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   2013| July-December  | Volume 3 | Issue 2  
    Online since May 7, 2014

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Thyroglossal duct cyst: Unusual presentation in an adult
W.V.B.S. Ramalingam, Rajeev Chugh
July-December 2013, 3(2):61-63
Thyroglossal duct cyst is a congenital lesion of the neck resulting from the remnant of the thyroglossal tract. A 59-year-old male patient presented with a progressive cystic swelling in the neck which moved on swallowing and protrusion of tongue. Investigations were inconclusive and thyroid profile was normal. Sistrunk's operation was performed and histopathological examination revealed it as thyroglossal duct cyst. There were no post-operative complications and no evidence of malignancy. The objective of this article is to emphasize on the importance of considering thyroglossal duct cyst as differential in an unusually large cystic neck swelling in adults with no conclusive evidence on investigations. Complete excision of the cyst with the tract and part of the body of hyoid (Sistrunk's operation) will significantly improve the outcome with reduced risk of recurrence.
  25,272 115 1
A study on behavior and management of suicidal cut throat patients
Kalpana Sharma, Kaberi Kakati, Subodh C Goswami, Dipesh Bhagawati, Manigreeva Krishnatreya
July-December 2013, 3(2):57-60
Background: Suicide is one of the 10 leading causes of death in the world and cut throat injuries (CTI) are fairly common due to suicide. Aims and Objective: The aim of the present study is to evaluate the pattern of injury, its management and associated psychiatric illness in suicidal CTI. Materials and Methods: A prospective study from August 2011 to April 2013 was carried out in the Department of Ear, Nose, and Throat (ENT) in collaboration with the Department of Psychiatry at  Gauhati Medical College and Hospital. A total of 17 cases of suicidal CTI were included in the study irrespective of age and sex, who were admitted in the department of ENT. Results: Majority of the patients were young adults, 82.35% in the age group of 20-40 years. According to anatomical zone, 77% had injury in Zone 2 and 23% had Zone 1 injury. Hesitation injury involving skin and soft-tissues were seen in the neck in 71% of cases, and common morbidity following CTI is secondary wound infection (23.52%), persistent dysphagia (23.54%) and ugly scar (17.64%). Majority of patients (47.05%) were of acute and transient psychosis. Conclusion: Suicidal CTI is an important cause of cut neck injury in ENT practice. Proper surgical and psychiatric management of suicidal CTI plays an important role in the prevention of complications and resultant death due to CTI.
  17,084 115 1
Herpes simplex laryngitis following primary genital herpes
Purnima Sangwan, Rakesh Datta, Ashwani Sethi, Awadhesh K Mishra, Satwinder P Singh
July-December 2013, 3(2):70-72
Primary genital herpes is associated with involvement of extragenital sites like thighs, buttocks, fingers and pharynx. This involvement occurs due to autoinoculation, orogenital exposure from the source and also seeding due to viremia in the initial period. Involvement of larynx in a case of primary genital herpes is extremely rare prompting us to report this case.
  13,077 104 1
External laryngocele: Points to remember
J Jishana, Jayita Das Poduval
July-December 2013, 3(2):67-69
Laryngocele is a rare cystic swelling arising from the saccule of larynx. It is seen mostly among trumpeters and glassblowers. In others, it is often associated with underlying malignancy. Here we report a case of external laryngocele in a young farmer who did not have any of the above mentioned associations.
  11,414 123 1
Lidocaine lozenge versus lidocaine spray as topical anesthesia before direct awake laryngoscopy: A randomized active controlled trial
Santosh K Kacker, B Jagannath, Sanjay H Maroo, Ketan R Patel, Vipul I Prajapati, Rakesh U Ojha
July-December 2013, 3(2):52-56
Context: Key to successful awake direct laryngoscopy is establishing reliable local anesthesia. Lidocaine spray was reported to be effective in laryngoscopic procedure with less hemodynamic and cardiovascular disturbances. Novel formulation of lidocaine as lozenges was developed to avoid problems of throat irritation and bitter taste associated with spray. Aims: The aim of the following study is to compare the efficacy and safety of lidocaine lozenges versus lidocaine spray in patients undergoing awake diagnostic direct laryngoscopy. Design: A prospective, randomized, open label, active controlled, multicentric study. Subjects and Methods: Patients of either sex, aged between 18 to 80 years and undergoing awake diagnostic direct laryngoscopy were enrolled after screening for eligibility criteria. Enrolled patients were randomized to one of the two treatment; lidocaine lozenges 200 mg and lidocaine spray 200 mg to be applied as a single dose before laryngoscopy. Immediately after the procedure, efficacy, and safety was assessed. Statistical Analysis: Between groups comparison was done using appropriate parametric or nonparametric tests. Results: Investigator experienced significantly lesser procedural difficulty and reduced gag reflex during the procedure with lidocaine lozenges compared to spray. Lesser number of patients experienced aversive symptoms (especially nausea, vomiting, cough, and pain) during and after the procedure and significantly more number of patients preferred to have a repeat procedure with lidocaine lozenges compared to spray. The global assessments by the patient and investigator favored lidocaine lozenges over spray. Conclusion: Lidocaine lozenges given before direct awake laryngoscopy provide a significant benefit by offering a more effective, safe, and convenient anesthesia compared to spray.
  7,949 156 -
Acoustical and perceptual analysis of voice projection in Marathi speaking actors
A Namita Joshi, S Bhushan Jirgale
July-December 2013, 3(2):41-45
Context: Exploring the characteristics of actor's voice is been the interest of the researchers in last two decades. Research on professional voice users in India is mostly concentrated on singers, teachers, radio jockeys etc. A literature search indicates two areas where more research is needed. Primarily detailing the way of perceptual evaluation of actor's voice (speaking voice) and correlating it acoustic parameters. Research needs to be carried out to find out whether the actors are special as in the strategies they use to project their voices in Indian contexts. Aims: The primary aim of the following study is to analyze acoustic and perceptual parameters for voice projection in actors and non-actors at three loudness levels and secondary aim is to find out correlation between them. Subjects and Methods: A total of 18 actors and 18 non-actors within the age range of 19-60 years participated in the study. Their voices were digitally recorded and analyzed using LTAS  (Dr. Speech, Real Analysis-Tiger Electronics, Version 5) on frequency-intensity parameters. Result and Discussion: The result showed that there is a significant difference between actors and non-actors at stage performance level (P < 0.01). Pattern of spectral slope was found sharply falling with higher energy concentration in actors at 3-4 kHz. Perceptual parameters correlated moderately only with average f0 at stage performance level. Conclusion: Actors are efficient in projecting their voice perceptually than non-actors which is in correlation with acoustic parameters at stage performance level.
  5,840 155 -
Histoplasmosis of the larynx
John M Carter, Kelsey Williams, Brian A Moore
July-December 2013, 3(2):64-66
Histoplasmosis is an infection caused by the fungus Histoplasma capsulatum. Disseminated histoplasmosis rarely presents in the larynx and may mimic the appearance of a laryngeal neoplasm. Here, we present a case of laryngeal histoplasmosis in an elderly patient undergoing treatment for rheumatoid arthritis with immunosuppressive medications.
  5,690 94 2
Quantitative analysis of pathological female human voice by processing complete sentences recordings
Andrea Ancillao, Manuela Galli, Michele Mignano, Rossella Dellavalle, Giorgio Albertini
July-December 2013, 3(2):46-51
Objectives: The aim of this work was to determine, by computing quantitative parameters over the recording of complete spoken sentences, female human voices obtained from dysphonic individuals. Healthy subjects were also recruited to compute reference values. Materials and Methods: In this study, a total of 15 female subjects who were diagnosed with dysphonia were enrolled. Age matched female controls were also enrolled. Each subject was asked to read aloud a text composed of three sentences. The subjects were all Italian native speakers and the sentences were written in Italian.Voice was digitally recorded and each sentence was processed by Praat software in order to compute frequency parameters (Pitch, Jitter, Shimmer) and harmonic to noise ratio. Parameters were then compared within the sentences spoken by the same subject and between pathological and control group. Results: The parameters resulted similar among the three sentences read by the same subject, while there were statistically significant differences between the pathological group and the control group. Conclusion: The quantitative analysis of voice, run over complete sentences, is therefore able to characterize pathological subjects and provides useful information that may support the diagnosis of dysphonia.Processing voices from a control group allowed also to develop reference data for female human voice. The found values can be assumed as representative of the normal female voice and may be used as reference data for other studies on pathological voices.
  5,076 115 -