scholarly journals Insertion of a tracheoesophageal speech valve: a novel approach in a difficult situation

2016 ◽  
Vol 131 (1) ◽  
pp. 88-89
Author(s):  
C P Yiannakis ◽  
R B Townsley ◽  
I G Smillie ◽  
G L Picozzi
Keyword(s):  
Gold Standard ◽  
Total Laryngectomy ◽  
Cost Effective ◽  
Voice Rehabilitation ◽  
Patient Factors ◽  
Shunt Valve ◽  
Difficult Situation ◽  
Novel Approach ◽  
Tracheoesophageal Speech ◽  
Functional Voice Rehabilitation

AbstractBackground:Functional voice rehabilitation is becoming increasingly important following total laryngectomy and pharyngolaryngectomy. Tracheoesophageal voice via a shunt valve is currently regarded as the ‘gold standard’ for voice rehabilitation. Traditional techniques usually allow for the replacement of valves in the out-patient setting; however, patient factors such as altered anatomy may occasionally prevent this.Objective:This paper describes a novel approach for speech valve insertion that is safe, quick and cost-effective, and which uses equipment commonly available in ENT wards and the operating theatre.

Use of Ultrasound for Sizing Tracheoesophageal Puncture Prostheses

2017 ◽  
Vol 157 (6) ◽  
pp. 1075-1078
Author(s):  
Aaron Smith ◽  
Vikrum Thimmappa ◽  
Julia Jones ◽  
Courtney Shires ◽  
Merry Sebelik
Keyword(s):  
Wall Thickness ◽  
Gold Standard ◽  
Total Laryngectomy ◽  
Primary Closure ◽  
Ultrasound Measurement ◽  
Voice Rehabilitation ◽  
Flap Reconstruction ◽  
Tracheoesophageal Puncture ◽  
Party Wall ◽  
Posterior Tracheal Wall

Tracheoesophageal puncture (TEP) with voice prosthesis placement is the gold standard voice rehabilitation following total laryngectomy. Ultrasound may be useful to determine tracheoesophageal wall thickness, guiding prosthesis choice. Therefore, 14 patients undergoing total laryngectomy and TEP or prosthesis change with 16-mHz ultrasound measurement of the posterior tracheal wall were included. Seven patients underwent secondary TEP, 3 primary TEP, and 4 TEP changes. Six patients underwent flap reconstruction, while 8 patients were closed primarily. Average party wall thickness was 9.6 ± 1.7 mm, without a difference ( P = .08) between primary closure (10.3 ± 1.7 mm) and flap reconstruction (8.6 ± 1.4 mm). Change from the hypothesized sizing was noted in 11 patients (79%). Prosthesis size did not correlate with age (–0.19, P = .51), height (–0.12, P = .69), weight (0.26, P = .38), body mass index (0.22, P = .46), or flap status (–0.48, P = .079). These data suggest that ultrasound is beneficial in patients with distorted or less predictable anatomy (eg, flap reconstruction) but also important for those patients undergoing primary closure.

An Endoscopic Technique for Restoration of Voice after Laryngectomy

1980 ◽  
Vol 89 (6) ◽  
pp. 529-533 ◽  
Author(s):  
Mark I. Singer ◽  
Eric D. Blom
Keyword(s):  
Total Laryngectomy ◽  
Speech Therapy ◽  
Radical Neck Dissection ◽  
Cost Effective ◽  
Rehabilitation Program ◽  
Wound Complications ◽  
Voice Rehabilitation ◽  
Simple Method ◽  
Voice Restoration ◽  
Endoscopic Method

Reports of restoration of voice after total laryngectomy include diversion of exhaled pulmonary air through planned or spontaneous fistulae with a variety of modified tracheal cannulas and valves. Limitations of these techniques include aspiration, scar closure of the shunts, wound complications, and failure to achieve voice consistently. We report a two-year experience with an endoscopic method using a unique valved prosthesis eliminating complicated surgical reconstructions, aspiration, and stenosis. Fifty-four of 60 patients (90%) achieved fluent voices with one deglutition problem. Radiation therapy preceded voice restoration in 63% of the patients and radical neck dissection in 72%. The endoscopic procedure, hospitalization and period of speech therapy are short and constitute a cost-effective voice rehabilitation program. The results of this simple method and lack of complications are encouraging.

Long-term Progress and Complications of Voice Rehabilitation using Voice Prosthesis after Total Laryngectomy

2009 ◽  
Vol 60 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Takashi Nasu ◽  
Shuji Koike ◽  
Daisuke Noda ◽  
Yoshihiro Onoe ◽  
Masaru Aoyagi
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Voice Rehabilitation

Condrosarcom laringian - prezentare de caz

ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 32-35
Author(s):  
Bogdan Mocanu ◽  
Aida Petca ◽  
Daniela Safta ◽  
Cornelia Niţipir ◽  
Liliana Mirea ◽  
...  
Keyword(s):  
Gold Standard ◽  
Total Laryngectomy ◽  
Cricoid Cartilage ◽  
Good Prognosis ◽  
Rare Cancers ◽  
Imaging Characteristics ◽  
Laryngeal Tumors ◽  
Grade Ii

Chondrosarcomas of the larynx are rare cancers, representing less than 1% of all laryngeal tumors. The most often involved site is the cricoid cartilage. They have generally good prognosis, and low metastatic tendency. Surgery is the treatment of choice, partial in small limited tumors or total laryngectomy if tumor extends beyond the half of the cricoid and/or is poor differentiated. Although there are some pathognomonic imaging characteristics for chondrosarcomas, the histology remains the gold standard for diagnostic. The authors present a case of large, medium differentiated chondrosarcoma (grade II), surgically treated by total laryngectomy.   

A Novel Approach for the Treatment of Sialolithiasis that Preserves Salivary Duct Anatomy

2021 ◽  
pp. 000348942110189
Author(s):  
Gani Atilla Şengör ◽  
Ahmet Mert Bilgili
Keyword(s):  
Salivary Gland ◽  
Success Rate ◽  
Cost Effective ◽  
Complete Removal ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Pneumatic Lithotripsy ◽  
Novel Approach ◽  
Surgical Methods ◽  
Salivary Gland Stones

Objective: The sialendoscopy era in the treatment of salivary gland stones has reduced the use of classical surgical methods. However, the miniature ducts and tools may cause difficulties in removing large sialoliths. Therefore, invasive combined oral surgeries or gland resection may be considered. We searched for the most suitable method in order to stay in line with the minimally invasive approach that preserves the ductus anatomy, and that can reduce the surgical fears of patients. Materials and Methods: The study included 84 cases (23 parotid and 61 submandibular) in whom stones were fragmented by pneumatic lithotripsy and removed between January 2015 and January 2020. The parotid cases comprised 7 females and 16 males, and the submandibular cases comprised 25 females and 36 males. Intraductal lithotripsy was performed using pneumatic lithotripter. This study has fourth level of evidence. Results: Based on total number of cases (n = 84), success rate was 67/84 (79.7%) immediately after sialendoscopy, and overall success rate was 77/84 (91.6%). Based on number of stones treated (n = 111), our immediate success rate was 94/111 (84.6%), and overall success rate was 104/111 (93.7%). The success criteria were complete removal of the stone and fragments in a single sialendoscopy procedure and resolution of symptoms. Conclusions: We successfully treated salivary gland stones, including L3b stones, in our patient cohort with sialendoscopy combined with pneumatic lithotripsy. The lithotripsy method that we have adapted seems to be more useful and cost-effective compared to its alternatives. We were also able to preserve the ductus anatomy and relieve patients’ concerns. Level of Evidence: Level IV

scholarly journals Gas Detection and Identification Using Multimodal Artificial Intelligence Based Sensor Fusion

2021 ◽  
Vol 4 (1) ◽  
pp. 3
Author(s):  
Parag Narkhede ◽  
Rahee Walambe ◽  
Shruti Mandaokar ◽  
Pulkit Chandel ◽  
Ketan Kotecha ◽  
...  
Keyword(s):  
Sensor Fusion ◽  
Network Architecture ◽  
Cost Effective ◽  
Sensor Data ◽  
Dense Layer ◽  
Gaseous Emissions ◽  
Multiple Sensors ◽  
Single Output ◽  
Novel Approach ◽  
Single Sensor

With the rapid industrialization and technological advancements, innovative engineering technologies which are cost effective, faster and easier to implement are essential. One such area of concern is the rising number of accidents happening due to gas leaks at coal mines, chemical industries, home appliances etc. In this paper we propose a novel approach to detect and identify the gaseous emissions using the multimodal AI fusion techniques. Most of the gases and their fumes are colorless, odorless, and tasteless, thereby challenging our normal human senses. Sensing based on a single sensor may not be accurate, and sensor fusion is essential for robust and reliable detection in several real-world applications. We manually collected 6400 gas samples (1600 samples per class for four classes) using two specific sensors: the 7-semiconductor gas sensors array, and a thermal camera. The early fusion method of multimodal AI, is applied The network architecture consists of a feature extraction module for individual modality, which is then fused using a merged layer followed by a dense layer, which provides a single output for identifying the gas. We obtained the testing accuracy of 96% (for fused model) as opposed to individual model accuracies of 82% (based on Gas Sensor data using LSTM) and 93% (based on thermal images data using CNN model). Results demonstrate that the fusion of multiple sensors and modalities outperforms the outcome of a single sensor.

scholarly journals Implementation of Fused Filament Fabrication in Dentistry

2021 ◽  
Vol 11 (14) ◽  
pp. 6444
Author(s):  
Jörg Lüchtenborg ◽  
Felix Burkhardt ◽  
Julian Nold ◽  
Severin Rothlauf ◽  
Christian Wesemann ◽  
...  
Keyword(s):  
Fused Deposition Modeling ◽  
Present Report ◽  
Cost Effective ◽  
Great Promise ◽  
Temperature Sensitive ◽  
Fused Filament Fabrication ◽  
Digital Light Processing ◽  
Fused Deposition ◽  
Surgical Guides ◽  
Novel Approach

Additive manufacturing is becoming an increasingly important technique for the production of dental restorations and assistive devices. The most commonly used systems are based on vat polymerization, e.g., stereolithography (SLA) and digital light processing (DLP). In contrast, fused filament fabrication (FFF), also known under the brand name fused deposition modeling (FDM), is rarely applied in the dental field. This might be due to the reduced accuracy and resolution of FFF compared to vat polymerization. However, the use of FFF in the dental sector seems very promising for in-house production since it presents a cost-effective and straight forward method. The manufacturing of nearly ready-to-use parts with only minimal post-processing can be considered highly advantageous. Therefore, the objective was to implement FFF in a digital dental workflow. The present report demonstrates the production of surgical guides for implant insertion by FFF. Furthermore, a novel approach using a temperature-sensitive filament for bite registration plates holds great promise for a simplified workflow. In combination with a medical-grade filament, a multi-material impression tray was printed for optimized impression taking of edentulous patients. Compared to the conventional way, the printed thermoplastic material is pleasant to model and can allow clean and fast work on the patient.

scholarly journals Voice Rehabilitation after Total Laryngectomy Using the Provox R Voice Prosthesis

2003 ◽  
Vol 106 (11) ◽  
pp. 1093-1100 ◽  
Author(s):  
Hiroyuki Yamada ◽  
Shin-ichiro Nishii ◽  
Shigetoshi Sakabe ◽  
Ryoji Ishida
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Voice Rehabilitation

Voice Rehabilitation after Total Laryngectomy and Tracheoesophageal Puncture Using Nonmuscle Closure

1993 ◽  
Vol 102 (10) ◽  
pp. 792-796 ◽  
Author(s):  
Ross A. Clevens ◽  
Duane O. Hartshorn ◽  
Ramon M. Esclamado ◽  
Jan S. Lewin
Keyword(s):  
Total Laryngectomy ◽  
Voice Rehabilitation ◽  
Rehabilitation Outcomes ◽  
Pharyngoesophageal Segment ◽  
Pharyngeal Plexus ◽  
Neck Recurrence ◽  
Tracheoesophageal Puncture ◽  
Early Primary ◽  
Successful Production

The successful production of voice with a tracheoesophageal puncture (TEP) and voice prosthesis requires a compliant pharyngoesophageal segment. Speech failure is commonly attributed to spasm of the pharyngoesophageal segment. During total laryngectomy (TL), a 3-layer closure is typically performed. This prospective single-arm study examines the safety and efficacy of TL and TEP with nonclosure of the pharyngeal musculature to prevent pharyngoesophageal spasm as an alternative to 3-layer closure with pharyngeal plexus neurectomy and/or pharyngeal constrictor myotomy. Twenty-one consecutive patients were enrolled by a single surgeon. The mean duration of follow-up was 19.5 ± 7.9 months. Surgical complications and voice rehabilitation outcomes were examined. An overall complication rate of 28.5% was observed. Fluency was achieved in 75% of patients within a mean of 4.3 ± 5.1 months. Speech failure was attributable to early primary site and neck recurrence (5%), hypoglossal nerve palsy (5%), hypopharyngeal stricture and recurrence (5%), dementia (5%), and intransigent alcohol abuse (5%). Pharyngeosophageal spasm was not observed in any subjects. We conclude that primary TEP with nonclosure of the pharyngeal muscle during TL is relatively safe. Furthermore, it is preferable over 3-layer closure because it avoids pharyngeosophageal spasm, a factor limiting voice rehabilitation.

Systematic Review of The Outcome of Different Modalities of Voice Rehabilitation Following Total Laryngectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adly Mohamed ◽  
Tarek Abdel hamid Hamdy ◽  
Anas Mohamed Askoura ◽  
Mohamed Samir Ahmed Kamal Mohamed Ghaly
Keyword(s):  
Quality Of Life ◽  
Total Laryngectomy ◽  
Voice Rehabilitation ◽  
Speech Impairment ◽  
Advantages And Disadvantages ◽  
Artificial Larynx ◽  
Oncologic Patients ◽  
Prisma Statement ◽  
Single Method

Abstract Background Speech impairment occurs in 34-70% of head and neck oncologic patients. Management of this impairment is through surgical and nonsurgical methods. Progress in voice rehabilitation following total laryngectomy has over the last 30 years, made an enormous difference in the whole concept of the management of laryngeal cancers. Objective To explore the outcome of different options of voice rehabilitation after total laryngectomy and the advantages and disadvantages of each method in order to improve the quality of life of laryngectomized patients and the suggestion of future directions for research. Patients and Methods The Aim of this work is to provide cumulative data about the efficacy and safety of the outcome of different modalities of voice rehabilitation following total laryngectomy. This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Metaanalyses (PRISMA) statement guidelines. Results Voice rehabilitation is one of the most important determinants of the quality of life after total laryngectomy. Recent advances in prosthetic voice devices have made such devices the gold standard for voice rehabilitation. They are thus preferred and used more often than old methods (esophageal speech and artificial larynx). Conclusion Although, no single method is considered to be the best for every patient, the tracheoesophageal puncture has become the most preferred method in the past decade. But it is not always possible in all patients, the results of this study indicate that ES, when achievable, is a viable option that should be considered by surgeons when making intervention decisions on patients, and should be revived when indicated. But we need much more studies.

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