Jad Hosri

Objective: To investigate the correlation between the morphology of vocal fold polyps, hemorrhagic versus nonhemorrhagic, and treatment outcome following office‐based blue laser therapy with intralesional steroid injection. Methods: All the medical records and video recordings of patients diagnosed with vocal fold polyps who underwent office‐based blue laser therapy with intralesional steroid injection at a tertiary referral center between June 2023 and August 2025 were reviewed. Vocal fold polyps were classified as hemorrhagic versus nonhemorrhagic. The treatment outcome measures included the Voice Handicap Index‐10 (VHI‐10) score, acoustic parameters, maximum phonation time (MPT), and disease regression. The mean follow‐up period was 12.79 ± 12.31 weeks. Results: A total of 29 patients with vocal fold polyps were included in the study. Twenty‐one patients had hemorrhagic polyps, while the remaining had nonhemorrhagic polyps. No significant differences in the demographic variables were noted between the two subgroups. The mean VHI‐10 score in the hemorrhagic polyp subgroup decreased by 10.2 ± 6.76 points, compared to 6.33 ± 7.14 points in the nonhemorrhagic subgroup ( p = 0.208). There was a significant difference in complete disease regression between the hemorrhagic and nonhemorrhagic subgroups (95.2% vs. 62.5% p = 0.022). No significant differences were observed in any of the acoustic parameters between the two subgroups except for jitter ( p = 0.017). Conclusion: The results of this investigation indicate that hemorrhagic vocal fold polyps respond better to office‐based blue laser therapy with intralesional steroid injection than nonhemorrhagic polyps. Level of Evidence: 3.

Dysphonia is defined as a change in voice timber, pitch, or loudness. Precipitating factors may be occupational or health-related, such as allergy and laryngopharyngeal reflux (LPR). To investigate the association between combined LPR, and allergic rhinitis (AR), and type of dysphonia, that is, functional versus non-functional. A retrospective chart review of all patients with dysphonia who presented to the Voice Unit at a tertiary referral center between November 2018 and February 2022 was conducted. Patients must have previously filled out the Reflux Symptom Index (RSI) and AR questionnaires to be recruited. Based on laryngeal examination, the etiology of dysphonia was stratified as functional versus non-functional (referred to as structural/neurologic). A total of 137 patients were included, 65 (47.4%) of whom had a structural voice disorder, 22 (16.1%) had neurologic voice disorders, and 50 (36.5%) had a functional voice disorder. Seventy-eight patients (56.1%) had a positive RSI ≥ 13, suggestive of LPR. In these patients, dysphonia was functional in 31, structural-in 34, and neurologic in 13 (p = 0.568). Sixty-eight patients (48.9%) had a positive AR score ≥ 1, suggestive of allergy, 62% of whom had functional dysphonia, 46.2% had structural dysphonia, and 31.8% had neurologic dysphonia (p = 0.046). Twenty-five of the 50 patients (50%) with functional dysphonia had RSI ≥ 13 and AR ≥ 1 versus 29.3% (19/65) of the structural subgroup and 31.8% (7/22) of the neurologic subgroup (p = 0.063). After adjusting for smoking, patients with both reflux and allergy had 2.913 (95%CI = 1.32–6.442) times the odds having functional dysphonia compared with those having either or none (p = 0.008). Patients with dysphonia and history of LPR and allergy are more likely to have a functional underlying etiology.

Objectives: This study aimed to investigate the risk of laryngopharyngeal reflux in Hubble Bubble smokers in comparison to non-smokers Methods: The medical records of patients who presented with hoarseness were reviewed. Patients with a history of Hubble Bubble smoking and a control group of non-smokers were included in the study. The risk of laryngopharyngeal reflux was assessed using the Reflux Symptom Index and the Reflux Finding Score. Results: Eighty-six Hubble Bubble smokers and 86 controls were included in the study. There was a statistically significant difference in the mean RSI between the two subgroups (10.05 ± 8.27 vs. 5.05 ± 6.58; p < 0.001). Hubble Bubble smokers were 4.24 times more likely to have a Reflux Symptom Index score greater than 13 in comparison to non-smokers (odds ratio = 4.24; 95 per cent confidence interval: 1.97–9.14). Conclusion: Hubble Bubble smoking increases the risk of laryngopharyngeal reflux by two-fold. A larger prospective study is needed to substantiate the association between Hubble Bubble smoking and laryngopharyngeal reflux.

Objective: To describe the prevalence and morphology of vocal fold contralateral reactive lesions in patients with vocal fold polyps or cysts, and to report disease regression following office‐based laryngeal surgery (OBLS). Methods: Medical records and video recordings of patients with vocal fold polyps or cysts who underwent OBLS between November 2023 and September 2025 were reviewed. Demographic data included age, gender, history of smoking, history of reflux disease, type of vocal fold pathology, and type of office‐based laryngeal procedure. Prevalence, morphology, and disease regression of CRLs were assessed by two otolaryngologists who independently reviewed the video recordings of patients included in this study. Results: Twenty‐six males and 19 females were included in the study. The mean age was 48.9 ± 14.9 years. The prevalence of CRLs was 60%. Most of these lesions were fibrous. Eighteen lesions were treated with ILSI, and 8 lesions were treated with the blue laser and steroid injection. Five patients were lost to follow‐up. Analysis of 21 CRLs showed complete disease regression in 52.4% of cases, and partial disease regression in 47.6% of cases. There was no statistically significant difference in disease regression between the two treatment subgroups ( p = 0.284) . There was a statistically significant difference in total disease regression of the primary lesion between those who had partial vs. complete disease regression of their CRL ( p < 0.001). Conclusion: CRLs are common in patients with vocal fold polyps and cysts. All lesions regressed partially or completely following OBLS using the blue laser and/or steroid injection. Level of Evidence: 3.

Dermatomyositis is an immune‐mediated inflammatory myopathy characterized by progressive proximal muscle weakness with sparing of distal muscles, accompanied by cutaneous manifestations. Laryngeal involvement in patients with dermatomyositis is extremely rare, with only seven cases described in the literature. We report the case of a 21‐year‐old man with dermatomyositis who presented with dysphonia, breathiness, and asthenia with a voice handicap index‐10 score of 24/40. Laryngeal examination showed whitish mucosal patches on the upper surface of both vocal folds with bowing of the vocal folds. Video‐stroboscopy revealed incomplete closure of the vocal folds during phonation, a decrease in vocal fold vibration amplitude, and diminished mucosal waves. One month after therapy with mycophenolate mofetil, the patient’s voice quality improved and his VHI‐10 score decreased to 16/40.

Comparing Flexible Nasal Endoscopy and Lateral Neck Radiography When Diagnosing Children with Adenoid Hypertrophy: A Case-Control Study - Turkish Archives of Otorhinolaryngology

Objective: To highlight risk factors affecting outcomes of vocal fold paralysis (VFP) in patients with Arnold‐Chiari malformations (ACM). Methods: A systematic review was conducted according to the 2020 PRISMA checklist. The authors comprehensively searched multiple databases from inception till August 2023 for both keywords and medical subject headings pertinent to ACM and VFP. Data from 33 studies was obtained by applying predetermined inclusion and exclusion criteria and quality assessment of the chosen articles. Meta‐analysis using Chi‐squared test and binary logistic regression was performed to determine the association between age and other variables. Results: The 33 studies included a total of 165 patients with a mean age of 15.31 months. The predominant type of Chiari malformation was type 2, observed in 120 cases. Bilateral vocal fold paralysis was confirmed in 103 patients while 12 patients had unilateral disease. The most common treatment modality was ventriculoperitoneal shunt placement in 108 patients (65.45%), followed by posterior fossa decompression surgery in 86 patients (52.12%). Regarding airway status, most patients were not intubated (65.45%); however more than one third of patients underwent tracheostomy (38.79%) following VFP. There was a significant association between the age of VFP onset and both recovery and survival in both the overall cohort and the ACM II cohort. Conclusion: Age at onset of VFP is a critical factor associated with both recovery and survival rates in paediatric patients, with younger ages linked to incomplete symptom resolution and worse survival.

This is the case of a healthy 10-year-old girl presenting to the pediatric otolaryngology clinic for an incidental finding of a 20 mm dilatation within the left posterior fossa on brain computed tomography done for evaluation of left retro-auricular pain. Comprehensive audiometry showed left sensorineural hearing loss at low frequencies. Magnetic resonance imaging revealed a cystic lesion along the posterior aspect of the left temporal bone with normal inner ear anatomy consistent with an enlarged endolymphatic sac anomaly. This pathology is a rare entity with only one previously reported case in the literature.