This article presents the results of analysis of observation of 390 patients which underwent thyroid surgery: the frequency of the recurrent laryngeal nerve dysfunction, significant predictive factors, frequency and timing of vocal folds mobility restoration. The authors provide evaluation of the dynamics of laryngostroboscopic pattern in compliance with the voice computer analysis and specify the reasons of dysphonia after thyroid surgery.
The article is devoted to a rare ENT disease. The introduction deals with pathogenesis, classification, and clinical course of ALamyloidosis, which is in most cases diagnosed in the larynx diseases. The article presents three authors’ own clinical cases of vestibular, vocal and sub-vocal larynx amyloidosis.
The objective of the present study was to evaluate the effectiveness of the application of homeovox for the combined treatment of small vocal cord nodules and acute laryngitis in the professional voice users. A total of 40 subjects presenting with dysphonia were examined after they were divided into two study groups and two groups of comparison depending on the nosological form of the pathological condition. The subjects comprising the study groups were given traditional therapy in the combination with the intake of homeovox whereas the patients included in the two groups of comparison received the traditional treatment alone. The outcome of the treatment was evaluated on days 1, 5, and 10 after the initiation of therapy based on the analysis of the changes in the videoendostroboscopic picture of the larynx and the acoustic characteristics obtained by the computer-assisted analysis of the voice. The analysis of the results of the combined treatment has demonstrated the statistically significant differences in some acoustic parameters of the voice between the subjects with small vocal cord nodules and acute laryngitis belonging to the study groups and the groups of comparison. It is concluded that the introduction of homeovox in the combined treatment of the patients presenting with the small nodules in the vocal cords and acute catarrhal laryngitis accelerates the recovery of the acoustic characteristics of the voice within various periods after the onset of the treatment in comparison with the patients treated with the use of traditional therapy alone.
Diagnosis and treatment of larynx diseases in voice professionals are an important task of otorhinolaryngology. 244 voice professionals have visited Phoniatric Department of Saint Petersburg Research Institute of Ear, Throat, Nose and Speech. The condition of larynx was assessed by videoendolaryngoscopic and videoendolaryngostroboscopy methods. Larynx pathology was found in 212 patients, 32 persons were healthy. The main causes of dysphonias were the continuous vocal stress, work in sick condition, the diseases of endocrine, gastroduodenal, respiratory, neural system. 77 patients with voice disorders were diagnosed with functional dysphonia, 61 patients – with acute or chronic laryngitis. The cause of hoarseness in 46 persons were the vocal fold nodules, and in 28 patients – the vocal fold polyps. The article describes the clinical manifestations of pathological changes of the larynx. Based on the studied voice disorder etiological factors and clinical picture of the larynx, the authors developed a clinical and diagnostic algorithm of otorhinolaryngologist’s work with voice professionals.
Among the symptoms of COVID-19, scientists pay the most attention to damage to the lower respiratory tract, neurological and cardiovascular systems, gastrointestinal tract, psychoemotional disorders and anosmia. Less common are articles about the state of auditory and vestibular as well as voice disorders. Inflammatory changes of the larynx, trauma due to intubation and severe coughing, neuropathy of the recurrent laryngeal nerve, consequences of the pathology of the bronchopulmonary system, psychogenic factors are indicated as the cause of dysphonia. The purpose of our study is to determine the structure of laryngeal morbidity in voice professionals during the COVID-19 pandemic. The analysis of case histories of 2,438 patients of voice professions who applied to the phoniatric department of the Saint Petersburg Institute of Ear, Throat, Nose, and Speech was performed. The diagnosis, a history of COVID-19, dysphonia directly during COVID-19 were considered. The number of patients compared to the period before the COVID-19 decreased by 39,8% due to anti-epidemic measures. The leading causes were functional dysphonia (29,3%), acute and chronic laryngitis (27,8%). Tumor-like disease are in third place (19,1%). Paresis of the larynx (8,5%) was diagnosed less frequently compared to the period before the pandemic, which is associated with a reduction in the number of elective operations on the organs of the head and neck. The frequency of laryngeal neoplasms (4,1%) has remained at the same level, almost half of them are malignant. Congenital malformations of the larynx were found in 2,9% of patients. Vascular pathology of the vocal folds was detected in 1.1%, scar stenosis, in 0,5%, rare diseases of the larynx, in 0,6% of patients. Appeals on the other occasions accounted for 6,1% of cases. 43,7% of patient have had COVID-19. The direct connection of dysphonia with COVID-19 was revealed in 18,0% of them. The most common cause of impaired vocal function against the background of coronavirus infection were functional dysphonia (39,1%) and inflammatory diseases of the larynx (34,9%). Tumor-like disease became the next most common (17,2%). Vascular pathology of the vocal folds was found less frequently (5,2%). Unilateral vocal fold paresis was detected in 3,1% of patients. One patient suffered from chondroperichondritis with granuloma formation in the area of the arytenoid cartilage of the larynx (0,5%). In relation to the total number of examined patients, COVID-19 as the cause of dysphonia was 7,9% of cases.
The aim of the study was to improve the efficiency of diagnosis of various forms of chronic hyperplastic laryngitis, which is referred to as precancerous conditions of the larynx, video laryngostroboscopy was performed in 249 patients. All patients have occupational hazards: increased voice load, smoking, working capacity in a hospital state during acute respiratory viral infections, laryngitis, bronchitis. In case of detection of areas of dyskeratosis of mucous membrane of vocal folds (leukoplacia, hyperkeratosis) biopsy followed by histological examination was carried out. The results of a histological study of leukoplakia showed the presence of metaplasia of stratified squamous epithelium in 100% of the examined. Among patients with vocal fold hyperkeratosis, metaplasia of stratified squamous epithelium was detected in 20,8%, grade II and III dysplasia – 15,1% of observations. 64,1% of patients were diagnosed with laryngeal cancer. The video laryngostroboscopic picture of the larynx in various forms of chronic hyperplastic laryngitis was studied. According to the results of the study, pathological changes in the mucosa of the vocal folds with possible malignation include hyperkeratosis. During video laryngostroboscopy, asymmetric, irregular, mucous waves oscillate in the hyperkeratosis area in 60,4% of patients, and in 39,6% of patients the absence of vibrations of the vocal fold in the area of hyperkeratosis is diagnosed.
Introduction. Today the high prevalence of benign vocal fold lesions is shown (up to 55-70%). The possibilities of surgical management of this pathology are very extensive. Laser technologies are becoming more and more popular among high-tech treatment methods. However the comprehensive postoperative management of these patients is equally important.The aim of the study was to assess the features of the postoperative period in patients undergoing the endolaryngeal surgery using a semiconductor laser with a wavelength of 445 nm.Material and methods. On the basis of Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech from February to June 2021 20 patients with benign vocal fold lesions 6 women and 14 men from 24 to 67 years old were examined and treated. All the patients underwent endolaryngeal surgery with direct microlaryngoscopy using a new semiconductor 445 nm laser in an inert gas atmosphere (intraoperative helium supply). After surgical treatment, the patients observed vocal rest, received antiinflammatory, antibacterial therapy, inhalations, as well as the drug Homeovox® according to the standard scheme.Conclusion. Endolaryngeal surgery with the removing of benign vocal fold lesions using a semiconductor laser with a wavelength of 445 nm has been proven to be safe and effective. According to the results of video laryngostroboscopy, acoustic analysis of the voice (the questionnaire “Voice handicap index-30”) it was noted that the laryngeal functions were restored in a short time. The inclusion of Homeovox® in the complex postoperative treatment had a favorable effect on the restoration of the phonatory function.
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