Ferrer Adjustable Speaking Valve for Early Phonation in a Deconditioned Patient.

A patient with multiple comorbidities and an eight-year history of tracheostomy was being treated for tracheitis. At this point, she became incapable of using regular speaking valves, and multiple attempts to reintroduce the speaking valve failed. A Ferrer adjustable speaking valve (FASV) was designed with gradations of outflow closure, allowing air to go through the vocal cords for phonation. The FASV was offered to her through the compassionate use program at the FDA. At 20% initial closure, the patient was able to tolerate the valve and was advanced to 50% closure, at which point she could phonate partially. The use of the valve was terminated at the time of her transfer, 23 days after the initiation of use. This suggests the safety and possible efficacy of using an adjustable speaking valve earlier than regular valves, allowing patients to communicate earlier and further exercise their diaphragms.

Chlorpheniramine Maleate Throat Spray for the Treatment of COVID-19-Induced Acute Viral Pharyngitis: Case Series.

Acute viral pharyngitis (AVP) is a common respiratory illness affecting many individuals. Despite symptomatic treatment management of AVP, therapies are lacking to target a broad spectrum of viruses and the inflammatory nature of the disease. Available for many years, Chlorpheniramine Maleate (CPM), is considered a low-cost and safe first-generation antihistamine displaying antiallergic, anti-inflammatory, and as of recently, identified as a broad-spectrum antiviral agent with activity against influenzas A/B viruses and SARS-CoV-2. Efforts have been made to identify repurposed drugs with favorable safety profiles that could significantly benefit the treatment of COVID-19-induced symptoms. The present case series highlights three patients in which a CPM-based throat spray was used to alleviate the symptoms of COVID-19-induced AVP. The CPM throat spray was associated with significant improvements in patient symptoms after approximately three days of use as opposed to the typical five to seven days reported elsewhere. While AVP is a self-limited syndrome and usually improves without pharmaceutical therapy, CPM throat spray may significantly reduce the overall time that the patient has symptoms. Additional clinical studies to evaluate the efficacy of CPM for the treatment of COVID-19-induced AVP are warranted.