Hoarseness is a common clinical symptom. Since 1996 we have treated 92 cases of hoarseness by needling Zhaohai (KI 6) point and achieved good therapeutic effects. This is reported as follows.
Right vocal cord paralysis in our present case was diagnosed on clinical and radiological examination which is precipitated by an anomalous right aortic arch with diverticulum. This is a very uncommon vascular etiolog...Right vocal cord paralysis in our present case was diagnosed on clinical and radiological examination which is precipitated by an anomalous right aortic arch with diverticulum. This is a very uncommon vascular etiology of hoarseness and is extremely rare. Because of this rarity, the practicing otolaryngologist may miss this finding while evaluating a case of idiopathic right vocal cord paralysis. Thus, the authors feel that idiopathic or unexplained right vocal cord paralysis should be routinely investigated with a CT or MRI of neck and chest with or without contrast to avoid such shortcomings. There is only one such case of right vocal cord paralysis by right aortic which has been reported earlier in literature.展开更多
Normal phonation is produced in the larynx by the blast of pulmonic air stream that vibrates the vocal cords. Hoarseness reflects changes in the structure or function of the vocal cords. Objective: This is to describe...Normal phonation is produced in the larynx by the blast of pulmonic air stream that vibrates the vocal cords. Hoarseness reflects changes in the structure or function of the vocal cords. Objective: This is to describe the clinical profile of hoarseness in children and aetiological factors in a tertiary health institution. Methodology: This is a retrospective eight-year (2006-2013) study of clinical records of patients with hoarseness as their main symptom seen in the ENT department of the Usmanu Danfodiyo University Teaching Hospital Sokoto. Results: Fifty-two children with hoarseness were studied. Thirty three (63.5%) were males, while 19 (36.5) were female with a male: female ratio of 1.7:1. The age range was 1 - 13 years with a mean age of 5.1 years. Age group 4 - 7 years (38.5%) were observed to be more affected with duration of hoarseness ranging from 1 day to 5 years. RRP 23 (44.2%) was the most common aetiology of hoarseness followed by foreign body 15 (28.8%) and Acute Laryngeal infections 9 (17.3%). Tracheostomy was done in 29 (55.8%) of patients. Two patients died post operatively due to improper tracheostomy tube care in the ward. Conclusion: With delayed presentation and its attendant grave sequelae, it has become imperative that persistent hoarseness in children lasting more than three weeks should be endoscopically evaluated by an otorhinolaryngologist.展开更多
Objective: to observe the therapeutic effect of dexamethasone palmitate injection on hoarseness caused by recurrent laryngeal nerve injury during thyroid surgery. Methods: 783 patients were divided into treatment grou...Objective: to observe the therapeutic effect of dexamethasone palmitate injection on hoarseness caused by recurrent laryngeal nerve injury during thyroid surgery. Methods: 783 patients were divided into treatment group (395 cases) and control group (388 cases). After thyroidectomy, the treatment group was sprayed with dexamethasone palmitate injection 1ml:4mg, while the control group was not sprayed with any drugs. The patients' hoarseness was observed on the 1st, 3rd, 7th and 30th day after operation. The GRBAS score, voice disorder index and VHI-13 Chinese version scale were used to evaluate the patients' voice. At the same time, the occurrence of severe adverse drug reactions, upper abdominal pain and hyperglycemia within 7 days after operation, and the infection in the operation area within 30 days after operation were observed. Results: the hoarseness in the treatment group was less than that in the control group on the 1st, 3rd and 7th day after operation (p<0.05), and there was no significant difference between the two groups on the 30th day after operation (p>0.05). There was no serious adverse drug reaction in the treatment group, upper abdominal pain and hyperglycemia within 7 days after operation, and there was no significant difference between the two groups within 30 days after operation (p>0.05). Conclusion: local application of dexamethasone palmitate injection during thyroid surgery has a certain therapeutic effect on reducing hoarseness caused by recurrent laryngeal nerve injury, but it has a limited therapeutic effect on recurrent laryngeal nerve injury which has not recovered its voice 30 days after operation.展开更多
Laryngeal tuberculosis is an uncommon disease of the larynx that can easily be missed. It is however the commonest granulomatous laryngeal pathology. Laryngeal tuberculosis and laryngeal cancer both have similar modes...Laryngeal tuberculosis is an uncommon disease of the larynx that can easily be missed. It is however the commonest granulomatous laryngeal pathology. Laryngeal tuberculosis and laryngeal cancer both have similar modes of clinical presentation. We present a case of isolated laryngeal tuberculosis in a 38-year-old Nigerian female, who presented with persistent hoarseness of 3 months duration with no respiratory symptoms and signs. Fiberoptic laryngoscopy showed hyperemia and oedema of the endolarynx, mucoid exudate and thickening of both false and true vocal cords. Tuberculosis was confirmed by gene Xpert. She was placed on rifampicin, isoniazid, pyrazinamide and ethambutol for two months intensive phase and rifampicin and isoniazid for four months continuation phase. There was complete resolution of hoarseness after completion of anti-tuberculous therapy.展开更多
A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonanc...A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.展开更多
Objective Bamboo node(BN)of vocal folds is a rare disease which is mostly associated with autoimmune diseases and always involves women as reported in literature.The purpose of this study is to investigate the clinica...Objective Bamboo node(BN)of vocal folds is a rare disease which is mostly associated with autoimmune diseases and always involves women as reported in literature.The purpose of this study is to investigate the clinical characteristics and the treatments in a series of BN cases.Methods We retrospectively collected and reviewed clinical information of all patients who presented bamboo nodes by fibreoptic laryngoscopy from 2011 to 2020 in our hospital,including the demographic information,clinical symptoms,associated autoimmune diseases,voice abuse,treatments,and outcomes.Patients were followed up periodically at clinics with fibreoptic laryngoscopy and/or voice recovery evaluation using the selt assessed voice visual analog scale(VAS).Results Tdtally 14 patients were diagnosed with BN and were included in the study.BN involved both women(8/14,57.1%)and men(6/14,42.9%).Bilateral lesions were found in 13 patients(92.9%).The most common symptom of BN was hoarseness(100%).Ten(71.4%)of 14 patients experienced voice abuse.Thirteen(92.9%)of them were concomitant with autoimmunity disease,and received medication therapy for the underlying autoimmune diseases;one patient received anti-acid treatment for the gastroesophageal reflux disease.Voice rests were performed in all patients.Voice recovered completely in 3 cases(21.4%),improved remarkably in 8 cases(57.1%),improved slightly in 1 case(7.1%),and no improvement in 2 cases(14.3%).Conclusions BNs are mostly associated with autoimmune disease and vocal abuse.It may occur in both females and males・Conservative treatment for the underlying autoimmune diseases and vocal rest are beneficial to voice recovery in most of the patients,and can be used as the first choice of treatment.展开更多
BACKGROUND Post-extubation cough is a common phenomenon in surgical patients undergoing general anesthesia,which can lead to potentially dangerous complications.In this meta-analysis,we evaluated the efficacy and safe...BACKGROUND Post-extubation cough is a common phenomenon in surgical patients undergoing general anesthesia,which can lead to potentially dangerous complications.In this meta-analysis,we evaluated the efficacy and safety of intracuff alkalinized lidocaine in patients with tracheal intubation to prevent cough and other airway complications during the perioperative period.AIM To perform a systematic review and meta-analysis of intracuff alkalinized lidocaine for the prevention of postoperative airway complications.METHODS PubMed,Embase,Cochrane,and Web of Science were searched for randomized controlled trials(RCTs)that compared intracuff alkalinized lidocaine to placebo.We used risk-of-bias assessment to assess the RCTs,and the quality of evidence was assessed using the grading of recommendations,assessment,development,and evaluations.RESULTS Twelve randomized trials(1175 patients)were analyzed.Meta-analysis showed that intracuff alkalinized lidocaine was associated with less cough compared to that produced by placebo[risk ratio(RR):0.38;95%confidence interval(CI):0.23-0.63].Similarly,intracuff alkalinized lidocaine was more effective than the control in reducing postoperative sore throat at 24 h(RR:0.19;95%CI:0.09-0.41)and postoperative hoarseness(RR:0.38;95%CI:0.21-0.69).CONCLUSION Intracuff alkalinized lidocaine is an effective adjuvant that can decrease airway complications,such as coughing,hoarseness,and sore throat.展开更多
BACKGROUND Arytenoid cartilage dislocation is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma.The most common symptom is persistent hoarseness.Although cases of arytenoid disl...BACKGROUND Arytenoid cartilage dislocation is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma.The most common symptom is persistent hoarseness.Although cases of arytenoid dislocation due to tracheal intubation are reported more frequently in otolaryngology,reports on its occurrence in the intensive care unit(ICU)are lacking.We report a case of delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the ICU.CASE SUMMARY A 20-year-old woman was referred to the ICU following a fall from a height.Her voice was normal;laryngeal computed tomography showed unremarkable findings on admission.However,due to deterioration of the patient’s condition,tracheal intubation,and emergency exploratory laparotomy followed by laparoscopic surgery two d later under general anesthesia were performed.After extubation,the patient was sedated and could not communicate effectively.On the 10th day after extubation,the patient complained of hoarseness and coughing with liquids,which was attributed to laryngeal edema and is common after tracheal intubation.Therefore,specific treatment was not administered.However,the patient’s symptoms did not improve.Five d later,an electronic laryngoscope examination revealed dislocation of the left arytenoid cartilage.The patient underwent arytenoid closed reduction under general anesthesia by an experienced otolaryngologist.Reported symptoms improved subsequently.The sixmonth follow up revealed that the hoarseness had resolved within four weeks of the reduction procedure.CONCLUSION Symptoms of arytenoid cartilage dislocation are difficult to identify in the ICU leading to missed or delayed diagnosis among patients.展开更多
The spectrum of disorders involving the tracheobronchial tree is diverse and tracheal diverticulum is an extremely rare entity accounting for 1%-2% of cases. Tracheal diverticulum is mainly asymptomatic and discovered...The spectrum of disorders involving the tracheobronchial tree is diverse and tracheal diverticulum is an extremely rare entity accounting for 1%-2% of cases. Tracheal diverticulum is mainly asymptomatic and discovered incidentally either on radiological examination or at autopsy. We hereby report two cases of tracheal diverticulum with hoarseness in one case and dysphagia in the second case, where intubation was difficult in both cases. However, laryngeal mask airway was inserted successfully in case one and endotracheal intubation using a smaller size intubation tube in case two.展开更多
Background Vocal cord movement disorder （VCMD） is a laryngeal disorder characterized by paradoxical adduction of the vocal cords during in inspiration, expiration or both. The nursing experience of patients with VCM...Background Vocal cord movement disorder （VCMD） is a laryngeal disorder characterized by paradoxical adduction of the vocal cords during in inspiration, expiration or both. The nursing experience of patients with VCMD after aortic dissection surgery is limited. Methods We retrospectively analyzed the clinical data and nursing records of 269 patients after aortic dissection surgery in Guangdong General Hospital between May 2010 and May 2012. We observed the patients＇ pronunciation, and judged if there was dysphagia undergoing water drinking test two hours after extubation, to confirm whether patients had VCMD. Results Seventeen patients had VCMD after aortic dissection surgery, of whom 2 suffered hoarseness, 3 had dysphasia and 12 had both hoarseness and dysphasia. After timely treatment and carefully nursing, all the patients recovered well. Conclusions With the enhanced care of patients with aortic dissection, observing hoarseness appearance and drinking experiment immediately after extubation can detect VCMD as soon as possible. Further rehabilita- tion training and psychology care can prevent bucking and aspiration effectively, and promoting recovery and improving patient＇s life quality.展开更多
A three mass model of vocal cords as well as mathematical expression of the model are discussed. Different kinds of typical hoarse speech due to laryngeal diseases are simulated on microcomputer and the effects of di...A three mass model of vocal cords as well as mathematical expression of the model are discussed. Different kinds of typical hoarse speech due to laryngeal diseases are simulated on microcomputer and the effects of different pathological factors of vocal cords on model parameters are studied. Some typical spectrum distribution of the simulated speech signals are given. Moreover, hoarse speech signals of some typical cases are analyzed by the methods of digital signal processing, including FFT, LPC, Cepstrum technique, Pseudocolor encoding, etc. The experiment results show that the three mass model analysis of vocal cords is an efficient method for analysis of hoarse speech signals.展开更多
Background: Coblation based bipolar plasma devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. Cobl...Background: Coblation based bipolar plasma devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. Coblation technology provides ablation, resection, coagulation of soft tissue and hemostasis of blood vessels in one convenient surgical device. Coblation technology can be used in the larynx and trachea for removing or debulking sessile polyps, lesions or tumors. Minimally invasive coblation technology can offer less invasive treatment with quicker recovery and shorter hospitalization. Aim: This case study aims to explore the advantages of coblation combined with microscopy to treat benign laryngeal lesions. Case report: We report the case of laryngeal papilloma treated with minimally invasive coblation resection. Fiberoptic laryngoscopy was done pre-operatively and that showed papillomatous mass at anterior half of right vocal cord involving inferior surface and also extending upto anterior commissure. Mobility of both vocal cords was normal. On the basis of the above findings with normal vocal cords mobility, the microlaryngeal surgery with coblation was planned. After complete pre-op work up, the patient underwent trans-oral microscopic coblation excision of mass under general anaesthesia. Power level was set to 7 for ablation and 3 for coagulation. The PROcise<sup>TM</sup> LW Plasma Wand system was chosen such that it was malleable to reach the papillomatous mass without obstructing the vision. It was totally excised and sent for histopathology examination. Post-operatively after four hours, he was able to take normal diet comfortably. He was followed up after 10 days. Histopathological report confirmed the diagnosis of papilloma. Check laryngoscopy was performed after 3 weeks. Laryngeal examination was absolutely normal with almost normal vocal cords and normal voice post-operatively. Conclusion: Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, increased completion rate and few complications.展开更多
BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.CONCLUSION ...BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.CONCLUSION Laryngeal myxoma is a rare benign tumor in the larynx.It is difficult to distinguish glottis myxoma from vocal cord polyps on laryngoscopy.We recommend that otolaryngologists acquire a better understanding of this disease.If a laryngeal myxoma is suspected,dynamic laryngoscopy,acoustic voice analysis,and pathological biopsy should be performed.展开更多
文摘Hoarseness is a common clinical symptom. Since 1996 we have treated 92 cases of hoarseness by needling Zhaohai (KI 6) point and achieved good therapeutic effects. This is reported as follows.
文摘Right vocal cord paralysis in our present case was diagnosed on clinical and radiological examination which is precipitated by an anomalous right aortic arch with diverticulum. This is a very uncommon vascular etiology of hoarseness and is extremely rare. Because of this rarity, the practicing otolaryngologist may miss this finding while evaluating a case of idiopathic right vocal cord paralysis. Thus, the authors feel that idiopathic or unexplained right vocal cord paralysis should be routinely investigated with a CT or MRI of neck and chest with or without contrast to avoid such shortcomings. There is only one such case of right vocal cord paralysis by right aortic which has been reported earlier in literature.
文摘Normal phonation is produced in the larynx by the blast of pulmonic air stream that vibrates the vocal cords. Hoarseness reflects changes in the structure or function of the vocal cords. Objective: This is to describe the clinical profile of hoarseness in children and aetiological factors in a tertiary health institution. Methodology: This is a retrospective eight-year (2006-2013) study of clinical records of patients with hoarseness as their main symptom seen in the ENT department of the Usmanu Danfodiyo University Teaching Hospital Sokoto. Results: Fifty-two children with hoarseness were studied. Thirty three (63.5%) were males, while 19 (36.5) were female with a male: female ratio of 1.7:1. The age range was 1 - 13 years with a mean age of 5.1 years. Age group 4 - 7 years (38.5%) were observed to be more affected with duration of hoarseness ranging from 1 day to 5 years. RRP 23 (44.2%) was the most common aetiology of hoarseness followed by foreign body 15 (28.8%) and Acute Laryngeal infections 9 (17.3%). Tracheostomy was done in 29 (55.8%) of patients. Two patients died post operatively due to improper tracheostomy tube care in the ward. Conclusion: With delayed presentation and its attendant grave sequelae, it has become imperative that persistent hoarseness in children lasting more than three weeks should be endoscopically evaluated by an otorhinolaryngologist.
文摘Objective: to observe the therapeutic effect of dexamethasone palmitate injection on hoarseness caused by recurrent laryngeal nerve injury during thyroid surgery. Methods: 783 patients were divided into treatment group (395 cases) and control group (388 cases). After thyroidectomy, the treatment group was sprayed with dexamethasone palmitate injection 1ml:4mg, while the control group was not sprayed with any drugs. The patients' hoarseness was observed on the 1st, 3rd, 7th and 30th day after operation. The GRBAS score, voice disorder index and VHI-13 Chinese version scale were used to evaluate the patients' voice. At the same time, the occurrence of severe adverse drug reactions, upper abdominal pain and hyperglycemia within 7 days after operation, and the infection in the operation area within 30 days after operation were observed. Results: the hoarseness in the treatment group was less than that in the control group on the 1st, 3rd and 7th day after operation (p<0.05), and there was no significant difference between the two groups on the 30th day after operation (p>0.05). There was no serious adverse drug reaction in the treatment group, upper abdominal pain and hyperglycemia within 7 days after operation, and there was no significant difference between the two groups within 30 days after operation (p>0.05). Conclusion: local application of dexamethasone palmitate injection during thyroid surgery has a certain therapeutic effect on reducing hoarseness caused by recurrent laryngeal nerve injury, but it has a limited therapeutic effect on recurrent laryngeal nerve injury which has not recovered its voice 30 days after operation.
文摘Laryngeal tuberculosis is an uncommon disease of the larynx that can easily be missed. It is however the commonest granulomatous laryngeal pathology. Laryngeal tuberculosis and laryngeal cancer both have similar modes of clinical presentation. We present a case of isolated laryngeal tuberculosis in a 38-year-old Nigerian female, who presented with persistent hoarseness of 3 months duration with no respiratory symptoms and signs. Fiberoptic laryngoscopy showed hyperemia and oedema of the endolarynx, mucoid exudate and thickening of both false and true vocal cords. Tuberculosis was confirmed by gene Xpert. She was placed on rifampicin, isoniazid, pyrazinamide and ethambutol for two months intensive phase and rifampicin and isoniazid for four months continuation phase. There was complete resolution of hoarseness after completion of anti-tuberculous therapy.
文摘A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.
文摘Objective Bamboo node(BN)of vocal folds is a rare disease which is mostly associated with autoimmune diseases and always involves women as reported in literature.The purpose of this study is to investigate the clinical characteristics and the treatments in a series of BN cases.Methods We retrospectively collected and reviewed clinical information of all patients who presented bamboo nodes by fibreoptic laryngoscopy from 2011 to 2020 in our hospital,including the demographic information,clinical symptoms,associated autoimmune diseases,voice abuse,treatments,and outcomes.Patients were followed up periodically at clinics with fibreoptic laryngoscopy and/or voice recovery evaluation using the selt assessed voice visual analog scale(VAS).Results Tdtally 14 patients were diagnosed with BN and were included in the study.BN involved both women(8/14,57.1%)and men(6/14,42.9%).Bilateral lesions were found in 13 patients(92.9%).The most common symptom of BN was hoarseness(100%).Ten(71.4%)of 14 patients experienced voice abuse.Thirteen(92.9%)of them were concomitant with autoimmunity disease,and received medication therapy for the underlying autoimmune diseases;one patient received anti-acid treatment for the gastroesophageal reflux disease.Voice rests were performed in all patients.Voice recovered completely in 3 cases(21.4%),improved remarkably in 8 cases(57.1%),improved slightly in 1 case(7.1%),and no improvement in 2 cases(14.3%).Conclusions BNs are mostly associated with autoimmune disease and vocal abuse.It may occur in both females and males・Conservative treatment for the underlying autoimmune diseases and vocal rest are beneficial to voice recovery in most of the patients,and can be used as the first choice of treatment.
文摘BACKGROUND Post-extubation cough is a common phenomenon in surgical patients undergoing general anesthesia,which can lead to potentially dangerous complications.In this meta-analysis,we evaluated the efficacy and safety of intracuff alkalinized lidocaine in patients with tracheal intubation to prevent cough and other airway complications during the perioperative period.AIM To perform a systematic review and meta-analysis of intracuff alkalinized lidocaine for the prevention of postoperative airway complications.METHODS PubMed,Embase,Cochrane,and Web of Science were searched for randomized controlled trials(RCTs)that compared intracuff alkalinized lidocaine to placebo.We used risk-of-bias assessment to assess the RCTs,and the quality of evidence was assessed using the grading of recommendations,assessment,development,and evaluations.RESULTS Twelve randomized trials(1175 patients)were analyzed.Meta-analysis showed that intracuff alkalinized lidocaine was associated with less cough compared to that produced by placebo[risk ratio(RR):0.38;95%confidence interval(CI):0.23-0.63].Similarly,intracuff alkalinized lidocaine was more effective than the control in reducing postoperative sore throat at 24 h(RR:0.19;95%CI:0.09-0.41)and postoperative hoarseness(RR:0.38;95%CI:0.21-0.69).CONCLUSION Intracuff alkalinized lidocaine is an effective adjuvant that can decrease airway complications,such as coughing,hoarseness,and sore throat.
基金Supported by the National Natural Science Foundation of China,No.82160020.
文摘BACKGROUND Arytenoid cartilage dislocation is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma.The most common symptom is persistent hoarseness.Although cases of arytenoid dislocation due to tracheal intubation are reported more frequently in otolaryngology,reports on its occurrence in the intensive care unit(ICU)are lacking.We report a case of delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the ICU.CASE SUMMARY A 20-year-old woman was referred to the ICU following a fall from a height.Her voice was normal;laryngeal computed tomography showed unremarkable findings on admission.However,due to deterioration of the patient’s condition,tracheal intubation,and emergency exploratory laparotomy followed by laparoscopic surgery two d later under general anesthesia were performed.After extubation,the patient was sedated and could not communicate effectively.On the 10th day after extubation,the patient complained of hoarseness and coughing with liquids,which was attributed to laryngeal edema and is common after tracheal intubation.Therefore,specific treatment was not administered.However,the patient’s symptoms did not improve.Five d later,an electronic laryngoscope examination revealed dislocation of the left arytenoid cartilage.The patient underwent arytenoid closed reduction under general anesthesia by an experienced otolaryngologist.Reported symptoms improved subsequently.The sixmonth follow up revealed that the hoarseness had resolved within four weeks of the reduction procedure.CONCLUSION Symptoms of arytenoid cartilage dislocation are difficult to identify in the ICU leading to missed or delayed diagnosis among patients.
文摘The spectrum of disorders involving the tracheobronchial tree is diverse and tracheal diverticulum is an extremely rare entity accounting for 1%-2% of cases. Tracheal diverticulum is mainly asymptomatic and discovered incidentally either on radiological examination or at autopsy. We hereby report two cases of tracheal diverticulum with hoarseness in one case and dysphagia in the second case, where intubation was difficult in both cases. However, laryngeal mask airway was inserted successfully in case one and endotracheal intubation using a smaller size intubation tube in case two.
文摘Background Vocal cord movement disorder （VCMD） is a laryngeal disorder characterized by paradoxical adduction of the vocal cords during in inspiration, expiration or both. The nursing experience of patients with VCMD after aortic dissection surgery is limited. Methods We retrospectively analyzed the clinical data and nursing records of 269 patients after aortic dissection surgery in Guangdong General Hospital between May 2010 and May 2012. We observed the patients＇ pronunciation, and judged if there was dysphagia undergoing water drinking test two hours after extubation, to confirm whether patients had VCMD. Results Seventeen patients had VCMD after aortic dissection surgery, of whom 2 suffered hoarseness, 3 had dysphasia and 12 had both hoarseness and dysphasia. After timely treatment and carefully nursing, all the patients recovered well. Conclusions With the enhanced care of patients with aortic dissection, observing hoarseness appearance and drinking experiment immediately after extubation can detect VCMD as soon as possible. Further rehabilita- tion training and psychology care can prevent bucking and aspiration effectively, and promoting recovery and improving patient＇s life quality.
文摘A three mass model of vocal cords as well as mathematical expression of the model are discussed. Different kinds of typical hoarse speech due to laryngeal diseases are simulated on microcomputer and the effects of different pathological factors of vocal cords on model parameters are studied. Some typical spectrum distribution of the simulated speech signals are given. Moreover, hoarse speech signals of some typical cases are analyzed by the methods of digital signal processing, including FFT, LPC, Cepstrum technique, Pseudocolor encoding, etc. The experiment results show that the three mass model analysis of vocal cords is an efficient method for analysis of hoarse speech signals.
文摘Background: Coblation based bipolar plasma devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. Coblation technology provides ablation, resection, coagulation of soft tissue and hemostasis of blood vessels in one convenient surgical device. Coblation technology can be used in the larynx and trachea for removing or debulking sessile polyps, lesions or tumors. Minimally invasive coblation technology can offer less invasive treatment with quicker recovery and shorter hospitalization. Aim: This case study aims to explore the advantages of coblation combined with microscopy to treat benign laryngeal lesions. Case report: We report the case of laryngeal papilloma treated with minimally invasive coblation resection. Fiberoptic laryngoscopy was done pre-operatively and that showed papillomatous mass at anterior half of right vocal cord involving inferior surface and also extending upto anterior commissure. Mobility of both vocal cords was normal. On the basis of the above findings with normal vocal cords mobility, the microlaryngeal surgery with coblation was planned. After complete pre-op work up, the patient underwent trans-oral microscopic coblation excision of mass under general anaesthesia. Power level was set to 7 for ablation and 3 for coagulation. The PROcise<sup>TM</sup> LW Plasma Wand system was chosen such that it was malleable to reach the papillomatous mass without obstructing the vision. It was totally excised and sent for histopathology examination. Post-operatively after four hours, he was able to take normal diet comfortably. He was followed up after 10 days. Histopathological report confirmed the diagnosis of papilloma. Check laryngoscopy was performed after 3 weeks. Laryngeal examination was absolutely normal with almost normal vocal cords and normal voice post-operatively. Conclusion: Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, increased completion rate and few complications.
文摘BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.CONCLUSION Laryngeal myxoma is a rare benign tumor in the larynx.It is difficult to distinguish glottis myxoma from vocal cord polyps on laryngoscopy.We recommend that otolaryngologists acquire a better understanding of this disease.If a laryngeal myxoma is suspected,dynamic laryngoscopy,acoustic voice analysis,and pathological biopsy should be performed.
