Vibratory Characteristics of Teflon-Injected and Noninjected Paralyzed Vocal Folds

1990 ◽  
Vol 55 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Thomas Watterson ◽  
Stephen C. McFarlane ◽  
Andrea L. Menicucci
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Head Turning ◽  
Glottal Closure ◽  
Vocal Fold Vibration ◽  
Digital Manipulation

This study compared the vibratory characteristics of normal vocal folds, Teflon-injected paralyzed vocal folds, and noninjected paralyzed vocal folds. Laryngeal videostroboscopy under eight phonatory conditions showed that the Teflon-injected vocal folds were adynamic. The noninjected vocal folds, however, vibrated during each of the phonatory conditions although not necessarily like a normal vocal fold. In terms of vocal fold physiology, it appeared that the noninjected paralyzed vocal folds were too compliant, whereas the Teflon-injected vocal folds were too stiff. Because vocal fold paralysis is often treated in voice therapy with "digital manipulation" and "head turning," the effect of these techniques on vocal fold vibration was also studied. The results showed that digital manipulation was superior to head turning for improving glottal closure but that neither technique appeared to influence the periodicity, amplitude, or extent of vocal fold vibration for either the injected or noninjected vocal folds.

Effects of Voice Therapy as Objectively Evaluated by Digitized Laryngeal Stroboscopic Imaging

2002 ◽  
Vol 111 (10) ◽  
pp. 902-908 ◽  
Author(s):  
Renée Speyer ◽  
Pieter A. Kempen ◽  
George Wieneke ◽  
Willem Kersing ◽  
Elham Ghazi Hosseini ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Lesion Size ◽  
Voice Therapy ◽  
Benign Lesions ◽  
Objective Measurements ◽  
Significant Parameter ◽  
Surface Areas ◽  
Vocal Fold Vibration ◽  
Maximal Opening

Objective measurements derived from digitized laryngeal stroboscopic images were used to demonstrate changes in vocal fold vibration and in the size of benign lesions after 3 months of voice therapy. Forty chronically dysphonic patients were studied. By means of a rigid stroboscope, pretreatment and posttreatment recordings were made of the vocal folds at rest and under stroboscopic light during phonation. From each recording, images of the positions at rest and during vibration at maximal opening and at maximal closure were digitized. The surface areas of any lesions and of the glottal gap were independently measured in the digitized images by 2 experienced laryngologists. Referential distances were determined in order to compensate for discrepancies in magnification in the various recordings. After 3 months of voice therapy, significant improvement in lesion size and degree of maximal closure during vibration could be demonstrated in about 50% of the patients. The degree of maximal opening did not prove to be a significant parameter.

A Synopsis of the Management of Vocal Fold Scar

2009 ◽  
Vol 19 (1) ◽  
pp. 15-23
Author(s):  
Edie R. Hapner ◽  
Adam Klein
Keyword(s):  
Lamina Propria ◽  
Vocal Fold ◽  
Wave Motion ◽  
Behavioral Treatment ◽  
Vocal Folds ◽  
Voice Therapy ◽  
Pitch Range ◽  
Glottal Closure ◽  
Vocal Fold Scar

Abstract Vocal fold scarring remains one of the greatest therapeutic challenges in laryngology and voice therapy. The loss of superior lamina propria results in a change in the pliability of the vocal folds with changes in glottal configuration, glottal closure, and reduced to absent mucosal wave motion. This results in dysphonia of varying severities including breathiness, roughness, loss of pitch range, and flexibility. The aim of this article is to present a brief review of vocal fold architecture and a discussion of the etiologies of vocal fold scarring. Methods to evaluate vocal fold scarring are presented with examples of findings in laryngoscopic, acoustic, aerodynamic, and perceptual assessments. Medical, surgical, and behavioral treatment for vocal folds scaring including sample therapy tasks are included.

Early voice therapy for unilateral vocal fold paralysis improves subglottal pressure and glottal closure

2020 ◽  
Vol 41 (6) ◽  
pp. 102727
Author(s):  
Eri Miyata ◽  
Makoto Miyamoto ◽  
Osamu Shiromoto ◽  
Yoshiki Kobayashi ◽  
Masao Yagi ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis ◽  
Glottal Closure ◽  
Subglottal Pressure

Reduction in Short- and Long-term Pneumonia Rate With Laryngoplasty for Unilateral Vocal Fold Paralysis

2021 ◽  
pp. 019459982110151
Author(s):  
Cheng-Ming Hsu ◽  
Yao-Te Tsai ◽  
Geng-He Chang ◽  
Yao-Hsu Yang ◽  
Tuan-Jen Fang ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Vocal Fold ◽  
Proportional Hazards ◽  
Vocal Fold Paralysis ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis ◽  
Short And Long Term

Objective To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP). Study Design Population-based retrospective cohort study. Setting Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan. Methods In the LHID2000, we identified 439 patients having new diagnoses of UVFP from 1997 to 2013. We grouped the aforementioned patients according to UVFP treatment and probed the occurrence of pneumonia: 305 patients underwent laryngoplasty or voice therapy, and 134 patients did not undergo treatment. Follow-up procedures were executed for the enrollees until death or December 31, 2013, representing the end of the study period. We assessed the association of UVFP treatment and pneumonia by executing Cox proportional hazards regression. Results The pneumonia cumulative incidence was significantly higher among enrolled patients without treatment than in those receiving treatment ( P < .001). The pneumonia incidence was significantly lower in patients receiving UVFP treatment (hazard ratio, 0.49; 95% CI, 0.27-0.88; P = .018), as validated by the Cox proportional hazards model after adjustment. Patients undergoing laryngoplasty with or without voice therapy had a significantly lower incidence of pneumonia at 6 months and 1, 3, and 5 years, whereas those undergoing voice therapy alone did not. Conclusion Laryngoplasty was associated with a lower incidence of short- and long-term pneumonia in patients with UVFP. Physicians should encourage patients with UVFP at risk of aspiration to receive prompt evaluation as well as treatment.

Reinke's Edema: Phonatory Mechanisms and Management Strategies

1997 ◽  
Vol 106 (7) ◽  
pp. 533-543 ◽  
Author(s):  
Steven M. Zeitels ◽  
Glenn W. Bunting ◽  
Robert E. Hillman ◽  
Traci Vaughn
Keyword(s):  
Lamina Propria ◽  
Fundamental Frequency ◽  
Vocal Fold ◽  
Management Strategies ◽  
Vocal Folds ◽  
Vocal Fold Vibration ◽  
Reinke’S Edema ◽  
Subglottal Pressure ◽  
Almost All ◽  
Superficial Lamina

Reinke's edema (RE) has been associated typically with smoking and sometimes with vocal abuse, but aspects of the pathophysiology of RE remain unclear. To gain new insights into phonatory mechanisms associated with RE pathophysiology, weused an integrated battery of objective vocal function tests to analyze 20 patients (19 women) who underwent phonomicrosurgical resection. Preoperative stroboscopic examinations demonstrated that the superficial lamina propria is distended primarily on the superior vocal fold surface. Acoustically, these individuals have an abnormally low average speaking fundamental frequency (123 Hz), and they generate abnormally high average subglottal pressures (9.7 cm H20). The presence of elevated aerodynamic driving pressures reflects difficulties in producing vocal fold vibration that are most likely the result of mass loading associated with RE, and possibly vocal hyperfunction. Furthermore, it is hypothesized that in the environment of chronic glottal mucositis secondary to smoking and reflux, the cephalad force on the vocal folds by the subglottal driving pressure contributes to the superior distention of the superficial lamina propria. Surgical reduction of the volume of the superficial lamina propria resulted in a significant elevation in fundamental frequency (154 Hz) and improvement in perturbation measures. In almost all instances, both the clinician and the patient perceived the voice as improved. However, these patients continued to generate elevated subglottal pressure (probably a sign of persistent hyperfunction) that was accompanied by visually observed supraglottal strain despite the normalsized vocal folds. This finding suggests that persistent hyperfunctional vocal behaviors may contribute to postsurgical RE recurrence if therapeutic strategies are not instituted to modify such behavior.

Videostrobolaryngoscopy of Mucus Layer during Vocal Fold Vibration in Patients with Laryngeal Tension-Fatigue Syndrome

2002 ◽  
Vol 111 (6) ◽  
pp. 537-541 ◽  
Author(s):  
Tzu-Yu Hsiao ◽  
Chia-Ming Liu ◽  
Kai-Nan Lin
Keyword(s):  
Mechanical Properties ◽  
Vocal Fold ◽  
Rough Surfaces ◽  
Voice Disorders ◽  
Vocal Folds ◽  
Voice Disorder ◽  
Mucus Layer ◽  
Vocal Fold Vibration ◽  
Fatigue Syndrome ◽  
Functional Dysphonia

The mucus layer on the vocal folds was examined by videostrobolaryngoscopy in patients with laryngeal tension-fatigue syndrome, a chronic functional dysphonia due to vocal abuse and misuse. Besides the findings in previous reports (such as abnormal glottal closure, phase or amplitude asymmetry, and the irregular mucosal wave), the vocal folds during vibration had an uneven mucus surface. The occurrence of an uneven mucus layer on vocal folds was significantly greater in subjects with this voice disorder (83% or 250 of 301 patients in this series) than in those without voice disorders (18.5% or 5 of 27). The increase of mucus viscosity, mucus aggregation, and the formation of rough surfaces on the vocal folds alter the mechanical properties that contribute to vibration of the cover of the vocal folds, and thereby worsen the symptoms of dysphonia in patients with laryngeal tension-fatigue syndrome.

Vocal Evaluation of Thyroplasty Type I in the Treatment of Nonparalytic Glottic Incompetence

1998 ◽  
Vol 107 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Fang-Ling Lu ◽  
Donna S. Lundy ◽  
Roy R. Casiano ◽  
Jun-Wu Xue
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Perceptual Judgment ◽  
Function Evaluation ◽  
Type I ◽  
Unilateral Vocal Fold Paralysis ◽  
Vocal Function ◽  
Voice Outcome ◽  
Minimal Improvement

This study investigated the prethyroplasty and postthyroplasty voices of patients with glottic incompetence of mobile vocal folds related to vocal fold bowing and scarring. Seventeen patients underwent vocal function evaluation preoperatively and 1 month postoperatively with videostrobolaryngoscopic examination, acoustic and aerodynamic analysis, and perceptual judgment of voice characteristics. The postoperative voice outcome in this group of patients was compared to that of a group of patients with unilateral vocal fold paralysis. Patients with vocal fold bowing showed significant improvement in glottic gap size and hoarseness after the surgery. There was minimal improvement on other test measures. Patients with vocal fold scarring exhibited worse preoperative and postoperative vocal functions, with little voice improvement after surgery. The outcome of thyroplasty type I in cases of vocal fold bowing or scarring is not as good as that in unilateral vocal fold paralysis.

The role of stroboscopy in the management of a patient with a unilateral vocal fold paralysis

1996 ◽  
Vol 110 (2) ◽  
pp. 141-143 ◽  
Author(s):  
Meredydd Lloyd Harries ◽  
Murray Morrison
Keyword(s):  
Surgical Treatment ◽  
Diagnostic Tool ◽  
Vocal Fold ◽  
Speech Therapy ◽  
Muscle Tone ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis

AbstractStroboscopy is well established as an essential diagnostic tool in the assessment of the vocal folds during phonation. This paper analyses the stroboscopic findings in 100 patients with a unilateral vocal fold paralysis. Reliable stroboscopic signals were only obtained in patients with the paralysed fold close to the midline. These patients seldom require surgery however, usually responding to speech therapy with laryngeal compensation giving a good voice. Most patients that require surgery have a large glottal deficiency, but in this series these patients did not give an adequate signal for analysis. Although useful in the assessment of the muscle tone of the paralysed fold, the influence of stroboscopy on the surgical treatment in this series was limited.

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