Giant cell tumour is a growth predominantly found in long bones of the body. Giant cell tumour has a rare occurrence in the head and neck. A case of a 31 year old male with no known comorbidities at the ENT Department, Shifa International Hospital, Islamabad presented with anterior neck swelling and hoarseness of voice. Patient was diagnosed as having Giant Cell Tumour of Larynx (GTCL) proven on FNA cytology and post-operative biopsy. GCTL is an uncommon entity with only 45 reported cases in the world.

OBJECTIVE: This study aimed to determine the impact of different types of masks on the voices of healthcare professionals who had to wear masks for an extended amount of time during the pandemic period and had a healthy voice.
METHODS: Our research included 41 healthcare workers. The participants were separated into two groups: surgical (n = 21) and N95 mask users (n = 20). Healthcare workers evaluated masks before and after wearing them for at least 8 hours throughout the workday. All subjects had a videolaryngoscopic examination; the Voice Handicap Index-10 (VHI-10), GRBAS, acoustic voice analysis (F0, jitter%, shimmer%, noise/harmonic ratio, relative average perturbation [RAP]), aerodynamic measures (maximum phonation time, MPT), and blood oxygen saturation were evaluated.
RESULTS: Although both groups\' VHI-10 scores increased after using the mask, this rise was not statistically significant in our research. According to the GRBAS classification, voice quality deterioration was identified in 9.6% (mild-moderate) of the group using surgical masks and 15% (mild) of the group wearing N95. Only the jitter and RAP values of individuals wearing both surgical and N95 masks were determined to be statistically significant. There was no significant change in MPT following mask wear in either group. Both the surgical and N95 mask-using groups showed a substantial drop in blood oxygen saturation before and after mask usage.
CONCLUSIONS: There was no change in voice quality between healthcare workers wearing surgical and N95 masks. It has been noticed that voice perception and quality are affected by the mask\'s barrier effect rather than the kind of mask.

暂无摘要。

A young woman in her early 30s presented with a right thyroid mass and progressive hoarseness due to a right vocal cord palsy. The preoperative fine-needle aspiration cytology was classified as Bethesda V and she underwent a total thyroidectomy and neck dissection. Intraoperatively, the thyroid mass was adherent to the oesophagus, trachea and encasing the right recurrent laryngeal nerve which was sacrificed. Final histopathology diagnosed a rare subtype of thyroid cancer known as intrathyroidal thymic carcinoma (ITC). She was then sent for adjuvant radiotherapy after a multidisciplinary tumour board discussion. This case report highlights the difficulty in preoperative diagnosis of ITC and the importance of immunohistochemical staining in clinching the diagnosis. In view of its rarity, there have been no published consensus on the treatment of ITC, hence we would like to share some learning points through a comprehensive literature review.

Many lecturers develop voice problems, such as hoarseness. Nevertheless, research on how voice quality influences listeners\' perception, comprehension, and retention of spoken language is limited to a small number of audio-only experiments. We aimed to address this gap by using audio-visual virtual reality (VR) to investigate the impact of a lecturer\'s hoarseness on university students\' heard text recall, listening effort, and listening impression. Fifty participants were immersed in a virtual seminar room, where they engaged in a Dual-Task Paradigm. They listened to narratives presented by a virtual female professor, who spoke in either a typical or hoarse voice. Simultaneously, participants performed a secondary task. Results revealed significantly prolonged secondary-task response times with the hoarse voice compared to the typical voice, indicating increased listening effort. Subjectively, participants rated the hoarse voice as more annoying, effortful to listen to, and impeding for their cognitive performance. No effect of voice quality was found on heard text recall, suggesting that, while hoarseness may compromise certain aspects of spoken language processing, this might not necessarily result in reduced information retention. In summary, our findings underscore the importance of promoting vocal health among lecturers, which may contribute to enhanced listening conditions in learning spaces.

BACKGROUND: This randomized controlled trial aimed to evaluate the efficacy of preoperative inhaled budesonide combined with intravenous dexamethasone on postoperative sore throat (POST) after general anesthesia in patients who underwent thyroidectomy.
METHODS: Patients who underwent elective thyroidectomy were randomly divided into the intravenous dexamethasone group (group A) and budesonide inhalation combined with intravenous dexamethasone group (group B). All patients underwent general anesthesia. The incidence and severity of POST, hoarseness, and cough at 1, 6, 12, and 24 hours after surgery were evaluated and compared between the 2 groups.
RESULTS: There were 48 and 49 patients in groups A and B, respectively. The incidence of POST was significantly lower at 6, 12, and 24 hours in group B than that in group A (P < .05). In addition, group B had a significantly lower incidence of coughing at 24 hours (P = .047). Compared with group A, the severity of POST was significantly lower at 6 (P = .027), 12 (P = .004), and 24 (P = .005) hours at rest, and at 6 (P = .002), 12 (P = .038), and 24 (P = .015) hours during swallowing in group B. The incidence and severity of hoarseness were comparable at each time-point between the 2 groups (P > .05).
CONCLUSIONS: Preoperative inhaled budesonide combined with intravenous dexamethasone reduced the incidence and severity of POST at 6, 12, and 24 hours after extubation compared with intravenous dexamethasone alone in patients who underwent thyroidectomy. Additionally, this combination decreased the incidence of postoperative coughing at 24 hours.

Endotracheal intubation is an airway management procedure commonly performed under general anesthesia. It is linked with postoperative voice changes. The incidence and reasons of hoarseness and vocal cord injury are not very well investigated, especially after short-term anesthesia and intubation in head and neck surgery. The aim of the study is to identify the causes of voice changes after short endotracheal anesthesia in head and neck surgery. The study will include patients scheduled for head and neck surgery under general anesthesia with endotracheal intubation up to 3 hours. There will be 3 groups of patients, as follows: thyroid surgery, non-thyroid surgery, and control group undergoing surgery outside head and neck. Videostroboscopy will be recorded before and after surgery. Further diagnostic workup will include voice status; subjective voice self-analysis; perceptive and objective acoustic voice analysis at 4 time points (preoperatively, postoperative day 2, 2 weeks and 1 month after surgery). Endotracheal intubation is a safe method of airway management although it can temporarily alter a patient\'s voice quality. It is not known how much of this is the result of anesthesia, general condition of the patient, or surgery. This trial is expected to shed some light on this issue.

OBJECTIVE: Lipoid proteinosis (LP) or Urbach-Wiethe disease (OMIM 247100) is a rare syndrome characterised by early vocal folds infiltration and subsequent multi-organ involvement. LP is often unrecognised and its associated hoarseness is overlooked. The main objective of the study was to investigate hoarseness in LP and implement a diagnosis among otolaryngologists.
METHODS: PubMed/MEDLINE and OMIM databases were systematically searched. Authors concentrated the search on published articles starting from the discovery of the pathogenesis of LP by Hamada et al. in 2002. Only cases in which a diagnosis was reported both clinically and through biopsy and/or genetic molecular testing were included. Characteristics of the LP cases were extracted from each included study. Results were obtained through Generalized Estimating Equations.
RESULTS: The search strategy yielded 217 articles, of which 74 (34.1%) met the selection criteria. A total of 154 cases were included. Hoarseness was described in all LP cases and clearly stated as the onset symptom in 68.8%. The onset was on average at 19 months of age (CI: 3.00-20.00), while the mean age at diagnosis was 15 years (CI: 10.00-30.00). Therefore, the diagnostic delay amounted to 13.42 years (CI: 8.00-23.83). Hoarseness alone was responsible for an LP diagnosis in only 14.3% of cases. In 43.5% of cases, genetic analysis of the ECM1 gene was performed and exon 6 was the most frequently altered portion.
CONCLUSIONS: Analysing the largest number of published cases, the study underlined that hoarseness is the key symptom for diagnosing LP since early childhood, though frequently overlooked.

OBJECTIVE: Though hemorrhagic vocal fold polyps are a common entity, hemorrhagic vocal fold cysts have not been previously described. In our study, we have evaluated patients who were diagnosed on stroboscopy with \"hemorrhagic\" cysts.
METHODS: This 18-month retrospective study has received institutional ethics clearance. Using the database of our voice clinic, 14 patients diagnosed with hemorrhagic cysts by stroboscopy were reviewed. Age, sex, chief complaints, symptom duration, videostroboscopy findings, surgical details, and histopathology were noted.
RESULTS: Out of a total 14 patients, 12 were males with a mean age of presentation of 41 years. The duration of hoarseness ranged from 2-24 months. Videostroboscopy revealed a markedly decreased amplitude of the mucosal waves over a well-delineated ovoid or spheroid hemorrhagic lesion, which seemed tethered down by overlying vocal fold epithelium. All patients had operative findings of a well-encapsulated hemorrhagic lesion in the superficial lamina propria with anterior and posterior fibrotic bands. Histopathology of 13 patients was similar and revealed a hemorrhagic polypoidal lesion. A pseudo-capsule could be identified occasionally. These lesions seemed to be hemorrhagic pseudocysts, named \"polyst\" by us. In one male patient, the histopathology revealed a true vocal fold cyst (type C Koren) with hemorrhage.
CONCLUSIONS: A hemorrhagic pseudocyst (polyst) of the vocal fold has stroboscopic and surgical findings resembling a true vocal fold cyst with hemorrhage; however, histologically it resembles a hemorrhagic polyp. A true hemorrhagic cyst however is typically a type C Koren cyst with hemorrhage. Both these entities have not been previously described.

OBJECTIVE: To evaluate the possible etiological factors of spontaneous pneumomediastinum and to describe a case that was unusual in its etiology: a thyroid cartilage fracture as a result of sneezing.
METHODS: Six patients (four male, two female, aged 16-82 years) were hospitalized with spontaneous pneumomediastinum diagnosed with a chest X-ray in five patients and 100% with computed tomography. Treatment was symptomatic.
RESULTS: The commonest symptoms (cough, shortness of breath, hoarseness) were in four patients. Spontaneous pneumomediastinum developed in three cases as a result of bronchospasm during an attack of bronchial asthma, in one patient after exercise, in one after fibrogastroscopy, in one after sneezing. We report a 30-year-old man who presenting subcutaneous emphysema on the neck, hoarseness, pain when swallowing, hemoptysis developed after sneezing. His computed tomography revealed a pneumomediastinum due to fistula of the fracture of the thyroid cartilage following sneezing while simultaneously obstructing both nostrils. At laryngoscopy, there was a linear hematoma in the resolution stage on the anterior wall of the larynx. He was treated conservatively and recovered rapidly. There are no previous published reports of spontaneous pneumomediastinum following fracture of the thyroid cartilage.
CONCLUSIONS: Fracture of the thyroid cartilage as a result of a sharp rapid increase in airway pressure during a sneeze with blocked nasal passages can be one of the rare causes of spontaneous pneumomediastinum. Avoid closing both nostrils at the same time when sneezing.
UNASSIGNED: Оценить возможные этиологические факторы спонтанного пневмомедиастинума и представить клиническое наблюдение перелома щитовидного хряща в результате чиханья как одну из возможных редких причин этого осложнения.
UNASSIGNED: Спонтанный пневмомедиастинум диагностирован у 6 пациентов на основании клинической картины, рентгенографии и компьютерной томографии грудной клетки. В исследование вошли 4 мужчины и 2 женщины в возрасте от 16 до 82 лет. Все пациенты успешно пролечены консервативно.
UNASSIGNED: Клинические симптомы (кашель, одышка, осиплость голоса) имелись у 4 пациентов. Спонтанный пневмомедиастинум развился в 3 случаях в результате бронхоспазма во время приступа бронхиальной астмы, у 1 пациента — после физической нагрузки, у 1 — после фиброгастроскопии, у 1 — после чиханья. Спонтанный пневмомедиастинум у всех больных диагностирован на компьютерной томографии, на рентгенограмме органов грудной клетки описан у 5 человек. У мужчины 30 лет после чиханья появились подкожная эмфизема на шее, осиплость голоса, болезненность при глотании, кровохарканье. На 2-е сутки на компьютерной томограмме органов грудной клетки выявлены пневмомедиастинум и перелом щитовидного хряща, через дефект в котором воздух поступал в средостение. При ларингоскопии на передней стенке гортани имелась линейная гематома в стадии разрешения. Проведено консервативное лечение. Подобных наблюдений в литературе нам не встретилось.
UNASSIGNED: Перелом щитовидного хряща в результате резкого быстрого повышения давления в дыхательных путях во время чиханья с зажатыми носовыми ходами может служить одной из редких причин спонтанного пневмомедиастинума. Следует избегать одновременного закрытия обеих ноздрей во время чиханья.