A 35 yr old male female singer presents with complains of hoarseness, vocal fatigue & pain in neck on prolonged phonation. Direct laryngoscopy shows bilateral pin head size swelling on Ant.1/3 & post 2/3 junction of vocal cord. What could be the probable diagnosis ?
Vocal nodule (singer's or screamer's node) Seen symmetrically on the free edge of vocal cord, at the junction of anterior one third, with the posterior two thirds (i.e. area of maximum vibration of cord). Vocal nodules are bilateral. Mostly seen in teachers, vendors, actors or pop singers as they speak in unnatural low tones or at high intensities for prolonged periods. symptoms include: hoarseness breathlessness a "rough" voice a "scratchy" voice a harsh-sounding voice shooting pain from ear to ear feeling like you have a "lump in your throat" neck pain less ability to change your pitch voice and body tiredness Vocal polyp is typically unilateral but arising from the same position as vocal nodule. Treatment Voice rest and speech therapy (Speech therapy re-education in voice production are essential in preventing recurrence) Microlaryngoscopic excision of nodules--Using microsurgical instruments or laser differential diagnosis is VOCAL CORD POLYP- Usually unilateral at the junction of anterior and middle third of vocal cord. caused by Voice abuse, chronic irritation like smoking Sudden shouting results in hemorrhage and submucosal edema. Treatment is Microlaryngeal excision. Acute laryngitis is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection. Acute laryngitis may be caused by viral infections. Acute pharyngitis is inflammatin of the pharynx causing Pain or irritation in the throat that can occur with or without swallowing, often accompanies infections, such as a cold or flu.
Vocal polyp
Vocal nodule
Acute laryngitis
Acute pharyngitis
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