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PloS One 2015Postoperative sore throat and other airway morbidities are common and troublesome after endotracheal tube intubation general anesthesia (ETGA). We propose lidocaine as... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Postoperative sore throat and other airway morbidities are common and troublesome after endotracheal tube intubation general anesthesia (ETGA). We propose lidocaine as endotracheal tube (ETT) cuff inflation media to reduce the postintubation-related emergence phenomenon.
METHODS
We searched PubMed, EMBASE, and Cochrane databases systematically for randomized controlled trials (RCTs) that have investigated the outcome of intracuff lidocaine versus air or saline in patients receiving ETGA. Using a random-effects model, we conducted a meta-analysis to assess the relative risks (RRs) and mean difference (MD) of the incidence and intensity of relevant adverse outcomes.
RESULTS
We reviewed nineteen trials, which comprised 1566 patients. The incidence of early- and late-phase postoperative sore throat (POST), coughing, agitation, hoarseness, and dysphonia decreased significantly in lidocaine groups, with RRs of 0.46 (95% confidence interval [CI]: 0.31 to 0.68), 0.41 (95% CI: 0.25 to 0.66), 0.43 (95% CI: 0.31 to 0.62), 0.37 (95% CI: 0.25 to 0.55), 0.43 (95% CI: 0.29 to 0.63), and 0.19 (95% CI: 0.08 to 0.5), respectively, when compared with the control groups. The severity of POST also reduced significantly (mean difference [MD] -16.43 mm, 95% CI: -21.48 to -11.38) at 1 h and (MD -10.22 mm, 95% CI: -13.5 to -6.94) at 24 h. Both alkalinized and non-alkalinized lidocaine in the subgroup analyses showed significant benefits in emergence phenomena prevention compared with the control.
CONCLUSION
Our results indicate that both alkalinized and non-alkalinized intracuff lidocaine may prevent and alleviate POST and postintubation-related emergence phenomena.
Topics: Anesthesia, General; Anesthetics, Local; Humans; Intubation, Intratracheal; Lidocaine; Pharyngitis; Postoperative Complications; Randomized Controlled Trials as Topic
PubMed: 26288276
DOI: 10.1371/journal.pone.0136184 -
Journal of Speech, Language, and... Jan 2022Background noise and voice problems among teachers can degrade listening conditions in classrooms. The aim of this literature review is to understand how these acoustic... (Meta-Analysis)
Meta-Analysis
PURPOSE
Background noise and voice problems among teachers can degrade listening conditions in classrooms. The aim of this literature review is to understand how these acoustic degradations affect spoken language processing in 6- to 18-year-old children.
METHOD
In a narrative report and meta-analysis, we systematically review studies that examined the effects of noise and/or impaired voice on children's response accuracy and response time (RT) in listening tasks. We propose the Speech Processing under Acoustic DEgradations (SPADE) framework to classify relevant findings according to three processing dimensions-speech perception, listening comprehension, and auditory working memory-and highlight potential moderators.
RESULTS
Thirty-one studies are included in this systematic review. Our meta-analysis shows that noise can impede children's accuracy in listening tasks across all processing dimensions (Cohen's between -0.67 and -2.65, depending on signal-to-noise ratio) and that impaired voice lowers children's accuracy in listening comprehension tasks ( = -0.35). A handful of studies assessed RT, but results are inconclusive. The impact of noise and impaired voice can be moderated by listener, task, environmental, and exposure factors. The interaction between noise and impaired voice remains underinvestigated.
CONCLUSIONS
Overall, this review suggests that children have more trouble perceiving speech, processing verbal messages, and recalling verbal information when listening to speech in noise or to a speaker with dysphonia. Impoverished speech input could impede pupils' motivation and academic performance at school.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.17139377.
Topics: Adolescent; Child; Dysphonia; Humans; Language; Noise; Speech Perception; Voice Quality
PubMed: 34902257
DOI: 10.1044/2021_JSLHR-21-00183 -
Journal of Voice : Official Journal of... Dec 2022To assess the effectiveness of voice disorder prevention programs and to verify the effectiveness of direct and indirect voice training on the Voice Handicap Index... (Review)
Review
PURPOSE
To assess the effectiveness of voice disorder prevention programs and to verify the effectiveness of direct and indirect voice training on the Voice Handicap Index (VHI), Voice-Related Quality of Life (V-RQOL), maximum phonation time (MPT), fundamental frequency and shimmer, for the prevention of voice disorders in regular-school teachers.
METHODS
This is a literature review with meta-analysis, carried out through an electronic search in PubMed, Cochrane Central, Embase, Web of Science, Scopus and BVS, and Google Scholar, as well as ClinicalTrials.gov databases for gray literature.
SELECTION CRITERIA
Randomized clinical trials and quasi-experimental studies were selected. The population consisted of regular schoolteachers, adults, with no vocal complaints submitted to a vocal health education and prevention program of voice disorders classified as direct (direct vocal tract training) and indirect (vocal hygiene guidelines that influence voice production). The outcomes vocal self-assessment: fundamental frequency, aerodynamic measurements (maximum phonation time), acoustic measures (shimmer) was analyzed in comparison with other vocal interventions or no vocal intervention.
DATA ANALYSIS
Studies were independently assessed using the Cochrane Risk of bias and ROBINS-I tools. Effect sizes were calculated only at post-treatment. GRADE criteria were used to assess the quality of evidence.
RESULTS
Twenty-six studies were included but, only 12 studies were included in the meta-analysis and investigated for direct and/or indirect intervention compared to no intervention. No studies were judged to be at low risk of bias, and the quality of evidence was considered high only for the Voice Handicap Index. No evidence was found that suggested effectiveness of direct and indirect voice training for any of the outcomes: VHI -1.87 (95% CI -7.03, 3.30), maximum phonation time -1.11 (95% CI -3.40, 1.17), fundamental frequency 0.87 (-1.06, 2.79) and shimmer 0, 28 (-1.50, 2.05).
CONCLUSION
Results of this study were not considered significant to conclude on the effectiveness of voice training for preventing dysphonia in teachers.
PubMed: 36494244
DOI: 10.1016/j.jvoice.2022.09.017 -
American Journal of Otolaryngology 2022Management of ectopic lingual thyroid (ELT) must balance the morbidity of disease with the morbidity of treatment. We investigate clinical outcomes associated with...
OBJECTIVE
Management of ectopic lingual thyroid (ELT) must balance the morbidity of disease with the morbidity of treatment. We investigate clinical outcomes associated with modern treatment options and analyze the role of transoral surgery in the treatment algorithm for ELT.
METHODS
This was a retrospective chart review of ELT patients treated at a tertiary care center from 1/1/1979 to 12/31/2019. In addition, a systematic review of the literature from 1979 to 2021 for reports of ELT was performed. Symptoms defined as high-risk were dysphagia, dysphonia, dyspnea, neck swelling, bleeding, and obstructive sleep apnea (OSA).
RESULTS
36 patients within the institutional cohort (IC) and 224 cases in the systematic review (SRC) met criteria. The most common presenting symptoms for both cohorts were dysphagia, globus sensation, and dysphonia. One third of each cohort were hypothyroid, while 3% (n = 1) and 9% (n = 21) of the IC and SRC, respectively, had clinical suspicion of malignancy at presentation. 27% (n = 10) of the IC and 55% (n = 121) of the SRC underwent surgical therapy. There was a 4% (3/72) transoral bleed rate for all patients undergoing transoral surgery. Other reported complications were minor. There were no tracheostomies, and no deaths. Among observed, medically treated, and surgically treated patients, symptoms improved during follow up for 43% or 68% in the IC and SRC, respectively. Following surgery, symptoms improved or resolved for 86% or 93% in the IC and SRC, respectively.
CONCLUSIONS
Asymptomatic ELTs with no concern for malignancy can be managed with observation. Patients with mild symptoms or hypothyroidism may trial thyroid suppressive therapy or RAI. RAI can be considered for patients with high-risk symptoms. For patients with symptoms resistant to conservative therapy, concern for malignancy or high-risk symptoms not conducive to RAI, surgery should be considered. Transoral approaches offer acceptable morbidity, and most patients experience resolution of symptoms following this approach.
Topics: Deglutition Disorders; Dysphonia; Humans; Hypothyroidism; Lingual Thyroid; Retrospective Studies; Tongue
PubMed: 35427937
DOI: 10.1016/j.amjoto.2022.103461 -
Journal of Speech, Language, and... Jun 2022Assessment of resonance characteristics is essential in research and clinical practice in individuals with velopharyngeal impairment. The purpose of this study was to...
INTRODUCTION
Assessment of resonance characteristics is essential in research and clinical practice in individuals with velopharyngeal impairment. The purpose of this study was to systematically review correlations between auditory-perceptual ratings and nasalance scores obtained by a nasometer in individuals with resonance disorders and to identify factors that affected the correlations between these two measures.
METHOD
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted for studies reporting a correlation between nasality ratings and nasalance scores using six electronic databases based on predefined inclusion and exclusion criteria.
RESULTS
A total of 27 studies were included in this systematic review. Characteristics of study components including participants, types of assessment and stimuli, correlation coefficients, and reliability values of each study were identified, and a narrative synthesis was conducted. The methodological quality of each study was also appraised. The correlation level between nasalance values and nasality ratings varied from nonsignificant to strong ( = .92). The quality rating scores of the selected studies ranged from 44% to 94%, with an average score of 75%.
DISCUSSION
Factors that did or did not affect the varied correlation between nasality ratings and nasalance scores were discussed. Speech stimuli and the listeners' background were associated with correlations between the two measures. In addition, the sex of the speakers could be a factor affecting its correlation. However, the types of perceptual scales and listening conditions did not influence its correlations between the two measures.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.19653207.
Topics: Dysphonia; Humans; Nose; Reproducibility of Results; Speech Disorders; Speech Production Measurement; Voice Quality
PubMed: 35500290
DOI: 10.1044/2022_JSLHR-21-00588 -
Journal of Clinical Anesthesia Sep 2016To evaluate the available data describing the use of single and double lumen VivaSight tubes. (Review)
Review
STUDY OBJECTIVE
To evaluate the available data describing the use of single and double lumen VivaSight tubes.
DESIGN
Systematic review.
SETTING
The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications.
PATIENTS
Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials.
INTERVENTIONS
Comparison of VivaSight single and double-lumen tubes with conventional tubes during normal airway and expected difficult airway management. The effectiveness of the devices was also evaluated during 1-lung ventilation for patients undergoing thoracic surgery.
MEASUREMENTS
Intubation time, success rate, the requirement for fiberoptic bronchoscope, and the rate of complications.
MAIN RESULTS
Following a VivaSight double-lumen tube, a flexible bronchoscope is still needed. It is difficult to agree that VivaSight tube reduces the need or use of a bronchoscope. According to the current literature, it is unclear if there is any advantage of the VivaSight compared with using flexible bronchoscopy to direct a blocker into the correct lung. The cost may be another issue. Studies comparing VivaSight tubes with standard double lumen tubes reported faster tracheal intubation rate and higher success rate at first attempt for VivaSight. However, VivaSight tubes may cause soft tissue trauma such as bleeding, hematoma, edema, and erythema. Sore throat and dysphonia are other reported complications. Due to the outer thickness, smaller-sized double-lumen tube may be necessary. It has been reported to have the disadvantages, such as melting due to the heat of light source before insertion and sudden shutdown without warning.
CONCLUSIONS
Problems such as overheating and melting on the distal end of the tube due to the light source and potential breakdowns of the cable should be solved by the manufacturer. This will probably require a redesign and necessitate further studies.
Topics: Airway Management; Bronchoscopy; Equipment Design; Humans; Intubation, Intratracheal; Randomized Controlled Trials as Topic; Respiration, Artificial
PubMed: 27555208
DOI: 10.1016/j.jclinane.2016.04.034 -
Journal of Voice : Official Journal of... Jan 2024Dysphonia is a disorder characterized by an alteration in the overall quality of the voice which reduces quality of life. Therefore, we assessed the effectiveness of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Dysphonia is a disorder characterized by an alteration in the overall quality of the voice which reduces quality of life. Therefore, we assessed the effectiveness of SOVTEs in the management of dysfunctional and organic dysphonia for acoustic, perceptual-auditive, aerodynamic parameters and self-perception of the disease.
METHODS
a systematic review and meta-analysis were conducted. Findings were reported according to the PRISMA statement. Five databases were searched for RCTs and non- or quasi-RCTs. Studies were independently assessed using the Cochrane Risk of bias (RoB) and ROBINS-I tools. Effect sizes (ES) were calculated only at post-treatment. GRADE criteria were used to assess the quality of evidence.
RESULTS
eight articles were included. Studies investigated several SOVTEs, alone or in combination. None of the study was completely judged at low RoB. The quality of evidence resulted very low for each analysis. SOVTEs revealed to be statistically more effective than control interventions in improving F0 (ES: -14.42; CI 95%: -27.16, -1.69); P = 0.03), whereas shimmer did not change significantly (ES: -0.43; CI 95%:-02.02, 1.15; P = 0.59). Not significant changes in favor of control groups were found for jitter (ES: 0.13; CI 95%: -0.14, 0.40; P = 0.34) and overall gravity in the perceptual-auditory evaluation (ES: 0.13 CI 95%: -0.50, 0.77; P = 0. 68). Among secondary outcomes, evidence suggested that SOVTEs are more effective than control interventions in Psub reduction (ES: -1.47; CI 95%: -2.84, -0.10; P = 0.03); self-assessment resulted not significantly in favor of SOVTEs (VHI/VRQoL: ES -0.23; CI 95% -1.14, 0.69; P = 0.63 and VTDS/VDSI: ES -4.85, CI 95% -25.13, 15.42; P = 0.64).
CONCLUSION
results obtained showed that voice therapy based on SOVTEs is not to consider significantly superior if compared to other treatments, even if a favorable trend was detected and should be taken into consideration. Further high-quality RCTs on specific SOVTEs are recommended to produce better-quality evidence.
Topics: Humans; Dysphonia; Quality of Life; Voice Quality; Voice Training; Self Concept
PubMed: 34284924
DOI: 10.1016/j.jvoice.2021.06.009 -
International Journal of Pediatric... Mar 2023This study aimed to systematically review the literature to determine outcomes following surgical treatment of pediatric vocal fold nodules. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study aimed to systematically review the literature to determine outcomes following surgical treatment of pediatric vocal fold nodules.
METHODS
Studies with patients ≤18 years with nodules who underwent surgery were reviewed for dysphonia improvement and recurrence in PubMed, EMBASE, Medline, CINAHL, Cochrane, Scopus, and Web of Science databases, searched from inception to November 1, 2022 using PRISMA guidelines. Non-English studies and case reports were excluded. Two evaluators independently reviewed each abstract and article. Heterogeneity and bias across studies were evaluated and meta-analysis was performed.
RESULTS
The literature search yielded 655 articles; 145 underwent full-text screening and eight were selected for systematic review and meta-analysis. There were 311 children with nodules, aged 2-18 years, with male-to-female ratio of 3.6:1. There were no surgical complications. Voice therapy was inconsistently reported. Follow-up time ranged from 1 month to 10 years. One study concluded that neither surgery nor voice therapy was effective, while five studies concluded that dysphonia improved with surgery. Voice grading by GRBAS, objective voice measures, and lesion size were improved following surgery, when reported. Meta-analysis of six studies demonstrated improvement in dysphonia in 90% of children post-operatively (95% CI: 74-99%). Meta-analysis of four studies showed that recurrence occurred in 19% of children (95% CI: 13-23%).
CONCLUSION
This systematic review suggests possible post-operative improvement in dysphonia for pediatric patients with vocal fold nodules; however, study measures, methods, and surgery utilized were heterogeneous and results should be interpreted cautiously. In order to better understand surgical outcomes, future studies should include standardized definition of nodules and objective measures of voice.
Topics: Humans; Child; Male; Female; Dysphonia; Vocal Cords; Voice Quality; Laryngeal Diseases; Voice; Polyps
PubMed: 36758441
DOI: 10.1016/j.ijporl.2023.111461 -
Nutrients Dec 2022Wernicke encephalopathy (WE) is a well-known neurological condition caused by thiamine (vitamin B1) deficiency that occurs in both alcoholic and non-alcoholic... (Review)
Review
Wernicke encephalopathy (WE) is a well-known neurological condition caused by thiamine (vitamin B1) deficiency that occurs in both alcoholic and non-alcoholic populations. We aimed to report a case of a patient with WE who presented with dysphagia and dysphonia and later developed typical symptoms of thiamine deficiency and to conduct a systematic review of the literature on this rare presentation of WE. We searched two databases (PubMed and Scopus) and included publications up to November 2022. We found 12 cases of WE and dysphagia, aged between 12 and 81 years; swallowing problems presented at the onset in nine patients (including the current case report). Our findings suggest that thiamine deficiency should be suspected in patients with dysphagia of unknown cause, even in the absence of alcohol abuse. In contrast to most WE patients, the majority of patients included in this review presented with dysphagia at the onset of their disease, even in the absence of the classic triad of cognitive impairment, ataxia, and oculomotor abnormalities, indicating that there could be varying susceptibilities to clinical manifestations of thiamine deficiency in different brain regions.
Topics: Humans; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Wernicke Encephalopathy; Deglutition Disorders; Thiamine Deficiency; Thiamine; Alcoholism
PubMed: 36558453
DOI: 10.3390/nu14245294 -
Medicine Aug 2016Comparisons between the efficacies of supraglottic airway devices (SGAs) and endotracheal tubes (ETTs) in patients undergoing laparoscopic surgeries have yielded... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Comparisons between the efficacies of supraglottic airway devices (SGAs) and endotracheal tubes (ETTs) in patients undergoing laparoscopic surgeries have yielded conflicting results. Therefore, in this meta-analysis, we compared the clinical performance and incidence of complications between SGAs and ETT intubation in laparoscopic surgery.
METHODS
A comprehensive search was conducted using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Google Scholar to identify randomized controlled trials that compared SGAs with ETTs in laparoscopic surgery.
RESULTS
In total, 1433 patients from 17 studies were included in the final analysis. SGAs and ETTs showed no difference in insertion success rate on the first attempt (relative risk [RR] 1.01, 95% confidence interval [CI] 0.99-1.03), insertion time (standardized mean difference 1.57, 95% CI -3.74 to 0.61), and oropharyngeal leak pressure (OLP) (mean difference -2.54, 95% CI -7.59 to 2.50). The incidence of desaturation (RR 3.65, 95% CI 1.39-9.62), gastric insufflations (RR 0.90, 95% CI 0.48-1.71), regurgitation (RR 0.98, 95% CI 0.02-49.13), and aspiration (RR 0.99, 95% CI 0.01-78.4) also showed no intergroup differences. However, the incidence of laryngospasm (RR 3.12, 95% CI 1.29-7.52), cough at removal (RR 6.68, 95% CI 4.70-9.48), dysphagia (RR 1.47, 95% CI 1.12-1.95) or dysphonia (RR 4.41, 95% CI 1.25-15.55), sore throat (RR 1.60, 95% CI 1.33-1.93), and hoarseness (RR 1.53, 95% CI 1.29-1.81) was higher in the ETT group than in the SGA group.
CONCLUSIONS
The incidence of laryngospasm, cough at removal, dysphagia or dysphonia, sore throat, and hoarseness were higher in the ETT group than in the SGA group. However, the groups showed no differences in the rate of insertion success on the first attempt, insertion time, OLP, and other complications. Therefore, SGAs might be clinically more useful as effective airways in laparoscopic surgery.
Topics: Humans; Intubation, Intratracheal; Laparoscopy; Laryngeal Masks
PubMed: 27537593
DOI: 10.1097/MD.0000000000004598