RESUMO
Recurrent respiratory papillomatosis is strictly connected with human papillomavirus (HPV) infection of the epithelium of the upper respiratory tract. The main treatment of lesions located in the larynx or lower pharynx includes microsurgical excision by using a CO2 laser. To decrease the amount of surgical procedures gain in importance combined therapy with antiviral agents. The aim of this study was to investigate the effect of the intralesional application of Cidofovir on the tissue of laryngeal papillomas. We have shown that simultaneous microsurgery with adjuvant therapy of Cidofovir reduces chronic inflammation (by measuring the expression of CD4 and CD8 in tissue samples), cell proliferation, and regulates the cell cycle of HPV-infected cells by reducing the expression of p53 and p63 proteins. In addition, this strategy reduces the multiple surgical procedures and regrowth of the pathology.
Assuntos
Neoplasias Laríngeas , Organofosfonatos , Infecções por Papillomavirus , Humanos , Cidofovir/uso terapêutico , Infecções por Papillomavirus/tratamento farmacológico , Projetos Piloto , Organofosfonatos/uso terapêutico , Citosina/uso terapêutico , Antivirais/uso terapêutico , Neoplasias Laríngeas/patologia , Epitélio/patologia , Ciclo Celular , ImunomodulaçãoRESUMO
INTRODUCTION: In daily phoniatric practice, apart from laryngoscopy, another simple and useful method of examining the voice organ is perceptual voice assessment based on the GRBAS scale. An extension to this examination can be the Voice Handicap Index test (VHI). MATERIALS AND METHODS: 79 female teachers taking part in a 7-week-long rehabilitation course on voice emission techniques. Before and after the course the participants were subject to phoniatric examination including laryngovideostroboscopy, GRBAS scale assessment and determining the voice handicap index (VHI). RESULTS: After the course, a substantial improvement has been observed in voice emission, perceptual assessment and the VHI test. It has been observed that there is a statistically significant correlation between GRBAS and VHI results and mean phonation time (MPT) measured before and after the course. CONCLUSIONS: The VHI test should be included in complex analysis of the effects of intensive rehabilitation.
Assuntos
Avaliação da Deficiência , Doenças Profissionais/reabilitação , Distúrbios da Voz/reabilitação , Qualidade da Voz , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Polônia , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fonoterapia/métodos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
Results of treatment of teacher's voice disorders were presented. Patients except pharmacological treatment and physiotherapy realised the course of voice emission exercises under speech therapist supervision. Ninety teachers were examined before and after treatment. Laryngological, phoniatric and laryngostroboscopic studies were carried out. In most patients phoniatric assessment revealed elongation of phonation time, changing of breathing route from cleidocostal to phrenocostal and voice creation without neck muscle tension after completing of treatment. 6 weeks lasting period of exercises was determined to be sufficient in most patients to learn correct breathing and phonation but to establish normal voice emission patient strong motivation, discipline and regularity during several months lasting exercises is needed.