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Computer Methods and Programs in... Dec 2013The human larynx is an important organ for voice production and respiratory mechanisms. The vocal cord is approximated for voice production and open for breathing. The...
The human larynx is an important organ for voice production and respiratory mechanisms. The vocal cord is approximated for voice production and open for breathing. The videolaryngoscope is widely used for vocal cord examination. At present, physicians usually diagnose vocal cord diseases by manually selecting the image of the vocal cord opening to the largest extent (abduction), thus maximally exposing the vocal cord lesion. On the other hand, the severity of diseases such as vocal palsy, atrophic vocal cord is largely dependent on the vocal cord closing to the smallest extent (adduction). Therefore, diseases can be assessed by the image of the vocal cord opening to the largest extent, and the seriousness of breathy voice is closely correlated to the gap between vocal cords when closing to the smallest extent. The aim of the study was to design an automatic vocal cord image selection system to improve the conventional selection process by physicians and enhance diagnosis efficiency. Also, due to the unwanted fuzzy images resulting from examination process caused by human factors as well as the non-vocal cord images, texture analysis is added in this study to measure image entropy to establish a screening and elimination system to effectively enhance the accuracy of selecting the image of the vocal cord closing to the smallest extent.
Topics: Algorithms; Endoscopy; Humans; Image Processing, Computer-Assisted; Larynx; Vocal Cords
PubMed: 24070546
DOI: 10.1016/j.cmpb.2013.08.005 -
European Archives of... 1998Bilateral vocal cord palsy due to a lesion of the recurrent laryngeal nerves is a serious complication of thyroid operations, with the airway obstruction usually...
Bilateral vocal cord palsy due to a lesion of the recurrent laryngeal nerves is a serious complication of thyroid operations, with the airway obstruction usually necessitating tracheostomy. In the cases presented, a stable airway was ensured with endolaryngeal cord laterofixation instead of tracheostomy. The operation was performed with the endo-extralaryngeal needle carrier instrument devised by Lichtenberger. During the operation, only minor surgical trauma occurred in the larynx. The fixing thread was then removed following recovery of contralateral vocal cord function, resulting in an improvement in the voice. Four patients are described who suffered bilateral recurrent laryngeal nerve palsy after thyroid gland operations. During the follow-up period of 3-12 months, airway stability was demonstrated by regular spirometric measurements. The simple method recommended spares patients the possible complications of tracheostomy.
Topics: Acute Disease; Adult; Aged; Airway Obstruction; Equipment Design; Female; Follow-Up Studies; Humans; Male; Middle Aged; Needles; Recurrent Laryngeal Nerve Injuries; Spirometry; Suture Techniques; Thyroidectomy; Tracheostomy; Vocal Cord Paralysis; Vocal Cords; Voice
PubMed: 9783137
DOI: 10.1007/s004050050081 -
Jibi Inkoka Otolaryngology Oct 1969
Topics: Anesthesia; Humans; Methods; Polyps; Vocal Cords
PubMed: 5390496
DOI: No ID Found -
The Laryngoscope May 1991Injection of Teflon paste is a commonly accepted procedure to improve the caliber of voice in unilateral vocal cord paralysis. There are several drawbacks to Teflon...
Injection of Teflon paste is a commonly accepted procedure to improve the caliber of voice in unilateral vocal cord paralysis. There are several drawbacks to Teflon injection, among them respiratory obstruction (from overinjected Teflon) and unsatisfactory voice quality (Teflon causes stiffness of the vocal folds). This paper is a preliminary report on lipoinjection instead of Teflon injection into a paralyzed vocal fold. Fat appears to impart a soft bulkiness to the injected cord, while allowing it to retain its vibratory qualities. It is autologous material and can be retrieved if excessively overinjected. The fate of autologous fat injected into a paralyzed vocal cord remains unknown. Most of the literature on lipoinjection concerns repairs of depressed scars or breast augmentation. Our longest follow-up has been 12 months. Three patients have had this procedure, and the results appear to be very encouraging.
Topics: Abdominal Muscles; Adipose Tissue; Aged; Female; Follow-Up Studies; Humans; Injections; Laryngoscopy; Male; Middle Aged; Vocal Cord Paralysis; Vocal Cords
PubMed: 1827654
DOI: 10.1288/00005537-199105000-00003 -
Journal of Voice : Official Journal of... Jul 2018Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal... (Review)
Review
INTRODUCTION
Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear.
MATERIAL AND METHODS
Review of literature on office-based procedures in laryngology and head and neck oncology.
RESULTS
Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages.
CONCLUSION
Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process.
Topics: Ambulatory Surgical Procedures; Anesthesia, Local; Biopsy; Humans; Injections; Laryngeal Diseases; Laryngoscopes; Laryngoscopy; Larynx; Laser Therapy; Office Visits; Predictive Value of Tests; Treatment Outcome; Vocal Cords; Voice Disorders
PubMed: 28935210
DOI: 10.1016/j.jvoice.2017.07.018 -
Rinsho Shinkeigaku = Clinical Neurology Apr 1996Bilateral vocal cord abductor paralysis (VCAP) is frequently associated with multiple system atrophy (MSA) and the early clinical manifestation of VCAP is nocturnal...
Bilateral vocal cord abductor paralysis (VCAP) is frequently associated with multiple system atrophy (MSA) and the early clinical manifestation of VCAP is nocturnal inspiratory stridor simulating heavy snoring observed in patients with obstructive sleep apnea syndrome. We examined six MSA patients with nocturnal stridor and four disease controls including sleep apnea syndrome. Vocal cord movements were analyzed by laryngofiberscopy during both wakefulness and sleep induced by intravenous administration of diazepam. The results were as follows: First, the stenotic portion in the upper airway tract was the larynx (the vocal cords) in MSA patients with stridor, while the soft palate or the pharynx in the disease controls. Second, in the MSA patients, while awake-laryngofiberscopy showed abduction restriction suggestive of VCAP in only one of the six patients, sleep-laryngofiberscopy showed obvious paradoxical movement of the vocal cord in all the rests, where the vocal cords abducted in expiration and adducted in inspiration. In addition, there were two patterns in the inspiratory vocal cord position during sleep: one pattern where vocal glottis was still opening at the posterior one-third area and the other pattern where vocal glottis was almost completely closed through total length of the cords. Tracheostomy should be considered in the latter stage of VCAP.
Topics: Aged; Diazepam; Female; Fiber Optic Technology; Humans; Laryngoscopy; Male; Middle Aged; Movement; Olivopontocerebellar Atrophies; Parkinson Disease; Shy-Drager Syndrome; Sleep; Tracheostomy; Vocal Cord Paralysis; Vocal Cords
PubMed: 8810844
DOI: No ID Found -
Rinsho Shinkeigaku = Clinical Neurology Jul 2009Non-invasive positive pressure ventilation (NPPV) has recently been applied to the patients with multiple system atrophy (MSA) with various respiratory complications...
Non-invasive positive pressure ventilation (NPPV) has recently been applied to the patients with multiple system atrophy (MSA) with various respiratory complications including vocal cord abduction impairment and respiratory disturbance by the central origin. Any consensus guidelines on setting up the inspiratory positive airway pressure (IPAP) and expiratory one (EPAP), however, have not been raised yet. To investigate this problem, we made the upper airway tract model with moderately and severely narrow glottis using a training/test lung and the artificial vocal cord which was developed for a humanoid talking robot in Waseda University. The artificial vocal cord was molded out of a high performance thermoplastic rubber in imitation of the human larynx. Previous studies using with a high-speed camera and a sound analyzer showed that the artificial vocal cord resembled human larynx closely both morphologically and functionally. The opening and closing movements of the artificial vocal cord were observed fiberscopically under various conditions of IPAP (4-20 cmH2O) and EPAP (4-10 cmH2O). The maximal glottic width during inspiration and expiration were measured by a pair of calipers on the video-monitored display. Both of the moderately and the severely narrow artificial vocal cords without non-paralytic factors showed typical paradoxical movement showing adduction in inspiration and abduction in expiration, which is characteristic to vocal cord abductor impairment seen in MSA. In the model with moderately severe narrow glottis, this paradoxical movement was released under any positive pressures of continuous (CPAP) and bilevel (Bilevel PAP) modes. In the model with severely narrow glottis, however, there existed a threshold in setting up the optimal EPAP to release the paradoxical movement. In conclusion, EPAP-leading procedure seems to be preferable to IPAP-leading procedure to dilate the narrow glottis as a pneumatic splint in the managements of the patients with MSA presenting with a paralytic type of vocal cord abductor impairment.
Topics: Humans; Models, Biological; Positive-Pressure Respiration; Vocal Cords
PubMed: 19715168
DOI: 10.5692/clinicalneurol.49.407 -
Acta Radiologica: Diagnosis May 1973
Topics: Humans; Laryngeal Neoplasms; Larynx; Phonetics; Radiography; Vocal Cord Paralysis; Vocal Cords
PubMed: 4726457
DOI: 10.1177/028418517301400304 -
Acta Oto-laryngologica Mar 1995Contact endoscopy allows an in vivo and in situ study of the superficial layers of the vocal cord epithelium. This technique offers access to some characteristics of the... (Comparative Study)
Comparative Study
Contact endoscopy allows an in vivo and in situ study of the superficial layers of the vocal cord epithelium. This technique offers access to some characteristics of the epithelium cells: dimension and shape of the nuclei, nucleus/cytoplasm ratio, keratosis, presence of nucleolus, mitosis and koylocites. Contact endoscopy was performed during microlaryngoscopies in 92 patients with benign, pre-malign and malign pathology of the vocal cords. Systematic confrontation with pathological examination and laryngectomy specimens studied by histology and electron microscopy were used to improve the interpretation of contact endoscopy findings. Based on this correlation it has been possible to analyse the transition of the squamous and ciliated epithelium of the vocal cord as well as to delineate some pathological patterns, e.g. chronic laryngitis, keratosis, dysplasia, tumor and papilloma.
Topics: Adolescent; Adult; Aged; Cell Movement; Child; Child, Preschool; Edema; Endoscopy; Epithelial Cells; Epithelium; Female; Humans; Keratosis; Laryngitis; Leukoplakia; Male; Microscopy, Electron; Middle Aged; Papilloma; Vocal Cords
PubMed: 7610830
DOI: 10.3109/00016489509139318 -
European Review For Medical and... Sep 2017The aim of this study was to assess the reliability and limitations of confocal laser endomicroscopy (CLE) for diagnosing lesions of the vocal cords and differentiating...
OBJECTIVE
The aim of this study was to assess the reliability and limitations of confocal laser endomicroscopy (CLE) for diagnosing lesions of the vocal cords and differentiating malignant from non-malignant lesions.
PATIENTS AND METHODS
During microlaryngoscopy, the vocal cords were scanned by probe-based CLE (pCLE: a GastroFlex probe with the Cellvizio® laser system, Mauna Technologies, Paris, France). The video recordings were analyzed and compared with the histological results. Thirty-one representative images were extracted and presented to four medical professionals (blinded examiners) for assessment.
RESULTS
The accuracy for the category malignant/nonmalignant ranged between 58.1% and 87.1%. Overall interrater reliability was 0.29. Sensitivity ranged between 45.5 and 100%, specificity between 60.0 and 100%, PPV between 38.5% and 100% and NPV between 66.7 and 100%.
CONCLUSIONS
CLE is a promising method for the non-invasive diagnosis of vocal cord lesions in vivo, but factors such as small penetration depth, not available contrast media for the nuclei and subjective analyses of the images limit, at the moment, its diagnostic value.
Topics: Female; France; Humans; Laryngeal Neoplasms; Male; Microscopy, Confocal; Middle Aged; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Vocal Cords
PubMed: 29028105
DOI: No ID Found