Prevalence of Minor Larynx Structural Alterations: Influence on the Concept of a Normal Vocal Fold

2018 ◽  
Vol 160 (2) ◽  
pp. 295-301 ◽  
Author(s):  
Bruno Teixeira Moraes ◽  
Noemi Grigoletto De Biase
Keyword(s):  
Vocal Fold ◽  
Medical Center ◽  
Upper Airway ◽  
Morphological Characterization ◽  
Cross Sectional ◽  
Structural Alterations ◽  
Sulcus Vocalis ◽  
Common Combination ◽  
Fold Cover

Objective To determine the prevalence of minor structural alterations (MSA) in the vocal fold cover in a population submitted to extralaryngeal site surgery and to characterize them according to morphological and epidemiological parameters. Study Design This was a cross-sectional and observational study. Setting Tertiary referral medical center. Subjects and Methods A total of 147 patients underwent general anesthesia for extralaryngeal site surgery indicated for a procedure extraneous to the study and irrespective of the presence of vocal complaint. Next, detection and morphological characterization of MSAs in the vocal fold cover were performed by means of suspension microlaryngoscopy with laryngeal inspection and palpation without surgical intervention related to this procedure. The laryngeal findings were compared with variables from a clinical and demographic characteristics questionnaire given to these individuals. Results A 21.1% prevalence of MSAs was identified in the sample, which included a majority of individuals without vocal complaint (95.9%). Of these, 5.4% of individuals had laryngeal microdiaphragms, 16.3% sulcus vocalis, and 4.1% epidermoid cysts. No pouch sulcus or mucosal bridges were found. The identification of these alterations occurred mainly after 10 years of age, without effects of sex, vocal abuse, or upper airway conditions. The most common combination of MSAs was bilateral sulcus vocalis. Conclusions The prevalence of MSAs in laryngeal coverage in this predominantly vocally asymptomatic population was 21.1%, with identification of sulcus vocalis, epidermoid cyst, and laryngeal microdiaphragm. Age was the only clinical or demographic characteristic associated with these alterations.

scholarly journals Minor Structural Alterations of the Vocal Fold Cover: Vocal Quality before and after Treatment

2020 ◽  
Author(s):  
Tatiany Cíntia da Silva Brito ◽  
Jullyane Florencio Pacheco da Silva ◽  
Bruno Teixeira Moraes ◽  
Mirella Bezerra Rodrigues Vilela ◽  
Coeli Regina Ximenes ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Structural Alterations ◽  
Before And After ◽  
Sulcus Vocalis ◽  
Vocal Quality ◽  
Fold Cover

Abstract Introduction Minor structural alterations of the vocal fold cover are important causes of dysphonia. The variability in the type of alteration and the grade of vocal deviation affects the definition of the conduit and the results of treatment. Objective To characterize the occurrence, the selected treatments adopted and vocal quality before and after treatment in patients with minor structural alterations of the vocal folds cover. Methods This was a cross-sectional study based on the records of patients treated by an interdisciplinary team at the laryngology outpatient clinic of a public university hospital from 2010 to 2018. Data collection consisted of access to a database of information on otorhinolaryngological diagnostic hypotheses, intervention and perceptual-auditory vocal assessments before and after the treatment. Data from 102 subjects were analyzed. Association tests were applied between the perceptual-auditory vocal results and the different alterations found and between these and the adopted treatments. The results of the degrees of vocal deviation before and after treatment were also compared. Results The degree of roughness was associated with the sulcus vocalis, and in this alteration the highest occurrence was mild degree of roughness. There was an improvement in the breathiness and general grade of vocal deviation after treatment. Conclusion Cysts were the most frequent structural alteration in the population studied. There was an association between the degree of general deviation and that of roughness in sulcus vocalis cases. The breathiness and the general grade of vocal deviation improved after treatment regardless of the type of treatment and alteration.

Three-Dimensional Anatomic Characterization of the Canine Laryngeal Abductor and Adductor Musculature

2000 ◽  
Vol 109 (5) ◽  
pp. 505-513 ◽  
Author(s):  
Corey W. Mineck ◽  
Roger Chan ◽  
Niro Tayama ◽  
Ingo R. Titze
Keyword(s):  
Vocal Fold ◽  
Dimensional Space ◽  
Three Dimensional ◽  
Cross Sectional ◽  
3 Dimensional ◽  
Moment Arms ◽  
Intrinsic Laryngeal Muscle ◽  
Posterior Cricoarytenoid ◽  
Intrinsic Laryngeal Muscles

The biomechanics of vocal fold abduction and adduction during phonation, respiration, and airway protection are not completely understood. Specifically, the rotational and translational forces on the arytenoid cartilages that result from intrinsic laryngeal muscle contraction have not been fully described. Anatomic data on the lines of action and moment arms for the intrinsic laryngeal muscles are also lacking. This study was conducted to quantify the 3-dimensional orientations and the relative cross-sectional areas of the intrinsic abductor and adductor musculature of the canine larynx. Eight canine larynges were used to evaluate the 3 muscles primarily responsible for vocal fold abduction and adduction: the posterior cricoarytenoid, the lateral cricoarytenoid, and the interarytenoid muscles. Each muscle was exposed and divided into discrete fiber bundles whose coordinate positions were digitized in 3-dimensional space. The mass, length, relative cross-sectional area, and angle of orientation for each muscle bundle were obtained to allow for the calculations of average lines of action and moment arms for each muscle. This mapping of the canine laryngeal abductor and adductor musculature provides important anatomic data for use in laryngeal biomechanical modeling. These data may also be useful in surgical procedures such as arytenoid adduction.

scholarly journals Characterization of the first symptoms of multiple sclerosis in a Brazilian center: cross-sectional study

2017 ◽  
Vol 135 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Vitor Breseghello Cavenaghi ◽  
Fernanda Martinho Dobrianskyj ◽  
Guilherme Sciascia do Olival ◽  
Rafael Paternò Castello Dias Carneiro ◽  
Charles Peter Tilbery
Keyword(s):  
Multiple Sclerosis ◽  
Medical Center ◽  
Cranial Nerves ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Cross Sectional ◽  
Immune Mediated ◽  
Initial Symptoms ◽  
Mean Time

ABSTRACT CONTEXT AND OBJECTIVE: Multiple sclerosis (MS) is a chronic, immune-mediated and degenerative central nervous system (CNS) disease with well-established diagnostic criteria. Treatment can modify the course of the disease. The objective of this study was to describe the initial symptoms of multiple sclerosis in a Brazilian medical center. DESIGN AND SETTING: Descriptive study, conducted in a Brazilian reference center for multiple sclerosis treatment. METHODS: Data on 299 patients with confirmed diagnoses of MS were included in the study. Their medical files were evaluated and the data were analyzed. RESULTS: The most common symptom involved the cranial nerves (50.83%) and unifocal manifestation was presented by the majority of this population (73.91%). The mean time between the first symptom and the diagnosis was 2.84 years. Unifocal symptoms correlated with longer time taken to establish the diagnosis, with an average of 3.20 years, while for multifocal symptoms the average time taken for the diagnosis was 1.85 years. Unifocal onset was related to greater diagnostic difficulty. CONCLUSIONS: MS is a heterogeneous disease and its initial clinical manifestation is very variable.

scholarly journals The Importance of Inspiratory Maneuver for Benign Laryngeal Lesions

2020 ◽  
Vol 24 (04) ◽  
pp. e513-e517
Author(s):  
Marília Batista Costa ◽  
Taynara Oliveira Ledo ◽  
Mariana Delgado Fernandes ◽  
Romualdo Suzano Louzeiro Tiago
Keyword(s):  
Vocal Fold ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Simple Method ◽  
Main Complaint ◽  
Laryngeal Lesions ◽  
Before And After ◽  
Sulcus Vocalis ◽  
Benign Laryngeal Lesions

Abstract Introduction Inspiratory maneuver corresponds to a simple method used during videolaryngoscopy to increase characterizations of laryngeal findings, through the movement of the vocal fold cover and exposure of the ligament, facilitating its evaluation. Objective To evaluate the increase in diagnosis of benign laryngeal lesions from the usage of inspiratory maneuvers during videolaryngoscopy in patients with or without vocal complaints. Methods A cross-sectional study performed from March 1 to July 1, 2018, in the Laryngology sector of a tertiary hospital. The age of the patients varied from 18 to 60 years old. They were divided into two groups, symptomatic and asymptomatic vocals, and evaluated through videolaryngoscopy together with inspiratory maneuvers. The exams were recorded and later evaluated by three trained laryngologists who determined the laryngeal lesions before and after the inspiratory maneuver. Results There were 60 patients in this sample, 41 of which were vocal symptomatic and 19 asymptomatic. The majority was female and the main complaint was about dysphonia. Before the inspiratory maneuver, the most observed lesions in both groups were chronic laryngitis, followed by vascular dysgenesis. After the inspiratory maneuver, sulcus vocalis was the most frequent additional finding. Conclusion With the inspiratory maneuver, it was possible to increase the identification of structural lesions in the vocal fold, and the most frequent lesion in patients with or without vocal complaints was sulcus vocalis.

scholarly journals Faithful Scanning Electron Microscopic (SEM) visualization of 3D printed alginate-based scaffolds

2020 ◽  
Author(s):  
Marcus Koch ◽  
Małgorzata K. Włodarczyk-Biegun
Keyword(s):  
High Water ◽  
Morphological Characterization ◽  
High Water Content ◽  
Electron Microscopic ◽  
Cross Sectional ◽  
3D Architecture ◽  
3D Printed ◽  
Preparation Techniques ◽  
Scanning Electron

AbstractThe morphological characterization of 3D printed hydrogel-based scaffolds is essential for monitoring their size, shape, surface texture and internal structure. Among other microscopic techniques, Scanning Electron Microscopy (SEM) is capable of visualizing nearly all kinds of materials at different length scales, with exceptional precision, if investigation under vacuum is possible. However, due to the high water content of hydrogel-based scaffolds and the connected volume change after drying, special preparation techniques are necessary to stabilize the 3D architecture when imaged by SEM. Here we present a straightforward cryo-SEM technique to visualize 3D printed hydrogel-based alginate scaffolds. By use of a homemade cryo-SEM holder and plunge-freezing in liquid ethane, scaffolds are visualized from the top and cross-sectional view at different magnifications. The proposed method is compared with SEM imaging in different modes (cyro-SEM, conventional SEM, ESEM) following other commonly used sample preparation techniques, such as plunging in liquid nitrogen, air-drying, freeze-drying and plunging in liquid ethane after graded dehydration. These approaches, except ESEM, lead to shrinkage, deformation, distortion or disintegration of the scaffolds and consequently give rise to artifacts in imaging. The presented results indicate that cryo-SEM after plunging in liquid ethane allows for the most faithful and time-efficient visualization of 3D printed alginate scaffolds.

The Combination of Anatomy and Genioglossus Activity in Predicting the Outcomes of Velopharyngeal Surgery

2017 ◽  
Vol 156 (3) ◽  
pp. 567-574 ◽  
Author(s):  
Di Zhao ◽  
YanRu Li ◽  
JunFang Xian ◽  
Yue Qu ◽  
Xin Cao ◽  
...  
Keyword(s):  
Roc Curve ◽  
Medical Center ◽  
Sleep Onset ◽  
Case Series ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
3 Dimensional ◽  
Surgical Success ◽  
Obstructive Sleep

Objective This study aims to evaluate the combination of genioglossus (GG) activity and anatomical characteristics in predicting outcomes of velopharyngeal surgery in patients with obstructive sleep apnea (OSA). Study Design Case series with planned data collection. Setting Sleep medical center. Subjects and Methods Forty patients with OSA underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway anatomy was evaluated by 3-dimensional computed tomography in patients with OSA. All patients received the same type of velopharyngeal surgery, consisting of revised uvulopalatopharyngoplasty with uvula preservation and concurrent transpalatal advancement pharyngoplasty. We followed up all patients using polysomnography for at least 3 months postoperatively. Results Twenty-five patients (62.50%) were responders, and 15 patients (37.50%) were nonresponders. The decreased apnea-hypopnea index was significantly positively correlated to the sleep onset GGEMG ( P = .006) but was negatively correlated to the change in GGEMG ( P = .013) and tonic GGEMG ( P = .018). Multiple regression analysis revealed that the minimal cross-sectional airway area at the velopharynx (VmCSA) (odds ratio [OR], 1.760; P = .019) and the sleep onset GGEMG (OR, 0.322; P = .043) were significant predictors for surgical outcomes. Combined the two predictors, the area under the ROC curve was 0.901 (OR, 0.789; P = .001) for surgical success, was more valuable than any one predictor. The area under the ROC curve with GGEMG was 0.843, VmCSA was 0.848. Conclusions The combination of sleep onset GGEMG and VmCSA can predict the outcome of velopharyngeal surgery in patients with OSA.

Characterization of Vocal Fold Vibration in Sulcus Vocalis Using High-Speed Digital Imaging

2017 ◽  
Vol 60 (1) ◽  
pp. 24-37 ◽  
Author(s):  
Akihito Yamauchi ◽  
Hisayuki Yokonishi ◽  
Hiroshi Imagawa ◽  
Ken-Ichi Sakakibara ◽  
Takaharu Nito ◽  
...  
Keyword(s):  
Digital Imaging ◽  
Healthy Subjects ◽  
Vocal Fold ◽  
High Speed ◽  
Control Group ◽  
Type I ◽  
Strong Correlations ◽  
Vocal Fold Vibration ◽  
Sulcus Vocalis

Purpose The aim of the present study was to qualitatively and quantitatively characterize vocal fold vibrations in sulcus vocalis by high-speed digital imaging (HSDI) and to clarify the correlations between HSDI-derived parameters and traditional vocal parameters. Method HSDI was performed in 20 vocally healthy subjects (8 men and 12 women) and 41 patients with sulcus vocalis (33 men and 8 women). Then HSDI data were evaluated by assessing the visual–perceptual rating, digital kymography, and glottal area waveform. Results Patients with sulcus vocalis frequently had spindle-shaped glottal gaps and a decreased mucosal wave. Compared with the control group, the sulcus vocalis group showed higher open quotient as well as a shorter duration of the visible mucosal wave, a smaller speed index, and a smaller glottal area difference index ([maximal glottal area – minimal glottal area]/maximal glottal area). These parameters deteriorated in order of the control group and Type I, II, and III sulcus vocalis. There were no gender-related differences. Strong correlations were noted between the open quotient and the type of sulcus vocalis. Conclusions HSDI was an effective method for documenting the characteristics of vocal fold vibrations in patients with sulcus vocalis and estimating the severity of dysphonia.

Morphological characterization of Oscillatoriales (Cyanobacteria) from Ross Island and southern Victoria Land, Antarctica

1991 ◽  
Vol 3 (1) ◽  
pp. 35-45 ◽  
Author(s):  
Paul A. Broady ◽  
Andrew L. Kibblewhite
Keyword(s):  
Ross Sea ◽  
Apical Cell ◽  
Morphological Characterization ◽  
Cross Sectional ◽  
Victoria Land ◽  
Terrestrial Habitats ◽  
Width Distribution ◽  
Morphology And Morphometry ◽  
Sectional Shape

Field populations of Oscillatoriales, from fresh and saline lakes and ponds, and from terrestrial habitats, are characterised on the basis of their morphology and morphometry. Fifteen morphotypes are recognized principally from the following characteristics; cross-sectional shape of the trichome, presence or absence of a calyptra on the apical cell, occurrence or otherwise of numerous trichomes within a common sheath, and trichome width distribution. Where possible morphotypes are assigned to traditional species described by earlier investigations of algae in the Ross Sea region and a reassessment is made of the early descriptions, in some cases using material from the identical locations to the original collections. The following traditional species are described; Lyngbya murrayi, Microcoleus vaginatus, Oscillatoria deflexa, O. koettlitzi, O. priestleyi, O. sancta, Phormidium autumnale and P. subproboscidea. Intraspecific morphotypes of M. vaginatus, O. priestleyi and P. autumnale are recognised on the basis of trichome width. A new species and variety of Crinalium (Crow) Winder, Stal & Mur, a genus characterized by flattened trichomes, are described from cryoconite ponds on glaciers. C. glaciale sp. nov. possesses wide, straight trichomes in contrast to C. glaciale var. helicoides nov. var. in which trichomes are narrower and helically coiled.

Prevalensi refluks laringofaring pada bayi laringomalasia primer

2012 ◽  
Vol 42 (2) ◽  
Author(s):  
Dina Putri Nasution ◽  
Susyana Tamin ◽  
Syahrial Hutauruk ◽  
Saptawati Bardosono
Keyword(s):  
Vocal Fold ◽  
Laryngopharyngeal Reflux ◽  
Clinical Signs ◽  
Upper Airway ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Abdominal Pressure ◽  
Sectional Study ◽  
Comorbid Disease ◽  
Cross Sectional

Background: Primary laryngomalacia is a congenital weakness of the supraglottis structures which collapsed during inspiration causing upper airway obstruction. This condition can cause changes in gradient of intrathoraxic-abdominal pressure resulting reflux of gastric juice into the upper airway causing laryngopharyngeal reflux (LPR). Purpose: To find out the prevalence of LPR as a comorbid disease of primary laryngomalacia in infant using fiberoptic laryngoscopy examination, to know the characteristics  of samples, and the correlation between laryngomalacia with LPR. Methods: This is a cross-sectional  study to assess the prevalence of LPR in infants with primary laryngomalacia at Cipto Mangunkusumo Hospital. LPR was diagnosed based on clinical signs from flexible laryngoscopy video records. Result: The prevalence of LPR was 90% in primary laryngomalacia. There were significant differences from three of five clinical findings with LPR, such as arytenoid edema/erythema (p<0,001), ventricular fold edema (p=0,001), and vocal fold edema (p<0,001). Conclusion: Most of the samples with laryngomalacia in this study also have LPR. The presence of LPR could worsen the clinical manifestation and delay the healing of laryngomalacia. Keywords: primary laryngomalacia, fiberoptic laryngoscopy, laryngopharyngeal reflux    Abstrak :  Latar belakang: Laringomalasia primer merupakan kelainan kongenital laring berupa kelemahan pada struktur supraglotis yang terhisap saat inspirasi dan menyebabkan sumbatan jalan napas atas. Kondisi ini dapat menyebabkan perubahan selisih tekanan intra-abdominal/ intratorakal sehingga terjadi refluks cairan lambung ke saluran napas atas, yang menyebabkan refluks laringofaring (RLF). Tujuan: Mengetahui prevalensi RLF pada bayi laringomalasia primer menggunakan pemeriksaan laringoskopi serat optik lentur, mengetahui karakteristik percontoh, dan hubungan laringomalasia primer dengan RLF.  Metode: Penelitian ini adalah penelitian observasional dengan metode potong lintang untuk mengetahui prevalensi RLF sebagai penyakit penyerta pada bayi laringomalasia di Rumah Sakit Cipto Mangunkusumo. Diagnosis RLF ditegakkan berdasarkan tanda klinis dari rekaman video laringoskopi serat optik lentur. Hasil: Prevalensi RLF diperoleh sebesar 90%. Terdapat tiga dari lima tanda klinis RLF yang berbeda bermakna dengan kejadian RLF, yaitu edema/eritema aritenoid (p<0,001), edema plika ventrikularis (p=0,001), dan edema plika vokalis (p<0,001). Kesimpulan: Hampir seluruh percontoh laringomalasia primer disertai dengan RLF. Penyakit penyerta RLF akan memperberat gejala dan memperpanjang waktu penyembuhan laringomalasia.   Kata kunci: laringomalasia primer, laringoskopi serat optik lentur, refluks laringofaring 

Morphological Characterization of Mycobacteriophage R1

1974 ◽  
Vol 32 ◽  
pp. 254-255
Author(s):  
B. L. Soloff ◽  
T. A. Rado
Keyword(s):  
Carbon Source ◽  
Stationary Phase ◽  
Growth Phase ◽  
Minimal Medium ◽  
Morphological Characterization ◽  
Logarithmic Growth Phase ◽  
Complete Lysis ◽  
Lysogenic Culture ◽  
Logarithmic Growth

Mycobacteriophage R1 was originally isolated from a lysogenic culture of M. butyricum. The virus was propagated on a leucine-requiring derivative of M. smegmatis, 607 leu−, isolated by nitrosoguanidine mutagenesis of typestrain ATCC 607. Growth was accomplished in a minimal medium containing glycerol and glucose as carbon source and enriched by the addition of 80 μg/ ml L-leucine. Bacteria in early logarithmic growth phase were infected with virus at a multiplicity of 5, and incubated with aeration for 8 hours. The partially lysed suspension was diluted 1:10 in growth medium and incubated for a further 8 hours. This permitted stationary phase cells to re-enter logarithmic growth and resulted in complete lysis of the culture.

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