Vocal Fold

Prolonged ulcerative laryngitis in an 18-year-old voice major

April 17, 2013     Brent L. Toland, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS

Management of prolonged ulcerative laryngitis requires close observation with strobovideolaryngoscopy; therapy involves steroids, antibiotics, antifungal drugs, and antireflux treatment.

Hemorrhagic vocal process granuloma

April 17, 2013     Farhad R. Chowdhury, DO; Kevin Hsu, DO; Robert T. Sataloff, MD, DMA, FACS

Most small vocal process granulomas will resolve spontaneously if the primary insult is removed, but these lesions have a very high tendency to recur.

Acute laryngitis superimposed on chronic laryngitis

February 25, 2013     David N. Myerson, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS

Radiation-induced fibrosis can be found in tissues of the neck, pharynx, larynx, esophagus, ear, and temporomandibular joint. It is associated histologically with aggregates of macrophages, fibroblasts, vascular connective tissue changes, and deposition of extracellular matrix. This fibrosis can lead to strictures, stenosis, trismus, ulcerations, and scarring, which can present as dysphagia and dysphonia.

Acute dystonic reaction to general anesthesia with propofol and ondansetron: A graded response

January 24, 2013     Matthew H.J. Size, MBChB, FRCA; John S. Rubin, MD, FACS, FRCS; Anil Patel, MBBS, FRCA


Propofol and ondansetron, alone and in combination, have been associated with acute dystonic reactions during recovery from anesthesia. We report the case of a 44-year-old woman who had undergone microlaryngoscopic fat injection to the vocal folds three times over a period of 10 months. Each procedure was performed by the same surgeon. On each occasion, the patient received an identical anesthetic that was administered by the same anesthetist. The anesthetic regimen included propofol and ondansetron. Following the first procedure, the patient experienced no reaction to these agents. However, she experienced a mild reaction after the second procedure and a severe acute dystonic reaction after the third. We believe this is the first report of a graded reaction to either propofol or ondansetron.

Silent vocal fold hemorrhage

October 31, 2012     Thomas M. d'Arville, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS

Although most vocal fold hemorrhages resolve spontaneously, accurate and timely diagnosis permits the laryngologist to prescribe precautions that will prevent further damage. This is especially important for patients who use their voices in their professions.

Vocal fold atrophy and Reinke edema

October 8, 2012     Eliana Verghese, MD; Rima A. DeFatta, MD; Robert T. Sataloff, MD, DMA, FACS

If voice therapy does not improve vocal fold atrophy and muscle tension dysphonia, then medialization laryngoplasty by injection or thyroplasty may be indicated. 

Sulcus vocalis

August 10, 2012     Johnathan B. Sataloff; Rima A. DeFatta, MD; Mary J. Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA, FACS

Sulcus vocalis causes stiffness of the vibratory margin of the vocal folds, and often in adynamic segments. Patients can experience hoarseness, breathiness, increased phonation threshold pressures, decreased vocal efficiency and, commonly, voice fatigue.

Extramedullary plasmacytoma of the true vocal fold

August 10, 2012     Nilantha De Zoysa, MRCS, DOHNS, BS; Belinda Sandler, MRCP, BSc; Kwame Amonoo-Kuofi, MRCS; Rajiv Swamy, FRCPath; Prasad Kothari, MDS, FDSRCS, FRCS(ORL–HNS); George Mochloulis, MD, CCST(ORL–HNS)


We report a rare case of extramedullary plasmacytoma (EMP) of the true vocal fold. Our patient, a 62-year-old woman, presented with dysphonia. On workup, fiberoptic laryngoscopy detected a lesion arising from the anterior half of her left true vocal fold. No evidence of other pathology was noted. The patient underwent radical radiotherapy, and the lesion resolved. Follow-up revealed no sign of recurrence. A type of myeloma, EMP is rare, especially in the larynx. To the best of our knowledge, our patient represents the sixth case of glottic EMP to be reported in the literature.

Laryngeal lipoma

June 4, 2012     Rima A. DeFatta, MD; Tre Landrum, DO; Joseph Whitten, MD; Robert T. Sataloff, MD, DMA, FACS

Reactive intracordal fibrovascular lesion

February 18, 2012     Matthew E. Leach, MD, Joel H. Blumin, MD, Chun He, MD, PhD, and Jonathan M. Bock, MD

Pertussis presenting as hoarseness in an adult

February 18, 2012     Stephen V. Tornabene, MD, Joshua Crose, BS, and Raul M. Cruz, MD


Pertussis is a rare condition in adults. This report describes a 65-year-old man presenting to the otolaryngology service with hoarseness secondary to pertussis. He had a history of worsening cough and hoarseness occurring over several weeks. Laryngoscopy showed significant erythema at the medial edges of the vocal folds. Stroboscopy demonstrated bilateral decreased amplitude and decreased mucosal wave of the vocal folds. Polymerase chain reaction testing of the sputum revealed Bordetella pertussis. The patient was started on azithromycin, and he reported gradual resolution of the chest and laryngeal symptoms over the next few months. Pertussis, or whooping cough, is not common in the United States because of childhood vaccination protocols. Nevertheless, otolaryngologists need to be aware of this condition as a possible cause of hoarseness.

Hemorrhage into a vocal fold cyst

December 15, 2011     Farhad R. Chowdhury, DO, Nishant Reddy, MD, and Robert T. Sataloff, MD, DMA, FACS
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