History
57 year old female
Complaints
- 20 years ago her voice began deepening.
- Now many of her clients think she is a man when on the phone with her.
- This is causing problems with her business.
- At times her voice actually stops and only air comes out.
- She cannot yell.
- She attributes the problem to a peritonsillar abscess and series of sore throats she had 20 years ago.
Medical history
- Singing: was a soprano when young, no singing now
- Smoking: 1 ppd x 20 years
- Fluids:
- Water: 3 cup per day
- Caffeine: 5 caffeinated beverage/day
- Alcohol: 0 glass per month
Character
- Talkativeness: 4 on a scale of 7 (1 quiet, 7 talkative)
- Loudness: 4 on a scale of 7 (1 is soft, 7 is loud)
- Vocal commitments at Work: 4 hours per workday
Vocal capabilities
See Vocal capabilities testing guidelines for explanations
- Reading pitch: low, monotonal
- Anchor pitch: F2 (yes, it is that low)
- Range: F2 – G3
- Max phonation: >14 seconds @ C3
- Loudness: soft yell
- Swelling tests: G3 marked air leak
- Neurogenicity: none
- Psychogenicity: none
- Valving: soft edge
- Respiration: normal
Stroboscopic Examination of the Larynx
| Video examination |
 |
Click on photo for a before and after video |
| Presurgical Photo evaluation. |
|
|
This view during inspiration shows the indrawing of the large fluid filled sacs on either vocal cord.
Click on photo for high resolution view.
|
 |
This is a stroboscopic view at pitch A2 during mid closure. Both polyps are being blown toward the viewer on the superior surface of the vocal cord.
Click on photo for high resolution view.
|
| 5 weeks after surgery - Photo evaluation |
|
5 weeks after surgery. During inspiration or abduction. mild swelling along the edges of the vocal folds. Surgical incision is on superior surface of the vocal folds.
Click on photo for high resolution view.
|
|
5 weeks after surgery. Stroboscopic view during mid closure. It is comparable to above photo except that the pitch is about an octave higher at B3.
Click on photo for high resolution view.
|
Treatment
Surgical excision, with attention to preserving some of the lamina propria and prevent stiff vocal folds post operatively.
Other photos of smoker’s polyps.
|
)
)
)
)