scholarly journals Multiple laser puncture for Reinke’s edema: surgical outcome and voice assessment

2021 ◽  
Vol 7 (9) ◽  
pp. 1398
Author(s):  
Jameel N. Alswaiheb ◽  
Mohammed Ali Motiwala ◽  
Chih-Ying Su
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Performance ◽  
Type I ◽  
Type Ii ◽  
Voice Assessment ◽  
Clinical Series ◽  
Reinke’S Edema ◽  
Wave Patterns ◽  
The Voice

<p class="abstract"><strong>Background: </strong>The two important principles in Reinke’s edema treatment are minimal intervention and superficial resection with evacuation the edema and preservation the medial edge of the vocal fold to improve the voice quality. The aim of this study was to evaluate a novel surgical technique in treatment of Reinke’s edema and its effect on subjective and quantitative voice characteristics. The study design was a prospective clinical series.</p><p class="abstract"><strong>Methods: </strong>We evaluated 67 patients from 19 to 73 years (mean, 47.7 years) with Reinke’s edema. The patients were divided into 3 types, mild, moderate and sever. Clinical voice assessment was composed of stroboscopy, subjective voice evaluation (GRBAS hoarseness scale) and quantitative voice evaluation were evaluated pre- and postoperatively. All patients underwent endolaryngeal CO2 laser puncturing for treatment of Reinke’s edema.</p><p class="abstract"><strong>Results: </strong>67 patients diagnosed as Reinke’s edema were classified by H. Yonekawa classification into three types. Type I 25 (37.3%) patients, type II 30 (44.8%), type III 12 (17.9%). Out of 67 patients, fifty two (77.6%) were smoker. In all the patients, the laryngostrobscopic findings showed an improvement of mucosal wave patterns with little vocal fold scaring. Significant vocal improvement was also noted in subjective and objective voice assessments.</p><p class="abstract"><strong>Conclusions: </strong>The laser puncture technique is safe, effective and less invasive to treat Reinke’s edema with significant improvement in vocal performance after surgery.</p>

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.

scholarly journals Optimising outcome assessment of voice interventions, II: sensitivity to change of self-reported and observer-rated measures

2007 ◽  
Vol 122 (1) ◽  
pp. 46-51 ◽  
Author(s):  
I N Steen ◽  
K MacKenzie ◽  
P N Carding ◽  
A Webb ◽  
I J Deary ◽  
...  
Keyword(s):  
General Health ◽  
Voice Quality ◽  
Voice Handicap Index ◽  
Effect Sizes ◽  
Voice Therapy ◽  
Vocal Performance ◽  
Symptom Scale ◽  
Wide Range ◽  
The Voice ◽  
Responsiveness To Change

AbstractObjectives:A wide range of well validated instruments is now available to assess voice quality and voice-related quality of life, but comparative studies of the responsiveness to change of these measures are lacking. The aim of this study was to assess the responsiveness to change of a range of different measures, following voice therapy and surgery.Design:Longitudinal, cohort comparison study.Setting:Two UK voice clinics.Participants:One hundred and forty-four patients referred for treatment of benign voice disorders, 90 undergoing voice therapy and 54 undergoing laryngeal microsurgery.Main outcome measures:Three measures of self-reported voice quality (the vocal performance questionnaire, the voice handicap index and the voice symptom scale), plus the short form 36 (SF 36) general health status measure and the hospital anxiety and depression score. Perceptual, observer-rated analysis of voice quality was performed using the grade–roughness–breathiness–asthenia–strain scale. We compared the effect sizes (i.e. responsiveness to change) of the principal subscales of all measures before and after voice therapy or phonosurgery.Results:All three self-reported voice measures had large effect sizes following either voice therapy or surgery. Outcomes were similar in both treatment groups. The effect sizes for the observer-rated grade–roughness–breathiness–asthenia–strain scale scores were smaller, although still moderate. The roughness subscale in particular showed little change after therapy or surgery. Only small effects were observed in general health and mood measures.Conclusion:The results suggest that the use of a voice-specific questionnaire is essential for assessing the effectiveness of voice interventions. All three self-reported measures tested were capable of detecting change, and scores were highly correlated. On the basis of this evaluation of different measures' sensitivities to change, there is no strong evidence to favour either the vocal performance questionnaire, the voice handicap index or the voice symptom scale.

Thyroplasty for functional rehabilitation of the incompetent larynx

1998 ◽  
Vol 112 (12) ◽  
pp. 1172-1175 ◽  
Author(s):  
M. F. Abdel-Aziz ◽  
N. A. Gad El-Hak ◽  
P. N. Carding
Keyword(s):  
Physical Performance ◽  
Vocal Fold ◽  
Abdominal Pressure ◽  
Vocal Performance ◽  
Type I ◽  
Wound Sepsis ◽  
Functional Rehabilitation ◽  
Valsalva's Manoeuvre ◽  
Objective Improvement ◽  
Type I Thyroplasty

AbstractType I thyroplasty was performed in 12 patients with unilateral paralysis of the vocal fold. Subjective as well as objective improvement in vocal performance was reported in 11 patients. Aspiration was improved in six out of eight patients. Effort closure was evaluated by the ability of the patient to voluntarily raise his intra-abdominal pressure during Valsalva's manoeuvre. A comparison of pre- and post-thyroplasty measures, showed a statistically significant improvement in the efficacy of effort glottic closure (p < 0.05), indicating a better physical performance. We had one case of wound sepsis and another case of implant extrusion.

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.

scholarly journals Effects on Vocal Fold Collision and Phonation Threshold Pressure of Resonance Tube Phonation With Tube End in Water

2013 ◽  
Vol 56 (5) ◽  
pp. 1530-1538 ◽  
Author(s):  
Laura Enflo ◽  
Johan Sundberg ◽  
Camilla Romedahl ◽  
Anita McAllister
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Glass Tube ◽  
Audio Signals ◽  
Resonance Tube ◽  
Phonation Threshold Pressure ◽  
Before And After ◽  
Subglottal Pressure ◽  
Voice Pathologies ◽  
The Voice

Purpose Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively. Method Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography, and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel, who also rated the subjects' singing experience. Results Resonance tube phonation significantly increased CTP and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced. Conclusion Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP did not reach significance.

scholarly journals The Role of Immediate Recurrent Laryngeal Nerve Reconstruction for Thyroid Cancer Surgery

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Tetsuji Sanuki ◽  
Eiji Yumoto ◽  
Ryosei Minoda ◽  
Narihiro Kodama
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Muscle Tone ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Cancer Surgery ◽  
Type I ◽  
Nerve Reconstruction ◽  
Normal Ranges

Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in conducting surgery for thyroid cancer. Different treatments are available for the management of UVFP including intracordal injection, type I thyroplasty, arytenoid adduction, and laryngeal reinnervations. The effects of immediate recurrent laryngeal nerve (RLN) reconstruction during thyroid cancer surgery with or without UVFP before the surgery were evaluated with videostroboscopic, aerodynamic, and perceptual analyses. All subjects experienced postoperative improvements in voice quality. Particularly, aerodynamic analysis showed that the values for all patients entered normal ranges in both patients with and without UVFP before surgery. Immediate RLN reconstruction has the potential to restore a normal or near-normal voice by returning thyroarytenoid muscle tone and bulk seen with vocal fold denervation. Immediate RLN reconstruction is an efficient and effective approach to the management of RLN resection during surgery for thyroid cancer.

The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects

2012 ◽  
Vol 38 (4) ◽  
pp. 352-365 ◽  
Author(s):  
W.L. Lam ◽  
W.N. Lin ◽  
D. Bell ◽  
J. P. Higgins ◽  
Y. T. Lin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Venous Congestion ◽  
Reverse Direction ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Venous Flaps ◽  
Venous Shunt ◽  
Clinical Series ◽  
Venous Flap

Reconstruction of digital defects using the venous flap offer several advantages but remained unpopular owing to levels of venous congestion rates. We performed animal studies to test the hypothesis that an arterio-venous shunt increases pressure for peripheral flap perfusion and decreases venous congestion. Using an abdominal adipofascial flap model in six male Sprague–Dawley rats, microcirculation was modified as follows: type I – arterial flap; type II – flow-through arterio-venous flap (AVF); and type III – shunt-restricted AVF. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type II flaps, blood flow oscillated without a dominant direction and came to a standstill. In type III flaps, blood flowed proximally in a reverse direction whereas distally, flow was similar to type I flaps. In a clinical series, 21 patients received a total of 22 shunt-restricted AVFs. All 22 clinical flaps survived; four flaps suffered epidermolysis but recovered without full thickness loss.

scholarly journals Importance of timely diagnosis of diseases of the larynx during initial examination performed by an otorhinolaryngologist

2018 ◽  
pp. 58-64 ◽  
Author(s):  
Yu. E. Stepanova ◽  
T. V. Gotovyakhina ◽  
N. N. Makhotkina
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Diagnostic Techniques ◽  
Vascular Pathology ◽  
Initial Examination ◽  
Functional Dysphonia ◽  
Urgent Task ◽  
The Voice ◽  
Constant Growth ◽  
Vocal Fold Nodules

Diagnosis and treatment of diseases of the larynx in patients with dysphonia are an urgent task of modern otorhinolaryngology. The reason for this is the constant growth of professions with high requirements for voice quality. The modern methods of diagnosis in diseases of the larynx are based on endoscopic diagnostic techniques. The article provides detailed description of the clinical and endoscopic signs of functional and organic diseases of the larynx that are significantly more prevalent in voice professionals: hypotonic and hypo-hypertonic functional dysphonia, soft and hard vocal fold nodules, acute and chronic occupational laryngitis, and vascular pathology of vocal cords. The article presents the main approaches to the treatment of diseases of the larynx, including using the drug Homeovox. The article will be useful to the otorhinolaryngologists of the outpatient network to establish the diagnosis and assign а therapy to the voice and speech professionals.

Lateral neck dissection affects the voice in thyroid cancer patients

2017 ◽  
Vol 131 (10) ◽  
pp. 853-859 ◽  
Author(s):  
I-C Nam ◽  
J-S Bae ◽  
S-H Lee ◽  
J-O Park ◽  
S-Y Kim ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Medical Records ◽  
Vocal Fold ◽  
Initial Period ◽  
Voice Quality ◽  
Lateral Neck ◽  
Lateral Neck Dissection ◽  
Voice Change ◽  
Fundamental Frequencies ◽  
The Voice

AbstractObjective:This study aimed to identify the effect of lateral neck dissection on voice change in thyroidectomised patients.Methods:Medical records from 264 patients who underwent thyroidectomy with (n= 65) or without (n= 199) lateral neck dissection were reviewed. Clinical and voice evaluation data were compared between the two groups.Results:Patients who underwent surgery that included lateral neck dissection had lower fundamental frequencies and speaking fundamental frequencies. They also had a higher incidence of asymmetric mucosal wave and vocal fold oedema on videostroboscopy during the first month after surgery, with the incidence of vocal fold oedema remaining significantly higher at three months. Self-assessed voice quality scores were significantly higher in lateral neck dissection patients at both one and three months after surgery.Conclusion:In thyroidectomised patients, lateral neck dissection lowers the vocal pitch in the initial period after surgery and induces vocal fold oedema that persists for several months. Although most objective parameters improved within a month, subjective symptoms lasted for longer.

Medialization thyroplasty in glottis insufficiency due to unilateral vocal fold paralysis and after laser cordectomies – preliminary report

2017 ◽  
Vol 71 (1) ◽  
pp. 22-29
Author(s):  
Anna Rzepakowska ◽  
Ewa Osuch-Wójcikiewicz ◽  
Ewelina Sielska-Badurek ◽  
Kazimierz Niemczyk
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Standard Procedure ◽  
Thyroid Cartilage ◽  
Voice Quality ◽  
Type I ◽  
Vocal Fold Paresis ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Medialization Thyroplasty

Medialization thyroplasty (type I) is surgical procedure performed on the thyroid cartilage. The major indication for this surgery is significant glottis insufficiency due to unilateral vocal fold paresis. However the proce¬dure is also performed after vocal fold resections during cordectomy. The aim: The evaluation of voice results in patients after medialisation throplasty. Material and methods: In Otolaryngology Department of Medical University of Warsaw there were performed so far 8 thyroplasty procedures under local anaesthesia with implantation of medical silicon protesis. 6 patients had unilat¬eral vocal fold paresis and the rest two underwent in the past laser cordectomy due to T1a vocal carcinoma. Results: There were no complications during and post the surgery. The follow up examination in 1st , 3rd, 6th i 12th months postoperatively revealed for all patients significant improvement of glottal closure in laryngeal videostrobos¬copy. The voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shim¬mer, NHR) in both patients groups. However the rate of improvement was much more significant in group with uni¬lateral vocal fold paresis. In all patients the maximum phonation time (MPT) increased. The self-evaluation of voice quality with Voice Handicap Index questionnaire confirmed also individual improvement. Conclusions: The speech rehabilitations is not successful in each patient with glottis insufficiency. The medialisation thyroplasty remains the standard procedure for permanent improvement of voice quality in those cases.

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