The role of imaging in the evaluation of hoarseness: A review

Assessing the Effectiveness of Voice Therapy Techniques in Treating Dysphonia: An Otolaryngological Review

Dysphonia is a prevalent condition that can impact individuals across all age groups. It occurs when normal voice quality is altered, caused by structural and/or functional issues. Evaluation and assessment from clinicians are warranted if dysphonia persists for more than four weeks and/or is coupled with risk factors or other concerning clinical manifestations. Additionally, voice disorders can increase the risk of depression and anxiety disorders, as well as raise stress levels and lower self-reported health indicators. Dysphonia can have a substantial influence on interpersonal interactions and lower overall quality of life since effective communication relies significantly on spoken language. Hence, managing dysphonia is essential for enhancing communication abilities, improving quality of life, maintaining vocational functioning, promoting psychological well-being, and addressing underlying health concerns. Speech and language therapy, medical management, surgery, or a combination of the aforementioned are all possible treatments for dysphonia. Speech and language therapy is often the first-line treatment option for dysphonia patients who do not meet the criteria for surgical intervention. Voice therapy is often beneficial and remains the first line of treatment, even when patients approach with benign vocal fold nodules. A well-designed voice therapy program improves both the quality of life and vocal performance. The majority of the studies in the existing literature advocate for and report beneficial outcomes associated with voice therapy; however, more research is needed to provide evidence-based findings to guide clinical practice and achieve optimal outcomes. This comprehensive review elaborately highlights the utilization and efficacy of various voice therapeutic modalities utilized for the management of dysphonia in light of current literature.

Cricoarytenoid subluxation presenting as vocal cord palsy following endotracheal intubation – A case report

Airway interventions commonly present with self-limiting throat pain and hoarseness of voice. Persistent hoarseness is rare and should be evaluated for serious complications. Cricoarytenoid injuries may present as vocal cord palsies which need careful evaluation. We encountered a case of intubation-related cricoarytenoid subluxation in a 49-year-old diabetic female with a past history of pulmonary tuberculosis was planned for a modified radical mastectomy after a course of neoadjuvant chemotherapy. During intubation by a third-year resident, Cormack Lehane's grade was 3, and bougie-guided railroading of 7 mm endotracheal tube was done blindly. The patient developed haemoptysis and desaturation following intubation and was on ventilator support for 24 hours. Following extubation, the patient had throat pain and hoarseness in voice for more than 2 days. Fibreoptic laryngoscopy revealed right vocal cord palsy. A detailed evaluation revealed right cricoarytenoid subluxation which was treated successfully by closed reduction after 1 week. Cricoarytenoid subluxation, though rare is a serious complication after interventional airway procedures. According to the literature, unfavourable intubating conditions, predisposing patient factors and inadequate experience of the anaesthesiologist are the major contributors to this complication. Injury may produce submucosal haemorrhage and haemarthrosis, which cause adhesions and scarring leading to fixing of vocal cord in abnormal position and permanent disability. Early diagnosis by fibreoptic laryngoscopy and CT imaging and prompt interventions like closed reduction or laryngoplasty should be done to restore vocal cord function.