effectiveness of a voice care program among primary school teachers in Northeastern Malaysia

Objectives: We sought to determine the effectiveness of a voice care program among primary school teachers in a northeastern district in Malaysia

Methods: We conducted a randomized community trial in eight primary schools in a northeastern district in Malaysia. The self-administered and validated Malay-Voice Handicap Index-10 [M-VHI-10] questionnaire was used to assess overall voice handicap scores pre-intervention and eight weeks post-intervention. Teachers with a score of five or more [n = 86] were randomized into intervention [n = 41] and control groups [n = 45]. The intervention group received portable voice amplifiers and vocal hygiene instruction, which was delivered by lectures and a booklet. The control group was not prescribed any intervention

Results: The sociodemographic, lifestyle, and occupational characteristics of the teachers [except maximum number of students per class] were similar between both groups. The baseline M-VHI-10 scores between both groups were also comparable. After the intervention phase, there was a significant effect observed in the total M-VHI-10 scores [p = 0.021, F-stat [df]: 5.33 [1,79]] between both groups after controlling for the maximum number of students per class

Conclusions: Our results support the use of voice amplification in adjunct with vocal hygiene instruction as a prevention and treatment modality to reduce voice handicap among teachers. Our study demonstrated encouraging evidence on the low-cost voice care program as well as the success of group and workplace-based approaches in the school setting

Cervical aerocele: a rare delayed complication of tracheostomy

Acquired cervical aerocele in adults is a rare condition and its delay development after tracheostomy decannulation is reported rarely. Our patient presented eight years after tracheostomy decannulation with a compressible anterior neck mass that only appeared when she coughed and could be deflated using manual compression. The mass was situated suprasternal at the previous tracheostomy scar. Computed tomography scan showed a paratracheal air sac without significant defect at the tracheal wall. Surgical intervention is the best treatment for symptomatic patients. As in this patient, we advise direct laryngoscopy and bronchoscopy for diagnostic and therapeutic purposes in such cases. However, our patient refused any surgical intervention

Postural management of airway obstruction secondary to Pierre Robin Sequence

Pierre Robin Sequence commonly presents with upper airway obstruction secondary to craniofacial anomalies and can be managed with several treatment modalities. In mild cases, non-invasive postural management is a good treatment option. Prone position has been established as the posture of choice to reduce potential upper airway obstruction. We report a case of Pierre Robin Sequence with airway obstruction that did not respond to prone position but responded to supine position with slight tilting of the head.

Iatrogenic foreign body from left to right bronchus: the lessons learnt

Iatrogenic foreign body in the airway is a known complication of medical treatment that may occur in various clinical settings. The foreign material can be from extraluminal or intraluminal source. The symptoms may manifest acutely or months and years after treatment. Our case highlighted the possibility of the dislodgement of the foreign body during retrieval from the initial site, and the importance of prompt identification and management

Lingual tonsillitis post tonsillectomy: a rare cause of odynophagia

Lingual tonsil is a part of Waldeyer’s ring. It consists of lymphoid follicles and subject to proliferation and hypertrophy. Palatine tonsillitis, by far is the commonest cause of odynophagia originating from oropharyngeal region. Lingual tonsillitis is a rare occurrence. We reported a patient who presented with severe odynophagia after two months of palatine tonsillectomy. Examination revealed the lingual tonsils were inflamed and covered with exudates.

Laser posterior cordectomy for bilateral abductor vocal cord palsy: A case report

Bilateral abductor vocal cord palsy is comparatively a rare vocal cord lesion, especially in a patient with no history of neck mass, previous surgery or trauma. Many patients are not stridulous. A patient presenting with stridor may need emergency airway management before the other treatment is commenced. We report a case of bilateral abductor palsy which required an emergency tracheostomy and subsequently a laser posterior cordectomy.