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   Table of Contents - Current issue
Coverpage
January-June 2021
Volume 11 | Issue 1
Page Nos. 1-27

Online since Monday, July 5, 2021

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ORIGINAL ARTICLES  

Usefulness of the reflux symptom index in laryngopharyngeal reflux p. 1
Saai Ram Thejas, Ganganamoni Rajamohan, Mohan Sindu, Kowsalya Swarna
DOI:10.4103/jlv.JLV_11_20  
Introduction: Laryngopharyngeal reflux (LPR) is highly prevalent in the general population and its impact on health systems is growing dramatically by the day. The term reflux means back flow. The contents of the stomach flowing back into the esophagus, pharynx, and larynx because of a transient relaxation of the lower esophageal sphincter cause of a spectrum of symptoms diagnosed with LPR and gastroesophageal reflux disease. Aims and Objectives: To study in detail the symptoms caused in LPR and to ascertain if and how they hamper the routine of an individual by using the reflux symptom index (RSI). Materials and Methods: The RSI is a self-administered nine-item outcomes instrument for LPR. Ninety-one patients with clinically diagnosed LPR were taken up for this study and were issued the RSI (translated into the local language for better results) before and after treatment. Data were assessed at the end of 3 months and 6 months. Observations and Results: The tabulated data showed significant improvement in the symptomatic index after treatment. Conclusion: It can thus be concluded that RSI is still highly valid in the follow-up for patients with LPR because of it can be easily administered and gives excellent validation for accurate results.
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Effect of paan masala on voice parameters p. 7
K Sandhya, N Priyanka, C Chethan
DOI:10.4103/jlv.JLV_6_20  
Introduction: Ingestion of paan masala (a mixture of areca nut with catechu, slaked lime, and added flavoring agents) is one of the means of smokeless tobacco usage which can also have adverse effect on voice such as dryness in vocal folds which in turn may result in depletion of mucosal layer of the vocal folds. Aim: Aim of the study was to investigate the consequence of paan masala usage on voice parameters and to compare the acoustic parameters amid two groups who were paan users and non paan users respectively. Method: A total of 120 samples (3 trials of phonation of sustained vowel /a/) were obtained from male participants between age ranges of 18 – 40 years. 60 recordings were taken from 20 individuals who indulged in intake of paan masala from past 5-10 years. Another 60 recordings were from 20 individuals who were non paan masala users. The recorded samples were subjected to two types of analysis viz. perceptual evaluation was carried out by 10 qualified speech language pathologists based on standardized voice rating scale and acoustic analysis was done using clinically acceptable software. Results: Results of perceptual analysis indicated increased breathiness which was supported by acoustical NNE. Greater values in jitter, shimmer and Normalized Noise Energy (NNE) in paan users indicates of being at risk of having vocal pathologies. These parameters of voice had a significant difference between paan users and individuals who do not consume paan. Conclusion: The results do indicate that consumption of paan poses an impending threat to voice which is evident in abnormal acoustical findings and it is essential for people to be aware of the consequences of devouring paan for mere pleasure of minutes.
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Etiology of unilateral vocal cord paralysis: A 16-year retrospective review p. 12
Sachin Gandhi, Subash Bhatta, Nilanjan Bhowmick
DOI:10.4103/jlv.jlv_18_20  
Introduction: Vocal fold paralysis is a common clinical entity. Vocal fold immobility is defined as the restriction of movement of the vocal folds secondary to neuropathy or mechanical fixation. Neurogenic immobility may result from damage to the vagus and recurrent laryngeal nerve. Unilateral vocal cord paralysis (UVCP) is a highly variable clinical entity that warrants a thorough evaluation to assess the functional status of the larynx and to determine the etiology. Vocal fold paralysis is a sign of an underlying disease, not a disease in itself, and finding its etiology determines its prognosis and management options. Aims and Objectives: To study the etiology of unilateral vocal cord paralysis in patients in a tertiary referral centre Materials and Methods: The present study was conducted in a tertiary referral center between January 2003 and December 2019. A retrospective review of the case records of all patients diagnosed with UVCP who presented to us was carried out. A total of 435 cases who met the inclusion criteria were considered. The etiology of UVCP was determined using history, examination and appropriately directed investigations. Observation and Results: The most common identifiable cause of UVCP in our study was found to be surgical trauma, followed by non laryngeal malignancies. Conclusion: Though surgical trauma has been found to be the most common etiological factor in UVCP, a large proportion of patients had idiopathic UVCP and further research as to the pathophysiology of these cases is warranted.
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CASE REPORTS Top

Early-onset respiratory distress in a child: A rare presentation p. 17
Aishwarya Prateep, Gowri Priyadharshini Vijayaraj, Aruna Parameswari, Prasanna Kumar Saravanam
DOI:10.4103/jlv.jlv_14_20  
A stridulous child with failure to thrive needs to be evaluated and emergent management is required to reduce the morbidity and mortality. The reasons for stridor in early childhood are usually due to laryngomalacia. Laryngeal cyst can pose a potential risk and challenge in management, especially in children. Laryngeal cysts have been described to occur in the glottis, laryngeal pouch, epiglottis, aryepiglottic folds, and subglottic areas. Clinical features of the laryngeal cyst depend on the size and localization of the cyst. They may present with voice change, hoarseness, dysphagia, laryngeal stridor, and dyspnea. Prompt diagnosis and early management can prevent major respiratory compromise. This case reports a 6-month old infant who was referred to us with stridor and failure to thrive since birth. The child was evaluated and a diagnosis of aryepiglottic fold cyst was made and treated surgically. The management protocol and available literature are reviewed and discussed.
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Concomittant epiglottic and multiple vallecular cyst: An exceptioally rare case report p. 21
Kamalpreet Singh, Awadhesh Kumar Mishra, Arun Gupta, Amrindarjeet Kour
DOI:10.4103/jlv.jlv_13_20  
Laryngeal cysts are rare and are often diagnosed incidently as majority of the patients are symptom free or have nonspecific complaints. Here, we describe single large epidermoid inclusion epiglottic cyst and multiple small mucosal retention vallecular cysts presenting concomitantly which has not been described previously in literature.
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Acquired subglottic stenosis in a child: A diagnostic dilemma p. 24
Prasanna Kumar Saravanam, Sudhagar Eswaran, Nufra Senopher Zaffrullah
DOI:10.4103/jlv.jlv_12_20  
The most common benign cause of laryngotracheal stenosis is postintubation injury caused by mechanical ventilation in intensive care units. The incidence of postintubation laryngotracheal stenosis in pediatric population is found to be 11.3%. In this report, we present a case of Soft Subglottic Stenosis(SGS) following recurrent intubation in a 3 year old child. Elective tracheostomy and serial dilatation with tracheal intubation stylets was performed which resulted in significant improvement of airway and the child was successfully decannulated. This case report highlights the importance of high index of suspicion in diagnosis of postintubation SGS in a child and reviews the literature in regard to challenges that are faced during evaluation and management of children presenting with stridor.A
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