-
European Annals of Otorhinolaryngology,... Sep 2021
Topics: Adipose Tissue; Humans; Injections; Larynx; Vocal Cord Paralysis; Vocal Cords
PubMed: 34053889
DOI: 10.1016/j.anorl.2021.04.006 -
Anesthesia Progress 2019An estimation of the appropriate tubing depth for fixation is helpful to prevent inadvertent endobronchial intubation and prolapse of cuff from the vocal cord. A...
An estimation of the appropriate tubing depth for fixation is helpful to prevent inadvertent endobronchial intubation and prolapse of cuff from the vocal cord. A feasible estimation formula should be established. We measured the anatomical length of the upper-airway tract through the oral and nasal pathways on cephalometric radiographs and tried to establish the estimation formula from the height of the patient. The oral upper-airway tract was measured from the tip of the incisor to the vocal cord. The nasal upper-airway tract was measured from the tip of the nostril to the vocal cord. The tracts were smoothly traced by using software. The length of the oral upper-airway tract was 13.2 ± 0.8 cm, and the nasal upper-airway tract was 16.1 ± 0.9 cm. We found no gender difference ( p > .05). The correlations between the patients' height and the length of the oral and nasal upper-airway tracts were 0.692 and 0.760, respectively. We found that the formulas (height/10) - 3 (in cm) for oral upper-airway and (height/10) + 1 (in cm) for nasal upper-airway tract are the simple fit estimation formulas. The average error and standard deviation of the estimated values from the measured values were 0.50 ± 0.66 cm for the oral tract and 0.39 ± 0.63 cm for the nasal tract. Thus, considering the length of the intubation marker of each product (DM), we would like to propose the length of tube fixation as (height/10) + 1 + DM for nasal intubation and (height/10) - 3 + DM for oral intubation. In conclusion, the estimation formulas of (height/10) - 3 + DM and (height/10) + 1 + DM for oral and nasal intubation, respectively, are within almost 1 cm error in most cases.
Topics: Humans; Intubation, Intratracheal; Nose; Retrospective Studies; Trachea; Vocal Cords
PubMed: 30883238
DOI: 10.2344/anpr-65-04-04 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Oct 2021To investigate the predictive risk factors of vocal fold leukoplakia under electronic laryngoscope and influential factors of malignancy. A total of 163 cases with vocal...
To investigate the predictive risk factors of vocal fold leukoplakia under electronic laryngoscope and influential factors of malignancy. A total of 163 cases with vocal cord leukoplakia were analyzed retrospectively. The relationship between the clinical features, including site, size, whether involving the anterior commissure, morphology and pathological grade were analyzed. Then the associations with malignant transformation in vocal cord leukoplakia were evaluated by using multiple Logistic regression analysis. There were one side lesions in 96 cases(58.9%), and bilateral vocal cord lesions in 67 cases(41.1%). The vocal cord leukoplakia with extension less than half of the vocal cord was observed in 135 cases(82.8%) and beyond half of the vocal cord was seen in 28 cases(17.1%). Lesions involving the anterior commissure were 42 cases(25.8%), without involving the anterior commissure were 121 cases(74.2%). According to morphological features, 82 patients(50.3%) had a superficial type, followed by exophytic type(=65, 39.9%), and ulcerative type(=16, 9.8%). The pathological type included squamous epithelial simple hyperplasia in 65 cases(39.9%), mild hyperplasia in 44 cases(27.0%), moderate hyperplasia in 31 cases(19.0%), severe hyperplasia and carcinoma in situ in 23 cases(14.1%). 140 cases(85.9%) were in low risk group, and 23 cases(14.1%) were in high risk group. The site of the vocal fold leukoplakia was not associated with the pathological grade(>0.05), whether the vocal fold leukoplakia range exceeds 1/2 of the total length of the vocal fold, and whether involving the anterior commissure were associated with the pathological grade(both <0.05). There were statistically significant differences between the pathological grade and the morphological type(<0.01). Ten cases developed larynx cancer, the ratio of malignant transformation was 6.1%. The multiple Logistic regression showed that whether involving the anterior commissure and histopathological classification were the risk factors of malignant transformation in vocal cord eukoplakia. The pathological results of vocal cord leukoplakia can be predicted by laryngoscopy features. Involving of the anterior commissure and histopathological classification are the risk factors of malignant transformation in vocal cord leukoplakia.
Topics: Electronics; Humans; Laryngeal Neoplasms; Laryngoscopes; Leukoplakia; Retrospective Studies; Vocal Cords
PubMed: 34628812
DOI: 10.13201/j.issn.2096-7993.2021.10.008 -
Endokrynologia Polska 2020Bilateral vocal fold paralysis presents as their complete or partial immobilisation. The median or paramedian position of vocal folds contributes to the narrowing of the... (Review)
Review
Bilateral vocal fold paralysis presents as their complete or partial immobilisation. The median or paramedian position of vocal folds contributes to the narrowing of the airway at the level of the glottis and manifests as inspiratory dyspnoea. For many years iatrogenic injury of recurrent laryngeal nerves during thyroidectomy has been viewed as the most common underlying reason. It is very often a lifethreatening condition requiring not only corticosteroid administration and intubation, which only constitute a short-term symptomatic therapy, but also surgical intervention, including tracheostomy. The most common surgical methods implemented in bilateral vocal fold paralysis include posterior cordectomy, arytenoidectomy, and, more and more commonly, re-innervation. Other techniques used in restoring airway patency include laterofixation, botulinum toxin injection, and laryngeal stimulation, which is still under research. Stem cell and gene therapy are also being researched. Notably, the main purpose of surgical treatment is the provision of airway patency with the preservation of the phonatory and protective functions of the larynx.
Topics: Female; Humans; Laryngoscopy; Male; Thyroidectomy; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords; Voice Quality; Voice Training
PubMed: 32852048
DOI: 10.5603/EP.a2020.0042 -
The Journal of Allergy and Clinical... May 2024Asthma and vocal cord dysfunction (VCD), also known as inducible laryngeal obstruction (ILO), may coexist, resulting in worse outcomes for patients. The experience of...
BACKGROUND
Asthma and vocal cord dysfunction (VCD), also known as inducible laryngeal obstruction (ILO), may coexist, resulting in worse outcomes for patients. The experience of people with VCD/ILO and coexisting asthma is unknown.
OBJECTIVE
We sought to determine whether coexistent VCD/ILO and asthma have deleterious impacts on quality of life.
METHODS
We undertook a descriptive qualitative study using one-to-one semistructured interviews with 30 purposively recruited adult participants with a prior confirmed doctor asthma diagnosis and laryngoscopy-confirmed VCD/ILO. A thematic and content analysis was conducted to explore the data.
RESULTS
Participants were mostly female (63%), mean ± SD age 63 ± 12 years. Four themes were identified: trapped voice, altered life, knowledge about VCD/ILO, and looking for solutions. Participants reported their voice being trapped in their throat or the voice being suddenly cut off when talking or singing. Self-reported VCD/ILO symptoms including throat tightness and breathlessness were highlighted by participants. The second theme described how patients struggle to communicate or tended to shorten conversations. Insufficient knowledge and existing confusion regarding whether asthma was causing the breathlessness was described in the third theme. Looking for solutions depicted participants' diagnostic journey and how they sought an explanation for the symptoms.
CONCLUSIONS
People with asthma and coexisting VCD/ILO experience a substantial burden affecting the quality of life. These data describe the impact on patients with coexisting conditions and should be used to increase clinician awareness of the experience of VCD/ILO from patients' perspectives to support a personalized approach to care.
Topics: Humans; Female; Asthma; Male; Middle Aged; Vocal Cord Dysfunction; Quality of Life; Aged; Adult; Airway Obstruction; Vocal Cords
PubMed: 38290607
DOI: 10.1016/j.jaip.2024.01.028 -
JAMA Otolaryngology-- Head & Neck... Aug 2022Unilateral vocal fold paralysis (UVFP) is a common and life-changing complication of cancer, trauma, and an estimated 500 000 head, neck, and chest surgeries performed...
Multicenter Development and Validation of the Vocal Cord Paralysis Experience (CoPE), a Patient-Reported Outcome Measure for Unilateral Vocal Fold Paralysis-Specific Disability.
IMPORTANCE
Unilateral vocal fold paralysis (UVFP) is a common and life-changing complication of cancer, trauma, and an estimated 500 000 head, neck, and chest surgeries performed annually in the US, among other causes (eg, idiopathic). Consequent disabilities are profound and often permanent and can include severe voice, swallowing, and breathing dysfunction and concomitant anxiety, isolation, and fear. Physiological measures often correlate poorly with patient-reported disability. The measure described herein was designed to be a comprehensive, psychometrically sound UVFP-specific patient-reported outcome measure (PROM) for use in clinical trials or at point of care.
OBJECTIVE
To evaluate the reliability and validity of the CoPE (vocal Cord Paralysis Experience) PROM in a nationally representative sample for both clinical and research use.
DESIGN, SETTING, AND PARTICIPANTS
This survey validation study was performed at 34 tertiary care centers across the US and included English-speaking adults with unilateral vocal fold immobility confirmed via laryngoscopy.
MAIN OUTCOMES AND MEASURES
Reliability (internal consistency, alternate form, and test-retest) and validity (convergent and known-group).
RESULTS
In total, 613 patients (mean [SD] age, 58 [15.3] years; 394 [64.5%] women) were recruited, and 555 (92.3%) completed surveys for all time points. Internal consistency was high in the overall 22-item PROM and psychosocial, swallow, and voice subscales (Cronbach α > 0.91). Intraclass correlations for individuals between the baseline and 2-week administrations were moderate for the overall score and subscales (intraclass correlations range, 0.66-0.80). There were significant differences between the online and 2-week paper administrations for the overall score and voice and psychosocial subscales (overall scale mean: 54.4 [95% CI, 49.7-59.1] vs 48.9 [95% CI, 43.7-54.0] at 2 weeks). The confirmatory model was found to be suitably fitted based on average r2 values 0.5 or greater for subscale and overall scores. Correlations between subscales and existing PROMs (Voice-Related Quality of Life, Eating Assessment Tool, and Communication Participation Item Bank) were all greater than 0.69, and mean PROM subscale scores were significantly different across known quartiles of existing PROMs.
CONCLUSIONS AND RELEVANCE
The findings of this survey validation study suggest that the CoPE PROM could serve as a psychometrically sound, comprehensive measure of UVFP-attributed disability suitable for use in clinical and research settings to assess within-person changes. The results will inform a user manual to facilitate use in clinical trials comparing the effectiveness and durability of treatments including behavioral (speech therapy), temporary (eg, injection augmentation), and permanent surgical treatments for UVFP.
Topics: Adult; Female; Humans; Male; Middle Aged; Patient Reported Outcome Measures; Quality of Life; Reproducibility of Results; Vocal Cord Paralysis; Vocal Cords
PubMed: 35797026
DOI: 10.1001/jamaoto.2022.1545 -
The Journal of the Acoustical Society... Dec 2021In this study we investigated the effect of sex- and age-related differences in vocal fold length, thickness, and depth on voice production in a three-dimensional vocal...
In this study we investigated the effect of sex- and age-related differences in vocal fold length, thickness, and depth on voice production in a three-dimensional vocal fold model. The results showed that the cause-effect relationships between vocal fold physiology and voice production previously identified in an adult male-like vocal fold geometry remained qualitatively the same in vocal folds with geometry representative of adult females and children. We further showed that the often-observed differences in voice production between adult males, adult females, and children can be explained by differences in length and thickness. The lower F0, higher flow rate, larger vocal fold vibration amplitude, and higher sound pressure level (SPL) in adult males as compared to adult females and children can be explained by differences in vocal fold length. In contrast, the thickness effect dominated and contributed to the larger closed quotient of vocal fold vibration, larger normalized maximum flow declination rate, and lower H1-H2 in adult males as compared to adult females and children. The effect of differences in vocal fold depth was generally small. When targeting a specific SPL, adult males experienced a lower peak vocal fold contact pressure during phonation than adult females and children.
Topics: Adult; Child; Female; Humans; Larynx; Male; Phonation; Vibration; Vocal Cords; Voice
PubMed: 34972311
DOI: 10.1121/10.0009033 -
PloS One 2022Currently there is no consistent and widely accepted approach to the diagnosis of vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO). Harmonised diagnostic...
INTRODUCTION
Currently there is no consistent and widely accepted approach to the diagnosis of vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO). Harmonised diagnostic methods are vital to enable optimal diagnosis, advance management and enable research. We aim to obtain consensus on how expert clinicians recognise and diagnose VCD/ILO.
METHODS AND ANALYSIS
Two-round modified Delphi, with workshop validation.
ETHICS AND DISSEMINATION
Institutional Board Review was obtained from the Monash Health Human Research Ethics Committee. The dissemination plan is for presentation and publication.
REGISTRATION DETAILS
Registered at Australia and New Zealand Clinical Trials Registry ACTRN12621001520820p.
Topics: Humans; Delphi Technique; Vocal Cord Dysfunction; Laryngeal Diseases; Airway Obstruction; Laryngoscopy; Vocal Cords
PubMed: 36580467
DOI: 10.1371/journal.pone.0279338 -
Scientific Reports May 2021Laryngoscopes are widely used in the clinical diagnosis of laryngeal lesions, but such diagnosis relies heavily on the physician's subjective experience. The purpose of...
Laryngoscopes are widely used in the clinical diagnosis of laryngeal lesions, but such diagnosis relies heavily on the physician's subjective experience. The purpose of this study was to develop a computer-aided diagnostic system for the detection of laryngeal lesions based on objective criteria. This study used the distinct features of the image contour to find the clearest image in the laryngoscopic video. First to reduce the illumination problem caused by the laryngoscope lens, which could not fix the position of the light source, this study proposed image compensation to provide the image with a consistent brightness range for better performance. Second, we also proposed a method to automatically screen clear images from laryngoscopic film. Third, we used ACM to segment automatically them based on structural features of the pharynx and larynx, using hue and geometric analysis in the vocal cords and other zones. Finally, the support vector machine was used to classify laryngeal lesions based on a decision tree. This study evaluated the performance of the proposed system by assessing the laryngeal images of 284 patients. The accuracy of the detection for vocal cord polyps, cysts, leukoplakia, tumors, and healthy vocal cords were 93.15%, 95.16%, 100%, 96.42%, and 100%, respectively. The cross-validation accuracy for the five classes were 93.1%, 94.95%, 99.4%, 96.01% and 100%, respectively, and the average test accuracy for the laryngeal lesions was 93.33%. Our results showed that it was feasible to take the hue and geometric features of the larynx as signs to identify laryngeal lesions and that they could effectively assist physicians in diagnosing laryngeal lesions.
Topics: Disease Management; Humans; Image Interpretation, Computer-Assisted; Laryngoscopy; Larynx; Video Recording; Vocal Cords
PubMed: 33980940
DOI: 10.1038/s41598-021-89680-9 -
JNMA; Journal of the Nepal Medical... 2018The term 'voice' is the acoustic energy generated from the vocal tract that are characterized by their dependence on vocal fold vibratory pattern. Teachers as...
INTRODUCTION
The term 'voice' is the acoustic energy generated from the vocal tract that are characterized by their dependence on vocal fold vibratory pattern. Teachers as professional voice users are afflicted with dysphonia and are discouraged with their jobs and seek alternative employment. Loud speaking and voice straining may lead to vocal fatigue and vocal fold tissue damage. The objective of the study is to assess the quality of voice of school teachers before and after teaching practice.
METHODS
Sixty teachers from various schools, volunteered to participate in this study. Acoustic analysis Doctor Speech Tiger Electronics, USA was used to assess the voice quality of the school teachers before and after teaching practice. The data were collected and analyzed using Doctor Speech Tiger Electronics, USA. Analysis was performed in terms of perturbation (jitter and shimmer), fundamental frequency, harmonic to noise ratio and maximum phonation time.
RESULTS
We found statistically significant difference in all the four parameters except the Jitter value. The fundamental frequency and shimmer value has significantly increased (P<0.001) and (P=0.002) respectively after teaching practice. Unlikely, there was significant decrease in harmonic to noise ratio value (P<0.001) and maximum phonation time value (P<0.01) after teaching practice.
CONCLUSIONS
Vocal abuse, overuse, or misuse in teaching practice over a long period of time can result in inadequate phonatory pattern due to vocal fold tissue damage, which ultimately results in vocal nodules or polyps. So voice evaluation is particularly important for professional voice users and for the people who are concerned about their quality of voice.
Topics: Adult; Female; Humans; Laryngoscopy; Middle Aged; Nepal; Occupational Diseases; Phonation; School Teachers; Speech Acoustics; Vocal Cords; Voice Disorders; Voice Quality
PubMed: 30381759
DOI: No ID Found