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Medialisation laryngoplasty can relieve pain related to voice use

Odynophonia, or pain associated with voice use, is a relatively uncommon manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI). Its incidence is approximately 15% in patients with vocal fold paresis. Medialisation laryngoplasty (ML) was popularised by Isshiki...

Voice after posterior cordotomy: we think voice is bad, patients think it’s better!

Bilateral vocal fold immobility (BVFI) is a condition that can affect voice with an impact on quality of life (QOL). Surgical trauma from damage to bilateral recurrent laryngeal nerves, such as from previous thyroid, parathyroid, or mediastinal surgery are common...

Steroids for vocal cord mucus retention cysts

This is an interesting paper that describes the use of intralesional steroid injections to treat vocal cord mucus retention cysts. The gold standard is microlaryngoscopy and excision of the lesion. In patients who may be unable to undergo surgery, this...

Should we routinely perform steroid injections following microlaryngeal excision of benign lesions?

This retrospective cohort study assessed a single surgeon’s outcomes before and after the routine administration of intralesional triamcinolone following microsurgical removal of benign vocal fold lesions (polyps, nodules and cysts). A total of 211 patients were recruited for the study....

Voice therapy is an effective treatment for presbyphonia

The quality of an individual’s voice often declines with age. This deterioration occurs firstly as a result of vocal fold atrophy secondary to histologic alteration of the vocal fold mucosa as well as atrophy of the laryngeal musculature. Phonatory efficiency...

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

What blood tests should be requested to investigate vocal cord paralysis?

Patients who are discovered to have a vocal cord palsy with no obvious cause on history or examination routinely undergo investigations to exclude an underlying pathology. Cross-sectional imaging of the relevant recurrent laryngeal nerve is required, but considerable variability has...

Unilateral vocal cord mobility impairment and laryngopulmonary physiology

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Reactive lesions of the contralateral vocal cord – excise or leave?

It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...

What is the optimum duration of voice rest after microlaryngoscopy procedures?

Recent survey data looking at the opinions and practices of otolaryngologists in the US and the UK demonstrate that there is a wide variation in recommendations made for voice rest after vocal fold surgery. In the US, the most common...