Multiple vocal fold lesions (original) (raw)

Pathology of Nonneoplastic Lesions of the Vocal Folds

Voice and Swallowing Disorders [Working Title]

Nonneoplastic vocal fold lesions are common that can cause hoarseness and voice change. Reactive lesions of Reinke's space can be observed in all ages and genders and comprise the majority of the benign nonneoplastic vocal fold lesions. Although clinically different terms are used to define reactive lesions of Reinke's space, they share the same histopathologic features. In order to differentiate vocal fold polyp and nodule and Reinke's edema, clinical findings should be considered. Epithelial changes such as pseudoepitheliomatous and verrucous hyperplasia may cause diagnostic challenge due to resemblance of squamous cell carcinoma. Evaluation of the invasion border and cellular atypia may aid in correct diagnosis.

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

Brazilian Journal of Otorhinolaryngology, 2014

Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n = 17), teacher (n = 4), salesclerk (n = 4), nurse (n = 1), retired (n = 1), and psychologist (n = 1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

A CLINICAL STUDY OF BENIGN VOCAL LESIONS.

International Journal of Advanced Research (IJAR), 2019

Benign vocal lesions are non-cancerous growths of abnormal tissue on the vocal folds. Vocal nodules and polyps account for the majority of benign structural vocal fold disorders, which are usually associated with abusive phonation habits. Material and Methods: This prospective study was conducted in 100 patients who were diagnosed with various benign lesions of larynx during a period of 6 months. All malignant cases were excluded from this study. Results:Male preponderance was seen in our study. Vocal cord polyps were commonest type of lesion. In our study Hoarseness of voice was seen 100% patients.

Cross Sectional Study of Laryngeal Pathology in Dysphonic Patients

Objectives: To determine the frequency of laryngeal pathology in dysphonic patients and the relationship of patient variables with voice disorders. Background: Voice has been termed disordered when the production of one or more of its perceptual aspects (pitch, loudness, quality and resonance) are audibly dissimilar to those of people of the same sex, age and culture. An alternative definition is that voice is disordered when it no longer meets the requirements previously attained by the individual speaker. Patients and Methods: The study included 169 patients who consulted with dysphonia at the ear, nose and throat department of Al-Yarmouk teaching hospital from June 2010 to June 2011. Laryngeal examination was done with indirect mirror laryngoscopy, flexible fiberoptic endoscopy and direct laryngoscopy. Results: Twenty three laryngeal pathologies were reported under 5 main categories of voice problems which were: inflammatory, structural, neoplastic, neuromuscular and psychogenic dysphonia. Pathologies were significantly more common in males (53.3%) than females (46.7%).Inflammatory organic voice disorders were most frequently diagnosed (56.8%).Vocally demanding occupation accounted for (75.3%). Professional voice users accounted for (10.1%) of the workforce population, with teachers (65%) as main category. Conclusions: The inflammatory organic voice disorders were the most common cause of voice disorders. Significant association was found between age, vocally demanding occupations, smoking and alcohol. Professional voice users represent almost one tenth of the studied group. Teachers being the main subgroup with organic voice disorder as the main cause for their dysphonia.

Voice Disorders: Etiology and Diagnosis

Journal of Voice, 2016

Voice disorders affect adults and children and have different causes in different age groups. The aim of the study is to present the etiology and diagnosis dysphonia in a large population of patients with this voice disorder.for dysphonia of a large population of dysphonic patients. Methods. We evaluated 2019 patients with dysphonia who attended the Voice Disease ambulatories of a university hospital. Parameters assessed were age, gender, profession, associated symptoms, smoking, and videolaryngoscopy diagnoses. Results. Of the 2019 patients with dysphonia who were included in this study, 786 were male (38.93%) and 1233 were female (61.07). The age groups were as follows: 1-6 years (n = 100); 7-12 years (n = 187); 13-18 years (n = 92); 19-39 years (n = 494); 41-60 years (n = 811); and >60 years (n = 335). Symptoms associated with dysphonia were vocal overuse (n = 677), gastroesophageal symptoms (n = 535), and nasosinusal symptoms (n = 497). The predominant professions of the patients were domestic workers, students, and teachers. Smoking was reported by 13.6% patients. With regard to the etiology of dysphonia, in children (1-18 years old), nodules (n = 225; 59.3%), cysts (n = 39; 10.3%), and acute laryngitis (n = 26; 6.8%) prevailed. In adults (19-60 years old), functional dysphonia (n = 268; 20.5%), acid laryngitis (n = 164; 12.5%), and vocal polyps (n = 156; 12%) predominated. In patients older than 60 years, presbyphonia (n = 89; 26.5%), functional dysphonia (n = 59; 17.6%), and Reinke's edema (n = 48; 14%) predominated. Conclusions. In this population of 2019 patients with dysphonia, adults and women were predominant. Dysphonia had different etiologies in the age groups studied. Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly.

Outcome Analysis in Patients with Benign Vocal Fold Lesions

International Journal of Phonosurgery & Laryngology, 2016

Introduction Benign vocal cord lesions cause significant dysphonia by disrupting the normal vibratory function of the vocal fold mucosa. Multidimensional assessment of voice characteristics allows for an accurate analysis of voice impairment and can be used to assess the outcome of different treatment modalities. Aims To evaluate the outcome in patients treated for benign vocal fold lesions using multidimensional voice assessment Materials and methods Thirty adult patients with benign vocal fold lesions were treated according to standard protocols and followed up for 6 months. Voice was evaluated by visual analog scale (VAS), GRBAS (grade, roughness, breathiness, asthenia, strain) scale, maximum phonation time (MPT), S/Z ratio, and acoustic parameters using PRAAT. Pre- and posttreatment voice was compared. Results Benign lesions observed were vocal polyps (16), vocal nodules (7), vocal fold cysts (5), vocal cord papilloma (1), and sulcus vocalis (1). Mean VAS rating improved from 7....

Vocal fold lesions in the pediatric age group: our experiences at a tertiary care teaching hospital of India

Background: Vocal fold lesions are commonly found in the pediatric age group. The lesions of the vocal fold among children are variable. The laryngoscopic examination is needed for the identification of the vocal fold lesions. The objective of this study is to find out the different vocal fold lesions, clinical presentations, and diagnoses of the vocal fold lesions. Methods: The children aged from 5 to 18 years diagnosed with vocal fold lesions were included in this study. The study was conducted between June 2017 to July 2022. All the children with vocal fold lesions were subjected to video laryngoscopy for assessment of the larynx. Results: There were 156 children diagnosed with vocal fold lesions. The majority of this study's participants were male children (52.56%). The most common symptom was hoarseness. Most common vocal fold lesion was vocal fold nodule (43.58%). Voice abuse was the most common etiological factor behind the vocal fold lesions. Out of 156 children with vocal fold lesions, 72 children (46.15%) underwent microlaryngeal surgery under anesthesia. Voice therapy was given to all the children along with vocal hygiene care. Conclusions: Vocal fold lesions are often found among children. Dysphonia is the commonest clinical presentation of children with vocal fold lesions. Microlaryngeal surgery and voice therapy are two important options for the treatment of vocal fold lesions in pediatric patients.

Vocal fold paresis accompanying vocal fold polyps

European Archives of Oto-Rhino-Laryngology, 2014

The aim of this study was to evaluate patients with vocal fold polyps using laryngeal electromyography (LEMG) for the presence of vocal fold paresis and to compare transnasal fiberoptic and rigid stroboscopic findings between polyp patients with normal LEMG and with vocal fold paresis. Thirty-five patients with a vocal fold polyp underwent transnasal fiberoptic laryngoscopy, rigid laryngostroboscopy, and LEMG. The findings were compared between the LEMG-confirmed vocal fold paresis patients and the normal LEMG patients. LEMG resulted in a diagnosis of unilateral or bilateral vocal fold paresis in 17 of 35 patients (48.6 %). More men than women with vocal fold polyps had vocal fold paresis (p \ 0.05). The vocal fold paresis group had higher presence of axial rotation and hypomobility of vocal folds, higher asymmetry of vertical height of vocal folds, and less presence of longitudinal stretch of vocal folds (p \ 0.05). Medial-lateral compression of the false vocal folds and anterior-posterior approximation of the larynx did not show any difference between the groups. No significant difference was found in vibratory wave characteristics between the groups through rigid laryngostroboscopy. Vocal fold paresis was present in almost half of the patients with vocal fold polyps. Paresis can only be accurately diagnosed with LEMG. Transnasal fiberoptic laryngoscopic examination is helpful to recognize vocal fold paresis in vocal fold polyp patients, while stroboscopic examination is not useful to identify it in vocal fold polyp patients.