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Scientific Reports Feb 2022The human voice carries socially relevant information such as how authoritative, dominant, and attractive the speaker sounds. However, some speakers may be able to...
The human voice carries socially relevant information such as how authoritative, dominant, and attractive the speaker sounds. However, some speakers may be able to manipulate listeners by modulating the shape and size of their vocal tract to exaggerate certain characteristics of their voice. We analysed the veridical size of speakers' vocal tracts using real-time magnetic resonance imaging as they volitionally modulated their voice to sound larger or smaller, corresponding changes to the size implied by the acoustics of their voice, and their influence over the perceptions of listeners. Individual differences in this ability were marked, spanning from nearly incapable to nearly perfect vocal modulation, and was consistent across modalities of measurement. Further research is needed to determine whether speakers who are effective at vocal size exaggeration are better able to manipulate their social environment, and whether this variation is an inherited quality of the individual, or the result of life experiences such as vocal training.
Topics: Auditory Perception; Humans; Individuality; Life Change Events; Magnetic Resonance Imaging; Phonetics; Social Environment; Sound; Speech Acoustics; Speech Perception; Vocal Cords; Voice
PubMed: 35173178
DOI: 10.1038/s41598-022-05170-6 -
American Family Physician Jan 2010Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. Patients may present with respiratory distress that is often... (Review)
Review
Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. Patients may present with respiratory distress that is often mistakenly diagnosed as asthma. Exercise, psychological conditions, airborne irritants, rhinosinusitis, gastroesophageal reflux disease, or use of certain medications may trigger vocal cord dysfunction. The differential diagnosis includes asthma, angioedema, vocal cord tumors, and vocal cord paralysis. Pulmonary function testing with a flow-volume loop and flexible laryngoscopy are valuable diagnostic tests for confirming vocal cord dysfunction. Treatment of acute episodes includes reassurance, breathing instruction, and use of a helium and oxygen mixture (heliox). Long-term management strategies include treatment for symptom triggers and speech therapy.
Topics: Airway Obstruction; Asthma; Asthma, Exercise-Induced; Diagnosis, Differential; Humans; Laryngeal Diseases; Laryngoscopy; Respiration Disorders; Sinusitis; Vocal Cord Paralysis; Vocal Cords
PubMed: 20082511
DOI: No ID Found -
Postgraduate Medical Journal Mar 2007Paradoxical vocal cord motion disorder (PVCM), also called vocal cord dysfunction, is an important differential diagnosis for asthma. The disorder is often misdiagnosed... (Review)
Review
Paradoxical vocal cord motion disorder (PVCM), also called vocal cord dysfunction, is an important differential diagnosis for asthma. The disorder is often misdiagnosed as asthma leading to unnecessary drug use, very high medical utilisation and occasionally tracheal intubation or tracheostomy. Laryngoscopy is the gold standard for diagnosis of PVCM. Speech therapy and psychotherapy are considered the cornerstone of management of this disorder. The aim of this article is to increase the awareness of PVCM among doctors, highlighting the main characteristics that distinguish it from asthma and discuss the recent medical achievements and the possible future perspectives related to this disorder.
Topics: Asthma; Diagnosis, Differential; Humans; Laryngeal Diseases; Terminology as Topic; Vocal Cords
PubMed: 17344570
DOI: 10.1136/pgmj.2006.052522 -
Respirology (Carlton, Vic.) Jul 2023Vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO), is a common condition characterized by breathlessness associated with inappropriate laryngeal... (Review)
Review
Vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO), is a common condition characterized by breathlessness associated with inappropriate laryngeal narrowing. Important questions remain unresolved, and to improve collaboration and harmonization in the field, we convened an international Roundtable conference on VCD/ILO in Melbourne, Australia. The aims were to delineate a consistent approach to VCD/ILO diagnosis, appraise disease pathogenesis, outline current management and model(s) of care and identify key research questions. This report summarizes discussions, frames key questions and details recommendations. Participants discussed clinical, research and conceptual advances in the context of recent evidence. The condition presents in a heterogenous manner, and diagnosis is often delayed. Definitive diagnosis of VCD/ILO conventionally utilizes laryngoscopy demonstrating inspiratory vocal fold narrowing >50%. Computed tomography of the larynx is a new technology with potential for swift diagnosis that requires validation in clinical pathways. Disease pathogenesis and multimorbidity interactions are complex reflecting a multi-factorial, complex condition, with no single overarching disease mechanism. Currently there is no evidence-based standard of care since randomized trials for treatment are non-existent. Recent multidisciplinary models of care need to be clearly articulated and prospectively investigated. Patient impact and healthcare utilization can be formidable but have largely escaped inquiry and patient perspectives have not been explored. Roundtable participants expressed optimism as collective understanding of this complex condition evolves. The Melbourne VCD/ILO Roundtable 2022 identified clear priorities and future directions for this impactful condition.
Topics: Humans; Vocal Cord Dysfunction; Laryngeal Diseases; Airway Obstruction; Vocal Cords; Laryngoscopy; Diagnosis, Differential
PubMed: 37221142
DOI: 10.1111/resp.14518 -
European Archives of... Aug 2016The terms used to describe vocal fold motion impairment are confusing and not standardized. This results in a failure to communicate accurately and to major limitations... (Review)
Review
The terms used to describe vocal fold motion impairment are confusing and not standardized. This results in a failure to communicate accurately and to major limitations of interpreting research studies involving vocal fold impairment. We propose standard nomenclature for reporting vocal fold impairment. Overarching terms of vocal fold immobility and hypomobility are rigorously defined. This includes assessment techniques and inclusion and exclusion criteria for determining vocal fold immobility and hypomobility. In addition, criteria for use of the following terms have been outlined in detail: vocal fold paralysis, vocal fold paresis, vocal fold immobility/hypomobility associated with mechanical impairment of the crico-arytenoid joint and vocal fold immobility/hypomobility related to laryngeal malignant disease. This represents the first rigorously defined vocal fold motion impairment nomenclature system. This provides detailed definitions to the terms vocal fold paralysis and vocal fold paresis.
Topics: Humans; Laryngeal Neoplasms; Reference Standards; Terminology as Topic; Vocal Cord Dysfunction; Vocal Cord Paralysis; Vocal Cords
PubMed: 26036851
DOI: 10.1007/s00405-015-3663-0 -
Ear, Nose, & Throat Journal Sep 2021Type 1 thyroplasty is an established procedure for the treatment of vocal fold paralysis to improve voice and swallowing outcomes. At our institution, we commonly...
OBJECTIVE
Type 1 thyroplasty is an established procedure for the treatment of vocal fold paralysis to improve voice and swallowing outcomes. At our institution, we commonly perform this procedure on an outpatient basis in medically stable patients. With this study, we assess the safety of outpatient thyroplasty by examining complication and readmission rates, need for revision surgery, and predictors of these outcome measures.
METHODS
We performed a retrospective review of patients undergoing outpatient type 1 thyroplasty for vocal fold paralysis between 2013 and 2018 at our institution. We documented the etiology of paralysis, comorbidities, and demographic data. Our primary outcome measures were complications, need for readmission, and need for revision surgery.
RESULTS
During the study period, 160 patients met our inclusion criteria. Mean age at time of surgery was 62.1 ± 13.9 years; there were 82 (51%) males and 78 (49%) females. Nine (5.6%) patients experienced major complications after surgery and 7 (4.4%) patients required unplanned readmission. Mean time to complication was 6.9 ± 9.7 days. There were no instances of postoperative airway compromise requiring intervention. There were no mortalities. Of those who underwent primary surgery, 22 (14%) patients required revision surgery.
CONCLUSION
Given that complications tend to occur in a delayed fashion rather than in the acute postoperative period, same-day discharge seems reasonable as compared to overnight observation in medically stable patients undergoing type 1 thyroplasty.
LEVEL OF EVIDENCE
IV.
Topics: Adult; Aged; Aged, 80 and over; Ambulatory Surgical Procedures; Female; Hematoma; Humans; Incidence; Intraoperative Complications; Laryngoplasty; Male; Middle Aged; Postoperative Complications; Reoperation; Retrospective Studies; Vocal Cord Paralysis; Vocal Cords; Voice Quality
PubMed: 31903781
DOI: 10.1177/0145561319894414 -
European Archives of... Mar 2022We investigated the role of Glut-1 and H/K-ATPase expression in pepsin-induced development of human vocal cord leukoplakia cells (HVCLCs). Next, we analyzed the...
PURPOSE
We investigated the role of Glut-1 and H/K-ATPase expression in pepsin-induced development of human vocal cord leukoplakia cells (HVCLCs). Next, we analyzed the relationship between Glut-1 and H/K-ATPase expression with the clinicopathological features of laryngeal carcinoma.
METHODS
Glut-1 and H/K-ATPase expression levels in HVCLCs were determined after treatment with artificial gastric juice containing pepsin and laryngeal carcinoma tissues.
RESULTS
Exposure to pepsin-containing artificial gastric juice significantly enhanced the migration and proliferation of VSCLCs in a time-dependent manner. The apoptotic rate of VSCLCs decreased over time after exposure to pepsin and reached a nadir on day 7 (p < 0.01). With increasing duration of exposure to pepsin, the proportion of VSCLCs in G0/G1 phase decreased and the proportions in the S and G2/M phases significantly increased (p < 0.05). After treatment with pepsin-containing artificial gastric juice, RT-PCR and Western blotting showed that the expression of Glut-1 and H/K-ATPase α, β significantly increased in HVCLCs compared to in the absence of pepsin (p < 0.05). The expression of Glut-1 and H/K-ATPase α, β gradually increased from vocal cord leukoplakia (VLC) to laryngeal carcinoma (p < 0.05). Lentivirus-mediated inhibition of Glut-1 expression in VCL significantly inhibited the cells' migration and proliferation (p < 0.05) but enhanced their apoptosis (p < 0.05). Also, inhibition of Glut-1 expression resulted in an increased proportion of cells in G0/G1 phase and a significantly decreased proportion in G2/M phase (p < 0.05).
CONCLUSIONS
Elevated Glut-1 expression may promote the development of VCL by upregulating laryngeal H/K-ATPase expression to reactivate absorbed pepsin, thus damaging the laryngeal mucosa.
Topics: Adenosine Triphosphatases; Glucose Transporter Type 1; H(+)-K(+)-Exchanging ATPase; Humans; Laryngeal Neoplasms; Laryngopharyngeal Reflux; Leukoplakia; Pepsin A; Vocal Cords
PubMed: 34800155
DOI: 10.1007/s00405-021-07172-y -
The Tohoku Journal of Experimental... Aug 2022Long-term voice abuse or sudden vocal fold microvascular disruption may lead to injury and subsequent repair/remodeling in the vocal fold mucosa. Periostin is known to...
Long-term voice abuse or sudden vocal fold microvascular disruption may lead to injury and subsequent repair/remodeling in the vocal fold mucosa. Periostin is known to be involved in airway remodeling and also in various otolaryngological diseases. The aim of this article was to investigate the expression and the role of periostin in the formation of vocal fold polyps. The expression patterns of periostin in 59 surgical specimens of vocal fold polyps from 54 patients were investigated immunohistochemically. Normal vocal fold mucosa specimens from 5 patients who had undergone total laryngectomy were used as the control group. Retrospective study with planned data collection was conducted at Tohoku Medical and Pharmaceutical University. Expression of periostin was detected in 43 (72.9%) samples and four patterns of periostin expression were observed in vocal fold polyps: negative type, superficial type, infiltrative type, and diffuse type. An association was observed between periostin expression patterns and the histological subtypes of vocal fold polyps. The infiltrative pattern of periostin expression was significantly dominant in vascular-hyaline types. Expression of transforming growth factor-β (TGF-β) was also detected in the vocal fold polyps. Our results confirmed that periostin might be involved in certain pathological changes in vocal fold polyps, such as extracellular matrix accumulation, local fibrosis, and formation and development of vocal fold polyps.
Topics: Humans; Laryngeal Diseases; Polyps; Retrospective Studies; Vocal Cords
PubMed: 35793946
DOI: 10.1620/tjem.2022.J055 -
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 -
BMJ Case Reports Feb 2022A 24-year-old woman visited the Ear Nose Throat (ENT) outpatient department with complaints of hoarseness for 2 months not responding to conservative management....
A 24-year-old woman visited the Ear Nose Throat (ENT) outpatient department with complaints of hoarseness for 2 months not responding to conservative management. Laryngoscopic examination revealed a whitish ulceroproliferative lesion in the anterior commissure and anterior two-thirds of bilateral true vocal cords with surrounding necrosis. In view of the above findings, the patient was planned for biopsy under general anaesthesia. Intraoperative findings showed multiple whitish necrotic friable tissue involving anterior two-thirds of bilateral false vocal cords, ventricle, bilateral true vocal cords, both aryepiglottic folds and laryngeal surface of epiglottis. Postoperative histopathology was consistent with tuberculosis. A pulmonology consultation was taken, and the patient was started on anti-tuberculosis chemotherapy. One month post therapy, the voice was symptomatically better. A flexible fibreoptic laryngoscopic examination was done, which revealed almost complete resolution of the lesion with minimal ulceration at the anterior one-third of right true vocal cord.
Topics: Adult; Female; Hoarseness; Humans; Laryngoscopy; Larynx; Tuberculosis, Laryngeal; Vocal Cords; Young Adult
PubMed: 35131802
DOI: 10.1136/bcr-2021-248095