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Biomedical subjects

A E Aronson

Publications and source records attributed to A E Aronson.

At least 37 records · Page 2Linked to original sources
PubMed1983

Psychogenic aphonia masking mutational falsetto.

Aphonia, originally due to laryngeal inflammation, became psychogenic and superimposed on the unstable pitch of adolescent voice change. We presumed that the aphonia was adopted as a means of dealing with peer pressure to maintain a high preadolescent pitch as well. Voice therapy was effective in alleviating both the aphonia and mutational falsetto. Clinicians should be alert to underlying mutational falsetto when confronted with an aphonic or dysphonic adolescent patient with no organic laryngeal pathologic condition.

Adolescent↗
PubMed1983

Adductor spastic dysphonia: three years after recurrent laryngeal nerve resection.

The voices of 33 patients, ages 44 to 79 years, were assessed after recurrent laryngeal nerve resection for adductor spastic dysphonia. Voice improvement was noted in all patients 24 hours after surgery: in 97% at 1 month, 97% at 6 months, 82% at 1 year, 70% at 1 1/2 years, 58% at 2 years, 52% at 2 1/2 years, and 36% at 3 years. Of the 64% with failed voices by 3 years, 48% were worse than before surgery. Of the 36% whose voices remained improved, 58% were worse than at any previous period and 42% were better. Failures among women (77%) were considerably higher than among men (36%). Except for one patient, none of the patients with improvement achieved a normal voice. Patients with improvement had varied types and degrees of dysphonia: breathiness, hoarseness, diplophonia, and falsetto pitch breaks. The voices of some patients approached normalcy. A high percent of patients had voice tremor and regular voice arrests on vowel prolongation, signaling that the spastic dysphonia may have been related to essential (voice) tremor and that the spastic dysphonia returned because of increased severity of the neurologic tremor. We conclude that recurrent laryngeal nerve surgery for adductor spastic dysphonia has long-term limitations and that the differential diagnosis between neurologic and psychogenic types is imperative prior to therapeutic decision making.

Adult↗
PubMed1982

Diadochokinetic syllable rate and regularity in normal and in spastic and ataxic dysarthric subjects.

Rate and regularity of diadochokinetic syllable repetitions of /p/, /t/, and /k/ in 30 normal subjects, 30 subjects with spastic dysarthria, and 30 subjects with ataxic dysarthria were measured by computer. Normal subjects had rates (syllables per second) of 6.4, 6.1, and 5.7; spastic dysarthric subjects, 4.6, 4.2, and 3.5; and ataxic dysarthric subjects, 3.8, 3.9, and 3.4 for /p/, /t/, and /k/, respectively. Spastic and ataxic subjects were significantly slower and more variable than normal subjects and ataxic subjects were significantly more variable than spastic subjects. The significantly slower than normal rate of repetition in the ataxic subjects and the significantly more variable than normal rhythm of repetition in the spastic subjects were unexpected findings and are in contrast with results from perceptually based investigations of dysarthria. The study demonstrates that slowness of syllable repetition is not restricted to spastic dysarthria and that dysrhythmia of syllable repetition is not restricted to ataxic dysarthria, thus suggesting the need for additional quantitative measurements of acoustic features on which certain notions about the dysarthrias are currently based.

Aged↗
PubMed1982

Superior laryngeal neuralgia: carotidynia or just another pain in the neck?

A clinical pain syndrome similar to "carotidynia" developed in a patient several years after undergoing carotid endarterectomy. The pain was reversed by superior laryngeal nerve block, followed by superior larnygeal neurectomy. A diagnosis of superior laryngeal neuralgia was suggested by several characteristic features: (1) pain along the anterior cervical triangle, with extension to the ipsilateral ear and eye, (2) hoarseness, and (3) paralysis of the ipsilateral cricothyroid muscle on laryngoscopy. Carotidynia usually refers to neck pain arising from the carotid artery in the neck and is often viewed as a migraine variant. Our observations suggest that carotidynia may not be a migraine variant and that "carotidynia" may not be an accurate term for all pains in the anterior cervical triangle. We suggest that evaluation of neck pain include speech pathology and otolaryngologic consultations (including laryngoscopy) if any voice disorder is reported or noted. Since the superior laryngeal nerve is the neural structure most contiguous to the bifurcation of the carotid artery, the superior laryngeal nerve may have become entrapped in a fibrotic process that developed after carotid endarterectomy. Such pain may be a rare complication of carotid endarterectomy. When other causes have been excluded and pain continues, a superior laryngeal nerve block should be considered.

Carotid Arteries↗
PubMed1982

Respiratory distress after recurrent laryngeal nerve sectioning for adductor spastic dysphonia.

Adductor spastic dysphonia is a voice sign associated with various neurologic and psychologic disorders. Treatment of spastic dysphonia in selected patients is unilateral recurrent laryngeal nerve sectioning. Except for voice change or, in some patients, return of phonatory spasticity, there have been no long-term sequelae or complications of this treatment. We describe three patients with adductor spastic dysphonia who underwent recurrent laryngeal nerve sectioning and who, 3 to 38 months later, suffered respiratory distress that required tracheostomy. The respiratory distress in all three patients was due to episodic jerky vocal cord hyperadductions that caused stridor during inspiration and expiration. These repetitive laryngospasms during respiration and phonation were progressive. Two patients needed an arytenoidectomy to achieve a useful voice, and all three required a permanent tracheostomy to alleviate inspiratory laryngeal obstruction.

Aged↗
PubMed1981

Adductor spastic dysphonia as a sign of essential (voice) tremor.

Adductor spastic dysphonia may not be one disorder but a voice sign of several different neurologic and psychiatric syndromes. This study evaluates whether rhythmic voice arrests, often components of "spastic dysphonia," are signs of essential tremor, a neurologic disorder. Data on 22 patients originally diagnosed as having spastic dysphonia, who had tremor-like or rhythmic voice arrests, were compared with data on two groups of patients who had essential (voice) tremor. The frequency of voice arrest on vowel prolongation in the group labeled spastic dysphonia was compared with the frequency of voice tremor in the groups with essential tremor. The median frequencies of 5.7, 5.0, and 5.5 Hz were not significantly different among the three groups. Patients in all three groups had tremor in other parts of the body, other scattered neurologic signs, and histories of life stress associated with the onset of their voice disorders. Although the results do not prove conclusively that the patients diagnosed as having spastic dysphonia in this study actually had essential tremor, the similarities to that disorder strongly suggest a linkage.

Adult↗
PubMed1981

Clinical investigations of intermittent breathy dysphonia.

Case history and voice data for 17 patients who presented with intermittent moments of breathy dysphonia (IBD) in contextual speech were analyzed. From recorded samples of vowel prolongation four variants of phonation were identified. Of 13 patients examined neurologically, 10 (77%) had positive neurologic signs. Psychiatric and physical illnesses were often associated with onset of the voice disorder. Sex ratio of the patients in this study was nearly the same as that for adductor spastic dysphonia. Age at onset was similar to that which has been described for "functional" voice disorders. Different therapies were generally ineffective in alleviating the disorder. Although not conclusive, patients presenting with IBD in connected speech may have an underlying neurologic or psychologic disorders.

Adolescent↗
PubMed1980

Summated potentials evoked by speech sounds for determining cerebral dominance for language.

Ten normal adult right-handed subjects receive phonemic combinations (/epik/, /epak/, /a/, /pi/, /pa/) and pure tones (2500 and 8000 Hz) binaurally through matched earphones. Fifty responses from electrodes at P5, P6, C5, C6, F7 and F8 (referenced to linked mastoids) were summated, and evoked potentials from homologous areas were measured separately and superimposed in order to observe differences. Visual inspection of superimposed responses showed no consistent gross asymmetries that lateralized to either hemisphere. Comparison between amplitude of evoked potentials (N1, P2) at P5 and P6 were not significant (P < 0.05; paired t test). We suggest that our technique may not be a useful clinical test for cerebral dominance.

Adult↗
PubMed1980

Hemispheric potentials evoked by speech sounds during discrimination tasks.

We studied the feasibility of adapting the method of Wood et al. (1971) for determining cerebral dominance for language and did not obtain consistent asymmetries of evoked responses in the left hemisphere to stop consonant task (SCT) as compared with fundamental frequency task (FFT). Likewise, the right hemisphere-evoked potentials for SCT and FFT did not show consistent asymmetries. However, we did find that the evoked responses at T3 were attenuated as compared with those at T4, regardless of the task performed (FFT or SCT). These findings may be useful in developing a test for cerebral dominance for language.

Adult↗
PubMed1980

Tongue force in normals and in dysarthric patients with amyotrophic lateral sclerosis.

Tongue force, rate of syllable repetition, and judgments of articulatory defectiveness were measures obtained on 19 dysarthric adults with amyotrophic lateral sclerosis and on 125 normal adults. Anterior and lateral tongue forces were measured by means of a pressure transducer clasped between the teeth; the tongue forces were recorded on a pen-writing ECG apparatus. Audio-recorded syllable repetitions of /p lambda/, /t lambda/, and /k lambda/ also were transcribed on ECG paper and counted. Three listeners rated articulatory precision on a 7-point scale of severity. The normal males had significantly higher tongue forces than normal females; normal subjects had significantly higher tongue forces than dysarthric patients; and anterior tongue forces were significantly greater than lateral in normal and dysarthric patients. There was a high negative correlation between tongue force and severity of articulatory defect. Syllable repetitions were significantly slower in the dysarthric patients than in the normal patients, and a high negative correlation was obtained between syllabic rate and severity of articulatory defect.

Adult↗
PubMed1979

A comparison of EEG activity in the left and right cerebral hemispheres by power-spectrum analysis during language and non-language tasks.

In 10 female subjects, power-spectrum analysis was performed on the alpha activity elicted during the resting state, 4 right hemispheric tasks, and 3 left hemispheric tasks. The data were treated in 3 ways: approach 1, comparing the right and left hemispheric alpha activity; approach 2, comparing the right and left hemispheric alpha activity adjusted for the resting state; and approach 3, comparing the right and left hemispheric alpha activity adjusted for the previous task. Approaches 1 and 2 revealed few significant differences in the alpha activity of the hemispheres, but approach 3 provided data that better fit the theory of decreased power spectrum of attenuation of activity in the activated hemisphere. Thus, approach 3 may be useful in developing an electroencephalographic test for determining cerebral dominance for language.

Adult↗
PubMed1979

No morphometric abnormality recurrent laryngeal nerve in spastic dysphonia.

Spastic dysphonia is a disorder of phonation that is usually markedly improved by surgical resection of one recurrent laryngeal nerve (RLN). In this study, biopsies of the RLN were obtained at surgery from nine patients with spastic dysphonia (disease group) and eight patients with laryngeal cancer (control group). The RLN was found to be composed of several nerve regions having characteristic fiber compositions. For the various nerve regions and for the whole nerve, we evaluated morphology, median fiber diameter, density, and size distribution of fibers. The morphologies of teased fibers were also evaluated. We found no significant differences between the nerves of the disease and control groups. Therefore, we were unable to verify previous reports of neuropathic abnormality of the RLN in spastic dysphonia.

Adult↗
PubMed1977

Patterns of dysfunction in schizophrenic patients on an aphasia test battery.

Twenty-seven schizophrenic patients free of any known neurologic deficit were tested with an aphasia test battery. The objective of the research was to derive a profile of schizophrenic language performance to permit its comparison with the profiles characteristic of aphasia, apraxia of speech, generalized intellectual impairment, and confused language. Results indicate that schizophrenic patients exhibit a profile of language performance distinctive from those found in aphasia, apraxia of speech, confusion, or generalized intellectual impairment and demonstrate that the disruption of language in schizophrenia is not aphasic in nature.

Adult↗