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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... Aug 2018Vocal cord leukoplakia is a clinical diagnosis defined as a whitish patch or a plaque on a mucosal surface. Because of the diversity of histopathological types, the... (Review)
Review
Vocal cord leukoplakia is a clinical diagnosis defined as a whitish patch or a plaque on a mucosal surface. Because of the diversity of histopathological types, the complexity and unpredictability risks for malignant transformation, there are still many controversies about its histopathological classification, diagnosis and treatment. The aim of this article is to review the epidemiology, etiology, pathological classification, diagnosis, treatment and prognosis of vocal cord leukoplakia.
Topics: Biomedical Research; Female; Humans; Laryngeal Diseases; Leukoplakia; Male; Prognosis; Vocal Cords
PubMed: 30122006
DOI: 10.3760/cma.j.issn.1673-0860.2018.08.016 -
Science (New York, N.Y.) Mar 2024Phonation critically depends on precise controls of laryngeal muscles in coordination with ongoing respiration. However, the neural mechanisms governing these processes...
Phonation critically depends on precise controls of laryngeal muscles in coordination with ongoing respiration. However, the neural mechanisms governing these processes remain unclear. We identified excitatory vocalization-specific laryngeal premotor neurons located in the retroambiguus nucleus (RAm) in adult mice as being both necessary and sufficient for driving vocal cord closure and eliciting mouse ultrasonic vocalizations (USVs). The duration of RAm activation can determine the lengths of both USV syllables and concurrent expiration periods, with the impact of RAm activation depending on respiration phases. RAm neurons receive inhibition from the preBötzinger complex, and inspiration needs override RAm-mediated vocal cord closure. Ablating inhibitory synapses in RAm neurons compromised this inspiration gating of laryngeal adduction, resulting in discoordination of vocalization with respiration. Our study reveals the circuits for vocal production and vocal-respiratory coordination.
Topics: Animals; Male; Mice; Brain Stem; Medulla Oblongata; Neurons; Respiration; Phonation; Vocal Cords; Mice, Inbred C57BL; Female; Proto-Oncogene Proteins c-fos
PubMed: 38452069
DOI: 10.1126/science.adi8081 -
European Archives of... Apr 2022Review literature data on the coblation method in otorhinolaryngology. (Review)
Review
OBJECTIVE
Review literature data on the coblation method in otorhinolaryngology.
MATERIALS AND METHODS
All materials from our study are published in peer-reviewed journals. The review is PubMed generated. In our clinic, 20 patients with bilateral paralytic laryngeal stenosis underwent cold-plasma posterior arytenoidcordotomy with Coblator II.
RESULTS
The analysis of the high-energy techniques currently applied in otorhinolaryngology shows the benefits of coblation due to the effect of lower temperatures on tissues. Patients subjectively reported improved breathing on day 10 with a closed coblation tracheostoma; after 3-6 months everyone underwent successful decannulation with plastic surgery of the cutaneous-tracheal fistula. Lately, the operated vocal fold was in the abduction position and the lumen of the glottis in the posterior third was 7-8 mm. Compensation of vocal function in the long-term postoperative period was achieved by patients due to long-term orthophonic training and the development of a vestibuloscapular phonation mechanism.
CONCLUSION
The advantages of coblation are mainly minimal trauma to the surrounding tissues, convenient resection, the ability to perform complete hemostasis at one time, and easier postoperative period for the patient.
Topics: Glottis; Humans; Otolaryngology; Phonation; Vocal Cord Paralysis; Vocal Cords
PubMed: 34482444
DOI: 10.1007/s00405-021-07055-2 -
Pediatric Critical Care Medicine : a... Oct 2021Laryngeal ultrasound is a nonirradiating, noninvasive method for assessing the upper airway in children. This systematic review and meta-analysis examine available... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Laryngeal ultrasound is a nonirradiating, noninvasive method for assessing the upper airway in children. This systematic review and meta-analysis examine available evidence for accuracy of laryngeal ultrasound in diagnosing vocal cord immobility in infants and children after surgery and trauma affecting the vocal cords.
DESIGN
Medical subject heading terms were used to search MEDLINE, Embase, Google Scholar, Web of Science, and the Cochrane Library for relevant citations. Publications from January 1, 2000, to June 30, 2020 were included in the search strategy. Study inclusion criteria consisted of randomized control trials and nonrandomized retrospective or prospective observational studies where vocal cord motion was evaluated by laryngeal ultrasound and compared with a reference test. Studies were excluded if there was insufficient data to compute a sensitivity/specificity table. Case reports, case series less than 10, and manuscripts not published in English were also excluded.
PATIENTS
Studies which included subjects younger than or equal to 18 years were considered for full article review.
SETTINGS
No restrictions on study settings were imposed in this systematic review.
MEASUREMENTS AND MAIN RESULTS
The initial search returned 1,357 citations. After de-duplication, abstract, and full review, eight citations were included in the final meta-analysis. A bivariate random-effects meta-analysis was performed, which revealed a pooled sensitivity for laryngeal ultrasound in detecting vocal cord immobility of 91% (95% CI, 83-95%), specificity of 97% (95% CI, 82-100%), diagnostic odds ratio 333.56 (95% CI, 34.00-3,248.71), positive likelihood ratio 31.58 (95% CI, 4.50-222.05), and negative likelihood ratio 0.09 (95% CI, 0.05-0.19).
CONCLUSIONS
Laryngeal ultrasound demonstrates high sensitivity and specificity for detecting vocal cord motion in children in a wide range of clinical settings. Laryngeal ultrasound offers a low-risk imaging option for assessing vocal cord function in children compared with the current gold standard of laryngoscopy.
Topics: Child; Humans; Infant; Laryngoscopy; Larynx; Observational Studies as Topic; Randomized Controlled Trials as Topic; Retrospective Studies; Ultrasonography; Vocal Cords
PubMed: 33833204
DOI: 10.1097/PCC.0000000000002734 -
Advances in Oto-rhino-laryngology 2020Injection laryngoplasty as used in this chapter is synonymous with the term "injection augmentation." Injection augmentation is a technique designed to enhance glottic... (Review)
Review
Injection laryngoplasty as used in this chapter is synonymous with the term "injection augmentation." Injection augmentation is a technique designed to enhance glottic closure in patients with glottic insufficiency, or failure of glottic closure, by injecting material into the lateral aspect of the vocal fold to move the vibrating surface to the midline. This type of injection augments the vocal fold and improves glottic closure. Injection augmentation originated over 100 years ago. However, the current indications, techniques, and materials have changed significantly. Paralysis, defined as loss of function due to neu-rological injury, remains a common cause of glottic insufficiency. In cases of paralysis, nerve function to adduct the vocal folds for voice production and coughing is interrupted, bilaterally or unilaterally, and the glottis becomes insufficient. While unilateral vocal fold paralysis remains the most common indication for vocal fold injection augmentation, due to the development of newer injectable materials and less invasive injectable techniques, surgeons routinely perform injection augmentation for glottic insufficiency due to other causes such as vocal fold paresis, vocal fold atrophy, presbylarynx, vocal fold scar, and soft tissue loss. Additionally, there is an increasing performance of vocal fold injection in the awake patient. This allows for immediate feedback and reduced anesthetic risk. Outcomes assessment for injection augmentation remains varied by lack of consensus and large-scale studies to identify the factors most instrumental in documenting optimal results. We review the history of injection laryngoplasty, the indications for injection, choice of injectate, outcomes, complications, and future directions of injection laryngoplasty for augmentation.
Topics: Humans; Injections; Laryngoplasty; Patient Selection; Vocal Cord Paralysis; Vocal Cords
PubMed: 33166968
DOI: 10.1159/000456684 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Mar 2016Unilateral vocal cord paralysis(UVCP) is defined as affected side vocal cord emerges immobility or motion weakening and abnormal tension due to unilateral intrinsic... (Review)
Review
Unilateral vocal cord paralysis(UVCP) is defined as affected side vocal cord emerges immobility or motion weakening and abnormal tension due to unilateral intrinsic laryngeal muscles suffering from disorder about motor nerve. The patients usually present with hoarse voice, disability of high pitch, cough, aspiration, or a combination of these symptoms. There are increasing therapeutics researches and case analyses regarding UVCP in recent years. Thus this review summarized the progression about its causes and treatment methods.
Topics: Cough; Hoarseness; Humans; Laryngeal Muscles; Vocal Cord Paralysis; Vocal Cords
PubMed: 27382698
DOI: No ID Found -
The Laryngoscope Apr 2020Gradual impairment of nerve conduction is expected to be tightly associated with simultaneous gradual loss of vocal cord contractility, related to the fact that injured...
OBJECTIVE
Gradual impairment of nerve conduction is expected to be tightly associated with simultaneous gradual loss of vocal cord contractility, related to the fact that injured axons are connected to a defined number of muscle cells. In clinical studies, there is a time gap between observed adverse electromyographic (EMG) changes and examination of vocal cord function. This study evaluates the impact of intraoperative EMG changes on synchronous vocal cord contractility by simultaneous use of continuous intraoperative neuromonitoring (C-IONM) and accelerometry for registration of actual vocal cord function at a given change of EMG amplitude.
METHODS
EMG was obtained following vagus nerve stimulation by use of C-IONM. A vocal cord accelerometer probe that could be attached to the vocal cords was developed based on a LIS3DH ultra low-power high performance three axis linear accelerometer (STMicroelectronics, Geneva, Switzerland). Accelerometer data were registered continuously together with EMG data during traction injury of the recurrent laryngeal nerve (RLN) until an amplitude depression ≤100 μV.
RESULTS
Six RLN from four immature domestic pigs were studied. Vocal cord contractility assessed by vocal cord accelerometry decreased in parallel with EMG amplitude, with significant correlations ranging from 0.707 to 0.968.
CONCLUSION
Decrease of EMG amplitude during traction injury to the RLN injury is closely associated with a parallel drop in vocal cord contractility.
LEVEL OF EVIDENCE
NA Laryngoscope, 130:1090-1096, 2020.
Topics: Accelerometry; Animals; Disease Models, Animal; Electromyography; Monitoring, Physiologic; Recurrent Laryngeal Nerve Injuries; Swine; Vocal Cords
PubMed: 31373695
DOI: 10.1002/lary.28215 -
Immunology and Allergy Clinics of North... May 2018Exertional dyspnea is common in health and disease. Despite having known for centuries that breathlessness can arise from the larynx, exercise-induced laryngeal... (Review)
Review
Exertional dyspnea is common in health and disease. Despite having known for centuries that breathlessness can arise from the larynx, exercise-induced laryngeal obstruction is a more prevalent condition than previously assumed. This article provides a brief overview of the history, epidemiology, and pathophysiology of exercise-induced laryngeal obstruction.
Topics: Airway Obstruction; Diagnosis, Differential; Dyspnea; Exercise; Humans; Laryngoscopy; Prevalence; Vocal Cord Dysfunction; Vocal Cords
PubMed: 29631735
DOI: 10.1016/j.iac.2018.01.001 -
Medical Physics Jan 2022Laryngoscopy, the most common diagnostic method for vocal cord lesions (VCLs), is based mainly on the visual subjective inspection of otolaryngologists. This study aimed...
PURPOSE
Laryngoscopy, the most common diagnostic method for vocal cord lesions (VCLs), is based mainly on the visual subjective inspection of otolaryngologists. This study aimed to establish a highly objective computer-aided VCLs diagnosis system based on deep convolutional neural network (DCNN) and transfer learning.
METHODS
To classify VCLs, our method combined the DCNN backbone with transfer learning on a system specifically finetuned for a laryngoscopy image dataset. Laryngoscopy image database was collected to train the proposed system. The diagnostic performance was compared with other DCNN-based models. Analysis of F1 score and receiver operating characteristic curves were conducted to evaluate the performance of the system.
RESULTS
Beyond the existing VCLs diagnosis method, the proposed system achieved an overall accuracy of 80.23%, an F1 score of 0.7836, and an area under the curve (AUC) of 0.9557 for four fine-grained classes of VCLs, namely, normal, polyp, keratinization, and carcinoma. It also demonstrated robust classification capacity for detecting urgent (keratinization, carcinoma) and non-urgent (normal, polyp), with an overall accuracy of 0.939, a sensitivity of 0.887, a specificity of 0.993, and an AUC of 0.9828. The proposed method also outperformed clinicians in the classification of normal, polyps, and carcinoma at an extremely low time cost.
CONCLUSION
The VCLs diagnosis system succeeded in using DCNN to distinguish the most common VCLs and normal cases, holding a practical potential for improving the overall diagnostic efficacy in VCLs examinations. The proposed VCLs diagnosis system could be appropriately integrated into the conventional workflow of VCLs laryngoscopy as a highly objective auxiliary method.
Topics: Area Under Curve; Machine Learning; Neural Networks, Computer; ROC Curve; Vocal Cords
PubMed: 34813114
DOI: 10.1002/mp.15371 -
BioMed Research International 2015Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and... (Review)
Review
Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and reliable and can be performed at the bedside and does not carry the risk of exposure to ionizing radiation. Apart from use in diagnostics it may also provide safe guidance for invasive and semi-invasive procedures. Ultrasound examination of the oral cavity structures, epiglottis, vocal cords, and subglottic space may help in the prediction of difficult intubation. Preoperative ultrasound may diagnose vocal cord palsy or deviation or stenosis of the trachea. Ultrasonography can also be used for confirmation of endotracheal tube, double-lumen tube, or laryngeal mask placement. This can be achieved by direct examination of the tube inside the trachea or by indirect methods evaluating lung movements. Postoperative airway ultrasound may reveal laryngeal pathology or subglottic oedema. Conventional ultrasound is a reliable real-time navigational tool for emergency cricothyrotomy or percutaneous dilational tracheostomy. Endobronchial ultrasound is a combination of bronchoscopy and ultrasonography and is used for preoperative examination of lung cancer and solitary pulmonary nodules. The method is also useful for real-time navigated biopsies of such pathological structures.
Topics: Epiglottis; High-Energy Shock Waves; Humans; Intubation, Intratracheal; Laryngeal Masks; Mouth; Perioperative Care; Trachea; Tracheal Diseases; Tracheostomy; Ultrasonography; Vocal Cords
PubMed: 26788507
DOI: 10.1155/2015/754626