Glottic web at the striking zone.A 61-year-old telephone receptionist presented to our office with a 10-month history of hoarseness and loss of lower range. Her symptoms arose during an upper respiratory tract infection upper respiratory tract infection URI Infectious disease A nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx, and larynx, the prototypic URI is the common cold; flu/influenza is a systemic illness involving the URT . She had had no antecedent vocal complaints. Another otolaryngologist had diagnosed an "anterior glottic glot·tic adj. 1. Of or relating to the tongue. 2. Of or relating to the glottis. glottic pertaining to (1) the glottis, or (2) the tongue. web" and recommended surgical lysis lysis /ly·sis/ (li´sis) 1. destruction or decomposition, as of a cell or other substance, under influence of a specific agent. 2. mobilization of an organ by division of restraining adhesions. 3. . She came to us for a second opinion. The patient's medical history included ulcerative colitis, hypertension, Bell's palsy, arthritis, and skin cancer. She had been intubated during multiple surgeries, the most recent of which occurred 3 years earlier. Her voice was high in pitch but only mildly hoarse. Stroboscopic examination of the larynx detected a glottic web at the striking zone. Multiple varices varices /var·i·ces/ (var´i-sez) [L.] plural of varix. Varices A type of varicose vein that develops in veins in the linings of the esophagus and upper stomach when these veins fill with blood and swell ran perpendicular to the vibrating surface of each vocal fold, suggesting previous trauma (figure). There was evidence of laryngopharyngeal reflux. Findings on neurolaryngologic evaluation were unremarkable. [FIGURE OMITTED] The patient was started on voice therapy and placed on intensive medical therapy for reflux. We explained to her that although surgery would likely help her regain her lower register and maintain good vocal quality, there was a chance that the underlying vocal fold would be adynamic ad·y·na·mi·a n. Loss of strength or vigor, usually because of disease. [a-1 + dynam(ism) + -ia1. and further worsen her vocal quality. The patient chose not to proceed with surgery and has had satisfactory improvement through therapy. From the Department of Otolaryngology--Head and Neck Surgery, Graduate Hospital and Thomas Jefferson University It began as Jefferson Medical College in 1824. On July 1, 1969 the institution officially became Thomas Jefferson University. The university is made up of three colleges:
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