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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
Vocal fold nodules are small bilateral swellings (less than 3 mm in diameter) that develop on the free edge of the vocal fold at the maximal contact area (Figure 57.5). Associated with certain occupations (e.g. teaching, singing).In children, found more often in boys than in girls.In adults, strikingly more frequent in women, predominately less than 30 years old.
Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
The framework of the larynx is formed by the thyroid, cricoid and epiglottic cartilages and by pairs of arytenoid, corniculate and cuneiform cartilages. The aryepiglottic folds and the arytenoids are located immediately behind the epiglottis (Fig. 11.6). The aperture of the glottis (rima glottidis) is formed by the true vocal folds (plicae vocales) and the posterior commissure between the arytenoids. The anterior ligament of the true vocal folds is located at the anterior angle of the vocal folds. Between the true vocal folds and the false vocal folds (vestibular folds; plicae ventriculares) is the laryngeal ventricle. The nodular swellings located medially in the aryepiglottic folds are the corniculate cartilages which sit on top of the arytenoid cartilages. Lateral to the corniculate cartilages are the cuneiform cartilages.
The spectrum of voice disorders – presentation
Published in Stephanie Martin, Working with Voice Disorders, 2020
Vocal fold sub-mucous haemorrhages occur when there is rupture of blood vessels due to phonotrauma and extreme effort in voicing. There is bleeding into the superficial layer of the lamina propria. They may be seen as a small mass on the free edge of the vocal fold and may vary in size and site of injury. The mucosal wave may be limited in the affected area of the vocal fold or observed as reduced amplitude of vibration in the affected vocal fold. The patient often experiences a sudden disturbance to voice. This should be treated by voice rest to allow healing and recovery in the vocal fold. All habitual or recurring factors of extreme vocal effort should be addressed and any MTD should be treated to avoid recurrence. Occasionally the haemorrhage may become encapsulated into a cyst or polyp. This usually resolves spontaneously with time, but may require eventual surgical removal Lucian. Sulica at the Sean Parker Institute for the Voice, Weill Cornell Medicine voice.weill.cornell.edu notes the difference between the treatment of voice rest for a single, isolated haemorrhage as compared to repeated haemorrhage where there is an underlying cause, be it related to harmful voice behaviour or some other aetiology. In repeated haemorrhage, delicate microlaryngoscopy may be required to remove or repair any small irregularities or blood vessels prone to bleeding.
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
Medical records were reviewed to determine COVID-19 status, presence of vocal cord injury, duration of intubation, endotracheal tube size, pronation status, pronation duration, and patient age, sex, and height. Vocal fold injury was organized into eight categories: none, any injury, edema/erythema, granulation/ulceration, subglottic stenosis, posterior glottic stenosis, impaired vocal fold mobility, and vocal fold paralysis. The clinical significance of vocal fold injury was determined by whether intervention was required. Interventions were endoscopic management of injury (endoscopic or microscopic repair of injury using cold techniques or laser), tracheostomy or inability to decannulate existing tracheostomy, or aspiration or prolonged dysphagia due to injury requiring feeding tube placement. Clinical significance categories included no injury, mild injury (no intervention required), and severe injury (intervention required).
Prevalence of vocal fatigue and associated risk factors in university teachers
Published in Speech, Language and Hearing, 2022
Shruthi Padmashali, Srikanth Nayak, Usha Devadas
Present study results showed a significant association between university teachers reporting vocal fatigue with variables like stress, frequent cold, dry mouth, need to raise the voice, and acid reflux, similar to past studies (Gomes et al., 2020; Higgins & Smith, 2012; Korn et al., 2016; Kyriakou et al., 2018). Studies in the literature have identified a direct relationship between stress and voice problems (Korn et al., 2016; Kyriakou et al., 2018). Prevalence of stress among university teaching faculty ranged from 5.5% to 25.9% refer to a review by Tai, Ng, and Lim (2019). Under stressful conditions, vocal folds may lose their precision of movement (Stemple, Glaze, & Klaben, 2000) and increase musculoskeletal tension, pain, and discomfort in the laryngeal muscles, leading to vocal fatigue symptoms (Johnson, 1994). Work-related stress is reported to be a common health problem among teachers (Besser et al., 2022; Noor & Ismail, 2016; Vertanen-Greis, Löyttyniemi, & Uitti, 2020). Several sociodemographic (age, sex, marital status & educational level) (Chong & Chan, 2010; Noor & Ismail, 2016) and occupational factors (school characteristics, teaching experience, workload, teaching experience) (Noor & Ismail, 2016) were reported to increase the stress among teachers. Studies have reported that working under emotionally stressful conditions increases neck muscle tensions and decreases vocal efficiency (Roy & Bless, 2000; Van Houtte, Van Lierde, & Claeys, 2011; Van Lierde, Van Heule, De Ley, Mertens, & Claeys, 2009).
Preliminary dynamic observation of wound healing after low-temperature plasma radiofrequency ablation for laryngeal leukoplakia
Published in Acta Oto-Laryngologica, 2022
Fang Hao, Liyan Yue, Xiaoyan Yin, Chunguang Shan
The vocal folds are composed of epithelium, lamina propria, and muscularis. The lamina propria is rich in extracellular matrix. The abundance and distribution of proteins and glycans in this extracellular matrix maintain the biomechanical properties of vocal folds vocalization, while injury to the extracellular matrix often affects postoperative pronunciation [17]. The arrangement and content of fibronectin and other components in the extracellular matrix of the wound after vocal fold surgery determine the formation of vocal fold lamina propria scars. Damage to the adult skin can lead to scar formation, which increases as the depth of the injury increases [18]. Although the skin and vocal folds tissue structures are different, there are similarities, and the vocal folds mucosa is a special tissue with unique repair and regeneration requirements [19]. The scars of the vocal folds are not evident after the LTPA treatment of LL wounds. Because the wound was in the mucosal layer, the lamina propria was not damaged or slightly damaged, and did not reach the muscle layer, which is consistent with the observation of postoperative wound healing in the later stage of scar formation. Similarly, Zhang et al. [20] summarized the healing of the vocal folds after treatment with LTPA in patients with early glottic laryngeal cancer and found that postoperative vocal folds scar formation was not apparent.