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Paediatrics
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Paula Coyle, Eishaan Bhargava, Adnan Darr, Karan Jolly, Kate Stephenson, Michael Kuo
Differential diagnoses (paediatric): Chronic laryngitisVocal cord nodulesVocal cord polyps
Stammering and voice
Published in Trudy Stewart, Stammering Resources for Adults and Teenagers, 2020
Mechanical: Pushing, forcing, hard attack are all examples of ‘abuse’ behaviours that can cause laryngeal trauma and muscle tension dysphonia’s. Dryness, ‘tickling’ sensation or a feeling of a lump in the throat (globus) can contribute to coughing or throat-clearing behaviour. Persistent and repetitive behaviours such as these can lead to the development of vocal cord nodules. Poor posture for speaking, smoking and alcohol intake can also be considered as mechanical behaviours that impact voice performance and laryngeal health.
Hypopharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Patrick J. Bradley, Neeraj Sethi
Flexible nasendoscopy will identify the majority of tumours (phonation or Valsalva can open the piriform fossae for better visualisation). Vocal cord fixation is vital to staging the primary tumour (see Table 10.9).
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
Although recent research has examined the specific incidence of mild to severe vocal cord lesions, the data vary greatly among studies. Data suggest that the incidence of postextubation laryngeal injury ranges from 41% to 83%, with a variety of factors identified as increasing risk.1–3 This variability suggests that additional investigation into the prevalence and possible causes of laryngeal injury is needed so that prevention guidelines can be established. Previous studies have demonstrated that patients with COVID-19 are more susceptible to mucosal injuries. Mechanisms that may increase risk include pronation, prothrombotic and antifibrinolytic states affecting laryngotracheal microcirculation, weakened mucosa due to high viral replication and chronic high-dose steroid use, lower arterial oxygen partial pressure to fractional inspired oxygen ratio causing increased hypoxia of the laryngotracheal mucosa, and comorbidities.4
Impact of pregnancy on voice: a prospective observational study
Published in Logopedics Phoniatrics Vocology, 2022
Burak Ulkumen, Burcu Artunc-Ulkumen, Onur Celik
Many significant anatomic and metabolic changes occur throughout the course of pregnancy [1]. These changes peak by the end of the third trimester. During pregnancy, total body water seriously increases due to increased cardiac output and blood volume. Composition of this excess fluid changes according to the trimester. Specifically, plasma volume increases during the first and second trimester while extravascular fluid increases during the last trimester [2]. Therefore, edema peaks in the third trimester, which is expected to enhance the mass of mucosal membranes of the upper airway, including the larynx. We already know that vocal cords play a direct role in voice production, while the remaining upper airway plays a role in the resonance characteristics of a human voice. For this reason, it is expected that the voices of pregnant women would be affected by edema of the vocal cord mucosa and remaining upper respiratory tract mucosa. During the postpartum period, plasma volume decreases abruptly while interstitial fluid decreases gradually, which may cause gradual recovery of subjective and objective voice parameters. Although edema of the upper airway is the main factor paving the way for gestational voice changes, some other pregnancy related factors like diaphragmatic elevation and increased chest diameter may also affect voice quality [1].
Tracheotomy as a predictor of remission and demise for juvenile-onset recurrent respiratory papillomatosis
Published in Acta Oto-Laryngologica, 2022
Zijie Niu, Yang Xiao, Lijing Ma, Xiaoli Qu, Yuge Wang, Sihan Zhou, Jun Wang
The disease often appears in the vocal cords, false vocal cords, epiglottic larynx, and subglottis. The main clinical manifestation is hoarseness. If papillomas obstruct the airway seriously, it could cause dyspnea and even threaten children’s life. The laryngeal cavity of young children is narrow, which increases the probability of dyspnea. Tracheotomy is a classic treatment to keep the airway adequate in emergency and enhance the safety during the operation [2]. Nonetheless, tracheotomy disrupts airway mucosa, which will increase the squamo-columnar junction, provide a site suitable for seeding of virus particles and papillomas, and even promote lower airway dissemination of papillomas [3,4]. The pros and cons of tracheotomy seem to be recognized, and it has become an accepted view that tracheotomy should be avoided in patients with JORRP and every effort should be made to remove the tracheal cannula when it is unavoidable [5]. Although it has been reported that tracheotomy may be associated with poor prognosis [6], there is relatively limited information assessing the exact impact of tracheotomy on prognosis for JORRP.