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   Table of Contents - Current issue
July-December 2018
Volume 8 | Issue 2
Page Nos. 29-50

Online since Wednesday, July 24, 2019

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Type I thyroplasty for unilateral vocal fold palsy: Silastic or titanium implant? p. 29
Nidhi Vohra Maggon, Ashwani Sethi, Awadhesh Kumar Mishra, Ajay Mallick
Introduction: Process of speech involves adduction of true vocal cords, and their palsy results in dysphonia with or without aspiration. Medialization thyroplasty is the standard of care and involves insertion of an implant to achieve apposition. We conducted a randomized prospective study to evaluate two types of implants (Silastic vs. titanium) in terms of surgical time and perceptive, acoustic, and aerodynamic evaluation. Materials and Methods: Twenty-six patients were randomized into two groups and were implanted one type of implant. They were evaluated and compared on the basis of voice handicap index (VHI), voice quality evaluation (VQE), and maximum phonation time (MPT). Results: The mean time taken for Silastic implantation was 83.07 min and for titanium implantation was 52.16 min. VHI and VQE decreased significantly following implantation in both groups, while MPT increased in both groups significantly. There was no significant difference between two groups. Conclusion: Medialization thyroplasty with both types of implants achieves good and comparable results. Silastic implant surgery takes longer time but is relatively inexpensive.
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Taste disturbance following microlaryngoscopic surgery p. 36
Urmila Gurung, Yashashwi Man Anand
Aims: Taste disturbance following microlaryngoscopic surgery (MLS), although reported, is not a commonly discussed complication. This study was conducted to assess the frequency and recovery of taste disturbances following MLS and its relation with operative time. Subjects and Methods: It was a prospective, observation study conducted in a tertiary center. Fifty-nine patients underwent MLS for benign laryngeal lesions between July 2014 and January 2016. Chemogustometry using tastants' sucrose, salt, citric acid, and caffeine was done a day before surgery, on 1st postoperative day (POD) and 3 weeks postoperatively to assess taste disturbance. The tongue compression by laryngoscope during MLS was taken as operative time. SPSS 16.0 for Windows™ was used for statistical analysis. Genderwise taste disturbance and the recovery of taste disturbance from first POD to 3rd postoperative week were analyzed using Yates's Chi-squared test. Mann–Whitney test was used to compare the mean operative time between patients with and without taste disturbance. The level of statistical significance was set at P < 0.05. Results: Eight out of fifty-nine (13.5%) patients had taste disturbance on first POD. The operative time ranged from 18 to 33 min (mean 21.3 min ± 4.89) in patients with taste disturbance while the time ranged from 10 to 20 min (mean 13.68 ± 2.33) for patients with no taste disturbance; the difference was statistically significant (P < 0.001). At 3 weeks' postoperative follow-up, only two patients (3.2%) had taste disturbance while six recovered. Conclusions: Transient taste disturbance following MLS is likely more so with longer operative time; hence, preoperative discussion about this potential risk is essential.
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Fatal airway complication during root canal treatment p. 40
Santosh Kumar Swain, Mahesh Chandra Sahu
Foreign body (FB) in the tracheobronchial tree is not uncommon, especially in infants and children. They often present with respiratory obstruction, which can lead to death if not removed in time. Despite public awareness and education, FB aspiration continues to be a problem among patients. We report a case of tracheobronchial FB in a 13-year-old boy who had accidentally aspirated a sharp metallic needle, used during root canal treatment by a dental surgeon. The FB was removed successfully without any complication. FB inhalation is possible while conducting a surgical procedure in the oral cavity. This situation is a life-threatening condition, affecting the patient, and may also create a legal issue to the concerned caregivers. Every clinician should be aware of this type of mishappening during oral cavity procedure.
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Primary aspergillosis of bilateral vocal cords in an immunocompetent individual p. 43
Sachin Sharad Gandhi, Supreetha B Shenoy
Aspergillosis is an inflammatory fungal infection rarely affecting larynx. There are, invariably, certain risk factors which may predispose to fungal infections, such as immune deficiency states, use of inhaled or systemic steroids, and long and continuous use of antibiotics. Primary aspergillosis in an immunocompetent individual is very rare. A case report of such patient is presented in this article. Treatment with voriconazole led to complete resolution of aspergillosis.
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High-frequency jet ventilation: An invaluable tool for anesthesia in microlaryngoscopy with carbon dioxide laser p. 46
Swapna Prasad Naik
Airway management in laryngeal surgeries is a challenge for an anesthesiologist due to sharing of airway with a surgeon. The airway is often compromised with potential for perioperative worsening. Use of carbon dioxide (CO2) laser further narrows the choice of airway device as conventional endotracheal tubes are combustible by CO2 laser. High-frequency jet ventilator is an invaluable tool in anesthetic armamentarium. Apart from laser safety, it offers a nearly tubeless field for the surgeon to excise airway lesions. Careful patient selection, total intravenous anesthesia, and judicious use of anesthetic and vasoactive agents to minimize pressor response are the factors contributing to successful outcome.
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A case of primary mucosa-associated lymphoid tissue lymphoma of the larynx p. 50
Mahmood Dhahir Al-Mendalawi
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