Bastian Voice Institute

This 46-year-old woman is an intense, dynamic teacher who was chronically hoarse for several years. Laryngeal examination reveals swelling of the right vocal cord mucosa (polypoid), and a double mucosal bridge on the left due to vocal overuse. In a new, high resolution photo essay on Laryngopedia, the mucosal bridge and glottic sulcus underneath is clearly seen during surgical removal of the polypoid. 10 days later, the patients voice is restored to baseline with the bridge untouched: https://lnkd.in/gv8UP7bC

This man has had longstanding laryngeal dystonia causing adductory spasmodic dysphonia. More than a year before these photos, he underwent SLAD-R on the left side (right of photo). One can see full recovery of the LCA (lateral cricoarytenoid) muscle, but the TA (thyroarytenoid) muscle is atrophic and flaccid: https://lnkd.in/gBHfNKDB

Diffuse leukoplakia (seen under standard light) in a man who had undergone removal elsewhere at least twice, with rapid return of diffuse disease on both vocal cords. Basement membrane peel and subsequent laser ablation helped restore this tenors singing voice! https://lnkd.in/gFPHbzUx

Several months after removal of exuberant papillomas, voice remains quite good, but is becoming a little deeper. The obvious lesion here is not important; the subtle one (papilloma) is the key. In a new JOL article, Dr. Bastian demonstrates how the three step Integrative Diagnostic Model (Patient History, Vocal Capability Battery, and Laryngeal Examination) protects against premature conclusions based on red herrings. Go to https://lnkd.in/gC7mGhWn for the full article.

This middle-aged man came for evaluation of a “white lesion” (leukoplakia) that other doctors believed to be the cause of his voice change. As it turns out, the leukoplakia was incidental to his voice change, which was instead due to scissoring / overlap of one cord on the other and bowing/flaccidity—possible TA-only paresis of the right cord. In a new JOL article, Dr. Bastian demonstrates how the three step Integrative Diagnostic Model (Patient History, Vocal Capability Battery, and Laryngeal Examination) protects against premature conclusions based on red herrings: https://lnkd.in/g3d68PQQ

We asked ChatGPT about Laryngopedia, here is what it said:

This unfortunate man suffered a severe auto accident, resulting in multi-system injuries, including a cervical spinal cord injury, closed head injury, and multiple fractures. Closer inspection and patient attempts to speak (with momentary trach occlusion) reveal true cause—a large, ball valving, avascular granuloma: https://lnkd.in/gvqxXrfz

Dr. Bastian recently returned from the Danish Laryngological Society conference, held at a convention center in Nyborg, about two hours from Copenhagen. He was graciously hosted by Dr. Jesper Balle and Dr. Kristine Gregersen. During the conference, Dr. Bastian was invited to deliver two tutorials: Sensory Neuropathic Cough and Retrograde Cricopharyngeus Dysfunction—also known as the “no-burp” syndrome. Dr. Balle, who has built a caseload of patients with R-CPD extending beyond Scandinavia to include patients from Canada, works in a private clinic in Charlottenlund, a suburb of Copenhagen. You can contact him here: https://lnkd.in/gwwt-9zC or, at a website that is coming soon: https://lnkd.in/g9QyjeYi. Dr. Balle’s approach prioritizes efficiency and minimizes unnecessary barriers, much like our philosophy at Bastian Voice Institute, ensuring cost-effective care for both Danish and international patients. His colleague, Dr. Kristine Gregersen, provides similar care within Denmark’s national health system. Her contact is: https://lnkd.in/gi6dJjtf Both Dr. Balle and Dr. Gregersen are outstanding professionals and excellent choices for individuals seeking treatment for R-CPD in Denmark, and a much wider area.

In some patients, the cricophargyeus muscle begins failing to relax completely when swallowing (Antegrade circopharyngeus dysfunction, A-CPD). At first, one may experience lodgment of pills. After a few years, the person begins to eat only soft, well-chewed food, avoiding things like meat and bread: https://lnkd.in/gYyp5QND

In Papillary Squamous Cell Cancer, the tumor is more infiltrating at the interface with normal tissue and there usually is a higher mitotic rate. The prognosis for treatment is very good as this is a relatively “lazy” variant of SCCA. Review a new photo essay showcasing removal via microlaryngoscopy: https://lnkd.in/gR-F8ruU