Perioperative Voice Recovery: An Exercise Physiology Perspective

2013 ◽  
Vol 23 (2) ◽  
pp. 47-52 ◽  
Author(s):  
Mary J. Sandage
Keyword(s):  
Skeletal Muscle ◽  
Performing Arts ◽  
Vocal Fold ◽  
Exercise Physiology ◽  
Cell Physiology ◽  
Vocal Function ◽  
Laryngeal Surgery ◽  
Voice Outcome ◽  
Before And After ◽  
Good For

Voice professionals have differing views on the amount of voice rest prescribed before and after laryngeal surgery. Current recommendations are largely based on a long-standing belief that voice rest is good for the vocal mechanism, particularly when pathology is present or following surgical interruption of the vocal fold tissue. There is little evidence to support the benefit of extensive voice rest prior to laryngeal surgery, as is often recommended in the performing arts. In fact, preoperative voice therapy has shown benefit for postoperative voice outcome. From a wound-healing perspective, voice conservation immediately following vocal fold surgery contributes to the best vocal function outcome. There is no supportive evidence for postoperative voice rest that extends for weeks into months, as some performing artists have reported following surgery. From the perspective of skeletal muscle cell physiology and what is currently known about skeletal muscle adaptations that occur with training and detraining, a guideline for optimal voice recovery and return to performance may be clearer. The well-intentioned, long-held belief that extensive voice conservation is good for the voice may actually trigger a skeletal muscle detraining cascade that could lengthen return to optimal voice function, particularly in the vocal performing arts.

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.

scholarly journals Does Voice Therapy Cure All Vocal Fold Nodules?

2014 ◽  
Vol 4 (2) ◽  
pp. 55-59 ◽  
Author(s):  
Baisakhi Bakat ◽  
Arunima Roy ◽  
Amitabha Roychoudhury ◽  
Barin Kumar Raychaudhuri
Keyword(s):  
Vocal Fold ◽  
Tertiary Care ◽  
Vocal Folds ◽  
Voice Therapy ◽  
Care Hospital ◽  
Laryngeal Surgery ◽  
Voice Outcome ◽  
Vocal Nodules ◽  
A Prospective Study ◽  
Vocal Fold Nodules

ABSTRACT Introduction Vocal nodules are known to be one of the most common benign lesions, commonly situated at the junction of anterior one third and posterior two third of vocal folds. Voice therapy is considered to be the gold standard of treatment of vocal fold nodule. Objectives To determine the efficacy of voice therapy in the treatment of vocal fold nodules and to identify any possible reason for failure to voice therapy in managing vocal fold nodules. Materials and methods A prospective study, conducted over a period of 6 months. Eighteen adult patients diagnosed with vocal fold nodules at a tertiary care hospital were subjected to 6 weeks of voice therapy. Pre and post therapy subjective (Voice Handicap Index-10) and objective (Rigid fiber optic laryngoscopy) evaluation was done. Patients with no improvement after 6 weeks of voice therapy underwent micro laryngeal surgery. All patients were followed up at 3 months and 6 months. Results In majority of patients, objective and subjective voice outcome parameters were significantly improved after voice therapy. Although a few cases showed no significant improvement after therapy, they recovered completely after microlaryngoscopic surgery. It was found that patients who required surgery even after voice therapy had hard nodules. How to cite this article Bakat B, Gupta A, Roy A, Roychoudhury A, Raychaudhuri BK. Does Voice Therapy Cure All Vocal Fold Nodules? Int J Phonosurg Laryngol 2014;4(2):55-59.

scholarly journals Vocal outcomes after video assisted cold knife endolaryngeal phonosurgery of benign vocal fold lesions

2021 ◽  
Vol 7 (11) ◽  
pp. 1757
Author(s):  
Sanjeev Mishra ◽  
Aishwarya Ullal ◽  
Shiv Kumar Rathaur
Keyword(s):  
Vocal Fold ◽  
Conservative Therapy ◽  
High Definition ◽  
Video Assisted ◽  
Laryngeal Surgery ◽  
Benign Vocal Fold Lesions ◽  
Voice Outcome ◽  
Endolaryngeal Surgery ◽  
Static Images ◽  
Cold Knife

<p class="abstract"><strong>Background:</strong> This study focuses on therapeutic possibilities in managing benign superficial vocal fold lesions with video assisted cold knife endolaryngeal phonosurgery.</p><p class="abstract"><strong>Methods: </strong>Fifty patients with benign vocal fold lesions presented to us between September 2013 and October 2015 who failed conservative therapy were subjected to video assisted cold knife endolaryngeal phonosurgery. The pre and postoperative results were evaluated based on voice rating by visual analogue scale and GRBAS scale.</p><p class="abstract"><strong>Results</strong>: Encouraging results were achieved with cold knife endolaryngeal surgery as 96.3% of patients were symptom free without any recurrence after single operation. Most of them have achieved &gt;90% of voice outcome by 1 month postoperatively based on voice assessment and laryngoscopic evaluation.</p><p class="abstract"><strong>Conclusions:</strong> Using a telescope with high definition video system for performing phonosurgery is economic, enables the surgeon to acquire static images and video sequences. Cold knife endoscopic laryngeal surgery is possibly a better option for addressing BVFLs.</p>

Videoendoscopic Laryngeal Surgery

2000 ◽  
Vol 109 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Koichi Omori ◽  
Tomoko Tsuji ◽  
Kaoru Shinohara ◽  
Hisayoshi Kojima
Keyword(s):  
High Resolution ◽  
Vocal Fold ◽  
Charge Coupled Device ◽  
Vocal Function ◽  
Laryngeal Surgery ◽  
Benign Vocal Fold Lesions ◽  
Laryngeal Lesions ◽  
Laryngeal Tumors ◽  
High Resolution Images ◽  
Device Chip

This paper introduces videoendoscope-assisted laryngeal surgery with office-based equipment. With this technique, a patient is seated and the nose, pharynx, and larynx are topically anesthetized. A flexible videoendoscope with a light-sensitive charge-coupled device chip built into the tip is transnasally inserted by an assistant. Specially designed fine-tipped forceps and scalpels were developed for removal of laryngeal lesions. Videoendoscopic laryngeal surgery was undertaken in 114 cases of laryngeal lesions such as polyps, granuloma, and cancer. For benign vocal fold lesions, postoperative vocal function was shown to be improved on aerodynamic and perceptual analyses. For laryngeal tumors, biopsy of the lesion was easily undertaken. Videoendoscopic laryngeal surgery presents the following advantages. It is applicable to outpatients not requiring general anesthesia, it enables functional monitoring of the patient's voice and vocal fold during phonation, it allows for delicate manipulations with both hands, and it gives high-resolution images in comparison to conventional fiberscopy.

Voice outcome after vocal fold injection augmentation with carboxymethyl cellulose versus calcium hydroxyapatite

2020 ◽  
Vol 134 (3) ◽  
pp. 263-269 ◽  
Author(s):  
J T Cohen ◽  
L Benyamini
Keyword(s):  
Carboxymethyl Cellulose ◽  
Vocal Fold ◽  
Voice Quality ◽  
Calcium Hydroxyapatite ◽  
Vocal Fold Paralysis ◽  
Glottic Insufficiency ◽  
Laryngeal Surgery ◽  
Voice Outcome ◽  
Vocal Fold Injection ◽  
Sulcus Vocalis

AbstractBackgroundVocal fold injection augmentation is a recognised treatment modality for glottic insufficiency. Causes of glottal closure insufficiency include vocal fold paralysis, paresis, atrophy, sulcus vocalis, scarring and vocal fold deficiency after laryngeal surgery. A variety of materials exist for injection augmentation. This study aimed to compare voice improvement after injection augmentation between two injectable materials: carboxymethyl cellulose and calcium hydroxyapatite.MethodThis retrospective study included 66 consecutive patients with glottic insufficiency who underwent injection augmentation.ResultsAmong the patients who received their first injection augmentation with carboxymethyl cellulose and their second injection augmentation with calcium hydroxyapatite (n = 28), voice quality improved significantly after both injection augmentations. No significant differences were observed in any of the objective and subjective voice quality measurements examined following carboxymethyl cellulose and calcium hydroxyapatite injections.ConclusionVoice improvement after injection augmentation depends mainly on the improvement of glottic closure, rather than the injection material.

Vitamin B6 Deficiency can Reduce Fuel Storage and Utilization in Physically Trained Rats

2008 ◽  
Vol 78 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Choi ◽  
Cho
Keyword(s):  
Skeletal Muscle ◽  
Fatty Acid ◽  
Muscle Protein ◽  
Plasma Free Fatty Acid ◽  
Vitamin B ◽  
Liver Protein ◽  
Protein Levels ◽  
Before And After ◽  
Fuel Storage ◽  
Exercise Muscle

This study investigated the effect of vitamin B6 deficiency on the utilization and recuperation of stored fuel in physically trained rats. 48 rats were given either vitamin B6-deficient (B6–) diet or control (B6+) diet for 4 weeks and were trained on treadmill for 30 minutes daily. All animals were then subdivided into 3 groups: before-exercise (BE); during-exercise (DE); after-exercise (AE). The DE group was exercised on treadmill for 1 hour just before being sacrificed. Animals in the AE group were allowed to take a rest for 2 hours after being exercised like the DE group. Glucose and free fatty acids were compared in plasma. Glycogen and triglyceride were compared in liver and skeletal muscle. Protein levels were compared in plasma, liver, and skeletal muscle. Compared with the B6+ group, plasma glucose levels of the B6– group were significantly lower before and after exercise. Muscle glycogen levels of the B6– group were significantly lower than those of the B6+ group regardless of exercise. The liver glycogen level of the B6– group was also significantly lower than that of B6+ group during and after exercise. Before exercise, plasma free fatty acid levels were not significantly different between the B6+ and B6– groups, and plasma free fatty acid levels of the B6– group were significantly lower during and after exercise. The muscle triglyceride level of the B6– group was significantly lower than that of the B6+ group before exercise, and there were no differences between B6+ and B6– groups during and after exercise. Liver triglyceride levels were not significantly different between B6+ and B6– groups. Plasma protein levels of the B6– group were lower than those of B6+ before and after exercise. Muscle protein levels of the B6– group were not significantly different from those of the B6+ group. Liver protein levels of the B6– group were significantly lower than that of the B6+ group after exercise. Liver protein levels of both B6+ and B6– groups were not significantly changed, regardless of exercise. Thus, it is suggested that vitamin B6 deficiency may reduce fuel storage and utilization with exercise in physically trained rats.

Application of a Computer Vision Tool for Automated Glottic Tracking to Vocal Fold Paralysis Patients

2021 ◽  
pp. 019459982198960
Author(s):  
Tiffany V. Wang ◽  
Nat Adamian ◽  
Phillip C. Song ◽  
Ramon A. Franco ◽  
Molly N. Huston ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Assessment Tool ◽  
Medical Center ◽  
Characteristic Curve ◽  
Academic Medical Center ◽  
Vocal Fold Paralysis ◽  
Control Group ◽  
Large Patient ◽  
Patient Reported ◽  
Before And After

Objectives (1) Demonstrate true vocal fold (TVF) tracking software (AGATI [Automated Glottic Action Tracking by artificial Intelligence]) as a quantitative assessment of unilateral vocal fold paralysis (UVFP) in a large patient cohort. (2) Correlate patient-reported metrics with AGATI measurements of TVF anterior glottic angles, before and after procedural intervention. Study Design Retrospective cohort study. Setting Academic medical center. Methods AGATI was used to analyze videolaryngoscopy from healthy adults (n = 72) and patients with UVFP (n = 70). Minimum, 3rd percentile, 97th percentile, and maximum anterior glottic angles (AGAs) were computed for each patient. In patients with UVFP, patient-reported outcomes (Voice Handicap Index 10, Dyspnea Index, and Eating Assessment Tool 10) were assessed, before and after procedural intervention (injection or medialization laryngoplasty). A receiver operating characteristic curve for the logistic fit of paralysis vs control group was used to determine AGA cutoff values for defining UVFP. Results Mean (SD) 3rd percentile AGA (in degrees) was 2.67 (3.21) in control and 5.64 (5.42) in patients with UVFP ( P < .001); mean (SD) 97th percentile AGA was 57.08 (11.14) in control and 42.59 (12.37) in patients with UVFP ( P < .001). For patients with UVFP who underwent procedural intervention, the mean 97th percentile AGA decreased by 5 degrees from pre- to postprocedure ( P = .026). The difference between the 97th and 3rd percentile AGA predicted UVFP with 77% sensitivity and 92% specificity ( P < .0001). There was no correlation between AGA measurements and patient-reported outcome scores. Conclusions AGATI demonstrated a difference in AGA measurements between paralysis and control patients. AGATI can predict UVFP with 77% sensitivity and 92% specificity.

Muscle glycogen availability and temperature regulation in humans

1989 ◽  
Vol 66 (1) ◽  
pp. 72-78 ◽  
Author(s):  
L. Martineau ◽  
I. Jacobs
Keyword(s):  
Skeletal Muscle ◽  
Muscle Glycogen ◽  
Temperature Regulation ◽  
Vastus Lateralis ◽  
Water Immersion ◽  
Vastus Lateralis Muscle ◽  
Glycogen Concentration ◽  
Exercise Regimen ◽  
Before And After ◽  
Muscle Groups

The effects of intramuscular glycogen availability on human temperature regulation were studied in eight seminude subjects immersed in 18 degrees C water for 90 min or until rectal temperature (Tre) decreased to 35.5 degrees C. Each subject was immersed three times over a 3-wk period. Each immersion followed 2.5 days of a specific dietary and/or exercise regimen designed to elicit low (L), normal (N), or high (H) glycogen levels in large skeletal muscle groups. Muscle glycogen concentration was determined in biopsies taken from the vastus lateralis muscle before and after each immersion. Intramuscular glycogen concentration before the immersion was significantly different among the L, N, and H trials (P less than 0.01), averaging 247 +/- 15, 406 +/- 23, and 548 +/- 42 (SE) mmol glucose units.kg dry muscle-1, respectively. The calculated metabolic heat production during the first 30 min of immersion was significantly lower during L compared with N or H (P less than 0.05). The rate at which Tre decreased was more rapid during the L immersion than either N or H (P less than 0.05), and the time during the immersion at which Tre first began to decrease also appeared sooner during L than N or H. The results suggest that low skeletal muscle glycogen levels are associated with more rapid body cooling during water immersion in humans. Higher than normal muscle glycogen levels, however, do not increase cold tolerance.

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