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   2015| January-June  | Volume 5 | Issue 1  
    Online since December 17, 2015

 
 
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EVIDENCE BASED LARYNGOLOGY
Therapeutic interventions by speech language pathologist in managing adult dysphagia: An evidence based review
Ruchika Mittal, Awadhesh Kumar Mishra, Ajith Nilakantan
January-June 2015, 5(1):11-16
DOI:10.4103/2230-9748.172105  
The speech and language pathologist provides nonsurgical, nonpharmacological treatment to patients with oropharyngeal dysphagia. There is a notable lack of knowledge or awareness among the professionals in managing dysphagia using this therapeutic intervention. The present article, therefore, reviews the therapeutic interventions offered by speech and language pathologist in managing adult dysphagia and its efficacy data. Literature was searched and all the therapeutic interventions offered were included and studies were quoted mentioning their efficacy. In general, positive therapy effects were found.
  4,785 17 -
CASE REPORTS
Paradoxical vocal cord motion disorder - An unexpected mimicker of bronchial asthma
Abdul Wadood Mohammed, Pearl Sara George, Kasim Kolakkadan, Jishnu Narayanan, Deepak Raj
January-June 2015, 5(1):17-20
DOI:10.4103/2230-9748.172107  
Paradoxical vocal cord motion (PVCM) disorder, otherwise called vocal cord dysfunction is a very peculiar disorder often misdiagnosed and mistreatment. The awareness of such a condition is very little between practicing pulmonologist and otolaryngologist and often patients are treated as bronchial asthma or get tracheostomized misdiagnosed as bilateral abductor cord palsy. We present a case of a 25-year-old lady, who was being treated for bronchial asthma in the form of oral and inhaled steroids. She presented to the emergency with a supposed acute exacerbation of asthma. However, the patient did not respond to intravenous and nebulized steroids. The patient was referred to the otolaryngologist and fiber optic laryngoscopy was done and a diagnosis of bilateral abductor cord palsy. The patient was subsequently tracheostomized and decannulated once the vocal cord motion recovered. However, the patient again presented to the emergency with stridor, but this time a detailed fibreoptic laryngoscopy helped us to diagnose PVCM disorder. The patient was treated with nothing other than psychotherapy and speech therapy and the patient recovered never to get a further episode. We discuss the important aspects of clinical features, diagnosis, and management of this unique condition.
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ORIGINAL ARTICLES
Electroglottographic patterns in physiologic and pathologic types of sulcus vocalis
N Sreedevi, Gopi Kishore Pebbili, TK Prakash, Shishira S Bharadwaj
January-June 2015, 5(1):2-6
DOI:10.4103/2230-9748.172088  
Introduction: Sulcus vocalis is a condition of true vocal folds presenting as a linear furrow on the mucosal lining, lengthening toward the entire vibratory surface. Differential diagnosis between physiologic and pathologic sulcus vocalis has traditionally been based upon videostroboscopy that does not conclusively differentiate between the two. Hence, the present study was intended to utilize the electroglottograph (EGG), a routinely utilized voice evaluation tool to track morphological vibratory patterns in these conditions aiding in differential diagnosis. Method: A total of 40 individuals diagnosed as physiologic (17) and pathologic sulcus (23) based on stroboscopic examinations and history details were recruited as the participants for the study and were made to undergo the EGG procedure. Results: The majority of the participants with physiologic sulcus, obtained normal wave morphology barring four participants who demonstrated deviant patterns. In cases of pathologic sulcus, varied wave patterns obtained were prolonged open phase, pit such as undulation in closed phase, abrupt closing phase, and reduced amplitude waveform. Conclusions: The current study enhances the utility of EGG in cases of sulcus and its types (physiologic and pathologic sulcus) by revealing distinct waveform patterns in each and thereby aiding differential diagnosis too. These results from EGG are much relevant to voice clinicians especially in conditions where other evaluation tools are restricted.
  3,192 17 -
STUDENTS CORNER
Dysarthrophonia: A case report
Swetha Grandhi, Pawana P Poojary, BS Premalatha
January-June 2015, 5(1):24-25
DOI:10.4103/2230-9748.172117  
Voice analysis in dysarthria is challenging because of the complexity of the disorder and its effects on the speech production system. A combination of perceptual and acoustic analysis has become increasingly common because of its convenience. The aim of this report is to describe the voice analysis in a 66-year-old male diagnosed as spastic dysarthria. Based on the assessment, we can conclude that voice analysis reveals interesting data on the multiplicity of voice quality in spastic dysarthria.
  2,394 17 -
CASE REPORTS
Laryngeal synovial sarcoma: Case report and literature review
D Sridhar Reddy, K Srinivas, Ch Sravan Kumar, Chandra Sekhar
January-June 2015, 5(1):21-23
DOI:10.4103/2230-9748.172112  
A 17-year-old female patient presented with complaints of difficulty in swallowing of 1-year duration, which was gradually progressive, associated with throat pain radiating to the left ear. There is no history of change in voice. There is no history of an injury or previous surgery. Computed tomography scanning confirmed a mass arising from the left aryepiglottic fold. On direct laryngoscopy, a mass was seen on the left aryepiglottic fold, which was excised and subjected to immunohistochemistry which revealed synovial sarcoma (SS). SS is a very rare tumor in the larynx, we report this case for its rarity.
  2,268 17 -
EDITORIAL
Sulcus vocalis: Solving the puzzle
Rakesh Datta
January-June 2015, 5(1):1-1
DOI:10.4103/2230-9748.172087  
  2,153 16 -
ORIGINAL ARTICLES
Vowel harmonic amplitude differences in individuals with unilateral vocal fold paralysis
B Radish Kumar, Jayashree S Bhat, Jasna Usman
January-June 2015, 5(1):7-10
DOI:10.4103/2230-9748.172095  
Background: The studies reviewed suggest the potential clinical applications of vowel harmonic amplitude differences. In this study, it was hypothesized that there would be abnormal reduction of higher harmonic amplitudes relative to the amplitude of the first harmonics in individuals with unilateral vocal fold paralysis (UVFP) as they are characterized by breathy voice due to inadequate closure of vocal folds. Method: A total of 80 participants were divided into clinical group and control group. They were instructed to phonate/a/at their most comfortable pitch and loudness. Fourier transformation of the recorded acoustic signal was first performed to create a spectrum. Amplitudes were measured for the first and second harmonics as well as the harmonics at the first, second, and third formants using the Computerized Speech Science Lab. Results: Independent t-test was employed to compare the significant differences between the clinical and the control group in both males and females. The results revealed significant differences across the two groups and gender at P < 0.05. The obtained results were discussed with respect to the underlying pathophysiology. Conclusion: Spectral deviations in the clinical group are explained due to the presence of phonatory gap due to the UVFP.
  2,151 16 -
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