I had seen her 3 months earlier for her tracheostomy tube which had been removed and she had completely normal vocal cords at that point. The swelling beneath her vocal cords is from the previous tracheostomy tube scar. She then developed hoarseness, which I would attribute to using a Flovent inhaler. She developed a fairly invasive fungal laryngitis. View with Pentax high definition endoscope.
An interview by Dave Palumbo with James P. Thomas, M.D. on Heavy Muscle Radio discussing how to alter vocal pitch. The emphasis in the show was particularly on female bodybuilders who have had their pitch drop after exposure to androgenic steroids and the use of an office KTP laser to tighten and tune up the vocal cords.
Dr. Fermin Zubiaur is on radio today. Hoy (17.9.2012) a las 10:00hrs, Tratamiento y Cirugía para los trastornos de la voz en 96.9 de FM con Martha Debayle, tambíen en el podcast.
Decision Making in vocal fold paralysis AAO-HNS Session 10:30, September 11, 2012 Chairman: Al Merati, MD Panel: Joel Blumin, MD, Michael Johns, MD & Blake Simpson, MD
The neurolaryngology study section had an interesting presentation on the treatment of bilateral recurrent laryngeal nerve injury (paralysis/paresis/synkinesis) chaired by Lucian Sulica and Stacy Halum. Speaker David Zealear, Ph.D. from Vanderbilt began by mentioning iatrogenic thyroidectomy as the number one etiology behind bilateral recurrent laryngeal nerve injury. He spoke about three of his research projects for dealing with this injury. AAO-HNS Meeting at the Washington Convention Center, Washington, DC - September 11, 2012
Granulomas are wound healing lesions. They occur as a result of trauma which denudes the mucosa and exposes the underlying tissue to the bacteria of the throat. They typically start off life as an ulceration and are associated with pain frequently. It is the type of pain that you might experience when you bite your tongue or cheek, so it has a sharp quality. The granuloma is a collection of capillaries which are hypertrophic.
I was able to attend the 9th Congress of the European Laryngologic Society held in Helsinki, Finland June 13-16, 2012. Meeting Organizers Teemu Kinarai and Heikki Rihkanen. It was an excellent Congress with a great many new ideas. Helsinki, Finland was completely blue and sunny for the three nearly 24 hour sunlit days of the conference. Some of the sessions that stood out in my mind:
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. This exam highlights how using the "trumpet maneuver", cancers of the piriform sinus or lower fairings can be visualized. The patient seals their lips and pretends like they are blowing up a balloon. This back pressure opens up the throat both behind and lateral to the larynx or voice box.
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. Since voice disorders are always related to the vibrating edge of the vocal cords, the high definition format, 1080i uses up 1920 x 1080 pixels and placing the edge of the vocal cords along the axis of the 1080 pixels wastes much of the viewing frame.