Laryngospasm in a Child

Washington Post published a story July 23, 2012 regarding a child who suffered from laryngospasm attack that was erroneously diagnosed as asthma.

Laryngospasm is when the true vocal cords (TVC) come together rather than apart when breathing. Normally, only when talking do the vocal cords come together (or adduct) and vibrate to create a voice. When breathing, the vocal cords separate (or abduct) to allow air to pass between the vocal cords and into the lungs. Watch video.

What the story portrayed is not uncommon and patients who suffer from laryngospasm may go for years without the correct diagnosis.

The voice therapy that was recommended is also appropriate to help him cope when an attack occurs.

However, that's also the point where I start to disagree with the article.

It is all fine and dandy to learn breathing coping strategies, but that only deals with WHEN an attack occurs. What about what causes an attack to happen in the first place? Would it not be better to prevent an attack from happening at all and thereby coping strategies don't even need to be initiated?

As such, I do feel it important to start an aggressive workup to evaluate all the known triggers that may initiate a laryngospasm attack. Such triggers include allergy, post-nasal drainage, and reflux.

As long as the trigger is not addressed, a patient can continue to suffer recurrent attacks.

Once the triggers are found and fixed... the laryngospasm attacks can be "cured."

Watch the video below depicting larygnospasm as well as less severe forms of the same (vocal cord dysfunction or paradoxical vocal cords).

Source:
Long-ago asthma diagnosis didn’t explain boy’s difficulty breathing. Washington Post 7/23/12

Working in a Salon Can Be Unhealthy for Your Nose and Throat!

We already know that small hair clippings from cutting hair can cause septal perforation and chronic sinusitis due to long-term inhalation. Worse case scenario, it can even lead to an external nasal deformity! (Read blog about this here.)

However, it seems that it's not just hair that can damage the nose, but also hair products especially to straighten/smoothen hair popularly known as "Brazilian" treatments.

In a report published by Washington Post on Oct 17, 2011, such Brazilian hair smoothing treatments often contain a known toxic chemical called formaldehyde and methylene glycol. The FDA has pronounced such products to be unsafe. These chemicals are most commonly used as a preservative to prevent dead tissue (ie, corpses) from decay.

And yet... these products are commonly used in hair salons to potentially unsafe levels resulting in health problems to not just workers, but also customers.

Common symptoms that can result from formaldehyde and methylene glycol exposure include:

• nose-running (rhinitis)
• eye tearing
• throat burning

It can also cause symptoms of chronic sinusitis, taste alteration, smell loss, dry nose, scabbing at the nose entrance, etc.

Best to avoid if at all possible!

Read the WP article here.

The Vocal Problems of Professional Singers

The Washington Post on May 20, 2011 published a great article on the travails of opera singers regarding their vocal cords and the stresses placed on them (the singers and their vocal cords).

The opera singer (as well as any other professional singer) are the Olympic athletes of the voice.  As such, peak performance is mandatory in order to sustain a successful career. Just as an Olympic sprinter measures their success in milliseconds... the professional singer is judged by the most minute inflections, variances, irregularities of their voice. Never mind the back-biting and gossip.

99.9% is not good enough in this cut-throat world when anything less than 100% perfection is considered failure.

As such, the demands placed on the vocal cords are tremendous and rather than pulled hamstrings of a world-class sprinter, vocal cord swelling let alone nodules or muscle tension dysphonia can cut a career short.

Push the voice too hard... and they can get damaged, especially when vocal technique gets sacrificed to perform pieces beyond appropriate range (and even ability). Even professional opera singers have vocal instructors and coaches... a point I regularly make with amateur singers with injured vocal cords when they argue against the necessity of voice therapy and singing lessons ("I already know how to sing!").

Read the Washington Post story here.

I did want to point out that there was one error in the story...

Near the end of the story, it is stated that Giuseppe Filanoti had thyroid surgery. Although this can affect the voice, it is NOT vocal cord surgery as reported.