Objective: Management of bilateral abductor paralysis of vocal folds often poses a surgical challenge. Among various surgical modalities, surgical transaction/excision of posterior aspect of the vocal folds is an established modality. The objective of the present study is to evaluate the effectiveness and safety of the technique using Coblation technology. Study Design: This was a retrospective review. Setting: This study was conducted in a tertiary health care center. Materials and Methods: Fourteen consecutive patients meeting inclusion criterion undergoing posterior cordectomy using Coblator were included in this study. Preoperative subjective voice analysis was done and compared with measurements at 6 months postprocedure. Parameters studied included voice handicap index (VHI), the need for repeat procedures, effect of decannulation, and subjective improvement in respiratory distress. Results: There was a significant improvement in the airway as adjudged by the postoperative subjective improvement in respiratory distress (in 2 nontracheostomized patients) and uneventful decannulation (in 12 tracheostomized patients). However, the postoperative VHI scores showed no statistically significant difference with the preoperative assessment. One of the patients required the procedure to be repeated owing to recurrence of respiratory distress. No untoward incident was reported in any of the surgical procedures. Conclusion: Posterior cordectomy using a Coblator offers a safe and efficacious option for the management of compromised airway secondary to bilateral abductor paralysis of vocal folds. It offers a significant airway improvement without any significant effect on voice.

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Context: Auditory feedback controls segmental and non-segmental features of speech. The lack of auditory feedback in children with impaired hearing affects voice, speech production and speech perception skills. In children using hearing aids or cochlear implants, better auditory feedback is seen and thus voice and speech skills are improved. The present study looks at the comparison of voice parameters in children with cochlear implants and those with normal hearing. Aims: The study aims to compare voice parameters across a group of male and female children with cochlear implant and normal hearing. Study Design: The design of the study was cross sectional with one time evaluation of the objective voice parameters. Method and Materials: The 15 children with cochlear implant were of the mean age 3.99 years and 1.5 of hearing age for males and mean age of 4.39 years and 1.4 years of hearing age for females. The control group with normal hearing had 30 children with a mean age of 3.81 years. The two groups were evaluated for their voice parameters with MDVP 5105 software of CSL instrument, for sustained vowel /a/. Statistical Analysis: Mean, SD, t-test and significance of variance (p<0.05) were done to compare the voice parameters across both groups of gender. Results: Results showed that significant differences (<0.05) were seen in parameters mean fundamental frequency, perturbation and shimmer among females and including jitter for males when both groups were compared. VTI = Voice turbulence index; SPI = Soft phonation index did not show any significant difference. Conclusion: The study concludes that with early intervention and training, the children with cochlear implants are able to achieve normal voice parameters though the range of variability is higher compared to normal hearing children.

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Purpose: The study aims to observe whether any systematic change in vocal fold configuration occurs during and after phonation into a tube using computerized tomography (CT). Materials and Methods: Ten participants diagnosed with functional dysphonia were included in the study. CT was performed when participants produced the sound (a:), phonated into a drinking straw and when repeating (a:) after the exercise. Similar procedure was performed with a stirring straw after 20 min of vocal rest. Anatomic variables included: (1) glottal area, (2) glottal width, (3) vertical vocal fold thickness, (4) vocal fold area, and (5) vocal fold length. Each vocal fold was separately analyzed. Results: Only glottal area for stirring straw was statistically different throughout the three time points. This variable increased during tube phonation compared to conditions pre- and post-tube. Discussion: Since vocal fold length did not change during tube phonation, the increment in glottal area was likely due to increased amplitude of vibration. Increased vibratory amplitude has been found in previous studies with high-speed imaging, suggesting an increased subglottic pressure. From the physiologic point of view, transglottal pressure plays an important role in vocal fold amplitude of vibration. Conclusions: Tube phonation seems to cause increased glottal area during exercise. This change is more prominent during exercise with a higher degree of airflow resistance. Therefore, the degree of flow resistance is an important clinical variable to be considered when choosing the right voice exercises regarding the voice status/phonatory pattern of patients during voice therapy.

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An overwhelming majority of primary tumors of the hypopharynx are squamous cell carcinomas, accounting for approximately 95%. Synovial sarcoma (SS) is exceedingly rare at this anatomical site. A 41-year-old, otherwise healthy male presented with a 2-year history of dyspnea and dysphonia. Flexible laryngoscopy revealed a very large, well-circumscribed, pedunculated mass with near-total airway obstruction. On computed tomography imaging, a 4.7 cm × 2.6 cm supraglottic mass was demonstrated. Transoral CO₂ laser microsurgery was carried out for en bloc removal. Final margins were clear and the patient is currently disease-free and symptom-free. Since the first case of head and neck SS was described in 1954, there have been fewer than 200 cases reported in the world literature. To the best of our knowledge, this is the first known case of a laryngeal SS that presented with airway obstruction which was managed with a negative-margin transoral CO₂ laser microsurgery resection.

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Necrotising sialometaplasia is a benign disease which can affect any mucosal surface having minor salivary glands. Most accepted theory of aetiopathogenesis is ischemia of minor salivary glands and surrounding tissue. Most of the cases are asymptomatic. Though it's self limiting, proper diagnosis by incisional or excisional biopsy is required to differentiate it from malignancy and to avoid aggressive treatment. Regular follow up is necessary till complete remission of the lesion. In this article, we are presenting a rare case of symptomatic metachronous necrotising sialometaplasia which was treated surgically and followed up regularly till complete recovery.

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