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1.
Wiad Lek ; 73(4): 814-817, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731723

RESUMO

Voice is a work tool for many professional groups. Currently, cases of dysphonia of multiple origin consist a growing issue. Voice disorders may result from disturbed voice production process, congenital defects, post-traumatic conditions, chronic diseases or hormonal disorders. Chronic diseases causing voice disorders include laryngopharyngeal reflux disease and esophageal reflux disease.The chronic character of reflux causes the formation of numerous morphological changes of the larynx, including: hyperemia of the mucosa limited to arytenoid and intraarytenoid area, edema of the vocal folds, edema of the larynx mucosa. These changes contribute to voice disorders. Among the pathological changes of voice organ etiologically associated with reflux, the following disease units may be distinguished: reflux laryngitis, subglottic edema, contact ulceration, larynx granuloma, larynx and pharynx cancer. Many of disorders in the upper respiratory tract are etiologically related to reflux, e.g. dysphonia, grunting, coughing and dyspnoea.


Assuntos
Disfonia , Edema , Refluxo Gastroesofágico , Humanos , Laringite , Laringe
3.
J Laryngol Otol ; 134(1): 63-67, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31910909

RESUMO

BACKGROUND: Determining prognostic factors for the probability of tracheostomy decannulation is key to an adequate therapeutic plan. METHODS: A retrospective cohort study of 160 paediatric patients undergoing tracheostomy was conducted. Associations between different parameters and eventual tracheostomy decannulation were assessed. RESULTS: Mean follow-up duration was 27.8 months (interquartile range = 25.5-30.2 months). Median age at tracheostomy was 6.96 months (interquartile range = 3.37-29.42 months), with median tracheostomy maintenance of 14.5 months (interquartile range = 3.7-21.5 months). The overall tracheostomy decannulation rate was 22.5 per cent. Factors associated with a higher probability of tracheostomy decannulation included age at tracheostomy (hazard ratio = 1.11, 95 per cent confidence interval = 1.03-1.18) and post-intubation laryngitis as an indication for tracheostomy (hazard ratio = 2.25, 95 per cent confidence interval = 1.09-4.62). Neurological (hazard ratio = 0.30, 95 per cent confidence interval = 0.12-0.80) and pulmonary (hazard ratio = 0.41, 95 per cent confidence interval = 0.18-0.91) co-morbidities were negatively associated with tracheostomy decannulation. The probability of tracheostomy decannulation decreased significantly with increasing numbers of co-morbidities (p < 0.001). CONCLUSION: Age, post-intubation laryngitis, and number and type of co-morbidities influence tracheostomy decannulation rate in the paediatric population.


Assuntos
Extubação/estatística & dados numéricos , Laringite/etiologia , Traqueostomia/instrumentação , Extubação/métodos , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Medição de Risco , Traqueostomia/efeitos adversos
4.
J Laryngol Otol ; 134(1): 68-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31918788

RESUMO

OBJECTIVE: To determine whether patients would have equivalent or improved outcomes when receiving non-surgical management versus surgical removal for vocal process granulomas. METHODS: A chart review was performed for 53 adults with vocal process granulomas. All patients received baseline anti-reflux treatment consisting of twice-daily proton pump inhibitors and vocal hygiene education. Further treatment approaches were divided into non-surgical (i.e. inhaled corticosteroids, voice therapy, botulinum toxin injections) and surgical groups. Subjective parameters (Voice Handicap Index 10 and Reflux Symptom Index) and outcomes were tabulated and statistically compared. Cause of granuloma was also analysed to determine if this influenced outcomes. RESULTS: Of 53 patients, 47 (89 per cent) experienced reduction in granuloma size, while 37 (70 per cent) experienced complete resolution. The rate of complete granuloma resolution after initial treatment strategy alone was significantly higher in non-surgical compared to surgical patients (67 and 30 per cent, respectively; p = 0.039). No difference in outcome was seen between iatrogenic and idiopathic granulomas. CONCLUSION: Non-surgical patients were more likely to experience initial treatment success than those who underwent surgical removal. Continued emphasis should be placed on conservative treatment options prior to surgery for patients with this condition.


Assuntos
Granuloma/terapia , Laringite/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Prega Vocal/fisiopatologia , Adulto , Idoso , Terapia Combinada , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Inibidores da Bomba de Prótons/farmacologia , Resultado do Tratamento , Prega Vocal/efeitos dos fármacos , Qualidade da Voz/efeitos dos fármacos , Treinamento da Voz
5.
Dis Mon ; 66(1): 100848, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30803725

RESUMO

Gastroesophageal reflux disease (GERD) is one of the most common diseases encountered by both internists and gastroenterologists. GERD can cause a wide variety of symptoms ranging from heartburn and regurgitation to more atypical symptoms such as cough, chest pain, and hoarseness. The diagnosis is often times made on the basis of history and clinical symptomatology. The prevalence of GERD is currently estimated to be 8-33% with the incidence of disease only expected to increase over time. Although most cases of GERD can be diagnosed based on symptoms and clinical presentation, the diagnosis of GERD can be challenging when symptoms are atypical. In this review, we provide a comprehensive summary of the epidemiology, pathophysiology, evaluation and diagnosis of gastroesophageal reflux disease.


Assuntos
Refluxo Gastroesofágico/diagnóstico , Asma/etiologia , Sulfato de Bário , Meios de Contraste , Tosse/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Endoscopia do Sistema Digestório , Monitoramento do pH Esofágico , Feminino , Alimentos/efeitos adversos , Refluxo Gastroesofágico/fisiopatologia , Predisposição Genética para Doença , Hérnia Hiatal/complicações , Humanos , Laringite/etiologia , Manometria , Obesidade/complicações , Gravidez , Complicações na Gravidez , Inibidores da Bomba de Prótons , Fatores de Risco , Fumar
6.
Ann Ital Chir ; 90: 398-403, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31814599

RESUMO

PURPOSE: The study analysed the presence of HPV in samples tissue from laryngeal chronic hyperplastic inflammation, with and without pre-neoplastic potential, and from squamous cell carcinoma of the larynx. The aim of this analysis was to evaluate the presence/absence of different types of HPV and their relationship to the clinical profile of the patients studied (habit of smoking and drinking). METHODS: Sixty cases were randomly selected from patients undergoing surgical treatment of the larynx for inflammatory/ neoplastic lesions and of neck nodes. Patients underwent standard clinical workup, comprising medical history and physical examination, panendoscopy, whole-body CT scan (in cancer patients), diagnostic or therapeutic microlaryngoscopy with laryngeal biopsy, and HPV evaluation. RESULTS: The HPV analysis showed an increased risk for heavy smokers of HPV positivity, as well as precancer lesions and cancer. Type 6 and 16 seem to be prevalent in all types of laryngeal mucosa disease, but pre-neoplastic conditions versus cancer seem to show a wider variety of HPV infections while cancer patients are invariably affected by types 6 and 66. Heavy smoking is related to HPV infection likewise alcohol in association with smoking. Advanced T is more associated with HPV positivity. CONCLUSIONS: These data impose a closer follow-up of smokers and pre-neoplastic cases and the utility of the broadspectrum polymerase chain reaction assay in laryngeal dysplastic and cancer lesions. This study may allow to develop biomarkers for early detection or recurrence surveillance, to identify therapeutic targets, and to begin individualization of treatment based on the biology of these tumours. KEY WORDS: HPV infection, Larynx, Laryngeal chronic hyperplastic inflammation, Squamous cell carcinoma.


Assuntos
Carcinoma de Células Escamosas/epidemiologia , Neoplasias Laríngeas/epidemiologia , Laringite/epidemiologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Lesões Pré-Cancerosas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Biópsia , Carcinoma de Células Escamosas/virologia , Comorbidade , Feminino , Humanos , Hiperplasia , Neoplasias Laríngeas/virologia , Laringite/virologia , Laringoscopia , Laringe/patologia , Laringe/virologia , Masculino , Pessoa de Meia-Idade , Pólipos/epidemiologia , Pólipos/virologia , Lesões Pré-Cancerosas/virologia , Fatores de Risco , Amostragem , Fumar/epidemiologia , Tomografia Computadorizada por Raios X , Imagem Corporal Total , Adulto Jovem
7.
BMC Infect Dis ; 19(1): 1034, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31805893

RESUMO

BACKGROUND: The incidence of Taralomyces marneffei infection in HIV-infected individuals has been decreasing, whereas its rate is rising among non-HIV immunodeficient persons, particularly patients with anti-interferon-gamma autoantibodies. T. marneffei usually causes invasive and disseminated infections, including fungemia. T. marneffei oro-pharyngo-laryngitis is an unusual manifestation of talaromycosis. CASE PRESENTATION: A 52-year-old Thai woman had been diagnosed anti-IFNÉ£ autoantibodies for 4 years. She had a sore throat, odynophagia, and hoarseness for 3 weeks. She also had febrile symptoms and lost 5 kg in weight. Physical examination revealed marked swelling and hyperemia of both sides of the tonsils, the uvula and palatal arches including a swelling of the epiglottis, and arytenoid. The right tonsillar biopsy exhibited a few intracellular oval and elongated yeast-like organisms with some central transverse septum seen, which subsequently grew a few colonies of T. marneffei on fungal cultures. The patient received amphotericin B deoxycholate 45 mg/dayfor 1 weeks, followed by oral itraconazole 400 mg/day for several months. Her symptoms completely resolved without complication. CONCLUSION: In patients with anti-IFN-É£ autoantibodies, T. marneffei can rarely cause a local infection involving oropharynx and larynx. Fungal culture and pathological examination are warranted for diagnosis T. marneffei oro-pharyngo-laryngitis. This condition requires a long term antifungal therapy.


Assuntos
Antifúngicos/uso terapêutico , Laringite/tratamento farmacológico , Micoses/tratamento farmacológico , Faringite/tratamento farmacológico , Talaromyces/patogenicidade , Anfotericina B/uso terapêutico , Autoanticorpos/sangue , Ácido Desoxicólico/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Interferon gama/imunologia , Itraconazol/uso terapêutico , Laringite/microbiologia , Laringite/patologia , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Mycobacterium abscessus/patogenicidade , Micoses/etiologia , Micoses/microbiologia , Faringite/microbiologia , Faringite/patologia , Tailândia
8.
Adv Respir Med ; 87(5): 308-316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31680234

RESUMO

In about 3% of children, viral infections of the airways that develop in early childhood lead to narrowing of the laryngeal lumen in the subglottic region resulting in symptoms such as hoarseness, abarking cough, stridor, and dyspnea. These infections may eventually cause respiratory failure. The disease is often called acute subglottic laryngitis (ASL). Terms such as pseudocroup, croup syndrome, acute obstructive laryngitis and spasmodic croup are used interchangeably when referencing this disease. Although the differential diagnosis should include other rare diseases such as epiglottitis, diphtheria, fibrinous laryngitis and bacterial tracheobronchitis, the diagnosis of ASL should always be made on the basis of clinical criteria.


Assuntos
Laringite/complicações , Laringite/diagnóstico , Infecções Respiratórias/complicações , Doença Aguda , Obstrução das Vias Respiratórias/etiologia , Infecções Bacterianas/complicações , Criança , Crupe/etiologia , Dispneia/etiologia , Humanos , Laringite/terapia , Infecções Respiratórias/diagnóstico
9.
Biomed Res Int ; 2019: 7150942, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31534961

RESUMO

To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper airways (UA). Recently, topical administration of ectoine has just been recognized as adjuvant treatment in the Allergic Rhinitis (AR) and Rhinosinusitis (ARS). The aim of this work is to review the published literature regarding all the potential therapeutic effects of ectoine in the acute and chronic inflammatory diseases of UA. Pertinent studies published without temporal limitation were selected searching on MEDLINE the following terms: "ectoine" and "nasal spray," "oral spray," "upper respiratory tract infections," "rhinosinusitis," "rhinitis," "rhinoconjunctivitis," "pharyngitis," and "laryngitis." At the end of our selection process, six relevant publications were included: two studies about the effect of ectoine on AR, one study about ARS, one study about rhinitis sicca anterior, and two studies about acute pharyngitis and/or laryngitis. Due to its moisturizing and anti-inflammatory properties, topical administration of ectoine could play a potential additional role in treatment of acute and chronic inflammatory diseases of UA, in particular in the management of sinonasal conditions improving symptoms and endoscopic findings. However, these results should be viewed cautiously as they are based on a limited number of studies; some of them were probably underpowered because of their small patient samples.


Assuntos
Diamino Aminoácidos/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Doença Aguda , Administração Tópica , Doença Crônica , Humanos , Inflamação/tratamento farmacológico , Inflamação/patologia , Laringite/tratamento farmacológico , Laringite/patologia , Sprays Orais , Infecções Respiratórias/patologia , Rinite/tratamento farmacológico , Rinite/patologia , Sinusite/tratamento farmacológico , Sinusite/patologia
10.
Laryngorhinootologie ; 98(7): 461-472, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31291658

RESUMO

Subglottic pathologies are rare and show a clinical unspecific appearance i. e. through tissue increase around the cricoid or the cranial trachea. Typical symptoms are hoarseness, an overstimulated coughing, a globus laryngeus feeling as well as dyspnea or a stridor. Differential diagnosis include benign diseases like involving a posttraumatic status (e. g. stenosis), infection (i. e. pseudocroup), rheumatic disease (i. e. granulomatosis with polyangiitis) or benign tumor (i. e. papilloma, hemangioma or granular cell tumor). On the other hand, malignant diseases like the squamous cell carcinoma, a chondrosarcoma or the very rare laryngeal lymphoma manifestation must be considered as well. Idiopathic causes should also be taken into account. To secure the final diagnosis of such tumor formation a tissue sample should be histologically analyzed. The therapy is multimodal e. g. in close collaboration with internal medicine and ENT specialists.


Assuntos
Tumor de Células Granulares , Hemangioma , Neoplasias Laríngeas , Laringite , Laringe , Rouquidão , Humanos
11.
Expert Rev Gastroenterol Hepatol ; 13(9): 827-838, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31322443

RESUMO

Introduction: Gastroesophageal reflux disease (GERD) is one of the most prevalent conditions in Western Countries, normally presenting with heartburn and regurgitation. Extra-esophageal (EE) GERD manifestations, such as asthma, laryngitis, chronic cough and dental erosion, represent the most challenging aspects from diagnostic and therapeutic points of view because of their multifactorial pathogenesis and low response to proton pump inhibitors (PPIs). In fact, in the case of EE, other causes must by preventively excluded, but instrumental methods, such as upper gastrointestinal endoscopy and laryngoscopy, have low specificity and sensitivity as diagnostic tools. In the absence of alarm signs and symptoms, empirical therapy with a double-dose of PPIs is recommended as a first diagnostic approach. Subsequently, impedance-pH monitoring could help to define whether the symptoms are GERD-related. Areas covered: This article reviews the current literature regarding established and proposed EE-GERD, reporting on all available options for its correct diagnosis and therapeutic management. Expert opinion: MII-pH could help to identify a hidden GERD that causes EE. Unfortunately, standard MII-pH analysis results are often unable to define this association. New parameters such as the mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index may have an improved diagnostic yield, but prospective studies using impedance-pH are needed.


Assuntos
Refluxo Gastroesofágico/complicações , Asma/etiologia , Doença Crônica , Tosse/etiologia , Refluxo Gastroesofágico/epidemiologia , Humanos , Laringite/etiologia , Erosão Dentária/etiologia
12.
Eur Arch Otorhinolaryngol ; 276(9): 2507-2512, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31214824

RESUMO

PURPOSE: Acute supraglottic laryngitis (ASL) is manifested by supraglottic inflammation that has the potential for rapid and fatal airway obstruction. Complete/incomplete vocal fold immobility (VFIm) in the setting of ASL may contribute to airway obstruction. The rate of VFIm complicating ASL is not known, and it is not clear whether its occurrence alters the course and the management of ASL, particularly the need to secure the airway (by endotracheal intubation/tracheostomy). This study seeks to describe the natural history of VFIm associated with ASL (ASLIm) and to determine the added effect of VFIm on ASL severity, management, and the need for intervention to secure the airway. METHODS: This is a retrospective cohort study in a tertiary referral center. The medical records of all patients hospitalized due to ASL between January 2007 and December 2016 were reviewed. RESULTS: Of the 214 patients admitted due to ASL, VFIm was identified in 9 (4.2%). The VFIms resolved within 1-90 days in all 8 patients with available follow-up of 1-3 months. One patient required endotracheal intubation. The 9 ASLIm patients had significantly higher rates of hoarseness and a history of diabetes mellitus. There was no group difference in the need to secure the airway. CONCLUSIONS: VFIm is an apparently uncommon finding among patients with ASL. It appears to be usually transient, short-lasting, and full recovery can be expected. VFIm did not alter the ASL course, nor did it put our patients at increased risk for the need for intervention to secure the airway. LEVEL OF EVIDENCE: 4.


Assuntos
Laringite/complicações , Paralisia das Pregas Vocais/etiologia , Doença Aguda , Adulto , Obstrução das Vias Respiratórias/etiologia , Feminino , Rouquidão/etiologia , Humanos , Intubação Intratraqueal , Laringite/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
13.
Mediators Inflamm ; 2019: 6518308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31049027

RESUMO

The aim of the study was to evaluate the inflammatory reaction in children with pseudocroup and compare it with other laryngological diseases according to the available literature data. The study group included 51 children hospitalized because of pseudocroup. The measurements of the acute phase proteins (APP), such as C-reactive protein (CRP), alpha-1-antitrypsin (AT), alpha-1-antichymotrypsin (ACT), alpha-1-acid glycoprotein (AGP), ceruloplasmin (Cp), transferrin (Tf), alpha-2-macroglobulin (A2M), and haptoglobin (Hp) were obtained at 3 time points. The glycosylation profiles of AGP, ACT, and Tf were completed. An increased AGP level was observed in girls. The AGP glycosylation revealed the advantage of the W0 variant over the W1 variant. W1 and W2 were decreased in boys. W3 emerged in boys. The Tf concentration and T4 variant were lower compared to the control group. The A2M level was lower after treatment. The Hp and AT levels were decreased a few weeks later. The ACT glycosylation revealed a decrease of the A4 variant in boys. In conclusion, the inflammatory reaction during pseudocroup was of low intensity. The APP glycosylation suggested a chronic process. In a follow-up investigation, no normalization of the parameters was noted, but signs of persistent inflammation were observed.


Assuntos
Reação de Fase Aguda/metabolismo , Crupe/metabolismo , Laringite/metabolismo , Proteínas da Fase Aguda/metabolismo , Proteína C-Reativa/metabolismo , Ceruloplasmina/metabolismo , Haptoglobinas/metabolismo , Humanos , Orosomucoide/metabolismo , Transferrina/metabolismo , alfa 1-Antiquimotripsina/metabolismo , alfa 1-Antitripsina/metabolismo
14.
Otolaryngol Clin North Am ; 52(4): 607-616, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31101358

RESUMO

Chronic laryngitis is an inflammatory process of at least 3 weeks duration and affects phonation, breathing, and swallowing. This article describes the infectious, inflammatory, and autoimmune causes of chronic laryngitis. Symptoms of chronic laryngitis are nonspecific and may range from mild to airway compromise requiring emergent tracheostomy.


Assuntos
Laringite/diagnóstico , Laringite/etiologia , Laringite/terapia , Doenças Autoimunes/complicações , Infecções Bacterianas/complicações , Doença Crônica , Diagnóstico Diferencial , Disfonia/diagnóstico , Sensação de Globus/etiologia , Humanos , Inflamação/complicações , Neoplasias Laríngeas/patologia , Laringoscopia , Micoses/complicações
15.
Otolaryngol Clin North Am ; 52(4): 597-605, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31101359

RESUMO

The Hoarseness Guideline Update provides an evidence-based approach to a patient who presents to the clinic with hoarseness. The guidelines cover management decisions in acute and chronic dysphonia for patients of all ages before and after laryngeal examination. The present review discusses the process used to develop these guidelines, including limitations of the process and each key action statement.


Assuntos
Disfonia/diagnóstico , Disfonia/terapia , Rouquidão/diagnóstico , Rouquidão/terapia , Guias de Prática Clínica como Assunto , Doença Aguda , Doença Crônica , Diagnóstico Diferencial , Humanos , Laringite/tratamento farmacológico , Laringoscopia , Complicações Pós-Operatórias/epidemiologia , Inibidores da Bomba de Prótons/uso terapêutico
17.
Vestn Otorinolaringol ; 84(1): 68-71, 2019.
Artigo em Russo | MEDLINE | ID: mdl-30938347

RESUMO

Laryngitis is one of the commonest causes of dysphonia in the subjects engaged in the voice and speech professions. This condition can be either associated with the professional activities or related to voice fatigue. It is a common practice to distinguish between acute and chronic forms of occupational laryngitis. The main factors responsible for development of both conditions include the non-observance of directions concerning the protection and hygiene of the speaking and singing voice. The present study included 478 (100%) subjects engaged in the voice and speech professions presenting with the diagnosis of acute or chronic occupational laryngitis who applied for medical assistance to our Phoniatric Care Department. The clinical state of their larynx was evaluated with the use of the videoendostroboscopic technique. Acute laryngitis was diagnosed in 103 (21.5%) of the examined subjects while the remaining 375 (78.5%) ones presented with chronic laryngitis. A characteristic feature of acute occupational laryngitis documented in 38 (36.9%) examined professional voice users with this condition (practically healthy in all other respects) was the development of this disorder as a result of overloading the speech organs. On the contrary, viral and/or bacterial laryngitis revealed in 65 (63.1%) of the patients was preceded by acute respiratory symptoms. A total of 62 (16.5%) patients suffered from chronic occupational laryngitis attributable to overloading of the organs of speech during protracted periods. The remaining 313 examined professional voice users were found to present with various forms of chronic laryngitis including catarrhal laryngitis in 175 (46.7%) of them, edematous-polypoid and atrophic forms in 32 (8.5%) and 19 (5.1%) subjects respectively. The main etiological factors underlying the development of all the tree forms of chronic laryngitis were smoking, chronic tonsillitis, gastroesophageal reflux disease, bronchial asthma, and diabetes mellitus.


Assuntos
Disfonia , Laringite , Canto , Distúrbios da Voz , Doença Crônica , Disfonia/etiologia , Disfonia/terapia , Humanos , Laringite/complicações , Fala , Distúrbios da Voz/etiologia , Distúrbios da Voz/terapia
18.
Ear Nose Throat J ; 98(6): E44-E50, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30961379

RESUMO

Laryngopharyngeal reflux (LPR) is an inflammatory condition suspected to be associated with dysphonia. In this study, we investigated multidimensional perceptual, aerodynamic, and acoustic voice changes in patients with clinically diagnosed LPR compared to healthy participants. We prospectively included 80 outpatients with Reflux Finding Score (RFS) >7 and Reflux Symptom Index (RSI) >13 from September 2013 to April 2016 and we compared clinical and voice quality assessments of these patients with 80 healthy participants. Statistically significant differences were found between groups with regard to Voice Handicap Index, perceptual voice quality (grades of dysphonia, roughness, strain, breathiness, asthenia, and instability), phonatory quotient, percentage jitter, percentage shimmer, peak-to-peak amplitude variation, standard deviation of fundamental frequency, and noise to harmonic ratio. Granulation score of RFS was found to affect the highest number of acoustic parameters. We did not identify significant correlation between vocal fold edema and objective voice quality measurements. This study supports that patients with LPR have significant deterioration of both subjective and objective voice quality compared to healthy participants.


Assuntos
Laringite/fisiopatologia , Refluxo Laringofaríngeo/fisiopatologia , Distúrbios da Voz/fisiopatologia , Qualidade da Voz , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Disfonia/etiologia , Disfonia/fisiopatologia , Edema/etiologia , Edema/patologia , Edema/fisiopatologia , Feminino , Tecido de Granulação/patologia , Humanos , Laringite/etiologia , Laringite/patologia , Refluxo Laringofaríngeo/complicações , Refluxo Laringofaríngeo/patologia , Laringoscopia , Masculino , Pessoa de Meia-Idade , Espirometria , Estroboscopia , Prega Vocal , Distúrbios da Voz/etiologia , Adulto Jovem
19.
Laryngoscope ; 129(11): 2534-2536, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30912581

RESUMO

Chronic laryngitis commonly presents with dysphonia, and infectious causes include tuberculosis and endemic mycoses. We present a 58-year-old female with laryngitis for 5 years, fevers, chills, fatigue, malaise, myalgias, anterior neck pain, and night sweats after multicontinent exposure. Bronchoscopy cultures were negative. Bilateral microflap excision of vocal fold lesions demonstrated thickened epithelium and a deep vocal fold mass. Biopsy showed necrotizing granulomatous inflammation with acid-fast bacilli. Mycobacterium kansasii was identified. Treatment led to improvement in dysphonia, systemic symptoms, and vocal fold irritation. To our knowledge, this is the first case of isolated nontuberculous mycobacterial vocal fold infection. Laryngoscope, 129:2534-2536, 2019.


Assuntos
Laringite/microbiologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium kansasii , Doença Relacionada a Viagens , Doença Crônica , Feminino , Humanos , Pessoa de Meia-Idade
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