Clinical characteristics and prognosis of laryngeal tuberculosis combined with respiratory tuberculosis.

PURPOSE: To investigate the clinical characteristics, diagnosis and prognosis of patients with laryngeal tuberculosis (LTB) combined with respiratory tuberculosis. MATERIALS AND METHODS: A retrospective analysis was conducted on 134 patients who underwent endoscopy and were eventually diagnosed with LTB. The patients' demographic characteristics, clinical manifestations, endoscopic features, auxiliary examination, imaging examination and prognostic characteristics were analyzed. RESULTS: LTB patients had a median age of 45.5 years (range from 12 to 87 years) and a median course of 3.0 months (range from 0.1 to 72 months). The patients' symptoms mainly presented as hoarseness (97.0 %), abnormal sensation of pharyngeal (49.3 %), cough and sputum (41.0 %), pharyngalgia (39.6 %), dysphagia (10.4 %) and dyspnea (8.2 %). The positive rate of tuberculous symptoms was 25.4 %. Endoscopic features showed that the lesions mainly involved the glottis (87.3 %), presenting as unilateral lesions (66.7 %), near-full-length involvement (88.0 %), with mucosal waves significantly reduced (86.3 %), followed by supraglottis (43.3 %), subglottis (24.6 %) and the pharynx (15.7 %). The lesions may present as granulomatous proliferation (66.4 %), ulceration (65.7 %) or swelling and exudation (51.5 %). A total of 75 patients (56.0 %) were finally diagnosed with combined pulmonary tuberculosis (PTB), with a positive chest X-ray rate of 25.6 % and a positive chest CT rate of 71.2 %. A total of 42 patients who received anti-tuberculosis treatment were followed up, and 73.8 % of patients had significant improvement in symptoms. The morphology of the pharyngeal and laryngeal mucosa returned to basically normal (59.4 %) or scar-like (34.4 %). CONCLUSIONS: LTB is usually found in middle-aged men, and patients' symptoms are mainly hoarseness, abnormal sensation of pharyngeal, pharyngalgia, cough and sputum, and can be combined with tuberculous symptoms. These lesions mainly involve multiple subregions, mainly in the glottis, and can be combined with pharyngeal involvement. There were various types of lesions. Half of the patients were complicated with PTB, and chest CT was superior to X-ray in the detection of pulmonary lesions. After regular anti-tuberculosis treatment, the symptoms and morphology of the pharyngeal and laryngeal mucosa of most patients were significantly improved.

The role of spatiotemporal and spectral cues in segregating short sound events: evidence from auditory Ternus display.

Previous studies using auditory sequences with rapid repetition of tones revealed that spatiotemporal cues and spectral cues are important cues used to fuse or segregate sound streams. However, the perceptual grouping was partially driven by the cognitive processing of the periodicity cues of the long sequence. Here, we investigate whether perceptual groupings (spatiotemporal grouping vs. frequency grouping) could also be applicable to short auditory sequences, where auditory perceptual organization is mainly subserved by lower levels of perceptual processing. To find the answer to that question, we conducted two experiments using an auditory Ternus display. The display was composed of three speakers (A, B and C), with each speaker consecutively emitting one sound consisting of two frames (AB and BC). Experiment 1 manipulated both spatial and temporal factors. We implemented three 'within-frame intervals' (WFIs, or intervals between A and B, and between B and C), seven 'inter-frame intervals' (IFIs, or intervals between AB and BC) and two different speaker layouts (inter-distance of speakers: near or far). Experiment 2 manipulated the differentiations of frequencies between two auditory frames, in addition to the spatiotemporal cues as in Experiment 1. Listeners were required to make two alternative forced choices (2AFC) to report the perception of a given Ternus display: element motion (auditory apparent motion from sound A to B to C) or group motion (auditory apparent motion from sound 'AB' to 'BC'). The results indicate that the perceptual grouping of short auditory sequences (materialized by the perceptual decisions of the auditory Ternus display) was modulated by temporal and spectral cues, with the latter contributing more to segregating auditory events. Spatial layout plays a less role in perceptual organization. These results could be accounted for by the 'peripheral channeling' theory.

Clinical Characteristics and Prognosis of Herpes Zoster Laryngitis With Vocal Fold Immobility.

OBJECTIVE: To investigate the clinical characteristics and prognosis of herpes zoster laryngitis with vocal fold immobility. STUDY DESIGN: Retrospective study. METHODS: Clinical characteristics, laryngeal signs on strobolaryngoscopy, imaging examination findings, and outcomes of patients were analyzed retrospectively. RESULTS: This study included 17 patients (11 males [64.7%] and six females [35.3%]), with a mean age of 63.3 ± 6.7 years. The primary symptoms were hoarseness (94.1%), dysphagia (76.5%), pharyngalgia on one side (76.5%), and aspiration (70.6%). No patient had skin herpes of the head and neck. The duration of symptoms was 5-30 days (median: 10 days). Twelve patients (70.6%) were in an immunocompromised state before the disease. Strobolaryngoscopy showed congestion and swelling of the mucosa on one side of the larynx, with whitish eruptions on the supraglottic mucosa and ipsilateral vocal fold immobility. Five patients (29.4%) exhibited signs of ipsilateral accessory nerve injury. The imaging examination showed supraglottic inflammatory changes in 12 patients (70.6%). Among the 14 patients whose treatment could be clearly described, only one patient received antiviral treatment, whereas others received neurotrophic and symptomatic treatment. Notably, all patients demonstrated good outcomes because their symptoms eventually returned to normal. CONCLUSION: Herpes zoster laryngitis is caused by varicella-zoster virus infection of the vagus nerve. It is characterized by laryngeal herpetic changes on one side and unilateral vocal fold immobility. The inducement of the disease tends to be associated with the abnormal immune state of patients. It can be easily misdiagnosed because of the absence of skin herpetic changes. Regardless of antiviral therapy, patients generally exhibit a favorable outcome.

Effects of Medical Masks on Voice Assessment During the COVID-19 Pandemic.

OBJECTIVE: Voice assessment is of great significance to the evaluation of voice quality. Our study aims to explore the effects of medical masks on healthy people in acoustic, aerodynamic and formant parameters during the COVID-19 pandemic. In addition, we also attempted to verify the differences between different sexes and ages. METHODS: Fifty-three healthy participants (25 males and 28 females) were involved in our study. The acoustic parameters, including fundamental frequency (F0), sound pressure level (SPL), percentage of jitter (%), percentage of shimmer (%), noise to harmonic ratio (NHR) and cepstral peak prominence (CPP), aerodynamic parameter (maximum phonation time, MPT) and formant parameters (formant frequency, F1, F2, F3) without and with wearing medical masks were included. We further investigated the potential differences in the impact on different sexes and ages (≤45 years old and >45 years old). RESULTS: While wearing medical masks, the SPL significantly increased (71.22±4.25 dB, 72.42±3.96 dB, P = 0.021). Jitter and shimmer significantly decreased (jitter 1.19±0.83, 0.87±0.67 P = 0.005; shimmer 4.49±2.20, 3.66±2.02 P = 0.002), as did F3 (2855±323.34 Hz, 2781.89±353.42 Hz P = 0.004). F0, MPT, F1 and F2 showed increasing trends without statistical significance, and NHR as well as CPP showed little change without and with wearing medical masks. There were no significant differences seen between males and females. Regarding to age, a significant difference in MPT was seen (>45-year-old 16.15±6.98 s, 15.38±7.02 s; ≤45-year-old 20.26±6.47 s, 21.44±6.98 s, P = 0.032). CONCLUSION: Healthy participants showed a significantly higher SPL, a smaller perturbation and an evident decrease in F3 after wearing medical masks. These changes may result from the adjustment of the vocal tract and the filtration function of medical masks, leading to the stability of voices we recorded being overstated. The impacts of medical masks on sex were not evident, while the MPT in the >45-year-old group was influenced more than that in the ≤45-year-old group.

Effects of Medical Masks on Voice Quality in Patients With Voice Disorders.

PURPOSE: The purpose of this study was to explore the effects of medical masks on the voice quality of patients with voice disorders. METHOD: We included 106 patients diagnosed with voice disorders. Among them, 59 were diagnosed with vocal-fold benign lesions, 27 with insufficient glottis closure, and 20 with precancerous lesions/early-stage glottic carcinoma. Perceptual parameters (GRBAS [grade, roughness, breathiness, asthenia, strain] scale), acoustic parameters (f o, sound pressure level [SPL], jitter, shimmer, noise-to-harmonic ratio [NHR], and cepstral peak prominence [CPP]), and maximum phonation time (MPT) without and with medical masks were analyzed. Changes in the GRBAS scale after wearing medical masks were also evaluated. RESULTS: With medical mask wearing, the G, R, and B scales in the vocal-fold benign lesion and insufficient glottic closure groups decreased, with a statistical significance seen in the G and R scales of the vocal-fold benign lesion group (G 1.07 ± 0.59, 0.95 ± 0.68, p < .01; R 1.07 ± 0.59, 0.95 ± 0.68, p < .01). The B scale in the precancerous lesions/early-stage glottic carcinoma (95%) and vocal-fold benign lesion groups (83%) and R scale in the insufficient glottic closure group (77.8%) were stable with mask wearing. f o and SPL in the vocal-fold benign lesion group and f o and jitter in the insufficient glottic closure group increased significantly with medical masks. The NHR and CPP in each group changed little, and all the parameters in the precancerous lesions/early-stage glottic carcinoma group showed no significant change. CONCLUSIONS: The effects of medical masks on the voice quality of patients with voice disorders were associated with the type of the disease, degree of hoarseness, and subjective scale influencing specific voice disorder. When wearing medical masks, the pitch and loudness of patients increased as compensation. Medical masks had the least impact on the precancerous lesions/early-stage glottic carcinoma group.

Perception of visual apparent motion is modulated by a gap within concurrent auditory glides, even when it is illusory.

Auditory and visual events often happen concurrently, and how they group together can have a strong effect on what is perceived. We investigated whether/how intra- or cross-modal temporal grouping influenced the perceptual decision of otherwise ambiguous visual apparent motion. To achieve this, we juxtaposed auditory gap transfer illusion with visual Ternus display. The Ternus display involves a multi-element stimulus that can induce either of two different percepts of apparent motion: 'element motion' (EM) or 'group motion' (GM). In "EM," the endmost disk is seen as moving back and forth while the middle disk at the central position remains stationary; while in "GM," both disks appear to move laterally as a whole. The gap transfer illusion refers to the illusory subjective transfer of a short gap (around 100 ms) from the long glide to the short continuous glide when the two glides intercede at the temporal middle point. In our experiments, observers were required to make a perceptual discrimination of Ternus motion in the presence of concurrent auditory glides (with or without a gap inside). Results showed that a gap within a short glide imposed a remarkable effect on separating visual events, and led to a dominant perception of GM as well. The auditory configuration with gap transfer illusion triggered the same auditory capture effect. Further investigations showed that visual interval which coincided with the gap interval (50-230 ms) in the long glide was perceived to be shorter than that within both the short glide and the 'gap-transfer' auditory configurations in the same physical intervals (gaps). The results indicated that auditory temporal perceptual grouping takes priority over the cross-modal interaction in determining the final readout of the visual perception, and the mechanism of selective attention on auditory events also plays a role.

Spatial references and audio-tactile interaction in cross-modal dynamic capture.

In audiotactile dynamic capture, judgment of the direction of an apparent motion stream (such as auditory motion) was impeded (hence 'captured') by the presentation of a concurrent, but directionally opposite apparent motion stream (such as tactile motion) from a distractor modality, leading to a cross-modal dynamic capture (CDC) effect. That is to say, the percentage of correct reporting of the direction of the target motion was reduced. Previous studies have revealed the effect of stimulus onset asynchronies (SOAs) and the potential spatial remapping (by adopting a cross-hands posture) in CDC. However, further exploration of the dynamic capture process under different postures was not available due to the fact that only two levels of time asynchronies were employed (either synchronous or with an SOA of 500 ms). This study introduced a broad range of SOAs (-400 ms to 400 ms, tactile stream preceded auditory stream or vice versa) to explore the time course of audio-tactile interaction in CDC with two spatial references--arms-uncrossed or arms-crossed postures. Participants judged the direction of auditory apparent motion with tactile distractors. The results showed that in the arms-uncrossed condition, the CDC effect was prominent when the auditory-tactile events were in the temporal integration window (0-60 ms). However, with a preceding tactile cueing effect of SOA equal to and above 150 ms, the CDC effect was reduced, and no CDC effect was observed with the arms-crossed posture. These results suggest CDC effect is modulated by both cross-modal interaction and the spatial reference (especially for the distractors). The magnitude of the CDC effects in audiotactile interaction may be accounted for by reliability of tactile spatial-temporal information.