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History Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
The palatine tonsils form part of Waldeyer's ring of lymphoid tissue in the pharynx along with the adenoid pad, lingual tonsils and mucosa-associated lymphoid tissue (MALT). They sit within the tonsillar fossa, bordered anteriorly by the palatoglossal arch (anterior pillar) and posteriorly by the palatopharyngeal arch (posterior pillar). Acute tonsillitis involves inflammation of the palatine tonsillar tissue and is extremely common, especially in the paediatric population; and contributes to missed days of school and work every year. There are other causes of ‘sore throats’ that are worth bearing in mind including viral upper respiratory tract infections, pharyngitis, and in the adult population, Candida, gastro-oesophageal reflux and malignancy.
Voice Disorders and Laryngitis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Laryngitis is a descriptive term indicating a degree of erythema, oedema, epithelial change that may include ulceration, leukoplakia, and/or stiffness of the mucosa of the vocal fold. Often there is an increased amount of thick mucus present. Most acute laryngitis is associated with upper respiratory tract infections. Chronic laryngitis has close links with smoking, alcohol, reflux, occupational exposures, social activities, allergies, and vocal/throat hygiene. The voice is usually hoarse (rough, strained, breathy, or whispery), which may be due to vocal fold stiffness from the inflammatory process and/or secondary to muscle tension imbalance. The majority of acute infections are self-limiting. Treatment of chronic laryngitis consists of voice hygiene (VH) with reduced use/abuse and rest.
Building the patient profile
Published in Stephanie Martin, Working with Voice Disorders, 2020
Optimal voice use, whether for speech or singing, requires a healthy and mobile vocal tract, with sufficient stamina and flexibility for the patient’s daily voice tasks. It is therefore essential to identify any intermittent, chronic or acute factors that may compromise the health of the mucosal linings and be manifest as irritation, increased secretions, throat clearing, gastro-oesophageal reflux disorder (GORD) or laryngopharyngeal reflux (LPR). Patients may report episodes of no voice disturbance but of discomfort, dryness, irritation, dry cough, throat clearing, a feeling of a ‘lump in the throat’, difficulty swallowing or neck discomfort. Lenderking et al. (2003) described many of these symptoms as being those commonly associated with LPR.
Partial vs full glottic view with CMACTM D blade intubation of airway with simulated cervical spine injury: a randomized controlled trial
Published in Expert Review of Medical Devices, 2023
Chao Chia Cheong, Soon Yiu Ong, Siu Min Lim, Wan Zakaria Wan A., Marzida Mansor, Sook Hui Chaw
Previous report associates higher risk of mucosal injury in hyper angulated blade with reduced space available for tracheal tube advancement [30]. The tip of CMACTM D blade is positioned proximally from vallecula when reducing POGO to <50%, thus create more space to negotiate tracheal tube through glottis. The maneuver should theoretically lower the risk of mucosal trauma. However, the incidence of oral trauma in our study is higher in group POGO< 50% compared to group POGO 100% (42% vs 29%; p = 0.15). All cases of oral trauma in our study were self-limiting mucosal injuries which required no interventions. The higher incidence of mucosal injuries in group POGO < 50% in our study may be attributed to a two steps procedure which involved advancement of the CMACTM D blade tip on the vallecula, followed by withdrawal the of blade dorsally to reduce POGO opening. In addition to difficult video laryngoscopy and tracheal intubation, sore throat and hoarseness of voice may be a complication of laryngology surgery. One patient underwent lingual tonsillectomy in our study but was uneventful. The patients who develop sore throat and hoarseness of voice have complete resolution of symptoms by post operative day three.
Clinical and demographic differences in the willingness to use self-administered at-home COVID-19 testing measures among persons with opioid use disorder
Published in Substance Abuse, 2022
Colleen B. Mistler, Matthew Sullivan, Jeffrey A. Wickersham, Michael M. Copenhaver, Roman Shrestha
We measured participants’ willingness to engage in various self-administered at-home COVID-19 testing methods. Specifically, participants were asked to indicate “yes” or “no” to identify their willingness to use: (a) throat culture test (by rubbing a cotton swab on the back of the throat); (b) saliva test (by spitting into a test tube); and (c) blood prick test (by pricking a finger and collecting the sample onto a test strip) for COVID-19. The basis of these questions was hypothetical, posing a scenario in which participants would apply to receive a confidential self-administered at-home COVID-19 test, complete the instructed procedures, mail the sample to a laboratory, and then review results electronically and privately. Additional COVID-19 questions were included, asking participants if they had ever been tested for COVID-19 and experiences with healthcare and treatment for those who tested positive.
Prevalence of vocal fatigue and associated risk factors in university teachers
Published in Speech, Language and Hearing, 2022
Shruthi Padmashali, Srikanth Nayak, Usha Devadas
Furthermore, experiencing acid reflux was found to be significantly associated with reporting voice problems in university teachers. Similar findings were reported in the literature, indicating a strong association between experiencing voice problems and having Laryngopharyngeal reflux (LPR) (Cantor-Cutiva et al., 2022a; Devadas, Bellur, & Maruthy, 2017; Koufman, Radomski, Joharji, Russell, & Pillsbury, 1996; Lowden, McGlashan, Steel, Strugala, & Dettmar, 2009; Pribuisiene, Uloza, Kupcinskas, & Jonaitis, 2006; Sataloff, 2008). According to these authors, LPR induces functional laryngeal movement disorders such as muscle tension dysphonia, laryngospasm, and frequent throat clearing. Frequent throat clearing can cause laryngeal mucosa damage and a change in voice quality. This could be the reason for the significant association between acid reflux symptoms in university teachers and vocal fatigue.