Introduction: The risk of fire during laser microlaryngoscopy is well known. However, limited information is available about fire risk with the novel TruBlue laser. This study systematically evaluates its interactions with common surgical supplies, offering valuable insights into safety considerations for surgeons.
View Article and Find Full Text PDFAnn Otol Rhinol Laryngol
November 2024
Objectives: Photoangiolytic lasers have yielded significant innovation in laryngeal surgery in the last 25 years. After the discontinuation of the potassium titanyl phosphate (KTP) laser, a novel 445-nm blue laser was developed. The optimal balance between a laser's desired tissue effects and collateral tissue damage is a major determinant of laser selection in microlaryngeal surgery.
View Article and Find Full Text PDFBackground: Pneumonia is a serious complication in patients with unilateral vocal fold paralysis (UVFP). Traditional Chinese medicine Xiang-Sheng-PoDi-Wan plays a role in promoting health and may reduce pneumonia rates in those with UVFP. The study aimed to evaluate Xiang-Sheng-PoDi-Wan treatment's effectiveness in preventing pneumonia hospitalization in patients with UVFP.
View Article and Find Full Text PDFObjective: Previous studies indicate that certain voice outcomes can improve following a single office-based steroid injection with voice therapy for vocal fold scar. We evaluated voice outcomes after a series of three timed office-based steroid injections with voice therapy.
Study Design: Retrospective case series with chart review.
The North American Airway Collaborative (NoAAC) previously published a 3-year multi-institutional prospective cohort study showing variation in treatment effectiveness between 3 primary surgical techniques for idiopathic subglottic stenosis (iSGS). In this report, we update these findings to include 5 years of data evaluating treatment effectiveness. Patients in the NoAAC cohort were re-enrolled for 2 additional years and followed using the prespecified published protocol.
View Article and Find Full Text PDFObjective: To describe treatment pathways and long-term outcomes in 64 patients with idiopathic subglottic stenosis (iSGS), including the impact of serial intralesional steroid injection (SILSI) on degree of stenosis, need for subsequent operation, and patient-reported outcome measures.
Methods: Retrospective review of 64 female patients with iSGS undergoing varied management approaches, 57 of whom underwent SILSI as at least part of their care. Treatment pathways included SILSI only, endoscopic intervention followed by SILSI only, endoscopic interventions only, endoscopic intervention followed by SILSI followed by need for repeat endoscopic intervention, open surgery, and tracheotomy.
Am J Speech Lang Pathol
November 2021
Purpose Patients undergoing vocal fold procedures significantly reduce but often do not cease voice use during absolute postprocedure voice rest. We hypothesized that patients who completed preprocedure voice therapy would increase adherence to postprocedure voice rest. Method Eighty-six participants completed this prospective cohort study.
View Article and Find Full Text PDFObjectives/hypothesis: Airway access in the setting of unsuccessful ventilation and intubation typically involves emergent cricothyrotomy or tracheotomy, procedures with associated significant risk. The potential for such emergent scenarios can often be predicted based on patient and disease factors. Planned tracheotomy can be performed in these cases but is not without its own risks.
View Article and Find Full Text PDFObjectives: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients.
Methods: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.
Objectives/hypothesis: Awake, unsedated in-office upper airway procedures are performed frequently and have high completion rates, yet less is known about the patients' pain experience and potentially influencing factors. It is also unclear if patients' pain experiences become worse with repeated procedures. We identified procedure- and patient-related factors that might influence procedural completion and pain scores.
View Article and Find Full Text PDFThe main purpose of this study is to investigate the spatiotemporal interstitial fluid dynamics in a vibrating vocal fold. A self-oscillating poroelastic model is proposed to study the liquid dynamics in the vibrating vocal folds by treating the vocal fold tissue as a transversally isotropic, fluid-saturated, porous material. Rich spatiotemporal liquid dynamics have been found.
View Article and Find Full Text PDFObjective: Idiopathic subglottic stenosis (iSGS) is a chronic inflammatory condition that causes dyspnea and affects middle-aged women of White race and non-Latino or Hispanic ethnicity. To better characterize its phenotype and pathogenesis, we assessed the proteomic and genomic methylation signatures of subglottic tissue collected from iSGS patients compared to controls.
Study Design: Molecular analysis of clinical biospecimens.
Objective: Office-based steroid injection has shown promise for idiopathic subglottic stenosis (iSGS). It is important to understand safety and patient-lived experience. We report patient experience related to airway restriction, voice, and side effects.
View Article and Find Full Text PDFJAMA Otolaryngol Head Neck Surg
January 2020
Importance: Surgical treatment comparisons in rare diseases are difficult secondary to the geographic distribution of patients. Fortunately, emerging technologies offer promise to reduce these barriers for research.
Objective: To prospectively compare the outcomes of the 3 most common surgical approaches for idiopathic subglottic stenosis (iSGS), a rare airway disease.
Ann Otol Rhinol Laryngol
February 2020
Objective: To assess the prevalence of microlaryngeal teaching course in Accreditation Council for Graduate Medical Education (ACGME)-accredited otolaryngology residency programs in an effort to evaluate the nature, perceived value and barriers to implementation of microlaryngeal courses.
Method: A 14-question survey to all ACGME-accredited otolaryngology programs in the United States.
Result: Out of 119 ACGME-accredited otolaryngology programs identified on the ACGME Fellowship and Residency Electronic Interactive Database, responses were received from 67 programs (56%).
Sulcus vocalis, defined as a type of groove along the free edge of the vocal fold, disrupts the normal, pliable vocal fold cover, causing alterations in the intrinsic mucosal wave. The primary symptom is breathy, effortful dysphonia. Diagnosis may be challenging, and this classically has led to difficulties with identification and management.
View Article and Find Full Text PDFBackground: Injection medialization is performed to improve glottic closure, thereby airway protection. Overall objective to determine if unilateral injection medialization changes glottal area with concomitant adjustments in penetration/aspiration scale (PAS) scores and pharyngeal high-resolution manometry (HRM) parameters.
Methods: Enrolled 17 adults with unilateral vocal fold paralysis/paresis and aspiration/penetration.
Zenker's diverticulum is a rare cause of progressive dysphagia that is treated surgically. KTP laser-based diverticulotomy is one effective treatment. Developing a simulation model is helpful for rare conditions.
View Article and Find Full Text PDFIntroduction: Office-based evaluation of glottic lesions has progressed significantly, but there can still be discrepancies compared with direct microlaryngoscopy (DML) in the operating room. We performed a prospective evaluation comparing diagnosis of epithelial and lamina propria glottic lesions on rigid telescopic strobovideolaryngoscopy (RTS) with DML.
Methods: Fifty subjects were enrolled and underwent RTS followed by DML.
Purpose: The objective of this study was to describe a patient with idiopathic supraglottic stenosis who experienced persistent disease despite multiple office-based and operative interventions, whose disease is now better controlled with scheduled serial office-based steroid injections.
Methods: This is a case report and literature review.
Results: A 42-year-old female was referred for worsening supraglottic stenosis despite systemic steroids.
Objectives/hypothesis: Current treatment options for idiopathic subglottic stenosis include endoscopic interventions, resection, and tracheotomy. Recently, serial office-based steroid injections were proposed as an alternative that may stabilize or induce regression of airway stenosis without the need for repeated operations. Procedure completion rate, pain, complications, effect on stenosis, time since the last operation, and limitations have not been described.
View Article and Find Full Text PDFObjective: To describe a homogeneous idiopathic subglottic stenosis (ISS) population undergoing endoscopic balloon dilation and evaluate factors affecting inter-dilation interval (IDI).
Methods: Retrospective review of 37 patients. Co-morbidity prevalence versus normal population was evaluated using chi-square tests.
Otolaryngol Head Neck Surg
November 2016
Objective: Persistent dysphonia from vocal fold scar remains a clinical challenge, with current therapies providing inconsistent outcomes. We evaluated voice outcomes after a single office-based steroid injection.
Study Design: Case series with chart review.