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Revue Medicale Suisse Oct 2020The surgical management of unilateral and bilateral vocal cord paralysis depends on the severity of the condition, the potential for spontaneous recovery, the patient's... (Review)
Review
The surgical management of unilateral and bilateral vocal cord paralysis depends on the severity of the condition, the potential for spontaneous recovery, the patient's age and vocal expectations. Standardized re-innervation surgeries, unilateral non-selective and bilateral selective, are viable alternatives to static procedures currently under evaluation in prospective studies. Neurorraphy of the ansa cervicalis loop to the recurrent laryngeal nerve allows lasting vocal recovery and potentially superior results to medialization and thyroplasty, by maintaining the visco-elastic properties of the vocal cord and preventing its atrophy. Selective bilateral reinnervation shows potential for recovery of inspiratory abduction with improved respiratory function without vocal deterioration.
Topics: Humans; Larynx; Prospective Studies; Recurrent Laryngeal Nerve; Vocal Cord Paralysis; Vocal Cords
PubMed: 33026725
DOI: No ID Found -
Otolaryngologic Clinics of North America Aug 2019This article discusses vocal fold paresis as a separate and distinct condition from vocal fold paralysis. The signs and symptoms of paresis may be different and less... (Review)
Review
This article discusses vocal fold paresis as a separate and distinct condition from vocal fold paralysis. The signs and symptoms of paresis may be different and less obvious than those for paralysis, so this condition is often misdiagnosed or underdiagnosed. Elements necessary to heighten clinical suspicion are included to assist in educating practitioners on these subtle findings. Once paresis is suspected, associated respiratory or sensory abnormalities also should be sought, because these may change the treatment plan when recognized. Utility of laryngeal electromyography is discussed along with potential treatment options for both the motor and often-present sensory symptoms.
Topics: Diagnosis, Differential; Electromyography; Humans; Paresis; Prognosis; Stroboscopy; Vocal Cord Paralysis; Vocal Cords
PubMed: 31088695
DOI: 10.1016/j.otc.2019.03.008 -
Current Problems in Pediatric and... Apr 2018Vocal fold motion abnormalities in children are the second most common form of laryngeal pathology seen in children, and often present in the first 24 months of life. A... (Review)
Review
Vocal fold motion abnormalities in children are the second most common form of laryngeal pathology seen in children, and often present in the first 24 months of life. A thorough evaluation of the aerodigestive tract will include an examination of the vocal folds, and a proper diagnosis is essential in order to decipher the etiology of swallowing, voicing and breathing abnormalities. This article reviews the workup, management options and clinical outcomes of unilateral and bilateral vocal fold motion impairment in the pediatric population.
Topics: Child; Electromyography; Humans; Laryngeal Diseases; Laryngoscopy; Respiratory Sounds; Vocal Cord Dysfunction; Vocal Cords
PubMed: 29653906
DOI: 10.1016/j.cppeds.2018.03.004 -
Ugeskrift For Laeger Nov 2022Injection augmentation of the vocal cords is a recognized treatment modality in patients with glottal closure deficiency caused by paresis or paralysis of the vocal... (Review)
Review
Injection augmentation of the vocal cords is a recognized treatment modality in patients with glottal closure deficiency caused by paresis or paralysis of the vocal cord. The treatment can improve voice quality and also quality of life. It is preferable to minimize waiting time for the procedure for patients with lung cancer and mediastinal involvement, because the one-year mortality is above 40%, as argued in this review.
Topics: Humans; Vocal Cords; Quality of Life; Mediastinum; Lung Neoplasms; Palliative Care
PubMed: 36426831
DOI: No ID Found -
Pediatric Radiology Aug 2022Vocal cord paralysis is a common cause of respiratory and feeding problems in the pediatric population. While the causes of vocal cord paralysis are multiple, iatrogenic... (Review)
Review
Vocal cord paralysis is a common cause of respiratory and feeding problems in the pediatric population. While the causes of vocal cord paralysis are multiple, iatrogenic injury of the recurrent laryngeal nerve after cardiovascular surgery is the most frequent cause. Vocal cord paralysis increases the risk of swallowing dysfunction, tracheal aspiration and pneumonia. It also increases the need for nasoenteric feeds and gastrostomy tube placement. Flexible nasopharyngolaryngoscopy is considered the gold standard for diagnosing vocal cord paralysis, but it has significant drawbacks: it is uncomfortable, it can trigger a cardiovascular event in children with unstable cardiovascular status, it can be challenging to perform, and it can be difficult to interpret. Laryngeal US has become a popular imaging modality to evaluate the function of the vocal cords. Laryngeal US is well-tolerated, easy to perform, simple to interpret and has a lower physiological impact compared to flexible nasopharyngolaryngoscopy. Laryngeal US is an accurate and low-cost diagnostic test for vocal cord paralysis. In this review, we describe the anatomy of the larynx and recurrent laryngeal nerve; the causes, symptoms and pathophysiology of vocal cord paralysis; laryngeal US technique; diagnostic criteria for vocal cord paralysis; and a reporting system.
Topics: Child; Humans; Infant; Laryngoscopy; Larynx; Recurrent Laryngeal Nerve; Vocal Cord Paralysis; Vocal Cords
PubMed: 34841448
DOI: 10.1007/s00247-021-05235-0 -
American Family Physician Nov 2021Vocal cord dysfunction (i.e., vocal cords closing when they should be opening, particularly during inspiration) should be suspected in patients presenting with... (Review)
Review
Vocal cord dysfunction (i.e., vocal cords closing when they should be opening, particularly during inspiration) should be suspected in patients presenting with inspiratory stridor or wheezing; sudden, severe dyspnea (without hypoxia, tachypnea, or increased work of breathing); throat or chest tightness; and anxiety, particularly in females. Common triggers include exercise, asthma, gastroesophageal reflux disease, postnasal drip, upper or lower respiratory tract infection, and irritants. Nasolaryngoscopy and pulmonary function testing, with provocative exercise and methacholine, can help diagnose vocal cord dysfunction and are helpful to evaluate for other etiologies. Conditions that can trigger vocal cord dysfunction should be optimally treated, particularly asthma, gastroesophageal reflux disease, and postnasal drip, while avoiding potential irritants. Therapeutic breathing maneuvers and vocal cord relaxation techniques are first-line therapy for dyspnea that occurs with vocal cord dysfunction. A subset of vocal cord dysfunction leads to dysphonia, as opposed to dyspnea, secondary to abnormal laryngeal muscle spasms (vocal cord closure is less severe). OnabotulinumtoxinA injections may be helpful for spasmodic dysphonia and for treating dyspnea in certain cases, although evidence is limited.
Topics: Airway Management; Humans; Laryngoscopy; Respiratory Function Tests; Respiratory Therapy; Speech Therapy; Vocal Cord Dysfunction; Vocal Cords
PubMed: 34783512
DOI: No ID Found -
HNO Sep 2021Laryngeal framework surgery is an umbrella term for all phonosurgical procedures by which the cartilaginous structure of the larynx and thereby the position and tension... (Review)
Review
Laryngeal framework surgery is an umbrella term for all phonosurgical procedures by which the cartilaginous structure of the larynx and thereby the position and tension of the vocal folds are changed. The aim is to improve the voice. By far the best known and most frequently performed operation is thyroplasty type 1 according to Isshiki, also known as medialization thyroplasty, which is indicated for treatment of glottic insufficiency. Although the first medialization thyroplasty was successfully performed by Payr in Germany in 1915, more than 100 years later, it is still not widely used in Germany.
Topics: Glottis; Humans; Laryngoplasty; Larynx; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords
PubMed: 33978776
DOI: 10.1007/s00106-021-01054-9 -
American Journal of Respiratory and... Jul 2022
Topics: COVID-19; Humans; Laryngoscopy; Vocal Cord Dysfunction; Vocal Cords
PubMed: 35649174
DOI: 10.1164/rccm.202106-1384IM -
Head & Neck Dec 2023Accurate vocal cord leukoplakia classification is critical for the individualized treatment and early detection of laryngeal cancer. Numerous deep learning techniques...
BACKGROUND
Accurate vocal cord leukoplakia classification is critical for the individualized treatment and early detection of laryngeal cancer. Numerous deep learning techniques have been proposed, but it is unclear how to select one to apply in the laryngeal tasks. This article introduces and reliably evaluates existing deep learning models for vocal cord leukoplakia classification.
METHODS
We created white light and narrow band imaging (NBI) image datasets of vocal cord leukoplakia which were classified into six classes: normal tissues (NT), inflammatory keratosis (IK), mild dysplasia (MiD), moderate dysplasia (MoD), severe dysplasia (SD), and squamous cell carcinoma (SCC). Vocal cord leukoplakia classification was performed using six classical deep learning models, AlexNet, VGG, Google Inception, ResNet, DenseNet, and Vision Transformer.
RESULTS
GoogLeNet (i.e., Google Inception V1), DenseNet-121, and ResNet-152 perform excellent classification. The highest overall accuracy of white light image classification is 0.9583, while the highest overall accuracy of NBI image classification is 0.9478. These three neural networks all provide very high sensitivity, specificity, and precision values.
CONCLUSION
GoogLeNet, ResNet, and DenseNet can provide accurate pathological classification of vocal cord leukoplakia. It facilitates early diagnosis, providing judgment on conservative treatment or surgical treatment of different degrees, and reducing the burden on endoscopists.
Topics: Humans; Vocal Cords; Narrow Band Imaging; Deep Learning; Endoscopy; Laryngeal Neoplasms; Endoscopy, Gastrointestinal; Leukoplakia; Hyperplasia
PubMed: 37837264
DOI: 10.1002/hed.27543 -
Ear, Nose, & Throat Journal May 2022To evaluate the characteristics of laryngopharyngeal reflux (LPR) in patients with different hypertrophic laryngeal diseases and to explore the relationship between LPR...
OBJECTIVES
To evaluate the characteristics of laryngopharyngeal reflux (LPR) in patients with different hypertrophic laryngeal diseases and to explore the relationship between LPR and these diseases.
METHODS
A retrospective analysis was performed. The clinical data of 154 patients were collected. According to their diagnoses, patients were divided into 3 groups. Group 1 included 49 patients with vocal cord polyps. Group 2 contained 52 patients with vocal cord leukoplakia. Group 3 included 53 patients with laryngeal carcinoma. The reflux symptom indexes (RSIs), reflux finding scores (RFSs), and Ryan scores of all patients were evaluated and compared.
RESULTS
Patients with vocal cord polyps were the youngest of the 3 groups, and those with laryngeal carcinoma were the oldest. A male preponderance emerged in each group. In total, 128 patients (83.12%) had positive RSI/RFS values and 60 (60/146, 41.1%) patients had positive Ryan scores. The positive RSI/RFS rates of both groups 1 and 2 (89.80% and 92.16%, respectively) were significantly higher than that of group 3 (69.81%). Moreover, the positive Ryan score rates in both groups 1 and 2 (39.58% and 53.85%, respectively) were significantly higher than that of group 3 (28.26%).
CONCLUSIONS
Laryngopharyngeal reflux occurs in many patients with vocal cord polyps, vocal cord leukoplakia, and vocal cord carcinoma, indicating that LPR may be important in the pathogenesis of these diseases. Laryngopharyngeal reflux occurs more common in patients with vocal cord polyps and leukoplakia and less common in those with laryngeal carcinoma, suggesting the role of LPR on these diseases may be different.
Topics: Carcinoma; Humans; Laryngeal Diseases; Laryngeal Neoplasms; Laryngopharyngeal Reflux; Leukoplakia; Male; Polyps; Retrospective Studies; Vocal Cords
PubMed: 32865459
DOI: 10.1177/0145561320953232