(Disclaimer: This article is for general use only, and the information in the following content has been processed to protect Ms. Li’s privacy)
Abstract: The subject of this case is 39-year-old Ms. Li, who presented to the outpatient clinic with a complaint of recurrent hoarseness for 1 year, aggravated for 1 month. After outpatient dynamic laryngoscopy, a polyp-like object was found in the anterior middle 1/3 of the left vocal cord, so Ms. Li was recommended to be hospitalized for surgery. After completing the preoperative examination, the diagnosis of vocal fold polyp was clarified and laryngoscopic excision of vocal fold mass was performed.
[Basic information] Female, 39 years old
Type of disease】Vocal fold polyp
Hospital】Henan Provincial People’s Hospital
Consultation time】June 2018
Treatment plan】Surgical treatment (supported laryngoscopic vocal fold mass excision) + medication (inhalation budesonide suspension, glycine bingmei tablets)
Treatment Period】3 days of hospitalization
Treatment effect] The hoarseness was relieved, and the voice was discharged successfully.
I. Initial consultation
Ms. Li came to the clinic with the complaint of recurrent hoarseness for 1 year and aggravation for 1 month. After laryngoscopy at the local hospital, she was diagnosed as having vocal cord inflammation and was advised to take oral medication (name and process of medication unknown), and her symptoms were relieved. One month ago, due to excessive use of voice again, her voice became hoarse again and her symptoms were not relieved after taking oral amoxicillin capsules by herself, so she came to the hospital for treatment. After outpatient examination of dynamic laryngoscopy, a polyp-like neoplasm was found in the anterior middle 1/3 of the left vocal cord, so Ms. Li was recommended to be hospitalized for surgery.
(Otolaryngoscopy report form)
II. Treatment process
After Ms. Li was admitted to the hospital, she underwent preoperative routine examination, including blood routine, biochemical examination, electrocardiogram and chest X-ray examination, which showed that all indicators were normal and met the indications for surgery, and decided to perform laryngoscopic excision of vocal fold masses. Before the operation, Ms. Li and her family were informed that the operation could be performed, and were informed of the possible complications and risks during and after the operation, and expressed that they could understand, agreed to the operation and signed. The operation was successfully completed with complete removal of the mass and no polyps remained in the vocal cord. After waking up from general anesthesia, there was no uncomfortable reaction and she returned to the ward safely. After the operation, Ms. Li was advised to rest her voice, and was given inhalation treatment with budesonide suspension nebulizer and oral symptomatic treatment with glycine bingme tablets.
III. Treatment effect
Ms. Li’s postoperative hoarseness was satisfactorily relieved, her vocalization was normal, and there were no other complications. She felt slight pain in the pharynx, which was probably related to the mucous membrane touched by the laryngoscope under the operation. Ms. Li’s treatment went smoothly and her postoperative recovery was satisfactory, and she was discharged from the hospital after 3 days of admission. At the time of discharge, Ms. Li was advised to continue to rest her voice for 1 week to avoid vocal cord edema, and to continue to take oral sweet orange and plum tablets to consolidate the therapeutic effect.
IV. Notes
We are glad that Ms. Li’s hoarseness was relieved after the treatment, but the pathology report showed that Ms. Li was discharged from the hospital: vocal fold polyp-like changes, so we informed Ms. Li that vocal fold polyp is a common benign tumor of the vocal folds, and after the surgery to remove it, it is basically completely cured, but there is a possibility of recurrence. Since Ms. Li is a salesperson and usually speaks too much for a long time, if she has too many high-pitched tones and incorrect pronunciation for a long time, there is also a possibility of recurrence, so to avoid recurrence, Ms. Li was told to pronounce correctly and avoid high-pitched pronunciation. In normal life, avoid spicy and stimulating food and drink more water. Life should be regular, protect the gastrointestinal tract and prevent acid reflux, which can avoid the recurrence of polyps again to some extent.
V. Personal insight
Vocal fold polyp is a common benign tumor of the vocal folds, incorrect vocalization, excessive vocalization, decreased body resistance, upper respiratory tract infection, bacteria and viruses are easy to invade the vocal folds, the symptoms of inflammation of the vocal folds, hoarseness, generally given after the recess drug treatment, the symptoms will mostly be relieved. In this case, Ms. Li suffered from vocal cord polyps due to excessive vocalization for occupational reasons. If vocal fold inflammation is repeated, it may cause vocal fold nodules, and early vocal fold nodules can be relieved after medication, but if we don’t pay attention to it, vocal fold nodules will grow up and form vocal fold polyps, and medication is not effective, and polyps must be removed surgically to be cured.