Therapeutic choices for curing dysodia?...three clinical cases.

These three clinical cases provide an approach to the management of anatomical voice disorders. When confronted with a laryngeal diagnosis, talented musicians often suffer a crisis of self-confidence which may propel them toward maladaptive compensations; these may destabilize their usual techniques, already disrupted by the changes in their vocal acoustics. In their forties, each of these patients presents with an angiomatous lesion of the vocal fold, associated in two of the cases with a congenital structural weakness. For the three of them, the recommended therapeutic choice was alternating recorded laryngoscopic follow-up, alternative medicine prescriptions, and "artistic sessions" that required that their phoniatrician adapt to their repertory, their temperament, the constraints of the stage and their laryngeal disorder in order that they achieve a compromise between the needs of their career and the laryngeal anatomic realities of the moment. These "artistic guidance sessions" are recorded so as to allow the patient to become aware of the quality of their public performance and to learn the functional elements contributing to it.

[The "intra-cordal polyp": a clinical alternative to recognize?]. / Le polype "intra-cordal" : une variante clinique à reconnaitre?

UNLABELLED: The vocal cord polyp is an inflammatory false tumour of the larynx. It is characterized mainly by the specific existence of fibrinous exsudats organized in loose network or mounds, surrounded by newly formed vascular slits. The epithelium covering the polyp is usually more or less impaired. CLINICAL CASES: The authors report two adult patients among whom the initial presentation in video-stroboscopy was that of an intracordal lesion of a cystic type, however; with unusual characteristics (purplish color, angiomatous aspect). The surgery consisted of a cordotomy, the surface epithelium appearing normal. After dissection, the two lesions seemed to be presenting the typical aspect of fibrinoïd mound of a polyp, observation confirmed by the anatomo-pathological study. In these cases, the resection was finally carried out with no mucous loss. CONCLUSION: The particular etiopathogeny of these lesions is been discussed. The treatment, medical and of rehabilitation could achieve a partial recovery. In the event of surgery, an access to the lesion through a cordotomy and not directly by removal with microcissors is advised.