Chaitanya Gadepalli

• MS(ENT) MD (Voice), FRCS (ORL-HNS)
• Consultant at Salford Royal NHS Foundation Trust

Granulomatosis polyangiitis (GPA) is an autoimmune condition causing inflammation of small blood vessels. It is a rare disorder that may affect various parts of the body. The diagnosis is often based on clinical examination, laboratory investigations and tissue biopsy. In about 10–20% of patients, the anti-neutrophilic cytoplasmic antibody (ANCA) c...

Background: Mucopolysaccharidoses (MPSs) are rare congenital lysosomal storage disorders due to a deficiency of enzymes metabolising glycosaminoglycans, leading to their accumulation in tissues. This multisystem disease often requires surgical intervention, including valvular cardiac surgery. Adult MPSs have complex airways making anaesthesia risky...

Mucopolysaccharidoses (MPS) are rare lysosomal storage diseases characterized by multiorgan involvement and shortened longevity. Due to advances in therapies such as enzyme replacement therapy and haematopoietic stem cell therapy, life expectancy has increased posing newer challenges to patients and health professionals. One such challenge is cardi...

Mucopolysaccharidoses (MPS) are a heterogeneous group of disorders that results in the absence or deficiency of lysosomal enzymes, leading to an inappropriate storage of glycosaminoglycans (GAGs) in various tissues of the body such as bones, cartilage, heart valves, arteries, upper airways, cornea, teeth, liver and nervous system. Clinical manifest...

Background: Mucopolysaccharidosis (MPS) is a rare congenital lysosomal storage disorder with complex airways. High anterior larynx is assessed by thyromental distance (TMD) nasendoscopy. A simpler method to assess this hyoid bone is described. The distance between the central-hyoid and symphysis of the mandible (hyo-mental distance; HMD) and incli...

Abstract Purpose: This paper addresses the application of digital signal processing (DSP) techniques to the robust measurement of acoustical features of the human voice. It then addresses the use of regression based techniques for the estimation of grade, roughness, breathiness, asthenia and strain, from these acoustical features. These five proper...

(1) Background: Mucopolysaccharidoses (MPS) are a heterogeneous group of lysosomal storage disorders caused by the absence of enzymes required for degradation of glycosaminoglycans (GAGs). GAGs deposition in tissues leads to progressive airway narrowing and/or tortuosity. Increased longevity of patients has posed newer problems, especially the airw...

ENT specialist and Mucopolysaccharidosis

Relapsing polychondritis can involve the respiratory tract; prompt intervention prevents mortality and improves quality of life.

Accepted as abstract, conference postponed due to current health situation in the World Introduction: Mucopolysaccharidosis (MPS) is a diverse group of rare (incidence 1: 25 000 new-born) congenital lysosomal storage disorders caused by deficiency of enzymes metabolising glycosaminoglycans (GAGs) leading to their accumulation in various tissues. A...

Balloon dilatation for laryngotracheal stenosis: Our experience

Objective: To characterise the burden of voice disorders in teachers in a UK population, compare it with non-teachers; and identify groups of teachers who may be particularly at risk of developing a voice problem. Design: Questionnaire based survey of primary, secondary teachers and non-teachers. Questions consisted of general demographics, VHI-...

Voice problems are routinely assessed in hospital voice clinics by speech and language therapists (SLTs) who are highly skilled in making audio-perceptual evaluations of voice quality. The evaluations are often presented numerically in the form of five-dimensional ‘GRBAS’ scores. Computerised voice quality assessment may be carried out using digita...

Chance corrected agreement coefficients such as the Cohen and Fleiss Kappas are commonly used for the measurement of consistency in the decisions made by clinical observers or raters. However, the way that they estimate the probability of agreement (Pe) or cost of disagreement (De) 'by chance' has been strongly questioned, and alternatives have bee...

Measurement of consistency in the decisions made by observers or raters is an important problem in clinical medicine. Chance corrected agreement coefficients such as the Cohen and Fleiss Kappas are commonly used for this purpose, though the way that they estimate the probability of agreement 'by chance' has been strongly questioned. Alternatives ha...

This paper is about the assessment of voice quality as required routinely in hospital voice clinics. It describes a computer application capable of analysing recordings of a patient’s voice and producing quantitative assessments of its quality, simulating those traditionally made by trained speech and language therapists (SLT). Voice samples were r...

The assessment of consistency in the categorical or ordinal decisions made by observers or raters is an important problem especially in the medical field. The Fleiss Kappa, Cohen Kappa and Intra-class Correlation (ICC), as commonly used for this purpose, are compared and a generalised approach to these measurements is presented. Differences between...

The assessment of consistency in the categorical or ordinal decisions made by observers or raters is an important problem especially in the medical field. The Fleiss Kappa, Cohen Kappa and Intra-class Correlation (ICC), as commonly used for this purpose, are compared and a generalised approach to these measurements is presented. Differences between...

This paper concerns the assessment of voice quality as required for patients who attend a hospital voice clinic. Clinicians currently make assessments subjectively according to a well known 'GRBAS' scale. Our aim is to use machine learning (ML) to make computerised GRBAS assessments from measurements of features extracted and parameterised using di...

Audit cycle of head and neck fine needle aspiration cytology service over a three-year period T he College's Clinical Effectiveness department wishes to encourage high-quality clinical audit. We therefore periodically publish interesting examples of audits that have been successfully evaluated through our clinical audit certification scheme. Backgr...

The assessment of consistency in the categorical or ordinal decisions made by observers or raters is an important problem especially in the medical field. The Fleiss Kappa, Cohen Kappa and Intra-class Correlation (ICC), as commonly used for this purpose, are compared and a generalised approach to these measurements is presented. Differences between...

Voice pathology: Assessment of Voice and Analysis of the Disease Burden, Chaitanya Gadepalli, Doctor of Medicine (MD), The University of Manchester.2016 Aims: The global aim of this project is to investigate what we can learn from existing and new voice quality assessment techniques. The objectives are as follows: 1) To investigate problems arising...

Voice quality assessment is required by healthcare professionals in patients suffering from voice problems. Speech and language therapists (SLTs) use a well-known subjective assessment approach which is called GRBAS, to quantify voice problems. GRBAS is an acronym for a five dimensional scale of measurements of voice properties which were originall...

The GRBAS scale is a widely used subjective measure of voice quality. The aim of this paper is to investigate the correlation between the 'grade', 'roughness', 'breathiness', 'asthenia' and 'strain' dimensions of this scale and the objective measurements provided by the 'Analysis of Dysphonia in speech and Voice' (ADSV) software package. To do this...

To compare the key functional results (regarding swallowing and voice rehabilitation) in patients treated by pharyngo-laryngectomy with flap reconstruction, versus standard, wide-field, total laryngectomy. We studied 97 patients who had undergone total laryngectomy and pharyngo-laryngectomy with flap reconstruction. The main outcome measures were s...

Dacryoliths are concretions formed in the lacrimal sac from cellular debris and proteins, which may calcify and cause further obstruction of the nasolacrimal pathway. Dacryoliths are often underlying contributors in cases of intermittent or chronic dacryocystitis (i.e. nasolacrimal sac inflammation, characterised by epiphora, pain, erythema, sac di...

Cervicofacial necrotising fasciitis (CNF) is a potentially fatal infection which can occasionally present in the head and neck. An early diagnosis and aggressive treatment is imperative for minimising the associated mortality and morbidity. The early clinical features are usually non-specific which makes it difficult to differentiate it from other...

We report a case of anterior spinal artery syndrome, an extremely rare complication, following head and neck surgery. A case report and literature review concerning anterior spinal artery syndrome is presented. A 64-year-old man developed an anterior spinal artery infarction following total laryngectomy and bilateral neck dissections for post-radio...

The nasopharyngeal airway is a simple airway adjunct used by various healthcare professionals. It is the least invasive method of safely managing upper airway obstruction. The objective of this report was to describe a rapid and very simple method of securing a nasopharyngeal airway in an agitated patient. We describe a simple method of securing a...

We present a case of a 43-year-old man who attended the ENT clinic complaining of bilateral hearing loss. He had multiple bony swellings in both ear canals that mimicked exostoses. An audiogram showed bilateral symmetrical mixed hearing loss. Excision was carried out to facilitate the use of a hearing aid. Intraoperatively, the swellings were confl...