Voice and Speech Disorders MCQs

Reinke’s edema is usually bilateral Usual cause is smoking and vocal abuse Involves whole of membranous part of the vocal cords Patient has a hoarse, low pitched voice Mainstay of treatment – Decortication of vocal cord Re-education in voice production and cessation of smoking Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no – 342, 353 Scott Brown’s Otolaryngology, Head and Neck Surgery – 8 th edition – Volume 3 – Page number – 952

Reinke's oedema is due to oedema of the subepithelial space of the vocal cord (Reinke's space). TREATMENT- Decortication of the vocal cord (removal of strip of epithelium is done on one side and 3 - 4weeks on the other). Voice rest, speech therapy, cessation of smoking Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no - 342

Under the epithelium of vocal cords is a potential space with scanty subepithelial connective tissues. It is bounded above and below by the arcuate lines, in front by anterior commissure, and behind by vocal process of arytenoid. Oedema of this space causes fusiform swelling of the membranous cords (Reinke’s oedema). Stopping smoking and Subepithelial cordectomy is the treatment of choice. Reference: Diseases of Ear, Nose, AND Throat by PL Dhingra, Pg.342

Rhinolalia clausa is hyponasality. It is due to blockage of the nose or nasopharynx. Common causes include common cold, nasal polyp, sinusitis, adenoid hypertrophy, nasopharyngeal mass. Rhinolalia aperta is hypernasality - Seen in cleft palate, palatal perforation, palatal palsy Hot potato voice is seen in peritonsillar abscess(quinsy). Dysphonia Plica ventricularis - Here voice is produced by false vocal cords. May be secondary to impaired function of the true vocal cords like paralysis, surgical excision or cancer. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Pg. no. 366, 368 , 311

Trismus is a feature of parapharyngeal abscess. Hoarseness of voice is a common feature of vocal cord problems. Retropharyngeal Space - Between the buccopharyngeal & the prevertebral fascia Extends from base of skull to bifurcation of trachea Divided by a fibrous raphe into 2(spaces of Gilette) Abscess causes U/L bulge on posterior pharyngeal wall Abscess commonly seen in children Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Pg. no. 313, 366

Vocal polyp is caused by sudden shouting resulting in haemorrhage in the vocal cord and subsequent submucosal oedema. Treatment is surgical excision under operating microscope followed by speech therapy. Reference- Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no - 353

Sulcus vocalis Furrow like depression in vocal cord Due to deficiency of lamina propria, the epithelium dips down forming a furrow. Can be congenital or due to phonotrauma. Laryngopharyngeal reflux causes pseudosulcus vocalis. Reference - Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, pg. no - 355 Scott Brown’s Otolaryngology, Head and Neck Surgery – 8 th edition – Volume 3 – Page number – 1095

Thyroid surgery (Total thyroidectomy) is the most common cause of bilateral vocal cord palsy. Most common cause of unilateral vocal cord palsy is idiopathic followed by carcinoma bronchus. Reference – Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra ,8 th Edition, pg. no 348 REFERENCE- Scott Brown’s Otolaryngology, Head and Neck Surgery – 8 th edition – Volume 3 – Page number – 1108