Laryngitis Research Articles

Voice disorder classification using speech enhancement and deep learning models

With the recent development of speech-enabled interactive systems using artificial agents, there has been substantial interest in the analysis and classification of voice disorders to provide more inclusive systems for people living with specific speech and language impairments. In this paper, a two-stage framework is proposed to perform an accurate classification of diverse voice pathologies. The first stage consists of speech enhancement processing based on the original premise, which considers impaired voice as a noisy signal. To put this hypothesis into practice, the noise lestral harmonic-to-noise ratio (CHNR). The second stage consists of a convolutional neural network with long short-term memory (CNN-LSTM) architecture designed to learn complex features from spectrograms of the first-stage enhanced signals. A new sinusoidal rectified unit (SinRU) is proposed to be used as an activation function by the CNN-LSTM network. The experiments are carried out by using two subsets of the Saarbruecken voice database (SVD) with different etiologies covering eight pathologies. The first subset contains voice recordings of patients with vocal cordectomy, psychogenic dysphonia, pachydermia laryngis and frontolateral partial laryngectomy, and the second subset contains voice recordings of patients with vocal fold polyp, chronic laryngitis, functional dysphonia, and vocal cord paresis. Dysarthria severity levels identification in Nemours and Torgo databases is also carried out. The experimental results showed that using the minimum mean square error (MMSE)-based signal enhancer prior to the CNN-LSTM network using SinRU, led to a significant improvement in the automatic classification of the investigated voice disorders and dysarhtria severity levels. These findings support the hypothesis that using an appropriate speech enhancement preprocessing has positive effects on the accuracy of the automatic classification of voice pathologies thanks to the reduction of the intrinsic noise induced by the voice impairment.

Modern Approaches to the Management of Children with Acute Obstructive Laryngitis and Epiglottitis

Experts of the Union of Pediatricians of Russia have developed modern guidelines on the management of children with acute obstructive laryngitis and epiglottitis. Croup is the most common cause of acute upper respiratory obstruction in children aged from 6 months to 6 years. Usually respiratory viruses are the pathogenic agents of the disease. The etiological factor of epiglottitis is Haemophilus influenzae type b in the vast majority of cases (> 90%). However, nowadays, epiglottitis caused by this pathogen agent is more common in adults in countries with mass immunization against hemophilic infection. This article considers in detail etiology, pathogenesis, and classification issues. Special attention is given to diagnosis, differential diagnosis, and therapy (via evidence-based approach) of acute obstructive laryngitis in children.

Nasopharyngolaryngoscopy in the Diagnosis of Various Pathologies of the Larynx in a Tertiary Care Hospital.

Introduction: Laryngeal disorders are frequently encountered in ENT practice. Nasopharyngolaryngoscopy is an outpatient department procedure that is used for the diagnosis and management of laryngeal disorders. The objective so the study was to study the prevalence of different laryngeal disorders by the use of Nasopharyngolaryngoscopy as an outpatient department procedure in ENT. Materials and Methods: A hospital-based prospective and analytical study was conducted in the department of ENT at Dhulikhel hospital, Kathmandu University Hospital during the period of 2 years. A total of 132 patients, who had various laryngeal symptoms and underwent NPL were included in this study. A careful and detailed history and clinical examination of the patients was done. Data were recorded and analyzed. Results A total of 132 patients with various laryngeal symptoms underwent Nasopharyngolaryngoscopy. Among them, 54.5% (72) were male and 45.5% (60) were female. The age range was from 18-84 years. The most common laryngeal disorder observed was Laryngopharyngeal reflux disease, followed by chronic laryngitis, true vocal cord nodule, and true vocal cord polyp. Conclusion Nasopharyngolaryngoscopy is a safe outpatient department procedure that is helpful for the diagnosis and management of various laryngeal disorders.

Plasmacytoma of the larynx: case report and literature review of laryngeal extra-medullary plasmacytoma

BackgroundMonoclonal plasma cell neoplasms are rare; laryngeal solitary plasmacytoma is very rare.Case presentationThis is the case of a 46-year-old man who has been treated for chronic laryngitis for 8 months; he presented first with dysphonia, dyspnea, and dysphagia. The initial tests showed normal erythrocyte counts, elevated erythrocyte sedimentation rates, elevated CRP, and a thrombocytopenia at 40.000. The rest of the test panel was without incidence. Whole body MRI was performed which showed no additional lesion besides the laryngeal location. Bone marrow biopsy was normal. The patient underwent pan-endoscopy under general anesthesia. The biopsy result showed plasmacytoma. The patient had radiotherapy, after which the patient needed tracheotomy with a good outcome. This work presents a very rare case of laryngeal solitary plasmacytoma, with a literature review of differential diagnosis, as well as current trends in diagnosis, and therapy.ConclusionThe essential take-home message is that however, this is a rare entity, it should be considered and treated as a malignant disease that could progress to diseases with worse diagnoses. Timely diagnosis and treatment can allow good outcomes and prevention of progression.

Фітотерапія гострих респіраторних вірусних захворювань

У статті наведено методи фітотерапії гострих респіраторних захворювань та їх ускладнень у дітей і дорослих. Також наводяться показання та протипоказання до проведення фітотерапії хворим на гострі респіраторні вірусні інфекції, правила призначення лікарських рослин дітям з урахуванням віку дитини та зазначенням доз фітопрепаратів, методів фітотерапії залежно від стадії захворювання, частоти використання лікарських трав та тривалості курсу лікування. Стаття містить рекомендації з використання лікарських трав для лікування гострих респiраторних вiрусних захворювань та їх ускладнень, таких як риніт, ларингіт, бронхіт, гiпертермiчний синдром, у дітей та дорослих. У статті наведені рекомендації професора О.Д Барнаулова щодо фітотерапії гострих респiраторних вiрусних захворювань, педіатра-фітотерапевта О.А. Данилюк щодо фітотерапії у дітей, правила застосування деяких лікарських рослин за Ю.І. Коршиковою, схема дозування фітопрепаратів дітям, запропонована Н.П. Меньшиковою, а також практичні рекомендації щодо складання фітосборів для лікування і профілактики гострих респіраторних вірусних інфекцій та прописи фітотерапевта О.В. Костарева.

Sensation and Repercussion of the Use of Humid Heat in the Treatment of Dysphonia due to Laryngitis in Singers

To verify the efficiency of thermotherapy perceptively and acoustically with hot vapor in the treatment of acute laryngitis. This is a pre and post test quasi-experimental study without a control group, approved by the ethics committee. Its sample counted with 65 singers - 37 females (56.9%) and 28 males (43.1%), mean age 33.7 years (±7.9) years, nonsmokers, with dysphonia due to acute laryngitis. They were submitted to videolaryngostroboscopy and perceptive-acoustic assessment of the voice before and 30 minutes after applying the inhalation of hot vapor. The appropriate statistical tests were used, adopting the significance level lower than 0.05. In the acoustic assessment, there was a statistically significant improvement in jitter and shimmer for vowels A and E, P < 0.001. The F0 assessed separately per sex, as it presented a significant difference, P < 0.001. The women's F0 results before and after the heat were higher than the men's. In the analysis of the acoustic results based on harmonics-to-noise ratio and normalized noise energy, there was significant improvement after the heat. All the mean values increased after the heat. There was a statistically significant decrease in the parameters related to the perceptive-auditory assessment for G (grade of hoarseness), R (roughness), B (breathiness), and S (strain). Of the 47 singers that scored 2 for G, 28 (59.6%) reduced it to 1 after the heat, P < 0.001. All the 45 that scored 2 for R reduced it to 1, P=0.011. Of the 8 who scored 2 for B, 6 (75%) reduced it to 1, P=0.020. All the 28 singers that scored 1 for S reduced it to 0, P < 0.001. Only for A (asthenia), there was no significant improvement, P=0.513. The results of the videolaryngostroboscopy revealed a statistically significant difference in all parameters analyzed, such as hyperemia, edema, muco-undulatory movement, and glottal coaptation. The thermotherapy with using humid heat, provide symptomatic benefits in the treatment of dysphonia caused by laryngitis, demonstrating that the hyperthermoterapy is a potential auxiliary therapeutic resource for the treatment of acute dysphonia due to laryngitis since the intervention with the technique proposed increased the voice quality. It is suggested that this method be used in speech-language clinical practice and that new studies be conducted with stronger designs for its efficacy to be confirmed.

Endoscopy audit in the ENT Outpatient Clinic of the Lagos State University Teaching Hospital

Background: Endoscopy is a minimally invasive diagnostic tool useful in medical practice and also in the field of Orthorhinolaryngology to visualize the interior surfaces of a tissue or organ that are not usually seen when performing a standard examination of the larynx and surrounding structures. This serves both a diagnostic and therapeutic purpose. Aims and Objectives: (i) To ascertain the number of videolaryngoscopy and nasal endoscopy carried out in the ORL Outpatient Clinic of the Lagos State University Teaching Hospital. (ii) To identify the commonest diagnosis made after both procedures Patients and Method: This was a 1 year retrospective study (March 2020 to March 2021) at the Outpatient Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. 219 patients had either a nasal endoscopy or videolaryngoscopy within the study period. Data collected included the bio data, symptoms, procedure done and diagnosis post procedure. Data was analyzed using SPSS. Result: 219 patients underwent endoscopies in the ENT Outpatient Clinic of the Lagos State University Teaching Hospital within the study duration. The study population was made up of 73 males and 146 females with a Male: female ratio of 1:2. Age range was 11 to 80 years. 143 patients had Video laryngoscopy, 73 Nasal endoscopy were done while 3 patients had both procedures done. The commonest symptoms for patients that had a nasal endocopy were nasal blockage and nasal discharge with a frequency of 31.58% and 28.95% respectively with Chronic rhionsinusitis, Nasal polyposis and Nasopharyngeal tumor being the common diagnosis made with a percentage of 43.8%, 15.73% and 13.48% respectively. Pre-operative assessment of patients for thyroidectomy was the commonest indication for videolaryngoscopy (35.29%) followed by hoarsensess/voice change (24.51%). Vocal cord paralysis (28.97%), Chronic pharyngitis (19.63%) and chronic laryngitis (11.21%) were the common diagnosis made after the procedure. Conclusion: Nasal endoscopy and Video laryngoscopy remains an essential diagnostic tool in ORL practice and its use cannot be over emphasized.

Comparative Study of Videolaryngostroboscopic Findings and Voice Handicap Index Before and After Treatment in Patients Presenting with Hoarseness Due to Non Malignant Lesions.

Voice personifies an individual. Change in voice can be the only presentation for a benign malady like vocal nodule or acute laryngitis but can also indicate life threatening malignancy. Hence every voice change must be evaluated. The aim of this pioneering study was to assess patients with voice change due to non-malignant conditions, using Videolaryngostroboscopy (VLS) and Voice Handicap Index (VHI) pre and post1 month therapy. Diagnosis determined conservative therapy or Co2 laser phonosurgery according to accepted medical protocol. On VLS, glottic closure pattern and wave form was noted both before and after treatment. Patient completed VHI form before and after treatment. There is no previous study comparing pre and post treatment VHI and VLS in a extensive etiology of conservatively managed patients. In our study, 100 patients were enrolled in the age group between 10years to the eighties, with majority in their thirties. The male to female ratio was 1.9:1. The majority of patients belonged to level IV occupation. A wide gamut of diagnosis was noted, majority being vocal nodules, followed by polyps, cysts, vocal cord palsy etc. A statistically significant improvement was seen pre and post treatment VLS in glottic closure pattern, waves presence along with improvement in VHI. Thus, Voice Handicap Index and Videostroboscopy can be used to prognosticate the vocal cord lesions and measure the effectiveness of treatment in both surgically and conservatively managed patients.

Results of a prospective observational study of the effectiveness of the complex drug Homeovox in adult patients with various types of dysphonia

To evaluate the clinical efficacy and safety of the use of the drug Homeovox in patients with acute and chronic catarrhal laryngitis as monotherapy. To fulfill the set goal of the study, the following tasks were solved: evaluation of the clinical effectiveness of the drug Homeovox as monotherapy for various types of dysphonia; evaluation of the effectiveness of the drug Homeovox as monotherapy from the 1st day of use. The basis for the implementation of the tasks was the analysis of the results of the examination and treatment of 60 patients with voice disorders aged 18 to 75 years. Among them, 10 (17%) patients with acute laryngitis and 50 (83%) patients with chronic laryngitis. To establish the diagnosis, a comprehensive examination was carried out, involving examination, videolaryngostroboscopy, acoustic analysis of the voice. The study design included three patient visits, during which the functional state of the vocal apparatus was examined by subjective and objective methods. As a result of the treatment with the use of the drug Homeovox, the efficacy and safety of this drug in the treatment of dysphonia in adult patients with acute and chronic laryngitis from the first days of therapy has been proven, which is confirmed by the method of videolaryngostroboscopy and acoustic analysis of the voice. The drug Homeovox is an effective, safe remedy and can be included in the complex treatment of laryngeal pathology in order to increase its effectiveness and achieve a therapeutic effect in a shorter time, manifested by an improvement in the clinical and functional state of larynx.

Острый ларингит. Современные аспекты физиотерапевтического лечения с позиции синдромно-патогенетического подхода

Despite the widespread prevalence of acute laryngitis and known methods of therapy, the task of improving a personalized approach to treatment based on the knowledge of otolaryngology, physical and rehabilitation medicine (physiotherapy), and pharmacology still remains an urgent task. Acute laryngitis is an inflammation of the mucous membrane of the larynx, which is accompanied by a violation of the voice function. Patients with this pathology seek help from an otolaryngologist and generalist. Acute laryngitis can occur as an independent disease or as a manifestation of acute respiratory viral infection (ARVI). Also, the development of acute laryngitis can also be due to irritative (noninfectious) reasons: excessive voice use, climatic conditions, smoking, gastroesophageal reflux disease, occupational hazards. The purpose of this article is to substantiate the algorithm for prescribing physical factors to patients with acute laryngitis based on modern ideas about their therapeutic effects. The paper presents current information about the etiology and pathogenesis of acute laryngitis. The main pathophysiological syndromes are identified: inflammatory, neuromuscular transmission disorders, dystonic, dystrophic, microcirculation disorders, psycho-emotional. The general principles of the syndromic-pathogenetic approach to the prescription of therapeutic physical factors in patients with acute laryngitis are substantiated. General absolute and relative contraindications to the prescription of therapeutic physical factors in patients with dysphonia are listed. The algorithm for prescribing physiotherapy is substantiated, the most illustrative examples of the choice of physical methods of treatment are presented.

Анализ диагностики и лечения хронического гиперпластического ларингита в Республике Беларусь на примере пациентов Добрушского района Гомельской области

Objective. To analyze the current state of diagnosis and treatment of patients with chronic hyperplastic laryngitis (CHL) for the period 2010–2021 in the Republic of Belarus on the example of patients in the Dobrush District of the Gomel Region and to identify shortcomings for the subsequent development of measures to prevent malignant diseases of the larynx. Material and research methods. The material for the study was patients of the Dobrush District of the Gomel Region (61 patients: 39 (64%) men and 22 (36%) women) with a diagnosis of chronic hyperplastic laryngitis who are registered with an otorhinolaryngologist. The median age at diagnosis was 45.6 years (18 to 76 years). In the age distribution, 2 peaks were observed: from 36 to 40 years and from 51 to 55 years – 16% (10 out of 61) of the entire group, 87% of patients were of working age. Results and discussion. Patients with precancerous diseases of the larynx, who are on regular medical check-up in the Dobrush Central District Hospital, were analyzed. Age-specific incidence rates were analyzed and differentiated by gender and place of residence. The analysis of symptoms, the time spent by patients on regular medical check-up, the frequency of visits to the otorhinolaryngologist in the order of regular medical check-up was carried out. All patients had voice changes of various nature and severity: 50 (82%) patients complained of hoarseness, 6 (10%), of hoarseness, 5 (8%) had aphonia. More than half of the patients had the following complaints: feeling of a coma or a foreign body in the throat – 90%, the presence of a cough not associated with colds – 75%, and shortness of breath on exertion – 70% of patients. The median time spent by patients on regular medical check-up was 5 years (from 0 for patients registered in 2021 to 30 years). The frequency of visiting an otorhinolaryngologist in the order of regular medical check-up was from 1 time in 2–4 months (10% of patients) up to 1 time in 5 years (3%), 44% – 1 time per year, 27 (44%) patients received outpatient treatment, 5 (8%) patients received inpatient treatment, and 29 (48%) patients received both outpatient and inpatient treatment. During inpatient treatment, 16 (47%) hospitalized patients underwent surgical treatment to remove hyperplastic areas of the mucosa, the rest received antibiotic therapy, 15 (44%) patients underwent a biopsy. Conclusion. The study revealed a number of problems in the diagnosis and treatment of CHL, the main of which is the establishment of a generalized clinical diagnosis without performing a biopsy and clarifying the form of CHL and, as a result, conducting numerous ineffective courses of conservative treatment, both on an outpatient basis and in a hospital setting. It is necessary to develop a system of measures to improve the effectiveness of treatment of patients with CHL and the prevention of malignant neoplasms of the larynx.

Влияние пандемии COVID-19 на заболеваемость гортани

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.

Screening for laryngeal disease in patients with gastroesophageal reflux disease

To improve the diagnosis of laryngeal disease in patients with gastroesophageal reflux disease (GERD). 171 patients (89 (52%) men, 82 (48%) women) with non-erosive (39 (23%) people) and erosive (132 (77%) people) forms of GERD were examined. None of the patients made active complaints about the condition of the larynx and pharynx. The examination included a questionnaire, examination by an otorhinolaryngologist, and videoendolaryngoscopy. The survey revealed the presence of symptoms of otorhinolaryngological pathology in 74% of patients. Videolaryngoscopy revealed no laryngeal pathology in 55 (32%) patients, and signs of GERD-associated laryngitis were detected in 116 (68%) patients. The most common pathology was pachydermia in interarytenoid region - in 89 people, laryngeal granuloma was detected in 7 patients, leukoplakia - in 2 patients, chronic edematous polypous laryngitis - in 2 patients, benign laryngeal formations - in 9 patients. In patients with GERD (erosive and non-erosive forms), an asymptomatic course of chronic laryngitis associated with this pathology was observed in 44% of cases. In 52% of patients, pachydermia in interarytenoid region was diagnosed, of which every second had pronounced hyperplasia and folding of the mucous membrane in interarytenoid region, which must be differentiated from laryngeal cancer (in this case, patients should be under the dynamic supervision of an otorhinolaryngologist). Other precancerous formations of the larynx (granulomas and leukoplakia) were found in 5% of patients. Benign neoplasms of the larynx (polyps and cysts) were also detected in 5% of cases. Despite the high frequency of detection of otorhinolaryngological diseases in the examined patients with gastroesophageal reflux disease, none of the patients presented complaints related to the pathology of the larynx, which indicates the need for active detection of this pathology in this category of patients by questioning, questioning, as well as examination by an otorhinolaryngologist.

Application of Voice Handicap Index score and flexible laryngoscopy in the evaluation of patients with laryngeal disorders

Background: Laryngeal disorders are common in our environment, and a number of studies have been carried out. However, there is a paucity of literature with regard to the evaluation of voice-related handicap, and Voice Handicap Index (VHI) score for specific laryngeal disorders. Aim: The aim of this study was to apply the VHI score and flexible laryngoscopy in the evaluation of patients with laryngeal disorders and to determine the mean VHI score for specific laryngeal disorders in our environment. Methodology: A cross-sectional study was conducted among patients with the clinical diagnosis of laryngeal disorder who presented at the otolaryngology clinic of our institution. Patients who had previous laryngeal surgery or tracheostomy were excluded. Data was collected on sociodemographic variables, clinical history, and flexible laryngoscopic findings. The VHI score, which comprised of functional, physical, and emotional subscales was also collected and analyzed. Results: A total of 90 patients completed the study; 56.7% of them were males, whereas 43.3% were females. The mean VHI was highest in patients with laryngeal tumor (68.8 ± 14.8) followed by patients with vocal cord palsy (58.2 ± 5.7), but it was lowest in patients with acute laryngitis (27.1 ± 5.3). There was a statistically significant difference in mean VHI for each laryngeal disorder (P = 0.000). Conclusion: The patients with laryngeal tumor and those with vocal cord palsy had the highest VHI score, which affected their functional and emotional well-being. Therefore, applying VHI score and flexible laryngoscopy is important in the holistic evaluation of patients with laryngeal disorders.

Полипы голосовых складок у профессионалов голоса

Vocal fold polyps (VFP) are referred to as tumor-like formations of the larynx. They also, like nodules, occur in less than 1% of the population, while the ratio of men and women is 2:1. The voice of patients with VFP is characterized by pronounced dysphonia, which creates significant problems for voice professionals. A change in voice function affects the communicative abilities of patients, psychological status, limits their ability to work. 60 patients with VFP who applied to the phoniatric department of the Saint Petersburg Research Institute of Ear, Throat, Nose, and Speech were examined: 34 (57%) women and 26 (43%) men, aged 20 to 61 years, the average age of patients was 33,8 ± 1,7 years. All patients were representatives of voice professions. The main complaint in all patients with polyps of the vocal folds was hoarseness. The duration of vocal disorders in 40 (67%) patients with VFP ranged from 1 month to 1 year. The rest of the patients suffered from dysphonia for more than a year. The average duration of phonation disturbance was 1,6 ± 0,7 years. The main cause of voice problems was considered by patients to be excessive voice use. When collecting anamnesis, it turned out that 35 (58%) people smoked. The analysis of concomitant diseases according to the anamnesis and the documentation provided by the patients revealed somatic pathology in all patients. Diseases of the gastroduodenal, endocrine, and cardiovascular systems were more common than others. Laryngeal diseases were diagnosed by video laryngoscopy, video laryngostroboscopy. Unilateral localization of the formation was detected in 58 (97%) cases, bilateral, in 2 (3%) cases. The background condition for the formation of VFP was hypotension of the vocal folds in 26 (43%) of the examined. In addition, signs of chronic laryngitis, nodules of the vocal folds on the vocal fold opposite to the polyp, hypertrophy, and hyperfunction of the vestibular folds were revealed. Thus, excessive voice use, pathological changes in the vocal apparatus, nervous, endocrine, gastroduodenal, and other systems as well as smoking contributed to the formation of vocal fold polyps in voice professionals.

Impact of social distancing in response to COVID-19 on hospitalizations for laryngitis, tracheitis, otitis media, and mastoiditis in children aged 0 to 9 years in Brazil.

ABSTRACTObjectiveThe objective of this study is to evaluate the impact of social distancing resulting from COVID-19 in hospitalizations for infections of the upper airways (URTI), such as acute laryngitis, tracheitis, and otitis media in children aged 0 to 9 years in Brazil, considering that they share the same forms of transmission.MethodsData on hospitalizations for acute airway changes and their complications in children <9 years old were obtained from the Database of the Brazilian Department of Public Health Informatics for the period 2015 to 2020. These data were also analyzed by macroregions of Brazil (North, Northeast, Southeast, South, and Midwest). The effect of the social distancing strategy on the increase of acute laryngitis, tracheitis, otitis media, and mastitis, as absolute and relative reductions, was calculated by analyzing the annual calculation of 2015-2019 vs 2020.ResultsAll the hospitalizations compared in the Unified Health System (SUS) for laryngitis and acute tracheitis and otitis media decreased, considering all states of Brazil. The largest reduction in hospitalization reduction was in the North, with -94% in 2015-2019 vs 2020 in cases of laryngitis and acute tracheitis, and in the Midwest, with - 85% in 2015-2019 vs 2020 in cases of otitis media.ConclusionHospitalizations for laryngitis, acute tracheitis, and acute otitis media in children <9 years old decreased between March and July 2020 in Brazil, when social distancing measures were adopted due to the COVID-19 pandemic.

Methods of sparing surgical treatment of chronic edematous-polypous laryngitis, edema Reinke

Introduction. Laryngeal pathology occupies a leading place in the general structure of diseases of the upper respiratory tract, chronic edematous-polypous laryngitis, Reinke-Gayek edema accounts for 5.5% of all benign diseases of the vocal folds. The main method of treating Reinke-Gayek's disease is surgical treatment, which consists in removing excess mucosa, or “stripping” - tearing a strip of mucosa with forceps from the vocal fold. One of the main principles of laryngeal surgery is the maximum preservation of the structures of the vocal fold, obtaining a flexible vibration of the muscular-membranous part and the mucous membrane of the vocal fold.Purpose. The purpose of our work is to improve the effectiveness of treatment of chronic edematous-polypous laryngitis using a CO2 laser.Tasks. To develop a differentiated approach to the surgical treatment of chronic edematous-polypous laryngitis using a carbon dioxide laser.Materials and Methods. We treated 46 patients with Reinke-Gayek disease, including 35 women and 11 men. The age of the patients ranged from 40 to 67 years. Preoperative examination included endoscopic examination, laryngostroboscopy. The type was determined according to the classification of H. Yonekawa, for the choice of further surgical tactics. In type II, an incision of the mucosa, aspiration of gelatinous matter from the Reinke space, and laying of the mucosa were performed. With type III, it is made by forming M-shaped flap to close the defect.Results. All patients in the preoperative period were surveyed with the VOICE HANDICAP INDEX(VHI-30) questionnaire, laryn-gostroboscopy, and maximum phonation time. In the postoperative period, the examination was performed twice, 1 month after the operation and 3 months after the operation. There is a significant increase in indicators, an increase in the maximum phonation time, a decrease in VHI-30 points.Conclusion. The use of this technique allowed to significantly accelerate the recovery of the voice, reduce the time spent in the hospital, minimally damaging the structure of the mucous membrane of the vocal folds.

Role of stroboscopy in evaluation of patients with vocal abnormalities

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Stroboscopy is an examination in which strobe light is combined with laryngoscopy, to visualize the vocal fold vibration. It makes use of the Talbot’s law for visualizing the vibrating vocal fold having frequency of around 250 times per sec. This technique was used for studying voice abnormalities and evaluate related pathologies. The aim and objective was to evaluate patients with vocal abnormalities with the help of stroboscope and to study the mucosal wave pattern pre and post treatment of vocal cord pathologies.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective observational study was conducted at a tertiary care facility in central India. 50 patients with vocal abnormalities for more than 2 weeks were subjected to stroboscopy. Written informed consent from eligible patients was obtained and they were evaluated by stroboscopy using Karl Storz stroboscope with 70 degree 8 mm telescope, model no.: 20140020032. A second follow up stroboscopy was done two months post treatment and the parameters were recorded.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; VC nodule was observed as the most common pathology followed by vocal polyp, carcinoma and chronic laryngitis. It was also observed that there was statistically significant difference (p&amp;lt;0.001) in pre and post treatment findings of different parameters of voice evaluated using stroboscopy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Video stroboscopic evaluation proved to be a useful and reliable tool for evaluation and treatment of the patients with voice abnormalities as the changes in pre and post treatment voice parameters were found to be statistically significant.&lt;/p&gt;

FORENSIC MEDICAL ASSESSMENT OF INJURY SEVERITY OF LARYNX AND HYOID BONE BASED ON PRE-JUDICIAL AND JUDICIAL INVESTIGATION

Victims with fatal and non-fatal closed blunt trauma of the larynx and hyoid bone often become the object of forensic medical service during the pre-judicial and judicial investigation. The purpose of this study is to analyze the features of expert qualification of bodily injuries in victims with closed blunt trauma of the larynx and hyoid bone, depending on the nature and severity to determine ways to unify its forensic diagnosis. Materials and methods. The study was based on the conclusions of 35 forensic medical examinations of cases of closed blunt trauma of the larynx and hyoid bone, obtained from the leading expert institution of the Kharkiv region. Results. We determined the peculiarities of estimating the degrees of severity of above bodily injuries. Severe injuries were found in 12 (34.4%) cases of death of the victims from mechanical asphyxia, in one case of reflex cardiac arrest, and in one case of traumatic shock. Injuries of moderate severity were established by experts in 6 (17.1%) cases of lethal and in 6 (17.1%) cases of non-lethal cases with laryngeal cartilage fractures; in 2 (6.2%) cases of non-lethal injuries with acute oedema, hematoma, laryngeal stenosis of the second degree. 7 (20%) cases of non-lethal laryngeal injuries with further development of acute posttraumatic laryngitis were qualified as simple injuries. Conclusion. There are no clear morphoclinical criteria for objective assessment of injuries of the larynx and hyoid bone that can lead to pre-diagnostic expert errors. According to the results of the work, the ways to unify forensic medical assessment and diagnosis of such injury was determined.

Clinical Profile of Hoarseness of Voice: A Hospital-Based Cross-Sectional Study

Abstract Introduction Hoarseness is a symptom with a varied etiology ranging from inflammatory condition, benign lesions to malignant lesions. Benign conditions are more common than malignant. Proper knowledge of clinical profile and evaluation is necessary to treat the cause. Objective It was conducted with the aim to study the clinical profile of patients with hoarseness of voice. Materials and Methods It was a descriptive cross-sectional study of 2 years conducted at Department of ENT at Tertiary Health Care Hospital, India. Patients aged above 10 years presenting with hoarseness of voice were included in the study. After detailed history related to sociodemographic particulars, clinical examinations including Hopkin’s rod examination in all patients and direct laryngoscopy, and radiological and histopathological examination were performed whenever indicated. Results Out of total 100 patients, maximum patients (32%) were in the age group of 21 to 30 years. There was slight male preponderance with male:female ratio of 1.17:1. Laborer (29%) was the major group affected in terms of occupation. Most common predisposing factor was smoking (35%). Commonest etiology for hoarseness of voice was chronic laryngitis (20%). Conclusion Hoarseness of voice as a symptom should never be ignored as its etiology may range from simple infection to malignancy. At our tertiary care center majority of patients come from rural area. Most of the etiological factors found in our study were treatable medically or surgically. Early diagnosis is the key to improve the outcome of treatment.