-
Archives of Disease in Childhood Nov 1988
-
The Cochrane Database of Systematic... May 2015This is an update of the original review published in 2005. Acute laryngitis is a common illness worldwide. Diagnosis is often made by case history alone and treatment... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This is an update of the original review published in 2005. Acute laryngitis is a common illness worldwide. Diagnosis is often made by case history alone and treatment often targets symptoms.
OBJECTIVES
To assess the effectiveness and safety of different antibiotic therapies in adults with acute laryngitis. A secondary objective was to report the rates of adverse events associated with these treatments.
SEARCH METHODS
We searched CENTRAL (2014, Issue 11), MEDLINE (January 1966 to November week 3, 2014), EMBASE (1974 to December 2014), LILACS (1982 to December 2014) and BIOSIS (1980 to December 2014).
SELECTION CRITERIA
Randomised controlled trials (RCTs) comparing any antibiotic therapy with placebo for acute laryngitis. The main outcome was objective voice scores.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted and synthesised data.
MAIN RESULTS
We included three RCTs (351 participants) that had moderate to high risk of bias. The quality of the evidence was very low for all outcomes. We downgraded the studies because of limitations in study design or execution (risk of bias), imprecision and inconsistency of results. We included a new trial presented only as a conference abstract in this update.In one study of acute laryngitis in adults, 100 participants were randomised to receive penicillin V (800 mg twice daily for five days) or an identical placebo. A recording of each patient reading a standardised text was made at the first visit, during re-examination after one and two weeks, and at follow-up after two to six months. No significant differences were found between the groups. The trial also measured symptoms reported by participants and found no significant differences.One study investigated erythromycin for acute laryngitis in 106 adults. The mean objective voice scores measured at the first visit, at re-examination after one and two weeks, and at follow-up after two to six months did not significantly differ between the groups. At one week there were significant beneficial differences in the severity of reported vocal symptoms (slight, moderate and severe) as judged by participants (P value = 0.042). However, the rates of participants having improved voice disturbance (subjective symptoms) at one and two weeks were not significantly different among groups. Comparing erythromycin and placebo groups on the rate of persistence of cough at two weeks, the risk ratio (RR) was 0.38 (95% confidence interval (CI) 0.15 to 0.97, P value = 0.04) and the number needed to treat for an additional beneficial outcome (NNTB) was 5.87 (95% CI 3.09 to 65.55). We calculated a RR of 0.64 (95% CI 0.46 to 0.90, P value = 0.034) and a NNTB of 3.76 (95% CI 2.27 to 13.52; P value = 0.01) for the subjective voice scores at one week.A third trial from Russia included 145 patients with acute laryngitis symptoms. Participants were randomised to three treatment groups: Group 1: seven-day course of fusafungine (six times a day by inhalation); Group 2: seven-day course of fusafungine (six times a day by inhalation) plus clarithromycin (250 mg twice daily for seven days); Group 3: no treatment. Clinical cure rates were measured at days 5 ± 1, 8 ± 1 and 28 ± 2. The authors reported significant differences in the rates of clinical cure at day 5 ± 1 favouring fusafungine (one trial; 93 participants; RR 1.50, 95% CI 1.02 to 2.20; P value = 0.04) and fusafungine plus clarithromycin (one trial 97 participants; RR 1.47, 95% CI 1.00 to 2.16; P value = 0.05) when compared to no treatment. However, no significant differences were found at days 8 ± 1 and 28 ± 2. Also, no significant differences were found when comparing fusafungine to fusafungine plus clarithromycin at days 5 ± 1, 8 ± 1 and 28 ± 2.
AUTHORS' CONCLUSIONS
Antibiotics do not appear to be effective in treating acute laryngitis when assessing objective outcomes. They appear to be beneficial for some subjective outcomes. Erythromycin could reduce voice disturbance at one week and cough at two weeks when measured subjectively. Fusafungine could increase the cure rate at day five. The included RCTs had important methodological problems and these modest benefits from antibiotics may not outweigh their cost, adverse effects or negative consequences for antibiotic resistance patterns.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Clarithromycin; Depsipeptides; Erythromycin; Fusarium; Humans; Laryngitis; Penicillin V; Randomized Controlled Trials as Topic
PubMed: 26002823
DOI: 10.1002/14651858.CD004783.pub5 -
Otolaryngologia Polska = the Polish... Jul 2023<br><b>Introduction:</b> The taxonomy of vocal fold lesions has been refined, and it serves as a common descriptive language for diagnosis, treatment...
<br><b>Introduction:</b> The taxonomy of vocal fold lesions has been refined, and it serves as a common descriptive language for diagnosis, treatment algorithms, and reporting of outcomes. However, we observe rare cases when numerous pathologies overlap, resulting in an unclear and complicated clinical presentation of the glottis.</br> <br><b>Aim:</b> The aim of this paper is to present cases of overlapping etiopathological factors which poses a challenge when making a diagnosis and referring a patient for adequate treatment.</br> <br><b>Material and method:</b> The study presents different photographs of the glottis, including some unique and unusual images in which overlapping pathologies were captured. The photographs are accompanied by case descriptions, comments, and pathological analyses.</br> <br><b>Results:</b> Four selected photographs showed a bunch of exophytic growth lesions with foci of whitish plaques, covered by yellowish crusts, with thinned, reddened vocal folds presenting foci of leukoplakia. The study discussed possible causes of vocal folds edema, diffuse erythema, presence of crusts or exudate, whitish debris/plaques or development of leukoplakia, non-neoplastic ulceration, as well as injected and reddened mucous membrane. Chronic infectious laryngitis, idiopathic ulcerative laryngitis, and drug-induced laryngitis were also mentioned. The study also raised the issues concerning diabetics and patients treated with inhaled corticosteroids, including candidiasis and primary aspergillosis of the larynx.</br> <br><b>Conclusions:</b> To conclude, everyday clinical practice involves encountering cases of unclear onset and course, with complicated presentation of the glottis. Therefore, comprehensive history-taking and thorough investigation of systemic causes are of immense importance. Recommended management includes conducting the most meticulous differential diagnosis, implementing treatment for the most likely cause, and, whenever possible, refraining from biopsy in order to avoid permanent damage to vocal cords.</br>.
Topics: Humans; Laryngitis; Glottis; Vocal Cords; Larynx; Leukoplakia
PubMed: 37772377
DOI: 10.5604/01.3001.0053.7263 -
Critical Reviews in Toxicology Mar 2011Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those... (Review)
Review
Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those reports have raised concern that it might be a respiratory sensitizer. To better understand that possibility, we reviewed the in silico, in chemico, in vitro, and in vivo toxicology literature, and also epidemiologic and occupational medicine reports related to the respiratory effects of MMA. Numerous in silico and in chemico studies indicate that MMA is unlikely to be a respiratory sensitizer. The few in vitro studies suggest that MMA has generally weak effects. In vivo studies have documented contact skin sensitization, nonspecific cytotoxicity, and weakly positive responses on local lymph node assay; guinea pig and mouse inhalation sensitization tests have not been performed. Cohort and cross-sectional worker studies reported irritation of eyes, nose, and upper respiratory tract associated with short-term peaks exposures, but little evidence for respiratory sensitization or asthma. Nineteen case reports described asthma, laryngitis, or hypersensitivity pneumonitis in MMA-exposed workers; however, exposures were either not well described or involved mixtures containing more reactive respiratory sensitizers and irritants. The weight of evidence, both experimental and observational, argues that MMA is not a respiratory sensitizer.
Topics: Air Pollutants, Occupational; Animals; Asthma; Computer Simulation; Disease Models, Animal; Humans; Hypersensitivity; Inhalation Exposure; Irritants; Laryngitis; Methylmethacrylates; Occupational Diseases; Occupational Exposure; Respiratory Mucosa; Structure-Activity Relationship
PubMed: 21401327
DOI: 10.3109/10408444.2010.532768 -
Journal of Clinical Laboratory Analysis Feb 2021Tissue engineering has been a topic of extensive research in recent years and has been applied to the regeneration and restoration of many organs including the larynx.... (Review)
Review
OBJECTIVE
Tissue engineering has been a topic of extensive research in recent years and has been applied to the regeneration and restoration of many organs including the larynx. Currently, research investigating tissue engineering of the larynx is either ongoing or in the preclinical trial stage.
METHODS
A literature search was performed on the Advanced search field of PubMed using the keywords: "(laryncheal tissue engineering) AND (cartilage regeneration OR scaffolds OR stem cells OR biomolecules)." After applying the selection criteria, 65 articles were included in the study.
RESULTS
The present review focuses on the rapidly expanding field of tissue-engineered larynx, which aims to provide stem cell-based scaffolds combined with biological active factors such as growth factors for larynx reconstruction and regeneration. The trend in recent studies is to use new techniques for scaffold construction, such as 3D printing, are developed. All of these strategies have been instrumental in guiding optimization of the tissue-engineered larynx, leading to a level of clinical induction beyond the in vivo animal experimental phase.
CONCLUSIONS
This review summarizes the current progress and outlines the necessary basic components of regenerative laryngeal medicine in preclinical fields. Finally, it considers the design of scaffolds, support of growth factors, and cell therapies toward potential clinical application.
Topics: Animals; Humans; Larynx; Printing, Three-Dimensional; Tissue Engineering; Tissue Scaffolds
PubMed: 33320365
DOI: 10.1002/jcla.23646 -
The Journal of the Acoustical Society... Mar 2021In the clinic, many diagnostic and therapeutic procedures focus on the oscillation patterns of the vocal folds (VF). Dynamic characteristics of the VFs, such as...
In the clinic, many diagnostic and therapeutic procedures focus on the oscillation patterns of the vocal folds (VF). Dynamic characteristics of the VFs, such as symmetry, periodicity, and full glottal closure, are considered essential features for healthy phonation. However, the relevance of these individual factors in the complex interaction between the airflow, laryngeal structures, and the resulting acoustics has not yet been quantified. Sustained phonation was induced in nine excised porcine larynges without vocal tract (supraglottal structures had been removed above the ventricular folds). The multimodal setup was designed to simultaneously control and monitor key aspects of phonation in the three essential parts of the larynx. More specifically, measurements will comprise (1) the subglottal pressure signal, (2) high-speed recordings in the glottal plane, and (3) the acoustic signal in the supraglottal region. The automated setup regulates glottal airflow, asymmetric arytenoid adduction, and the pre-phonatory glottal gap. Statistical analysis revealed a beneficial influence of VF periodicity and glottal closure on the signal quality of the subglottal pressure and the supraglottal acoustics, whereas VF symmetry only had a negligible influence. Strong correlations were found between the subglottal and supraglottal signal quality, with significant improvement of the acoustic quality for high levels of periodicity and glottal closure.
Topics: Acoustics; Animals; Glottis; Larynx; Phonation; Pressure; Swine; Vocal Cords
PubMed: 33765793
DOI: 10.1121/10.0003602 -
BioMed Research International 2018Laryngopharyngeal reflux (LPR) exhibits nonspecific clinical presentations, and these symptoms may be associated with other conditions such as allergies, including... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVES
Laryngopharyngeal reflux (LPR) exhibits nonspecific clinical presentations, and these symptoms may be associated with other conditions such as allergies, including allergic rhinitis and laryngitis. However, there is a gap in the literature regarding the correlation of laryngopharyngeal reflux with allergic rhinitis/laryngitis. Hence, the aim of this study is to explore the correlation between these two conditions.
PATIENTS AND METHODS
A total of 126 patients with suggestive manifestations of laryngopharyngeal reflux were included in this study. Patients were classified into LPR positive and negative groups based on the results of a 24-hour oropharyngeal pH monitoring system while allergic rhinitis status was assessed with the score for allergic rhinitis (SFAR).
THE RESULTS OF THE TWO GROUPS WERE COMPARED REGARDING THE SFAR SCORE CORRELATION BETWEEN THE PH RESULTS AND SFAR SCORE WAS EXPLORED RESULTS
The LPR positive group demonstrated significantly higher SFAR scores compared to the negative LPR group ( < 0.0001). In addition, the Ryan score was significantly correlated with the It seems that laryngopharyngeal reflux increases patients' self-rating of allergic manifestations. It appears that there is an association between laryngopharyngeal reflux and allergic rhinitis/laryngitis.
Topics: Adolescent; Adult; Esophageal pH Monitoring; Female; Humans; Laryngitis; Laryngopharyngeal Reflux; Male; Middle Aged; Rhinitis, Allergic; Young Adult
PubMed: 29765981
DOI: 10.1155/2018/2951928 -
Journal of Speech, Language, and... May 2023The purpose of this study was to determine whether patient voice-related diagnosis, severity of dysphonia, and rater's experience influence the relationship between...
PURPOSE
The purpose of this study was to determine whether patient voice-related diagnosis, severity of dysphonia, and rater's experience influence the relationship between laryngeal oscillation ratings made from videostroboscopic and high-speed videoendoscopic (HSV) exams.
METHOD
Stroboscopy and HSV exams from 15 patients with adductor spasmodic dysphonia (ADSD) and 15 with benign vocal fold lesions were rated for laryngeal oscillation and closure by 10 licensed speech-language pathologists (SLPs). Raters were divided into low- (< 5 years) and high-experience (> 5 years) groups. Ratings of vocal fold amplitude, mucosal wave, periodicity, phase symmetry, nonvibrating portion of the vocal fold, and glottal closure were examined using an online form adapted from the Voice Vibratory Assessment of Laryngeal Imaging (VALI).
RESULTS
Stroboscopy and HSV ratings were more strongly positively correlated for patients with benign vocal fold lesions ( between .43 and .75) than for those with ADSD ( between .40 and .68). Differences between stroboscopy and HSV exams were significantly greater for ratings of amplitude, mucosal wave, and periodicity in patients with ADSD than for patients with benign vocal fold lesions. Raters with < 5 years of experience showed significantly greater differences between stroboscopy and HSV ratings of amplitude and nonvibrating portion of the vocal fold for patients with ADSD only. Significantly greater differences between ratings of periodicity and phase symmetry were observed in patients with more severe dysphonia.
CONCLUSIONS
Differences in laryngeal ratings made between HSV and stroboscopy exams may be influenced by patient diagnosis, severity of dysphonia, and rater experience. Future study is warranted to determine how the differences observed influence clinical diagnosis and outcomes.
Topics: Humans; Dysphonia; Video Recording; Larynx; Vocal Cords; Laryngoscopy
PubMed: 37040690
DOI: 10.1044/2023_JSLHR-22-00649 -
Journal of Anatomy Sep 2021High-resolution, noninvasive and nondestructive imaging of the subepithelial structures of the larynx would enhance microanatomic tissue assessment and clinical decision...
High-resolution, noninvasive and nondestructive imaging of the subepithelial structures of the larynx would enhance microanatomic tissue assessment and clinical decision making; similarly, in situ molecular profiling of laryngeal tissue would enhance biomarker discovery and pathology readout. Towards these goals, we assessed the capabilities of high-resolution magnetic resonance imaging (MRI) and matrix-assisted laser desorption/ionisation-mass spectrometry (MALDI-MS) imaging of rarely reported paediatric and adult cadaveric larynges that contained pathologies. The donors were a 13-month-old male, a 10-year-old female with an infraglottic mucus retention cyst and a 74-year-old female with advanced polypoid degeneration and a mucus retention cyst. MR and molecular imaging data were corroborated using whole-organ histology. Our MR protocols imaged the larynges at 45-117 μm in-plane resolution and capably resolved microanatomic structures that have not been previously reported radiographically-such as the vocal fold superficial lamina propria, vocal ligament and macula flavae; age-related tissue features-such as intramuscular fat deposition and cartilage ossification; and the lesions. Diffusion tensor imaging characterised differences in water diffusivity, primary tissue fibre orientation, and fractional anisotropy between the intrinsic laryngeal muscles, mucosae and lesions. MALDI-MS imaging revealed peptide signatures and putative protein assignments for the polypoid degeneration lesion and the N-glycan constituents of one mucus retention cyst. These imaging approaches have immediate application in experimental research and, with ongoing technology development, potential for future clinical application.
Topics: Aged; Child; Diffusion Tensor Imaging; Female; Humans; Infant; Laryngeal Muscles; Larynx; Magnetic Resonance Imaging; Male; Mass Spectrometry
PubMed: 34032275
DOI: 10.1111/joa.13451 -
The American Journal of Managed Care Oct 2000Gastroesophageal reflux disease (GERD) accompanied by regurgitation and aspiration has been suggested as the cause of many conditions, but the strongest evidence exists... (Review)
Review
Gastroesophageal reflux disease (GERD) accompanied by regurgitation and aspiration has been suggested as the cause of many conditions, but the strongest evidence exists for a relationship between asthma and GERD and posterior laryngitis and GERD. The exact mechanism of the tracheopulmonary damage has not been determined, but studies show that proton pump inhibitor therapy can ameliorate to some extent the laryngeal symptoms in laryngitis as well as asthma symptoms, asthma medication use, and lung function. Antireflux surgery appears to be more effective than antireflux medication in asthma patients with GERD symptoms. The role of tracheopulmonary damage in patients with chest pain is less clear, and the difficulty lies in determining which patients have gastroesophageal etiology.
Topics: Asthma; Chest Pain; Gastroesophageal Reflux; Humans; Laryngitis; Life Style; Pharyngitis; Treatment Outcome
PubMed: 11184658
DOI: No ID Found