Severe chronic laryngitis mimicking a granulomatous disease.
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The aim of this paper was presentation of voice estimation in smokers, who did not complain of voice disorders. The examination was performed in 20 patients with history of chronic tobacco using (at least 20 years). The videolaryngostroboscopy and acoustic voice analysis were performed. The specific changes as in organic dysphonia were found in larynx in both examinations. The most important finding in acoustic voice analysis was abnormal parameter describing vFo--Fundamental Frequency Variation and lower comparing to normal voices fundamental frequency.
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OBJECTIVES: To determine the efficacy of voice therapy techniques in 37 patients with functional dysphonia. PATIENTS AND METHODS: The patients were divided into three groups according to the type of functional voice disorder, including mutational falsetto (n=16), vocal nodule (n=17), and muscle-tension dysphonia (n=4). All the patients received voice therapy which varied according to the frequency of visits, time, and techniques for the type of functional voice disorder. Voices of the patients were evaluated subjectively by a questionnaire and the GRBAS scale, and objectively by videolaryngostroboscopy and computed voice analysis before and after the therapy. RESULTS: Fifteen patients with mutational falsetto (93%), eight patients with vocal nodules (47%), and all the patients with muscle-tension dysphonia were cured by voice therapy techniques. Vocal nodules were reduced in 35% of the patients and were stable in three patients (18%). CONCLUSION: Successful results can be obtained by voice therapy techniques in functional voice disorders, which are common in otolaryngology practice, causing difficulties in diagnosis and management.
We report a case of lingual thyroid. A woman presented with a few years history of mild dysphagia, cough and uncomfortable breathing when going to sleep at night. Laryngostroboscopy showed a mass lesion at the base of the tongue. A CT scan and thyroid scanning revealed a bilobar mass of thyroid tissue, compatible with a lingual thyroid. No thyroid gland was found at its usual location. The woman was euthyroid and since her symptoms were mild she was treated with thyroxin and observation. Lingual thyroid is a rare phenomenon caused by abnormal migration of thyroid cells during the first weeks of fetal life. Females are affected more often than males and although this condition is often asymptomatic, symptoms can occur, most often during puberty, pregnancy and menopause. On examination a mass is noted at the base of the tongue and the diagnosis is then confirmed with CT/MRI and thyroid scanning. Treatment can vary from observation to thyroxin medication, radioactive iodine and complicated surgical intervention, depending on the symptoms and the overall health of the patient.
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Chronic hypertrophic laryngitis concerns many people in our population. Their aetiopathogenesis is complicated and usually connected with exogenous harmful factors like occupational or environmental exposure. The basic aim of this research was to asses phonation function of the larynx after microsurgery on the basis of videostroboscopy examination. The second aim was to estimate the surgical treatment effectiveness depending on vocal fold hypertrophy extensiveness. The research was conducted on 50 subjects chosen from the population of patients with vocal fold hypertrophy treated at the Department of Laryngology Silesian Medical Academy in Zabrze from January to December 2003. All the examined patients underwent classical microsurgery. Videostroboscopy examination was done just before microsurgery and 3 months after operation. Examination results in two groups with different extensiveness of vocal fold hypertrophy were compared. The first group consist of patients with minor vocal fold lesions (limited to I of vocal fold length), the second group consist of patients with extensive vocal fold lesions (above I of vocal fold length). The control group presented 30 subjects without any voice disorders who did not use their voice for professional purposes. In both groups (with minor and extensive vocal fold lesions) significant improvement in videostroboscopy parameters was observed. The functional results in the group with minor vocal fold lesions were better after microsurgery, but it turned out that results were not statistically significant.
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OBJECTIVES: It has been decided to identify the most frequent diseases of the larynx in people occupationally exposed to a considerable voice load and to assess the feasibility of using videostroboscopy to diagnose voice disorders and their organic effects in order to improve the reliability of certification of occupational vocal organ diseases as well as to evaluate the functioning of new regulations on diagnosing and certifying occupational vocal organ diseases and to assay the conformity of clinical diagnoses made at voivodeship (provincial) centers (level I) with those made at scientific research institutes (level II). MATERIALS AND METHODS: The study involved an analysis of 1261 cases (1042 women and 219 men) with the vocal organ disorders referred to the ENT Unit, Nofer Institute of Occupational Medicine, Lódź, by voivodeship centers during 1999-2004 for consultation or under the appeal procedure (if applicants were denied the right to be included in the category of patients with occupational disease of the vocal organ). The majority of the patients (65.7%) were primary school teachers, and those aged 51-60 years made 54.8%. Laryngological, phoniatric and videostroboscopic examinations, when necessary, supplemented with other testing procedures (paranasal sinus imaging, allergenic tests) were taken to assess the clinical state of the patients. RESULTS: As a result of these comprehensive examinations, organic changes in the larynx were detected in 161 (12.7%) cases, including 139 (11.0%) women and 22 (1.7%) men. According to current diagnostic/certifying criteria those pathologies could be classified into the category of occupational disease of the vocal organ. Paresis of vocal folds due to the insufficiency of vocal fold adductor and tensor muscles with permanent dysphonia was found in 97 (7.6%) patients, vocal nodules in 53 (4.2%) and secondary hypertrophy changes in vocal folds in 11 (0.87%) patients. The most frequent reasons for excluding the occupational etiology of the disease were functional disorders of the voice observed in 82.3% of patients in the form of hyperfunctional dysphonia (64.3%), hypofunctional dysphonia (17.0%) and dysfunctional dysphonia (about 1.0%). In 9.0% of patients, the functional disorders of the voice were accompanied by organic changes in the larynx caused by non-occupational factors. CONCLUSIONS: The analysis showed that due to new Polish regulations, the number of certified occupational disease of the vocal organ was reduced; videostroboscopic tests proved to be a very helpful tool for discriminating between the functional and organic disorders of the vocal organ; and good agreement between clinical diagnoses issued at both levels (I and II) was also revealed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
INTRODUCTION: Chronic hypertrophic laryngitis concerns many people in our population. Their etiopathogenesis is complicated and usually connected with exogenous harmful factors like occupational or environmental exposure. Organic voice disorders of the larynx, particularly concerning vocal folds are the cause of dysphonia. Both surgical and conservative methods in the treatment of patients with laryngeal hypertrophy are applied. Objective assessment of the voice improvement after microsurgery is the subject of discussion of many authors. The problem of voice improvement is rarely approached to in the comprehensive way, that is with reference to activity and anatomy of the larynx. The basic aim of this research was to asses phonation function of the larynx after microsurgery on the basis of subjective and videostroboscopic voice analysis. The second aim was to estimate the surgical treatment effectiveness depending on vocal fold hypertrophy extensiveness. MATERIAL AND METHOD: The research was conducted on 50 subjects chosen from the population of patients with vocal fold hypertrophy treated at the Department of Laryngology Silesian Medical Academy in Zabrze from January to December 2003. All the examined patients underwent classical microsurgery. Voice quality examinations were done just before microsurgery and 3 months after the operation. On the basis of histopathological results, following diagnosis were established: vocal fold polyps (oedematosus, teleangiectaticus and inflammatorius), oedema Reincke, laryngeal papilloma, laryngeal granuloma and cyst. The research methodology included: perceptual voice examination based on GRBAS scale (G--grade; R--roughness; B--breathiness; A--asthenicity; S--strain) and assessment of vibrations of vocal folds in videostroboscopy. Examination results in two groups with different extensiveness of vocal fold hypertrophy were compared. The control group presented 30 subjects without any voice disorders who did not use their voice for professional purposes. RESULTS: In both groups (with minor and extensive vocal fold lesions) significant improvement in perceptual and videostroboscopic voice parameters was observed. The results in the group with minor vocal fold lesions were better after microsurgery. CONCLUSIONS: The methodology based on the application of the two methods of voice examination could be an objective rate in the estimation of the treatment progress.