Comparison of the long-term effectiveness of physiotherapy programs with low-level laser therapy and pulsed magnetic field in patients with carpal tunnel syndrome.

PURPOSE: The aim of the study was to compare the long term effects of low - level laser therapy (LLLT) and pulsed magnetic field (PMF) in the rehabilitation of patients with carpal tunnel syndrome (CTS). METHODS: The study included 38 patients with idiopathic CTS, confirmed by electroneurographic (ENG) examination. All patients were randomly assigned to 2 groups: group L (18 patients) treated with LLLT and group M (20 patients) with PMF therapy. Clinical assessment, including day and night pain, the presence of paresthesia, functional tests (Phalen, Tinel, armband tests) and pain severity according to the Visual Analogue Scale (VAS) was conducted before treatment, after the first series of 10 sessions, after a two-week break, after the second series of 10 sessions and six months after the last series. RESULTS: After LLLT a significant reduction of day and night pain was observed at each stage of treatment and 6 months after the last series (p<0.05). However, in group M, a significant reduction of both day and night pain was demonstrated only after the second series (p<0.05). A reduction of the incidence of Phalen's symptoms were noticed in both groups, however, only in group L the improvement was significant (p<0.05). In groups L and M a significant reduction of pain intensity was observed at every stage of treatment (p<0.05). CONCLUSIONS: Although after LLL as well as PMF therapy clinical improvement was observed, the most significant differences were registered after the second series and persisted for up to 6 months in both groups.

Morphological changes of the vocal fold mucosa in hyperfunctional dysphonia diagnosed by psychoacoustic and videostroboscopic methods.

PURPOSE: The aim of the study was to provide a morphological assessment of the laryngeal mucosa in patients with hyperfunctional dysphonia diagnosed by psychoacoustic and videostroboscopic methods. MATERIAL AND METHODS: Forty patients with voice quality disorders of hyperfunctional dysphonia were recruited for participation in the study. The diagnosis of dysphonia was based on the Voice Rating Scale GRBAS, and endoscopic and stroboscopic assessment of the vocal folds. Acoustic assessment was carried out using following parameters: fundamental frequency, Jitter, Shimmer, Noise to Harmonic Rate and Yanagihara (YG) scale. In order to evaluate the morphology of the vocal fold mucosa transmission electron microscopy was performed using postoperative material obtained from the larynx. Results of clinical and morphological analysis were compared with the reference group. The morphological material was obtained from patients with hypopharyngeal cancer without pathological changes of the vocal folds. RESULTS: The psychoacoustic assessment using the perceptual GRBAS scale enables the appropriate diagnostics of hyperfunctional dysphonia, which was confirmed by evaluation of acoustic parameters and YG scale analysis. In 40 patients with voice quality disorders causing by hyperfunctional dysphonia, in morphological assessment of the laryngeal mucosa, 4 (10%) patients demonstrated the presence of oedema and signs of intensive dysphonia in psychoacoustic and stroboscopic examination. CONCLUSIONS: Oedema of the laryngeal mucosa confirmed by stroboscopic and ultramorphological examination may coexist with hyperfunctional dysphonia. The presence of the laryngeal oedema in patients with hyperfunctional dysphonia has the negative impact on voice quality in psychoacoustic assessment with the use of the GRBAS and YG scales.

The evaluation of voice in elderly patients.

Results of voice analysis in 96 elderly patients are presented. The objective of the study was to evaluate dysphonia and its morphologic conditions. Videolaryngostroboscopic (VLSS) examination distinguished between oedematic and atrophic form of senile dysphonia. Morphologic evaluation of the vocal fold mucosa with the use of light microscopy (LM) and transmission electron microscopy (TEM) confirmed the clinical diagnosis. Evaluation of aerodynamic factors of the larynx function, particularly MPT and VVI, suggested hyperfunctional and hypofunctional modes of the voice formation in patients with the larynx oedema and in patients with atrophic changes, respectively.

[Analysis of voice function disorders using videostroboscopic techniques]. / Analiza czynnosciowych zaburzen glosu z wykorzystaniem techniki wideostroboskopowej.

Clinical applications of videostroboscope in phoniatrics were investigated. Altogether 79 patients with functional lesions of the larynx and 20 with normal were examined. Measurements of vibration, amplitude, frequency and mucosal wave of vocal cords yielded cords objective information about vibration in the functional dysphonia. Videolaryngostroboscope can help identify the kind of functional diseases of the larynx.

Assessment of the ability of mononuclear blood cells to produce IFN-gamma in patients with laryngeal cancer.

The ability of mononuclear blood cells (PBMC), derived from patients with cancer of the larynx, to produce IFN-gamma in vitro was assessed in this paper. Thirty patients (27 male, 3 female) were qualified to the study. Their mean age was 65 (range: 41 to 78 years), tumour sizes found in the group were from T2 to T4, levels of pathologic malignancy G2 or G3. The percentage rates different blood cells phenotypes (CD3+, CD3+ HLADR+, CD4+, CD8+, CD14+ HLADR+, CD19+, CD56+) were evaluated by means of flow cytometry (Coulter EPICS XL). The control group consisted of 20 healthy blood donors. PBMC were derived by centrifugation of heparinized venous blood on Lymphoprep gradient according to Boyum method. Double cell cultures were performed for 24 hours with antibody anti-CD3 or recombinant interleukins 12 (rhIL-12) or 18 (rhIL-18). The statistic analysis was based on Student t and Mann-Whitney's test with significancy at p<0.05. A significant decrease in the production of IFN-gamma by PBMC in patients with laryngeal cancer after stimulation with antiCD3 (p=0.018), rhIL-12 (p=0.027), rhIL-18 (p=0.016) was found in comparison with the controls. The results suggest a decreased production of IFN-gamma in patients with cancer of the larynx.

Voice creating aspect after horizontal laryngectomy and chordectomy in patients with carcinoma of the larynx.

Voice quality was assessed in 55 patients with the laryngeal carcinoma. A quality of voice was examined in 18 patients before and after chordectomy and in 37 patients before and after supraglottic surgery. Subjective and objective spectrography methods were applied to evaluate dysphony. The larynx was examined by indirect larngoscopy and videolaryngostroboscopy (VLSS). Significant voice pathology was found in patients before surgery when compared with the normal group. A change of voice colour was found, which was manifested in spectrography by decreased in formant levels, especially F3 and F4 in patients after supraglottic surgery. Dysphagia and longer tracheostomy were temporary complications after the surgery and resulted in further phoniatric rehabilitation. Early phoniatric rehabilitation after chordectomy helped to achieve subjective and objective improvement of voice quality in patients after surgery. Good voice quality in patients after chordectomy is due to preserved structure and increased levels F1, F2, F3, and F4 formants in spectrography.

Voice analysis after the partial laryngectomy in patients with the larynx carcinoma.

The paper presents 170 cases of patients with the larynx carcinoma after the partial laryngectomy. According to the procedure which we used, vertical, horizontal and subtotal supraglottis laryngectomies were distinguished. Voice pattern was analysed with the use of subjective and objective spectrography. The lowest degree of dysphonia was found in patients after the horizontal laryngectomy, while the highest degree dysphonia in those after subtotal supraglottis laryngectomy.

Evaluation of the voice function after the supraglottis subtotal laryngectomy.

Voice quality was analysed in 39 patients with the larynx carcinoma after the supraglottis subtotal laryngectomy. Voice pattern was analysed with the use of subjective and objective spectrography before and after the surgery. A deteriorated voice quality was found after the surgery. The spectrographic examination revealed decreased frequency levels of the formants F3 and F4 and the presence of a noise component generated in the glottis area.

[Video-laryngo-stroboscopy in diagnosis of senile voice disorders]. / Wideolaryngostroboskopia w diagnostyce zaburzen glosu wieku starczego.

Clinical applications of videolaryngostroboscopy (VLSS) in 110 senile persons in phoniatrics was investigated. Each patient was examined laryngologically and phoniatrically. The patients were divided into two groups, according to the changes observed in the larynx as edema and vocal folds atrophy. Measurements of vibration, amplitudae, frequency glottic closure and oscillation (mucosal wave) of vocal cords yielded objective information about vibration in edema and vocal fold atrophy. This method can find application in training and therapeutic procedures in patients with senile dysphonia.

[Evaluation of voice function in paralytic dysphonia]. / Ocena czynnosci glosowej w dysfonii porazennej.

The analysis of 112 patient's voice is presented in the study. Laryngeal pathology observed in the patients was classified as paralytic dysphonia. The voice was examined subjectively and objectively--spectrographic examination. The voice organ was described by means of indirect laryngoscopy during breathing and phonation as well as by means of videostroboscopy.

[Voice function in patients after partial laryngectomy]. / Czynnosc glosowa u chorych po laryngektomii czesciowej.

103 patients with cancer of the larynx treated with partial laryngectomy were presented. Voice quality before and after surgery was compared. Voice was analysed by subjective and objective-spectrographic methods. Partial laryngectomies consisted of: vertical, horizontal and supraglottic subtotal procedures. The least dysphony was found in horizontal laryngectomy, the biggest--in supraglottic subtotal laryngectomy.

[Voice function after chordectomy in patients with larynx carcinoma]. / Czynnosc glosowa u chorych po chordektomii z powodu raka krtani.

The quality of voice was examined in 18 patients with larynx carcinoma before and after chordectomy. Subjective and objective (spectrographic) methods were applied. The larynx was examined in indirect laryngoscopy and videostroboscopy. Significant voice pathology was found in patients before surgery when compared with norm. Early phoniatric rehabilitation helped to achieve subjective improvement of voice quality in patients after surgery.

[The voice function after horizontal laryngectomy]. / Czynnosc glosowa u chorych po operacji nadglosniowej.

Voice quality was assessed in 37 patients with cancer of the larynx before and after supraglottic surgery. Subjective and objective spectrography method were applied to evaluate dysphony. A change of the voice colour was found, which was manifested in spectrography by decrease of formant levels, specially F3 and F4. Dysphagia and longer tracheostomy were temporary complications after the surgery, and caused later beginning of phoniatric rehabilitation.

[Voice pathology in patients with allergic rhinitis]. / Zaburzenia glosu u chorych z alergicznym niezytem nosa.

The aim of work was evaluation of voice pathology in patients with allergic rhinitis. Larynx organic pathology were found in 75% patients with coexisting allergic rhinitis in the form of Reinke's oedema, chronic hypertrophic laryngitis, larynx polyp and vocal nodules. It caused serious voice pathology (dysphonia) which was confirmed by an objective spectrographic method. Larynx organic pathology was not in 15% patients. In these cases rhinophonia was found in consequence of resonance nasal defect.

[Effect of ethyl ether of apovincaminic acid (Cavinton) on the ototoxic action of sisomicin in guinea pigs]. / Wplyw estru etylowego kwasu apowinkaminowego (cavintonu) na efekt ototoksyczny sisomycyny u swinek morskich.

The aim of this work was to evaluate the protective effect of etyl ether of apovincaminic acid (Cavinton) against the ototoxic effect of sisomycin in the experimental condition. The first group of guinea pigs were given 14 days sisomycin. The second sisomycin and cavinton. The third was the control group. Hearing acuity was tested by the shivering audiometry. The spiral ganglion function was tested by the microphonic potentials and the integrity of cochlea was diagnosed by scanning microscopy. The results pointed out the ototoxicity of sisomycin. There were the deterioration of hearing acuity, lowering of microphonic potentials and degenerative changes in spiral ganglion. The damages were lowered by use of cavinton before the administration of sisomycin.