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Questions and Answers
What effects may not be associated with the use of certain drugs in individuals with capillary ectasia?
Which behavioral change is emphasized for patients with capillary ectasia regarding voice use?
What is a pivotal factor in the management of patients with both acid reflux and capillary ectasia?
Which procedure is described as an excellent option for patients not accepting vocal limitations after other treatments?
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What is true regarding the visible dilated capillaries post-surgery?
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What is one of the potential consequences of capillary ectasia in vocal performers?
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Which group is identified as most commonly affected by capillary ectasia?
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What characterizes the laryngeal examination findings for capillary ectasia?
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Which symptom is NOT commonly associated with capillary ectasia?
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In what context is capillary ectasia primarily diagnosed?
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What should be avoided in patients with capillary ectasia if medically appropriate?
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Which of the following could be a result of recent mucosal hemorrhage in patients with capillary ectasia?
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What is one possible appearance of capillary ectasia when observed visually?
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Study Notes
Capillary Ectasia Epidemiology
- Occurs most often in individuals who overuse their voice
- More prevalent in women, suggesting a possible estrogen connection
- May be a pre-existing condition prior to vocal fold hemorrhage
Capillary Ectasia Pathophysiology and Pathology
- Repeated microtrauma from vocal use can lead to capillary angiogenesis
- Dilated capillaries increase vulnerability to additional trauma, creating a vicious cycle
- Mucosal swelling is often larger on the side with increased capillary ectasia
- Can predispose to increased mucosal swelling (reduced vocal endurance), vocal fold hemorrhage, and hemorrhagic polyp formation
Capillary Ectasia Diagnosis
- Typically diagnosed in female singers with hoarseness after short periods of singing
- Associated with mucosal swelling, delayed phonatory onset, loss of high vocal range, and increased vocal effort
- May be observed after a vocal fold hemorrhage, even after bruising resolves
- Without mucosal swelling, voice capabilities may be normal
- With swelling, vocal limitations resemble those seen in vocal nodules
- Recent mucosal hemorrhage can cause severe hoarseness in both speech and singing
Capillary Ectasia Laryngeal Examination
- Characterized by dilated capillaries extending from anterior to posterior
- Clusters of dilated capillaries may also be seen
- Dilated capillaries may originate from Reinke's space and extend to the surface then back into the submucosa
- Some dilated capillaries merge and become large, resembling chronic hemorrhage, referred to as capillary lake
Capillary Ectasia Management
- Discontinue anticoagulant medication, like aspirin and NSAIDs
- Manage acid reflux, as it can exacerbate mucosal issues
- Implement behavioral changes similar to those for vocal nodules
- Encourage reduction in excessive vocal use and avoid explosive vocal techniques
- Limit voice use to three 20-minute sessions per day instead of one 1-hour session
- Consider laryngeal microsurgery if medical and behavioral management fails
- Dilated capillaries are spot-coagulated to halt blood flow
- Even after treatment, visible dilations may spontaneously disappear within weeks
- Managing dilated capillaries often resolves accompanying mucosal edema
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Description
Explore the epidemiology, pathophysiology, and diagnosis of capillary ectasia, particularly in individuals who use their voices extensively. This quiz delves into the impact of estrogen and the consequences of vocal trauma. Understand how these factors contribute to vocal issues, especially in female singers.
