scholarly journals Etiological Spectrum of Hoarseness of Voice in Western Regional Hospital, Pokhara, Nepal

2020 ◽  
Vol 3 (2) ◽  
pp. 249-253
Author(s):  
Devesh Singh ◽  
Akash Mani Bhandari ◽  
Sudha Shahi ◽  
Narendra Kumar Shrestha
Keyword(s):  
Vocal Cord ◽  
Laryngopharyngeal Reflux ◽  
Muscle Tension ◽  
Vocal Cord Palsy ◽  
Regional Hospital ◽  
Health Science ◽  
Common Symptom ◽  
Etiological Spectrum ◽  
Western Regional ◽  
Method Of Evaluation

Background: Hoarseness of voice is a common symptom presentation in the Department of ENT. The etiology ranges from benign to malignant causes. Video nasopharyngolaryngoscopy is an effective method of evaluation of the laryngeal pathologies. The aim of the study was to study the different etiological factors of hoarseness of voice presenting in the Department of ENT at Western Regional Hospital, Pokhara. Materials and Methods: A retrospective observational longitudinal study was done in the Department of ENT, Western Regional Hospital after approval from IRC, Pokhara Academy of Health Science. A total of 275 patients presenting to the ENT Department with hoarseness of more than two weeks duration were examined with video nasopharyngolaryngoscopy (NPL) from April 2018 to March 2019. The data were electronically entered and analyzed with SPSS Version 21. Results: Total number of cases were 275 among which 187 (68%) were females whereas 88 (32%) were males. Vocal cord nodules were observed in 107 patients (38.9%), features of laryngopharyngeal reflux were observed in 54 patients (19.6%) muscle tension dysphonia was seen in 49 (17.8 % ), vocal cord polyp in 6 patients (2.2%), left vocal cord palsy in 7 patients ( 2.5%), right sided vocal cord palsy in 2 patients (0.7%). The hemorrhagic polyp, leucoplakia and ventricular dysphonia were observed in 3 patients each. Conclusion: Since causes of hoarseness of voice range from simple benign diseases to malignant diseases, it is mandatory to evaluate every cases of hoarseness of voice replace with of more than 2 weeks duration with history, videolaryngoscopic examination and investigations.

Comparative Evaluation and Management of Dysphonia Between Adults <65 and ≥65 Years of Age

2020 ◽  
pp. 019459982097843
Author(s):  
Amy Jacks ◽  
Hannah Kavookjian ◽  
Shannon Kraft
Keyword(s):  
Vocal Cord ◽  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Muscle Tension ◽  
Voice Handicap Index ◽  
Voice Therapy ◽  
Old Patients ◽  
Presenting Symptoms ◽  
Muscle Tension Dysphonia ◽  
Significant Relationships

Objective To compare presenting symptoms, etiology, and treatment outcomes among dysphonic adults <65 and ≥65 years of age. Study Design Retrospective cohort study. Setting Tertiary care voice center between January 2011 and June 2016. Methods A total of 755 patients presenting for dysphonia were included in the study: 513 adults <65 years of age and 242 adults ≥65. Data collected included demographics, referral information, prior diagnoses, prior treatments, clinical examination findings, diagnosis, coexisting symptoms, treatments, and pre- and postintervention Voice Handicap Index scores. Statistical analysis was performed with SPSS to determine significant relationships between variables of interest. Results The most common etiologies of dysphonia were vocal cord atrophy (44.8%) in the ≥65 cohort and benign vocal cord lesions (17.8%) in the <65 cohort. When compared with adults <65 years old, patients ≥65 had a higher incidence of neurologic dysphonia ( P = .006) and vocal cord atrophy ( P < .001) but were less likely to have laryngopharyngeal reflux ( P = .001), benign vocal cord lesions ( P < .001), or muscle tension dysphonia ( P < .001). Overall, 139 patients had surgery, 251 received medical therapy, and 156 underwent voice therapy. The ≥65 cohort demonstrated improvement in Voice Handicap Index scores after surgery ( P = .001) and voice therapy ( P = .034), as did the <65 cohort (surgery, P < .001; voice therapy, P = .015). Adult surgical patients <65 reported greater improvements than patients ≥65 ( P = .021). Conclusions There are notable differences in the pathophysiology of dysphonia between patients aged ≥65 and <65 years. Although adults <65 reported slightly better outcomes with surgery, patients ≥65 obtained significant benefit from surgery and voice therapy.

scholarly journals Hoarseness of voice – an institutional study

2016 ◽  
Vol 2 (4) ◽  
pp. 220 ◽  
Author(s):  
Manish Munjal ◽  
Bindia Ghera
Keyword(s):  
Vocal Cord ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Systemic Disease ◽  
Vocal Cord Palsy ◽  
Vocal Nodule ◽  
X Ray ◽  
Fibreoptic Laryngoscopy ◽  
Laryngopharyngeal Reflux Disease ◽  
Duration Of Disease

<p class="abstract"><strong>Background:</strong> Hoarseness is one of the earliest signal of local and systemic disease. It should be emphasized that hoarseness is not a disease in itself but a symptom of disease or disturbance of larynx or laryngeal innervation. The aim of the study was to analyse various causes and conditions associated with hoarseness of voice.</p><p class="abstract"><strong>Methods:</strong> We studied 150 patients in a prospective randomised study with inclusion criteria of hoarseness of voice, attending otolaryngology outpatient department of Dayanand medical college and hospital, Ludhiana, irrespective of their age, sex and duration of disease. No exclusion criteria were applied. All the routine investigations like Hb, BT, CT, TLC, DLC, urine-for albumin and sugar were carried out in all patients. X-ray chest- PA view and X-Ray soft tissue neck- AP and lateral view were done when required. Larynx was examined by flexible fibreoptic laryngoscopy followed by biopsy if suspicious looking area was seen. 4% lignocaine spray was used orally and nasally to provide local anaesthesia.</p><p class="abstract"><strong>Results:</strong> In the present study of 150 cases 87 were males and 63 were females with M:F ratio of 1.4:1 and age ranged from 10–90 years with majority of cases in 4th and 6th decade of their life. All patients had history of hoarseness of voice with most of patients having duration of disease between one month to one year. On flexible fibreoptic laryngoscopy 27% of cases showed normal study, vocal nodule was  most common, seen in 20% of cases, 10% showed vocal cord palsy and 10% had laryngopharyngeal reflux disease. Bilateral lesion (72.6%) predominated overall, with left sided (15.2%) of larynx affected more as compared to right side (12%).</p><p><strong>Conclusions:</strong> Flexible fibreoptic laryngoscopy is an effective alternative for diagnosis of laryngeal lesions and various causes of hoarseness of voice. Vocal nodule has been found as the commonest cause of hoarseness of voice followed by vocal cord palsy and laryngopharyngeal reflux disease. </p>

scholarly journals Vocal cord palsy as a sequela of paediatric cardiac surgery – a review

2021 ◽  
pp. 1-9
Author(s):  
Aditi Sinha ◽  
Alexander Geragotellis ◽  
Guntaj Kaur Singh ◽  
Devika Verma ◽  
Daniyal Matin Ansari ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Vocal Cord ◽  
Vocal Fold ◽  
Heart Surgery ◽  
Vocal Cord Palsy ◽  
Standards Of Care ◽  
Management Options ◽  
Paediatric Cardiac Surgery ◽  
Cord Injury ◽  
Pda Ligation

Abstract Background: Vocal cord palsy is one of the recognised complications of complex cardiac surgery in the paediatric population. While there is an abundance of literature highlighting the presence of this complication, there is a scarcity of research focusing on the pathophysiology, presentation, diagnosis, and treatment options available for children affected by vocal cord palsy. Materials and methods: Electronic searches were conducted using the search terms: “Vocal Cord Palsy,” “VCP,” “Vocal Cord Injury,” “Paediatric Heart Surgery,” “Congenital Heart Surgery,” “Pediatric Heart Surgery,” “Vocal Fold Movement Impairment,” “VFMI,” “Vocal Fold Palsy,” “PDA Ligation.” The inclusion criteria were any articles discussing the outcomes of vocal cord palsy following paediatric cardiac surgery. Results: The two main populations affected by vocal cord palsy are children undergoing aortic arch surgery or those undergoing PDA ligation. There is paucity of prospective follow-up studies; it is therefore difficult to reliably assess the current approaches and the long-term implications of management options. Conclusion: Vocal cord palsy can be a devastating complication following cardiac surgery, which if left untreated, could potentially result in debilitation of quality of life and in severe circumstances could even lead to death. Currently, there is not enough high-quality evidence in the literature to aid recognition, diagnosis, and management leaving clinicians to extrapolate evidence from adult studies to make clinical judgements. Future research with a focus on the paediatric perspective is necessary in providing evidence for good standards of care.

Neonatal Vocal Cord Paralysis Following Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 793-796 ◽  
Author(s):  
Robert E. Schumacher ◽  
Irvin J. Weinfeld ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Membrane Oxygenation ◽  
The Right ◽  
Unilateral Vocal Cord Paralysis

Five cases of unilateral vocal cord paralysis/ paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.

Management of acquired tracheo-oesophageal fistula following intubation

1990 ◽  
Vol 104 (3) ◽  
pp. 267-269 ◽  
Author(s):  
A. E. Camilleri
Keyword(s):  
Tracheal Intubation ◽  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Subglottic Stenosis ◽  
Left Vocal Cord

AbstractThe management of acquired tracheo-oesophageal fistula due to tracheal intubation is reviewed and a case complicated by left vocal cord palsy and subglottic stenosis is presented. Permanent cricothyroidostomy was used in the management of this original triad of complications.

Vocal Cord Palsy Resulting From Spontaneous Carotid Dissection

2003 ◽  
Vol 113 (3) ◽  
pp. 537-540 ◽  
Author(s):  
Tiemo Wessels ◽  
R. Sparing ◽  
C. Neuschaefer-Rube ◽  
C. Kl??tzsch
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Carotid Dissection

scholarly journals Study on Epidemiology of Chronic Obstructive Pulmonary Disease (COPD) at Western Regional Hospital, Pokhara

2017 ◽  
Vol 9 (2) ◽  
pp. 65-69
Author(s):  
Vivek Ghosh ◽  
S Lamichhane ◽  
SB Thakuri ◽  
KCS Khadka ◽  
SS Teli ◽  
...  
Keyword(s):  
Health System ◽  
Regional Hospital ◽  
Chronic Obstructive ◽  
System Management ◽  
District Health ◽  
Obstructive Pulmonary Disease ◽  
District Health System ◽  
Medical College ◽  
Third Phase ◽  
Western Regional

According to the curriculum of Bachelor of Medicine and Bachelor of Surgery (MBBS) program of the Tribhuvan University (TU), Institute of Medicine (IOM), the Department of Community Medicine of Gandaki Medical College (GMC) has been conducting the District Health System Management (DHSM) study for the students of MBBS, third phase (4th year). This program provides us an opportunity for clinical and community orientation to develop skills to become a competent medical professional to work at different levels of hospitals and district health system. This course enables us to assess resource potentials and constraints, prioritize the health problems and set strategies for solving them. It also enables us to be able to work in promotive, preventive, curative and rehabilitative health services as part of district health team. The program begins with theory classes on management and orientation classes at the college and placement of the students in three different places with rotation along with field supervisions in between. Here we are presenting our investigations on epidemiology of chronic obstructive pulmonary disease made at Western Regional Hospital during our District Health System Management (DHSM) study in third phase (Fourth year).Journal of Gandaki Medical College Volume, 09, Number 2, July December  2016, Page: 65-69 

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