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PubMed1976

The primate hyolaryngeal apparatus and herbivorous modifications.

The predominantly herbivorous diet of the howler and baboon is responsible for modification in the configuration of the hyolaryngeal apparatus. In a herbivorous primate the air sac located in the concavity of the body of the hyoid bone takes on a resonating function. There is definite correlation between : (1) the presence of a large epiglottis with a convex superior surface, (2) close apposition of the soft palate with the epiglottis, (3) presence of high aryepiglottic and lateral epiglottic folds, (4) presence of air sacs and (5) concavity of the posterior surface of the body of the hyoid bone (basihyal), and the herbivorous diet of the species. These characteristics are not as pronounced in the less herbivorous rhesus, even less so in the frugivorous capuchin and the least in the insectivorous marmoset.

Air Sacs↗
PubMed2004

Findings of multiple muscle involvement in a study of 214 patients with laryngeal dystonia using fine-wire electromyography.

Although perceptual and stroboscopic data help in diagnosing and classifying laryngeal dystonia, these measures do not aid the voice clinician in targeting which specific muscles to treat with botulinum toxin. Most patients achieve smoother, less effortful voicing with standard injection regimens. However, there is a notable failure rate. We performed fine-wire electromyography on 214 consecutive patients with laryngeal dystonia. We correlated voice ratings, stroboscopy data, and fine-wire electromyography data. Videostroboscopy was successful in visually demonstrating most of the audible findings in isolated vocal tremor, but it was much less successful in identifying breaks alone or a combination of breaks and tremor. Fine-wire electromyography revealed that the thyroarytenoid muscle was significantly more likely than the lateral cricoarytenoid muscle to be the predominant muscle associated with adductor spasmodic dysphonia, and that the thyroarytenoid and lateral cricoarytenoid muscles were equally likely to be predominantly involved in tremor spasmodic dysphonia. In addition, several patients in both the adductor spasmodic dysphonia and the tremor spasmodic dysphonia groups presented with interarytenoid muscle predominance. All of the intrinsic laryngeal muscles are capable of being the predominant muscle in laryngeal dystonia, and there are patterns of muscle abnormalities that differ between adductor spasmodic dysphonia and tremor spasmodic dysphonia. Some of the failures in treating adductor spasmodic dysphonia with botulinum toxin, and the greater difficulty with success in treating patients with tremor spasmodic dysphonia, are due to failure to deliver toxin to the appropriate muscles.

Electromyography↗
PubMed2006

Surgical repair of laryngotracheoesophageal clefts by tracheoesophagoplasty with two overlapping flaps.

We report a technique for surgical repair of laryngotracheoesophageal clefts from type II to IV through an anterior approach that involves performing a tracheoesophagoplasty with two overlapping flaps (TEP-TOF). We offer a technical description, a retrospective study, and a review of the literature. Ten children were operated on for laryngotracheoesophageal clefts of types II, III, or IV of the Benjamin and Inglis classification by the TEP-TOF procedure. After a median follow-up of 58 months (2 months to 12 years), neither complications nor recurrences were observed. All surgical details of the TEP-TOF procedure, including the approach, the kind of sutures, the method of creating the flaps, and the preoperative and postoperative management, are discussed and compared with the data found in the literature.

Abnormalities, Multiple↗