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Indian Journal of Surgical Oncology Jun 2023To evaluate the QoL before and after prosthetic rehabilitation of partial mandibulectomy patients based on the type of surgery, effects of radiation, the type of... (Review)
Review
UNLABELLED
To evaluate the QoL before and after prosthetic rehabilitation of partial mandibulectomy patients based on the type of surgery, effects of radiation, the type of prosthesis, and to enlist their outcome on the rehabilitation. Literature search as per PICO format was carried out within a time range from January 2000 to June 2021. The review followed PRISMA guidelines and registered with the PROSPERO(CRD42021258472). The focus question was established as per the PICO format (Population, Intervention, Comparison, Outcome). The population involved partial mandibulectomy individuals with prosthetic rehabilitation as an intervention. The outcome, quality of life (QoL), was compared with the pre and post partial mandibulectomy patients rehabilitated with a prosthesis. The search yielded 367 articles and based on the search criteria only 7 articles were suitable for qualitative analysis. Marginal resection of the mandible is less aggressive than segmental resection which provided function, phonation, and esthetics at acceptable levels but the food mixing ability was reduced when resection is accompanied by glossectomy. However, the perceived chewing ability and OHRQoL were not accountable to the extent of surgical excision. An overall increase in the QoL on rehabilitation with acrylic prosthesis depicting satisfactory functionality with a considerable improvement in mastication, speech, and social life. QoL and Denture Satisfaction Index did not differ based on the number of implants in an implant overdenture prosthesis, but the chewing ability was improved. An increase in the number of remaining occlusal units improved the overall QoL. Restoration of the function, psychological comfort, and improvement in esthetics was significant in patients who underwent prosthetic rehabilitation. The QoL between conventional and implant prostheses was observed to be more similar, and the effect of remaining hard and soft tissue structures has a major influence on patient comfort signifying the influence of the extent of surgical excision.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s13193-022-01664-x.
PubMed: 37324294
DOI: 10.1007/s13193-022-01664-x -
Journal of Voice : Official Journal of... Nov 2014To perform a systematic literature review to evaluate the type and timing of therapy for vocal fold paresis/paralysis after thyroidectomy and develop a primary... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To perform a systematic literature review to evaluate the type and timing of therapy for vocal fold paresis/paralysis after thyroidectomy and develop a primary decision-making pathway.
STUDY DESIGN
Meta-analysis.
METHODS
Four databases and one journal were searched using the key words of "thyroidectomy," "vocal cord paresis/paralysis," and "therapy." Study quality was evaluated using the Cochrane Collaboration's risk of bias tools. Data regarding type and timing of therapy were extracted from 39 articles. Odds ratios (ORs), relative risk (RR), 95% confidence interval, and heterogeneity were recorded. Logistic regression analysis was performed to determine the relationships between timing and OR/RR.
RESULTS
Among the 13 studies investigating unilateral paresis/paralysis, five focused on early therapy (0-6 months). In these studies, the OR for clinical heterogeneity was significantly higher after neurolysis than after injection laryngoplasty and voice training (Q = 17.002, I(2) = 78%, P = 0.000), and the RR for heterogeneity was significantly higher after injection laryngoplasty at ≥12 months than <12 months (Q = 9.984, I(2) = 89.9%, P = 0.002). In the 26 studies that investigated bilateral paresis/paralysis, the OR for heterogeneity was significantly higher for bilateral posterior cordectomy than for endolaryngeal laterofixation (Q = 3.510, I(2) = 71.5%, P = 0.061) and laser arytenoidectomy with posterior cordectomy (Q = 2.90, I(2) = 65.6%, P = 0.088).
CONCLUSIONS
For unilateral vocal fold paresis/paralysis after thyroidectomy, we recommend absorbable mass injection laryngoplasty, voice training, and neurolysis during the first 12 months but laryngeal reinnervation after 12 months. For bilateral vocal fold paresis/paralysis, we recommend early laterofixation and combined laser arytenoidectomy with posterior cordectomy after 12 months.
Topics: Humans; Laryngoplasty; Logistic Models; Nerve Block; Odds Ratio; Phonation; Recovery of Function; Recurrent Laryngeal Nerve Injuries; Reoperation; Risk Factors; Thyroidectomy; Time Factors; Time-to-Treatment; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords; Voice; Voice Training
PubMed: 24739443
DOI: 10.1016/j.jvoice.2014.02.003 -
American Journal of Critical Care : An... Nov 2019To synthesize evidence of the safety and effectiveness of phonation in patients with fenestrated tracheostomy tubes.
OBJECTIVE
To synthesize evidence of the safety and effectiveness of phonation in patients with fenestrated tracheostomy tubes.
METHODS
PubMed, CINAHL, Scopus, Cochrane, and Web of Science databases were searched. The research question was, "Are fenestrated tracheostomy tubes a safe and effective option to facilitate early phonation in patients undergoing tracheostomy?" Studies of fenestrated tracheostomy tubes were assessed for risk of bias and quality of evidence. Data were abstracted, cross-checked for accuracy, and synthesized.
RESULTS
Of the 160 studies identified, 13 met inclusion criteria, including 6 clinical studies (104 patients), 6 case reports (13 patients), and 1 nationwide clinician survey. The primary indications for a tracheostomy were chronic ventilator dependence (83%) and airway protection (17%). Indications for fenestrated tracheostomy included inaudible phonation and poor voice intelligibility. Patients with fenestrated tubes achieved robust voice outcomes. Complications included granulation tissue (6 patients [5%]), malpositioning (1 patient [0.9%]), decreased oxygen saturation (3 patients [2.6%]), increased blood pressure (1 patient [0.9%]), increased peak pressures (2 patients [1.7%]), and air leakage (1 patient [0.9%]); subcutaneous emphysema also occurred frequently. Patient-reported symptoms included shortness of breath (4 patients [3.4%]), anxiety (3 patients [2.6%]), and chest discomfort (1 patient [0.9%]).
CONCLUSIONS
Fenestrated devices afford benefits for speech and decannulation but carry risks of granulation, aberrant airflow, and acclimation challenges. Findings highlight the need for continued innovation, education, and quality improvement around the use of fenestrated devices.
Topics: Adult; Aged; Aged, 80 and over; Airway Extubation; Critical Care Nursing; Female; Humans; Male; Middle Aged; Patient Safety; Phonation; Practice Guidelines as Topic; Respiration, Artificial; Tracheostomy
PubMed: 31676519
DOI: 10.4037/ajcc2019892 -
Journal of Voice : Official Journal of... Sep 2020The study aimed to determine the normative value of SVHI-10. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The study aimed to determine the normative value of SVHI-10.
STUDY DESIGN
The study is a systematic review and a meta-analysis.
METHODS
A systematic literature search was performed using PubMed and ScienceDirect to access relevant databases and to locate outcome studies. Eligibility criteria included type of publication, participant characteristics, and report of outcomes. Data analysis was conducted using the meta-analysis method.
RESULTS
Six articles were included for the final analysis. The normative values for the SVHI-10 for a group of 528 subjects were 8.38 with confidence levels of 7.43-9.34 (age range 16-83).
CONCLUSIONS
Based on the results of the meta-analysis the SVHI-10 can be used as a screening tool for a group of singers. In the future, it would be worthwhile to carry out a subordinate analysis to determine the SVHI-10 range for mild voice disorders or severe voice disorders in singing.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Humans; Middle Aged; Singing; Voice Disorders; Voice Quality; Young Adult
PubMed: 31031104
DOI: 10.1016/j.jvoice.2019.04.002 -
OTO Open 2022This review aims to describe the methods used to assess the vocal quality and quality of life of children after airway reconstruction and their limitations.
OBJECTIVE
This review aims to describe the methods used to assess the vocal quality and quality of life of children after airway reconstruction and their limitations.
DATA SOURCES
A systematic review was carried out in 10 databases for articles published between 2000 and 2021 following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses).
REVIEW METHODS
Articles were included that described perceptual voice assessment with or without acoustic measures and/or voice quality impact questionnaires. Articles with no description of a specific voice assessment were excluded.
RESULTS
A total of 12 studies were included, yielding 263 patients. The mean age at evaluation was 9 years. Follow-up varied from 5 months to 20 years with most patients being evaluated at least a year after surgery. Methods used to evaluate voice were perceptual, aerodynamic, and acoustic analysis and quality of life questionnaires. CAPE-V (Consensus Auditory Perceptual Evaluation-Voice) was the most used auditory-perceptual instrument (72.7%). Of the acoustic parameters, fundamental frequency and maximum phonation time were the most described (58.3%), and among the quality of life assessment questionnaires, pVHI (Pediatric Voice Handicap Index) was the most used (54.5%).
CONCLUSION
Multidimensional evaluations tailored to the individual child can be recommended after open airway surgery. CAPE-V scale, fundamental frequency, maximum phonation time, and pVHI are the most frequently used methods; therefore, their use may help broaden communication among authors. In the multitude of methods available, cognitive ability and degree of voice disturbance should be considered since they are the most important limiting factors in this population.
PubMed: 35663352
DOI: 10.1177/2473974X221103558 -
Journal of Voice : Official Journal of... May 2023Biomechanical modeling allows obtaining information on physical phenomena that cannot be directly observed. This study aims to review models that represent voice... (Review)
Review
Biomechanical modeling allows obtaining information on physical phenomena that cannot be directly observed. This study aims to review models that represent voice production. A systematic review of the literature was conducted using PubMed/Medline, SCOPUS, and IEEE Xplore databases. To select the papers, we used the protocol PRISMA Statement. A total of 53 publications were included in this review. This article considers a taxonomic classification of models found in the literature. We propose four categories in the taxonomy: (1) Models representing the Source (Vocal folds); (2) Models representing the Filter (Vocal Tract); (3) Models representing the Source - Filter Interaction; and (4) Models representing the Airflow - Source Interaction. We include a bibliographic analysis with the evolution of the publications per category. We provide an analysis of the number as well of publications in journals per year. Moreover, we present an analysis of the term occurrence and its frequency of usage, as found in the literature. In each category, different types of vocal production models are mentioned and analyzed. The models account for the analysis of evidence about aerodynamic, biomechanical, and acoustic phenomena and their correlation with the physiological processes involved in the production of the human voice. This review gives an insight into the state of the art related to the mathematical modeling of voice production, analyzed from the viewpoint of vocal physiology.
Topics: Humans; Phonation; Biomechanical Phenomena; Vocal Cords; Voice; Acoustics
PubMed: 33678534
DOI: 10.1016/j.jvoice.2021.02.014 -
International Journal of Paediatric... Nov 2020Information about the functional and morphological consequences that occur following the premature loss of anterior teeth is still insufficient. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Information about the functional and morphological consequences that occur following the premature loss of anterior teeth is still insufficient.
AIM
To evaluate the consequences in children's speech and arch integrity following premature loss of primary anterior teeth compared to those without premature losses.
DESIGN
Electronic searches were performed based on the PECO criteria. Observational studies in children (P) who suffered premature loss or extraction of primary anterior teeth (E) compared to children presenting normal occlusion development (C) and the consequences to speech and dental arch perimeter (O) were included. Risk of bias and data extraction were performed. The meta-analysis evaluated the influence of premature loss of primary anterior teeth in articulatory speech disorders (distortion, omission, and substitution) and space loss in the dental arches. Random- and fixed-effect models were used, and heterogeneity was tested. The certainty of evidence was estimated using the GRADE approach.
RESULTS
From a total of 2.234 studies, six studies were included in the qualitative synthesis, and four in speech disorders meta-analysis. Despite it was not possible to perform space loss meta-analysis due to the absence of available data, qualitative analysis showed that there was no space loss after premature loss of mandibular primary incisors; a space loss, however, could be observed in children who lost primary canines at an early stage of dental development. For speech disorders results, children who lost anterior tooth presented higher chance of suffering speech distortion, than children without tooth loss (OR 5.466 [1.689, 17.692] P = .005) with low certainty of evidence. On the other hand, there were no statistically differences between premature loss of primary anterior teeth and omission (OR (a) 1.157 [0.439, 3.049] P = .767 and (OR (b) 1.393 [0.434, 4.70] P = .577) or substitution (OR (a) 1.071 [0.581, 1.974] P = .827 and OR (b) 1.218 [0.686, 2.163] P = .5), both with very low certainty of evidence.
CONCLUSIONS
Premature loss of primary anterior teeth may affect children phonation causing speech distortion. Consequences of space loss to primary dental arch still need to be further studied. Despite the speech distortion results, included articles present low-level evidence-based quality, thus new studies should be performed.
Topics: Child; Dental Arch; Humans; Incisor; Mandible; Speech; Tooth, Deciduous
PubMed: 32243000
DOI: 10.1111/ipd.12644 -
Clinical Otolaryngology : Official... Sep 2023This systematic review and meta-analysis examines if intralaryngeal injection of basic fibroblast growth factor 2 (FGF2) can improve voice outcomes in those with vocal... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review and meta-analysis examines if intralaryngeal injection of basic fibroblast growth factor 2 (FGF2) can improve voice outcomes in those with vocal disability.
DESIGN
A Systematic review of original human studies reporting voice outcomes following intra-laryngeal injection of basic fibroblast growth factor 2 in those with vocal dysfunction. Databases searched were Medline (1946-July 2022), Embase (1947-July 2022), Cochrane database and Google Scholar.
SETTING
Secondary or tertiary care centres that undertook the management of voice pathology Hospital.
PARTICIPANTS
Inclusion criteria were original human studies reporting voice outcome measurements following intralaryngeal injection of FGF2 to treat vocal fold atrophy, vocal fold scarring, vocal fold sulcus or vocal fold palsy. Articles not written in English, studies that did not include human subjects and studies where voice outcome measures were not recorded before and after FGF2 injection were excluded from the review.
MAIN OUTCOME MEASURES
The primary outcome measure was maximum phonation time. Secondary outcome measures included acoustic analysis, glottic closure, mucosal wave formation, voice handicap index and GRBAS scale.
RESULTS
Fourteen articles were included out of a search of 1023 and one article was included from scanning reference lists. All studies had a single arm design without control groups. Conditions treated were vocal fold atrophy (n = 186), vocal cord paralysis (n = 74), vocal fold fibrosis (n = 74) and vocal fold sulcus (n = 56). A meta-analysis of six articles reporting on the use of FGF2 in patients with vocal fold atrophy showed a significant increase of mean maximum phonation time of 5.2 s (95% CI: 3.4-7.0) at 3-6 months following injection. A significant improvement in maximum phonation time, voice handicap index and glottic closure was found following injection in most studies assessed. No major adverse events were reported following injection.
CONCLUSIONS
To date, intralaryngeal injection of basic FGF2 appears to be safe and it may be able to improve voice outcomes in those with vocal dysfunction, especially vocal fold atrophy. Randomised controlled trials are needed to further evaluate efficacy and support the wider use of this therapy.
Topics: Humans; Fibroblast Growth Factor 2; Plastic Surgery Procedures; Vocal Cord Paralysis; Laryngeal Diseases; Atrophy
PubMed: 37246756
DOI: 10.1111/coa.14073 -
International Journal of Language &... Nov 2022Vocal fold nodules (VFNs) are the main cause of paediatric dysphonia. Voice therapy is recommended as the preferable treatment option for VFNs in children. (Review)
Review
BACKGROUND
Vocal fold nodules (VFNs) are the main cause of paediatric dysphonia. Voice therapy is recommended as the preferable treatment option for VFNs in children.
AIM
The aim of this systematic review is to provide an overview of the existing literature concerning the effects of voice therapy in children with VFNs.
METHODS & PROCEDURES
This systematic literature review was developed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed) and Embase were searched and the grey literature was checked. The search strategy was based on three concepts: VFNs, voice therapy and children. Two examiners independently determined article eligibility and extracted all relevant data from the included studies. The methodological quality of the included study was assessed using the QualSyst tool.
MAIN CONTRIBUTIONS
By identifying, evaluating and summarizing the results of all relevant studies about voice therapy in paediatric VFNs, this systematic review makes the available evidence more accessible to voice therapists, otolaryngologists and other relevant stakeholders.
CONCLUSIONS & IMPLICATIONS
24 studies were included in this systematic review. Eight studies (8/24) reported a significant improvement for at least one outcome parameter after voice therapy. However, five papers (5/24) could not demonstrate significant changes after voice therapy. All studies that did not test for significance (11/24) found improvements for one or more outcome parameters. The overall quality of the included studies is adequate (55%). In sum, there is some evidence that voice therapy is effective in children with VFNs, but further well-designed research, especially randomized controlled trials, is necessary to confirm these results.
WHAT THIS PAPER ADDS
What is already known on the subject Voice therapy is preferable in children with VFNs because of the phonotraumatic nature of the nodules and the associated high recurrence rate after phonosurgery. Most voice therapists in clinical practice offer an eclectic voice therapy programme, consisting of direct and indirect voice therapy techniques. What this study adds to existing knowledge This systematic review provides a clear overview of the available evidence concerning the effects of voice therapy in paediatric VFNs. There is some evidence that voice therapy is an effective treatment option in children with VFNs, but well-designed research is scarce on this subject. What are the potential or actual clinical implications of this work? This review shows that effectiveness studies with strong designs are very scarce in children with VFNs. Clinicians should be aware that few therapy techniques have been thoroughly investigated in this population. However, this review may guide voice therapists when creating a treatment plan for a child with VFNs because it identifies, evaluates and summarizes the results of all relevant individual studies about voice therapy in paediatric VFNs. Voice therapy seems to be effective in treating paediatric patients with VFNs, given the fact that a considerable number of included studies report significant improvements after voice therapy. Both direct and indirect therapy approaches appear to have a positive effect on the phonation of children with VFNs.
Topics: Humans; Child; Vocal Cords; Laryngeal Diseases; Voice Training; Voice; Phonation
PubMed: 35758272
DOI: 10.1111/1460-6984.12754 -
Clinical Rehabilitation May 2021To assess the effect of speech and language therapy (SLT) on Hypokinetic dysarthria (HD) in Parkinson's disease. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the effect of speech and language therapy (SLT) on Hypokinetic dysarthria (HD) in Parkinson's disease.
DESIGN
Systematic review and meta-analysis of randomized controlled trials.
METHODS
We performed a literature search of randomized controlled trials using PubMed, Web of Science, Science Direct and Cochrane database (last search October 2020). Quality assessment and risk of bias were assessed using the Downs and Black scale and the Cochrane tool. The data were pooled and a meta-analysis was completed for sound pressure levels, perceptual intelligibility and inflection of voice fundamental frequency.
RESULTS
We selected 15 high to moderate quality studies, which included 619 patients with Parkinson's disease. After pooling the data, 7 studies, which compared different speech language therapies to no treatment, control groups and 3 of their variables, (sound pressure level, semitone standard deviation and perceptual intelligibility) were included in the analysis.Results showed significant differences in favor of SLT for sound pressure level sustained phonation tasks (standard mean difference = 1.79; 95% confidence interval = 0.86, 2.72; ⩽ 0.0001). Significant results were also observed for sound pressure level and semitone standard deviation in reading tasks (standard mean difference = 1.32; 95% confidence interval = 1.03, 1.61; ⩽ 0.0001). Additionally, sound pressure levels in monologue tasks showed similar results when SLT was compared to other treatments (standard mean difference = 0.87; 95% confidence interval = 0.46, 1.28; ⩽ 0.0001).
CONCLUSION
This meta-analysis suggests a beneficial effect of SLT for reducing Hypokinetic Dysarthria in Parkinson's disease, improving perceptual intelligibility, sound pressure level and semitone standard deviation.
Topics: Dysarthria; Humans; Language Therapy; Parkinson Disease; Speech Therapy
PubMed: 33233932
DOI: 10.1177/0269215520976267