Etiology
The history is the significant element. There are many types of inflammatory disorders so there are many historical etiologies. Inflammation may come on after a cold/laryngitis. It may be from chronic irritation such as reflux, smoking, deep pitched speaking or an intubation. It may be completely spontaneous as in Wegener's Granumlomatosis.
Diagnosis
History
Change in voice.
Character of an inflammatory patient
Vocal capabilities
- General
- Inflammatory injures can do many things, cause the cords to swell lowering the pitch, cause a bump to swell keeping the cords from coming together and leaking air, cause stiffness of the vocal cords, etc.
- Reading voice
- variable depending on the injury
- Pitch range
- variable depending on the injury
- Singing
- variable depending on the injury
- Yelling voice
- variable depending on the injury
Laryngeal Exam
- Videolaryngeal exam
- Rigid and flexible exams are usually complementary
- Because the vocal capabilities are so variable, the visible exam greatly supplements the history..
- for other potential findings see photos
- Stroboscopy - helpful if there is a suspicion of stiffness of the true vocal folds
Treatment
Medical
Steroids, antibiotics, antireflux agents may play a role. Watchful waiting may also be appropriate.
Behavioral
- Speech Therapy probably has limited usefulness
- Feedback to the appropriate caregiver if the injury was iatrogenic can prevent further occurrences .
Surgical
Depends on the type of inflammation - these are some possibilities
- biopsy to diagnose some lesions
- intubation if swelling is severe and the airway is being compromised.
- granulomas caused by intubation can be surgically removed.
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