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Acquired Laryngotracheal Disease
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Vocal cord nodules in children may cause hoarseness and are best managed conservatively, ideally with the help of a speech and language therapist (SALT). Cysts, polyps and very rarely neoplasms may occur in the larynx and present with dysphonia. Vocal cord palsy may be iatrogenic following thoracotomy with injury to the recurrent laryngeal nerve. It is usually temporary, but long-standing cases may respond to injection techniques.
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.
The effect of voice disorders on lexical tone variation: Exploratory study in an African language
Published in International Journal of Speech-Language Pathology, 2020
Gail Jones, Anita van der Merwe, Lynda Olinger, Mia le Roux, Jeannie van der Linde
Experimental participants P1 (G1R1B0A0S0I1), P2 (G2R2B2A1S1I1), P4 (G2R1B1A1S2I1) and P5 (G2R2B1A1S0I0) had mean scores that were within the range of the control participants (see Table IV and Figure 2). Of the experimental participants, P1 attained the highest mean score and the highest score of 19/20 across judges (see Figure 2). This participant, who was the only experimental participant with a rating of “one” for Grade (G), presented with a mild voice disorder due to a vocal fold nodule. The “grade” ratings on the GRBASI scale of the other three participants, mentioned above, were G2. Their highest scores were 17/20, 18/20 and 18/20 and mean scores across judges were 15.4, 17.0 and 16.0, respectively. P2 attained slightly lower scores than P4 and P5. P4 was dysphonic since a thyroidectomy and P5 had a unilateral vocal fold paralysis. P2 presented with gastroesophageal reflux disease, a chronic post-nasal drip, oedema of the posterior commissure and had a polyp that was excised 1 month before data collection took place.
Utility of 24-hour pharyngeal pH monitoring and clinical feature in laryngopharyngeal reflux disease
Published in Acta Oto-Laryngologica, 2019
Gang Wang, Changmin Qu, Lei Wang, Hongdan Liu, Haolun Han, Bingxin Xu, Ying Zhou, Baowei Li, Yiyan Zhang, Zhezhe Sun, Jing Gong, Lianyong Li, Wei Wu
Acid reflux diseases are highly prevalent, and GERD and LPR are epidemic. The prevalence of LPRD dramatically increased and was demonstrated to be significantly associated with the current modern lifestyle [6]. The pathogenic abnormalities causing LPRD include a defective anti-reflux barrier, abnormal esophageal clearance and delayed gastric emptying. LPRD has nonspecific clinical and pathological presentation and often involves a comprehensive range of clinical specialties. LPRD can be expressed as chronic laryngopharyngitis, vocal fold nodule or polyp, asthma, chronic cough, laryngospasm and even laryngeal cancer. Due to the lack of any uniform diagnostic criteria, insufficient recognition, substandard treatment, overdiagnosis and overtreatment are common. Hence, it is particularly important to explore objective diagnostic standards or a method with satisfying sensitivity and specificity for the diagnosis of LPRD.
Voice therapy in paediatric dysphonia
Published in Hearing, Balance and Communication, 2020
Mattia Gambalonga, Davide Brotto, Niccolò Favaretto
The most common condition that leads to chronic dysphonia in children is vocal cord nodules, which are benign lesions that form at the junction between the anterior and the middle thirds of the vocal fold, mainly due to phonotrauma [10]. Different grades of vocal cord nodules can be held responsible for dysphonia in children in nearly 70% of the cases, according to some epidemiological studies [11]. Less frequently, children may develop vocal cord granulomas, benign inflammatory lesions of the posterior glottis, which can be caused either by laryngo-oesophageal reflux disease or by a history of intubation: the endotracheal tube can damage the delicate larynx of a child during the positioning manoeuvre or in case of long-lasting intubation [12]. Another pathology which can cause dysphonia in children is recurrent respiratory papillomatosis [13]. Children affected by this disease develop recurrent exophytic lesions of any region of the larynx that must be surgically treated: the objective is to avoid airway obstruction, and consequently, this may lead to dysphonia due to either the disease itself or to surgical complications. Also, congenital conditions can cause dysphonia. Laryngomalacia can present itself with stridor and dysphonia [14], but also subglottic webs or haemangiomas can cause impairment in vocal fold motility in case of extended involvement [15]; both conditions, in selected cases, are accountable for surgery. Another condition that could lead to dysphonia, even though it is not frequently seen in children, is vocal fold mobility impairment of paralysis due to damage to the laryngeal recurrent nerve. These conditions are often idiopathic, but in some cases, history of loco-regional trauma may explain the clinical situation; even in children, in rare cases, vocal fold paralysis can be caused by laryngeal nerve compression or by a medication-induced neuropathy [16]. Finally, children can develop dysphonia even in the absence of anatomical lesions, due to functional abnormalities during phonation.