BAMBOO NODES ASSOCIATED WITH VASCULITIS OF VOCAL CORDS AS INITIAL MANIFESTATIONS OF RHUPUS SYNDROME

Abstract Background Vocal cord lesions related to autoimmune diseases have been described as early as 1959, when Scarpelli et.al described a case of a woman with systemic lupus erythematosus (SLE) presented with laryngeal oedema. Pathological examination of the tissue revealed inflammatory cells and the lesions were labeled as “inflammatory nodules”. Since then numerous case reports were published describing patients with rheumatic diseases and abnormal vocal cords with Hosako et al. in 1993 proposing the term “bamboo nodes”. Methods A 27 year old female, lifelong nonsmoker, developed a husky voice which persisted through the day. She had no odynophagia or dysphagia and occasionally suffered from heartburn.She reported feeling fatigue and described a non-blanching purpuric rash affecting her lower limbs. She was referred to rheumatology and also to ear, nose and throat (ENT) specialist for further assessments including laryngeal endoscopy and autoimmune screen. Results The video laryngeal endoscopy revealed an area of linear thickening of the left mid-vocal fold. There was no evidence of reflux or muscle tension. Immunological test's revealed positive antinuclear, ribonuclear and Sm antibodies, with normal serum complement. The erythrocyte sedimentation rate was raised with normal C-reactive protein and there was a polyclonal increase of immunoglobulins. A diagnosis of mixed connective tissue disease with bamboo nodes was made. Her treatment consisted of local corticosteroid injections into the vocal cords with prednisolone 5mg (Solu-DecortinR) and systemic corticosteroids followed by hydroxychoroquine 5mg/kg and azathioprine 2mg/kg. Patient improved clinically but still requires speech therapy as adjunctive to the pharmacological treatment. Conclusion Bamboo nodes are a rare manifestation of autoimmune diseases and currently there is no gold standard on how to manage them. This case highlights the need of close collaboration between ENT, rheumatology and speech&language therapy. Disclosures D.C. Christidis None. M. Lloyd None.

Download Full-text

Bamboo nodes of the vocal cords

Canadian Medical Association Journal ◽

10.1503/cmaj.160460 ◽

2017 ◽

Vol 189 (15) ◽

pp. E572-E572 ◽

Cited By ~ 1

Author(s):

Yue Fan ◽

Xingming Chen

Keyword(s):

Vocal Cords ◽

Bamboo Nodes

Download Full-text

Cirugía de feminización de voz con técnica glotoplastia de Wendler en Barranquilla, Colombia. Voice feminization surgery with Wendler glottoplasty technique in Barranquilla, Colombia.

ACTA DE OTORRINOLARINGOLOGÍA & CIRUGÍA DE CABEZA Y CUELLO ◽

10.37076/acorl.v45i4.120 ◽

2018 ◽

Vol 45 (4) ◽

pp. 247-253 ◽

Cited By ~ 1

Author(s):

Antonio J. Ballestas ◽

Samir A. Ballestas ◽

Rocio Cuello

Keyword(s):

Fundamental Frequency ◽

Speech Therapy ◽

Vocal Cords ◽

Maximum Phonation Time ◽

Study Materials ◽

Before And After ◽

Upper Face ◽

Expert Surgeon ◽

Frequency Maximum ◽

Male To Female

Introducción: La glotoplastia de Wendler es la técnica que en la actualidad ofrece mejores resultados entre los diferentes tipos de cirugías para la feminización de la voz. Objetivo: Describir nuestra experiencia con la Glotoplastia de Wendler durante el proceso de feminización de la voz de mujeres transgénero. Diseño: Pseudoexperimental (antes-después) Materiales y Métodos: 36 pacientes transexuales en proceso de transformación de hombre a mujer se sometieron a cirugía y rehabilitación con terapias de voz con el equipo de VOICEFEM - Voice Feminization Colombia. La técnica utilizada consiste en la creación de una sinequia de las cuerdas vocales (CCVV) previa desepitelización de la cara interna del tercio anterior de las mismas, 2 puntos de sutura con Vicryl 4/0 y vaporización con electrocauterio en la región lateral de la cara superior de las CCVV y utilización de goma biológica en la sinequia creada. La medición de la frecuencia fundamental, el tiempo máximo de fonación, y la realización del cuestionario TSEQ, se llevaron a cabo antes y después de la cirugía. Resultados: Se obtuvo un aumento de la Frecuencia fundamental promedio de 112Hz(P<0.05) a los 6 meses posteriores al procedimiento quirúrgico y una disminución de cerca de 30 puntos en los resultados del cuestionario TSEQ. Conclusión: La glotoplastia de Wendler, llevada a cabo por cirujanos con experiencia en este campo, ofrece resultados favorables con aumentos significativos de la frecuencia fundamental a mediano plazo y debe estar necesariamente asociada al manejo postquirúrgico con terapias de voz, para obtener el desenlace óptimo esperado.Introduction: Wendler’s Glottoplasty is the technique that offers the best resultsamong the different types of voice feminization surgeries. Male to Female Transgender patients have in this technique the last step for their successful transformation. Objective: To describe our experience in carrying out Wendler’s glottoplasty during the process of feminization of the voice of transgender women. Design: Pseudoexperimental (before-after) study. Materials and methods: In 36 Male to Female Transgender patients, Wendler’s glottoplasty was conducted by VOICEFEM - Voice Feminization Colombia’s team, with further speech therapy rehabilitation. This technique consists of the creation of a synechia of the vocal cords which is carried out after the de-epithelization of the vocal cords on the inner face of its anterior third, 2 stitches with Vicryl 4/0 and vaporization with electrocautery in the lateral region of vocal cords upper face, and the use of biological glue in the created synechia. The measurement of the Fundamental Frequency, Maximum Phonation time, and the completion of the TSEQ questionnaire were carried out before and after the surgery. Results: There was an increase of 112 Hz in the average of Fundamental Frequency(P<0.05) 6 months after the surgery, and a decrease of approximately 30 points in the TSEQ questionnaire results. Conclusion: Wendler’s Glottoplasty conducted by an expert surgeon, provides positive results with a significant increase for fundamental frequency in the medium term, and it is imperative to do also voice therapy rehabilitation posterior to the procedure in order to obtain the expected optimal outcome.

Download Full-text

Reliability and Accuracy of Remote Fiberoptic Nasopharyngolaryngoscopy in the Pediatric Population

Ear Nose & Throat Journal ◽

10.1177/0145561320919109 ◽

2020 ◽

pp. 014556132091910

Author(s):

Lauren E. Miller ◽

Adva Buzi ◽

Ashley Williams ◽

Rachel S. Rogers ◽

Angel G. Ortiz ◽

...

Keyword(s):

Pediatric Population ◽

Upper Airway ◽

Office Visit ◽

Rater Agreement ◽

Vocal Cords ◽

Coupling Device ◽

Overall Evaluation ◽

Survey Results ◽

Device Use ◽

False Vocal

Introduction: Telemedicine is an increasingly prevalent component of medical practice. In otolaryngology, there is the potential for telemedicine services to be performed in conjunction with device use, such as with a nasolaryngoscope. This study evaluates the reliability of remote examinations of the upper airway through an iPhone recording using a coupling device attached to a nasopharyngolaryngoscope (NPL). Methods: A prospective, blinded study was performed for pediatric patients requiring an NPL during an office visit. The NPL was performed using a coupling device attached to a smartphone to record the examination. A second, remote otolaryngologist then evaluated the recorded examination. Both otolaryngologists evaluated findings of anatomic sites including nasopharynx, oropharynx, base of tongue, larynx including subsites of epiglottis, arytenoids, aryepiglottic folds, false vocal cords, true vocal cords, patency of airway, and diagnostic impression, all of which were documented through a survey. Results of the survey were evaluated through inter-rater agreement using the κ statistic. Results: Forty-five patients underwent an NPL, all of which were included in the study. The average age was 4.9 years. The most common complaint requiring NPL was noisy breathing (n = 16). The inter-rater agreement for overall diagnosis was 0.74 with 80% percent agreement, rated as “good.” Other anatomic subsites with “good” or better inter-rater agreement were nasopharynx (0.75), oropharynx (0.75), and true vocal cords (0.71), with strong percentage agreement of 89%, 91%, and 87%, respectively. Both users of the adaptor found the recording setup to run smoothly. Conclusion: A telemedicine device for NPL use demonstrates strong diagnostic accuracy across providers and good overall evaluation. It holds potential for use in remote settings.

Download Full-text

Two cases of malignant disease of the vocal cords; thyro-chondrotomy; non-recurrence in one case after two years

The Laryngoscope ◽

10.1288/00005537-189902000-00048 ◽

1899 ◽

Vol 6 (2) ◽

pp. 117-117

Keyword(s):

Malignant Disease ◽

Vocal Cords

Download Full-text

Effects of head positions on awake fiberoptic bronchoscope oral intubation: a randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-021-01397-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhuo Liu ◽

Li Zhao ◽

Zhongfeng Ma ◽

Meiqi Liu ◽

Xiaohang Qi ◽

...

Keyword(s):

Tracheal Tube ◽

Orotracheal Intubation ◽

Neutral Position ◽

Fiberoptic Bronchoscope ◽

Glottic Opening ◽

Vocal Cords ◽

Oral Intubation ◽

Vas Scores ◽

Head Positions ◽

Position Group

Abstract Background There are many factors affecting the success rate of awake orotracheal intubation via fiberoptic bronchoscope. We performed this study was to investigate the effects of head positions on awake Fiberoptic bronchoscope oral intubation. Methods Seventy-five adult patients, received general anaesthesia were included in this study. After written informed consent, these patients were undergoing awake orotracheal intubation via fiberoptic-bronchoscope and according to the head position, the patients were randomized allocated to neutral position group (NP group), sniffing position group (SP group) or extension position group (EP group). After sedation the patients were intubated by an experienced anesthesiologist. The time to view the vocal cords, the percentage of glottic opening scores (POGO), the time to insert the tracheal tube into trachea and the visual analog scale (VAS) scores for ease experienced of passing the tracheal tube through glottis, the hemodynamic changes and the adverse events after surgery were recorded. Results The time to view the vocal cords was significantly shorter and the POGO scores was significantly higher in the EP group compared with the other two groups (P < 0.05); The SpO2 in the EP group was higher than NP group at before intubation and higher than SP group and NP group at immediate after intubation (P < 0.05); The time to insert the tracheal tube into trachea, the VAS scores for passing the tracheal tube through glottis, the coughing scores had no significant differences among groups (P > 0.05). There were also no significant differences regard to the incidence of postoperative complications, mean arterial pressure and heart rate among the groups (P > 0.05). Conclusions The head at extension position had a best view of glottic opening than neutral position or sniffing position during awake Fiberoptic bronchoscope oral intubation, so extension position was recommended as the starting head position for awake Fiberoptic bronchoscope oral intubation. Trial registration Clinical Trials.gov. no. NCT02792855. Registered at https://register.clinicaltrials.gov on 23 september 2017.

Download Full-text