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Shui W, Hu W, Ma W, Han Y, Hao IY, Zhu S, Sun Y, Deng Z, Gao Y, Heng L, Zhu S. The effects of video double-lumen tubes on intubation complications in patients undergoing thoracic surgery: A randomised controlled study. Eur J Anaesthesiol 2024; 41:305-313. [PMID: 38298060 PMCID: PMC10906194 DOI: 10.1097/eja.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Tracheal injuries, vocal cord injuries, sore throat and hoarseness are common complications of double-lumen tube (DLT) intubation. OBJECTIVE This study aimed to evaluate the effects of 'video double-lumen tubes' (VDLTs) on intubation complications in patients undergoing thoracic surgery. DESIGN A randomised controlled study. SETTINGT Xuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June 2023. PATIENTS One hundred eighty-two patients undergoing elective thoracic surgery with one-lung ventilation were randomised into two groups: 90 in the DLT group and 92 in the VDLT group. INTERVENTION VDLT was selected for intubation in the VDLT group, and DLT was selected for intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to record tracheal and vocal cord injuries. MAIN OUTCOME MEASURES The primary outcomes were the incidence of moderate-to-severe tracheal injury and the incidence of vocal cord injury. The secondary outcomes included the incidence and severity of postoperative 24 and 48 h sore throat and hoarseness. RESULTS The incidence of moderate-to-severe tracheal injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT group ( P = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The incidence of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the DLT and VDLT groups, respectively ( P = 0.449). The incidence of postoperative 24 h sore throat and hoarseness was significantly higher in the VDLT group than in the DLT group (for sore throat: P = 0.032, relative risk 1.63, 95% CI, 1.03 to 2.57; for hoarseness: P = 0.018, relative risk 1.48, 95% CI, 1.06 to 2.06). CONCLUSION There was no statistically significant difference in the incidence of moderate-to-severe tracheal injury and vocal cord injury between DLTs and VDLTs. While improving the first-attempt success rate, intubation with VDLT increased the incidence of postoperative 24 h sore throat and hoarseness. TRIAL REGISTRATION Chinese Clinical Trial Registry identifier: ChiCTR2300067348.
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Affiliation(s)
- Weikang Shui
- From the Jiangsu Province Key laboratory of Anaesthesiology, Xuzhou Medical University (WS, WH, YS, ZD, SZ), Department of Anaesthesiology, Xuzhou Cancer Hospital, Xuzhou (WM, YH, SZ, LH, SZ), California State University, Los Angeles, USA (IYH) and Jiangsu University, Zhenjiang, Jiangsu, China (YG)
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Zhu G, Wang X, Cao X, Yang C, Wang B, Ang Y, Duan M. The effect of different endotracheal tube cuff pressure monitoring systems on postoperative sore throat in patients undergoing tracheal intubation: a randomized clinical trial. BMC Anesthesiol 2024; 24:115. [PMID: 38528475 PMCID: PMC10962134 DOI: 10.1186/s12871-024-02499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/15/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Postoperative sore throat (POST) is an unpleasant outcome that can occur as a result of tracheal intubation in adults. Increased pressure from the endotracheal tube (ETT) cuff often leads to local mucosal injury, resulting in sore throat. The purpose of this study was to compare the effect of two different ETT cuff pressure monitoring systems vs. no cuff pressure monitoring on the incidence and severity of POST in adults. METHODS One hundred and fourteen ASA I-III patients of either gender, aged 18-65 years, and undergoing surgery requiring endotracheal intubation were included in this study. Patients were randomized into three groups: control (C), cuff pressure gauge (G), and automated cuff controller (A). The ETT cuff pressure was not monitored intraoperatively in group C but was monitored using a cuff pressure gauge and an automated cuff controller in groups G and A, respectively. Postoperatively, patients were assessed at 2, 24, and 48 h for the presence and severity of POST, hoarseness and cough. RESULTS One hundred and eleven patients completed the study. POST occurred in 40.5% of the patients in group G (n = 37) (p = 0.013) and 23.7% of the patients in group A (n = 38) (p < 0.001) within 48 h after surgery, compared to 69.4% in group C (n = 36). There were no significant differences in hoarseness, coughing, and dysphagia across the groups at any time. When comparing groups A and C, individuals in group A exhibited a lower occurrence of significant (grade ≥ 2) POST and hoarseness (10.5% vs. 41.7%, p = 0.002; 26.3% vs. 58.3%, p = 0.005). The incidence of significant cough and dysphagia did not differ substantially across the patient groups within 48 h after surgery. POST scores in group A at 2, 24 h postoperatively were both 0 (0-0), which was significantly lower than those in group C (1 (0-2) at 2 h, p < 0.001 ; 1 (0-1) at 24 h, p = 0.001). POST in group G at 2 h postoperatively was graded as 0 (0-1.5) which was milder than group C (P = 0.024). The severity of hoarseness in group A with scores of 0 (0-2) was superior to that in group C (2 (0-2), p = 0.006) at 2 h postoperatively. CONCLUSIONS In conclusion, the findings of this study indicated that the occurrence of POST can be reduced by using either the cuff pressure gauge approach or the automated cuff controller method. The automated cuff controller monitoring can potentially decrease the severity of POST and hoarseness. TRIAL REGISTRATION Chinese Clinical Trial Registry, identifier: ChiCTR2100054089, Date: 08/12/2021.
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Affiliation(s)
- Guangli Zhu
- College of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Department of Anesthesiology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, 210002, China
- Department of Anesthesiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210019, China
| | - Xuan Wang
- Women's Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210004, China
| | - Xinyu Cao
- College of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Department of Anesthesiology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, 210002, China
| | - Chongya Yang
- College of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Department of Anesthesiology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, 210002, China
| | - Bin Wang
- Department of Anesthesiology, Jinling College affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210002, China
| | - Yang Ang
- Department of Anesthesiology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, 210002, China
| | - Manlin Duan
- College of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China.
- Department of Anesthesiology, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, Jiangsu Province, 210002, China.
- Department of Anesthesiology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210019, China.
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Putus T, Vilén L, Atosuo J. The Association Between Work-related Stress, Indoor Air Quality and Voice Problems Among Teachers - Is There a Trend? J Voice 2024; 38:541.e21-541.e29. [PMID: 34642072 DOI: 10.1016/j.jvoice.2021.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Hoarseness and other voice problems are common in occupations where the person has to speak, sing or shout in a work environment containing dust, noise, gaseous or particulate irritants. In recent years, stress has often been associated with voice problems. OBJECTIVE The aim of this study was to examine trends over a period of time of the prevalence of voice problems and reported stress in Finnish school buildings. STUDY DESIGN School buildings from different parts of the country were studied for ten years using a similar questionnaire (N = 1721). Five schools participated before and after the remediation of an indoor air problem in the school buildings (n = 315). RESULTS In the pilot study (2007-2008), the reported work-related stress was on a very low level (3%) and the prevalence of hoarseness was 10%. After the economic crisis in 2008, the stress was observed to have increased. During the follow-up (2008-2017), the reported stress had continued to increase and in the latest surveys it was 21% and the prevalence of hoarseness 34%. Indoor air factors correlated significantly with hoarseness even when controlling for age, gender, owning pets and job satisfaction in a logistic regression model. In the school buildings where the remediation of the building was completed, the prevalence of hoarseness decreased but the level of stress increased. In general, the proportion of respondents reporting stress was lower than the proportion of respondents with hoarseness. Additionally, the reported stress also correlated with factors other than health in the education branch, especially economic resources and major changes in the core curriculum. CONCLUSION Hoarseness and work-related stress have, to a large extent, different risk factors. Over time, the proportion of individuals with stress has been at a lower level than the proportion of respondents with voice problems; hence, we conclude that it is quite unlikely that stress would be a causative risk factor for hoarseness. We recommend that irritant dust and gases should be reduced from the work environment of teachers to enable recovery from hoarseness and other voice problems. Coping with work-related stress should be alleviated with other measures.
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Affiliation(s)
- Tuula Putus
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland.
| | - Liisa Vilén
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland
| | - Janne Atosuo
- Department of Life Technologies, The Laboratory of Immunochemistry, University of Turku, Turku, Finland
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Momah T, Lijofi O. Squamous Cell Carcinoma of the Supraglottis Presenting as Hoarseness. West Afr J Med 2024; 41:97-99. [PMID: 38412544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Hoarseness is a well-known condition in primary care offices, with over 1% of primary care visits secondary to this ailment.1 The most common causes are acute laryngitis (40%), functional dysphonia (30%), benign and malignant tumors (2.2 to 30%), neurogenic factors such as vocal cord paralysis (8%), physiological aging (2%), and psychogenic factors (2.2%). Most of these cases are secondary to viral infections and do not require antibiotics on most occasions. These viral infections subside after 1 to 2 weeks, and in the case of persistent hoarseness (above 4 weeks) the American Academy of Otolaryngology recommends direct visualization with a laryngoscopy before treatment with proton pump inhibitors, antibiotics, or steroids. Our patient presented with prolonged hoarseness (greater than eight weeks) but had a quick turn around time interval between primary care visit and laryngoscopy evaluation (less than 2 weeks). This led to her diagnosis and treatment with chemo and radiation therapy within three months of diagnosis with Squamous Cell Carcinoma of the Supraglottis. The Primary care physician serves as the number one point of visitation by sufferers of hoarseness. It is important that they are knowledgeable and up to date with recommendations and guidelines for managing this condition, as unwarranted delay can affect overall outcome on the part of the patient. This is especially important in patients such as ours with high risk factors including Nicotine dependence, alcohol use, asbestos exposure, and HPV infection.
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Affiliation(s)
- Tobe Momah
- Department of Family Medicine, University of Mississippi Medical Center (UMMC) Jackson, MS Clinical Science Building, 2500 North State Street, Jackson (Fourth Floor), MS 39216 USA. Emails include , 1-6019846800 (Office Phone)
| | - Olusegun Lijofi
- Department of Family and Pain Medicine , University of Mississippi Medical Center (UMMC) Jana, Taylor, School of Medicine, UMMC, USA
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Schraut T, Schützenberger A, Arias-Vergara T, Kunduk M, Echternach M, Döllinger M. Machine learning based estimation of hoarseness severity using sustained vowelsa). J Acoust Soc Am 2024; 155:381-395. [PMID: 38240668 DOI: 10.1121/10.0024341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
Auditory perceptual evaluation is considered the gold standard for assessing voice quality, but its reliability is limited due to inter-rater variability and coarse rating scales. This study investigates a continuous, objective approach to evaluate hoarseness severity combining machine learning (ML) and sustained phonation. For this purpose, 635 acoustic recordings of the sustained vowel /a/ and subjective ratings based on the roughness, breathiness, and hoarseness scale were collected from 595 subjects. A total of 50 temporal, spectral, and cepstral features were extracted from each recording and used to identify suitable ML algorithms. Using variance and correlation analysis followed by backward elimination, a subset of relevant features was selected. Recordings were classified into two levels of hoarseness, H<2 and H≥2, yielding a continuous probability score ŷ∈[0,1]. An accuracy of 0.867 and a correlation of 0.805 between the model's predictions and subjective ratings was obtained using only five acoustic features and logistic regression (LR). Further examination of recordings pre- and post-treatment revealed high qualitative agreement with the change in subjectively determined hoarseness levels. Quantitatively, a moderate correlation of 0.567 was obtained. This quantitative approach to hoarseness severity estimation shows promising results and potential for improving the assessment of voice quality.
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Affiliation(s)
- Tobias Schraut
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Anne Schützenberger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Tomás Arias-Vergara
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Melda Kunduk
- Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Munich, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
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Abstract
While many occupations are at risk for vocal health issues much of the current research has focused on teachers. The prevalence of hoarseness among nurses has not received much attention. The aim of this study was to determine the current prevalence of hoarseness among nurses and also to identify potential environmental risk factors from their working environment. The health data was collected from Finnish healthcare workers. Our findings are based on 13,560 health questionnaires which were statistically analyzed. Our results suggest that the one-year period prevalence of hoarseness was 30% and all the environmental problems which we evaluated (draft, room temperature too high, variable room temperature, room temperature too low, dry air, stuffy indoor air, moist air/ high humidity, inadequate ventilation, smell of mold or cellar, sewer odor, other unpleasant odors, tobacco smoke, noise and detectable dust or dirt) had an increasing effect on hoarseness. In conclusion, clear associations were found between environmental problems and hoarseness in nurses. Furthermore, efforts should be made to repair defective ventilation systems, remediate indoor air problems due to moisture damage and improve overall maintenance to protect the vocal health of nurses.
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Affiliation(s)
- Liisa Vilén
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland.
| | - Tuula Putus
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland
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Murugaiyan A, Sahoo AK, Rao PB, Misra S. Effect of 5% EMLA Cream on Postoperative Sore Throat in Adults Following General Endotracheal Anesthesia: A Randomized Placebo-Controlled Study. Anesth Analg 2023; 136:338-345. [PMID: 36638513 DOI: 10.1213/ane.0000000000006269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Postoperative sore throat (POST) is a distressing complaint in adults after endotracheal intubation. This study aimed to evaluate the effect of topical application of a eutectic mixture of local anesthetics (EMLA) cream over the endotracheal tube (ETT) cuff on the incidence and severity of POST, cough, and hoarseness of voice in adults after surgery. METHODS In this randomized, placebo-controlled study, adult patients 18 to 65 years old, in American Society of Anesthesiologists (ASA) physical status I and II, and of either sex were scheduled to receive 5% EMLA cream (intervention arm) or lubricant gel (placebo-controlled arm) applied over the ETT cuff. POST was graded as none (0), mild (1), moderate (2), or severe (3). A score of ≥2 was considered as significant POST. The incidence of POST at the sixth postoperative hour was the primary outcome. Secondary outcomes included the incidence of POST at 0, second, and 24 hours, and the incidence of significant POST (score ≥2). The incidence and severity of postoperative cough and hoarseness of voice were recorded simultaneously. RESULTS Two hundred and four patients completed the study. The incidence of POST was significantly lower in the EMLA group versus placebo at the sixth postoperative hour (4.9% vs 40.1%; relative risk [RR], 0.12; 95% confidence interval [CI], 0.05-0.29; P < .001); and at 0 hour (74.5% vs 93.1%; RR, 0.8; 95% CI, 0.7-0.9; P < .001) and second hour (51.9% vs 84.3%; RR, 0.61; 95% CI, 0.5-0.75; P < .001) but comparable at 24 hours (1.9% vs 3.9%; RR, 0.5; 95% CI, 0.09-2.67; P = .4). The number needed to treat to prevent POST with EMLA cream application was 5 at 0 hour and 3 at the second and sixth hour. The proportion of patients with significant POST over 24 hours were less in the EMLA group (9.8% vs 43.1%; P < .001). The incidence of postoperative cough and hoarseness of voice was significantly less at the 0, second, and sixth hours in the EMLA group, but comparable at 24 hours. The incidence of severe cough (8.8% vs 31.4%; P < .001) and hoarseness of voice (2% vs 7.4%; P < .001) over 24 hours was less in the EMLA group. CONCLUSIONS The application of EMLA cream over ETT cuff reduces the incidence and severity of POST, cough, and hoarseness of voice in adults after general anesthesia in the early postoperative period compared to lubricant gel.
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Affiliation(s)
- Abishek Murugaiyan
- From the Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
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Korsunsky SRA, Camejo L, Nguyen D, Mhaskar R, Chharath K, Gaziano J, Richter J, Velanovich V. Voice Hoarseness with Reflux as a Suspected Etiology: Incidence, Evaluation, Treatment, and Symptom Outcomes. J Gastrointest Surg 2023; 27:658-665. [PMID: 36652177 DOI: 10.1007/s11605-022-05574-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To describe the clinical evaluation course, treatments, and outcomes of patients with a primary complaint of hoarseness due to suspected laryngopharyngeal reflux (LPR). METHODS A retrospective chart review was conducted of patients with a primary complaint of hoarseness with acid reflux as the suspected cause at a single institution between October 2011 and March 2020 who underwent clinical evaluation, treatment, and follow-up. Data collected included diagnostic procedures and treatments received, subjective symptom outcomes, and final diagnosis as determined by the treating physician. RESULTS A total of 134 patients met the inclusion criteria. Videostroboscopy was the most performed procedure (n = 59, 44%) followed by endoscopy (n = 38, 28%) and pH monitoring (n = 28, 21%). Three patients were removed for statistical analysis of treatment differences and outcomes due to variant treatment plans. Most patients received sole medical management (n = 86, 66%), 7 patients received only voice therapy (5%), and 10 patients underwent surgical management (8%). Several patients received combined medical management and voice therapy (n = 21, 16%). Final diagnoses included gastroesophageal reflux disease (GERD) (25%), followed by multifactorial causes (17%) and dysphonia with unclear etiology (13%). Among all patients, 82 (61%) reported symptom improvement. Twenty-eight patients were diagnosed with LPR or LPR with GERD (21%), and 22 reported symptom improvement (79%). There was a statistically significant relationship between a final diagnosis with a reflux component and symptom improvement (p = .038). There was no statistically significant difference between treatment types and symptom outcomes both within the total patient population (p = .051) and patients diagnosed with a reflux condition (p = .572). CONCLUSION LPR remains a difficult diagnosis to establish and represents a minority of patients with voice complaints. Despite varying evaluation and treatment modalities, most patients with LPR improved during their treatment and evaluation period without a clear association with any specific type of treatment. Further studies should explore diagnostic criteria for LPR, the necessary and efficient clinical evaluation to establish a diagnosis, and possible beneficial treatments.
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Affiliation(s)
| | | | - Diep Nguyen
- USF Health Morsani College of Medicine, Tampa, FL, USA
| | - Rahul Mhaskar
- USF Health Morsani College of Medicine, Tampa, FL, USA
| | | | - Joy Gaziano
- USF Health Joy McCann Culverhouse Center for Swallowing Disorders, Tampa, FL, USA
| | - Joel Richter
- USF Health Joy McCann Culverhouse Center for Swallowing Disorders, Tampa, FL, USA
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Korsunsky SR, Camejo L, Nguyen D, Mhaskar R, Chharath K, Gaziano J, Richter J, Velanovich V. Resource utilization and variation among practitioners for evaluating voice hoarseness secondary to suspected reflux disease: A retrospective chart review. Medicine (Baltimore) 2022; 101:e31056. [PMID: 36254005 PMCID: PMC9575706 DOI: 10.1097/md.0000000000031056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study was to assess the variation in resource utilization for the diagnosis and treatment of dysphonia or hoarseness in patients with suspected laryngopharyngeal reflux (LPRD) and/or gastroesophageal reflux (GERD). Secondary data was collected from a single-institution database of charts from patients evaluated between October 1, 2011 and March 31, 2020. This study was conducted as a retrospective chart review. Key outcome variables included demographic data, initial specialty visit, date of first symptom evaluation to final follow-up visit, additional procedural evaluation, and final diagnosis as attributed by the diagnosing physician. Inclusion criteria included patients ≥18 older referred to providers for suspected LPRD/GERD with a primary complaint of voice changes or hoarseness and appeared for follow-up. A total of 134 subjects were included for analysis. Data analysis included descriptive and univariate analysis, chi-square test of independence, independent means t test, and 1-way analysis of variance. Most patients (88) received some form of procedural evaluation in addition to clinical evaluation. The most frequent was videostroboscopy (59). Patients who first visited a gastroenterologist were more likely to undergo esophageal pH-monitoring (n = 14, P < .001) and manometry (n = 10, P < .001). Patients referred to speech-language pathology were very likely to undergo videostroboscopic evaluation (n = 7, P < .001). The prevailing final diagnosis as attributed by the diagnosing physician was confirmed to be of non-reflux etiology (49) or due to GERD alone (34). LPRD only was the least frequent diagnosis (10). Our results demonstrate that there is significant variation in the number and type of diagnostic tests based on the type of practitioner initially seen by the patient. Additionally, of patients thought to have voice change or hoarseness because of LPRD and/or GERD, more than a third had a non-reflux cause of their symptoms. Further research should identify beneficial patterns in resource utilization and further diagnostic utility of diagnostic procedures for more accurate diagnosis.
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Affiliation(s)
- Sydney R.A. Korsunsky
- USF Health Morsani College of Medicine, Tampa, FL, USA
- *Correspondence: Sydney R.A. Korsunsky, USF Health Morsani College of Medicine, Tampa, FL 33602, USA (e-mail: )
| | | | - Diep Nguyen
- USF Health Morsani College of Medicine, Tampa, FL, USA
| | - Rahul Mhaskar
- USF Health Morsani College of Medicine, Tampa, FL, USA
| | | | - Joy Gaziano
- USF Health Joy McCann Culverhouse Center for Swallowing Disorders, Tampa, FL, USA
| | - Joel Richter
- USF Health Joy McCann Culverhouse Center for Swallowing Disorders, Tampa, FL, USA
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Arora U, Garg P, Baitha U. Giant aortic arch aneurysm presenting with hoarseness of voice. Trop Doct 2022; 52:591-592. [PMID: 35880526 DOI: 10.1177/00494755221105750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A middle-aged male with hypertension and dyslipidaemia presented with hoarseness of voice due to a left vocal palsy. The chest radiograph revealed a saccular opacity silhouetting the left border of the aortic knuckle, suggestive of a large aortic arch aneurysm. Routine investigations, such as a chest radiograph do occasionally identify potentially fatal pathology, even when perhaps not strictly indicated; uncommon presentations do occur!
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Affiliation(s)
- Umang Arora
- Department of Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Prerna Garg
- Department of Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, 28730All India Institute of Medical Sciences, New Delhi, India
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Alrahim A, Alshaibani AK, Algarni S, Alsaied A, Alghamdi AA, Alsharhan S, Al-Bar M. Prevalence and Determinants of Hoarseness in School-Aged Children. Int J Environ Res Public Health 2022; 19:5468. [PMID: 35564863 PMCID: PMC9103237 DOI: 10.3390/ijerph19095468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022]
Abstract
Hoarseness in school-aged children may affect their educational achievement and interfere with their communication and social skills development. The global prevalence of hoarseness in school-aged children ranges between 6% and 23%. To the best of our knowledge, there is a scarcity of studies describing the prevalence or determinates of hoarseness in Saudi school-aged children. Our aim was to measure the prevalence of hoarseness among school-aged children and to identify its determinants. A cross-sectional questionnaire-based survey was used that included randomly selected primary and early childhood schools from private and governmental sectors in Saudi Arabia. The data were collected using a questionnaire which was self-completed by the children's parents and covered the following aspects: sociodemographic features, health and its related comorbidities about children and their families, attendance and performance in school, child's voice tone, past history of frequent crying during infancy, history of letter pronunciation problems and stuttering, the Reflux Symptom Index (RSI) and the Children's Voice Handicap Index-10 for parents (CVHI-10-P). Determinants of hoarseness were investigated using the SPSS software (version 20). The mean age of the study children (n = 428) was 9.05 years (SD = 2.15), and 69.40% of them were male. The rate of hoarseness in the participants was 7.5%. Hoarseness was significantly common in children with a history of excessive infancy crying (p = 0.006), letter pronunciation issues (especially 'R' and 'S'; p = 0.003), and stuttering (p = 0.004) and in those with a previous history of hoarseness (p = 0.023). In addition, having the symptoms of gastrointestinal reflux increased the risk of hoarseness by four times (OR = 4.77, 95% CI = 2.171, 10.51). In summary, hoarseness in children may be dangerously underestimated, as it may reflect the presence of speech problems, in addition to the presence of laryngopharyngeal reflux (LPR). Hoarseness was assumed on the basis of parental complaints. Therefore, further research with diagnoses based on a clinical assessment is needed to understand the magnitude of the hoarseness problem and its consequences in children.
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Affiliation(s)
- Ahmed Alrahim
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
| | - Askar K. Alshaibani
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.K.A.); (S.A.)
| | - Saad Algarni
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.K.A.); (S.A.)
| | - Abdulmalik Alsaied
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
| | - Amal A. Alghamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Salma Alsharhan
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
| | - Mohammad Al-Bar
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
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12
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Abstract
Hoarseness is a common problem, typically of transient nature. When hoarseness does not resolve, or when it is associated with concerning symptoms, it is important to consider a wide differential and refer to an otolaryngologist. This article discusses the physiology of the voice and possible causes of dysphonia, and explores when it warrants further work-up by ENT. A discussion of diagnostic techniques and the myriad of tools to treat hoarseness follows. Additionally, the role of reflux in dysphonia is examined with a critical eye to aid in accurate assessment of the patient's complaint.
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Affiliation(s)
- Hayley Born
- Sean Parker Institute for the Voice at Weill Cornell Medicine, New York, NY, USA; Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, 240 East 59th Street, New York, NY, USA. https://twitter.com/drhayleyborn
| | - Anaïs Rameau
- Sean Parker Institute for the Voice at Weill Cornell Medicine, New York, NY, USA; Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, 240 East 59th Street, New York, NY, USA.
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13
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Rodarte J, Akhavan B, Salazar GA, Cherian SV, Estrada-Y-Martin RM. 52-Year-Old With Epistaxis, Hemoptysis, Hoarseness, and Weight Loss. Chest 2021; 159:e225-e230. [PMID: 34022023 DOI: 10.1016/j.chest.2020.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/15/2022] Open
Abstract
CLINICAL PRESENTATION A 52-year-old man presented with hemoptysis of 2 weeks' duration. He had been experiencing hoarseness, right-sided pleuritic chest pain, subjective fevers, chills, night sweats, and 10 pounds weight loss for the previous 2 months. He additionally reported severe frontal headaches, nasal congestion, and intermittent epistaxis, which had been present for a year before his current presentation. He had worked in construction and denied tobacco or illicit drug use.
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Affiliation(s)
- Julio Rodarte
- Department of Internal Medicine, University of Texas Health-McGovern Medical School, Houston, TX
| | - Bobak Akhavan
- Department of Internal Medicine, University of Texas Health-McGovern Medical School, Houston, TX
| | - Gloria A Salazar
- Divisions of Rheumatology and Clinical Immunogenetics, University of Texas Health-McGovern Medical School, Houston, TX
| | - Sujith V Cherian
- Divisions of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX.
| | - Rosa M Estrada-Y-Martin
- Divisions of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health-McGovern Medical School, Houston, TX
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14
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Zeng C, Lin Q. Ectopic Thyroid Tissue on the Vocal Cord: A Case Report. Laryngoscope 2020; 131:E1391-E1392. [PMID: 32985681 DOI: 10.1002/lary.29063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/25/2020] [Accepted: 08/09/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Chaojun Zeng
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of Putian City, Putian, China
| | - Qin Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of Putian City, Putian, China
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15
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Jalil BA, Smith JS, El-Kersh K. A 34-Year-Old Woman With Hoarseness of Voice and an Abnormal Echocardiogram. Chest 2020; 155:e163-e166. [PMID: 31174660 DOI: 10.1016/j.chest.2019.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/09/2018] [Accepted: 01/03/2019] [Indexed: 11/18/2022] Open
Abstract
CASE PRESENTATION A 34-year-old woman presented for evaluation of several months of a hoarse voice and dyspnea on exertion that progressed over the last 3 years. She had a clinical diagnosis of asthma that had been treated with bronchodilators and inhaled corticosteroids for a few years. She continued to use her inhalers but with minimal symptomatic improvement. The patient was a lifelong nonsmoker with no history of drug abuse. She worked as a college professor and denied any significant environmental exposures or recent travel.
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Affiliation(s)
- Bilal A Jalil
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
| | - J Shaun Smith
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Karim El-Kersh
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, KY
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16
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Hosokawa K, von Latoszek BB, Ferrer-Riesgo CA, Iwahashi T, Iwahashi M, Iwaki S, Kato C, Yoshida M, Umatani M, Miyauchi A, Matsushiro N, Inohara H, Ogawa M, Maryn Y. Acoustic Breathiness Index for the Japanese-Speaking Population: Validation Study and Exploration of Affecting Factors. J Speech Lang Hear Res 2019; 62:2617-2631. [PMID: 31296106 DOI: 10.1044/2019_jslhr-s-19-0077] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objectives The purposes of this study were to validate the Acoustic Breathiness Index (ABI) for the Japanese-speaking population and to determine whether it is independent of factors such as sex, age, and perceptual ratings of roughness. Method First, the concurrent validity of the ABI for perceptual breathiness was evaluated on the concatenations of continuous speech and sustained vowels from 288 patients with varying degrees of dysphonia. The diagnostic accuracy was examined on 343 samples with 55 additional normophonic speakers. Second, the validity related to responsiveness-to-change was estimated on 222 samples obtained before and after interventions for 111 voice-disordered patients. Third, the relationships between the ABI and other variables (i.e., perceptual hoarseness/breathiness/roughness, sex, and age) were explored using bivariate and multivariate analyses for the 288 patients. Results First, the concurrent validity and the responsiveness-to-change validity were confirmed by strong correlation coefficients of .890 and .878, respectively. Second, the receiver operating characteristic analysis showed the area under the curve to be 0.939, indicating excellent accuracy. The ABI of 3.44 exhibited a sensitivity of 76.3% and a specificity of 94.1%. Third, although bivariate analyses revealed a weak relationship between ABI and roughness and an ABI difference by age, multiple regression analyses showed a strong relation between only ABI and breathiness, without a meaningful contribution from roughness, sex, and age factors. Conclusion The study confirmed that the ABI is an accurate and specific tool to estimate breathiness levels in the Japanese-speaking population and neither roughness, sex, nor age significantly affects the ABI.
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Affiliation(s)
- Kiyohito Hosokawa
- Department of Otorhinolaryngology, Japan Community Health Care Organization, Osaka Hospital, Japan
- Department of Otorhinolaryngology, Osaka Police Hospital, Japan
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | | | - Carlos Ariel Ferrer-Riesgo
- Informatics Research Center, Central University of Las Villas, Santa Clara, Cuba
- Department of Computer Science, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Toshihiko Iwahashi
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | | | - Shinobu Iwaki
- Department of Otorhinolaryngology and Head & Neck Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Chieri Kato
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | - Misao Yoshida
- Department of Rehabilitation, Nishinomiya Kaisei Hospital, Hyogo, Japan
| | - Masanori Umatani
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | | | - Naoki Matsushiro
- Department of Otorhinolaryngology, Osaka Police Hospital, Japan
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | - Makoto Ogawa
- Department of Otorhinolaryngology, Japan Community Health Care Organization, Osaka Hospital, Japan
- Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Japan
| | - Youri Maryn
- Speech-Language Pathology, SRH University of Applied Health Sciences, Gera, Thuringia, Germany
- European Institute for ORL, Sint-Augustinus Hospital, Antwerp, Belgium
- Faculty of Education, Health & Social Work, University College Ghent, Belgium
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17
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Abstract
The Hoarseness Guideline Update provides an evidence-based approach to a patient who presents to the clinic with hoarseness. The guidelines cover management decisions in acute and chronic dysphonia for patients of all ages before and after laryngeal examination. The present review discusses the process used to develop these guidelines, including limitations of the process and each key action statement.
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Affiliation(s)
- David O Francis
- Division of Otolaryngology-Head and Neck Surgery, Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin - Madison, 600 Highland Avenue, K4/7, Madison, WI 53792-7375, USA.
| | - Libby J Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Eye & Ear Institute, Suite 500, 203 Lothrop Street, Pittsburgh, PA 15213, USA
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18
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Earasi K, Jaworek AJ, Sataloff RT. Atypical Vocal Fold Mass. Ear Nose Throat J 2019; 99:NP52-NP53. [PMID: 30974992 DOI: 10.1177/0145561319840146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Kranthi Earasi
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Aaron J Jaworek
- Department of Otolaryngology, Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Robert T Sataloff
- Department of Otolaryngology, Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
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19
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Abstract
Dysphonia is altered voice quality, pitch, loudness, or vocal effort that impairs communication or decreases voice-related quality of life. Hoarseness is vocal roughness and a possible manifestation of dysphonia. This article uses the broader term dysphonia because it reflects of a wide range of voice complaints, with or without vocal roughness. Dysphonia is often caused by benign conditions but may also be the sentinel symptom of a serious or progressive condition requiring immediate diagnosis and management. The role of laryngeal visualization in assessment and diagnosis for these patients is critical.
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Affiliation(s)
- Sandra Stinnett
- The University of Tennessee Health Science Center, Department of Otolaryngology-Head and Neck Surgery, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA.
| | | | - Lee M Akst
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287, USA
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20
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Kallvik E, Toivonen L, Peltola V, Kaljonen A, Simberg S. Respiratory Tract Infections and Voice Quality in 4-Year-old Children in the STEPS Study. J Voice 2018; 33:801.e21-801.e25. [PMID: 29506899 DOI: 10.1016/j.jvoice.2018.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/18/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Health-related factors are part of the multifactorial background of dysphonia in children. Respiratory tract infections affect the same systems and structures that are used for voice production. The purpose of this study was to investigate if the number of respiratory tract infections or the viral etiology were significant predictors for a more hoarse voice quality. METHODS The participants were 4-year-old children who participated in the multidisciplinary STEPS study (Steps to the Healthy Development and Well-being of Children) where they were followed up from pregnancy or birth to 4 years of age. Data were collected through questionnaires and a health diary filled in by the parents. Some of the children were followed up more intensively for respiratory tract infections during the first 2 years of life, and nasal swab samples were taken at the onset of respiratory symptoms. Our participants were 489 of these children who had participated in the follow-up for at least 1 year and for whom data on respiratory tract infections and data on voice quality were available. RESULTS The number of hospitalizations due to respiratory tract infections was a significant predictor for a more hoarse voice quality. Neither the number of rhinovirus infections nor the number of respiratory syncytial virus infections was statistically significant predictors for a more hoarse voice quality. CONCLUSIONS Based on our results, we would suggest including questions on the presence of respiratory tract infections that have led to hospitalization in the pediatric voice anamnesis. Whether the viral etiology of respiratory tract infections is of importance or not requires further research.
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Affiliation(s)
- Emma Kallvik
- Logopedics, Faculty of Arts, Psychology and Theology, Abo Akademi University, Åbo, Finland; Turku Institute for Child and Youth Research (Cyri), University of Turku, Åbo, Finland.
| | - Laura Toivonen
- Turku Institute for Child and Youth Research (Cyri), University of Turku, Åbo, Finland; Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Åbo, Finland
| | - Ville Peltola
- Turku Institute for Child and Youth Research (Cyri), University of Turku, Åbo, Finland; Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Åbo, Finland
| | - Anne Kaljonen
- Turku Institute for Child and Youth Research (Cyri), University of Turku, Åbo, Finland
| | - Susanna Simberg
- Logopedics, Faculty of Arts, Psychology and Theology, Abo Akademi University, Åbo, Finland; Turku Institute for Child and Youth Research (Cyri), University of Turku, Åbo, Finland; Department of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Oslo, Norway
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21
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Hamadani S, Wang B, Gupta S. IgG4-related disease presenting as hoarseness and postcricoid ulcer. Ann Allergy Asthma Immunol 2017; 120:211-212. [PMID: 29217085 DOI: 10.1016/j.anai.2017.10.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/21/2017] [Accepted: 10/25/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Syeda Hamadani
- Division of Basic and Clinical Immunology, University of California, Irvine, Irvine, California
| | - Beverly Wang
- Department of Pathology & Laboratory Medicine, University of California, Irvine, Irvine, California
| | - Sudhir Gupta
- Division of Basic and Clinical Immunology, University of California, Irvine, Irvine, California.
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22
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House SA, Fisher EL. Hoarseness in Adults. Am Fam Physician 2017; 96:720-728. [PMID: 29431404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more serious systemic, neurologic, or cancerous conditions. Medication-induced hoarseness is common and should be considered. The initial evaluation begins with a targeted history and physical examination, while also looking for signs of potential systemic etiologies. Treatment should begin with voice rest, especially avoidance of whispering, and conservative management directed toward a presumptive cause. For example, proton pump inhibitors are appropriate for hoarseness due to reflux, and proper vocal hygiene is recommended for vocal abuse-related indications. In the absence of a clear indication, antibiotics, oral corticosteroids, and proton pump inhibitors should not be used for the empiric treatment of hoarseness. Direct visualization of the larynx and vocal folds, commonly mislabeled as vocal cords, should be performed within three months if an etiology has not been determined or if conservative management has been ineffective. Patients who experience symptoms lasting longer than two weeks and who have risk factors for dysplasia (e.g., tobacco use, heavy alcohol use, hemoptysis) may require earlier laryngoscopic evaluation. Voice therapy is effective for improving voice quality in patients with dysphonia if conservative measures are unsuccessful, and it can also be helpful for prophylaxis in high-risk individuals (e.g., vocalists, public speakers). Surgical management is indicated for laryngeal or vocal fold dysplasia or malignancy, airway obstruction, or benign pathology resistant to conservative treatment.
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Affiliation(s)
- Steven A House
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Eric L Fisher
- University of Louisville School of Medicine, Louisville, KY, USA
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23
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Ono Y, Kazuma Y, Ochi Y, Matsuoka R, Imai Y, Ishikawa T. Two Cases of Neurolymphomatosis with Fatal Bilateral Vocal Cord Paralysis that were Diagnosed with 18F-fluorodeoxyglucose Positron Emission Tomography (FDG PET)/CT. Intern Med 2017; 56:1193-1198. [PMID: 28502935 PMCID: PMC5491815 DOI: 10.2169/internalmedicine.56.6998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Neurolymphomatosis is a rare entity defined as nerve infiltration by neurotropic abnormal lymphocytes which can lead to the development of neuropathy, with typical presentations including pain, hypoesthesia, paresthesis and palsy. We herein report two cases where critical bilateral vocal cord paralysis due to neurolymphomatosis in recurrent nerves occurred in refractory Burkitt lymphoma and adult T-cell lymphoma patients. High-dose methotrexate and intrathecal chemotherapy injection for the nervous lesions were ineffective, and the patients died. Neurolymphomatosis of the recurrent nerve is an emergent and difficult complication and should be suspected when sudden onset of aphasia, hoarseness or shortness of breath is found in refractory lymphoma patients.
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Affiliation(s)
- Yuichiro Ono
- Department of Hematology, Kobe City Medical Center General Hospital, Japan
| | | | - Yotaro Ochi
- Department of Hemato-oncology, Kyoto University, Japan
| | - Ryosuke Matsuoka
- Department of Pathology, Kobe City Medical Center General Hospital, Japan
| | - Yukihiro Imai
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Japan
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24
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Affiliation(s)
- D J Verret
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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25
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Cooper L, Quested RA. Hoarseness: An approach for the general practitioner. Aust Fam Physician 2016; 45:378-381. [PMID: 27622226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Hoarseness is a common presenting complaint that can be difficult to assess and treat in the general practitioner's rooms. This is because of the large number of differential diagnoses and the ability to perform only a limited examination without direct visualisation of the area. An important skill is to be able to identify the patients of concern who may require urgent referral to an otorhinolaryngologist. OBJECTIVE The aims of this article are to outline the basic assessment of the patient presenting with hoarseness; ascertain which patients require specialist referral; and discuss treatment for some benign causes of hoarseness. DISCUSSION Hoarseness can be a diagnostic dilemma and therefore difficult to treat. Vocal hygiene and speech therapy are valuable treatment tools for many benign conditions. Any patient with red flag features on history, or persistent hoarseness, should be referred to an otorhinolaryngologist.
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26
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Bolzoni Villaret A, Piazza C, Rossini M, Peretti G. Triple mucosal bridge of the glottis. Otolaryngol Head Neck Surg 2016; 137:678-9. [PMID: 17903592 DOI: 10.1016/j.otohns.2007.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 03/15/2007] [Indexed: 11/29/2022]
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27
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Affiliation(s)
- Sara Immerman
- New York University School of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
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28
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Affiliation(s)
- Regina Helena Garcia Martins
- Ophtalmology, Otorhinolaryngology and Head and Neck Surgery, Botucatu Medical Shool, Univ Estadual paulista, Botucatu, São Paulo, Brazil
| | - Adriana Bueno Benito Pessin
- Ophtalmology, Otorhinolaryngology and Head and Neck Surgery, Botucatu Medical Shool, Univ Estadual paulista, Botucatu, São Paulo, Brazil
| | - Norimar Hernandes Dias
- Ophtalmology, Otorhinolaryngology and Head and Neck Surgery, Botucatu Medical Shool, Univ Estadual paulista, Botucatu, São Paulo, Brazil
| | - Roberto Tunes
- Ophtalmology, Otorhinolaryngology and Head and Neck Surgery, Botucatu Medical Shool, Univ Estadual paulista, Botucatu, São Paulo, Brazil
| | - Thais Gomes Abrahão Elias
- Ophtalmology, Otorhinolaryngology and Head and Neck Surgery, Univ. Estadual Paulista, Botucatu, São Paulo, Brazil
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29
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van der Poel NA, Vleming M, Bok JW. [A smoker with hoarseness and a swelling of his neck]. Ned Tijdschr Geneeskd 2016; 160:A9848. [PMID: 27096477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 68-year-old man was referred to the Department of Otolaryngology because of a swelling of his neck and hoarseness. CT imaging of his neck revealed a cystic mass in the larynx as well as in the neck, with an air-fluid level. The diagnosis 'laryngopyocele' was made.
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30
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Aggarwal S, Kaushal V, Singla S, Sen R. Primary glottic malignant melanoma of the larynx (PGMML): a very rare entity. BMJ Case Rep 2015; 2015:bcr2015211317. [PMID: 26590185 PMCID: PMC4680593 DOI: 10.1136/bcr-2015-211317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2015] [Indexed: 01/23/2023] Open
Abstract
Primary glottic malignant melanoma of the larynx (PGMML) is a very rare clinical entity with less than 20 cases reported in the literature so far. The most frequently reported subsite in primary malignant melanomas of the larynx is the supraglottic larynx. The vocal cord as a subsite for primary malignant melanoma is very rare. The present case is a primary glottic malignant melanoma involving both vocal cords. PGMML may present early due to associated hoarseness of voice, unlike other non-cutaneous melanomas in the head and neck. Non-cutaneous malignant melanomas in the head and neck are historically very aggressive in nature and known for poor outcomes and survival. Most non-cutaneous melanomas described in the literature have been superficial spreading or ulcerative in nature, unlike the present case, in which proliferative, polypoidal growth was seen. No associated risk factor was present in this case. Every reported case of this rare entity further adds to the better understanding of tumour biology and expression.
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Affiliation(s)
- Sumeet Aggarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vivek Kaushal
- Department of Radiation Oncology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Sujata Singla
- Department of Surgery, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Rajeev Sen
- Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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Zanwar VG, Gambhire PA, Choksey AS, Rathi PM. Killian-Jamieson Diverticulum: Cervical Oesophageal Diverticulum. J Assoc Physicians India 2015; 63:65-66. [PMID: 29900714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Killian-Jamieson (K-J) diverticulum is an outpouching from the lateral wall of the proximal cervical oesophagus and is less commonly encountered compared to Zenker’s diverticulum (ZD). These diverticulae arise between the fibers of the cricopharyngeus muscle superiorly and longitudinal muscle of the oesophagus inferiorly. In this report we present a case of a symptomatic Killian Jamieson diverticulum and review the clinical presentation, differential diagnosis and radiological findings that distinguish it from the more common Zenker’s diverticulum.
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Abstract
OBJECTIVE Herpes zoster is a neurocutaneous disease resulting from the reactivation of endogenous varicella-zoster virus (VZV) in dorsal sensory or cranial nerve ganglia. Rarely, this infection manifests without the characteristic dermatomal rash, a condition termed zoster sine herpete. Viral spreading of herpes zoster in the head and neck may manifest as various signs and symptoms because of the multiple possible combinations of cranial neuropathies. With only six cases reported in the English literature up to now, isolated neuropathies of the vagus nerve in the absence of cutaneous lesions tend to be misdiagnosed as idiopathic laryngeal paralysis. METHODS We report a case of herpes zoster of the larynx in an 80-year-old man presenting with sore throat, dysphagia, and hoarseness. RESULTS Endoscopic examination revealed unilateral vocal fold paralysis, pooling of secretions, and mucosal vesicles of the hemilarynx. After the diagnosis of VZV infection with polymerase chain reaction (PCR) testing, the patient was treated with valacyclovir and corticosteroids, leading to complete recovery after 2 months. CONCLUSIONS Herpes zoster of the larynx is an uncommon condition that should be included in the differential diagnosis of laryngeal paralysis of idiopathic cause. We recommend performing a thorough examination of the pharyngolaryngeal structures and ordering PCR testing as the diagnostic method of choice.
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Affiliation(s)
- Sarah Hosseini
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Faisal Zawawi
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada; Department of Otolaryngology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jonathan Young
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
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Abstract
A 68-year-old man presented with a six-month history of painless dysphagia, malnutrition, anorexia and vocal hoarseness. Signs of severe mitral regurgitation and preserved left atrial dimensions were discovered on transthoracic echocardiography. However, electrocardiography and chest radiography were strongly suggestive of left atrial enlargement. Further investigations confirmed extrinsic compression of the oesophagus, which caused the dysphagia. Computed tomography of the throrax revealed a giant left atrium that was not appreciated on echocardiography. Hoarseness was found to be caused by right recurrent laryngeal nerve palsy. Ortner’s syndrome, which describes the occurrence of vocal hoarseness due to a cardiopulmonary disease that results in the compression of the left recurrent laryngeal nerve, is usually associated with severe mitral stenosis. Herein, we report an unusual case of Ortner’s syndrome caused by a giant left atrium, which resulted from severe mitral regurgitation, causing extrinsic oesophageal compression and right recurrent laryngeal nerve palsy. Physicians should remain cognisant of cardiovascular disorders as uncommon causes of painless dysphagia or vocal hoarseness.
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Yang J, Zhou W, Wen S, Luo Q. [A case of foreign body out of esophagus induced hoarseness]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 50:338-339. [PMID: 26081095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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35
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Lu H, Sima G, Yin P. [Hoarse voice as the first symptom of the thyroglossal cyst: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 50:67-68. [PMID: 25764934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Sima G, Deng J, Qi W, Sun Y. [Hoarseness caused by Ortner's syndrome: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 49:1036-1037. [PMID: 25623877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Oksuz S, Pektas E, Yavuz M, Aksungur N, Cayir Y, Akcay MN. An unusual cause of hoarseness: hydatid cyst of the thyroid. Trop Biomed 2013; 30:642-644. [PMID: 24522134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hydatid cyst is a parasitic infestation that is distributed world-wide. It may be found in nearly any part of the body, most often in the liver and the lungs, but occasionally in other structures such as the thyroid gland. Thyroid gland is very rarely involved by this parasitic infection even in Turkey where the echinococcal disease is endemic. In this article we report a very rarely encountered case of thyroid cyst revealed by hoarseness, and underwent subtotal thyroidectomy and diagnosed as primary hydatid cyst disease by histological studies.
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Affiliation(s)
- S Oksuz
- Ataturk University, Faculty of Medicine, Department of Family Medicine, Erzurum, Turkey
| | - E Pektas
- Ataturk University, Faculty of Medicine, Department of Family Medicine, Erzurum, Turkey
| | - M Yavuz
- Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - N Aksungur
- Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Y Cayir
- Ataturk University, Faculty of Medicine, Department of Family Medicine, Erzurum, Turkey
| | - M N Akcay
- Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
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Geraci G, Cupido F, Lo Nigro C, Sciuto A, Sciumè C, Modica G. Postoperative laryngeal symptoms in a general surgery setting. Clinical study. Ann Ital Chir 2013; 84:377-383. [PMID: 23918003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Vocal cord injuries (VI), postoperative hoarseness (PH), dysphonia (DN), dysphagia (DG) and sore throat (ST) are common complications after general anesthesia; there is actually a lack of consensus to support the proper timing for post-operative laryngoscopy that is reliable to support the diagnosis of laryngeal or vocal fold lesions after surgery and there are no valid studies about the entity of laryngeal trauma in oro-tracheal intubation. Aim of our study is to evaluate the statistical relation between anatomic, anesthesiological and surgical variables in the case of PH, DG or impaired voice register. MATERIALS AND METHODS 50 patients (30 thyroidectomies, 8 videolaparoscopic cholecistectomies, 2 right emicolectomies, 2 left emicolectomies, 1 gastrectomy, 1 hemorrhoidectomy, 1 nefrectomy, 1 diagnostic videothoracoscopy, 1 superior right lung lobectomy, 1 appendicectomy, 1 incisional hernia repair, 1 low anterior rectal resection, 1 radical hysterectomy) underwent clinical evaluation and direct laryngoscopy before surgery, within 6 hours, after 72 hours and after 30 days, to evaluate motility and breathing space, phonatory motility, true and false vocal folds and arytenoids oedema. We evaluated also mean age (56.6 ± 3.6 years), male:female ratio (1:1.5), cigarette smoke (20%), atopic comorbidity (17/50 = 34%), Mallampati class (32% 1, 38% 2, 26% 3, 2% 4), mean duration of intubation (159 minutes, range 50 - 405 minutes), Cormack-Lehane score (34% 1, 22% 2, 22% 3, 2% 4), difficult intubation in 9 cases (18%). No complication during the laryngoscopy were registered. We investigated the statistic relationship between pre and intraoperative variables and laryngeal symptoms and lesions. RESULTS In our experience, statistically significant relations were found in prevalence of vocal folds oedema in smokers (p < 0.005), self limiting DG and DN in younger patients (p < 0.005) and in thyroidectomy (p < 0.01), DG after thyroidectomy (p < 0.01). The short preoperative use of steroids and antihistaminic to prevent allergic reactions appears not related to reduction or prevention of DN, DG, PH and ST. No statistical relation in incidence of postoperative complications was found for the prolonged intubation, gastro-esophageal reflux, BURP manoeuvre (backward upward right sided pressure) and Mallampati and Cormack-Lehane class more than 2, maintenance with sevoflurane 2% and use of stilet. CONCLUSIONS Direct laryngoscopy is essential for the detection of arytenoid lesions after orotracheal intubation for general anesthesia. In our opinion, a part of temporary post-operative DN or PH is due to monolateral or bilateral arytenoids oedema, secondary to prolonged or difficult orotracheal intubation, valuable with laryngoscopy 72 hours after surgery. Is necessary to adjunct these complications in the surgical informed consensus scheme.
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You LG, Zhang KH, Zhang XA. [Clinical analysis of hypothyroidism hoarseness defective diagnosis]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 48:596-597. [PMID: 24313212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
CONCLUSION Closed reduction is an effective and safe treatment method for arytenoid dislocation. Early closed reduction of arytenoid cartilage plays an important role in voice recovery. OBJECTIVE The study reviewed the clinical characteristics of arytenoid dislocation with the aim of identifying factors influencing voice recovery in the closed reduction of arytenoid dislocation. METHODS A retrospective chart review was performed at Chonnam National University Hospital for the period from January 2007 to March 2012. RESULTS Eleven patients with arytenoid dislocation were identified. The causes of arytenoid dislocation were intubation (n = 9) and blunt trauma (n = 2). All cases of arytenoid dislocations were treated by closed reduction. There were no major complications resulting from surgical intervention. Six of the 11 patients (54.5%) regained normal voice and vocal fold movement after closed reduction. Five patients (45.5%) had significant voice improvement postoperatively. In arytenoid dislocation due to blunt trauma, the duration between injury and voice improvement was much longer than in other causes of arytenoid dislocation (p = 0.012).
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Affiliation(s)
- Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, South Korea
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Affiliation(s)
- Christopher J Hartnick
- Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
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Wei XD, Wei YH, He J. [One case of dermatomyositis with hoarseness and dyspnea as first symptom]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 47:427. [PMID: 22883592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Matteucci MLS, Rescigno G, Capestro F, Torracca L. Aortic arch patch aortoplasty for Ortner's syndrome in the age of endovascular stented grafts. Tex Heart Inst J 2012; 39:401-404. [PMID: 22719154 PMCID: PMC3368474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We present a case of hoarseness in a 68-year-old man with a post-traumatic saccular aortic arch aneurysm, effort dyspnea, and dysphonia. Oropharyngeal examination and flexible nasal endoscopy revealed left vocal fold palsy, with the left fold lying in the paramedian position. On account of these and other findings, we made the diagnosis of Ortner's syndrome. We treated the patient surgically by endoluminal repair with a Dacron patch. The postoperative course was uneventful. No additional procedure was necessary on the vocal folds, since he showed prompt postoperative speech improvement.We believe that an accurate evaluation should be made before switching a patient to endovascular treatment. Our case shows that careful preoperative planning, coupled with the most recent cerebral protection techniques, can enable a safe and straightforward surgical solution to a complex anatomic problem.
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Affiliation(s)
- Marco L S Matteucci
- Department of Cardiac Surgery, Ospedali Riuniti di Ancona, 60020 Ancona, Italy.
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Li XD, Yan XR, Lü M. [Take hoarseness as the cardinal symptom of one thoracic aortic aneurysm case]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46:1043. [PMID: 22336021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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46
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Li L, Yang TF, Xu ZM. [Analysis of the causes of 117 infants with persistent hoarseness]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46:275-278. [PMID: 21624244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To explore the causes of persistent hoarseness in infants. METHODS One hundred and seventeen infants with persistent hoarseness treated in the department of otorhinolaryngology in Children's Hospital of Fudan University between June 2008 and July 2010 were retrospectively analyzed (all patients received antibiotic therapy for 2 weeks and the symptoms were not relieved after that). The patients were divided into three groups according to the age at first visit: 22 newborns, < 6 months old in 60 cases, < 12 months old in 35 cases. All patients had video laryngoscope examinations. Some of them received CT scan, cardiac ultrasonography and pathological examination in additional. The diagnosis was established by clinical history and imaging modalities, and the causes were analyzed subsequently. RESULTS Among the 117 patients, 45 cases were vocal hypertrophy and hyperplasia (37.81%), 39 cases were vocal cord paralyses (32.78%), 7 cases were laryngeal hemangiomas (5.89%), 4 cases were laryngeal webs and cyst (3.36%), 2 cases were vocal cord polyps (1.68%), 2 cases were glottic incompetence (1.68%), 1 case was laryngeal papillomas(0.84%), 1 case was vocal code granulomas (0.84%), 1 case was glottis restricted by neck lymphangioma (0.84%); 4 cases were undetermined and 13 cases were no abnormalities. The percentage of patients with congenital heart diseases (19 cases) in vocal cord paralysis was 48.72%. The proportion of vocal cord paralysis in younger group was higher than that in elder one, their percentage were 50.00%, 36.67% and 17.14% respectively (χ(2) = 7.18, P < 0.05). CONCLUSIONS A variety of causes can lead to persistent hoarseness in infants. The majority of them are vocal hypertrophy and hyperplasia, followed by vocal cord paralyze. Vocal cord paralysis is more common in younger infants than in elder ones, and the main causes are post-cardiac surgery and congenital heart disease.
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Affiliation(s)
- Li Li
- Voice Assessment Center, Department of Otorhinolaryngology, Children's Hospital of Fudan University, Shanghai 201102, China
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Hjort M, Ljungberg M, Jakobsen L. [Late development of carotid dissection after traffic accident]. Ugeskr Laeger 2011; 173:658-659. [PMID: 21362395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This case study discusses the clinical manifestations of carotid dissection in a 58-year-old male admitted with minor injuries after a traffic accident. Within 24 hours the patient developed Horner syndrome, hoarseness and possible facial nerve palsy. A CT-angiogram showed dissection of the left carotid artery in its extracranial part. The patient was treated with anticoagulants and transferred to a neurological ward for further examination. Follow-up with CT angiography was scheduled for five months later.
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Affiliation(s)
- Mathias Hjort
- Ortopædkirurgisk Afdeling, Herlev Hospital, 2370 Herlev, Denmark.
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Abstract
Dysphonia in patients with bronchial asthma is generally ascribed to vocal-cord abnormalities or steroid myopathy secondary to inhaled corticosteroids. Herein, we report the case of a 55-year-old male patient - a diagnosed case of bronchial asthma being on inhaled corticosteroids - who presented with dysphonia and was diagnosed to be suffering from Aspergillus laryngotracheobronchitis.
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Gamal WL, Abdel Khalek MS, Crawford BE, Kandil EH. Hoarseness due to a thyroid mass. Symptomatic thyroid schwannoma. Neth J Med 2011; 69:39-40. [PMID: 21325701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- W L Gamal
- Department of Surgery, Division of Endocrine and Oncologic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
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50
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Gao L, Li WR, Ou XY. [Report of a case with long time persisted esophagus foreign associated with hoarse]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:772. [PMID: 21092679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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