We report four cases of hyalinosis cutis et mucosae. They developed hosrseness in their infancy and all had past history of frequent skin infections with accompanying varioliform scars. On physical examination, all the patients had beaded papules along their eyelid margins, hoarseness, varioliform scars and various skin and mucous membrane infiltrations. Pathologic examinations performed on skin infiltrations and eyelid papules revealed diastase resistant periodic acid Schiff positive materials deposited mainly in upper dermis. We have given three of four patients 1g/day of dimethyl sulphoxide from 6 to 12 months with no significant side effects nor remarkable clinical improvement.
Amylases ; Cicatrix ; Dermis ; Dimethyl Sulfoxide ; Eyelids ; Hoarseness ; Humans ; Lipoid Proteinosis of Urbach and Wiethe* ; Mucous Membrane ; Periodic Acid ; Physical Examination ; Skin

This is a rare hereditary disease characterized by hyaline and lipid deposits in the skin and mucous membrane. It starts in infancy or early childhood with hoarseness and swallowing difficulty due to the deposition of the characteristic material in the larynx and pharynx. And then, a skin eruption appears over the face and scalp with bulla, papule, crust and depressed scar forms. A pathognomonic feature is the appearance of translucent papules along free margins of eyelids, giving the appearance of "beads on a string". Other ocular involvement is rare and drusen or degeneration may be seen at the macula. We have observed two cases of Urbach-Wiethe disease in a 7-year-old girl and ll-year-old boy and confirmed by the histopathologic results.
Child ; Cicatrix ; Deglutition ; Eyelids ; Female ; Genetic Diseases, Inborn ; Hoarseness ; Humans ; Hyalin ; Larynx ; Lipoid Proteinosis of Urbach and Wiethe* ; Male ; Mucous Membrane ; Pharynx ; Scalp ; Skin

This is a rare hereditary disease characterized by hyaline and lipid deposits in the skin and mucous membrane. It starts in infancy or early childhood with hoarseness and swallowing difficulty due to the deposition of the characteristic material in the larynx and pharynx. And then, a skin eruption appears over the face and scalp with bulla, papule, crust and depressed scar forms. A pathognomonic feature is the appearance of translucent papules along free margins of eyelids, giving the appearance of "beads on a string". Other ocular involvement is rare and drusen or degeneration may be seen at the macula. We have observed two cases of Urbach-Wiethe disease in a 7-year-old girl and ll-year-old boy and confirmed by the histopathologic results.
Child ; Cicatrix ; Deglutition ; Eyelids ; Female ; Genetic Diseases, Inborn ; Hoarseness ; Humans ; Hyalin ; Larynx ; Lipoid Proteinosis of Urbach and Wiethe* ; Male ; Mucous Membrane ; Pharynx ; Scalp ; Skin

No abstract available.
Evaluation Studies as Topic* ; Hoarseness*

Humans ; Hoarseness/etiology* ; Larynx

Introduction: During a thyroidectomy, the neck is hyperextended. This position may inverse the tracheal axis to the endotracheal tube (ET), can cause damage to the vocal cords and tracheal wall. We propose a simple turn of the ET corresponding with the laryngo-tracheal axis to reduce of post-operative sore throat (PST) and hoarseness (H) in thyroidectomy patients. Methods: 122 patients undergoing general anesthesia were prospectively randomized divided into 4 groups. Gp1 (n=31): normal ET tube placement. Gp2 (n=30): normal ET tube rotated 180o following insertion. Gp3 (n=30): armoured tube. Gp4 (control, n=31): Normal ET tube in operations other than thyroidectomy, that require hyperextension. Cuff pressure (CP) and inspiratory peak pressure (IPP) were monitored during anesthesia. PST and H were evaluated by a VAS (0-10mm). Results: The 4 groups were similar in age, gender and intubation duration. IPP remained stable in all 4 groups. However, CP increased significantly in Gp1 and Gp4 after hyperextension. GP1 had the most PST and H (p<0.05). Tube rotation achieved the same results as the Armoured tube. Discussion: Rotating ET tube 180o reduced PST and H as much as intubation with a armoured tube. This rotation did not interfere with ventilation during anesthesia.
Thyroidectomy, Hoarseness, Pharyngitis, Intubation, Intratracheal

INTRODUCTION: Sore throat and hoarseness often follow general anesthesia administered via a single-lumen endotracheal tube (SLT). Numerous studies have investigated the role of factors as contributing causes, but the influence of double-lumen endobronchial tube (DLT) has not been examined systemically. The goal of this study was to examine the incidence of sore throat and hoarseness after DLT insertion. METHODS: 70 patients who were intubated with SLT or DLT were studied. Sore throat and hoarseness were evaluated after 24~48 hr from extubation of each tubes. RESULTS: In SLT and DLT group, the incidence of sore throat and hoarseness was 14 patients (40%) vs 16 patients (45.7%) and 8 patients (22.8%) vs 10 patients (28.5%), respectively. CONCLUSIONS: There are no statistical differences in incidence of sore throat and hoarseness between SLT and DLT.
Anesthesia, General ; Hoarseness* ; Humans ; Incidence* ; Intubation* ; Pharyngitis*

OBJECTIVES: We intended to evaluate the relationship between voice and the menopause, so we observed vocal symptoms and voice parameters in patients of postmenopausal syndrome compared with those in premenopausal women. MATERIALS AND METHODS: Forty postmenopausal and twenty premenopausal women were included in this study. Each woman was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The voices were recorded and analyzed by the Multi-Dimensional Voice Program and a Laryngograph. A statistical analysis of voice parameters was done by a paired-t-test. RESULTS: Vocal symptoms detected in the menopausal women were lowered pitch, voice fatigue, recurrent hoarseness, and loss of high tone. Jitter in postmenopausal group was significantly increased compared with the premenopausal group, but the fundamental frequency, shimmer, the Harmonics-to-noise ratio and the closing quotient showed no significant differences. There were no significant changes of voice parameters between menopausal patients with and without vocal symptoms. CONCLUSION: The change of voice may be objectively identified in postmenopausal women. In treating the postmenopausal symptoms, it may be required to take voice changes into consideration.
Female ; Hoarseness ; Humans ; Menopause ; Voice Disorders ; Voice*

OBJECTIVE: Vocal cord paralysis or immobility is debilitating condition that may result from neural or mechanical fixation of the vocal cord (VC). When permanent, therapy is aimed at improving closure by modifying the position of the vocal cord. Whatever surgical intervention is chosen, pre-and post-operative voice evaluation is important. This study aimed to investigate the usefulness of the Glottal Function Index (GFI) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) Scale in the evaluation of treatment outcomes in patients with unilateral vocal cord paralysis (UVCP) who underwent medialization thyroplasty type 1 with a modified lock-in soft silicone implant.

METHODS:
Design: Descriptive Case Series
Setting: Tertiary Government Hospital
Patient: Five

RESULTS: Five patients (3 females, 2 males) consulted due to hoarness underwent rigid endoscopy. Four (2 right, 2 left) had unilateral paramedian VC paralysis while one had bilateral paresis with bowing of the left vocal cord. One of those with left VC paralysis was diagnosed as idiopathic; the four were iatrogenic (3 form thyroid surgery, 1 from multiple surgical procedures). All patients underwent medialization thyroplasty type 1 using locked-in soft silicone implant. The GFI and GRBAS scale were utilized for pre-operative and post-operative perceptual evaluation of voice. The GFI showed severe glottic insufficiency among all five patients prior to surgery with improvement of the subjective symptoms one day and one week post-surgery in four patients. Likewise, the Hirano GRBAS scale showed improvement of voice quality and correlated the improvement of the patient's subjective symptoms from the from GFI scores. However, 5 cases with bilateral vocal cord paresis, showed no improvement of voice quality despite recovery from subjective symptoms.

CONCLUSIONS: For glottal insufficiency, perceptual voice evaluation using self-administered GFI and GRBAS scale assessment are important parameters in determining the quality of life among patients with glottal insufficiency undergoing medialization laryngoplasty.

OBJECTIVES: To present a rare case of primary laryngeal aspergillosis manifesting with hoarseness in a seemingly healthy, immunocompetent, postpartum patient and discuss the probable contributing factors leading to this unusual disease process.

METHODS
Design: Case Report

Setting: Tertiary Private University Hospital

Subjects:  One

RESULTS: A 28-year-old previously healthy postpartum woman presented with hoarseness of a few weeks duration and recent intake of antibiotics and steroids. Videolaryngoscopy revealed a creamy, exophytic mass overlying both vocal folds. Microscopic examination revealed septated, dichotomously branching hyphae with acute angles characteristic of Aspergillus sp. The patient recovered with anti fungal medications.

CONCLUSION: The clinical presentation of laryngeal aspergillosis can be very non-specific and should not be disregarded merely on the basis of immune competence. It should be considered, together with other host and environmental factors when a patient responds poorly to conventional treatment. There is a need for quick and accurate diagnosis as the disease responds quite rapidly with appropriate anti fungal medications.