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The Laryngoscope Nov 1973
Topics: Adolescent; Adult; Age Factors; Behavior; Child; Edema; Female; Hoarseness; Humans; Hypertrophy; Intelligence; Laryngeal Diseases; Male; Palate; Pharyngeal Diseases; Pharynx; Respiratory Tract Diseases; Skin Transplantation; Transplantation, Autologous; Vocal Cords; Voice
PubMed: 4585993
DOI: No ID Found -
Journal of Voice : Official Journal of... Jan 2014A unique case of acute onset vocal fold paralysis secondary to phonotrauma is presented. The cause was forceful vocalization by a drill instructor on a firearm range.... (Review)
Review
A unique case of acute onset vocal fold paralysis secondary to phonotrauma is presented. The cause was forceful vocalization by a drill instructor on a firearm range. Imaging studies revealed extensive intralaryngeal and retropharyngeal hemorrhage. Laryngoscopy showed a complete left vocal fold paralysis. Relative voice rest was recommended, and the patient regained normal vocal fold mobility and function after approximately 12 weeks.
Topics: Hemorrhage; Humans; Laryngoscopy; Male; Middle Aged; Occupational Injuries; Recovery of Function; Speech Acoustics; Time Factors; Tomography, X-Ray Computed; Vocal Cord Paralysis; Vocal Cords; Voice Quality
PubMed: 24291443
DOI: 10.1016/j.jvoice.2013.08.014 -
Advances in Oto-rhino-laryngology 2020Vocal fold immobility can be either unilateral or bilateral and partial or complete. The aim of this chapter is to discuss the management of unilateral paresis using... (Review)
Review
Vocal fold immobility can be either unilateral or bilateral and partial or complete. The aim of this chapter is to discuss the management of unilateral paresis using medialization thyroplasty with or without arytenoid adduction as a means of treating neurogenic causes as opposed to mechanical fixation. Medialization thyroplasty is an open surgical procedure that is performed under local or general anesthesia. Essentially, it aims to close the glottic gap, approximating both vocal folds together and thereby allowing for restoration of the efficiency of the larynx. The glottic gap results from atrophy of the affected vocal fold and in so doing results in glottic insufficiency which causes voice breathiness, strain, fatigue, aspiration, and swallowing difficulties that make up the bulk of symptoms associated with this condition. Unlike injection laryngoplasty, medialization thyroplasty does not increase the "bulk" of the atrophic vocal fold but merely brings the fold closer to its unaffected partner. Besides the obvious lateralization, there is occasionally a third dimensional component to the affected fold. The slipping and prolapse forward of the arytenoid cartilage due to atrophy of the muscles supporting it and the natural declination of the facet joint it rests on cause a vertical drop of the level of the affected vocal fold that may not be remedied with the medialization procedure, hence requiring arytenoid adduction. Although attempts to medialize the vocal fold have been described in the past with limited access, the basic premise of creating a window in the thyroid cartilage remains central. The differences between materials used, their respective strengths and weaknesses, the pitfalls and pearls in achieving a good closure and improvement in voice, swallow, and safety of the airway are all discussed accordingly.
Topics: Arytenoid Cartilage; Humans; Laryngoplasty; Patient Selection; Thyroid Cartilage; Vocal Cord Paralysis; Vocal Cords
PubMed: 33166967
DOI: 10.1159/000456686 -
Current Opinion in Otolaryngology &... Dec 2012This article reviews recent clinical applications of ultrasound imaging in laryngeal examinations and new developments in imaging techniques for laryngeal tissue... (Review)
Review
PURPOSE OF REVIEW
This article reviews recent clinical applications of ultrasound imaging in laryngeal examinations and new developments in imaging techniques for laryngeal tissue characterization.
RECENT FINDINGS
The B-mode image has become a popular tool for identifying masses, lesions, and nodules at the vocal folds, and combining the B-scan with Doppler imaging makes it possible to also evaluate their functionality. The B-mode image has been used to diagnose lesions and paralysis in vocal folds in children, and to evaluate nerve function by visualizing the structure of the larynx and the movement of the bilateral vocal folds. Ultrasound Nakagami imaging based on the statistics of backscattered signals is a new parametric imaging method that complements the conventional B-scan for tissue characterization. Nakagami imaging is a functional ultrasound imaging tool for visualizing the relative concentrations of collagen and elastic fibers, which are key factors influencing the biomechanical properties of the vocal folds.
SUMMARY
Future clinical applications could combine conventional B-mode and Nakagami images to allow physicians to simultaneously evaluate the morphology and scatterer properties of laryngeal tissues.
Topics: Biomechanical Phenomena; Humans; Laryngoscopy; Larynx; Ultrasonography; Vocal Cord Paralysis; Vocal Cords
PubMed: 23000732
DOI: 10.1097/MOO.0b013e32835896b4 -
The Annals of Otology, Rhinology, and... Aug 2002To objectively determine the incidence of dysphagia associated with unilateral vocal cord immobility (UVCI) and to evaluate the potential for response to vocal cord...
To objectively determine the incidence of dysphagia associated with unilateral vocal cord immobility (UVCI) and to evaluate the potential for response to vocal cord medialization, we made videofluoroscopic swallowing (VFS) recordings of patients with newly diagnosed UVCI and prospectively analyzed them in a blinded fashion using the Penetration-Aspiration Scale (PAS) and pharyngeal transport function measures. A subset of patients underwent vocal cord medialization and were evaluated with a postoperative VFS study. Comparison was made between preoperative and postoperative VFS results to study the effects of vocal cord medialization in this setting. Eighty-seven VFS recordings were studied in 64 adult patients with UVCI; 23 patients underwent VFS testing before and after vocal cord medialization. The UVCI was most commonly left-sided (53 cases) and most commonly resulted from thoracic or cardiac surgery (53.1%), followed by malignancy (15.6%). Overall, the median PAS score was 2.0 (25th-75th percentiles, 1.0-5.0), with 20 patients (31.3%) and 15 patients (23.4%) exhibiting penetration or aspiration, respectively. No significant differences in swallowing function were noted between surgical and nonsurgical causes of paralysis (PAS scores of 2.0 and 2.0, respectively; p = .901). The median PAS score improved from 4.0 to 3.0 (p = .395, Wilcoxon paired samples test) in patients studied after undergoing a vocal cord medialization procedure (6 laryngoplasties and 17 vocal cord injections). Laryngoplasty was not more successful than vocal cord injection in resolving aspiration (p = .27). Radiographically significant penetration or aspiration occurs in approximately one third of patients with UVCI, independent of the cause of paralysis. Vocal cord medialization may not be as effective as thought for eliminating aspiration in these patients.
Topics: Deglutition; Deglutition Disorders; Female; Fluoroscopy; Humans; Incidence; Male; Middle Aged; Pneumonia, Aspiration; Prospective Studies; Video Recording; Vocal Cord Paralysis; Vocal Cords
PubMed: 12184586
DOI: 10.1177/000348940211100803 -
The Western Journal of Medicine Jun 1991
Topics: Humans; Methods; Vocal Cord Paralysis; Vocal Cords
PubMed: 1877203
DOI: No ID Found -
Respirology (Carlton, Vic.) May 2014
Topics: Anti-Asthmatic Agents; Asthma; Botulinum Toxins; Female; Humans; Male; Vocal Cord Dysfunction; Vocal Cords
PubMed: 24689853
DOI: 10.1111/resp.12278 -
The Laryngoscope Nov 2016Voice disorders, such as unilateral vocal fold paralysis or paresis, and vocal fold scarring feature structural asymmetries of the vocal folds. Studies on how structural...
OBJECTIVES/HYPOTHESIS
Voice disorders, such as unilateral vocal fold paralysis or paresis, and vocal fold scarring feature structural asymmetries of the vocal folds. Studies on how structural asymmetries affect voice has mostly been limited to computational simulations and experiments on mechanical models. The purpose of the current study is to examine the effects of asymmetries in left-right position, height, and length of the vocal folds on the intraglottal flow characteristics, as well as acoustics in the canine larynx model.
STUDY DESIGN
Basic science.
METHODS
Measurements of intraglottal flow velocity fields were taken in excised canine larynges using particle image velocimetry. Asymmetries of the vocal folds are induced by translating the vocal processes in space using a prong apparatus connected to a micrometer.
RESULTS
Asymmetries in length height and abduction produced a reduction in the intraglottal vortices strength and subsequently the glottal efficiency.
CONCLUSION
Current findings can affect future recommendations for surgical interventions that are used to treat unilateral vocal fold paralysis.
LEVEL OF EVIDENCE
NA Laryngoscope, 126:2534-2538, 2016.
Topics: Animals; Dogs; Glottis; Laryngectomy; Rheology; Speech Acoustics; Vocal Cord Paralysis; Vocal Cords; Voice; Voice Disorders
PubMed: 26972976
DOI: 10.1002/lary.25948 -
The Laryngoscope Jun 1990Laryngeal framework surgery has become an increasingly popular alternative to Teflon injection for vocal rehabilitation. Vocal cord medialization requires custom...
Laryngeal framework surgery has become an increasingly popular alternative to Teflon injection for vocal rehabilitation. Vocal cord medialization requires custom tailoring of the implant's size and shape to optimize individual vocal quality, whether it be via the interposition of Silastic implants between the thyroid ala and the inner thyroid perichondrium or through a cartilage window. A new technique is described for vocal cord medialization using an implanted miniature tissue expander. Intraoperative and postoperative vocal cord medialization was achieved in a canine model by controlled percutaneous filling of a remote injection valve. The implants were well tolerated and allowed continued control of vocal cord position for several weeks. Using this technique, vocal quality can be fine-tuned with a degree of precision not previously possible. The advantages, limitations, and technical aspects of expansion laryngoplasty are discussed.
Topics: Animals; Dogs; Female; Laryngoscopy; Larynx; Recurrent Laryngeal Nerve; Tissue Expansion; Video Recording; Vocal Cord Paralysis; Vocal Cords
PubMed: 2348741
DOI: 10.1288/00005537-199006000-00012 -
Canadian Journal of Anaesthesia =... Dec 1996We report a case of paradoxical vocal cord motion as an unusual cause of postoperative stridor and wheezing. A means of diagnosis and management is discussed.
PURPOSE
We report a case of paradoxical vocal cord motion as an unusual cause of postoperative stridor and wheezing. A means of diagnosis and management is discussed.
CLINICAL FINDINGS
A 71-yr-old man developed paradoxical vocal cord motion following uncomplicated hip replacement. He was treated with standard therapy for postoperative stridor and wheezing. After extensive evaluation, a flexible fibreoptic laryngoscope was used and the vocal cords noted to move paradoxically. This was the cause of his postoperative stridor and wheezing. Paradoxical vocal cord motion should be suspected as a cause of postoperative stridor and wheezing when the airway is easily maintained by a bag and mask, there is previous history of psychological problems, and there exists an unexplained history of previous postoperative airway distress. The definitive diagnosis may be made using a fibreoptic laryngoscope. In this patient, intubation was deferred and a plan of conservative therapy pursued.
CONCLUSION
Paradoxical vocal cord motion is an unusual cause of postoperative respiratory distress. A definitive diagnosis may be made by the use of a flexible fibreoptic laryngo-scope using topical anaesthesia.
Topics: Aged; Humans; Laryngoscopy; Male; Postoperative Complications; Respiratory Sounds; Vocal Cords
PubMed: 8955976
DOI: 10.1007/BF03013434