New Webpage on Vocal Cord Granuloma

Given the sudden interest patients have expressed in vocal cord granulomas ever since singer John Mayer announced a hiatus in concerts due to his voicebox granuloma, a new webpage has been developed to describe this unusual mass as well as treatment options.

Read all about it here!

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Singer John Mayer Diagnosed with Vocal Cord Granuloma

On Sept 19, 2011, media reported that singer John Mayer has been forced to cancel all upcoming concert plans and delay release of a new album due to a voicebox growth.

This growth was described as a "granuloma."

What exactly is a granuloma?

It is a benign mass commonly due to repetitive mild vocal trauma resulting in exuberant growth of a specific region of the voicebox lining.

To be more precise, rather than the vocal cord itself, granulomas are most commonly found on the vocal process which is the "hinge" that allows for vocal cord movement. It is located in the back area of the voicebox.

An imprecise analogy of what a granuloma is would be a keloid of the skin.

Symptoms include mild (if any) hoarseness, mild intermittent pain on the side of the voicebox where the granuloma is located with talking/singing, rarely coughing up blood, and if large, shortness of breath.

Just like keloids of the skin, surgical removal alone is almost certainly going to fail with recurrence of the granuloma within weeks to months. All repetitive trauma to the area must be addressed to minimize risk of recurrence which is why restricted voice use must be pursued for several months (no loud talking/singing, talking ONLY when you must). Voice therapy helps to "teach" a person how to talk when they talk without causing further injury to the area. As such, botox injection to the vocal cord has been found helpful to semi-paralyze the vocal cords from coming together (chemically induced vocal cord paralysis). Reflux medications are necessary even if a patient has no symptoms as ANY acid exposure to the area is just as bad a trauma due to yelling.

Steroid injections are helpful to minimize the underlying exuberant inflammatory reaction that leads to granuloma recurrence and may need to be performed several times for effect.

To summarize, the steps followed when a granuloma-like mass is discovered on exam is as follows:

1) Trial restricted voice use and reflux medications. Voice therapy also strongly recommended.
2) If no improvement after a period of time, surgical excision to ensure it truly is a granuloma and not cancer or some other pathology
3) Follow-up with steroid injections to the granuloma site. Watch video below.
4) Botox injection can be considered which chemically prevents complete vocal cord adduction preventing the repetitive trauma to the granuloma site.

Read a Rolling Stone report here.

Read more about voicebox granulomas.

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Tongue Acrobatics

Impressive tongue acrobatics... Not much more to say! Watch the video here.

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World's Longest Human Tongue

The longest human tongue ever recorded is that of Stephen Taylor and measures 9.8 centimetres (3.86 in). Apparently, his tongue has not stopped growing even though he is a grown adult.

The longest tongue for a female is that of Los Angeles resident Chanel Tapper whose tongue measures 3.8 inches! Her tongue is also quite acrobatic as shown in this YouTube video.

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Another Rock Singer With Injured Voice

On Sept 16, 2011, the Stone Temple Pilots had to cancel their tour because their lead singer Scott Weiland was placed on voice rest due to damaged vocal cords at risk for permanent damage. Specifically, the doctors at University of Cincinnati Voice Health Center determined that he had scarring on his left vocal cord and a tremendously inflamed right vocal cord.

The left vocal cord scarring is likely from past vocal trauma that did not heal properly and is now permanently damaged whereas the right vocal cord is at risk of also becoming permanently damaged if not aggressively managed. The picture shown here is an example with inflammation involving both vocal cords. Compare this with the picture below which shows one normal vocal cord and one inflamed vocal cord.

Without further information, beyond voice rest to allow the vocal cord inflammation to resolve without further injury, treatment may also include steroids as well as reflux medication.

It seems to be a continuing trend for singers of all genres to be pushed to the point where their vocal cords get injured resulting in show cancellations and at worst, become a one-hit wonder.

Other singers THIS YEAR alone who have cancelled tours due to voice injury include Kings of Leon, Duran Duran, Adele, The Vaccines, etc

And it's not just rockers, but also opera singers.

If you are a singer and you don't have a voice coach and supportive management, you need to remedy this immediately or you risk having a career that's a one-hit wonder.

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World Record Large Ears

On September 2011, the Guinness Book of World Records announced the longest ears of any dog belongs to a Coonhound named Harbor. His magnificent ears measured 12.25 inches and 13.5 inches long (left and right respectively).

I wonder how much earwax he produces!

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Keychain Emergency Airway Device (Video)

Health professionals who know how to perform cricothyroidotomy to obtain an emergency airway in someone who is obstructing can appreciate a nifty keychain device called LifeStat.

LifeStat can be carried around and immediately utilized to perform emergency cricothyroidotomy in any setting.

Watch a video here to see how it works.

It can be purchase from Shippert Medical for $145 here.

Reference:
Utilization of the LifeStat emergency airway device. Ann Otol Rhinol Laryngol. 2008 Jan;117(1):1-4.

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