Voice Rehabilitation after Laryngectomy

2010 ◽  
Vol 2 (3) ◽  
pp. 231-236 ◽  
Author(s):  
Audrey B Erman ◽  
Daniel G Deschler
Keyword(s):  
Turning Point ◽  
Voice Rehabilitation ◽  
Past Century ◽  
Voice Restoration ◽  
Surgical Success ◽  
The Past ◽  
Surgical Options ◽  
Tracheoesophageal Puncture

Abstract Improvements in voice rehabilitation over the past century have paralleled the surgical success of laryngectomy. The establishment of the tracheoesophageal puncture marked a turning point in the development of successful and dependable voice rehabilitation. Surgical options include both primary and secondary placement of a tracheoesophageal puncture. Though complications, such as pharyngoesophageal spasm or prosthesis leakage may occur, patients should expect functional voice restoration after laryngectomy.

scholarly journals Operative Techniques for Cervical Radiculopathy and Myelopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
C. Moran ◽  
C. Bolger
Keyword(s):  
Cervical Spine ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Past Century ◽  
Operative Techniques ◽  
Disc Arthroplasty ◽  
The Past ◽  
Surgical Options

The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970's. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

scholarly journals Primary versus secondary tracheoesophageal puncture: systematic review and meta-analysis

2017 ◽  
Vol 132 (1) ◽  
pp. 14-21 ◽  
Author(s):  
P D Chakravarty ◽  
A E L McMurran ◽  
A Banigo ◽  
M Shakeel ◽  
K W Ah-See
Keyword(s):  
Systematic Review ◽  
Complication Rate ◽  
Meta Analysis ◽  
Case Series ◽  
Current Evidence ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Voice Restoration ◽  
Increased Risk ◽  
Tracheoesophageal Puncture

AbstractBackground:Tracheoesophageal puncture represents the ‘gold standard’ for voice restoration following laryngectomy. Tracheoesophageal puncture can be undertaken primarily during laryngectomy or in a separate secondary procedure. There is no current consensus on which approach is superior. The current evidence comparing primary and secondary tracheoesophageal puncture was assessed.Methods:A systematic review and meta-analysis of articles comparing outcomes for primary and secondary tracheoesophageal puncture after laryngectomy were conducted. Outcome measures were: voice success, overall complication rate and pharyngocutaneous fistula rate.Results:Eleven case series met the inclusion criteria, two prospective and nine retrospective. Meta-analysis did not demonstrate statistically significant differences in overall complication rate or voice outcomes, though it suggested a significantly increased risk of pharyngocutaneous fistula in primary compared to secondary tracheoesophageal puncture.Conclusion:Primary tracheoesophageal puncture is a safe and efficient approach for voice rehabilitation. However, secondary tracheoesophageal puncture should be preferred where there is a higher risk of pharyngocutaneous fistula.

Managing problems with tracheoesophageal puncture for alaryngeal voice rehabilitation

2006 ◽  
Vol 120 (6) ◽  
pp. 470-477 ◽  
Author(s):  
O A Albirmawy ◽  
M N Elsheikh ◽  
M E Saafan ◽  
E Elsheikh
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Medical Records ◽  
Multidisciplinary Approach ◽  
Clinical Analysis ◽  
Voice Rehabilitation ◽  
Voice Restoration ◽  
Early Results ◽  
Tracheoesophageal Puncture

Objectives: The tracheoesophageal puncture (TEP) technique and the insertion of its associated voice prostheses may give rise to adverse events. We present our experience with this technique, paying special attention to the incidence and management of these adverse events.Study design: A retrospective clinical analysis was undertaken.Methods: Seventy-five laryngectomized patients underwent TEP for voice restoration. They were divided into two groups: group one, 43 patients with secondary TEP; and group two, 32 patients with primary TEP. Patient medical records were reviewed for data on the incidence, management and outcome of adverse events encountered during patients' follow up.Results: Problems that arose in the patients were itemized as either early or late. The same patient could develop one or more problems in either group. The management of these problems, concerning the creation and maintenance of the TEP and associated prostheses, was noted. In group one, results were initially favourable in 91 per cent of patients and still positive in 81.4 per cent after three years. In group two, early results were favourable in all patients, and only two patients asked for late elective closure of the TEP (with a success rate of 93.7 per cent).Conclusions: Via an intensive and multidisciplinary approach to problems, most of the inevitable adverse events could be solved adequately, minimizing the discomfort of patients who had undergone laryngectomy and indwelling voice prosthesis insertion.

scholarly journals PREREQUISITES AND PLOT-COMPOSITIONAL FEATURES OF THE DIRECTION OF SURREALISM IN THE VISUAL ARTS

2020 ◽  
Vol 4 (10(79)) ◽  
pp. 10-15
Author(s):  
S. Krykbayeva ◽  
L. Bakirova ◽  
K. Zhedelov
Keyword(s):  
Visual Arts ◽  
Art Criticism ◽  
Turning Point ◽  
Past Century ◽  
Holistic View ◽  
Traditional Art ◽  
The Past ◽  
Death Time ◽  
Original Culture ◽  
Modern Era

The article reveals the preconditions for the emergence and features of surrealism as an artistic direction. The rejection of the traditions of realism, the autonomy of the artist's personality, irony, playfulness in creativity, the scandalous and shocking nature of his presentation are due to the turning point of the era. The study of surrealism is aimed at forming a systematic, holistic view of the art of the past century in the reader, developing his own position in relation to its diverse innovations. The influence of scientific art criticism in the field of surrealism on the formation of aesthetic views of modern Kazakhstani artists is considered. Philosophy, art or the real sciences: life, death, time, memory, war, love - these topics are always relevant for all areas of humanity and worldview. Describes traditional and modern artistic techniques used in the author's works of art based on the symbolic texts of surrealism. In today's era of globalization, when the country seeks to rethink its original culture and form a national idea and ideology, one of the most pressing problems of the modern era is the study of the origins and nature of our national traditional art. 

Effect of primary neopharyngeal repair on acoustic characteristics of tracheoesophageal voice after total laryngectomy

2008 ◽  
Vol 123 (4) ◽  
pp. 426-433 ◽  
Author(s):  
O A Albirmawy ◽  
A S El-Guindy ◽  
M N Elsheikh ◽  
M E Saafan ◽  
M E Darwish
Keyword(s):  
Total Laryngectomy ◽  
Speaking Rate ◽  
Voice Rehabilitation ◽  
Muscle Repair ◽  
Mean Values ◽  
Voice Restoration ◽  
Pharyngeal Plexus ◽  
Significant Difference ◽  
Tracheoesophageal Puncture ◽  
Repair Group

AbstractObjectives:The tracheoesophageal puncture technique of voice restoration enables successful voice rehabilitation after total laryngectomy. Because post-operative voice quality can vary significantly, depending on which type of hypopharyngeal repair is chosen, the aim of this study was to evaluate the effect of such repair on tracheoesophageal puncture voice after total laryngectomy.Study design:Prospective, clinical study.Setting:Otolaryngology department, Tanta University, Egypt.Methods:Tracheoesophageal puncture voice was quantitatively and qualitatively evaluated in 40 patients using a Provox 2TM prosthesis after standard total laryngectomy. The patients were divided, according to the type of hypopharyngeal repair, into four groups of 10 cases each, as follows: group one, pharyngoesophageal myotomy; group two, pharyngeal plexus neurectomy; group three, non-muscle vertical repair; and group four, transverse repair. These surgical groups were compared with each other with respect to different voice parameters.Results:Patient profiles were almost equivalent in all surgical groups. The mean values of most of the parameters of quantitative tracheoesophageal puncture voice did not differ significantly, comparing the four surgical groups; however, a slightly significant difference was observed regarding loud intensity in the non-muscle repair group, and soft and loud jitter in the transverse repair group. Mean values for qualitative measures of intelligibility and communicative effectiveness did not show significant difference. However, a slightly significant difference was observed regarding fluency, word correctness, speaking rate and wetness, with higher values for all these parameters except wetness in the myotomy group, and higher values for wetness in the non-muscle repair group.Conclusion:The four hypopharyngeal repair types – primary pharyngoesophageal myotomy, pharyngeal plexus neurectomy, non-muscle vertical repair and transverse hypopharyngeal repair – were almost equivalent in prevention of pharyngoesophageal spasm in total laryngectomy patients who had undergone primary tracheoesophageal puncture for voice restoration.

scholarly journals The pubovaginal sling: Reintroducing an old friend

2017 ◽  
Vol 11 (6S2) ◽  
pp. 147 ◽  
Author(s):  
Gregory G. Bailly ◽  
Kevin V. Carlson
Keyword(s):  
Surgical Technique ◽  
Midurethral Sling ◽  
Vaginal Surgery ◽  
Pubovaginal Sling ◽  
Female Stress Urinary Incontinence ◽  
Past Century ◽  
The Past ◽  
Surgical Options ◽  
Health Canada

The surgical management of female stress urinary incontinence (SUI) has evolved over the past century, using various techniques of retropubic colposuspensions and sling procedures. In the past two decades, the sling has become the mainstay of surgical treatment of SUI, with the synthetic midurethral sling (MUS) leading the way. With the recent concerns raised by the U.S. Food and Drug Administration (FDA) and Health Canada about the safety of vaginal surgery using mesh implants, including the MUS, urologists and gynecologists should be familiar with suitable alternatives, including the pubovaginal sling (PVS), which often incorporates autologous fascia. Surgeons should be expected to discuss the surgical options to patients in more detail so that an informed decision can be made by both parties on which surgery to choose. Despite the MUS still being considered the “gold standard” by many, both the urologist and gynecologist who manage SUI should understand the indications for a PVS with autologous fascia, as well as its surgical technique and outcomes. This knowledge is required to aid in the decision-making of both the patient and her surgeon. In this article, the role of the PVS and the description of its surgical technique are presented.

Transnasal oesophagoscopy-guided in-office secondary tracheoesophageal puncture

2007 ◽  
Vol 122 (3) ◽  
pp. 303-306 ◽  
Author(s):  
V S Doctor ◽  
D J Enepekides ◽  
D G Farwell ◽  
P C Belafsky
Keyword(s):  
Local Anaesthetic ◽  
Total Laryngectomy ◽  
Reliable Method ◽  
Voice Rehabilitation ◽  
Intravenous Sedation ◽  
Puncture Site ◽  
Endoscopic Techniques ◽  
Voice Restoration ◽  
Tracheoesophageal Puncture ◽  
Rigid Oesophagoscopy

AbstractObjective:Tracheoesophageal puncture is recognised as an effective and reliable method for voice restoration following total laryngectomy. Several techniques have been described, ranging from rigid oesophagoscopy under general anaesthesia to more recent endoscopic techniques utilising intravenous sedation or local anaesthetic. We describe our technique for secondary tracheoesophageal puncture utilising unsedated transnasal oesophagoscopy in an office setting.Method:Retrospective review of all total laryngectomy patients undergoing in-office transnasal oesophagoscopy-assisted tracheoesophageal puncture between October 1 2004 and December 31 2006.Results:Eleven patients undergoing transnasal oesophagoscopy-guided tracheoesophageal puncture were identified. Successful tracheoesophageal puncture placement was achieved in 10 of 11 patients (91 per cent). In one patient tracheoesophageal puncture could not be performed due to anatomic constraints. One patient had bleeding from the puncture site requiring silver nitrate cautery. All patients tolerated the procedure well. Voice results were satisfactory in all cases.Conclusions:Transnasal oesophagoscopy-guided tracheoesophageal puncture provides a simple, safe option for secondary voice rehabilitation in laryngectomy patients.

The zoonotic potential of bat-borne coronaviruses

2020 ◽  
Vol 4 (4) ◽  
pp. 365-381
Author(s):  
Ny Anjara Fifi Ravelomanantsoa ◽  
Sarah Guth ◽  
Angelo Andrianiaina ◽  
Santino Andry ◽  
Anecia Gentles ◽  
...  
Keyword(s):  
Genetic Material ◽  
Field Research ◽  
Sympatric Species ◽  
Animal Origin ◽  
Mammalian Host ◽  
Past Century ◽  
The Past ◽  
Novel Host ◽  
Horseshoe Bat ◽  
Human Infections

Seven zoonoses — human infections of animal origin — have emerged from the Coronaviridae family in the past century, including three viruses responsible for significant human mortality (SARS-CoV, MERS-CoV, and SARS-CoV-2) in the past twenty years alone. These three viruses, in addition to two older CoV zoonoses (HCoV-229E and HCoV-NL63) are believed to be originally derived from wild bat reservoir species. We review the molecular biology of the bat-derived Alpha- and Betacoronavirus genera, highlighting features that contribute to their potential for cross-species emergence, including the use of well-conserved mammalian host cell machinery for cell entry and a unique capacity for adaptation to novel host environments after host switching. The adaptive capacity of coronaviruses largely results from their large genomes, which reduce the risk of deleterious mutational errors and facilitate range-expanding recombination events by offering heightened redundancy in essential genetic material. Large CoV genomes are made possible by the unique proofreading capacity encoded for their RNA-dependent polymerase. We find that bat-borne SARS-related coronaviruses in the subgenus Sarbecovirus, the source clade for SARS-CoV and SARS-CoV-2, present a particularly poignant pandemic threat, due to the extraordinary viral genetic diversity represented among several sympatric species of their horseshoe bat hosts. To date, Sarbecovirus surveillance has been almost entirely restricted to China. More vigorous field research efforts tracking the circulation of Sarbecoviruses specifically and Betacoronaviruses more generally is needed across a broader global range if we are to avoid future repeats of the COVID-19 pandemic.

PCSK9 inhibition for LDL lowering and beyond – implications for patients with peripheral artery disease

VASA ◽  
2018 ◽  
Vol 47 (3) ◽  
pp. 165-176 ◽  
Author(s):  
Katrin Gebauer ◽  
Holger Reinecke
Keyword(s):  
Cardiovascular Risk ◽  
Risk Reduction ◽  
Ldl Receptor ◽  
Density Lipoprotein ◽  
Past Century ◽  
Pcsk9 Inhibitors ◽  
Cardiovascular Risk Reduction ◽  
Simultaneous Application ◽  
The Past ◽  
Pcsk9 Inhibition

Abstract. Low-density lipoprotein cholesterol (LDL-C) has been proven to be a causal factor of atherosclerosis and, along with other triggers like inflammation, the most frequent reason for peripheral arterial disease. Moreover, a linear correlation between LDL-C concentration and cardiovascular outcome in high-risk patients could be established during the past century. After the development of statins, numerous randomized trials have shown the superiority for LDL-C reduction and hence the decrease in cardiovascular outcomes including mortality. Over the past decades it became evident that more intense LDL-C lowering, by either the use of highly potent statin supplements or by additional cholesterol absorption inhibitor application, accounted for an even more profound cardiovascular risk reduction. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a serin protease with effect on the LDL receptor cycle leading to its degradation and therefore preventing continuing LDL-C clearance from the blood, is the target of a newly developed monoclonal antibody facilitating astounding LDL-C reduction far below to what has been set as target level by recent ESC/EAS guidelines in management of dyslipidaemias. Large randomized outcome trials including subjects with PAD so far have been able to prove significant and even more intense cardiovascular risk reduction via further LDL-C debasement on top of high-intensity statin medication. Another approach for LDL-C reduction is a silencing interfering RNA muting the translation of PCSK9 intracellularly. Moreover, PCSK9 concentrations are elevated in cells involved in plaque composition, so the potency of intracellular PCSK9 inhibition and therefore prevention or reversal of plaques may provide this mechanism of action on PCSK9 with additional beneficial effects on cells involved in plaque formation. Thus, simultaneous application of statins and PCSK9 inhibitors promise to reduce cardiovascular event burden by both LDL-C reduction and pleiotropic effects of both agents.

Archaeology in the Past Century

1901 ◽  
Vol 51 (1309supp) ◽  
pp. 20976-20977
Author(s):  
W. M. Flinders Petrje
Keyword(s):  
Past Century ◽  
The Past
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