Cases reported "Occupational Diseases"

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1/7. Vocal fold mucosal tears: maintaining a high clinical index of suspicion.

    Vocal fold mucosal tears have been discussed in the literature rarely, although they are not uncommon clinically. Disruptions in the epithelium usually follow trauma that may result from voice abuse and/or misuse, coughing, and other causes. A high index of suspicion is necessary to avoid missing vocal fold mucosal tears, and strobovideolaryngoscopy is indispensable in making the diagnosis. A brief period of complete voice rest is the standard of care and appears to be helpful in avoiding adverse sequelae and advancing the healing process, but there are no scientific studies to confirm its efficacy. Mucosal tears may heal completely or may be followed by the development of vocal fold masses, scar, and permanent dysphonia.
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ranking = 1
keywords = voice
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2/7. Bilateral mixed laryngoceles: simultaneous strobovideolaryngoscopy and external video examination.

    A music medicine practice affords a unique opportunity to diagnose and treat laryngeal music performers. Strobovideolaryngoscopic (SVL) and external video examination of the voice professional or brass instrument player may focus on the vocal folds, yet abnormalities of the supraglottis, neck, and thorax should be appreciated and documented. Laryngoceles are uncommon laryngeal disorders but may occur in up to 5% of benign laryngeal lesions. While many laryngoceles are asymptomatic, they may cause a cough, hoarseness, stridor, sore throat, pain, snoring, or globus sensation. In particular, musicians who play brass instruments are at high risk for laryngocele development. We highlight two patients with symptomatic laryngoceles to present anatomical, historical, classification, epidemiological, diagnostic, and management considerations.
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ranking = 0.5
keywords = voice
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3/7. Psychogenic voice disorders in performers: a psychodynamic model.

    Psychogenic voice disorders are not infrequently encountered in the busy voice clinic. A clinician-friendly psychodynamic model and a multidisciplinary management approach are presented which have proven helpful for our voice team and our patients. In essence the formulation revolves around an "event" occurring, which may be either organic or psychological in nature. The ensuing dysphonia then leads to emotional consequences which in turn have physical consequences on the vocal tract. The situation can become reinforcing and illness behaviors develop. Elucidating this event/process to the patient improves the likelihood of a successful long-term outcome. The diagnostic and management roles of the various team members are discussed.
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ranking = 3.5
keywords = voice
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4/7. Immediate hypersensitivity type of occupational laryngitis in a welder exposed to welding fumes of stainless steel.

    BACKGROUND: Although upper respiratory symptoms have been reported to occur in welders, occupational laryngitis of immediate hypersensitivity type due to welding fumes of stainless steel has not been previously reported. methods: Occupational laryngitis was diagnosed based on the specific challenge test combined with the patient's history of occupational exposure and laryngeal symptoms. RESULTS: During the past few years, a 50-year-old man had started to experience laryngeal symptoms while welding stainless steel. The welding challenge test with stainless steel caused significant changes in the laryngeal status 30 min after challenge: increased erythema, edema, and hoarseness of the voice. The referent inhalation challenge test by welding mild steel was negative. CONCLUSION: The welding of stainless steel should be included in the etiological factors of occupational laryngitis of immediate hypersensitivity type.
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ranking = 0.5
keywords = voice
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5/7. Varix of the vocal cord in the professional voice user.

    Singers and actors who abuse their voices may develop either polyps, nodules, contact ulcers, and/or contact granuloma. Rarely a vascular lesion consisting of a hypertrophic vessel projecting above the medial or superior mucosal surface of the vocal cord is encountered that may contain a small knucklelike deformity. Clinically this is not dissimilar in appearance to a vessel found on the anterior nasal septum that is responsible for epistaxis. When the voice is strained, these vessels can rupture, causing recurrent submucosal hemorrhages in the professional voice user. The case described is that of a well-known actress in whom vocal abuse did not produce a submucosal hemorrhage from the varix but rather an edematous change and symptoms identical to those of a soft, early vocal cord nodule.
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ranking = 3.5
keywords = voice
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6/7. diagnosis and treatment of persistent dysphonia after laryngeal surgery: a retrospective analysis of 62 patients.

    Sixty-two patients with persistent or recurrent dysphonia after laryngeal surgery underwent interdisciplinary voice evaluation, laryngostroboscopy, and objective measurements of vocal function. The causes of persistent dysphonia were attributed to vocal fold scarring (n = 22), residual mass lesion (n = 8), residual inflammation (n = 13), recurrent mass (n = 4), and hyperfunctional voice disorder (n = 7). laryngoscopy often showed excessive ventricular compression and anterior-to-posterior laryngeal compression. Ventricular dysphonia was often a compensatory gesture in response to poorly mobile vocal fold membranes. stroboscopy was able to document a number of abnormalities which included abnormalities of laryngeal configuration, vibratory asymmetry, reduction of amplitude, and mucosal wave. Using a diversified approach consisting of medical therapy, voice therapy, and repeat surgery, better vocal function was able to be restored in the majority of patients. An interdisciplinary approach to the dysphonic patient after laryngeal surgery was most useful in defining the pathology and refining a treatment rehabilitation program.
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ranking = 1.5
keywords = voice
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7/7. Excision and low-dose radiotherapy for refractory laryngeal granuloma.

    Laryngeal granulomas are uncommon lesions of an inflammatory origin. They are conventionally managed by simple excision with the occasional use of adjuvant treatment depending on the aetiological factors. Unfortunately, recurrences can occur, requiring repeated excision. Some lesions are refractory to this approach and alternative management approaches include excision and immediate adjuvant radiotherapy. The use of radiotherapy in the management of benign disease can be limited by the risk of induction of late malignancy and informed consent of a patient must include an assessment of this risk. We describe a case of refractory laryngeal granuloma successfully treated by excision and immediate radiotherapy in a patient occupationally dependent upon his voice.
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ranking = 0.5
keywords = voice
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