Clinical and diagnostic algorithm for otorhinolaryngologist’s work  with voice professionals

Stepanova, Yu. E.; Koren, E. E.; Gotovyakhina, T. V.

doi:10.18692/1810-4800-2019-1-116-123

2019

DOI: 10.18692/1810-4800-2019-1-116-123

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Clinical and diagnostic algorithm for otorhinolaryngologist’s work with voice professionals

Yu. E. Stepanova¹,

E. E. Koren²,

T. V. Gotovyakhina³

Abstract: 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 disease… Show more

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Cited by 4 publications

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Video endoscopic methods of laryngeal examination in modern phoniatry

Stepanova

Gotovyakhina

2022

Medicinskij sovet

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Introduction. Modern diagnostics of laryngeal diseases is based on the use of video endoscopic technologies. The authors of the article, having almost thirty years of experience with various methods of video endoscopy, proposed a classification of video endoscopic methods of laryngeal examination. Objective. To develop an algorithm for the application of various video endoscopic methods of laryngeal examination in voice professionals with functional and organic dysphonia. Materials and methods. From 2020 to 2022, 2308 patients aged 18 to 80 years (43.2 ± 11.5) were examined in the phoniatric department of the St. Petersburg Research Institute of ENT. There were 1424 women (61,7 %), 884 men (38,3 %) people. Functional dysphonia was detected in 705 (30,5 %) people, acute and chronic laryngitis in 668 (28,9 %), tumor-like formations in 436 (18,9 %), the remaining nosological forms were diagnosed in 499 (21,7). All the patients turned out to be representatives of voice-speaking professions and complained of dysphonia.For videolaryngoscopy, videolaryngostroboscopy, autofluorescence endoscopy, NBI–endoscopy, equipment from various manufacturers was used. Results. An algorithm for the application of video endoscopic research methods in persons of voice-speech professions with dysphonia has been developed. Overview videolaryngoscopy and videostroboscopy were mandatory research methods for all patients with complaints of voice function. The use of these two methods proved to be sufficient for the diagnosis of functional dysphonia, paresis and paralysis, congenital malformations of the larynx, scar stenosis. In-depth diagnostics and differential diagnostics of tumor-like formations, various forms of chronic laryngitis, benign and malignant formations, in addition to videolaryngoscopy and videostroboscopy, included autofluorescence endoscopy or NBI endoscopy, which revealed the earliest stages of the pathological process. Conclusions. Only the complex application of various methods of video endoscopy of the larynx provided timely diagnosis and early treatment of dysphonia, maximum restoration of voice function, and, consequently, the preservation of professional longevity by persons of voice-speech professions.

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Video endoscopic methods of laryngeal examination in modern phoniatry

Stepanova

Gotovyakhina

2022

Medicinskij sovet

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Clinical manifestations of autoimmune rheumatic diseases in the larynx

Stepanova,

Коren

2023

Medicinskij sovet

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Introduction. Autoimmune rheumatic diseases are attributed to a systemic process that develops in many organs, including the larynx. Complaints of impaired vocal function in patients with this pathology require a thorough clinical and endoscopic analysis.The purpose of the study. To determine the clinical-endoscopic changes of the larynx in patients with impaired vocal function in autoimmune rheumatic diseases..Materials and methods. 31 (100%) patients aged 25 to 84 (41 ± 15) years with autoimmune rheumatic diseases applied to the phoniatric department of the St. Petersburg Research Institute of ENT. There were 3 men (10%), 28 women (90%). All patients complained of impaired vocal function, 5 of the examined (16%) were also concerned about breathing disorders during exercise or at rest.Patients were grouped into three groups: systemic lupus erythematosus 4 (13%) people, systemic vasculitis 10 (32%) people, rheumatoid arthritis 17 (55%) people.Videolaryngoscopy, videolaryngostroboscopy, autofluorescence endoscopy, NBI – endoscopy (according to indications) were used to make the diagnosis.Results. The distribution of laryngeal pathology by nosological forms in patients with аutoimmune rheumatic diseases was as follows. The most numerous were groups with functional dysphonia of the hypotonic type 10 (32%) and bamboo nodules of 8 (26%) patients. Chronic laryngeal stenosis was diagnosed in 5 (16%), and chronic catarrhal laryngitis and soft nodules of the vocal folds in 3 (9.5%) people in each group (respectively). The smallest number of patients suffered from ulcerative necrotic changes of the larynx and pharynx – 2 (7%).Conclusion. Thus, laryngeal changes in аutoimmune rheumatic diseases had both specific manifestations and non-specific ones. The latter include functional dysphonia of the hypotonic type, chronic catarrhal laryngitis, soft nodules of the vocal folds. Bamboo nodules of the vocal folds, ulcerative necrotic diseases, chronic laryngeal stenosis (infiltrative and scarring) were specific for patients with аutoimmune rheumatic diseases.

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Fundamentals of phoniatry (lecture)

Stepanova

2023

Consilium Medicum

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Phoniatry is a branch of otorhinolaryngology and deals with issues related to the diagnosis, treatment and prevention of voice disorders. Violations of voice function, especially in persons of voice-speaking professions, worsen the quality of life, affect interpersonal relationships, create difficulties in communication, and in some cases lead to professional unfitness. It is known that about 6% of the population suffers from voice disorders, and laryngeal diseases are 56 times more common among specialists of voice-speaking professions. The invention of the laryngeal mirror became a landmark event in the emergence of laryngology, and subsequently phoniatry. The process of voice formation is provided by the voice apparatus, which consists of four departments and forms a single functional system. The vibrations of the vocal folds are a complex physiological process as a result of which sound appears. But this sound is not like the voice we hear. He acquires his unique timbre in the resonator department. It is possible to assess the state of voice function with the help of video endostroboscopy of the larynx and acoustic research methods. These diagnostic methods complement each other and create the most objective representation of the voice and its disorders.

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Clinical and diagnostic algorithm for otorhinolaryngologist’s work with voice professionals

Cited by 4 publications

References 0 publications

Video endoscopic methods of laryngeal examination in modern phoniatry

Video endoscopic methods of laryngeal examination in modern phoniatry

Clinical manifestations of autoimmune rheumatic diseases in the larynx

Fundamentals of phoniatry (lecture)

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