Use of transoral carbon dioxide laser for supraglottic web from caustic ingestion in a 13 year old.

A 13 year old male was referred to the Department of Otorhinolaryngology due to unsuccessful decannulation. At 2 years of age, patient accidentally ingested a caustic liquid alkali and underwent emergency tracheostomy, exploratory laparotomy, and tube gastrectomy. 11 years after, patient was seen at the outpatient department for decannulation. On nasopharyngolaryngoscopy, a supraglottic stenosis with a central 1-mm opening was visualized. Patient underwent transoral carbon dioxide laser excision of supraglottic stenosis. Fused aryepiglottic folds were released from the epiglottis. Patient was discharged well with no immediate complications and was successfully decannulated 1 month post operation with good voice outcome. No recurrence of stenosis at one year post operation. Accidental caustic ingestion commonly occurs in the pediatric age group. A frequent complication of accidental caustic ingestion is strictures. The use of transoral carbon dioxide laser in the surgical treatment of supraglottic stenosis is a suitable option for pediatric patients as this offer several advantages such as less post operative edema, good intraoperative control of hemorrhage, few post-operative complications and is less invasive compared to open laryngeal procedures. This case exhibits the importance of close monitoring for pediatric patients after caustic ingestion in order to diagnose complications earlier.

Prevalence of early laryngeal cancer and benign vocal cord pathology among patients undergoing videostroboscopy in Philippine General Hospital from 2008 to 2010

OBJECTIVE: To determine the types and prevalences of laryngeal pathology among patients undergoing videostroboscopy in the Philippine General Hospital. METHODS: A systematic review of videostroboscopy records patients from January 2008 to December 2010 was perform Demographic data, risk factors, diagnosis and their associat were determined. RESULTS: The following vocal cord pathologies were recorded the 507 subjects who underwent videostroboscopy during assessed time period: vocal cord nodules (17.4%) laryngopharygeal reflux (16.6%), vocal cord paralysis (12.8%) cyst (10.5%), polyp (8%) and laryngeal cancer (6%). Vocal cord nodules were found to be more common among professic voice users (odds ratio = 2.8). Risk factors found to be associated with cancer development include age, gender (male, odds ratio 19.8) and smoking history (odds ratio = 12.7). CONCLUSION: The most common laryngeal pathology among patients undergoing videostroboscopy is vocal cord nodules. One out of 20 patients who underwent the procedure was given a diagnosis of laryngeal cancer.

Measurement of the handicap of dysphonic patients using the Filipino voice handicap index

p style=text-align: justify;strongOBJECTIVE:/strong 1) To describe patterns of Filipino Voice Handicap Index (VHI) scores in relation to the demographic data of dysphonic patients; 2) To describe patterns of Filipino VHI scores in relation to the different pathologies of dysphonia as determined by videostroboscopy.br /br /strongMETHODS: br /Design:/strong Cross-sectional study br /strongSetting:/strong Tertiary Government Hospitalbr /strongPopulation:/strong Adult patients (? 18 years olrd), proficient in Filipinobr /br /A group of 124 dysphonic patients seen at the Videostroboscopy Unit completed the Filipino VHI. Demographic data were collected Videostroboscopy diagnoses were classified into six goups: normal, mass, lesions, inflammatory, mucosal irregularities, functional and neurogenic. The T-test was used to determine differences in scores among the demographic parameters and the pathology groups. ANOVA one-way factor was used to determine difference of subscaleo scres within each pathology group, and to determine difference of pathology scores in each subscale. Differences were considered statistically significant if plt;0.05. RESULTS: /strongStatistical analyses showed that Fiipino VHI scores were affected by age, gender, educational status and occupation. Younger patients significantly scored higher than patientsgt;40 years old. Females had significantly higher scores than males in the functional, physical and total subscales. Patients with lower educational status scored higher compared to college graduates. Voice professionals significantly scored higher than the non-voice professionals. Dysphonic patients significantly scored higher than normal volunteers. Among the pathological groups, neurogenic lesions had the highest scores. Physical subscale scores were significantly higher in all lesions except in functional lesions.br /br /strongCONCLUSION:/strong The Filipino VHI is comparable to the other versions of the VHI, with patterns similar to other versions. It gives the clinician a measure of a dysphonic patient's handicap, and is an invaluable tool in quantifying severity of dysphonia./p