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Elizabeth is in her 20s and began singing about 3 years ago. About 1 year ago, she noted some roughness in her singing voice. She loves to talk and rates herself a 7/7 on the talkativeness scale and a 7/7 on the loudness scale. Here are her vocal cords when I met her. On the left with the vocal cords open (abduction), there are fairly large white calluses in the center of each vocal cord with the right one being slightly larger.
James was age 27 when he first came to me for impairment of his singing voice. His singing became more effortful over 3 to 4 years. There was roughness in his upper vocal range. He recently switched from singing baritone, moving to a tenor. He has a very faint swelling on the right mid-vocal cord. ************************************ 2 years later:
A report on the Sociedad Venezuelana de Otorrinolaringologia - 2012 Meeting
Approximately 70-year-old male who has both smoked and consumed alcohol in the past. He also had a cancer removed from the floor of mouth one year ago. He reported a right-sided sore throat and intermittent referred otalgia to his right ear.
I spent the weekend at a professional otolaryngology meeting. I find these meetings interesting largely because I seldom learn what the speakers think they are going to to teach me. Rather, the I typically learn tidbits in the hallways during casual conversation. This time, two independent talks seem to run on parallel tracks.
When viewing the larynx with a rigid endoscope, my tendency has always been to place the camera on the endoscope such that the vocal cords are viewed in a vertical position. However, what matters for resolution is the number of pixels that the pathology fills up on the camera.
This gentleman had a squamous cell carcinoma or cancer of the right vocal cord. He had only smoked 2 cigarettes per year, so it is unlikely the tobacco had much to do with his cancer. As bad as this looks, it was possible to appeal this cancer off the vocal cord. It had not grown into the vocal cord. After removal, the right vocal cord was very stiff, but his voice returned to normal since the left vocal cord could vibrate normally.
So you think you would like to smoke cigarettes? Here is what smoking cigarettes for 30 years did to one person's larynx. See if you can actually see the vocal cords. This is what squamous cell carcinoma looks like when it grows on the surface of the vocal cords. The large pink area on the left is the left false vocal cord. It likely has tumor given its irregular surface appearance.
Someone sent me a link today saying I had made the U.S. News & World Report "Top doctors list". That seemed like a very nice compliment given that the nomination had come from my peers.
I am having the opportunity to compare images using the Pentax standard definition endoscope VNL-1170K and the high-definition VNL-1590STi. This patient has amyloid depositions in the vocal cords. They cause a stiffening of the vocal cord and allow air to leak out.
