomy is the standard treatment, non-operative intervention such as radiofrequency ablation (RFA) has been adopted as an alternative for the management of pHPT, as it has been utilized in other endocrine glands such as thyroid and adrenal. In this literature review, we aim to evaluate the current practice of RFA for pHPT.
METHODS
A systematic literature search using PubMed, Web of Science, and Embase through June 2022 was conducted. Studies included in the review consisted of patient cohorts who had an unequivocal diagnosis of pHPT and underwent the treatment of pHPT with RFA. When more than one study was published from a similar cohort of patients, only the study with the most number of patients was considered. Studies included were assessed for bias using the critical appraisal instruments from the Joanna Briggs Institute (JBI) System.
RESULTS
A total of 14 studies describing 167 parathyroid glands treated in 163 patients were reviewed. The overall cure rate was 91.2%, with 5 patients undergoing more than one ablation. The most common adverse effect encountered was temporary dysphonia. Incomplete ablation and missed multiglandular disease were the most common reasons for RFA treatment failure.
CONCLUSIONS
RFA may be an effective and safe alternative to parathyroidectomy in select patients with a well-localized, well-located parathyroid adenoma. Additional long-term data are needed to refine its role in the pHPT treatment algorithm.
PubMed: 38323227
DOI: 10.21037/gs-22-546 -
Ear, Nose, & Throat Journal Feb 2024Bullous pemphigoid (BP) is an autoimmune blistering disease that affects primarily the skin and rarely involves the mucosa of the oral cavity, larynx, pharynx, or...
Bullous pemphigoid (BP) is an autoimmune blistering disease that affects primarily the skin and rarely involves the mucosa of the oral cavity, larynx, pharynx, or esophagus. Diagnosis is based on the clinical presentation, histology, and immunopathological examination. Laryngeal involvement in BP is extremely rare and patients may be asymptomatic or may present with dysphonia, dysphagia, and/or respiratory distress. The authors of this article report a rare case of BP with laryngeal involvement with a review of the literature. Early diagnosis and initiation of treatment is highly recommended to prevent any long-term complications.
PubMed: 38321809
DOI: 10.1177/01455613241230252 -
Cureus Feb 2024Tapia's syndrome is a rare complication of airway manipulation, involving the simultaneous paralysis of the hypoglossal nerve and the recurrent laryngeal nerve. The...
Tapia's syndrome is a rare complication of airway manipulation, involving the simultaneous paralysis of the hypoglossal nerve and the recurrent laryngeal nerve. The etiological mechanism is commonly attributed to compression or stretching during airway manipulation. An efficient recognition of this condition is pivotal for a comprehensive multidisciplinary approach and optimized recovery time. The presence of persistent dysphagia and dysphonia, coupled with observable deviation or restriction of tongue movement, not only after oral endotracheal intubation for surgical interventions with general anesthesia but also after a prolonged orotracheal intubation period in the intensive care, should heighten the suspicion of this syndrome. This report details a case of Tapia's syndrome emerging as a complication of airway manipulation and prolonged intubation in the intensive care unit.
PubMed: 38314391
DOI: 10.7759/cureus.53486 -
AACE Clinical Case Reports 2024Paragangliomas are rare neuroendocrine tumors that primarily arise in the adrenal gland. Head and neck paragangliomas comprise approximately 3% of all extra-adrenal...
BACKGROUND/OBJECTIVE
Paragangliomas are rare neuroendocrine tumors that primarily arise in the adrenal gland. Head and neck paragangliomas comprise approximately 3% of all extra-adrenal paragangliomas, with a majority of those being found in the carotid body. Recurrent laryngeal nerve paragangliomas are exceedingly rare, with only 2 reported cases found in literature review. Here, we will present the third.
CASE REPORT
The patient is a 46-year-old woman with a history of a right thyroid nodule that had been previously biopsied benign with "paucity of diagnostic material." Neck ultrasonography revealed a 7.4 cm nodule that demonstrated interval growth over a 2-year period, so it was recommended to proceed with right thyroid lobectomy and isthmusectomy. During resection, the recurrent laryngeal nerve appeared to "disappear" into the nodule, and it was resected along with the nodule to ensure proper margins. The nerve was reconstructed with an ansa cervicalis interposition graft, and the nodule was sent to pathology. Pathology revealed that the nodule was a 4.8 cm paraganglioma of the recurrent laryngeal nerve.
DISCUSSION
Paragangliomas of the head and neck are exceedingly rare. In patients who present with symptoms of dysphagia or dysphonia, further workup, including laryngoscopy and magnetic resonance imaging, could potentially identify and allow for appropriate planning for surgical resection.
CONCLUSION
In rare cases, consideration of paraganglioma as part of the differential for thyroid nodules may assist with planning of surgery but will unlikely alter treatment.
PubMed: 38303769
DOI: 10.1016/j.aace.2023.07.002 -
Current Opinion in Allergy and Clinical... Apr 2024To describe recent findings in endotyping occupational asthma by addressing the role of specific biomarkers. (Review)
Review
PURPOSE OF REVIEW
To describe recent findings in endotyping occupational asthma by addressing the role of specific biomarkers.
RECENT FINDINGS
Studies on occupational asthma endotypes have focused on immune and inflammatory patterns associated with different occupational exposures to sensitizers or irritants.Sputum neutrophilia has been found in 58.5% patients with occupational asthma caused by high molecular weight (HMW) agents, and work-related dysphonia in patients with occupational asthma was described as associated with sputum neutrophilia too. Neutrophils have been associated also with irritant-induced asthma. The measurement of specific IgE has been confirmed as a valuable diagnostic tool in occupational asthma caused by HMW agents, on the contrary, for most low-molecular-weight agents, the presence of specific IgE has been proven in a small subset of affected workers. Fractional exhaled nitric oxide has been confirmed as a marker of type 2 (T2) inflammation in occupational asthma, mostly when induced by HMW agents (e.g. flour), and it has proved to be more sensitive than spirometry in measuring the efficacy of an intervention.MicroRNA-155 has been shown to contribute to airway inflammation in occupational asthma induced by toluene diisocyanate.
SUMMARY
Occupational asthma is heterogeneous, thus monitoring multiple biomarkers is crucial to understand, which inflammatory responses are prevalent.
Topics: Humans; Asthma, Occupational; Biomarkers; Inflammation; Neutrophils; Immunoglobulin E; Occupational Exposure; Occupational Diseases; MicroRNAs
PubMed: 38295127
DOI: 10.1097/ACI.0000000000000969