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The Second Half of the Nineteenth Century
Published in Arturo Castiglioni, A History of Medicine, 2019
Laryngology is usually combined with otology and rhinology as a clinical specialty, in university teaching, and in scientific publishing. These specialties made their most rapid growth — a truly remarkable one — in the two decades bordering on the turn of the century. Major contributory factors were the invention of the laryngoscope, the application of the discovery in 1884 of the local anesthetic effects of cocaine, and of X-rays in both diagnosis and treatment.
Phonosurgery
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Prior to any surgical intervention, complete assessment of patients with a voice disorder should minimally include a complete history (typically as informative as the physical examination) and thorough physical examination. Critical aspects of the physical examination include lateral neck palpation, thyroid examination, observation of laryngeal elevation, tongue and palate mobility, respiratory status, and nasal examination. Once these areas are sufficiently evaluated, the larynx may then be imaged via office-based indirect laryngoscopy. Indirect laryngoscopes (either flexible or rigid) are preferably combined with video recording, which is of crucial importance for immediate review of physical findings as well as comparative evaluation following interventions. Stroboscopy has been a standard of vocal fold cover evaluation, though this technology is inherently weakened by its requirement of normal vibratory patterns, which is discussed in further depth in Chapter 61, Assessment and examination of the larynx and Chapter 62, Evaluation of the voice. High-speed videolaryngoscopy is a useful adjunct in the diagnosis of voice disorders. Additional examination modalities include laryngeal electromyography and voice measurements (both quantitative and qualitative). The formation of multidisciplinary voice clinics allows an academic and scientific approach to voice disorders and greater emphasis on an evidence-based approach to laryngology.
In-clinic procedures
Published in Declan Costello, Guri Sandhu, Practical Laryngology, 2015
Nancy Solowski, Greg Postma, Paul Weinberger
Clinic-based procedures and laryngology are a perfect match, and the average laryngologist’s practice involves a significant amount of in-clinic work. In fact, the field of laryngology developed historically as an out-patient (clinic-based) discipline well over 100 years ago. This initial period where laryngology was practiced almost entirely outside of the operating room, over time transitioned to largely operating theatre-based procedures. This was largely due to better equipment available and improving general anaesthesia techniques. Most recently, with the rising costs of medical care and the advent of newer technology, in-clinic laryngology procedures have again become commonplace.
Effect of COVID-19 on the incidence of postintubation laryngeal lesions
Published in Baylor University Medical Center Proceedings, 2023
Madison Buras, Nicole DeSisto, Randall Holdgraf
Approval for this retrospective chart review was obtained through the institutional review board of Baylor Scott & White Medical Center in Temple, Texas. Patients included in this study were those with swallowing, voice, or airway symptoms identified by a primary physician, otolaryngologist, or speech-language pathologist and who underwent a FEES exam from August 14, 2020, to August, 18, 2021, by either the speech pathology team or the laryngology team. Patients were excluded from this study if they (1) did not have any evaluation with flexible endoscopy; (2) were previously diagnosed with a vocal cord injury, dysfunction, or lesion; or (3) previously received radiation to the larynx. Sixty-two patient charts were reviewed. Ten patients were excluded: one due to laryngeal injury from preexisting Blakemore tube placement; four due to prior radiation therapy to the larynx; one due to prior history of vocal cord paralysis after coronary artery bypass grafting; one due to vocal cord paralysis associated with myasthenia gravis; and three due to the presence of laryngeal malignant lesions. After appropriate exclusions, 25 patients in the COVID-19 group and 27 patients in the non-COVID group were included for data review (n = 52).
Vocal cord dysfunction/inducible laryngeal obstruction: novel diagnostics and therapeutics
Published in Expert Review of Respiratory Medicine, 2023
Joo Koh, Debra Phyland, Malcolm Baxter, Paul Leong, Philip G Bardin
Behavioral intervention by speech pathologists sub-specializing in functional laryngology is the first line treatment for VCD/ILO. This approach is known by other terms including laryngeal control training and respiratory retraining therapy. It describes a comprehensive behavioral intervention focusing on breathing and/or conscious vocal fold reposturing exercises, which aim to reduce abnormal breathing patterns to reduce laryngeal/supraglottic constriction or respiratory/phonatory incoordination [107–109]. It is most frequently delivered by speech pathologists, although it can be delivered by respiratory therapists or physiotherapists in different healthcare systems. This is often provided during an initial evaluation session followed by three to four treatment sessions [96].
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.