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History 57 year old female Complaints 20 years ago her voice began deepening. Now many of her clients think she is a man when on the phone with her. This is causing problems with her business. At times her voice actually stops and only air comes out. She cannot yell.
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This very talkative female in her 50s has asymmetric smokers polyps. She is a 20 pack-year history of smoking. The polyps are most visible when breathing inward, where Bernoulli effect draws them into the airway.
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19 yo female vocal overdoer with a singing impairment. The 2 thickenings or elevations in the center of the vocal cords represent vocal nodules. That is, thickening of the skin or mucosa where the vocal cords tend to collide with each other when making sound.
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27 yo teacher with chronic hoarseness. Treated surgically. The top photo shows the vocal nodules touching each other and interrupting vibrations. The lower 2 photos are taken six weeks post surgery.
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Case Study (multiple photos): Man in his 30s who yells at a lot of football games. He has bilateral hemorrhagic polyps. These consist of dilated capillaries on the vocal cord margin. When he speaks, these will fill with blood and become larger making his voice progressively more hoarse with use.
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Case study (multiple photos): Nearly 60 years old, a cancer (squamous cell carcinoma) was removed from the entire right vocal cord three months earlier. He still had a hoarse voice and a red bump on the vibrating edge of his right vocal cord.
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Capillary ectasia in a rock singer with a polyp. The polyp would be the primary cause of any hoarseness or singing impairment because it is on the edge of the vocal cord and prevents closure of the vocal cords. This allows the air to leak out when making sound.
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Case study (multiple photos): Radiation telangiectasias. Many years ago this woman had a vocal cord cancer treated with radiation therapy. She has been a horse for the past 15 years.
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Case study (multiple photos): Nearly 50-year-old female with a hoarse voice for 15 years. The left vocal cord polyp has blood within it. This is visible on the office exam, but more clearly visible at the time of surgery when rigid endoscopes can be placed up next to the vocal cord.
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Dilated capillaries are visible in the middle portion of this female's vocal cords. She is a vocal over doer. She has ruptured the normal capillaries and when they healed, they healed in a tortuous, dilated pattern.