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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...

Incidental thyroid nodules: should we observe or operate?

Thyroid nodules are extraordinarily prevalent, detected by physical examination in 7% and by imaging studies in 67% of the population. Although most of these nodules are benign, up to 20% are found to be malignant on excision. It’s a very...

Voice outcomes following extended laser resections for laryngeal cancer

It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...

Beware the skinny patient…

The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...

Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture

Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...

KTP laser ablation for early glottic cancer

TLM for glottic carcinoma has historically been performed with a carbon dioxide (CO2) laser. A much smaller literature base has examined the use of potassium titanyl phosphate (KTP) laser in this context. This retrospective chart review aims to fill that...

The laryngeal microdebrider – a useful adjunct in the surgical treatment of Reinke’s oedema?

The surgical treatment of Reinke’s oedema traditionally involves a cold steel incision placed in the lateral aspect of the vocal fold with aspiration of the characteristic gelatinous contents. In this paper, the authors compare voice outcomes in patients treated with...

Vascularised tissue in salvage total laryngectomy

Chemoradiation (CRT) has become the mainstay for locally advanced laryngeal cancer since the RTOG 91-11 trial. Unfortunately there is still a substantial demand for salvage laryngectomies, which have a higher complication rate, the most notable being pharyngocutaneous fistula (PCF). Several...

Bothersome ‘burping’ – speech therapy may help

Most people experience belching as a normal phenomenon, often after eating or drinking carbonated drinks in particular. However, separate to this normal physiological phenomenon, some people experience belches that can occur much more frequently (up to 20 times a minute)...

Bamboo nodes – a case series

Bamboo nodes are band-like, cream-coloured submucosal deposits affecting the middle third of the vocal cord. They are reported to affect women exclusively and are frequently bilateral but can be asymmetrical. They are distinct from vocal cord nodules but can be...

A novel scale for the assessment of tracheoesophageal voice quality – the SToPS

There is currently no assessment tool in widespread use that permits a valid and reliable perceptual assessment of voice quality following laryngectomy. Such a scale is needed to investigate the functional outcomes of surgical voice restoration and rehabilitation regimes. Existing...

Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?

Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...