Vocal fold polyp, scar, and sulcus vocalis.A 41-year-old woman--a physical education teacher and hockey, track, and basketball coach--developed a progressively worsening hoarseness over the course of approximately 1 year. Seven months prior to our evaluation, another otolaryngologist had diagnosed her as having vocal fold polyps Polyps A tumor with a small flap that attaches itself to the wall of various vascular organs such as the nose, uterus and rectum. Polyps bleed easily, and if they are suspected to be cancerous they should be surgically removed. . At that time, she underwent excision of both vocal fold masses and was placed on voice rest for 3 days. However, the quality of her voice was worse following surgery. She had had no preoperative pre·op·er·a·tive adj. Preceding a surgical operation. preoperative preceding an operation. preoperative care the preparation of a patient before operation. voice therapy. Approximately 2 months postoperatively, she had attended four sessions with a speech pathologist, but she noticed no improvement. She continued teaching, but found it difficult because of the hoarseness, decreased volume, and voice fatigue. She had a history of reflux, which had been treated with nizatidine for 2 months. Although she still had reflux symptoms, she was on no medication at the time of our evaluation. Strobovideolaryngoscopy revealed bilateral vocal fold scarring, with a marked stiffness of the right vocal fold and essentially no vibratory motion of the left vocal fold. Following intensive voice therapy and reflux control, she underwent surgery. At the time of the operation (figure), we confirmed that she had a polyp polyp, in medicine, a benign tumor occurring in areas lined with mucous membrane such as the nose, gastrointestinal tract (especially the colon), and the uterus. Some polyps are pedunculated tumors, i.e. on the posterosuperior surface of her right vocal fold, fibrotic masses on both vibratory margins, and right sulcus sulcus /sul·cus/ (sul´kus) pl. sul´ci [L.] a groove, trench, or furrow; in anatomy, a general term for such a depression, especially one on the brain surface, separating the gyri. vocalis. She also had numerous varicose varicose /var·i·cose/ (var´i-kos) variceal or variciform; of the nature of or pertaining to a varix; unnaturally and permanently distended. var·i·cose adj. vessels on the superior surfaces of her vocal folds and aberrant vessels running toward, rather than parallel to, the vibratory margin. She underwent staged surgery, which included fat implantation into her left vibratory margin, excision of her masses, and excision of her varicosities. She will probably require surgery for her right sulcus vocalis in order to optimize her phonatory result. From the Department of Otolaryngology--Head and Neck Surgery, 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:
implacable detective with photographic memory. [Br. Lit.: The Ticket-of-Leave Man, Barnhart, 546] See : Sleuthing ). |
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