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   Table of Contents - Current issue
July-December 2017
Volume 7 | Issue 2
Page Nos. 25-45

Online since Wednesday, September 26, 2018

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Postintubation recurrent laryngeal nerve palsy: A review p. 25
R Inita Matta, B Kanupriya Halan, Kavita Sandhu
Endotracheal intubation is one of the most common procedures performed in the Operating Theatre, Intensive Care Unit or wards, either on an elective or emergency basis. Recurrent laryngeal nerve injury leading to vocal cord paralysis is a lesser known but important complication of intubation. It is important to identify and monitor these patients to prevent confusion with regard to etiology and outcome. This article explores the etiopathogenesis of recurrent laryngeal nerve palsy following intubation and the various risk factors and possible mechanisms which contribute to this complication. Techniques to prevent and recognize this injury are also discussed. PubMed was the main database searched for articles related to the topic which were found through the period 1972–2017.
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Narrow-band imaging in chronic granulomatous laryngeal tuberculosis p. 29
Rakesh Srivastava, Ashish Chandra Agarwal, Giorgio Peretti
Context: The study analyzes the vascular pattern on narrow-band imaging (NBI) in laryngeal tuberculosis (TB) and its differentiation from premalignant and malignant lesions. Objective: NBI is an optical image enhancement technology using light of 415 nm and 540 nm wavelength. These have different depths of penetration and highlight the mucosa and submucosa. NBI has a proven role in the detection of premalignant and malignant lesions. This study analyzes the vascular pattern on NBI in laryngeal TB and its differentiation from premalignant and malignant lesions. Materials and Methods: A prospective study was done at a tertiary care center on patients presenting with hoarseness, breathing, or swallowing difficulty. An endoscopic examination of the larynx was done, and biopsy was taken on suspicion of a neoplastic lesion. A diagnosis of TB was made in nine patients. These patients were included in the study. NBI examination of the larynx was done to analyze the vascular pattern on the vocal folds. The margin and center of the lesion were analyzed in detail. Results: Two patients had primary laryngeal lesions and seven had laryngeal and lung involvement. History and clinical examination, supportive investigations, and NBI helped in the diagnosis. The intrapapillary capillary loop pattern seen in early premalignant or malignant lesion was not observed in any of the cases on NBI. Conclusion: NBI is not confined to the diagnosis of premalignant or malignant lesions. It is equally useful in ruling out malignancy in suspicious lesions on white-light endoscopy. The latter should be carefully evaluated before transoral surgery.
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Sequential swallow ability of 100 ml carbonated thin liquids in healthy young adults p. 33
Thejaswi Dodderi, Merin Shaju, Alisha Sara Thomas
Context: Using sour liquids to enhance sensory stimulation is practiced widely in oropharyngeal dysphagia. However, dysphagic population reports sour taste as unpalatable and difficult to adopt for daily meals. To overcome this, carbonated thin liquids (CTLs) are adopted by dysphagia practitioners. Yet, there are limited scientific experiments in this clinically significant area. Aims: The present study was undertaken to investigate any potential differences in swallowing ability between CTL in comparison with non-CTL (NCTL) using timed test of swallow in healthy young adults. Settings and Design: A cross-sectional comparative design was used for the study. Subjects and Methods: Thirty healthy young adults within the age range of 18–24 years ingested CTL and NCTL of 100 ml capacity in a 120 ml throwaway cup. In CTL, neutral, sweet, and sour taste was adopted. Based on which three swallow indices, namely, volume/swallow (V/S), time/swallow (T/S), and swallow capacity (SC) were derived. Statistical Analysis Used: Descriptive statistics and repeated measures of ANOVA were applied on the data. Results: In V/S, sweet CTL had higher volume intake, while sour CTL had least. In the temporal parameter, NCTL had the shortest T/S and sour CTL had increased T/S. Finally, sweet CTL had highest SC. These differences were not statistically significant. Conclusions: The data of the study suggest that sweet CTL promotes swallow performance, while sour CTL inhibits SC. These findings have practical implications in promoting safe swallow.
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Case series reporting hypothyroidism induced dysarthria : An unusual entity p. 37
Navgeet Mathur, Medha Mathur
Hypothyroidism is a common endocrinal disorder which may present as an unusual presentation like dysarthria. Knowledge about unusual presentations in hypothyroidism may help to make correct diagnosis and treatment. This case series includes two cases of hypothyroidism-induced dysarthria. Both cases were misdiagnosed on previous medical consultations. Complete recovery was achieved after correct diagnosis and thyroxin replacement.
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A case of primary mucosa-associated lymphoid tissue lymphoma of the larynx p. 40
Sachin Gandhi, Shashank Gupta, Sujit Joshi, Suvojit Ghosh
Mucosa- associated Lymphoid Tissue (MALT) Lymphoma is a Non-Hodgkin Lymphoma. This marginal zone lymphoma is typically a low-grade neoplasm. Primary Laryngeal MALT Lymphoma is an extremely rare entity. No case has been reported from India till now. We present a case of Laryngeal MALT Lymphoma in a 49 year old lady with complain of progressive hoarseness of voice since 6 months and history of orbital pseudo-tumour. MALT Lymphoma was diagnosed after biopsy and managed with 6 cycles of R-Benda Chemotherapy. The patient has had uneventful follow-up for past 3 years. Primary MALT lymphoma is a rare but curable disease and clinicians should keep it in mind while forming differential diagnosis for a suspicious mass during laryngeal evaluation.
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Arytenoid dislocation subsequent to difficult intubation p. 43
Anjali Venugopal, Yogesh G Dabholkar, Akanksha A Saberwal
Dislocation of arytenoid cartilage from the crico-arytenoid joint is an uncommon complication due to intubation of larynx. In many cases, it is frequently mistaken as vocal cord paresis, laryngospasm, or laryngeal edema. Early diagnosis of the arytenoid dislocation and prompt treatment with reduction is crucial to avoid the need for more invasive methods and for a better prognosis of the condition. We report the case of a 50-year-old male with arytenoid dislocation following an uneventful coronary artery bypass graft surgery. He complained of persistent hoarseness following 15 days of the surgery. On fiber-optic laryngoscopic examination, the right vocal cord was immobile with minimal movement of arytenoid. A surgical reduction was performed by the otolaryngologist. The patient was relieved of the symptom postreduction.
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