Treatment of Vocal Fold Immobility by Glutaraldehyde—Cross-Linked Collagen Injection: Longc-Term Results

1995 ◽  
Vol 104 (6) ◽  
pp. 437-441 ◽  
Author(s):  
Marc Remacle ◽  
Jean-Marc Dujardin ◽  
Georges Lawson
Keyword(s):  
Vocal Fold ◽  
Speech Therapy ◽  
Systemic Reaction ◽  
Long Term Effects ◽  
Maximum Phonation Time ◽  
Long Term Stability ◽  
Vocal Fold Immobility ◽  
The Voice

Fifty-three cases of unilateral vocal fold immobility treated by glutaraldehyde—cross-linked (GAX) collagen over a 6-year period with a mean follow-up of 4.5 years were reviewed for assessment of the immediate and long-term effects on phonation. The mean amount injected was 1.47 mL. No long-term local or systemic reaction to the collagen was seen. The median preoperative maximum phonation time (MPT) was 7.5 seconds, the median immediate postoperative MPT 12 seconds, and the median long-term postoperative MPT 11 seconds. The median preoperative phonatory quotient (PQ) was 564 mL/s. The median immediate postoperative PQ was 320 mL/s, whereas the median long-term postoperative PQ was 385 mL/s. The quantitative improvement in the voice as measured by the PQ was thus 67% for the short range and 49% for the long range. The decline in the results over time was 20.3%. Vocal frequency analysis showed that the fundamental frequency and harmonics returned and were maintained in the long term for more than 80% of the patients with the help of speech therapy. This relative stability is explained by the findings of previous histological work. The fact that collagen, unlike Teflon, does not cause an inflammatory reaction and the partial maintenance of the improvement achieved, which is to be compared with the instability of the effects produced by resorbable substances, make it the “least objectionable” injectable for the treatment of unilateral glottic fold immobility. One must overcompensate 20% to 30%, given the results of the long-term stability studies.

scholarly journals Characteristics of voice and personality of patients with vocal fold immobility

CoDAS ◽  
2015 ◽  
Vol 27 (2) ◽  
pp. 178-185 ◽  
Author(s):  
Anna Alice Figueirêdo de Almeida ◽  
Luana Ramos Fernandes ◽  
Elma Heitmann Mares Azevedo ◽  
Renata Serrano de Andrade Pinheiro ◽  
Leonardo Wanderley Lopes
Keyword(s):  
Risk Factors ◽  
Vocal Fold ◽  
Speech Therapy ◽  
Personality Characteristics ◽  
Voice Disorder ◽  
Moderate Intensity ◽  
Screening Protocol ◽  
Vocal Fold Immobility ◽  
Realization Factors ◽  
The Voice

Purpose: To examine the voice and personality characteristics of patients diagnosed with organic dysphonia secondary to vocal fold immobility. Methods: The study comprised patients of both genders, attending the Clinic School of Speech Therapy of the Federal University of Paraíba, with otorhinolaryngological diagnosis of vocal fold immobility and speech therapy diagnosis of dysphonia. The self-assessment of voice was measured through a Vocal Screening Protocol and Voice Symptoms Scale (VoiSS), the voice was collected for auditory-perceptive evaluation, and the Factorial Personality Battery (FPB) was used. Descriptive statistical analysis was performed to determine the frequency, mean, and standard deviation of the studied variables. Results: Eight patients participated in the study, of both genders, with average age of 40.4±16.9 years. The more frequent risk factors were the personal ones (4.7±2.1). In the VoiSS, the patients presented a higher average in the limitation score (34.1±15.7). From the auditory-perceptive evaluation, moderate intensity of vocal deviation was obtained, with predominant vocal roughness (57.7±25.2). In the FPB, the patients had an average higher than the cutoff scores in neuroticism (3.8±1.4) and accomplishment (5.2±1.0). Conclusion: The predominant vocal parameter was roughness. The patients referred to a few risk factors that compromise the vocal behavior and presented the neuroticism and realization factors as a highlight in their personality. Thus, individuals with vocal fold immobility show personality characteristics that may be a reflection of their voice disorder, not a factor that determines their dysphonia.

Impact of speech therapy on the improvement of voice quality in patients with unilateral vocal fold paralysis

2018 ◽  
Vol 7 (4) ◽  
pp. 1-7
Author(s):  
Anna Kuligowska ◽  
Barbara Jamróz ◽  
Joanna Chmielewska ◽  
Katarzyna Jędra ◽  
Tomasz Czernicki ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Speech Therapy ◽  
Acoustic Analysis ◽  
Vocal Tract ◽  
Voice Quality ◽  
Maximum Phonation Time ◽  
Before And After ◽  
Vocal Fold Palsy ◽  
The Voice

Aim of study: Evaluation of the speech therapy on voice quality in patients with unilateral vocal fold palsy. Material and methods: The study group included 11 patients, 8 women and 3 men, in age between 16 to 72 years, with unilateral vocal fold palsy, diagnosed in ENT Department of Warsaw Medical University between 2017-2018. Each person completed questionnaires: the voice disability self-assessment scale (VHI), the voice-based quality of life (VRQoL) scale, the vocal tract discomfort scale (VTD). All questionnaires were completed twice, before and after the voice therapy. In addition, the acoustic analysis of the voice, the assessment of the maximum phonation time and the breathing tract were performed twice in each patient. Each of the patients had a voice rehabilitation consisting of a series of 10 meetings. Results: Statistical analysis of the results of maximum phonation time, the self-assessment of voice disability, the quality of life depending on the voice, discomfort of the vocal tract voice acoustic analysis showed statistically significant differences in the results before and after rehabilitation (p <0.005). In addition, the improvement of the respiratory tract was observed in the majority of patients. Conclusions: Speech therapy significantly affects the voice quality of patients with unilateral laryngeal nerve palsy.

Novel Approach of Medialization Thyroplasty with Arytenoid Adduction Performed under General Anesthesia with a Laryngeal Mask

2011 ◽  
Vol 146 (2) ◽  
pp. 266-271 ◽  
Author(s):  
Nicholas W. Stow ◽  
Jennifer W. Lee ◽  
Ian E. Cole
Keyword(s):  
Vocal Fold ◽  
Case Series ◽  
Vocal Fold Paralysis ◽  
Laryngeal Mask ◽  
Unilateral Vocal Fold Paralysis ◽  
Maximum Phonation Time ◽  
Arytenoid Adduction ◽  
Medialization Thyroplasty ◽  
The Voice

Objective. To objectively assess the voice outcomes of patients with unilateral vocal fold paralysis treated with medialization thyroplasty and arytenoid adduction suture. Study Design. Case series of patients who underwent medialization thyroplasty and arytenoid adduction suture. Preoperative and postoperative voice testing was performed and the data were compared by statistical analysis. Setting. Tertiary referral teaching hospital in Sydney, Australia. Subjects. All patients had a unilateral vocal fold paralysis, with a large posterior glottic gap and vocal symptoms affecting their quality of life. Methods. Thirteen patients with a diagnosis of a unilateral vocal fold paralysis with a large posterior glottic gap, vocal symptoms, and total denervation of the vocal fold underwent medialization thyroplasty and arytenoid adduction suture. The surgery was performed in a novel method under a general anesthetic using a laryngeal mask and with direct intraoperative endoscopic feedback. Preoperative and postoperative measures of voice performance were compared, including acoustic analysis (fundamental frequency, speech intensity against quiet and loud background noise, speech rate) and aerodynamic assessment (airflow, maximum phonation time). Results. Medialization thyroplasty with arytenoid adduction suture significantly improved aerodynamic assessment and phonation duration for both male and female subjects overall. There were 2 of 13 treatment failures. Median follow-up time was 6 months. Conclusion. Preliminary results indicate that in selected patients with vocal fold paralysis, medialization thyroplasty with arytenoid adduction suture leads to significant improvements in objective voice measures. Longer follow-up data are required to further quantify the voice outcomes after this procedure.

Autologous Fat Injection for Unilateral Vocal Fold Paralysis

1996 ◽  
Vol 105 (8) ◽  
pp. 602-606 ◽  
Author(s):  
Maisie L. Shindo ◽  
Lauren S. Zaretsky ◽  
Dale H. Rice
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Fat Injection ◽  
Autologous Fat ◽  
The Voice ◽  
Fat Volume

This study evaluates the efficacy of autologous fat injection for medialization of the paralyzed vocal fold. In 21 patients with unilateral vocal fold paralysis, autologous abdominal fat was injected into the thyroarytenoid muscle to achieve medialization. All patients were followed up with serial videolaryngoscopy and voice evaluation. At 2 months' follow-up, the voice was judged to be excellent in 10 patients, slightly breathy but significantly better than the preoperative voice in 6 patients, and markedly breathy in 4 patients. At 3 to 4 months' follow-up, of the 10 patients with excellent results, 5 maintained an excellent voice, 3 had developed slight breathiness, and 1 had developed severe breathiness. Long-term (6 to 12 months) results were available in 11 patients, and all of them maintained the same voice quality that was noted during the 3 to 4 months' examination. Magnetic resonance imaging of the larynx was obtained in 7 patients at intervals ranging from 1 to 7 months and compared to the baseline scan obtained at 1 week postoperative to assess the amount of fat remaining in the muscle. The images showed fat volume to persist, but a decrease in the fat signal was observed over time. The results suggest that the duration of medialization with autologous fat is variable, but appears to last at least 2 to 3 months. This loss of volume after 3 months seems to be due to absorption of the fat and possibly muscle atrophy. Autologous fat injection is relatively safe and easy to perform, and is an ideal method of temporary vocal fold medialization in patients in whom return of vocal fold function is expected.

scholarly journals The course of subjective and objective chemosensory dysfunction in hospitalized patients with COVID-19: a 6-month follow-up

2021 ◽  
Author(s):  
Mattis Bertlich ◽  
Clemens Stihl ◽  
Enzo Lüsebrink ◽  
Johannes C. Hellmuth ◽  
Clemens Scherer ◽  
...  
Keyword(s):  
Long Term Effects ◽  
Initial Examination ◽  
Initial Cohort ◽  
Negative Controls ◽  
Chemosensory Function ◽  
Analogue Scales ◽  
Smell Identification ◽  
Snot 22

Abstract Purpose It has been established that the infection with SARS-CoV-2 may cause an impairment of chemosensory function. However, there is little data on the long-term effects of SARS-CoV-2 infection on chemosensory function. Methods Twenty three SARS-CoV-2-positive patients diagnosed in spring 2020 with subjective hyposmia (out of 57 positive patients, 40.3%) were compared to SARS-CoV-2-positive patients without hyposmia (n = 19) and SARS-CoV-2-negative patients (n = 14). Chemosensory function was assessed by the Brief Smell Identification Test (BSIT), Taste Strips (TS), Visual Analogue Scales (VAS), and the SNOT-22. The initial cohort with hyposmia were also examined at 8 weeks and 6 months after initial examination. Results There were no differences between the SARS-CoV-2-positive cohort without hyposmia and negative controls in terms of BSIT (8.5 ± 2.6 vs. 10.2 ± 1.8), TS (3.4 ± 0.6 vs. 3.9 ± 0.3) or VAS (2.1 ± 1.3 vs. 1.1 ± 0.5); yet the SNOT-22 was significantly elevated (27.7 ± 11.2 vs. 16.4 ± 10.8). The SARS-CoV-2-positive group with hyposmia performed significantly poorer in BSIT (4.0 ± 1.7 vs. 8.5 ± 2.6/10.2 ± 1.8), TS (2.6 ± 1.3 vs. 3.4 ± 0.6/3.9 ± 0.3), and VAS (7.9 ± 2.2 vs. 2.1 ± 1.3/1.1 ± 0.5) compared to both control groups. At week 8 and month 6 control, six and five patients, respectively, still suffered from subjectively and objectively impaired chemosensory function. The other patients had recovered in both respects. Conclusion SARS-CoV-2 patients with subjectively impaired chemosensory function regularly perform poorly in objective measurements. About 70% of patients suffering from olfactory dysfunction in SARS-CoV-2 quickly recover—the rest still suffers from considerable impairment 6 months after infection.

scholarly journals Long-term effects of a modified, low-protein infant formula on growth and body composition: Follow-up of a randomized, double-blind, equivalence trial

2021 ◽  
Author(s):  
Stefanie M.P. Kouwenhoven ◽  
Nadja Antl ◽  
Martijn J.J. Finken ◽  
Jos W.R. Twisk ◽  
Eline M. van der Beek ◽  
...  
Keyword(s):  
Body Composition ◽  
Infant Formula ◽  
Long Term Effects ◽  
Double Blind ◽  
Equivalence Trial ◽  
Low Protein

scholarly journals Long-term effects of the Dutch Schoolgruiten Project – promoting fruit and vegetable consumption among primary-school children

2009 ◽  
Vol 12 (8) ◽  
pp. 1213-1223 ◽  
Author(s):  
Nannah I Tak ◽  
Saskia J te Velde ◽  
Johannes Brug
Keyword(s):  
Primary School ◽  
Vegetable Consumption ◽  
Primary School Children ◽  
Secondary Outcome ◽  
Fruit Intake ◽  
Long Term Effects ◽  
Intervention Effects ◽  
Parent Reports

AbstractObjectivesTo evaluate the long-term effects of the Schoolgruiten Project, a Dutch primary school-based intervention providing free fruit and vegetables (F&V). In addition, we assessed whether children’s appreciation of the project mediated these intervention effects.Design and methodsParticipating schoolchildren (mean age 9·9 years at baseline) and their parents completed parallel questionnaires at baseline, at 1-year and at 2-year follow-up, including questions on usual F&V intake of the child, potential behavioural determinants, their appreciation of the project and general demographics. Primary outcomes were usual F&V intakes as assessed by parent and child self-reported food frequency measures. Secondary outcome measures were taste preference, knowledge of daily recommendations, availability and accessibility for fruit intake. Multilevel linear regression analyses were used to assess differences at second follow-up adjusted for baseline values between control and intervention groups.SubjectsReports were available for 346 intervention children (148 parents) and 425 control children (287 parents).ResultsBoth child and parent reports indicated that the intervention group had a significantly higher fruit intake at 2-year follow-up (difference, servings/d: 0·15; 95 % CI 0·004, 0·286 for child reports; 0·19; 95 % CI 0·030, 0·340 for parent reports). No significant effects on vegetable intake were observed. Significant positive intervention effects were also found for knowledge of fruit recommendations among boys. Some evidence was found for partial mediation analyses of the effects on fruit intake.ConclusionThe present study indicates that the Schoolgruiten scheme was effective in increasing children’s fruit intake and that appreciation of the project partially mediated this effect.

The acceptance of hearing aids for children with otitis media with effusion

1999 ◽  
Vol 113 (4) ◽  
pp. 314-317 ◽  
Author(s):  
A. H. Jardine ◽  
M. V. Griffiths ◽  
E. Midgley
Keyword(s):  
Otitis Media ◽  
Hearing Aids ◽  
Otitis Media With Effusion ◽  
Binaural Hearing ◽  
Long Term Effects ◽  
Non Invasive ◽  
Parents And Children ◽  
Binaural Hearing Aids

AbstractConservative treatment for otitis media with effusion (OME) led us to consider the use of hearing aids as a way of managing the associated hearing loss. This study aimed to assess the compliance of patients and acceptance of hearing aids for the management of children with OME.Thirty-nine children who had been given binaural hearing aids to manage OME were assessed at routine follow-up after six months. A clinician who did not prescribe the aid administered a questionnaire to assess compliance, change in symptoms and acceptance of the aids.Thirty-eight parents thought the aids were easy to use and 25 (66 per cent) were completely satisfied with the management. Aided hearing improved by a mean of 17 dB (Range 10–30) over three frequencies, 0.5, 1.0, 2.0 Khz and all parents reported subjective hearing improvement in their children. The stigma of an aid was reported as minimal under the age of seven.Hearing aids provide a non-invasive way of managing the problems associated with OME which is acceptable to certain parents and children. Long-term effects of using aids need to be evaluated before they can be recommended.

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