RESUMEN
Spontaneous onset pneumomediastinum, pneumothorax and subcutaneous emphysema are rare presentations of a foreign body in the airway. The possible mechanism for unexplainable and non traumatic subcutaneous emphysema can be attributed to "Air leak syndrome" following inhalation of foreign body in the airway.
RESUMEN
Difficult laryngeal exposure during suspension microlaryngoscopic surgeries is a common situation encountered by the phonosurgeons nowadays. It leads to unnecessary trauma, incomplete surgery and even abortion of the procedure. Although various methods have been described to counter the situation, they might not be adequate in some cases with very anteriorly placed larynx. This study is intended to determine the utility of angled rigid endoscope along with malleable endoscopic instruments to improve surgical access in cases with inadequate glottic exposure during suspension microlaryngoscopy. In this cross sectional study conducted at Lokmanya Tilak Municipal Medical College and General Hospital in Mumbai, 50 patients of voice disorders who underwent Suspension Microlaryngoscopy from July 2014 to December 2017 were included. Out of these patients, 5 patients (10%) presented with difficult laryngeal exposure that were operated using readily available angled rigid endoscope along with malleable endoscopic instruments, without requirement of any specially designed instruments. There was improvement in laryngeal exposure in all the cases following utilisation of angled endoscopes. The surgeries were carried out under video monitor guidance with complete excision of the vocal cord lesions. Our study concluded that the cases in which the laryngeal exposure cannot be improved even by various external procedures, can be enhanced by application of angled rigid endoscopes and the vocal cord lesions can be excised completely by using malleable endoscopic instruments.
RESUMEN
To evaluate treatment response in patients with laryngopharyngeal reflux (LPR). A prospective study of 100 patients with voice disorders was conducted. Patients were evaluated using reflux symptom index (RSI) and reflux finding score (RFS) by 70° rigid laryngoscope. Patients with RFS score of 7 or more were diagnosed of having LPR and were started with anti-reflux therapy for a period of 6 months. Patients were assessed at regular intervals using RSI and RFS. The prevalence of LPR in patients with voice disorders was found to be 25%. The mean RSI score improved gradually and significantly over a period of 6 months from 11.84 at presentation to 2.04 after 6 months of treatment (p value <0.001). The mean value of RFS improved from 7.92 at entry to 1.52 after 6 months of treatment (p value <0.001). However, it was found that the improvement was not significant at end of first month of treatment, and improvement in RSI and RFS scores was found only after 2 months of treatment. RSI and RFS improve significantly after treatment for 6 months with PPI like Omeprazole. But the improvement starts from the 2nd month from the onset of treatment. Treatment of LPR for at least 6 months may be indicated to attain a full resolution of physical findings.