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Laryngeal Contact Ulcer

Larynx Contact Ulcer


Presentation

  • Most patients present with hoarseness and may be noted to have low-pitched voices and frequent coughing. Occasionally, patients may present with severe pain.[entokey.com]
  • If the biopsy reveals that only a granuloma is present, treatment will need to be more intensive and last longer, and additional treatments may be added. 2.[voicefoundation.org]
  • CASE REPORT A 44-year-old man presented with complaints of orthopnea, hoarseness, and cough with hemoptysis. His initial symptoms of persistent dry cough and voice change began 7 months before presentation.[journals.lww.com]
  • Left vocal process granuloma on initial presentation (scope view of 70 ).[emedicine.medscape.com]
  • Often the patient will present with a neck node. The pictures shown below are from four patients with Squamous Cell Carcinoma of the supraglottis (top part of the voice box).[entusa.com]
Pathologist
  • Kerrie Beechler Obert, MA-CCC/SLP, is a clinical voice pathologist at The Ohio State University JamesCare Voice and Swallowing Disorders Clinic in Columbus, Ohio.[books.google.com]
  • For an appointment with a Speech Language Pathologist at NYEE, call 646-438-7805.[nyee.edu]
  • With the aid of a microscope, a lesion can either be removed entirely, or sampled and sent to a pathologist for further analysis.[voicefoundation.org]
  • Often successful treatment may take the combined efforts of the patient's otolaryngologist, speech ("voice") pathologist, voice coach, and manager.[thesingersresource.com]
  • […] a brief checklist provided by Sydney based Speech Pathologist, Judith Rough.[australiandysphonianetwork.org]
Abrupt Onset of Symptoms
  • If the patient presents with fever, lethargy, and a more abrupt onset of symptoms, infectious causes should be considered, such as supraglottic bacterial infection (group A streptococcus, Haemophilus influenzae ), or viral infection (parainfluenza, influenza[nature.com]
Goiter
  • Congenital malformations of other endocrine glands 2016 2017 2018 2019 Billable/Specific Code POA Exempt Applicable To Congenital malformation of parathyroid or thyroid gland Persistent thyroglossal duct Thyroglossal cyst Type 1 Excludes congenital goiter[icd10data.com]
Falling
  • Most other professional singers fall into the vocalist group, while actors, clergy, radio and television personalities fall into the vocal professional group.[thesingersresource.com]
Hoarseness
  • Symptoms of laryngeal contact ulcers include varying degrees of hoarseness and mild pain with phonation and swallowing. Diagnosis of laryngeal contact ulcers is by laryngoscopy. Biopsy to exclude carcinoma or tuberculosis is important.[merckmanuals.com]
  • The cause of hoarseness has many sources.[cmed.faculty.ku.edu]
  • […] if the hoarseness does not seem to have any identifiable cause.[health24.com]
  • Persistent hoarseness in a smoker. Check our suggestions[health365.com.au]
  • […] children 6-9% Incidence in adults 3-9% Incidence in elderly 47% Incidence in Professional Voice Users 30% Pitch monopitch, inappropriate pitch, pitch breaks, reduced pitch range Loudness monoloudness, loudness variation, reduced loudness range quality hoarse[quizlet.com]
Laryngeal Disease
  • Laryngeal disease shares the histologic features of tuberculosis found elsewhere, with caseating granulomatous inflammation and Langhans giant cells ( Fig. 15.4, e- Fig. 15.6 ). 15 Histochemical and immunohistochemical staining for acidfast bacilli can[entokey.com]
  • Obstructive Inflammatory Laryngeal Disease in Three Cats. Journal of Feline Medicine and Surgery , Vol. 1, Issue. 1, p. 53.[cambridge.org]
  • disease Laryngeal infection Laryngeal pachydermia Lesion of larynx Presbylarynx Ulcer of larynx Clinical Information Condition in which there is a deviation from or interruption of the normal structure or function of the larynx.[icd10data.com]
Laryngeal Pain
  • Contact Ulcers Etiology may be one of three causes Hard glottal attack Irritation as result of gastric reflux Intubation for surgery Symptoms Hoarseness/roughness of voice Laryngeal pain or pain lateralizing to ear Vocal fatigue Excessive throat-clearing[ucs.louisiana.edu]
Regurgitation
  • Habitual throat clearing, excessive glottic attack in initiation of speech, and, most important, acid regurgitation secondary to hiatal hernia are the causal factors of contact ulcers.[ncbi.nlm.nih.gov]
  • A thorough history was taken and disclosed that at time of his first visit, he saw a gastroenterologist for his heartburn and regurgitation and was administered pantoprazole 40 mg once daily.[laryngologyandvoice.org]
  • There is a muscle which these two areas and which allows food and liquid to move downwards when swallowing but tightens to prevent regurgitation of the swallowed material and any reflux from reaching the throat.[ohsu.edu]
  • Heartburn – frequent regurgitation of stomach juices into your oesophagus and throat can cause laryngeal inflammation and contact ulcers on your vocal cords. Ageing – as you age, your vocal cords can lose tension.[health365.com.au]
  • Heartburn (oesophageal reflux) – frequent regurgitation of stomach juices into your oesophagus and throat can cause laryngeal inflammation and contact ulcers on your vocal cords. Ageing – as you age, your vocal cords can lose tension.[health24.com]
Tinnitus
  • In addition to improving your ability to listen and understand in changing environments, new technology offers many additional features including: wireless Bluetooth technology, customizable tinnitus relief and rechargeable batteries. Q.[timetohear.com]
Speech Disorders
  • disorders lecture 9 61 terms SPA Ch.8 46 terms vd 2 OTHER SETS BY THIS CREATOR 29 terms 2.[quizlet.com]
  • It is not a speech disorder but rather, a problem with the larynx (voice box). When functioning well, the larynx generates voice by using complex and coordinated control of the vocal folds.[australiandysphonianetwork.org]
Meningism
  • Page 409 - Incidence of meningeal involvement by rhabdomyosarcoma of the head and neck in children. A report of the intergroup rhabdomyosarcoma study (1RS) - Tefft M., Fernandez C, Donaldson M. ‎ Page 53 - H, et al.[books.google.com]
Dysarthria
  • Speech problems include dysarthria (difficulty using muscles to form words) and dysphonia including hoarseness and poor volume and pitch control. Many people find speech therapy beneficial.[australiandysphonianetwork.org]

Treatment

  • The optimal approach to treatment of these lesions remains controversial.[ncbi.nlm.nih.gov]
  • The successful treatment of contact ulcers and granulomas is dependent on elimination of vocal abuse, cessation of throat clearing, and control of the factors that cause the irritation and throat clearing.[ncbi.nlm.nih.gov]
  • Definition / general Also called granulomatous ulcer, posterior commissure ulcer At level of posterior commissure, near vocal process of arytenoid cartilage May recur after local excision but eventually subsides Treatment Conservative (don't excise) because[pathologyoutlines.com]
  • This term is given further support on account of the spectacular recovery of the laryngeal lesion following antacid and antireflux treatment, rather than the traditional method of using vocal rest and speech therapy, assumed to be the best way of treating[jcp.bmj.com]
  • Apply the latest treatment options in pediatric care with new chapters on pediatric sleep disorders, pediatric infectious disease, and evaluation and management of the infant airway.[books.google.com]

Prognosis

  • ., when factors are eliminated, the contact granuloma resolves independently), because any irritation can cause the contact granulomas to reappear. [2] Outcomes and prognosis [ edit ] As the masses of granular tissue are most often benign, prognosis is[en.wikipedia.org]
  • Clinical Evolution of Laryngeal Granulomas: Treatment and Prognosis. The Laryngoscope , Vol. 109, Issue. 2, p. 289. CrossRef Google Scholar Tasker, S Foster, D J Corcoran, B M Whitbread, T J and Kirby, B M 1999.[cambridge.org]
  • When To Call a Professional See your doctor if you: Lose your voice for more than a few days Are hoarse for more than two weeks Have hoarseness accompanied by: Difficulty swallowing A lump in the throat Unexplained pain Coughing up blood Prognosis Vocal[drugs.com]

Etiology

  • Page 53 - Diet in the etiology of oral and pharyngeal cancer among women from the southern United States. ‎ Page 238 - Non epithelial tumors of the nasal cavity, paranasal sinuses, and nasopharynx: a clinicopathologic study. ‎[books.google.com]
  • Abstract Multiple etiological factors including gastroesophageal reflux, hyperfunctional voice use, and endotracheal intubation have been implicated in the development of posterior laryngeal ulcers and granulomas.[ncbi.nlm.nih.gov]
  • Contact Ulcers Etiology may be one of three causes Hard glottal attack Irritation as result of gastric reflux Intubation for surgery Symptoms Hoarseness/roughness of voice Laryngeal pain or pain lateralizing to ear Vocal fatigue Excessive throat-clearing[ucs.louisiana.edu]
  • Gastroesophageal reflux (GER), hyperfunctional use of the voice, and intubation injury are etiological factors. Patients usually complain of dysphagia, and dysphonia.[laryngologyandvoice.org]

Epidemiology

  • […] isolated LPR are not obese. 4, 5 Unfortunately, the remaining risk factors and patient profiles for LPR are not well established because epidemiologic studies in this area are lacking.[nature.com]
  • […] patients. [3] Surgical solutions are sometimes used, however rates of recurrence are higher. [3] Most recent research suggests that surgical options should only be explored once treatment of reflux with or without voice therapy has been introduced. [3] Epidemiology[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • This suggests that differences in pathophysiology between LPR and GERD patients are part of the basis for the contrasting symptomology.[nature.com]
  • Pathophysiology Contact granulomas are usually pale, pedunculated masses found on the medial or superior edge of the vocal process of the arytenoid cartilage; however, they may also be deep red, lobulated, and sessile.[emedicine.medscape.com]

Prevention

  • That is, if using a spacer device does not prevent symptoms.[drugs.com]
  • You might not be able to prevent some causes of throat sores, such as cancer treatment. Other causes may be more preventable.[healthline.com]
  • Treatment and Prevention If the cause is overuse of the voice, then the treatment is to rest the voice for an extended period of several weeks and to consider proper voice training. If caused by GERD, then that must be treated.[diagnose-me.com]
  • They believe that modified voice rest under observation of a speech therapist helps the ulcer to heal and allows the patient to acquire those vocal habits that may prevent recurrence.[emedicine.medscape.com]
  • TREATMENT OF VOCAL POLYP • POLYPS MAY SHRINK SPONTANEOUSLY • MEDICAL • VOICE THERAPY MAY PROVIDE COPING STRATEGIES, PREVENTIVE ADVICE, AND REDUCE SYMPTOMS • HOWEVER MEDICAL MANAGEMENT IS UNLIKELY TO CAUSE RESOLUTION OF POLYPS • MOST POLYPS REQUIRE REMOVAL[slideshare.net]

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