BackgroundVoice problems caused by pathologies in vocal folds are well known. Some types of laryngeal pathologies have certain acoustic characteristics. Objective evaluation helps characterize the voice and voice problems providing supporting evidences, severity of disorders. It helps assess the response to the treatment and measures the outcomes.
ObjectiveThe objective of the study is to determine the effectiveness of the voice therapy and quantify the results objectively by voice parameters.
MethodStudy includes 61 patients who presented with different types of laryngeal pathologies. Acoustic analyses and voice assessment was done with Dr. Speech ver 4 (Tiger DRS Inc.). Acoustic parameters including fundamental frequency, jitters, shimmers, Harmonic to noise ratio (HNR), Normalized noise energy (NNE) were analyzed before and after voice therapy.
ResultBilateral vocal nodules were the most common pathologies comprising 44.26%. All acoustic parameters showed a significant difference after the therapy (p<0.05) except for NNE. Dysphonia due to vocal fold polyp showed no improvement even after voice therapy (p>0.05).
ConclusionAcoustic analysis provides an objective, recordable data regarding the voice parameters and its pathologies. Though, few pathology require alternative therapy rather than voice therapy, overall it has a good effect on glottic closure. As the voice therapy can improve the different indices of voice, it can be viewed as imperative part of treatment and to monitor progression.
A case of bilateral fimbrial cyst with torsion of right side is presented, occurring in a 32 year old female. She presented in outpatient department with pain abdomen and feeling of mass in lower abdomen since six months. Initial assessment of ovarian cyst was made. Ultrasound showed cystic structures in left adnexa and complex cyst in right adnexa. Laprotomy was performed and bilateral fimbrial cysts in fallopian tubes were identified with torsion on right side which was subsequently confirmed on histopathology. Although huge fimbrial cysts with torsion of fallopian tube is rare, it should be considered in differential diagnosis of abdominal mass with pain in females.
IntroductionFimbrial (Paraovarian) cysts represent approximately 10%of adnexal masses.
Background: Successful management of vascular anomaly of head and neck region are often challenging. As the surgical modality carries high complications and bad aesthetic outcome, the treatment paradigm for these lesions has been shifting towards the non-invasive one. Because of its high sclerosing effect on vascular endothelium, low cost and easy availability intralesional Bleomycin injection can be an alternative. Objective: To determine the effi cacy and safety of intralesional Bleomycin sclerotherapy for head and neck haemangioma and slow fl ow vascular malformation. Methods: Thirty-six patients (12 males and 24 females) with head and neck haemangioma and slow fl ow vascular malformations were treated with intralesional Bleomycin injection in the dose of 0.5mg/kg/dose (not exceeding 15 mg/ dose) in a medical college of Nepal. The repeat injection was offered every three weeks if needed. The size of the lesion was measured and serial photographs were taken. Complications were also recorded. Results: Ten patients (28%) had complete resolution (cured), 19 patients (53%) had marked improvement fi ve (14%) had mild improvement and two (6%) had no response. Minor complications like fever and transient rise in temperature were seen in eight patients (22%). Hyperpigmentation of the overlying skin were observed in four(11%). None of the patients developed haematological toxic side effects or pulmonary fi brosis during the follow up. Conclusion: Intralesional Bleomycin injection is simple, safe, effective and non-invasive modality of the treatment for head and neck haemangioma and slow fl ow vascular malformation.
Background: Identifi cation of recurrent laryngeal nerve is of utmost importance during thyroid surgery. Different anatomical landmarks have been used to recognize and preserve the nerve. Injury may lead to vocal cord paralysis. Different adjuvant methods have been used to aid in the identifi cation of the nerve. Objective: To determine whether methylene blue smear helps to identify the recurrent laryngeal nerve safely and effi ciently. Methodology: Observational cross sectional study done in 30 patients who underwent different thyroidectomies within a duration of one year. Recurrent laryngeal nerve identifi ed using methylene blue smear and compared with the conventional visualization techniques exercising different known anatomical landmarks. The duration and ease of identifi cation of the nerve was noted and graded. Results: Total of 39 recurrent laryngeal nerves were identifi ed from 28 females and two males. The duration and the ease of dissection of the nerve was inconstant. Earliest time for recognition of the nerve was one and half minutes while the slowest time was 12 minutes.
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