Vocal Cord Lesions Research Articles

1682 Association between Obesity and Chronic Laryngitis in Women and Their Effects on Phonation

Introduction“Phonation” is the physical process by which the vocal folds produce certain sounds. According to laryngology, there are different factors that can affect our larynx (voice box) negatively, such as: Obesity, benign vocal cord lesions, sex hormones, head and neck surgeries and patients who are suffering from health complications recovered from COVID-19 after a prolonged intubation. These factors could show difficulties in voice, airway, and swallowing.AimThis study aimed to investigate the relationship between obesity and chronic laryngitis in which this inflammation hinders phonation and voice/sound output. This investigation in South Korea using data from Korea National Health and Nutrition Examination Survey (KNHANES) collected during 2008 – 2010.Method(KNHANES) was a cross-sectional survey of the civilian, non-institutionalized population of South Korea (n = 13,819) aged 19 years or older. Obesity status was measured by using BMI and waist circumference.ConclusionsObese women in Korea have an elevated risk for developing chronic laryngitis. Chronic laryngitis itself is a misfortune. Chronic laryngitis (CL) causes excess mucus, a sore throat, a persistent dry cough, loss of voice and phonation and difficulty swallowing. Moreover, obese women will suffer from hormonal imbalances that show changes in their voice tones. Elevated estrogen levels cause gastric acid secretion and GERD in women. To help those patients, it is better to shift into a healthy lifestyle, manage their weight by healthy diet and exercises. In this way, a lot of complications will be lessened such as: GERD that is responsible for benign vocal cord lesions possibility. Some women who suffer from chronic laryngitis and turns into cancer decide to do neck surgery. Otolaryngologists stated common side effects from head and neck surgery include temporary or permanent loss of normal voice, impaired speech, and hearing loss.

Noninvasive Detection of Arytenoid Cartilage Calcification Using Computed Tomography and Prediction of Prognosis in Laryngeal Contact Granuloma

Laryngeal contact granuloma (LCG) is a relatively uncommon disease with chronic inflammatory stimulation, and long-term reflux irritation is a vital factor for arytenoid cartilage calcification. Our investigation compared the severity of ipsilateral arytenoid cartilage calcification with the frequency of recurrence of LCG after surgical treatment. A retrospective chart review of prospectively gathered data over five years from 327 patients, including 153 subjects without laryngeal lesions, were age- and sex-matched normal controls, 103 patients with various other vocal cord lesions were in the laryngeal lesion group and 71 LCG patients met the diagnostic criteria pathologically. All subjects underwent laryngeal high-resolution computed tomography (HRCT) prior to therapeutic interventions. The computed tomography (CT) value and arytenoid cartilage calcification were obtained using image data before surgery, and their clinical significance was further analyzed. Seventy-one patients with LCG, including sixty-two males, were enrolled in the study. Among these cases, there were 67 patients with unilateral vocal cord lesions. Of the 103 eligible patients in the laryngeal lesion group, 87 had unilateral lesions, which including eighty-seven men. Of the 153 average subjects, 105 were male. The rate of arytenoid cartilage calcification in the LCG group was dramatically higher in the lesion side than in the laryngeal lesions and normal group (P < 0.01). Furthermore, the CT value (P < 0.01) and range of calcification (P < 0.01) were significantly higher in patients with LCG than in those with laryngeal lesions. Importantly, patients with high CT values and the calcification range of lesions in the arytenoid cartilage displayed a greater lesion size and recurrence rate than patients with low CT values and lesion areas (P < 0.01). Our results suggest that most patients with LCG present with calcification of the arytenoid cartilage. The more severe the calcification in the arytenoid cartilage, the greater the risk of granuloma size and recurrence in LCG after surgical treatment. CT and bone density testing of the arytenoid cartilage may be an essential method to evaluate the prognosis of LCG.

Risk prediction and malignant transformation in vocal cord leukoplakia based on electronic laryngoscope

Objective:To investigate the predictive risk factors of vocal fold leukoplakia under electronic laryngoscope and influential factors of malignancy. Methods:A total of 163 cases with vocal cord leukoplakia were analyzed retrospectively. The relationship between the clinical features, including site, size, whether involving the anterior commissure, morphology and pathological grade were analyzed. Then the associations with malignant transformation in vocal cord leukoplakia were evaluated by using multiple Logistic regression analysis. Results:There were one side lesions in 96 cases（58.9%）, and bilateral vocal cord lesions in 67 cases（41.1%）. The vocal cord leukoplakia with extension less than half of the vocal cord was observed in 135 cases（82.8%） and beyond half of the vocal cord was seen in 28 cases（17.1%）. Lesions involving the anterior commissure were 42 cases（25.8%）, without involving the anterior commissure were 121 cases（74.2%）. According to morphological features, 82 patients（50.3%） had a superficial type, followed by exophytic type（n=65, 39.9%）, and ulcerative type（n=16, 9.8%）. The pathological type included squamous epithelial simple hyperplasia in 65 cases（39.9%）, mild hyperplasia in 44 cases（27.0%）, moderate hyperplasia in 31 cases（19.0%）, severe hyperplasia and carcinoma in situ in 23 cases（14.1%）. 140 cases（85.9%） were in low risk group, and 23 cases（14.1%） were in high risk group. The site of the vocal fold leukoplakia was not associated with the pathological grade（P>0.05）, whether the vocal fold leukoplakia range exceeds 1/2 of the total length of the vocal fold, and whether involving the anterior commissure were associated with the pathological grade（both P<0.05）. There were statistically significant differences between the pathological grade and the morphological type（P<0.01）. Ten cases developed larynx cancer, the ratio of malignant transformation was 6.1%. The multiple Logistic regression showed that whether involving the anterior commissure and histopathological classification were the risk factors of malignant transformation in vocal cord eukoplakia. Conclusion:The pathological results of vocal cord leukoplakia can be predicted by laryngoscopy features. Involving of the anterior commissure and histopathological classification are the risk factors of malignant transformation in vocal cord leukoplakia.

Application of deep learning assisted electronic laryngoscope in diagnosis of laryngeal leukoplakia

In recent years, medical imaging technology and computer technology have made great progress. On the one hand, with the development and popularization of electronic laryngoscope, the image of electronic laryngoscope plays a very important role in the diagnosis of vocal cord lesions. On the other hand, deep learning algorithm，especially convolutional neural networkhas gradually become the first choice of medical image recognition since the foundation of deep learning algorithm. So far, deep learning algorithm has made great contributions in many disciplines. In this paper, the basic concept of deep learning, the current status of image recognition of vocal cord lesions, and the prospect of research based on deep learning in vocal cord image lesions recognition are reviewed.

Comparative study on surgical outcome for benign vocal cord lesions by conventional method versus coblation

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Benign&lt;strong&gt; &lt;/strong&gt;vocal cord lesions are common laryngeal pathology found in routine clinical practice.microlaryngeal surgery is useful in excision for pathology. Coblation assisted microlaryngeal surgery is a new technique for the vocal cord lesions&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Current study was conducted in Government Kilpauk medical college hospital and Government Royapettah hospital from the period of 2018 to 2019 in 40 patients with benign vocal cord lesion. The objectives of current study were to assess the voice handicap Index before and after surgery, to assess the surgical benefits and ease in doing the procedure intraoperatively and to assess the postoperative recovery in conventional micro laryngeal procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; The overall analysis shows coblation being an evolving technique has advantages over the conventional cold knife method. Blood loss and the surgery duration was less in coblation. But the assessment tools of both voice handicap index, voice analysisand GRBASscore favours conventional micro laryngeal surgery with reduced scores and improvement in performance with statistically significant values probably due to minimal tissue handling and decrease in post op scarring in conventional micro laryngeal surgery.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The overall voice handicap index and voice analysis showed improvement post operatively in both the groups with more favoring response to conventional method with statistically significant values. In the same away the GRBAS score also favors the conventional method. Coblation being a newer technique can be employed for surgical treatment for micro-laryngeal surgery considering its advantages and less time consumption. Stroboscopy and other acoustic analysis along with long term follow up is needed.&lt;/p&gt;

Role of videolaryngostroboscopy in the diagnosis of dysphonic patient with normal fiberoptic laryngoscopy

Background: Dysphonia is altered voice quality, pitch, loudness, or vocal effort that impairs people’s quality of life. It is a very common complaint affecting nearly one-third of a population at some point in their life and could be caused by infection, tumor, trauma, vocal cord paralysis, etc . Indirect mirror or endoscopic laryngoscopy is used to assess the laryngeal condition in dysphonic patients seeking mainly for the cause, but frequently the findings were normal or unremarkable . Videolaryngoscopy (VLS) is very useful in dysphonic patients who have an otherwise normal indirect or flexible laryngoscopic examination. In addition to providing information regarding vocal fold vibrations, the image obtained through VLS can be magnified to make a more detailed assessment of the vocal cord anatomy than is possible with rigid of flexible laryngoscopy. Objective of study: To assess the videolaryngostroboscopic findings in dysphonic patients with normal fiber-optic laryngoscopy. Patient &amp; Method: A cross-sectional study, Fifty patients were included in the study; They had complained of dysphonia, and the fiber-optic laryngoscopic examination was normal. Videostroboscopy were obtained for all patients to assess vocal fold vibration and seek any abnormal findings. Results: A total of 50 patients were enrolled in this study. Regarding the stroboscopic findings, 42% of the patients were normal, 15 (30%) had early soft singer’s nodules, 6 patients (12%) had intracordal lesions, 4 patients (8%)had vocal cord polypoidal changes, 2 patients (4%) had presbylaryngis, and the other 2 patients (4%) had sulcus vocalis. Conclusion: VLS is beneficial in detecting vocal cord lesions in patients with normal fiber-optic laryngoscopy. A high proportion (more than half) of dysphonic patients with normal fiber-optic laryngoscopy had abnormal findings. Keywords: Stroboscopy, Videolaryngoscopy, Fiberoptic laryngoscopy, Dysphonia.

Prevalence and Risk Factors of Benign Laryngeal Lesions among Teachers

Introduction: Subjects using their voice as the main professional instrument oftendevelop vocal disorders. Teachers present a high prevalence of vocal problems incomparison to other professional categories depending on their voice as professionaltool; voice changes could be assigned to the interaction between occupational (vocalloading), behavioral and lifestyle factors. Voice disorders due to professional overuseare usually chronic and can lead to an increase in sick absenteeism. Aim of work:To determine the prevalence of abnormal laryngeal findings among public-schoolteachers in Menoufia Governorate, Egypt using strobovideolaryngoscopy. Materialsand methods: A case-control nested into a cross-sectional study was held from March1st to May 1st, 2019. The sample is composed of four hundred and fifty-seven (457)teachers of public schools in Menoufia Governorate, Egypt. Results: The prevalence ofvocal lesions among the studied group was 22.1% with (17.79-26.41) 95% confidenceinterval. On stroboscopic evaluation, vocal nodules were the most common structurallesion affecting the larynx; it was present in 42 (9.1%) of teachers. Other structuralabnormalities included the presence of swollen arytenoids, vocal cords paresis,vocal polyps, vocal cord cyst, and epiglottic mass in a percentage of (5.9, 3.7, 1.7,1.1, 0.4) respectively. There was higher prevalence of vocal cord lesions amongolder teachers with increase duration of employment/years, number of classes /days,smokers and teachers of primary school; although it didn’t show statistically significantdifference. A significant relationship was reported between laryngoscopic findings and laryngopharyngeal reflux (15.1% vs 28.7% with 0.002 p-value) and water intake/day (t = 2.41, df = 2, p =.047). Conclusion: Results of the current work highlighted the needfor large-scale regular educational programs to minimize vocal cord lesions amongteachers.

The value of bronchoscopy in patients with non-massive haemoptysis and a clear or benign computer tomogram scan.

The preferred diagnostic pathway for patients presenting with non-massive haemoptysis and normal or benign computer tomography (CT) radiological findings is unclear. The common approach is to investigate with both CT and bronchoscopy, irrespective of patient-specific factors. The value of performing fibreoptic bronchoscopy (FOB) in patients with non-massive haemoptysis and clear or benign CT findings remains undetermined. We aimed to investigate its value using a large retrospective case series. A retrospective review of 4376 FOBs performed in Northumbria Healthcare NHS Foundation Trust from January 2012 to December 2019 for patients presenting with haemoptysis and clear or benign CT findings. Statistical analysis was performed to describe patient-specific variables, clinical characteristics, pathological findings and subsequent management decisions. A total of 4376 FOBs were performed during the study period, 275 were indicated to investigate non-massive haemoptysis. Two hundred and fifty-nine patients underwent a CT scan (158 before and 101 after FOB); 16 never had a CT because the treating physician did not feel it was necessary. About 258 CT scans showed normal anatomy. All patients underwent FOB; 192 showed normal findings. Bronchoscopic findings did not alter clinical management in 274 patients. One patient was referred to the ear, nose and throat department following the identification of polypoid vocal cord lesion which, following thorough investigation, was confirmed as benign. FOB provides minimal value for identifying lung malignancies in patients with non-massive haemoptysis and a clear or benign CT scan irrespective of patient-specific risk factors. Cost savings would be associated if physicians altered practice accordingly.

A STUDY ON VOCAL CORD LESIONS

Introduction - Vocal cord lesions may be benign or malignant or pseudotumors. Patients usually come to us with symptoms of hoarseness of voice, cough, foreign body sensation, or throat pain. The patient should be evaluated properly to find out the causes. A malignant condition should be detected as early as possible to give prompt treatment and the best prognosis. Aim and objectives - To study the clinical and pathological behavior of vocal cord lesions. Materials and methods - 30 cases of vocal cord lesions were studied. Results - Commonest age group is 61 - 70 years (36.7%). The male to female ratio is 3.28:1. Hoarseness of voice is the commonest symptom followed by cough. Smoking and alcohol are the commonest predisposing factor followed by vocal abuse. The commonest vocal cord lesion is the malignancy (squamous cell carcinoma)(56.6%) and the commonest benign condition is the vocal polyp (30%).

The value of narrowband imaging using the Ni classification in the diagnosis of laryngeal cancer.

IntroductionNarrowband imaging (NBI) is a special endoscopic optical enhancement setting allowing better visualization of mucosal microvasculature compared to white light endoscopy. This study evaluates the validity of NBI using the Ni classification in the detection and differentiation of severe dysplasia (SD) and glottic squamous cell carcinoma (SCC).MethodsPatients with suspicious vocal cord lesions underwent conventional white light endoscopy followed by clinically indicated biopsy. At the same time, NBI images were obtained and graded independently. Lesions were graded from I to V according to the Ni classification and compared to histopathological findings.ResultsFifty‐two patients were included in this study (40 SCC and 12 SD). The sensitivity and specificity of NBI in diagnosing laryngeal cancer was 95.0% (CI, 83.9%‐99.4%) and 83.3% (CI, 51.6%‐97.9%), respectively. The negative likelihood ratio was 0.06. Higher Ni grades correlated very strongly with more advanced disease.ConclusionsNBI using the Ni classification is a sensitive diagnostic tool for the detection and differentiation of early neoplastic and preneoplastic glottic lesions. As higher Ni classification correlates strongly with advanced disease, it serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal cancer.Level of Evidence: Level IV.

Prevalence of Benign Vocal Fold Lesions in Ear, Nose, and Throat Outpatient Unit of Dr. Soetomo General Hospital, Surabaya, Indonesia

Introduction: Benign vocal fold lesions reduce the efficiency of sound production. Reports of dysphonia cases caused by vocal principles in Indonesia are still very limited. This study aimed to determine incidence and prevalence of benign vocal fold lesions, namely vocal cord nodules, cysts, and polyps.Methods: A descriptive retrospective study was conducted using patient’s medical record of Ear, Nose, and Throat (ENT) Outpatient Unit. Dysphonia patients with benign vocal cord abnormalities were identified. The data analyzed using descriptive analytic.Results: There were 20 patients with benign vocal fold lesions, consisting of 13 patients (65%) with nodules, 3 patients (15%) with polyps, and 4 patients (20%) with cysts. The ratio of male and female patients was 1: 1. Most patients belonged to age group of 20-59 years (12 patients; 60%). In term of occupation, most patients belonged to group III, which is a group of workers who are not professional voice users (12 patients; 60%). Most vocal fold lesions were found in the 1/3 of bilateral anterior (17 patients; 85%). Most therapy was non-operative in 13 patients (65%). Conclusion: Benign vocal fold lesions, including vocal cord nodules, polyps, and cysts, are found in all patients with dysphonic complaints. The prevalence of dysphonia symptoms is quite high every year, but only a small portion are diagnosed with benign vocal cord lesion.

A Descriptive Study of Benign Vocal Cord Lesions with Speech Prameters Operated with Microlaryngoscopy

Background:Humanity has appreciated the importance and power of the human voice. Voice disorders like benign, malignant lesions of vocal cord affect the voice quality and also can have a devastating effect on daily functioning and quality of life. These lesions can be diagnosed and treated with microlaryngoscopy. Micro-laryngoscopy is a procedure for visualization of a magnified view of the voice box (larynx) with the help of a laryngoscope assisted with an operating microscope for precise laryngeal surgery. Speech parameters helps in voice quality assessment for vocal cord lesions.Method:We have studied 30 cases of benign vocal cord lesion by simple random sampling for two years which got operated with microlaryngoscopic conventional surgery. Their pre and post-operative assessment is done with respect to speech parameters like Maximum Phonation Time, Voice Handicap Index and GRBAS Score. Clinical history and rigid Hopkins 700 also helped in diagnosing of benign vocal cord lesions. Result: After conventional microlaryngeal surgery helps in improvement in MPT, VHI score, GRBAS Score post-operatively that of 3 months follow up. The effectiveness was seen more along with voice rest, corticosteroids and most important speech therapy.

Study of laryngeal lesions undergoing microlaryngeal surgery in a tertiary health centre

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Patients with laryngeal lesions were evaluated for age and sex ratio, analysis of clinical features, videolaryngoscopic findings and histopathological features. Assessment of therapeutic role of microlaryngeal surgery (MLS) by telescopic method and also prognosis after surgery and voice therapy were evaluated.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective institutional based study. A total of 18 patients with vocal cord lesions the chief complaint being hoarseness of voice were subjected to surgery in a tertiary health centre. After thorough evaluation patients underwent MLS by telescopic method. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study 6 patients stand out to be benign lesions and 12 patients stand out to be pre malignant and malignant lesions. Improvement in voice after surgery was reported in all patients. No recurrence was reported after 6-8 months of follow-up.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; MLS is a good tool as it is precise and cost effective. MLS by telescopic method is a good therapeutic tool in both benign and malignant vocal cord lesions.&lt;/p&gt;

Hoarseness of voice-prospective study: etiology, evaluation and treatment

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Despite advances in medical technologies and improvement in diagnostic armamentarium in laryngology about 20% of cases remain undiagnosed until suspension laryngoscopy. The study was undertaken to identify etiological factors, type of lesions, age and sex distribution, sites of involvement, efficacy of different diagnostic and treatment modalities.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective study of 45 cases of benign vocal cords lesions was carried out. Patients with hoarseness of voice for &amp;gt;3 weeks were investigated and treated with conservative management and surgery. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Hoarseness of voice presented within 6 months after onset of symptom. The common age of presentation was between 21 to 40 years, with male:female ratio of 1.25:1. Vocal abuse, laryngopharyngeal reflux disease (LPRD) and smoking, were the most common etiological factors. Housewives were most common group. Wide angled 70&lt;sup&gt;0&lt;/sup&gt; telelaryngoscopy showed 80% accuracy rate. Suspension laryngoscopy showed 100% accuracy rate. Involvements of both the vocal cords were more common, vocal cord nodule being the commonest. 70% responded very well to conservative management.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Dysphonia is the most common presenting symptom having vocal cord lesion, non-professional voice user young females are most common sufferers with delay of 6 months in presenting to a laryngologist. Vocal abuse and LPRD are most common aetiologies. Telelaryngoscopy can diagnose up to 80% of them which is cost effective Outpatient Department procedure. 70% of them respond well to medical therapy and voice training. Identification of causative factor and management of them is mandatory for treatment and prevention of recurrence.&lt;/p&gt;

A case of vocal polyps improved with herbal medicine: A case report

Vocal polyps are benign vocal cord lesions, which mainly manifest as a hoarse voice. Laryngeal microsurgery is the most common treatment. However, because of anxiety regarding invasive treatment, it is necessary to have a non-invasive treatment option. A 43 year old female patient who is a teacher visited a Korean medical hospital for persistent hoarseness with a vocal polyp. After taking herbal medicine for hoarseness (Kyung-Hee-cheong-um-whan) and pharyngitis (cheong-in-li-gyok-tang and cheong-in-ryu-que-whan) for almost 10 weeks, the vocal polyp was reduced and symptoms improved. Herbal prescription for pharyngitis and hoarseness can be applied to vocal polyps as non-invasive treatment.

The diagnostic value of perpendicular vascular patterns of vocal cords defined by narrow-band imaging.

According to the classification of glottic lesions by narrow-band imaging (NBI) proposed by the European Laryngological Society (ELS), lesions without perpendicular patterns are benign, while wide- and narrow-angled perpendicular lesions include both papilloma and carcinoma/high-grade lesions, respectively. The purpose of the study was to investigate the effectiveness of the ELS classification. One hundred and forty four patients with glottic lesions underwent microlaryngoscopy with NBI. The affected vocal cords (arm A) were histologically analysed. The unaffected vocal cords (arm B) were not histologically analysed and were considered to be true negatives if no suspicious changes appeared during the follow-up. The vocal cords from arm A were categorised into three groups-those with a benign disease (papilloma excluded), those with a carcinoma/high-grade lesion and those with papilloma. The ratio of vascular patterns was determined and the groups were statistically compared using the Chi-square test. Perpendicular patterns were identified only in 9.3% (9/97) of those in the benign group (without papilloma). Wide-angled patterns were mainly identified in cases of papilloma (80%, 12/15), while the narrow-angled ones were mostly identified in cases of carcinoma and high-grade lesions (96.2%, 76/79) (P < 0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were 98%, 95%, 88%, 99% and 95%, respectively. The ELS classification of vocal cord lesions by NBI is effective in differentiating between carcinoma/high-grade lesions and papilloma and the remaining benign lesions of the vocal cords.

A descriptive study of benign vocal cord lesions

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Various vocal cord lesions have a significant influence on vocalization. In India and other developing countries, the prevailing lower economic status, poor general health of population, different food habits, vocal habits, smoking and drinking habits, unhealthy environment and different social customs definitely influence the incidence of various vocal cord lesions. Objective of this was study was to find out the incidence of various vocal cord lesions, factors affecting the voice and treatment.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a prospective study carried out in ENT Department from June 2018 to September 2019 at a tertiary care teaching hospital of Western Gujarat. We evaluated 48 patients who had various lesions on vocal cord. Incidence, age, gender, occupational factors, contributing factors, clinical features, histopathological findings were studied. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Vocal cord lesions were more common in males (64.58%), 21 to 40 years of age group. Change of voice (100%) was the most common presenting symptom. Vocal abuse (83.33%) was most common etiological factor. Students (27.08%) were most commonly affected. Maximum cases were of vocal cord nodules (39.58%). All vocal cord lesions (except papilloma) had good recovery with no recurrence.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Vocal cord lesions were more common in males and in 3&lt;sup&gt;rd &lt;/sup&gt;and 4&lt;sup&gt;th&lt;/sup&gt; decades of life. Change of voice was the most common presenting symptom. Vocal abuse was most common etiological factor. Students were more affected in vocal cord lesions. Vocal cord nodules were the most common lesions. Microlaryngeal surgery, voice rest and speech therapy are the mainstay of the treatment for benign lesions.&lt;/p&gt;

Voice Outcome after Video Laryngoscopic Surgery on Benign Lesions of Vocal Cord

Voice Outcome after Video Laryngoscopic Surgery on Benign Lesions of Vocal Cord

The differential diagnosis of narrow-banding imaging endoscopy for different vocal cord lesions in the same patient

The differential diagnosis of narrow-banding imaging endoscopy for different vocal cord lesions in the same patient

Use of Voice Handicap Index (VHI) as Predictor of Outcome of Non-surgical Treatment in Vocal Nodules

Introduction&#x0D; Vocal Nodule is commonest benign vocal cord lesion which causes varying degree of dysphonia having serious impact on personal and professional well being. Voice Handicap Index (VHI) is a psychometrically validated tool for measuring pshycosocial handicapping effect of voice disorder.&#x0D; &#x0D; Materials and Methods&#x0D; From data available since last 18 months, patients who had undergone treatment for vocal nodule were selected as study population. In Group A, 50 patients were selected who required surgery and Group B, 50 patients who responded to medical treatment. Patients filled in VHI-30 form at time of diagnosis and subjected to voice therapy and adjunctive medical treatment for 1 month and reassessed using VHI-30. Successful treatment consisted of absence of pathology by laryngoscopy and decrease of VHI total score ≥18.&#x0D; &#x0D; Results&#x0D; The cut-off score was calculated using Receiver Operating Characteristics (ROC). VHI cut-off of total score was 45 (Sensitivity 94%, Specificity76%). The cut-off score for functional, physical and emotional domains are 14(Sensitivity 94%, Specificity 64%) , 15(Sensitivity 92%, Specificity 60%) and 15(Sensitivity 90%, Specificity 66%) respectively.&#x0D; &#x0D; Discussion &#x0D; Hard consistency of nodules can explain refractoriness to speech therapy and higher VHI score. The physical subscale of VHI was higher among both groups indicating patients’ perceptions of laryngeal discomfort and voice output affected them more. According to our study patients with higher VHI score should be counselled for MLS at earliest instead of speech therapy for one month which would not have given good outcome.&#x0D; &#x0D; Conclusion&#x0D; These scores give a good idea about categories of patients who will not benefit by non-surgical treatment and hence early surgical intervention will obviate the duration of handicap and delay in appropriate treatment.