Accessible anatomy introduction. Three functions of the larynx: regulate breathing, create sound, keep food out of lungs. Describes thyroid cartilage (Adam’s apple), cricoid cartilage, hyoid bone, and how testosterone thickens/elongates vocal cords lowering pitch. Written from a café observation scene with a Japanese-speaking couple. References the book.
Migration note: Part I “Anatomy of the Voice Box” page content.
Home›Clinical & Educational›“Nanomargin” Approach to Vocal Cord Tumor Surgery Challenges traditional cordectomy protocols (Remacle et al. 1999/2000, ELS). Proposes paradigm shift from wide surgical margins to precision “nanomargin” technique using modern HD chip endoscopes, NBI/selective color imaging, and programmable CO2 laser. “Orange peel surgery”: Peeling tumor tissue from underlying healthy structures using CO2 laser. Differential…
Home›Clinical & Educational›Review: Thyroid Surgery Neural Dysfunction Guidelines Detailed critical review of: Dhillon VK, Randolph GW, Stack BC Jr, et al. Head & Neck 2020. Takes on flawed terminology (“immediate VFP”) and offers corrected statements for each of the paper’s 5 consensus points. Key arguments: “Vocal fold paralysis” is wrong terminology for surgical nerve injury…
Home›Clinical & Educational›Summary of Vocal Capabilities Vocal capabilities pattern matching — the most substantive blog post. Four patterns: (1) Vocal cord margin swellings (impairment at low volume, high pitch = lower right quadrant), (2) RLN paresis anterior branch (low pitch, low volume = lower left), (3) Vocal cord bowing (impairment at low volume across range),…
Home›Clinical & Educational›Thyroid Surgery Guidelines for Voice Evaluation — Letter to JAMA OTO Letter to editor submitted to JAMA Otolaryngology Head & Neck Surgery in response to Shonka & Terris (2016). Argues that current AAO-HNS and ATA guidelines are insufficient — vocal capability recording before and after any thyroid/parathyroid surgery is the gold standard. Vocal…
Home›Clinical & Educational›Hoarseness: We All Know It When We Hear It Introduces Faith N. Metsan story (recurring character from the book). Core definition: hoarseness = (1) unwanted air leak through vocal cords, or (2) irregular leak of air through vocal cords. “That is it. That is the essence and foundation of my entire book.” Every…
Home›Clinical & Educational›Video and the Voice Why video recording of vocal cords is essential — most vocal events happen too fast for live perception; stroboscopy needed to slow and reveal. Rigid vs. flexible endoscopy approaches. If patients can view video of their own cords, they can often assess whether their physician’s explanation makes sense. References…
