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Objective To evaluate the impact of face masks on voice in a sub-population of healthcare workers, namely residents, medical students, and nurses, during the COVID-19 era. Materials and Methods A cross-sectional study was conducted in a large tertiary care center where a 23-items web-based questionnaire was conveyed to sub-population of healthcare professionals, namely residents, medical students, and nurses. The questionnaire included demographic data, type, and duration of mask use. Voice outcome measures included the Voice Handicap Index (VHI)-10 questionnaire and the visual analogue scale for vocal effort and vocal fatigue. Results A total of 178 participants answered the survey. One third had an abnormal score on the VHI-10 questionnaire, one third reported moderate to severe vocal fatigue, and 45% of the participants had moderate to severe vocal effort based on a visual analogue scale score. There was a significant association between the type of mask used and vocal fatigue ( P = 0.044). No significant association was seen between the duration of mask used and the different voice outcome measures. Conclusion Masking habits during the COVID-19 pandemic were associated with a high prevalence of vocal fatigue, effort and abnormal VHI-10 score among residents, medical students, and nurses.

Crohn’s disease is an immune mediated inflammatory disease that affects the gastrointestinal tract anywhere from the oral cavity proximally, to the anus distally. A large number of patients with Crohn’s disease may present with a multitude of oropharyngeal manifestations, such as mucositis, granulomas and ulcerations. Infliximab, a monoclonal antibody that binds to TNFα, is a treatment modality used in the management of Crohn’s disease. 10% to 30% of patients with Crohn’s disease develop intra-abdominal abscesses in the course of the disease, a finding that is much less common in oropharyngeal manifestations. We herein present the case of a painless peri-tonsillar abscess in a patient with Crohn’s disease maintained on infliximab that required surgical drainage as means of treatment. To our knowledge, this is the first case demonstrating such a finding in a patient that is maintained on infliximab.

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Objective. To investigate the risk of fibromyalgia in patients with primary muscle tension dysphonia. Methods. A retrospective review was conducted of patients with primary muscle tension dysphonia, diagnosed based on history of dysphonia with evidence of laryngeal muscle tension on examination. Fibromyalgia was assessed using the Fibromyalgia Rapid Screening Tool ('FiRST').Results. Fifty patients were enrolled: 25 with primary muscle tension dysphonia (study group) and 25 matched controls. The mean age of the study group was 50.7 ± 15.2 years versus 49.5 ± 18.6 years for the controls, with a male to female ratio of 3:2 for both groups. Fiftysix per cent tested positive for fibromyalgia in the study group versus 4 per cent in the controls ( p < 0.001). The mean Voice Handicap Index 10 score in the study group was significantly higher for those who screened positive for fibromyalgia compared to those who screened negative. There was a positive, strong point-biserial correlation between Fibromyalgia Rapid Screening Tool and Voice Handicap Index 10 scores (r = 0.39; p = 0.09). Conclusion. These results suggest that fibromyalgia is a significant co-morbid condition in primary muscle tension dysphonia.