Voice Management Following Surgery

Vocal cord is innervated by?

• Olfactory nerve (I)
• Glossopharyngeal nerve (IX)
• Vagus nerve (X)
• Hypoglossal nerve (XII)

Which statement regarding intubation reduces vocal cord trauma?

• Intubation using direct laryngoscope
• Intubation using video laryngoscope
• Intubation using high pressure low volume cuff
• Multiple attempts of intubation

Which of the following statements is true?

• Intubation using low -pressure high-volume cuff ETT reduces vocal cord trauma
• NG tube insertion does not increase the risk of hoarseness
• Transoesophageal echocardiography doesn’t cause vocal cord paresis
• Usage of nitrous oxide intraop is safe and doesn’t require additional monitoring

At what pressure should the ETT cuff be inflated to?

• < 10cm H20
• 10 – 20cm H20
• 20 – 30cm H20
• 30 – 40cm H20

Which of the following statements is true in cardiothoracic surgery?

• Sternal traction is safe and doesn’t cause vocal cord palsy
• Topical cooling of heart using ice slush is safe
• Left internal mammary artery harvesting isn’t associated with vocal cord palsy postop
• Aortic surgeries are at high risk of developing vocal cord palsy post op

The external branch of the superior laryngeal nerve supplies:

• Cricothyroid
• Interarytenoid
• Cricoarytenoid
• Thyroarytenoid

Voice therapy is mostly effective for the following condition:

• Bilateral abductor palsy
• Bilateral adductor palsy
• Unilateral adductor palsy
• Unilateral vocal fold paresis

The following is not a main goal of voice therapy for a 60-year-old housewife with unilateral vocal fold paresis:

• To reduce roughness
• To reduce breathiness
• To improve vocal hygiene
• To improve breathing for phonation

What is the most important first step in evaluating a patient with a voice disorder?

• Ordering a CT scan
• Trial of voice therapy
• Detailed history and physical examination
• Starting empirical antibiotics

Which of the following symptoms most strongly suggests a potential laryngeal malignancy?

• Voice breaks with vocal fatigue
• Hoarseness improving with rest
• Hoarseness lasting more than 2 weeks in a smoker
• Occasional vocal strain after speaking loudly