Sudden onset aphonia caused by a Japanese-style bath

Abstract

An 86-year-old man was referred by his family physicianto our clinic because of sudden onset aphonia immediately after a Japanese-style bath. On examination, the only abnormality was aphonia, with an otherwise normal physical examination. However, we found vocal fold oedema on laryngeal fibrescopy. For treatment, he was immediately given 30 mg prednisolone intravenously. Twelve hours after injection the oedema had completely disappeared and his aphonia had resolved. The patient was healthy for three months after returning home. However, at the beginning of a cold winter night he again complained of sudden onset hoarseness, after taking a Japanese-style bath.Japanese-style baths are completely different from Western-style baths. There is a temperature difference of almost 30°C between the inside and outside of a bath; the transition may represent a type of physical exercise in elderly and exhausted individuals. This difference could cause a cold or heat-induced allergic reaction. We strongly recommend a laryngeal study in case of sudden onset aphonia.

Detectable voice change with the edrophonium test in laryngeal myasthenia gravis

“…This case emphasizes the need to consider systemic diseases in the differential diagnosis of hoarseness. As well as myasthenia gravis, conditions such as genetic diseases, 7 allergic diseases 8 and collagen diseases 9 may be present but may be missed due to concomitant vocal fold atrophy due to physiological ageing. In the case reported here, an initial diagnosis of sulcus vocalis with vocal fold atrophy due to ageing was made and the patient was treated with voice therapy and exercises.…”

Impact of syllable stress and phonetic context on the distribution of intermittent aphonia

“…Earlier research has shown that PTP varies with factors such as prephonatory glottal width and biomechanical properties of the vocal folds, such as mucosal wave velocity, vocal fold thickness and vocal fold viscosity (Titze, 1994(Titze, , 2009Zhang, 2009). Increased viscosity of the vocal folds can be due to, e.g., allergic reaction, dryness, polyps, nodules or inflammation of the vocal fold mucosa (Finkelhor, Titze, & Durham, 1988;Holmberg et al, 2001;Tsunoda, Takanozawa, & Choh, 1998;Verdolini-Marston, Titze, & Druker, 1990;Verdolini-Marston, Titze, & Fennell, 1994;Verdolini-Marston, Sandage, & Titze, 1994;Wang, Shau, & Hsiao, 2010). Also fundamental frequency has been shown to vary systematically with PTP; the higher the F0, i.e.…”