Multidimensional assessment of voice quality after injection augmentation of the vocal fold with autologous adipose tissue or calcium hydroxylapatite

Abstract Purpose Endoscopic arytenoid abduction lateropexy (EAAL) is a reliable surgical solution for the minimally invasive treatment of bilateral vocal fold palsy (BVFP), providing a stable airway by the lateralization of the arytenoid cartilages with a simple suture. The nondestructive manner of the intervention theoretically leads to higher regeneration potential, thus better voice quality. The study aimed to investigate the respiratory and phonatory outcomes of this treatment concept. Methods 61 BVFP patients with significant dyspnea associated with thyroid/parathyroid surgery were treated by unilateral EAAL. Jitter, Shimmer, Harmonics to Noise Ratio, Maximum Phonation Time, Fundamental frequency, Voice Handicap Index, Dysphonia Severity Index, Friedrich’s Dysphonia Index, Global-Roughness-Breathiness scale, Quality of Life, and Peak Inspiratory Flow were evaluated 18 months after EAAL. Results All patients had a stable and adequate airway during the follow-up. Ten patients (16.4%) experienced complete bilateral motion recovery with objective acoustic parameters in the physiological ranges. Most functional results of the 13 patients (21.3%) with unilateral recovery also reached the normal values. Fifteen patients (24.6%) had unilateral adduction recovery only, with slightly impaired voice quality. Eleven patients (18.0%) had false vocal fold phonation with socially acceptable voice. In 12 patients (19.7%) no significant motion recovery was detected on the glottic level. Conclusion EAAL does not interfere with the potential regeneration process and meets the most important phoniatric requirements while guaranteeing the reversibility of the procedure—therefore serving patients with transient palsy. Further, a socially acceptable voice quality and an adequate airway are ensured even in cases of permanent bilateral vocal fold paralysis.

Download Full-text

Student Voice Use and Vocal Health During an All-State Chorus Event

Journal of Research in Music Education ◽

10.1177/0022429410387145 ◽

2010 ◽

Vol 58 (4) ◽

pp. 346-367 ◽

Cited By ~ 4

Author(s):

James F. Daugherty ◽

Jeremy N. Manternach ◽

Kathy K. Price

Keyword(s):

Vocal Fold ◽

Voice Quality ◽

Health Perceptions ◽

Singing Voice ◽

Vocal Health ◽

Close Proximity ◽

Rest Time ◽

Field Notes ◽

Voice Use

This field-based case study documented students’ ( N = 256) voice use and voice health perceptions during a 3-day all-state high school chorus event through daily surveys, phonation duration data, analysis of rehearsal voice use behaviors, and field notes. Among the primary results are the following: (a) First and final day survey comparisons indicated significant declining changes in 5 of 7 voice health indicator statements and in self-perceptions of singing voice quality, yet (b) most students (78.8%) believed they had taken good care of their voices; (c) self-reported sleep hours decreased significantly; (d) vocal fold contact time measured with two students ranged from 15% to 38% during rehearsal periods, 1% to 27% during on-site non-rehearsal times, and 3% to 17% during measured pre- and post-event activities, but (e) overall percentages of vocal fold contact varied little between regular rehearsal and on-site non-rehearsal events (female: 19.37% rehearsal, 20.11% non-rehearsal; male: 22.89% rehearsal, 20.54% non-rehearsal); (f) rehearsal voice rest time (63%) exceeded voice use time (37%); (g) students sat in close proximity to other choristers for approximately 73% of rehearsal time; and (h) the two compositions ranked highest relative to demands on adolescent voices consumed 61% of rehearsal time.

Download Full-text

Vocal fold injury following endotracheal intubation

The Journal of Laryngology & Otology ◽

10.1258/002221505774481192 ◽

2005 ◽

Vol 119 (10) ◽

pp. 825-827 ◽

Cited By ~ 15

Author(s):

Satoshi Kitahara ◽

Yukihiro Masuda ◽

Yoko Kitagawa

Keyword(s):

Endotracheal Intubation ◽

Fibrin Glue ◽

Vocal Fold ◽

Case Reports ◽

Voice Quality ◽

Fibrous Tissue ◽

Normal Result ◽

Perceptual Evaluation ◽

Vibratory Pattern

Vocal fold scarring results in the formation of fibrous tissue which disturbs the vibratory pattern of the fold during phonation. However, vocal fold scarring in humans is poorly understood because of the lack of clear case reports focusing on voice quality. The authors present a case of vocal fold scarring with changes in voice quality. At the time of injury the pedicle mucosa was cemented with fibrin glue. Phonation was inhibited for two weeks and tranilast (300 mg/day) was given for 3 months. Sixty-nine days later, perceptual evaluation showed a normal result and the phonation time became better, but the mucosal vibration was still lacking. Ninety-seven days later, mucosal vibration was finally restored. We suggest that characterization of vocal fold scarring in humans may be different from that in animals, and recommend that surgical management should be avoided for at least three months after injury.

Download Full-text

Using Innovative Acoustic Analysis to Predict the Postoperative Outcomes of Unilateral Vocal Fold Paralysis

BioMed Research International ◽

10.1155/2016/7821415 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Yung-An Tsou ◽

Yi-Wen Liu ◽

Wen-Dien Chang ◽

Wei-Chen Chen ◽

Hsiang-Chun Ke ◽

...

Keyword(s):

Vocal Fold ◽

Linear Prediction ◽

Acoustic Analysis ◽

Characteristic Curve ◽

Voice Quality ◽

Treatment Strategies ◽

Vocal Fold Paralysis ◽

Unilateral Vocal Fold Paralysis ◽

Outcome Predictor ◽

Laryngeal Framework Surgery

Objective.Autologous fat injection laryngoplasty is ineffective for some patients with iatrogenic vocal fold paralysis, and additional laryngeal framework surgery is often required. An acoustically measurable outcome predictor for lipoinjection laryngoplasty would assist phonosurgeons in formulating treatment strategies.Methods.Seventeen thyroid surgery patients with unilateral vocal fold paralysis participated in this study. All subjects underwent lipoinjection laryngoplasty to treat postsurgery vocal hoarseness. After treatment, patients were assigned to success and failure groups on the basis of voice improvement. Linear prediction analysis was used to construct a new voice quality indicator, the number of irregular peaks (NIrrP). It compared with the measures used in the Multi-Dimensional Voice Program (MDVP), such as jitter (frequency perturbation) and shimmer (perturbation of amplitude).Results.By comparing the [i] vowel produced by patients before the lipoinjection laryngoplasty (AUC = 0.98, 95% CI = 0.78–0.99), NIrrP was shown to be a more accurate predictor of long-term surgical outcomes than jitter (AUC = 0.73, 95% CI = 0.47–0.91) and shimmer (AUC = 0.63, 95% CI = 0.37–0.85), as identified by the receiver operating characteristic curve.Conclusions.NIrrP measured using the LP model could be a more accurate outcome predictor than the parameters used in the MDVP.

Download Full-text