phenylephrine-hydrochloride and Hoarseness

The purpose of the study was to assess the suitability and safety of the flexible reinforced laryngeal mask airway (FRLMA) for intranasal surgery (INS) anesthesia. A secondary objective was to compare the incidence of complications of removal of the FRLMA with tracheal extubation in awake and anesthetized patients. One hundred fourteen ASA physical status I and II patients requiring INS were randomly assigned into three groups: Group I = FRLMA, Group II = endotracheal tube (ET) extubated awake, and Group II = ET extubated deeply anesthetized. In Group I, the incidence of coughing and oxyhemoglobin desaturation at removal was significantly reduced compared with that in Groups II and III (P < 0.05). There were no episodes of postremoval laryngospasm in Group I; in Group III, the incidence was 19% (P < 0.05), whereas in Group II, it was 6% (not significantly different). The number of patients with oxyhemoglobin desaturation < or = 92% on admission to the postanesthesia care unit was 0% in Group I, 26% in Group II (P < 0.05), and 16% in Group III (not significantly different). At bronchoscopy, the incidence of blood visible in the airway was low and similar among the three groups (3%, 6%, and 3%, respectively). There were no significant differences in the incidence of airway complications between Groups II and III.. We compared airway management for intranasal surgery anesthesia using a new device, the flexible reinforced laryngeal mask airway, with the current standard of tracheal intubation. The study demonstrates that the flexible reinforced laryngeal mask airway can provide a safe, protected airway with a smoother emergence from anesthesia than tracheal intubation.

Topics: Adult; Anesthesia Recovery Period; Anesthesia, General; Bronchoscopy; Cough; Equipment Design; Female; Follow-Up Studies; Hoarseness; Humans; Incidence; Intubation, Intratracheal; Laryngeal Masks; Laryngismus; Male; Nose; Oxyhemoglobins; Pharyngitis; Pliability; Postoperative Hemorrhage; Respiration; Respiration, Artificial; Safety; Wakefulness

To remind special attention to atypical symptoms of Hansen's disease, we report a case of an atypical case due to a delayed diagnosis.. Clinical features of leprosy are well known, cutaneous lesions and involvement of the peripheral nerves being the cardinal clinical signs. Among these presentations, systemic involvement, including mucous membranes of the upper respiratory tract and eyes, is rarely reported even if it is still commonly seen in endemic areas, in particular lepromatous leprosy.. We describe here a new case of Hansen's disease in a 51-year-old Tunisian woman with an atypical presentation and a delayed diagnosis. The early symptoms of the disease were different from the main clinical signs of Hansen's disease since they involved the upper respiratory tract and the eyes. A nasal smear was positive for acid-fast bacilli, thus confirming the diagnosis of bacilliferous leprosy. Histological findings suggested the diagnosis of leprosy and were somewhat more characteristic of the borderline lepromatous type.. Diagnosis of Hansen's disease in patients with neither apparent skin lesions nor neurological signs is still problematic. Clinicians should not only pay attention to the more obvious signs in their own fields of expertise but should be aware of the possible systemic involvement of leprosy.

Topics: Alopecia; Delayed Diagnosis; Ectropion; Female; Hoarseness; Humans; Leprosy, Lepromatous; Middle Aged; Mycobacterium leprae; Nasal Obstruction; Nose

To screen orofacial function in people with various ectodermal dysplasia (ED) syndromes and compare with a healthy reference sample.. The ED group comprised 46 individuals (30 M and 16 F; mean age 14.5 years, range 3-55). Thirty-two had hypohidrotic ED, while 14 had other ED syndromes. The reference sample comprised 52 healthy individuals (22 M and 30 F; mean age 24.9 years, range 3-55). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S) protocol containing 12 orofacial function domains (maximum score 12 points).. The total NOT-S score was higher in the ED group than in the healthy group (mean 3.5 vs. 0.4; p<0.001). The dysfunctions most frequently recorded in the subjects with ED occurred in the domains chewing and swallowing (82.6%), dryness of the mouth (45.7%), and speech (43.5%). Those with other ED syndromes scored non-significantly higher than those with hypohidrotic ED (mean 4.6 vs. 3.0; p>0.05).. Individuals with ED scored higher than a healthy reference sample in all NOT-S domains, especially in the chewing and swallowing, dryness of the mouth, and speech domains. Orofacial function areas and treatment and training outcomes need to be more closely evaluated and monitored.

Topics: Adolescent; Adult; Child; Child, Preschool; Deglutition Disorders; Ectodermal Dysplasia; Face; Facial Expression; Female; Hoarseness; Humans; Male; Mandible; Mass Screening; Mastication; Masticatory Muscles; Middle Aged; Nose; Respiration; Speech Disorders; Voice; Xerostomia; Young Adult

The purpose of this study was to elucidate whether misdirected swallowing is an extra-laryngeal cause of hoarseness and investigate whether the prevalence of misdirected swallowing and hoarseness in patients with hiatal hernias differ from those with and without pathological gastroesophageal reflux (GER). One hundred and ninety eight patients with hiatal hernias diagnosed via esophageal manometry and pH-reflux test and 262 subjects in the general population who did not have a hiatal hernia at endoscopy, filled in a questionnaire about symptoms on hoarseness, misdirected swallowing, and heartburn. Hoarseness (35%), misdirected swallowing to the larynx (MSL; 35%), misdirected swallowing to the nose (MSN; 22%) and heartburn (85%) were significantly more common in patients with hiatal hernia than in controls (13, 5, 1, and 6%, respectively, P<0.001). MSL and MSN in the patient group were significantly interrelated (P<0.0001). Hoarseness and MSL were not significantly associated (P<0.076). Hoarseness and MSL were as common in the hernia group with normal GER, as in the group with pathological GER. There is a predisposition for hoarseness and MSL in patients with hiatal hernias, but the cause-and-effect relationship is unclear. Hoarseness does not seem to be caused by pathological GER.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Case-Control Studies; Deglutition Disorders; Female; Gastroesophageal Reflux; Hernia, Hiatal; Hoarseness; Humans; Larynx; Male; Middle Aged; Nose; Prevalence

Post kala-azar dermal leishmaniasis (PKDL) involving the mucus membranes is relatively rare on the Indian sub-continent. We describe 3 cases of PKDL presenting with hoarseness of voice. In one case the skin, nasal, oral, oropharyngeal and laryngeal mucosa had nodular and nodulo-ulcerative lesions; in the 2 other cases, genitalia and anorectal mucosa were also affected. Laryngoscopic examination revealed nodular lesions on the vocal cords. Biopsy smear and culture confirmed their leishmanial origin.

Topics: Adolescent; Genitalia; Hoarseness; Humans; India; Laryngeal Diseases; Laryngeal Mucosa; Leishmaniasis, Visceral; Male; Middle Aged; Mouth; Nose; Oropharynx; Rectum; Skin; Vocal Cords

The purpose of this study was to determine the prevalence of voice quality deviations in a normal adult population. One-hundred twelve subjects, aged 17 to 80, read a short paragraph aloud into a high-fidelity tape recorder and completed a case history questionnaire. A group of 11 pretrained judges rated overall performance of each taped sample on a seven-point equal-appearing intervals scale, then designated those quality components which contributed toward deviant ratings. Eighty-two percent of the group received a mean severity rating lower than 1.99; 16% had a rating between 2.00 and 2.99; and 2% was assigned a mean rating higher than 3.00.

Topics: Adolescent; Adult; Aged; Female; Hoarseness; Humans; Male; Middle Aged; Nose; Pennsylvania; Self-Assessment; Sex Factors; Smoking; Speech Production Measurement; Voice; Voice Disorders; Voice Quality

A series of 1,187 nasotracheal intubations, carried out from January 1973 to December, 1975, used a new tube. The design included a smooth tip, a cuff with a large area of contact, low pressure and a high residual volume, and a radiopaque line which is easily visible on chest X-ray. A secondary irrigating lumen opening distal to the cuff provides closed-system irrigation, measurement of airway pressures, and sampling of tracheal gases. In the 811 intubated nontracheostomized patients who survived, the overall incidence of significant laryngeal damage was 1%. In patients intubated in excess of 10 days the damage incidence was 10%, and we suggest that tracheostomy should be carried out at this time. No patients suffered from any known permanent laryngeal damage.

Topics: Adult; Aged; Airway Obstruction; Female; Hoarseness; Humans; Intubation, Intratracheal; Male; Middle Aged; Nose; Pressure

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Hoarseness; Humans; Infant; Infant, Newborn; Intubation, Intratracheal; Laryngeal Diseases; Male; Middle Aged; Mucous Membrane; Nasal Mucosa; Necrosis; Nose; Nose Diseases; Pharyngeal Diseases; Polyps; Respiratory Tract Diseases; Time Factors

Topics: Ear Deformities, Acquired; Ear, External; Epistaxis; Granulomatosis with Polyangiitis; Hoarseness; Humans; Nose; Nose Deformities, Acquired; Otitis Media; Otolaryngology; Polyarteritis Nodosa