Laryngitis

Laryngomalacia is the most common cause of stridor in infants-strider results from upper airway obstruction due to supraglottic tissue collapse. Most causes of laryngomalacia are mild and self solve investigation and intervention required in severe causes. There is a strong association with gastroesophgeal reflux disease in patients with laryngomalacia and thus medical treatment with antireflux medications surgical treatment is preferred, while it indicate supraglottoplasty, severe cases are reserved. Proper identification of those patients when requires medical and surgical invention is key to providing with successful outcomes.

UNLABELLED Gastroesophageal reflux disease (GERD) with extradigestive manifestations is a disorder increasingly recognized both by gastroenterologists, pneumologists, otolaryngologists and cardiologists. AIM To evaluate the demographical, clinical, biological and endoscopic features of the patients with gastroesophageal reflux disease and extradigestive manifestations (chronic laryngitis, asthma, pseudoangina). MATERIAL AND METHODS Prospective case-control study, including 137 patients selected from patients referred to the Iasi Institute of Gastroenterology and Hepatology between July 2014-September 2015. In the presence of typical GERD symptoms (heartburn or regurgitation), the patients were assessed by upper digestive endoscopy for the detection or exclusion of esophagitis. Despite the absence of esophageal lesions, the patients were further assessed by impedance-pHmetry. RESULTS Depending on the dominant extradigestive manifestation, the patients were assigned into 3 groups: 94 ...

This study aimed to identify a broad spectrum of respiratory pathogens from hospitalized and not-preselected children with acute respiratory tract infections in the Farhat Hached University-hospital of Sousse, Tunisia. Between September 2013 and December 2014, samples from 372 children aged between 1 month and 5 years were collected, and tested using multiplex real-time RT-PCR by a commercial assay for 21 respiratory pathogens. In addition, samples were screened for the presence of Streptococcus pneumoniae 16S rDNA using real-time PCR. The viral distribution and its association with clinical symptoms were statistically analyzed. Viral pathogens were detected in 342 (91.93%) of the samples of which 28.76% were single positive and 63.17% had multiple infections. The most frequent detected viruses were rhinovirus (55.64%), respiratory syncytial virus A/B (33.06%), adenovirus (25.00%), coronavirus NL63, HKU1, OC43, and 229E (21.50%), and metapneumovirus A/B (16.12%). Children in the you...

The aim of the study was to investigate if voice ergonomic risk factors in classrooms correlated with acoustic parameters of teachers' voice production. The voice ergonomic risk factors in the fields of working culture, working postures and indoor air quality were assessed in 40 classrooms using the Voice Ergonomic Assessment in Work Environment - Handbook and Checklist. Teachers (32 females, 8 males) from the above-mentioned classrooms recorded text readings before and after a working day. Fundamental frequency, sound pressure level (SPL) and the slope of the spectrum (alpha ratio) were analyzed. The higher the number of the risk factors in the classrooms, the higher SPL the teachers used and the more strained the males' voices (increased alpha ratio) were. The SPL was already higher before the working day in the teachers with higher risk than in those with lower risk. In the working environment with many voice ergonomic risk factors, speakers increase voice loudness and us...

With the flexible fiberoptic esophagogastroduodenoscopes now in use, the larynx and posterior pharynx can be easily viewed during routine upper gastrointestinal endoscopy. Screening laryngeal-pharyngeal examinations were carried out during 1120 upper gastrointestinal ...

The mechanisms underlying the effects of cigarette smoke and smoking cessation on respiratory secretion, especially in the larynx, remain unclear. The aims of this study were to determine the effects of cigarette smoke and smoking cessation on laryngeal mucus secretion and inflammation, and to investigate the effects of glucocorticoid administration. We administered cigarette smoke solution (CSS) to eight-week-old male Sprague Dawley rats for four weeks, then examined laryngeal mucus secretion and inflammatory cytokine expression on days 1, 28 and 90 after smoking cessation. We also investigated the effects of the glucocorticoid triamcinolone acetonide when administered on day 1 after smoking cessation. Exposure to CSS resulted in an increase in laryngeal mucus secretion that was further excacerbated following smoking cessation. This change coincided with an increase in the expression of mRNA for the inflammatory cytokines tumor necrosis factor and interleukin-6, as well as mRNA for...

SUMMARY: Atmaca S, Ünal R, Şeşen T, Kılıçarslan H, Ünal A. Laryngeal foreign body mistreated as recurrent laryngitis and croup for one year. Turk J Pediatr 2009; 51: 65-66. Foreign body aspiration (FBA) is a common, dangerous problem among children of all ages. Laryngeal foreign ...

SUMMARY: Atmaca S, Ünal R, Şeşen T, Kılıçarslan H, Ünal A. Laryngeal foreign body mistreated as recurrent laryngitis and croup for one year. Turk J Pediatr 2009; 51: 65-66. Foreign body aspiration (FBA) is a common, dangerous problem among children of all ages. Laryngeal foreign ...

Supraglottitis is a rapidly progressive, life-threatening airway emergency in pediatric patients typically caused by Haemophilus influenzae type B (HIB). With distribution of the first efficacious vaccine for HIB in April 1985, changing disease patterns have begun to emerge; however, certain characteristics have remarkably persisted. The authors reviewed 252 pediatric patients with acute supraglottitis spanning the prevaccination and postvaccination years 1980 to 1992 at three major regional pediatric hospitals in Massachusetts, Ohio, and California, as well as at two community hospitals in Massachusetts. Findings include a decline in disease prevalence in all geographic areas with demographic, etiologic, and management evolution all seen. Children who had been immunized yet developed supraglottitis have been examined as predictive of future trends.

Twenty induced pain cries from the same number of infants with laryngeal disorders (infectious laryngitis, laryngomalacia, recurrens paresis and subglottic stricture) have been analyzed by means of sound spectrography. For each cry 21 phonetical cry features have been evaluated. This cry material was then compared with 120 pain cries from healthy infants. In the pathological group a significant increase could be noted in the occurrence of the following cry attributes: second pause, abnormal melody types, instability of the fundamental frequency, biphonation, vibrato, half-voiced voice quality, and inspiratory stridor. Furthermore, a significant decrease could be noticed in the occurrence of voiceless voice quality and glottal roll. For the other cry parameters no significant differences have been observed. In the light of these findings, the neuropathognomic significance, which has been up to now attached to such spectrographic features as very high maximum pitch, biphonation, glidi...

The mechanisms underlying the effects of cigarette smoke and smoking cessation on respiratory secretion, especially in the larynx, remain unclear. The aims of this study were to determine the effects of cigarette smoke and smoking cessation on laryngeal mucus secretion and inflammation, and to investigate the effects of glucocorticoid administration. We administered cigarette smoke solution (CSS) to eight-week-old male Sprague Dawley rats for four weeks, then examined laryngeal mucus secretion and inflammatory cytokine expression on days 1, 28 and 90 after smoking cessation. We also investigated the effects of the glucocorticoid triamcinolone acetonide when administered on day 1 after smoking cessation. Exposure to CSS resulted in an increase in laryngeal mucus secretion that was further excacerbated following smoking cessation. This change coincided with an increase in the expression of mRNA for the inflammatory cytokines tumor necrosis factor and interleukin-6, as well as mRNA for...

Dysphagia is described as a complaint in 32% of patients with laryngitis. The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement an...

The main factors considered responsible for the onset of laryngeal cancer are tobacco smoking and alcohol abuse. Recently, gastroesophageal reflux has also been implicated as a causative factor in several laryngeal disorders, including laryngeal cancer. However, the significance of gastroesophageal reflux in laryngeal cancer is controversial. We investigated the histologic features of the esophagus and larynx in a rat model of reflux of the duodenal contents. Cell proliferation was also evaluated in laryngeal samples by detection of Ki67 antigen. In this reflux model, laryngitis with infiltration of inflammatory cells and proliferation of small mucous glands was evident from 10 weeks after operation, and basal cell hyperplasia around the epiglottis and hyperplastic changes in the larynx were detected at 30 weeks. No dysplastic or malignant lesions were detected in the laryngeal samples within the duration of the experiment, in spite of detection of malignancy in 31.3% of lesions in ...

Intravenous vaccination of rats with either viable or Formalin-inactivated Mycoplasma pulmonis reduced the incidence and severity of lower respiratory tract lesions after intranasal challenge with viable organisms. Intranasal vaccination with killed organisms reduced the severity of rhinitis, but did not affect lesions in any other region of the respiratory tract. The maximum protection against upper tract lesions (rhinitis, otitis, and laryngotracheitis) was provided by intravenous immunization with viable organisms. Dual vaccination (intraperitoneal plus intranasal) with killed organisms provided no significant protection in any segment of the tract. However, these ineffective vaccine regimens did not potentiate the lesions. These results conclusively demonstrate that vaccination of rats against mycoplasma respiratory disease is feasible and also suggest that systemic vaccination may provide greater protection for the lungs than intranasal vaccination, at least when equivalent ant...

Objective: This guideline provides evidence-based recommendations on managing hoarseness (dysphonia), defined as a disorder characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication or reduces voice-related quality of life (QOL). Hoarseness affects nearly one-third of the population at some point in their lives. This guideline applies to all age groups evaluated in a setting where hoarseness would be identified or managed. It is intended for all clinicians who are likely to diagnose and manage patients with hoarseness. Purpose: The primary purpose of this guideline is to improve diagnostic accuracy for hoarseness (dysphonia), reduce inappropriate antibiotic use, reduce inappropriate steroid use, reduce inappropriate use of anti-reflux medications, reduce inappropriate use of radiographic imaging, and promote appropriate use of laryngoscopy, voice therapy, and surgery. In creating this guideline the American Academy of Otolaryngology—Head and...

This study focuses on the relation of smoking, carcinophobia and voice handicap in dysphonic patients. Fifty-four German-speaking outpatient voice clinic attendees suffering from dysphonia of benign origin took part in this study. All patients completed the German version of the Voice Handicap Index (VHI) and were asked about their fear of suffering from laryngeal cancer without prior information about their diagnosis. Smokers did not fear to suffer from laryngeal cancer more than nonsmokers. However, former smokers were slightly more often found to be carcinophobic than nonsmokers. There was neither a significant difference in VHI scores comparing smokers to non- and former smokers nor when comparing carcinophobic to noncarcinophobic patients. Smoking may cause laryngeal cancer and influence the voice but does not affect patients' handicap due to dysphonia as measured by the VHI. Smoking habits do not influence the development of carcinophobia and carcinophobic dysphonic patien...

Our aims were to describe clinical characteristics of patients with chronic posterior laryngitis and to predict the response to omeprazole therapy. Ninety-one patients with posterior laryngitis were evaluated by a questionnaire, esophageal manometry and pH recording, ...

SUMMARY: Atmaca S, Ünal R, Şeşen T, Kılıçarslan H, Ünal A. Laryngeal foreign body mistreated as recurrent laryngitis and croup for one year. Turk J Pediatr 2009; 51: 65-66. Foreign body aspiration (FBA) is a common, dangerous problem among children of all ages. Laryngeal foreign ...

Histoplasmosis is an endemic and systemic mycosis, caused by the dimorphic fungus Histoplasma capsulatum var capsulatum. Disseminated disease in immunocompromised patients generally results from the reactivation of latent foci after a prolonged period of asymptomatic infection. We report a case of laryngeal histoplasmosis as the unique clinical manifestation of a progressive form of the disease in a patient with advanced HIV/AIDS disease. Histopathological analysis of laryngeal biopsy smears revealed granulomas containing Histoplasma-like organisms. Treatment with amphotericin B followed by itraconazole resulted in complete remission of laryngeal lesions. To our knowledge, this is the third case report of laryngeal histoplasmosis in a patient with AIDS.

Although it is accepted that reflux of stomach acid causes gastroesophageal reflux disease (GERD), it is less well understood that it also contributes to the clinical signs and symptoms of laryngitis in the form of laryngopharyngeal reflux (LPR). Study objectives were to identify what is known about the impact of LPR on health-related quality of life (HRQL) compared with the impact of GERD on HRQL and to assess whether currently available HRQL instruments adequately measure this impact or if a new disease-specific instrument should be recommended. The authors combined a systematic literature review with prospective patient evaluation via focus groups. The review, using MEDLINE, focused on clinical characteristics and HRQL measurement and impact. Focus groups involving a total of 30 patients with LPR provided input on clinical manifestations of the disease and its HRQL impact. Information gleaned from the literature indicates that less than 40% of patients presenting with symptoms of...