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At least 253 records · Page 14Linked to original sources
PubMed2005

[Frequency and risk factors of voice disorders among teaching staff of La Rioja, Spain. Clinical study: questionnaire, function vocal examination, acoustic analysis and videolaryngostroboscopy].

OBJECTIVE: To the analyse the risk factors of voice disorders among teaching staff of La Rioja, Spain. DESIGN: We carried out a transversal study of voice disorders in teaching staff of La Rioja (a random sample of 931 of 3.113 teachers). PATIENTS: 527 teachers of random sample took part of study: 332 female (63%) and 195 male (37%). METHODS: All teachers filled in a standard questionnaire and posteriorly they underwent an, ENT and functional vocal cord examination, videolaryngostroboscopy and acoustic analysis with MDVP. RESULTS: The prevalence of voice disorders among La Rioja Teachers was 57%: 20% for organic lesions, 8% for chronic laryngitis and 29% for functional disorders. Women compared with men did not have a higher prevalence of voice disorders (p > 0.05) (OR: 1.138). Professional and personal factors as well as classroom atmosphere were studied. The most relevant factors in the pathological group were previous vocal pathology, laryngeal surgery, gastroesophageal reflux and, classroom dryness and smoking habits. CONCLUSIONS: The most relevant factor of voice disorders in teaching professional is the vocal overwork during their job. It is advisable to carry out a clinical evaluation of all the future teachers in their educational programs.

Acoustics↗
PubMed2005

[Prevalence and incidence studies of voice disorders among teaching staff of La Rioja, Spain. Clinical study: questionnaire, function vocal examination, acoustic analysis and videolaryngostroboscopy].

OBJECTIVE: The aim of this study was calculate the prevalence and incidence of voice disorders among teaching staff of La Rioja, Spain. DESIGN: We carried out a transversal study of voice disorders in teaching staff of La Rioja (a random sample of 931 of 3113 teachers) and a longitudinal study (we collect the new cases during the 3 years which lasts the study). PATIENTS: 527 teachers of random sample took part of study: 332 female (63%) and 195 male (37%). METHODS: All of teachers fill in a standard questionnaire, ENT and function vocal examination, videolaryngostroboscopy and acoustic analysis with MDVP. RESULTS: The prevalence of voice disorders among La Rioja Teachers was 57%: 20.3% for organic lesions [nodular lesions (14%), polyps (2%), submucous suffusions (1.4%), edema Reinke (1.2%) Sulcus (0.4%), scalp (0.6%), leucoplasia (0.2%) vocal cord paralysis (0.2%)] 8.1% for chronic laryngitis [not specific (2.8%), smoke (3.9%) gastroe-sofageal reflux (2.5%)] and 29% for functional lesions [hyperfunctional dysphonia (7.5%) hypofunctional dysphonia (0.4%) vocal overefforts (18%) hyperplasia false cords (2.8)]. The incidence rate was 4 new cases each 1000 teachers and year. CONCLUSIONS: Organic lesions were more prevalent in women (25.4%) than in men (9.5%), but functional lesions and chronic laryngitis were more prevalent in men (36.5% and 13.2%) than in women (24% and 5%).

Acoustics↗
PubMedDate not supplied

[Stroboscopic assessment of chronic laryngitis].

INTRODUCTION: The laryngostroboscopy allows analysis of the vocal fold vibrations during phonation. Disruption of normal viscoelastic properties of the superficial lamina propria results in aberrant vocal fold vibration and mucosal wave propagation. Therefore, an investigation was performed to relate the stroboscopic results with the anatomopathologic results of chronic laryngitis and glottic cancer. MATERIAL AND METHODS: We performed a retrospective study, which included 30 direct laryngoscopies with biopsy of 25 patients and their corresponding laryngostroboscopies. RESULTS: 60% of the cases of "absence of mucosal wave" displayed severe dysplasia or carcinoma. 20% of the cases of "limited or present mucosal wave" were carcinoma. CONCLUSIONS: The probability of finding severe dysplasia or carcinoma is significantly greater when we find absence of mucosal wave. The presence of mucosal wave does not exclude the possibility of malignant lesion of the vocal fold.

Adult↗
PubMed2005

[Dysphonia: current methods of evaluation].

OBJECTIVES: The aim of this review article was to provide an update on current techniques for evaluation of dysphonia in routine clinical practice. MATERIALS AND METHODS: Recent medical and other scientific literature was reviewed and pertinent current theories concerning the physiology of laryngeal function described. RESULTS: Perceptual voice quality evaluation by a professional jury of listeners is still considered to be the most reliable and complete means of evaluating pathologic voice, even though it is difficult to perform in routine and the results lack reproducibility. The objective evaluation of the vocal fundamental frequency and its variations and the spectral characteristics of voice has the advantage of being simple to perform, reproducible and quantifiable. However, automatic measurements need to be analyzed with precaution for severe dysphonia, the computer algorithms being designed for voices retaining a certain periodicity. Aerodynamic measurements are quantifiable and reproducible and provide information as to the quality of laryngeal function as a transducer of aerodynamic energy into acoustic energy. Videostroboscopy and electroglottography provide information as to the quality of the laryngeal vibrations, the source of sound production. CONCLUSIONS: All of these types of analysis are complementary, informing as to different aspects of vocal quality and laryngeal function. No one measurement alone can diagnose or characterize dysphonia.

Electrodiagnosis↗
PubMed2005

Laryngeal assessment in rheumatic disease patients.

UNLABELLED: Rheumatic diseases usually promote several systemic disorders, which can affect blood vessels, mucosa and serosa of the aerodigestive tract. Scarce laryngeal involvement has been described in these patients and this study aims at investigating laryngeal alterations found in patients with rheumatic diseases. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: A transversal study was developed with systemic lupus erythematous, systemic sclerosis and mixed connective tissue disease's patients. They were evaluated by means of clinical examinations and videolaryngoestroboscopy. RESULTS: Twenty-seven patients were included in the study, 26 succeeded in completing the videolaryngoestroboscopy. Laryngeal abnormalities were seen in 11 of 12 patients with lupus, in all 11 patients with sclerodermia and in 3 patients with mixed connective tissue disease. Vocal fold bamboo node was observed in 5 patients and 92.3% of all patients presented laryngeal signs of gastroesophageal reflux disease. CONCLUSION: We noticed 5 vocal fold bamboo nodes and gastroesophageal reflux disease in almost all patients.

Adult↗
PubMed2006

Voice analysis of patients with diverse types of Reinke's edema and clinical use of electroglottographic measurements.

CONCLUSIONS: Reinke's edema shows a variety of clinical patterns and differences in voice analysis depending on its type. Electroglottographic measurements help to objectively assess the severity of edema and voice quality before and after surgery. OBJECTIVES: Reinke's edema manifests various clinical findings and different voice characteristics depending on the degree of swelling and the severity of voice impairment. The aim of this study was to compare the aerodynamic, acoustic and electroglottographic parameters for the different types of Reinke's edema according to its morphological, perceptual and histopathological classifications, and to assess voice quality in patients with Reinke's edema before and after laryngomicrosurgery. We also aimed to determine which parameter was most associated with the improvement in postoperative voice quality and to investigate the clinical usefulness of electroglottographic analysis in Reinke's edema. MATERIAL AND METHODS: The clinical and voice records of 61 patients with Reinke's edema were reviewed. All the patients were classified according to stroboscopic findings (Yonekawa's classification), perceptual grade and histopathological findings. Voice analysis of the perceptual, acoustic, aerodynamic and electroglottographic measurements was carried out using various classifications, and the voices of 23 patients who underwent laryngomicrosurgery were evaluated 2 months after surgery. Furthermore, the voices of 30 normal speakers (controls) were recorded and analyzed. RESULTS: The fundamental frequency (FxM) of Yonekawa Type III was significantly lower than those of the other types of Reinke's edema, and the SD of the FxM, the percentage irregularity of the FxM (CFx) and the percentage irregularity of the amplitude were larger than those of the other types of Reinke's edema. The closed quotient was significantly higher in Yonekawa Type III. In addition, the mean flow rate (MFR), maximum phonation time and harmonics:noise ratio (HNR) differed significantly among the different types of Reinke's edema. The postoperative results showed an increase in the FxM and an improvement in the MFR, subglottic pressure, shimmer and HNR. Correlation analysis showed that jitter, the HNR, the mean closed quotient and the irregularity of the frequency were the parameters that had the best correlation with improvement in postoperative voice quality.

Adolescent↗
PubMed2005

Health and voice quality in smokers: an exploratory investigation.

Thirty-two adults (20 smokers and 12 non-smokers) were examined to determine the effects of cigarette smoking on health (diseases and larynx histology), on fundamental frequency (regularity and jitter) and stress level. The examination consisted of nasovideostroboscopy analysis, history case, electrolaryngography assessment for different task performance and self-assessment of stress. Although not statistically different, results indicate that smokers in comparison to non-smokers show: 1) slightly more health problems; 2) histological larynx changes; 3) a higher level of stress; 4) a lower mean F0 for all speech tasks. A statistically significant difference for percentage jitter was found according to voice status for: 1) vowel [a] (the group with voice problems show higher levels of jitter than both groups without voice problems); 2) vowel [i] (the smokers with voice problems show higher levels of jitter than the smokers without voice problems).

Adult↗
PubMed2006

Diagnostic value of voice acoustic analysis in assessment of occupational voice pathologies in teachers.

It has been shown that teachers are at risk of developing occupational dysphonia, which accounts for over 25% of all occupational diseases diagnosed in Poland. The most frequently used method of diagnosing voice diseases is videostroboscopy. However, to facilitate objective evaluation of voice efficiency as well as medical certification of occupational voice disorders, it is crucial to implement quantitative methods of voice assessment, particularly voice acoustic analysis. The aim of the study was to assess the results of acoustic analysis in 66 female teachers (aged 40-64 years), including 35 subjects with occupational voice pathologies (e.g., vocal nodules) and 31 subjects with functional dysphonia. The acoustic analysis was performed using the IRIS software, before and after a 30-minute vocal loading test. All participants were subjected also to laryngological and videostroboscopic examinations. After the vocal effort, the acoustic parameters displayed statistically significant abnormalities, mostly lowered fundamental frequency (Fo) and incorrect values of shimmer and noise to harmonic ratio. To conclude, quantitative voice acoustic analysis using the IRIS software seems to be an effective complement to voice examinations, which is particularly helpful in diagnosing occupational dysphonia.

Adult↗
PubMed2006

Investigation of voice initiation and voice offset characteristics with high-speed digital imaging.

This study involves preliminary investigation of the characteristics of the voice initiation period (VIP) and voice offset period (VOP) using high-speed digital imaging. The goals of the study were to develop a methodology to objectively analyze these periods of phonation and to explore the feasibility of studying the effects of aging on these phonation segments. Results of the analysis of the data from two female subjects, one younger and one older, with the developed methodology, demonstrated that the older subject's VIP was characterized by a slow and irregular increase in glottal area waveform (GAW) until reaching 90% of the maximum opening of the glottis at 244 frames or 122 ms. The younger subject demonstrated a sharp increase in GAW during VIP, taking only 155 frames or 77.5 ms to reach the 90% mark. Also, the older subject took a greater number of frames for the vocal fold vibration to come to a complete stop than the younger subject during the VOP; 275 frames and 150 frames respectively.

Adult↗
PubMedDate not supplied

A temporal and spatial analysis of cavitation on mechanical heart valves by observing faint light emission.

Cavitation on mechanical heart valves (MHVs) could cause the mechanical failure of the occluder. A simple and reliable in vitro test method to evaluate cavitation potential must be developed. The bubble implosion damages the MHV material; thus, observing the behavior of the bubble implosion is essential. According to sonoluminescence, the collapsing cavity emits faint light. Therefore, in this study, the bubble collapse was analyzed both temporally and spatially by observing faint light emission. A photon counting system has been developed using a photomultiplier tube (H7360-01, Hamamatsu Photonics, Japan). The highest time resolution of this system is 5 microsec. A quartz optical fiber bundle of 2 mm diameter can be connected to this photomultiplier tube and traversed two-dimensionally over the MHV. The closure of the MHV triggers the photon counter, and the photons through 500 beats are recorded and integrated. A 20 mm Björk-Shiley valve was submerged in a water tank containing 10 L deionized water, and the pressure difference of 120 mm Hg was exerted on the valve at a rate of 60 bpm with a pulse duplicator. Approximately 700 microsec after the valve closure, light emission was detected along the edge of the occluder on the inflow side in the major orifice. Then, approximately 1,000 microsec after the closure, light along the occluder's edge in the minor orifice was recorded as well. Compared with the analysis, using a stroboscope and a high-speed camera, faint light was emitted from the collapsing cavities. In conclusion, sonoluminescnece was successfully observed around the MHV, and the photon counting technique and the traversing mechanism of the optical fiber bundle revealed the temporal and spatial distribution of the cavity collapse on the MHV.

Biomedical Engineering↗
PubMed2005

Influence of aging and sex on voice parameters in patients with unilateral vocal cord paralysis.

OBJECTIVES: The objective of this study was to investigate influences of aging and sex on different voice parameters in patients with unilateral vocal cord paralysis (VCP). STUDY DESIGN: Retrospective review of patients with unilateral VCP. MATERIALS AND METHODS: Forty-seven patients, 22 males, 25 females (24-85 years), were enrolled in the study. The diagnosis of VCP was established by videolaryngostroboscopy. The acoustic parameters of jitter, shimmer, degree of subharmonic, noise to harmonic ratio, fundamental frequency, and maximal intensity were measured. The auditive voice analysis included roughness, breathiness, and hoarseness. Statistical analysis involves Pearson's bivariate correlation coefficients and two-way analysis of variance with interaction variables. RESOLUTION: After unilateral VCP in the elderly, some sex- and age-related differences in the restriction of the voice can be documented. CONCLUSION: In general, the investigated voice parameters showed similar tendencies to those in otherwise healthy aging persons.

Adult↗
PubMed2005

Prevention of anterior glottic stenosis after transoral microresection of glottic lesions involving the anterior commissure with mitomycin C.

OBJECTIVE: To evaluate the effectiveness of topical mitomycin C (MMC) in preventing anterior glottic stenosis (AGS) after transoral microresection of glottic lesions involving the anterior commissure (AC). STUDY DESIGN: Prospective clinical study. METHODS: Sixteen patients with benign or malignant glottic lesions involving the AC were studied. The lesions were removed by transoral microsurgery using a CO2 laser or cold microinstruments. In all patients, the anterior glottis was treated topically with 0.4 mg/mL MMC for 5 minutes at the end of surgery. The postoperative vocal folds and voice quality of patients were evaluated using video strobolaryngoscopy and voice recordings. RESULTS: Four patients had local recurrences after surgery and were treated with repeat microsurgery. Postoperatively, five patients (31%) developed acceptable small webs in the anterior glottis; one resolved with web lysis and a second with topical MMC. Postoperative vocal quality was affected mainly by the extent of vocal fold resection and the subsequent wide glottal gaps and extensive scarring, rather than by MMC use per se. Significant local side effects or atrophy of the vocal folds owing to MMC were not found. CONCLUSION: Topical MMC may be useful for preventing AGS and subsequent dysphonia after transoral microresection of glottic lesions involving the AC.

Administration, Topical↗
PubMed2005

Long-term effects of micronized Alloderm injection for unilateral vocal fold paralysis.

OBJECTIVES: Micronized Alloderm (Cymetra) is a relatively new product used for vocal fold augmentation. Previous studies evaluating possible long-term effectiveness of this product have shown mixed results. The objective of this present study is to reassess possible long-term results of Cymetra injection laryngoplasty in patients with unilateral true vocal fold paralysis. STUDY DESIGN: Retrospective review of patients with unilateral true vocal fold paralysis who received Cymetra injection laryngoplasty between March 2001 and March 2004. METHODS: Preoperative voice samples and videostroboscopic findings were compared with the most recently available postoperative data to assess efficacy of the procedure. A panel of voice experts analyzed both vocal and vibratory function in these samples. In addition, pre- and postoperative voice-related quality of life measures and patients' self-ratings of voice outcomes were compared. RESULTS: Twenty patients (7 male, 13 female; 14 with left-sided paralysis, 6 with right-sided paralysis) were identified in the study population. Cymetra injection was performed an average of 45.1 months after onset of vocal fold paralysis (range -216 months), and average follow-up postinjection was 11.2 (range -35) months. Comparing pre- and postoperative measures, voice quality (P < .0001), glottal closure (P < .0001), and degree of vocal fold bowing (P < .0001) were all improved by injection. Quality of life measures and patients' self-perceptions of vocal quality were also improved (P < .01). Fifteen (75%) patients showed long-lasting results. Eight patients showed improvement for more than 12 months after injection. CONCLUSION: Cymetra injection laryngoplasty offers improved vocal and vibratory function to patients with unilateral true vocal fold paralysis. The benefits of such medialization may be longer lasting than previously reported, and further long-term study is warranted.

Adult↗
PubMed2006

West Nile virus induced vocal fold paralysis.

OBJECTIVE: West Nile virus has recently become a public health concern in the United States, after an outbreak in New York City in 1999. It is a mosquito-borne virus that causes a spectrum of disease from flu-like symptoms to encephalopathy, muscle weakness, and, in some cases, death. STUDY DESIGN: Case Report. METHODS: A patient infected with West Nile virus presented with progressive muscle weakness, and later developed bilateral vocal fold paresis. His clinical presentation, physical and laboratory examination findings, and course of illness will be discussed. RESULTS: After a prolonged hospital stay, and presumptive treatment for Guillain-Barré, repeat CSF analysis revealed infection with the West Nile virus. The patient developed bilateral vocal fold paralysis during his hospital course. At long-term follow-up, the patient's left vocal fold paralysis persisted, while the right vocal fold paralysis had resolved. CONCLUSIONS: Although several viruses have been associated with recurrent laryngeal nerve injury, this is the first report of West Nile virus induced vocal fold paralysis.

Aged↗
PubMed2006

Early laryngeal inhalation injury and its correlation with late sequelae.

OBJECTIVE: Inhalation injury can permanently alter normal laryngeal function. The aim of this study was to examine the early changes in voice, swallowing, and breathing in laryngeal inhalation injuries. STUDY DESIGN: This was a prospective analysis of nine patients with inhalation injuries at a tertiary care institution. METHODS: Laryngeal function of patients admitted for inhalation injury requiring intubation was documented using videostroboscopy and swallowing evaluation by the speech pathology service. Bronchoscopy was used to classify the degree of inhalation injury. Association among total body surface area, facial burns, severity of laryngotracheal injuries, and loss of function was attempted. RESULTS: All three patients with severe tracheal inhalation injury presented persistent hoarseness at 1-year follow up with abnormal videostroboscopy findings. No association was found between inhalation injury and total body surface area burned. None of the patients in this series presented permanent swallowing dysfunction. CONCLUSION: The otolaryngologist plays an important role in the initial and long-term management of inhalation injuries. Inhalation injuries should be managed in a multidisciplinary fashion. There may be a correlation between the degree of tracheal injury and laryngeal injury and hoarseness.

Adult↗