A Journal of Observational Laryngology
Clinical observations, anecdotes, case series, and conceptual frameworks of laryngology for further exploration.
Arytenoid Dislocation: A Diagnostic Strategy
Arytenoid dislocation is a mechanical injury of the larynx where an arytenoid cartilage becomes displaced from the cricoid
EMG-Guided Injection of Botulinum Toxin for R-CPD
Background: What Is R-CPD? R-CPD (Retrograde Cricopharyngeus Dysfunction) is a disorder of the upper esophageal sphincter, a ring-shaped muscle in the lower throat that acts as a valve. It opens briefly to allow swallowing or, in the reverse direction, to permit burping or vomiting. In persons with R-CPD, this muscle
The Trumpet Maneuver During CT Scanning and Office Videoendoscopy
Introduction At rest, the laryngopharynx (throat and voice box) lie closely against one another. The pharynx essentially “hugs” the laryngeal inlet. Because of this, the point of attachment of a tumor in the laryngopharynx can be difficult to define without operative endoscopy under general anesthesia. This is especially true when
Steroid and Local Anesthetic Injection Strategy for Sensory Neuropathic Cough
What Is the Source of This Idea? The first peer-reviewed publication for steroid and local anesthetic injections we are aware of came from Simpson and colleagues in 20181. As an aside: Our first use of superior laryngeal nerve (SLN) injection with local anesthetic was in 2005, in a patient whose
R-CPD Neck Symptoms and “Throat Nausea”
Persons with R-CPD (Retrograde Cricopharyngeus Dysfunction)—the inability to burp or to burp adequately—experience a constellation of symptoms, each individual’s set drawing from about ten common possibilities. Alongside the inability to burp, these symptoms may include: Audible gurgling Abdominal bloating and distention Excessive flatulence Painful hiccups Nausea after eating Mechanical shortness
Clinical Diagnosis of Sensory Neuropathic Cough (SNC) via Syndrome-Matching
Abnormal narrowing of a passageway in the body. At our practice, stenosis typically refers to narrowing in the breathing passage, such as for narrowing in the glottic, subglottic, or tracheal areas. Stenosis in the airway can be the result of prolonged endotracheal intubation, external trauma such as gunshot wound, crush
Clinical Diagnosis of R-CPD via Syndrome-Matching: A Case Against Unnecessary Testing
ABSTRACT This article presents a strong case for clinical diagnosis of retrograde cricopharyngeus dysfunction (R-CPD) based on syndrome-matching. When symptoms align precisely with the well-established R-CPD profile, this approach allows clinicians to avoid unnecessary, uncomfortable, and costly diagnostic procedures—relying instead on high-confidence, pattern-based recognition to lead directly to treatment. Introduction
Swallowing Vincibility Syndrome (SVS)
Swallowing Vincibility Syndrome is a person’s mistaken belief that the swallowing mechanism does not work, when in fact it is working well.
What is the role of SLAD-R in treating AD-SD?
Consider This Scenario I have a 40-year-old male patient with adductor spasmodic dysphonia (SD)—a successful businessman—who has received reasonable benefit from botulinum toxin injections. However, he finds the initial breathy phase frustrating and is seeking more consistent, near-perfect results. He also wishes for longer-lasting effects. For these reasons, he is
Nonorganic Cough (Differential Diagnosis and Management)
Abstract Nonorganic cough is a behavioral disorder characterized by a persistent, stereotyped cough in the absence of an organic cause. It is often associated with secondary gain and is most frequently seen in young females. This article outlines the clinical features, differential diagnosis, and recommended approach for diagnosis and management,