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Introduction: In Laryngopharyngeal Reflux (LPR), refluxate rich in acid, pepsin, and bile regurgitates above the upper oesophageal sphincter onto the laryngeal mucosa. However, not all patients with LPR present with subjective voice changes. This may be due to a gradual change in voice that remains unnoticed. The clinical subtlety is important for diagnosis or at least awareness for better treatment and care. Aim: To objectively determine preclinical acoustic changes in patients with LPR who have not reported any voice complaints. Materials and Methods: This cross-sectional study was conducted on adult patients visiting the Out-patient department of a Tertiary Care Teaching Institute in Northern India, from September 2022 to October 2022. Patients with LPR but without voice changes were included in the study. They underwent multidimensional voice analysis during the phonation of the vowel /a/. Mean fundamental frequency (MF0), absolute jitter, absolute shimmer, and Soft Phonation Index (SPI) were analysed for the sample and compared to the gender-specific mean values provided by the software used. Statistical significance was determined using the one-sample t-test. Results: A total of 27 participants (20 females, 7 males) completed the study. In the female group, the mean MF0 (204.30±32.49 Hz) was significantly lower, absolute jitter (92.41±87.93 μs), absolute shimmer (0.38±0.31 dB), and SPI (25.62±15.24) were significantly higher than the reference mean. In the male group, the mean MF0 (138.03 Hz), absolute jitter (104.01±84.28 μs), and absolute shimmer (0.34±0.16 dB) were not significantly different from the reference mean. However, SPI (25.09±16.95) remained significantly higher than the reference mean. Conclusion: Increased jitter, shimmer, and SPI are primary acoustic changes observed in patients with LPR. These changes appear even before patients experience any voice changes. [ABSTRACT FROM AUTHOR]

Objective: To determine the demographic, aetiopathological and diagnostic profiles of patients presenting with hoarseness to a laryngology unit of a tertiary care centre in India. Methods: A retrospective observational study was conducted. Results: The 1033 patients who presented with dysphonia showed a male predominance (70 per cent), high rates of malignancy (18 per cent), late presentation (mean, 24 months) and poor follow-up trends (53 per cent with 3 months' follow up), which contrasts with data from developed countries. The patient population hailed from different states in India and neighbouring countries around India, serving as a good sample for the subcontinent. The majority (67 per cent) were managed conservatively; however, surgical management was the preferred choice for those who presented with airway stenosis (91 per cent) and laryngeal trauma (75 per cent). Significant associations between vocal professionalism level and co-morbidities and dysphonia aetiopathologies are discussed. Conclusion: These findings give insight into the trends of hoarseness in the developing Indian subcontinent, which can aid understanding and management. [ABSTRACT FROM AUTHOR]

Granulomatous lesions, though rare, can affect diverse body regions, including the larynx, presenting diagnostic challenges. In India, where malignancy and tuberculosis prevail, fungal infections are often overlooked. We present a case of 34 year old male with complaint of change in voice which was approached as malignancy but later turned out to be histoplasmosis on histopathology. Diagnostic challenges arise due to symptoms overlapping with other conditions. Our case underscores the importance of considering fungal etiologies in endemic regions, especially when symptoms persist despite treatment. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Primary fungal laryngitis is a fungal infection of the larynx without affecting the other body parts such as the lungs, pharynx, and oral cavity. It is an extremely rare clinical entity. Hoarseness of the voice is common clinical presentations. OBJECTIVE: This study aimed to evaluate the etiology, clinical presentations, diagnosis, and treatment of primary fungal laryngitis at a tertiary care teaching hospital in Eastern India. MATERIALS AND METHODS: This is a retrospective study of seven cases of primary fungal laryngitis managed between 2014 and 2019. The detailed etiology, clinical presentations, investigations, and treatment of primary fungal laryngitis patients were studied. RESULTS: Primary fungal laryngitis is common among males with a mean age ranging from 15 to 63 years. There were five male and two female patients. The most common clinical symptom was hoarseness of voice (n = 7), dry irritating cough (n = 2), odynophagia (n = 1), discomfort in throat (n = 1), and dyspnea (n = 1). Laryngoscopic pictures of primary fungal laryngitis included leukoplakic lesions (n = 3), ulcerative lesions (n = 1), polypoidal lesions (n = 1), and nonspecific lesions (n = 2). Histopathological examination is confirmatory for the diagnosis. All the patients had taken antifungal treatment for 3–4 weeks after confirmation of the diagnosis. CONCLUSION: The diagnosis of the primary fungal laryngitis is often overlooked and delayed among patients, as it is usually evident among immunocompromised patients. It often confuses with certain laryngeal diseases such as granulomatous diseases, leukoplakia, and malignancy. Delayed diagnosis and treatment will lead to high morbidity and mortality of the patients. [ABSTRACT FROM AUTHOR]

Respiratory fungal infections are usually found in immunocompromised individuals who have received either long-term steroid therapy or broad-spectrum anti-microbial therapy or have a non-resolving underlying chronic disease. These infections are seen as a part of bronchopulmonary fungal infections, and their isolated and primary occurrence as laryngeal diseases is highly uncommon. Laryngeal fungal infections can also mimic various diseases, such as gastroesophageal reflux disease, granulomatous diseases, leukoplakia, and carcinoma, thereby misleading the treating team from correct diagnosis and management. It is therefore important to identify the lesion at the earliest point possible to avoid morbid or life-threatening consequences. We report a case of isolated laryngeal candidiasis in an immunocompetent Indian male with an unusual presentation mimicking laryngeal carcinoma. The clinical and histological features are highlighted with a review of relevant literature to demonstrate the possibility of such an isolated fungal lesion, even in an immunocompetent individual. [ABSTRACT FROM AUTHOR]

Electroglottography (EGG) is a method to monitor the vibrations of the vocal folds by measuring the varying impedance to a weak alternating current through the tissues of the neck. Non-invasive measures of vocal fold activity are useful for describing normal and disordered voice production. Measures of open, closed and speed quotient from glottal airflow and electroglottographic (EGG) waveforms have been used to describe timing events associated with vocal fold vibration. There are very few studies in western context and no Indian studies were done using speech task. The aim of the present study was to analyze the laryngeal behavior of individuals with chronic laryngitis using electroglottograph on reading voiced passage and to compare with normal individuals. 10 adults with chronic laryngitis and 10 age and gender matched normal adults in the age range of 30 - 40 years participated in the present study. All the recorded samples were analyzed for contact quotient (CQ), open quotient (OQ) and speed quotient (SQ). Results indicated that there was significant statistical difference between normal and abnormal group on all the three EGG quotients for voiced passage reading task. These results also suggested that the closed duration during vocal fold vibratory pattern was longer in individuals with chronic laryngitis and open duration was reduced thereby reducing the speed quotient which indicates the asymmetry of vocal fold vibration during reading passage task in these individuals. It also suggest that connected speech context, as in passage reading, can give better representation, due to the fact that passage is more representative to one's daily speech characteristics than sustained phonation. The laryngeal measures obtained from connected speech context offer a more accurate representation in differentiating normal versus pathological voices. Implications of the findings are discussed and topics for further exploration are identified. [ABSTRACT FROM AUTHOR]

Background: Laryngeal injuries following intubation have a reported incidence from 63 to 94% and permanent sequelae are reported to be about 10 to 22% in the world literature. While several studies assessing the laryngeal complications are available in Caucasoid populations, minimal data is available in the literature regarding south Indian population. Aim: The aim of this study was to evaluate laryngeal lesions in patients after prolonged intubation (>24 h), to correlate these lesions with the variables involved in the process of intubation and to determine the risk factors. Materials and Methods: This is a prospective study for 1 year of patients who were intubated for more than 24 h in our critical care unit. Patients underwent laryngeal video endoscopy on the day of extubation and after 3 weeks by an ENT surgeon who was blinded to the intubation variables. Result: About 51 patients were included in the study. Laryngeal abnormalities were seen in 41 patients on the day of extubation. At the end of third week after extubation, only 10 patients had abnormal laryngeal findings. A multivariate stepwise regression model showed that bigger tube size (P=0.02), longer duration of intubation (P=0.01) and emergency intubation (P= 0.02) was associated with higher incidence of laryngeal complications on the day of extubation. At the end of third week laryngeal findings were influenced only by the duration of intubation (P=0.001). Conclusion: Laryngeal sequelae after extubation is directly associated with duration of intubation. [ABSTRACT FROM AUTHOR]