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Biomedical subjects

L Crevier-Buchman

Publications and source records attributed to L Crevier-Buchman.

36 records · Page 2Linked to original sources
PubMed1998

Comparison and evolution of perceptual and acoustic characteristics of voice after supracricoid partial laryngectomy with cricohyoidoepiglottopexy.

The present prospective study, based on a series of 12 male patients managed with supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP), was designed i) to compare the perceptual and acoustic parameters before surgery and at 6 months after sugery, ii) to evaluate the evolution of the perceptual and acoustic parameters between 6 and 18 months postoperatively, and iii) to determine the correlations between the perceptual and acoustic parameters preoperatively and at 18 months postoperatively. The roughness was found to be significantly worsened after SCPL-CHEP. The jitter, shimmer, noise-to-harmonic ratio, and degree of voiceless increased significantly after SCPL-CHEP. Neither acoustic nor perceptual parameters varied significantly between 6 and 18 months postoperatively. Preoperatively, a strong statistical correlation was found between grade, roughness and strain and all acoustic parameters but F0. Breathiness was statistically correlated with all acoustic parameters but jitter. Postoperatively the only statistical correlation noted was between roughness and F0.

Carcinoma, Squamous Cell↗
PubMed1998

Speech and voice characteristics after near-total laryngectomy. A preliminary prospective study.

Selected characteristics were prospectively compared in the speech and voice of 10 patients managed with near-total laryngectomy. Tape-recorded speech samples were measured for durational features with a stopwatch. Acoustic features were analyzed with the Computerized Speech Lab and the Multidimensional Voice Program from Kay Elemetrics. Speech and voice parameters recorded preoperatively were compared with the parameters recorded postoperatively. Our data corroborate the prior reported good quality of the voice and speech after near-total laryngectomy.

Adult↗
PubMed1998

[Vertical partial laryngectomy with false vocal cord flap reconstruction: carcinologic and functional results].

Glottic reconstruction with false vocal cord flap was carried out to improve vocal function after vertical partial laryngectomy. This retrospective study reports carcinologic and functional results of 77 patients operated by vertical partial laryngectomy with or without glottic reconstruction. Five years actuarial survival rate and tumoral control rate were 79% and 90% respectively, without significant differences between patients with or without glottic reconstruction. Vocal study found that supraglottic structures were involved in neoglottic closure in 47% of the patients. Anterior commissure web was statistically reduced in patients with glottic reconstruction. The carcinologic results of this study allow for glottic reconstruction at the time of vertical partial laryngectomy. Neoglottic closure and postoperative anterior commissure web are factors which could influence final vocal results.

Aged↗
PubMed1998

[Intra-cord injection of autologous fatty tissue and recurrent unilateral paralysis].

A prospective analysis of intracordal autologous fat injection for inferior laryngeal nerve paralysis of various origins was conducted in a series of 20 patients with a minimum 6 month follow-up. Adverse side effects were a sub-cutaneous abdominal hematoma, and a pseudo intracordal cyst in 1 patient. Aspiration, noted in 11 patients, disappeared immediately after the injection of fat in 10 patients. Subjective evaluation and objective acoustic recordings documented improvement in voice quality at 6 months. Three patients had a secondary reinjection of fat resulting in an overall 100% success rate. Such preliminary data, together with the review of the literature suggests, that intracordal autologous fat injection is a highly valuable treatment option in patients with unilateral inferior nerve paralysis.

Abdomen↗
PubMed1997

Supracricoid hemilaryngopharyngectomy conversion to Pearson's near-total laryngectomy: a case report.

BACKGROUND: Pearson's near-total laryngectomy was initially advocated in patients with extended glottic carcinoma and hypopharyngeal carcinoma. More recently, the utility of near-total laryngectomy for supraglottic pharyngeal, base of tongue, and other cancers such as thyroid cancer with anterior tracheal wall invasion has also been reported. METHODS: The purpose of this case report was to demonstrate the feasibility of this procedure in the setting of severe aspiration after supracricoid hemilaryngopharyngectomy. RESULTS: The first case of successful conversion from supracricoid hemilaryngopharyngectomy to Pearson's near-total laryngectomy in a patient with severe and recurrent aspiration is presented. CONCLUSIONS: This case report suggests that when partial laryngopharyngectomy results in severe and recurrent aspiration, rather than having to convert the patient to a total laryngectomy with tracheoesophageal puncture, a near-total laryngectomy is a reasonable option with acceptable functional results.

Carcinoma, Squamous Cell↗
PubMed1997

Adductor spasmodic dysphonia: case reports with acoustic analysis following botulinum toxin injection and acupuncture.

We analyzed frequency and duration parameters of voice and speech in two men with adductor spasmodic dysphonia (SD). One was treated with botulinum toxin injection; the other received acupuncture therapy. Improvement after acupuncture therapy in terms of standard deviation of fundamental frequency, acoustic perturbation measurements, durational measurements of voice and speech, and spectrographic analysis was comparable to the results achieved with botulinum toxin injection. Voice and speech parameters were stable 1 year after acupuncture therapy.

Acupuncture Therapy↗
PubMed1997

In situ lifetime, causes for replacement, and complications of the Provox voice prosthesis.

One hundred Provox voice prostheses consecutively inserted in 37 patients and replaced only when phonation was impaired or complications noted were analyzed for in situ lifetime, causes for replacement, and complications. The mean in situ lifetime was 311 days. Actuarial analysis (Kaplan-Meier method) of the in situ lifetime revealed that 65.9%, 23.7%, and 16.4% of the voice prosthesis were still in situ by the 6th, 12th, and 18th postinsertion month. Cause for replacement was salivary leakage through the prosthesis valve, salivary leakage around the prosthesis, deterioration of the prosthesis, and excessive crusting resulting in increased airflow resistance in 33%, 27%, 24%, and 16% of cases, respectively. Complications included granulation tissue formation, cervical cellulitis, necrosis of the tracheoesophageal puncture, tracheostomal stenosis, and swallowing impairment in six, two, one, three, and one patient, respectively.

Actuarial Analysis↗
PubMed1996

[Contribution and limits of acoustic analysis of the voice and alaryngeal speech with a computerized system].

Through a review of published acoustical analyses of alaryngeal voice and speech, our aim was to establish the interest and the limitations of a computerized acoustical system. One case of esophageal voice and one case of tracheoesophageal voice were analysed with the Kay Elemetrics Multidimensional Voice Program for voice and Computerised Speech Lab for speech. All the acoustical parameters are altered in alaryngeal voice. The automatic calculation of frequential parameters are promising but there are errors due to the importance of altered voicing. Speech analysis is an important complement to evaluate the phonatory behavior of laryngectomized patients.

Computer Systems↗
PubMed1996

Differentiated perceptual evaluation of pathological voice quality: reliability and correlations with acoustic measurements.

The perceptual GRBAS scale for deviant voice quality (completed with a "I" parameter: Instability = fluctuation of voice quality over time) was tested in 5 different institutes on 943 voice patients. Each voice was evaluated separately by 2 professionals. The interrater correlation reaches 0.87 for G (grade), 0.70 for R (roughness), 0.69 for B (breathiness) and 0.65 for A/S (asthenicity/strain). Experience with the scale significantly improves the interrater agreement. The intrarater correlation (80 voices; time interval 2-6 months) is systematically slightly stronger than the interrater correlation. Further, GIRBAS/acoustical correlations were investigated on 80 pathological voices, by using the Multidimensional Voice Program (MDVP) of Kay. Principal component analysis allows reduction of 21 MDVP parameters to 5 clinically relevant aspects, with a typical acoustical measurement for each of them. The strongest correlations are found between G and Shimmer/Noise to harmonics ratio, R and Jitter, and B and Shimmer. As tremor and diplophonia are easily identified perceptually and acoustically, it seems useful to add this information respectively to AS and R. The GIRBAS scale seems to be a valuable instrument for clinical practice.

Humans↗
PubMed1996

[Laryngectomies and pharyngo-laryngectomies with tracheo-laryngo-pharyngeal shunt of Pearson type. Technique, indications and preliminary results].

The preliminary results achieved in a series of 10 patients consecutively managed at our department with Pearson's subtotal pharyngolaryngectomy, during the year 1995, are presented. The surgical procedure is described. Follow up varied from 6 to 13 months. None of the patients were lost to follow-up. None of the patients recurred locally or died from surgical-related complications. Nine patients achieved successful rehabilitation of speech and voice. One patient refused to use a functional shunt. Speech and voice parameters achieved by the third postoperative month are presented. Postoperative swallowing impairment was not encountered. The preliminary data achieved and the review of the medical literature suggested that Pearson's subtotal pharyngolaryngectomy should be discussed in patients conventionally managed with total laryngectomy or pharyngolaryngectomy and tracheosophageal puncture with voice prosthesis insertion.

Adult↗
PubMed1995

Evolution of speech and voice following supracricoid partial laryngectomy.

The evolution of voice and speech parameters following supracricoid partial laryngectomy (SCPL) has been evaluated in a prospective fashion over an 18-month period of time in three patients using the Computerized Speech Lab (from Kay Elemetrics). Preliminary results demonstrate the post-operative instability of voice parameters. Speech parameters remain stable with time. Our data stresses that voice is attained post-operatively even if one arytenoid cartilage is disarticulated at time of resection.

Aged↗
PubMed1995

Acoustic parameters and speech analysis after supracricoid hemilaryngopharyngectomy.

Selected characteristics of speech and voice were compared in 10 patients who had undergone supracricoid hemilaryngopharyngectomy (SCHLP) and 20 normal adult laryngeal (NAL) speakers. Durational features of tape-recorded speech samples were measured using a stopwatch. Frequency features were analyzed with the Computerized Speech Lab and the multidimensional voice program. SCHLP speech proved comparable to NAL speech in average fundamental frequency, speech rate, and group phrasing. SCHLP speech and voice were statistically less efficient than NAL speech in fundamental frequency range, jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time. Age, associated cricopharyngeal myotomy, postoperative radiation therapy, and time elapsed from SCHLP completion were not statistically related to the speech and voice parameters of SCHLP speakers.

Adult↗
PubMed1994

[Computerized evaluation of acoustic parameters of voice and speech after partial supracricoid laryngectomy with cricohyoidoepiglottopexy].

Nineteen supracricoid porticol laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) speakers and 19 normal adult laryngeal (NAL) male speakers took part in this prospective study. Computed analysis of the voice and speech parameters was performed using the Computed Speech Lab from Kay Elemectrics. Parameters recorded for voice analysis were the average fundamental frequency, the fundamental frequency standard deviation, the jitter, the shimmer, the noise to harmonic ratio and the degree of voiceless. Parameters recorded for speech analysis were the maximum phonation time of the /a/ vowel, the phrase grouping and number of words read per minute. Speech and voice parameters statistically differed among NAL and SCPL with CHEP speakers. Among SCPL with CHEP speakers, none of the following factors (age, cricopharyngeal myotomy, piriform sinus tension, associated ipsilateral neck dissection, speech rehabilitation therapy) were statistically related to the frequential and durational variables. Jitter of SCPL with CHEP speakers was reduced as time elapsed from CHEP completion increased (p = .002). Maximum phonation time was reduced if one arytenoid cartilage was resected (p = 0.025).

Adult↗
PubMed1993

[Classification of dysphonia. Vocal dysfunction].

A review of functional dysphonia is presented, pointing out the frequent association with organic dysphonia as a releasing or an aggravating factor. Each pathology is described with its psychopathological and histological features, its clinical and psychophysiological symptoms and its treatment, most of the time based on voice therapy.

Cysts↗
PubMed1993

[Acoustic evaluation and use of computers].

Thanks to the measurements of the acoustical parameters of voice and speech, an objective semeiology can be set up to assess a diagnosis and, to a certain extent, a prognosis and the follow up after therapy. A computerized analysis is a good complement to the clinical evaluation. It gives quantitative values, with statistics and the means to compare patients to themselves and to other patients. After defining the parameters we are interested in, we review the different softwares at our disposal with their limits.

Diagnosis, Computer-Assisted↗
PubMed1993

[Laryngostroboscopy].

Videostroboscopy has become an essential examination for the assessment of vocal function. The authors describe and review the development of this technique with an analysis and discussion of its indications and results.

Fiber Optic Technology↗
PubMed1991

[Comparative study of temporal parameters of alaryngeal voices. Esophageal and tracheo-esophageal voices].

Recent studies have established significant acoustic and phonetic differences between tracheo-oesophageal (TE) and conventional esophageal voices (EV). 12 alaryngeal voices (2 esophageal, 6 myomucosal shunts, 4 tracheoesophageal phonatory protheses), and 7 normal laryngeal voices were recorded and analyzed. Speech timing including voicing and pauses distribution was evaluated and compared to laryngeal voices. Speakers with TE voices using pulmonary air were able to preserve the rythm and the syntactico-semantic structure of their speeches, as opposed to speakers with EV who often had to insufflate air into the esophagus and therefore had a staccato-like speech. The phonation time was quite similar in both situations, but the length and the number of pauses made the difference.

Aged↗