Clinicopathological study of non-malignant lesions of larynx: a prospective observational study

<p class="abstract"><strong>Background:</strong> Non-malignant lesions of the larynx constitute an interesting array of lesions. The significance of non-malignant lesions lies in the fact that it cannot only cause change in voice but, at times, can lead to breathing difficulty or life-threatening stridor.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study done between November 2019 - July 2020. All the details were filled up by the principal investigator in a structured study proforma. This proforma contains data regarding essential demographic details, clinical features, ENT examination, flexible video laryngoscopy findings, stroboscopy findings, voice handicap index, diagnosis and management. Statistical method and data analysis in this study we tried to describe the analysis process with appropriate methods and principles of statistics, using the data collected from the patients, participated in this study. </p><p class="abstract"><strong>Results:</strong> The most common non-malignant lesion among the 50 patients studied was vocal cord polyp; second most common being the vocal cord cyst. The relation of hoarseness of voice, difficulty in breathing, smoking or alcohol intake with non-malignant lesions showed a statistically significant result. On interpreting the stroboscopic findings of various lesions, all cases of vocal nodule showed an hourglass-shaped glottic closure.</p><p class="abstract"><strong>Conclusions:</strong> These lesions can create a lot of mental and emotional tension in the patient and the family. Early diagnosis of the lesions can lead to effective management and functional recovery. Stroboscopy is valued for its excellent ability to examine the structure and the function of the glottis during phonation.</p>

Comparison between Conventional Microdissection and CO2 Laser in the Treatment of Vocal Cord Polyp

Background: Vocal cord polyp usually arises from the epithelium and the lamina propria. Minimally invasive dissection procedures are employed to treat these vocal cord polyp for an effective outcome. Two types of microsurgical techniques were developed gradually and practiced namely, the conventional laryngeal microsurgery, which involves the use of cold instruments and the laryngeal laser micro-surgery. Objective: To compare the conventional cold dissection and CO2 laser methods in treatment of vocal cord polyp. Methods: A randomized prospective study was conducted at the Department of Otolayngology- Head & Neck Surgery, at Bangabondhu Sheikh Muzib Medical University (BSMMU) between July 2017 and June 2019. A total of 60 cases were studied on the following parameters: a. Visual analysis on stroboscopy b. Voice analysis –GRBAS (grade, roughness, breathiness, asthenia, strain) indices c. Duration of surgery d. Peroperative bleeding. Results: During first postoperative assessment, both groups had the normal symmetrical waves, while 50% of cases still had aperiodicity but all patients had the near normal periodicity in the second postoperative assessment. Regarding glottic closure, during preoperative assessment, almost all patients had incomplete glottic closure due to mass lesion as polyps. During first postoperative assessment, glottic closure was found to be better in group B (83% of cases) than group A (76% of cases), while during second postoperative assessment, all patients of both groups had around 95% glottic closure. The mean duration oflaser technique (7.1 ± 1.1 minutes) was less than the conventional technique time (15.6 ± 1.9 minutes), also mean of operative bleeding of laser technique (zero pack) is less than the conventional two(2 packs). Conclusion: There is no significant difference between both groups in all parameters except operative time and bleeding, as laser technique has less time and clear field. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 17-24

CLINICO-PATHOLOGICAL CHARACTERISTICS OF BENIGN LARYNGEAL LESIONS OF PATIENTS FROM CENTRAL INDIA

Background: In ENT clinics, benign lesions of the larynx are fairly normal. It is not always simple to have a clinical-histological link, but a correct diagnosis is of the utmost importance. The purpose of the present study was to study the clinical profile of benign lesions of the larynx and histopathological trends. Material and Methods: With indirect laryngoscopy or video laryngoscopy, a total of 100 patients clinically diagnosed as cases of benign laryngeal lesion were examined. Under local or general anaesthesia, direct laryngoscopy was performed. The lesion biopsy was sent for histopathological research. Results: Most of the patients were between 21-30 years old, i.e. 38%. Males were more generally affected (62 percent) than females. The principal concern in (84 percent) of cases was hoarseness or change of speech. In 56 per cent of cases, verbal abuse has been shown to be a predisposing factor. The most common clinical diagnosis was vocal cord nodule in 34 percent of cases, followed by vocal cord polyp in 22 percent of cases. Conclusion: The nodules of the vocal cord are the most common benign laryngeal lesions, causing speech hoarseness as the main complaint. The ENT diagnosis and the pathological diagnosis of benign laryngeal lesions were strongly associated. Keywords: Larynx, benign lesions, hoarseness of voice, histopathology.