Laryngopharyngeal reflux (LPR) occurs due to retrograde movement of gastric acid to the larynx and pharynx. This clinical entity affects the upper aerodigestive tract which is different from gastroesophageal reflux disease (GERD). Patients of LPR often present with dysphonia, foreign body sensation in the throat, presence of phlegm, and chronic cough. In case of professional singers, it will affect extension of the voice, particularly loss of high notes, change in tone of voice that can be expressed as loss of crystal or opaqueness of voice, voice fatigue, trills, and breaks with inability to sing without interruption. [1] The sound produced from the larynx is nothing, but a buzz which is different from that of wonderful voice of singers. This sound coming from the larynx is made up of tones and the tones called harmonics in musical language or overtones in English language. [2] Although LPR is a well-established cause for laryngeal manifestations in adults, it is a less known among singers. At present, LPR in professional singers is still associated with recurrent clinical symptoms and poor quality of voice which has a significant cost for the professional excellence. In this review article, we will discuss the impact of LPR singers including etiopathology, clinical presentations, diagnosis, treatment, and lifestyle modifications.

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Fish bone as foreign body in throat is very common in otorhinolaryngology practice. But a live fish in oropharynx is very rare. Small fishes, if ingested, can cross the oral cavity and migrate to esophagus, nasopharynx, or airway, but large fishes get impacted in the oropharynx. Most of these cases are life-threatening and require immediate intervention to save the patient.Sometimes, tracheostomy is required to establish the airway and to remove the fish. We are reporting a case of live climbing perch (Anabas testudineus) which was successfully removed from the oropharynx of a 30-year-old male without tracheostomy. We will mainly discuss the proper technique to remove live foreign bodies without causing any complications.

Glomus tumors are benign, slow-growing tumors of the temporal bone and most commonly present as hearing loss and tinnitus with an intact tympanic membrane. Most of the time, the diagnosis is delayed and sometimes missed as it is associated with chronic suppurative otitis media (CSOM). History of the disease and proper clinical examination followed by radiological investigations are required for diagnosis and management. Surgery is the treatment of choice, but larger tumors may require other modalities of treatment. Histopathology with immunohistochemistry confirms the diagnosis. We report a case of 63-year-old female patient with glomus tympanicum associated with CSOM. She had symptoms for the last 10 years, but the diagnosis was missed because of coexisting CSOM. She was diagnosed with the help of radiological investigative modalities. She underwent mastoidectomy with complete excision of tumor. She was managed successfully without recurrence. Glomus tumor is an uncommon disease in the middle ear, and sometimes, its diagnosis is missed because of the presence of other diseases. Radiology helps in diagnosis and management of the tumor. Complete surgical excision with regular follow-up prevents recurrence.

Bilateral choanal atresia is an uncommon congenital malfor mation and its association with duodenal atresia and lagophthalmos is very rare. It is a lifethreatening condition where immediate intervention is always needed. A systemic examination is required to find its association with other anomalies. Though different approaches for its treatment are described endoscopic transnasal approach is the most acceptable less traumatic approach till date. We are having a case report of a premature baby with choanal and duodenal atresia with lagophthalmos and was managed successfully with endoscopic transnasal approach. How to cite this article Gupta S, Pradhan S. Congenital Bilateral Choanal Atresia with Duodenal Atresia and Lagophthalmos. Int J Otorhinolaryngol Clin 2014;6(3):137139.