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The Laryngoscope May 2024Hearing loss (HL) (receptive communication impairment) is a known risk factor for depression. However, dysphonia (expressive communication impairment), has received...
OBJECTIVES
Hearing loss (HL) (receptive communication impairment) is a known risk factor for depression. However, dysphonia (expressive communication impairment), has received little study. We study HL, self-reported voice disorder, and combined impairment as risk factors for depression in a large national cohort.
METHODS
This was a cross-sectional epidemiologic study. Data were analyzed from the Korean National Health and Nutrition Examination Survey (KNHANES) cycles 2008-2012 and 2019-2020. KNHANES uniquely contains both audiometry and voice disorder data. HL (yes/no) was defined as ≥25 dB pure tone average. Voice disorder (yes/no) was defined by self-report. Depression (yes/no) was defined by physician diagnosis. Odds ratios for depression were calculated using multivariable logistic regressions with HL and voice disorder.
RESULTS
8,524 individuals aged 19 to 80 years old had complete data. The mean age was 57.3 years (SD = 13.4) and 64% were women. All regressions were controlled for age and sex. Those with HL, versus those without, had 1.27 times the odds (95% CI = 1.07-1.52, p = 0.007) of depression. Those with self-reported voice disorder, versus those without, had 1.48 times the odds (1.22-1.78, p < 0.001) of depression. Those with HL and self-reported voice disorder, versus those with neither, had 1.79 times the odds (1.27-2.48, p < 0.001) of depression.
CONCLUSIONS
This study demonstrates independent relationships between HL and depression and self-reported voice disorder and depression. Combined HL and self-reported voice disorder had nearly 1.8 times the odds of depression. This is likely due to the grossly additive effect of difficulty with incoming and outgoing communication streams.
LEVEL OF EVIDENCE
II Laryngoscope, 2024.
PubMed: 38804637
DOI: 10.1002/lary.31536 -
Laryngoscope Investigative... Jun 2024This scoping review seeks to understand the existing research in otolaryngological mucosal emphysematous infections and to elucidate gaps in knowledge in the field. We...
OBJECTIVE
This scoping review seeks to understand the existing research in otolaryngological mucosal emphysematous infections and to elucidate gaps in knowledge in the field. We also present a case of bilateral necrotizing tonsillitis in an immunocompromised patient with the first reported imaging findings of emphysematous abscess of the tonsils.
DATA SOURCES
PubMed, Embase, Web of Science.
REVIEW METHODS
We conducted our review according to the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews. Patient presentation, management, and outcomes were summarized. We also describe the case of a patient with aplastic anemia found to have emphysematous tonsillitis, managed with intubation, broad spectrum intravenous antibiotics and bilateral tonsillectomy.
RESULTS
We identified seven case reports or series, involving nine total patients, who presented with emphysematous epiglottitis, supraglottitis, or tonsillitis. The hallmark imaging characteristic was submucosal "gas bubble" on computed tomography. Presenting symptoms included dysphagia, odynophagia, dysphonia, cough, and fever. Both immunocompetent and immunocompromised patients were affected. All patients were treated with broad spectrum antibiotics, and most with steroids. Patients at risk of airway compromise also underwent intubation and surgical drainage or debridement of the emphysematous infection.
CONCLUSION
Emphysematous pharyngeal infections are rare but potentially life-threatening infections that can progress rapidly, resulting in airway compromise and sepsis in both immunocompetent and immunocompromised individuals. We highlight the importance of swift intervention, with intubation and surgical intervention often required for severe cases. More research is needed on common pathogens and patient risk factors to guide future medical and surgical management.
PubMed: 38803461
DOI: 10.1002/lio2.1274 -
The American Journal of the Medical... May 2024
PubMed: 38801947
DOI: 10.1016/j.amjms.2024.05.018 -
Acta Otorrinolaringologica Espanola May 2024Among the symptoms presented by patients with SARS-Cov-2 infection, we can find various otorhinolaryngological alterations. Dysphonia appears in up to 79% of infected... (Review)
Review
Among the symptoms presented by patients with SARS-Cov-2 infection, we can find various otorhinolaryngological alterations. Dysphonia appears in up to 79% of infected patients during the acute phase. Dysphonia can also occur as a sequelae, often underestimated, possibly due to its appearance along with other symptoms, also in patients after prolonged intubation or tracheostomy. We present a systematic review of the literature with a bibliographic search in PubMed, Cochrane and Google Scholar, with MESH terms including studies in English and Spanish. The results of the studies found and the vocal manifestations in patients during COVID-19 disease and the consequences produced are analysed. Dysphonia is an acute manifestation of COVID-19 with alterations in aerodynamic and acoustic analysis and in fibrolaryngoscopy. Post-COVID dysphonia can be a persistent symptom that is often underestimated, requiring multidisciplinary management and speech therapy intervention. Laryngeal sequelae are common in post-intubation or post-tracheostomy patients and are related to intubation time, tube number, pronation and respiratory sequelae.
PubMed: 38797375
DOI: 10.1016/j.otoeng.2024.02.005 -
Journal of Voice : Official Journal of... May 2024Minor structural alterations (MSA) of the laryngeal mucosa are entities involving epithelial vocal cord covering modifications. Among differentiated structural...
INTRODUCTION
Minor structural alterations (MSA) of the laryngeal mucosa are entities involving epithelial vocal cord covering modifications. Among differentiated structural alterations of the vocal cords are sulcus vocalis, epidermoid cysts, micro diaphragms, mucosal bridges, and vasculodysgenesis. While many of these MSA are evident and can be easily visible using conventional endoscopic methods, diagnosis can be difficult even with the help of stroboscopy. MSA can often go unnoticed and may be associated with polyps, cysts or vascular alterations. Its impact on the voice could be significant. In many cases, direct suspension laryngoscopy under general anesthesia is necessary to obtain a definitive diagnosis.
OBJECTIVES
The purpose of this article is to describe a new diagnostic endoscopic method that uses contrast dyes, such as indigo carmine, for the detection of MSA of the vocal fold mucosal covering.
MATERIAL AND METHODS
This research work uses the contrast dye Indigo Carmine as an endoscopic tissue stain, which is applied to the mucosal surface of the vocal cords under local anesthesia in the office or under general anesthesia in the operating room. The dye fills the interstices, highlighting irregularities such as depressions and elevations in architecture.
RESULTS
Our study involved performing indigo carmine chromoendoscopy procedures on patients suspected of having vocal fold MSA-type sulcus vocalis, mucosal bridge, or bag-type sulcus. We identified cases where this technique is useful for diagnosing previously undetected alterations, shedding light on dysphonia "without an apparent cause."
CONCLUSIONS
Indigo carmine chromoendoscopy is a useful technique for detecting MSA of the mucosal surface of the vocal folds. It has the potential to diagnose MSA in patients where current in-office endoscopic techniques are insufficient.
PubMed: 38796396
DOI: 10.1016/j.jvoice.2024.04.012 -
Journal of Clinical Medicine May 2024Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific post-operative complications include dysphagia,...
Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific post-operative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have not been clarified yet. This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and post-operative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the incidence rate of post-operative interscapular pain. The mean age was 57.6 ± 10.8 years, and the M:F ratio was 2.1. Pre-operative mean VAS-arm was 7.15 ± 0.81 among the 20 patients reporting brachialgia, and mean VAS-neck was 4.36 ± 1.43 among those 9 patients reporting cervicalgia. At 1 month, interscapular pain was still reported by 8 out of the 17 patients who experienced it post-operatively, and it was recovered in all patients after 2 months. The regression analysis showed that interscapular pain was not directly associated with age ( = 0.74), gender ( = 0.46), smoking status ( = 0.44), diabetes (0.42), pre-operative brachialgia ( = 0.21) or cervicalgia ( = 0.48), symptoms duration ( = 0.13), baseline VAS-arm ( = 0.11), VAS-neck ( = 0.93), or mJOA ( = 0.63) scores, or disc height modification ( = 0.90). However, the post-operative increase in the mean zygapophyseal joint rim distance was identified as an independent factor in determining interscapular pain ( = 0.02). Our study revealed that the onset of interscapular pain following ACDF may be determined by over distraction of the zygapophyseal joint rim. Then, proper sizing of prosthetic implants could reduce this painful complication.
PubMed: 38792516
DOI: 10.3390/jcm13102976 -
Bioengineering (Basel, Switzerland) May 2024(1) Background: Assessing phonatory disorders due to laryngeal biomechanical alterations requires aerodynamic analysis, assessing subglottic pressure, transglottic flow,...
(1) Background: Assessing phonatory disorders due to laryngeal biomechanical alterations requires aerodynamic analysis, assessing subglottic pressure, transglottic flow, and laryngeal resistance. This study explores whether the acoustic parameter, the relative fundamental frequency (RFF), can be studied using the current acoustic analysis protocol at the University of Navarra's voice laboratory and its association with pathologies linked to laryngeal biomechanical alterations. (2) Methods: A retrospective cohort study included patients diagnosed with muscular tension dysphonia, organic lesions of the vocal fold, and vocal fold paralysis (VFP) at the Clínica Universidad de Navarra from 2019 to 2021. Each patient underwent endoscopic laryngeal exploration, followed by acoustic study, RFF calculation, and an aerodynamic study. Additionally, a control group was recruited. (3) Results: 79 patients and 22 controls were studied. Two-way ANOVA showed significant effects for groups and cycles in offset and onset cycles. Statistically significant differences were observed in cycle 1 onset among all groups and in cycles 1 and 2 between the control group and non-healthy groups. (4) Conclusions: RFF is a valuable indicator of phonatory biomechanics, distinguishing healthy and pathological voices and different disorders. RFF in onset cycles offers a cost-effective, accurate method for assessing biomechanical disorders without complex aerodynamic analyses. This study describes RFF values in VFP for the first time, revealing differences regardless of aerodynamic patterns.
PubMed: 38790342
DOI: 10.3390/bioengineering11050475 -
Studies in Health Technology and... May 2024This study proposes an innovative application of the Goertzel Algorithm (GA) for the processing of vocal signals in dysphonia evaluation. Compared to the Fast Fourier...
This study proposes an innovative application of the Goertzel Algorithm (GA) for the processing of vocal signals in dysphonia evaluation. Compared to the Fast Fourier Transform (FFT) representing the gold standard analysis technique in this context, GA demonstrates higher efficiency in terms of processing time and memory usage, also showing an improved discrimination between healthy and pathological conditions. This suggests that GA-based approaches could enhance the reliability and efficiency of vocal signal analysis, thus supporting physicians in dysphonia research and clinical monitoring.
Topics: Humans; Algorithms; Dysphonia; Signal Processing, Computer-Assisted; Sound Spectrography; Reproducibility of Results; Fourier Analysis; Female; Male
PubMed: 38785022
DOI: 10.3233/SHTI240081 -
Turkish Archives of Otorhinolaryngology Dec 2023This study aimed to classify the degree of edema in patients with Reinke's edema (RE) and examine its impact on their voice parameters using both objective and...
OBJECTIVE
This study aimed to classify the degree of edema in patients with Reinke's edema (RE) and examine its impact on their voice parameters using both objective and subjective assessment methods.
METHODS
Objective and subjective voice data of 104 patients diagnosed with RE between 2018 and 2021 were evaluated retrospectively. RE is classified into 4 groups (types 1, 2, 3, and 4). The evaluation included videolaryngostroboscopic examination, acoustic voice analysis, and aerodynamic measurements, GRBAS, Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life Scale (V-RQOL), and Reflux Septum Index (RSI).
RESULTS
Patients with type 1 RE had a significantly lower mean age than those with types 3-4. Although there were no significant differences in acoustic and aerodynamic parameters between the groups, it was observed that F0 and the maximum phonation time decreased as the degree of edema increased. The GRBASTotal, G, and R scores of types 1 and 2 were significantly lower than those of types 3 and 4, as were the scores of type 1 S. There were no statistically significant differences between the RE groups in terms of VHI-10, V-RQOL, and RSI scores.
CONCLUSION
It has been observed that as the severity of RE increases, voice perception and quality (especially types 3 and 4) are negatively affected. Determining the degree of edema will guide the clinician in both the planning of the intervention phase and the follow-up phase.
PubMed: 38784955
DOI: 10.4274/tao.2023.2023-8-10 -
Radiology Case Reports Aug 2024De-differentiated primary mediastinal liposarcomas account for less than 1% of all liposarcoma pathology. We report the case of an 82-year-old male who was suffering...
De-differentiated primary mediastinal liposarcomas account for less than 1% of all liposarcoma pathology. We report the case of an 82-year-old male who was suffering from progressive dysphagia, shortness of breath, and dysphonia for a period of 2 months. A CT scan of the chest with contrast revealed a large heterogeneously enhancing posterior mediastinal mass extending into the posterior soft tissues of the neck, abutting bilateral carotid arteries, and displacing the trachea and esophagus. Treatment chosen for our patient was surgical resection followed by adjuvant radiation therapy which resolved the patient's presenting symptoms. The insights gained through the diagnosis, management, and treatment of our patient can be utilized to approach this type of rare neoplasm.
PubMed: 38783933
DOI: 10.1016/j.radcr.2024.04.054