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   2013| January-June  | Volume 3 | Issue 1  
    Online since September 24, 2013

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"Doctor I have a frog in my throat": Bilateral pharyngoceles in a recreational trumpet player
Charles Daultrey, Steve Colley, Declan Costello
January-June 2013, 3(1):18-21
Pharyngocele is defined as "lateral pharyngeal wall herniation located in the piriform recess or at the valleculae" and was first described in 1886. The phenomenon is rare. It is characterised by bulging of the pharynx locally and is associated with recurrent increase in intrapharyngeal pressure, reduced muscle resilience, and increasing age. The case describes a 51-year-old recreational trumpeter with bilateral pharyngoceles that demonstrated when blowing into his instrument, reminiscent of a "bullfrog." Differential diagnosis included "Zenker's diverticulum", (pharyngeal pouch), laryngocele, and jugular venous phlebectasia, which may be confirmed through clinical examination and investigation. The report includes remarkable images seen on examination and images of the swelling seen with plain film radiography, barium swallow, and computed tomography. We discuss the management options available, including repair and excision of the pouch, either as an open procedure or endoscopically, and explore the conservative measures as a basis in the management of even significant pharyngoceles.
  11,832 163 3
Acute laryngeal abscess following acute sinusitis: A rare presentation in the modern era
Shraddha Jain, Sagar Gaurkar, Prasad Deshmukh, Sunil Kumar
January-June 2013, 3(1):26-28
Acute laryngeal abscess is a rare but potentially lethal condition. There are historic descriptions of its association with systemic illnesses like typhoid fever or as a result of spread of infection following upper respiratory tract catarrh. The etiology of laryngeal abscess in recent times has changed to those with underlying malignancy, trauma due to airway instrumentation, nasogastric intubation, and external beam radiotherapy. Here we report a case of acute laryngeal abscess following catarrh, identical to the historic descriptions, probably the first such report in the modern era, highlighting the importance of its early diagnosis and high index of suspicion, which led to a very good recovery in our patient.
  9,025 123 3
Laryngeal aerodynamic analysis of vocal nodules
S Sheela
January-June 2013, 3(1):10-13
The present study is aimed to investigate the effects of vocal nodules on the aerodynamic analysis of the voice. The study included twelve females with normal laryngeal and respiratory functions and twelve age, gender and language matched females with bilateral vocal nodules within the age group of 18-40 years. All participants were subjected to non-invasive aerodynamic analysis using Aeroview 1.4.4 version (Glottal Enterprises Inc, USA). The participants were instructed to produce the CV syllable train "papapapa" into the circumvented mask at comfortable pitch and loudness. The recorded stimuli were analyzed to obtain laryngeal aerodynamic measures such as estimated subglottic pressure, mean airflow rate, laryngeal airway resistance, and laryngeal airway conductance. Mean and standard deviation for all the four laryngeal aerodynamic measures were calculated separately for both control and clinical groups. The results revealed significant effect of voice on laryngeal measures such as estimated subglottic pressure and mean airflow rate. Thus, results suggest that indirect measurement of laryngeal aerodynamic parameters are effective and essential investigative tools in assessment of vocal nodules.
  7,691 317 1
The prevalence and impact of voice problems in call center operators
Usha Devadas, B Rajashekhar
January-June 2013, 3(1):3-9
Background: Since the past 10 years, the call center industry has expanded rapidly in India. Effective and healthy voice is a primary need for these professionals. Voice problems may threaten both the working ability and occupational health and safety of call center operators (CCOs). Western literature reports higher prevalence of voice problems in CCOs: Yet such investigations are not reported in India. Hence, the present study was focused on investigating the prevalence of voice problems among CCOs and its impact on their working performance. Materials and Methods: A cross sectional survey study was conducted using self-reported questionnaires. Data for the present study were obtained through convenient sampling by distributing 2000 questionnaires in 11 voice-based call centers in Bengaluru, Karnataka, India. The results of the study are analyzed and discussed, based on 1093 eligible questionnaires. Results: The career and point prevalence of voice problems in CCOs were observed to be 59% and 27%, respectively, with no significant gender difference (P > 0.05). The impact of the voice problem in terms of missing work was found to be significantly greater in female CCOs as compared with their male counterparts. Conclusions: This study supports the findings in the literature that CCOs are at greater risk of developing voice problems and that voice problems affect their performance. Thus, there is a great need to identify the risk factors associated with these voice problems and educate the CCOs and employers/organizations about the consequences of voice problems for monitoring effective functioning of CCOs.
  7,408 273 5
Vocal cord granuloma and voice change following tracheal intubation in an actor
Ramanathan Kasivisvanathan, Alan McGlennan
January-June 2013, 3(1):32-33
This is a clinical report highlighting a vocal cord granuloma, a rare complication of short-term tracheal intubation, as a cause for persisting voice change and hoarseness in a 42-year male actor. The etiology and treatment for vocal cord granulomas are briefly discussed.
  5,976 142 -
Laryngeal movements in stutterers
Swapna Sebastian, Anto Suresh Benedict, Achamma Balraj
January-June 2013, 3(1):14-17
Background: The etiology of stuttering is a puzzle. Abnormal laryngeal movements have been assumed to be a cause of stuttering by many researchers. We aimed at comparing the laryngeal functions of stutterers using electroglottogram (EGG) and vocal tract functioning using formant frequency analysis. Materials and Methods: We compared the acoustic and electroglottographic parameters in the phonation of stutterers between the age range of 15-25 years and normal subjects matched for age and sex. Results and Discussion: All the electroglottographic parameters of stutterers differed from that of normal speaking subjects which is indicative of difficulty in adjustment of the laryngeal gestures for speech in stutterers. There was no significant difference between the stutterers and non-stutterers in terms of formant frequencies. Similar formant frequencies in stutterers and normal speakers and abnormal electroglottographic parameters are suggestive of abnormal laryngeal movements and normal vocal tract functioning in stutterers.
  5,710 196 1
The saga of a neglected foreign body in esophagus
A Ravikumar, Prasanna S Kumar, L Somu, M. N. Thowfeeka, S Balagopal
January-June 2013, 3(1):22-25
An ingested foreign body lodged in the esophagus is common in children. Button batteries impacted in the esophagus need early diagnosis and intervention to avoid complication. We report a case of neglected button battery impacted in the upper esophagus in a 15-month-old female child. The problems encountered during the course of management have been discussed along with the review of the literature. Button battery ingestions in children need to be considered as an emergency and prompt endoscopic removal should be advocated. Rigid esophagoscopy is the gold standard technique of removing esophageal foreign bodies. Complication must be anticipated and managed at the earliest.
  4,948 122 -
Tracheal leiomyoma: A clinical dilemma
Vaishali Gupta, Rajesh Vishwakarma, Kalpesh Patel, Hemina Desai
January-June 2013, 3(1):29-31
Benign tumors of the trachea are rare with leiomyomas even less common. A high degree of clinical suspicion is required for their diagnosis as they usually mimic chest pathology. We report a case of 23-year-old male who presented with orthopnea since 6 weeks without any improvement despite medical treatment. His chest X-ray was normal but the neck computed tomography scan and flexible bronchoscopy showed a tracheal mass. It was resected by anterior endotracheal approach and diagnosed as leiomyoma on histopathology and immunohistochemistry.
  3,689 97 -
Occupational hazards of the emerging voice professions
Rakesh Datta
January-June 2013, 3(1):1-2
  3,173 194 3