scholarly journals Laryngeal framework surgery

2020 ◽  
Vol 12 (5) ◽  
pp. 151-154
Author(s):  
Guilherme Simas do Amaral Catani ◽  
Maria Eduarda Carvalho Catani ◽  
Letícia Raysa Schiavon Kinasz ◽  
Gabriela Alves Marroni ◽  
Marcelly Botelho Soares ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
European Society ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Laryngeal Framework Surgery ◽  
The Voice

Laryngeal framework surgery is defined as surgical procedures performed on the laryngeal skeleton and the insertion of muscles to correct vocal fold positioning and tension. Its main objective is to improve the voice without directly intervening in the vocal folds. The European Society of Laryngology proposed in 2000 a classification and nomenclature of these surgeries according to their purpose. Such standardization has divided these procedures into four groups: Approximation laryngoplasty, Expansion laryngoplasty, Relaxation laryngoplasty, and Tensioning laryngoplasty. Indications, techniques, and complications of each procedure will be described in this review.

Laryngeal Framework Surgery in the Management of Spasmodic Dysphonia

1989 ◽  
Vol 98 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Harvey M. Tucker
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Long Term Results ◽  
Spasmodic Dysphonia ◽  
Management Problem ◽  
Cure Rate ◽  
Adductor Spasmodic Dysphonia ◽  
Laryngeal Framework Surgery ◽  
Selective Lysis

Spasmodic dysphonia continues to be a management problem for otolaryngologists. Selective lysis of the recurrent laryngeal nerve has been useful in the management of this disease. Reported long-term results, however, reveal that spasm recurs in approximately 40% to 50% of initially successful patients in spite of persistence of the unilateral vocal fold paralysis. Although some of these failures can be recaptured with subsequent laser surgery, the overall “cure” rate does not exceed 70%, even in the best hands. The contributions of Isshiki, LeJeune, and Tucker have demonstrated that tension in the vocal folds can be adjusted by laryngeal framework surgery. Experience with 16 patients suffering from adductor spasmodic dysphonia suggests that laryngeal framework surgery is useful in the management of this disorder.

Omohyoid Muscle Transposition for the Treatment of Bowed Vocal Fold

1996 ◽  
Vol 105 (7) ◽  
pp. 536-540 ◽  
Author(s):  
Hisayoshi Kojima ◽  
Shigeru Hirano ◽  
Koichi Omori ◽  
Kazuhiko Shoji ◽  
Iwao Honjo
Keyword(s):  
Vocal Fold ◽  
Anterior Commissure ◽  
Muscle Flap ◽  
Vocal Folds ◽  
Scar Tissue ◽  
Muscle Transposition ◽  
The Past ◽  
Vocal Process ◽  
Laryngeal Framework Surgery ◽  
Omohyoid Muscle

Imperfect glottal closure is usually the most important factor causing dysphonia in patients with bowing of the vocal folds. We have performed laryngeal framework surgery, which allows the medialization of the vocal folds from the outside without creating any scar tissue on them. Over the past 6 years, however, we encountered three cases with marked bowing of the vocal folds that could not be cured by laryngeal framework surgery alone. We used an open laryngeal procedure in these cases, even though such procedures had been considered contraindicated in the treatment of hoarseness. After performing a laryngofissure, we made a small pocket beneath the vocal fold mucosa at the anterior commissure. The superiorly based omohyoid muscle flap was then transposed into the mucosal pocket and sutured to the vocal process. This procedure should be considered an option in treating highly bowed vocal folds.

Age-Related Changes of the Macula Flava of the Human Vocal Fold

1995 ◽  
Vol 104 (11) ◽  
pp. 839-844 ◽  
Author(s):  
Kiminori Sato ◽  
Minoru Hirano
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Ground Substance ◽  
Elastic Fibers ◽  
Electron Microscopic ◽  
Age Related ◽  
Transmission Electron ◽  
Abnormal Metabolism ◽  
The Voice ◽  
Age Related Changes

This investigation was carried out to determine the histologic structure and age-related changes of the macula flava of human aged vocal folds. Excised human adult senescent larynges served as the material for this study. Light microscopic and transmission electron microscopic observations were made. The results are summarized as follows. 1) The anterior and posterior maculae flavae were elliptical in shape and about 1.5 × 1.5 × 1 mm in size. 2) The macula flava was composed of fibroblasts, elastic fibers, collagenous fibers, and ground substance. 3) The number of fibroblasts decreased. 4) Components in the cytoplasm, such as Golgi apparatus and rough endoplasmic reticulum, were fewer than in younger adults. 5) Some fibroblasts and some components in the cytoplasm degenerated. 6) The accumulation of glycogen granules and lipid droplets were seen in the cytoplasm. 7) The number of collagenous and elastic fibers synthesized by the fibroblasts decreased. 8) These findings were evident to various degrees and suggested the reduction of fibroblast activation, abnormal metabolism, and degeneration. A decrease in the number and activation of fibroblasts in maculae flavae indicates decreased synthesis of fibrous components in the vocal fold mucosa. This in turn influences the viscoelasticity and stiffness of vibrating tissue and contributes partially to aging of the voice.

Changes in the male voice at puberty: vocal fold length and its relationship to the fundamental frequency of the voice

1998 ◽  
Vol 112 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Meredydd Harries ◽  
Sarah Hawkins ◽  
Jeremy Hacking ◽  
Ieuan Hughes
Keyword(s):  
Fundamental Frequency ◽  
Vocal Fold ◽  
Gradual Increase ◽  
Vocal Folds ◽  
Frequency Change ◽  
Male Voice ◽  
Pubertal Stage ◽  
Sudden Drop ◽  
Ultrasound Measurements ◽  
The Voice

AbstractUltrasound measurements of the vocal folds were taken for a number of boys passing through puberty. The boys were grouped according to their pubertal stage as defined by Tanner and there was a gradual increase in the length of the vocal folds as puberty progressed. The fundamental frequency of the boys' speaking voice was recorded via laryngography and a good correlation between the length of the vocal folds and the frequency of the voice was seen. The sudden drop in frequency seen between Tanner stages 3 and 4 did not correlate with similar changes in the length of the vocal folds at this time but stroboscopic findings suggest a change in the structure and mass of the vocal folds at this time of maximum frequency change.

scholarly journals Impact of hydration on vocal loading using phonetogram measures

2021 ◽  
Vol 7 (8) ◽  
pp. 1317
Author(s):  
Sujan Ghosh ◽  
Indranil Chatterjee ◽  
Piyali Kundu ◽  
Susmi Pani ◽  
Suman Kumar ◽  
...  
Keyword(s):  
Fundamental Frequency ◽  
Vocal Fold ◽  
Negative Impact ◽  
Vocal Folds ◽  
Graphical Display ◽  
Male And Female ◽  
Range Profile ◽  
Vocal Intensity ◽  
Voice Range ◽  
The Voice

<p><strong>Background:</strong> Vocal loading is a phenomenon that affects the vocal folds and voice parameters. Prolonged vocal loading may cause vocal fatigue. Hydration is one of the easiest precautions to reduce the effect of vocal loading. Voice range profile is an analysis of a participant’s vocal intensity and fundamental frequency ranges. Speech range profile is a graphical display of frequency intensity interactions occurring during functional speech activity. Phonetogram software can analyse VRP and SRP.</p><p><strong>Methods:</strong> Total sixty normophonic participants (thirty male and thirty female) were included in this study. Phonetogram, version 4.40 by Tiger DRS, software used to measure the voice range profile and speech range profile. For VRP, participants were asked to produce vowel /a/ and a passage reading task was given for SRP measurement.</p><p><strong>Results:</strong> All sample recording were done at pre vocal loading task, VLT and after hydration. Parameter that were used to measure the effects were Fo-range, semitone, max-F, min-F, SPL range, max-I, min-I, area (dB). Result showed that after VLT all other parameters like Fo-range, semitone, max-F, min-F, SPL range, max-I, min-I, area (dB) in VRP and SRP were reduced except min-F VRP in male, min-I VRP and min-I SRP in both male and female participants. After hydration all other parameters were improved except max-F VRP and min-F VRP in female, max-I VRP, min-F VRP and area VRP.</p><p><strong>Conclusions:</strong> This study concluded that vocal loading has negative impact on vocal fold tissue and mass. </p>

scholarly journals Methods of sparing surgical treatment of chronic edematous-polypous laryngitis, edema Reinke

2021 ◽  
pp. 184-191
Author(s):  
B. Z. Abdullaev ◽  
I. I. Nazhmudinov ◽  
Kh. Sh. Davudov ◽  
T. I. Garashchenko ◽  
I. Kh. Guseynov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mucous Membrane ◽  
Vocal Fold ◽  
Carbon Dioxide Laser ◽  
General Structure ◽  
Vocal Folds ◽  
Endoscopic Examination ◽  
Upper Respiratory Tract ◽  
Maximum Phonation Time ◽  
The Voice

Introduction. Laryngeal pathology occupies a leading place in the general structure of diseases of the upper respiratory tract, chronic edematous-polypous laryngitis, Reinke-Gayek edema accounts for 5.5% of all benign diseases of the vocal folds. The main method of treating Reinke-Gayek's disease is surgical treatment, which consists in removing excess mucosa, or “stripping” - tearing a strip of mucosa with forceps from the vocal fold. One of the main principles of laryngeal surgery is the maximum preservation of the structures of the vocal fold, obtaining a flexible vibration of the muscular-membranous part and the mucous membrane of the vocal fold.Purpose. The purpose of our work is to improve the effectiveness of treatment of chronic edematous-polypous laryngitis using a CO2 laser.Tasks. To develop a differentiated approach to the surgical treatment of chronic edematous-polypous laryngitis using a carbon dioxide laser.Materials and Methods. We treated 46 patients with Reinke-Gayek disease, including 35 women and 11 men. The age of the patients ranged from 40 to 67 years. Preoperative examination included endoscopic examination, laryngostroboscopy. The type was determined according to the classification of H. Yonekawa, for the choice of further surgical tactics. In type II, an incision of the mucosa, aspiration of gelatinous matter from the Reinke space, and laying of the mucosa were performed. With type III, it is made by forming M-shaped flap to close the defect.Results. All patients in the preoperative period were surveyed with the VOICE HANDICAP INDEX(VHI-30) questionnaire, laryn-gostroboscopy, and maximum phonation time. In the postoperative period, the examination was performed twice, 1 month after the operation and 3 months after the operation. There is a significant increase in indicators, an increase in the maximum phonation time, a decrease in VHI-30 points.Conclusion. The use of this technique allowed to significantly accelerate the recovery of the voice, reduce the time spent in the hospital, minimally damaging the structure of the mucous membrane of the vocal folds.

The Role of Adjustment of Expiratory Effort in the Control of Vocal Intensity: Clinical Assessment of Phonatory Function

2005 ◽  
Vol 132 (4) ◽  
pp. 641-646 ◽  
Author(s):  
Kiyoshi Makiyama ◽  
Hidetaka Yoshihashi ◽  
Manabu Mogitate ◽  
Akinori Kida
Keyword(s):  
Vocal Fold ◽  
Airway Resistance ◽  
Vocal Cord Paralysis ◽  
Vocal Folds ◽  
Control Group ◽  
Loading Test ◽  
Reinke’S Edema ◽  
Vocal Intensity ◽  
The Voice

OBJECTIVE: To determine the role of the adjustment of expiratory effort in the control of vocal intensity. STUDY DESIGN: An intensity-loading test was performed by using the airway interruption method. Three groups of subjects were used: a control group thought to resemble normal vocal fold closure, a group of patients with Reinke's edema thought to represent increased mass at the level of the vocal folds, and a group with vocal fold paralysis that was thought to represent a group with lack of adequate vocal fold closure. RESULTS: In the control group, expiratory lung pressure and airway resistance slightly increased. In the patients with Reinke's edema, expiratory lung pressure, and airway resistance significantly increased. In this group, the voice intensity was controlled by laryngeal adjustment, but a greater expiratory effort was needed because of a greater increase in glottal resistance. In the patients with vocal cord paralysis, airway resistance did not increase even with a high-intensity voice. Vocal intensity was controlled by expiratory effort. CONCLUSIONS: If there is sufficient ability for laryngeal adjustment, vocal intensity is controlled primarily by laryngeal adjustment and by expiratory adjustment in response to increased glottal resistance. However, vocal intensity is controlled by expiratory effort when laryngeal adjustment ability is poor.

Arytenoid Separation for Impaired Pediatric Vocal Fold Mobility

1994 ◽  
Vol 103 (7) ◽  
pp. 510-515 ◽  
Author(s):  
Steven D. Gray ◽  
Steven M. Kelly ◽  
Heather Dove
Keyword(s):  
Vocal Fold ◽  
Surgical Techniques ◽  
Vocal Folds ◽  
Vocal Fold Paralysis ◽  
Bilateral Vocal Fold Paralysis ◽  
Cricoarytenoid Joint ◽  
Electrical Pacing ◽  
The Voice ◽  
Vocal Fold Motion

Impaired vocal fold motion may result from cricoarytenoid joint fixation, bilateral vocal fold paralysis, or interarytenoid scarring. Traditional surgical techniques have focused on lateralization or resection of the arytenoid for airway improvement. This paper discusses 3 cases of bilateral reduced vocal fold motion of neurogenic cause treated with posterior cricoid grafting to cause a wider resting position of the vocal folds and arytenoids. Airway improvement occurred in all. The voice results have been encouraging. Advantages of this procedure are that the vocal folds are symmetric, there is no vocal fold or joint scarring, and the larynx remains a candidate for electrical pacing when that becomes available. Acoustic and aerodynamic voice results are presented. The results should be considered preliminary.

scholarly journals Dynamic Biomechanical Analysis of Vocal Folds Using Pipette Aspiration Technique

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 2923
Author(s):  
Florian Scheible ◽  
Raphael Lamprecht ◽  
Marion Semmler ◽  
Alexander Sutor
Keyword(s):  
Material Properties ◽  
Vocal Fold ◽  
Soft Tissues ◽  
Vocal Folds ◽  
Biomechanical Analysis ◽  
Tissue Movement ◽  
Aspiration Technique ◽  
The Voice ◽  
Shed Light

The voice producing process is a complex interplay between glottal pressure, vocal folds, their elasticity and tension. The material properties of vocal folds are still insufficiently studied, because the determination of material properties in soft tissues is often difficult and connected to extensive experimental setups. To shed light on this less researched area, in this work, a dynamic pipette aspiration technique is utilized to measure the elasticity in a frequency range of 100–1000 Hz. The complex elasticity could be assessed with the phase shift between exciting pressure and tissue movement. The dynamic pipette aspiration setup has been miniaturized with regard to a future invivo application. The techniques were applied on 3 different porcine larynges 4 h and 1 d postmortem, in order to investigate the deterioration of the tissue over time and analyze correlation in elasticity values between vocal fold pairs. It was found that vocal fold pairs do have different absolute elasticity values but similar trends. This leads to the assumption that those trends are more important for phonation than having same absolute values.

Vocal Fold Atrophy and its Surgical Treatment

1996 ◽  
Vol 105 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Nobuhiko Isshiki ◽  
Kazuhiko Shoji ◽  
Hisayoshi Kojima ◽  
Shigeru Hirano
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Folds ◽  
Decision Making Process ◽  
Type I ◽  
Vocal Fold Atrophy ◽  
The Voice ◽  
Type I Thyroplasty

The effectiveness of surgical treatment for vocal fold atrophy of various causes was examined. Type I thyroplasty was performed on 31 patients with vocal fold atrophy, often bilaterally and occasionally combined with type III thyroplasty. Of these 31 patients, 3 patients underwent the operation twice, for a total of 34 operations. The surgery was found to be effective in improving the voice quality and the ease of phonation. When a scar or sulcus was present, the results were not as satisfactory. The intraoperative decision-making process as to which procedure to perform is extremely important for achieving an optimal voice, and should be based on the intraoperative voice quality, fiberoptic findings, and manual tests. In operations for vocal fold atrophy in which the vocal folds are mobile, a silicone shim should be firmly fixed to prevent migration. Overcorrection is generally recommended. No complications were encountered. It was often the increased ease of phonation rather than the improved voice quality that patients appreciated after surgery.

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