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At least 199 records · Page 11Linked to original sources
PubMed1995

Laryngograph: speech pattern element tools for therapy, training and assessment.

The clinically based, real-time analysis of speech into physically definable elements, which are of direct perceptual and productive importance, has become more readily possible in recent years as the result of microprocessor developments. The combination of the acoustic signal of speech derived from a microphone together with the accompanying Laryngograph signal provides the basis for a highly reliable set of facilities. The paper describes methods and results for the analysis of voice, frication and timbre for both quantitative analysis and teaching and therapy using interactive visual displays. A brief discussion is given of links to work in stroboscopy, electropalatography and the associated use of additional sensors. Finally reference is made to a complete clinical work station combining these different facilities together with the quantitative analytical procedures of the speech pattern audiometer.

Humans↗
PubMed1995

Quality analysis of laryngography in a busy hospital ENT voice clinic.

The Portable Laryngograph provides a non-acoustic plot of wet mucosal contact at the glottis over the vocal fold vibrational cycle called the Lx waveform in Laryngograph terminology. Although well-equipped clinics gain most ENT requirements for investigation from the video endoscope, the nature of stroboscopy prevents the investigation over single glottal periods and many transitory problems may be missed. A high-quality Lx signal waveform will reflect any irregularities in mucosal contact and substantially complements the endoscopy examination. Yield, however, is a problem in the environment of an ENT hospital voice clinic. In this topic paper the criterion of maximum acceptable normalised noise energy (NNE) = -15 dB is used to assess the quality of 61 Laryngograph measurements. By this criterion a pass rate of 78% was achieved. This is considered to be good within an ENT voice clinic population where voice problems are in fact the dominant reason for referral.

Diagnosis, Computer-Assisted↗
PubMed1998

[Analysis of pathological vocal fold vibrations using high-speed digital imaging].

There have been various methods devised to monitor vocal fold vibration. Stroboscopy provides clinically-celevant information concerning pathology of the vocal folds. However, slow motion observation is based on the regularity of the vibration, and this ignores the role of irregularity of the vocal fold vibration in pathological cases. In order to know more about the nature of the vocal fold vibratory pattern, it is essential to monitor the vibration on a cycle by cycle basis. We analysed vocal fold vibrations of 22 pathological larynges using a computer-assisted high-speed digital imaging technique. Observed items included symmetry, regularity, phase difference, glottal closure, amplitude, mucosal wave and periodicity difference. Vibratory patterns were classified by location of lesion, severity of disease, expiratory pressure and laryngeal modulation. Analyses of pathological vocal fold vibrations using high-speed digital imaging techniques are providing the theoretical support for voice therapy and elucidating the causes of hoarseness.

Adolescent↗
PubMed1994

[Pliability of vocal fold mucosa in relation to the location of subglottic mucosal upheaval during phonation].

Mucosal pliability was measured in 23 excised larynges, 19 canine and four human, at the three portions of the vocal fold, namely the midline, the anterior 1/4 and the posterior 1/4. The pliability at the midline showed a greater value than those at the other two portions. The free edge of the vocal fold showed a maximum pliability which gradually diminished toward the tracheal side and reached a minimum 3mm from the free edge of the fold. An increase in vocal fold tension resulted in lowering of mucosal pliability at all measured points and the point of minimal pliability shifted toward the oral side. The point of minimal pliability moved toward the tracheal side with direct electrical stimulation of the thyroarytenoid muscle (TA). Both pliability measurement and observation of mucosal vibration from the tracheal side using high speed cinematography or stroboscopy were performed on eleven of the excised canine larynges. The mucosal upheaval occurred at the point around which pliability was minimal. An increase in vocal fold tension resulted in an upward shift of the mucosal upheaval which occurred slightly below the point of minimal pliability. Electric stimulation of the TA resulted in a downward shift of the mucosal upheaval which occurred in accordance with the point of minimal pliability. Histological examination of the canine larynges revealed that the lamina propria became increasingly thin toward the point around which pliability was minimal and at which the mucosal upheaval occurred. At this point, the muscle layer approximated the epithelial layer with disappearance of the deep layer of the lamina propria. The point shifted to the oral side following an increment in vocal fold tension, while the point moved toward the tracheal side following contraction of the TA. Pliability of the vocal fold is minimal at the point around which the deep layer of the lamina propria disappears and the mucosal upheaval occurs.

Animals↗
PubMed1999

[Selected issues of health certification among teachers].

The authors propose a standardized model of phoniatric consultations aimed at certifying occupational diseases of the organ of voice. The study included the administration of an expanded questionnaire, laryngological and phoniatric examinations, stroboscopy and determination of the voice acoustic parameters essential in assessing the phonatory function of the larynx. A four-scale hoarness by Yanagihara was employed in the consulting examination and the measurement was taken for three vowels. The model presented should facilitate the diagnosis of occupational diseases of the voice organ.

Adult↗
PubMed2000

[Voice disorders in children with gastroesophageal reflux disease].

The study concerns 11 patients with gastroesophageal disease confirmed by pH-metric examination of esophagus. The clinical assessment included lupolaryngoscopy, stroboscopy and acoustic analysis of voice. Basing on the tests there were confirmed inflammatory lesions at the posterior part of larynx (laryngitis posterior) as well as pathological changes of voice acoustic tests.

Adolescent↗
PubMed2001

["Bamboo nodes": a clinical study of 19 cases].

This is an account of 19 cases undergoing surgery for submucosal deposits on the cords of a particular type, 8 of the 19 cases having an auto-immune disorder. The nineteen patients were operated and followed up between December 1986 and December 2001, the main symptom being dysphonia. Stroboscopy demonstrated a yellowish appearance, often transverse, of the middle third of the cord, giving the characteristic appearance of a bamboo node. Suspension microlayngoscopy was performed in all cases. Cordotomy was invariably required. Examination of the case notes of these patients has shown either a pre-existing auto-immune disorder or the development of suggestive pointers in 8 of these female patients. Histological examination necessarily demonstrates the common characteristics of these deposits, and may be able to show features which have predictive value in the absence of known auto-immune pathology.

Adult↗
PubMed2002

[Laryngeal reinnervation for unilateral recurrent laryngeal nerve injuries caused by thyroid surgery].

OBJECTIVE: To explore the protocols and effects of laryngeal reinnervation for unilateral recurrent laryngeal nerve (RLN) injury caused by thyroid surgery. METHODS: Different protocols of laryngeal reinnervation were performed upon 29 patients with unilateral recurrent laryngeal nerve injury caused by thyroid surgery, just coming on to with a course of 2 years, including nerve decompression upon 8 cases, end to end anastomosis of recurrent laryngeal nerve upon 6 cases, and anastomosis of main branch of ansa cervicalis to recurrent laryngeal nerve upon 15 cases. All were been subjected to preoperative and postoperative voice recording, acoustic analysis, videolaryngoscopy, stroboscopy and electromyography. RESULTS: Nerve decompression had restored the normal functional adductory and abductory motion of the vocal cord in 5 patients with a course of less than four months. Although functional motion of vocal cord had not been recovered in three patients who received nerve decompression, 2 being with a course of longer than 4 months and one with a course of less than 4 months, and in all cases who received ansa cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures resulted in medialization of vocal cords except in two cases, one receiving ansa cervicalis anastomosis, and the other receiving end to end anastomosis of RLN. Acoustic parameters (Jitter, Shimmer, NNE) measured 6 months after operation of any kind all returned to normal, however, without significant difference among different groups (P > 0.05). The amplitude of evoked potential of reinnervated laryngeal muscles was significantly greater in the group of nerve decompression than in the group of end to end anastomosis of RLN and group of ansa cervicalis anastomosis (both P < 0.05). However, the amplitude of evoked potential of reinnervated laryngeal muscles between the latter two groups was not significantly different (P > 0.05). Except in one case in the end to end anastomosis of RLN group and one case in the ansa cervicalis anastomosis group, the mass and tension of the reinnervated vocal cord became much the same as the contralateral normal vocal cord and symmetric vibration of the vocal cords and physiological phonation were recovered in all cases. CONCLUSION: (1) Nerve decompression is the best procedure in laryngeal reinnervation. (2) Main branch of ansa cervicalis anastomosis and end to end anastomosis of RLN effectively restore the laryngeal vocalization. (3) Selection of the laryngeal reinnervation protocols should depend on the course, severity and type of nerve injury.

Adult↗
PubMed2001

[Diagnostic value of computer-based endoscopy system].

OBJECTIVE: To assess the roles of computer-based endoscopy system as a clinical tool in evaluation of laryngeal disorder. METHOD: An extensive research of 100 patients under stroboscopy examination with acoustic and EGG signal was made, and a number of quantitative information, such as contact quotient, glottal noise and glottal area changes, was examined. RESULT: Quantitative information contributes significant diagnostic information in 14 cases, resulted in avoidance of surgery in 6 cases and 8 cases referred to surgery instead of voice and medical therapy. CONCLUSION: Acoustic and EGG measures should be used as substantially complements of endoscopy examination in the routine clinical examination.

Glottis↗
PubMed2002

[Study on voice characteristics of people with different sexes and ages].

OBJECTIVE: To study the voice characteristics and differences of normal people with different sexes and ages, and to analyze the related factors, adopt suitable acoustic parameter values. METHOD: To collect and analyze acoustic parameter values of 1200 normal people who were divided by sex (male and female) and age (group 1: before puberty; group 2: after puberty to 30; group 3: 31 to 45; group 4: 46 to 60; 5: 61 and older), laryngeal manifestations of different sex and age under stroboscopy were analyzed. RESULT: Acoustic parameters of men and women have different characteristics. (1) F0, jitter, NNE of women voice are significantly higher than men. (2) Voice amplitude, MPT and formant frequencies of men are significantly higher than those of women. (3) Male and female voice characteristics and anatomic and physiological mechanisms of different age--groups are different. CONCLUSION: Acoustic parameters of normal people with different sexes and ages have different characteristics, which are related to anatomic and physiological mechanisms and other factors.

Adolescent↗
PubMed2002

[Basic principles for managing and post-operative follow-up in phono-surgery].

The management of the voice in patients with benign lesions of the larynx causing chronic dysphonia follows certain simple rules, on which depend the final functional result. It also requires the closest collaboration between the voice surgeon and the speech therapy team. The indication for surgery rests on the most precise diagnosis of the condition, after examination of the larynx with the rigid endoscope and video-stroboscopy of the cord movements. When a final decision for surgery has been taken, it is essential that the patient should be thoroughly prepared for surgery if the post-operative phase is to pass smoothly, which is the criterion for a good functional recovery. The surgery must be both precise and thorough, with due respect to the structural elements of the vocal folds, and must involve the minimum of resection. Afterwards, a period of complete voice rest is mandatory, before the voice rehabilitation can commence. Finally, post-operative follow-up will be the best guide for selecting the appropriate speech therapy, which will allow the patient to overcome the anatomoical and functional changes brought about by surgery, to recover the potential qualities of his voice, and to resume his vocal and professional activity under the best conditions.

Adult↗
PubMed1999

[Surgical management of subglottic carcinoma].

OBJECTIVE: To explore the clinical features and the methods of surgery and functional restoration of subglottic carcinoma. METHODS: Thirteen cases with primary subglottic carcinoma were treated surgically in this department from 1981 to 1997. Among them, six had T1-2N0 lesions, one had T3N0 lesion and six had T3-4N1-2 lesions. Four cases underwent total laryngectomy and nine had subglottic partial laryngectomy. The extensive subglottic partial laryngectomy was performed on patients with tracheal invasion. The defects of larynx were reconstructed by using unilateral or bilateral pedicled musculocutaneous flap, myofascial flap accordingly. T-shape silastic tube was placed in to the reconstructed cavity of larynx during the operation and the patients were decannulated in 2 to 6 months. Unilateral radical neck dissection was performed on 4 patients and bilateral on 2. RESULTS: All cases had restored the function of phonation except for 4 who underwent total laryngectomy. Five out of 9 (55.6%) were decannulated. The swallowing function was restored in all patients. The 3-year and 5-year survival rates were 100% and 66.7% in the cases with total laryngectomy, 88.9% and 75.0% with subglottic partial laryngectomy, respectively. CONCLUSION: It is possible to detect early subglottic carcinoma by using fiberoptic laryngoscopy routinely with the combination of stroboscopy, CT, MRI in male patients over 40 with hoarseness. It is practical that the whole or partial function of larynx could be restored in most cases with subglottic carcinoma after partial laryngectomy or subtotal laryngectomy. Unilateral or bilateral neck dissection should be performed on patients with T3 or T4 lesion. Postoperative radiotherapy is necessary.

Adult↗
PubMed2002

[Reinnervation of the posterior cricoarytenoid muscle by the phrenic nerve for bilateral vocal cord paralysis in humans].

OBJECTIVE: To reestablish the respiratory abduction of the paralyzed vocal cord through reinnervation of the posterior cricoarytenoid(PCA) muscle by the phrenic nerve in humans. METHODS: In six cases with bilateral recurrent laryngeal nerve paralysis, the phrenic nerve was anastomosed to the anterior branch of recurrent laryngeal nerve, while the adductor branch of recurrent laryngeal nerve was severed and its proximal end was implanted into the PCA muscle belly in one side, for the other side nerve-muscle pedicle technique was used. All cases had been subjected to preoperative and postoperative video laryngoscopy, stroboscopy, electromyography, voice recording and acoustic analysis. RESULTS: Among the 6 patients, it is observed in five cases' phrenic nerve reinnervation side the inspiratory abducent motion evidently recovered, and the abducent range was from 3 to 5 mm, While only slight abductent motion or no motion could be recorded on the other side reinnervated with nerve-muscle pedicle technique, and the vocal cord excursion on this side was less than 1 mm in all cases. It is because the glottis is broad enough for the patients to have daily activities without short of breath, so all of them were decannulated postoperatively. The reinnervated PCA muscle by the phrenic nerve showed typical inspiratory high frequency discharge with 100-200 ms delay as compared with the other side, indicating the phrenic motoneuron pattern. No long-term diaphragmatic paralysis and lesion of respiratory function was found. All cases' voice was not weakened, and no aspiration occurred. CONCLUSION: The phrenic reinnervation is feasible clinically for treating vocal cord paralysis, and it is found to be more effective for restoring inspiratory abducent function than the nerve-muscle pedicle technique.

Adult↗
PubMedDate not supplied

[Laser surgery and phototherapy of the larynx and laryngopharynx under indirect laryngoscopy].

The authors elaborated the equipment and technique of endolaryngeal laser surgery under indirect laryngoscopy in conditions of local anesthesia as well as phototherapy of the larynx with coherent and noncoherent monochromatic light in the postoperative period. Therapy was conducted and assessment of its efficacy was made in 93 patients with benign tumours, cysts of the larynx and laryngopharynx, cicatricial membranes of the middle regions of the larynx. The efficacy of the given method was assessed on the basis of long-term laryngoscopic studies, stroboscopy and acoustic measurements of the voice. Indications and contraindications to the mentioned therapy have been specified.

Fibroma↗
PubMed1976

[Functional results obtained by radium contact irradiation of the glottic carcinoma].

45 patients having been treated with radium contact irradiation on account of a glottic carcinoma were continually checked up with a view to ascertaining the functional results obtained. By means of indirect and direct laryngoscopy as well as by stroboscopy vocal organ and vocal quality were tested for a period of few days up to 3 years 6 months. The findings were systematically compiled in a schedule, analized and discussed.

Adult↗
PubMed1992

Allergy and laryngeal disease.

The advent of stroboscopy has proved to be a breakthrough for the laryngologist studying the voice. It has also provided a tool for studying delayed food allergy affecting the larynx. Knowledge in this fascinating area is still in its infancy, but the future is bright. Patients suffering from laryngeal allergy will profit from investigation of allergies by this promising new technique.

Food Hypersensitivity↗
PubMed1990

[Pharmacotherapy of voice and articulation disorders in aphasia].

The phonation and articulation disorders in a group of aphasics with aphonia/dysarthrophonia could be considerably reduced by the use of medication. The group consisted of 10 apoplectic patients whose resulting aphasia could not be classified because of the vocal impairment. Extrapyramidal motion disorders were proved by laryngoscopy and stroboscopy. A definite improvement of phonation and articulation was observed after L-dopa medication.

Aphasia↗
PubMed1991

[Evaluation of the effect of chronic steroid inhalation therapy on the state of the upper airway in patients with chronic obstructive pulmonary disease].

The aim of the study was to assess the effect of chronic steroid inhalation therapy on the upper airways in patients with chronic obstructive pulmonary disease (COPD). 44 patients with a first time diagnosis of COPD were evaluated. 22 (11 males, 11 females) were treated with Beclomethasone (1 mg per day) for 6 months. 22 patients that were not treated made up the control group. All had a laryngological and phonic examination carried out, including stroboscopy of the vocal cords, bacteriological and mycological examination of the oral flora. Prior therapy in all patients abnormal findings were present. The six months therapy produced only further increase of hypo-tonus of the vocal cords, without significantly affecting the phonation time and voice pattern. An increase of voice hoarseness, fungal and bacteriological infections were not found.

Administration, Inhalation↗