Laser Plume From Human Papillomavirus-Infected Tissue: A Systematic Review.

BACKGROUND: Laser procedures are becoming more prevalent across multiple medical specialties for a variety of indications. The plumes created by these lasers have raised concern for the dissemination of an infectious material. OBJECTIVE: To review and summarize the information on viral dissemination in laser plumes available in the literature. MATERIALS AND METHODS: Data Sources A systematic review was performed on English and non-English articles using the PubMed and the Cochrane databases. A manual search of bibliographies from relevant articles was also performed to collect additional studies. STUDY SELECTION: Only articles in the English language with full texts available that pertained to viral particles in laser plumes were included. Data Extraction Two authors performed independent article selections using predefined inclusion and exclusion criteria. RESULTS: There have been case reports of possible transmission of human papillomavirus (HPV) by inhalation of laser-produced aerosols. Multiple investigators have attempted to recreate this scenario in the laboratory to qualify this risk. Others have conducted clinical experiments to determine the presence of HPV in laser plumes. CONCLUSION: The current body of the literature suggests that laser surgeons are at a risk for HPV exposure by inhalation of laser-derived aerosols. We offer best practice recommendations for laser operators.

An open-label, parallel-group, randomised controlled trial of antiseptic mouthwash versus antibiotics for oropharyngeal gonorrhoea treatment (OMEGA2).

New treatments for oropharyngeal gonorrhoea are required to address rising antimicrobial resistance. We aimed to examine the efficacy of a 14-day course of mouthwash twice daily compared to standard treatment (antibiotic) for the treatment of oropharyngeal gonorrhoea. The OMEGA2 trial was a parallel-group and open-labelled randomised controlled trial among men with untreated oropharyngeal gonorrhoea that was conducted between September 2018 and February 2020 at Melbourne Sexual Health Centre in Australia. Men were randomised to the intervention (rinsing, gargling and spraying mouthwash twice daily for 14 days) or control (standard treatment) arm and followed for 28 days. Participants in both arms were advised to abstain from sex and kissing with anyone for 14 days after enrolment. Oropharyngeal swabs were collected at baseline, Day 14 and Day 28 and tested for Neisseria gonorrhoeae by nucleic acid amplification test (NAAT) and culture. The primary outcome was the detection of oropharyngeal N. gonorrhoeae by NAAT at Day 14 after treatment. This trial was registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12618001380280). This trial stopped early due to a high failure rate in the mouthwash arm. Twelve men were randomly assigned to either mouthwash (n = 6) or standard treatment (n = 6). Of the 11 men who returned at Day 14, the cure rate for oropharyngeal gonorrhoea in the mouthwash arm was 20% (95% CI 1-72%; 1/5) and in the standard treatment arm was 100% (95% CI 54-100%; 6/6). A 14-day course of mouthwash failed to cure a high proportion of oropharyngeal gonorrhoea cases.

An Acoustic-Signal-Based Preventive Program for University Lecturers' Vocal Health.

INTRODUCTION: Professional activities of university lecturers involve continued and sustained use of the voice, leading in many cases to increased risk of developing voice disorders. Risk identification followed by the fast application of preventive or corrective measures is a key issue in this context. OBJECTIVE: Define and implement a preventive program for the vocal health of university lecturers by using acoustic features automatically extracted from voice recordings to identify risk groups and manage preventive or corrective actions MATERIAL AND METHODS: A total of 170 subjects, aged between 18 and 65, were recruited at the San Pedro de Alcántara Hospital and at the University of Extremadura in Cáceres (Spain). They formed three groups-one of 25 people suffering from vocal fold nodules, another of 25 healthy people, and the third of 120 university lecturers. Medical history and voice status assessment was performed, and voice recordings were made following a research protocol. A feature extraction, selection, and classification procedure was applied to the voice recordings to provide the best predictors for discriminating between pathological and healthy voices. The model parameters were then used to determine the lecturers' probability of suffering vocal fold nodules or other pathologies with similar dysphonic speech. These probabilities were used to classify the lecturers into three risk groups-low, medium, and high. These groups were taken as the basis to assign the lecturers to a primary, secondary, or tertiary prevention level. Different preventive or corrective actions were applied for each prevention level. RESULTS: The best set of predictors comprised sample entropy, correlation dimension, pitch period entropy, glottal noise excitation, and sex, achieving an overall accuracy of 92% with a random forest classifier. They all showed statistically significant differences between vocal fold nodules and healthy groups (P < 0.05). Three out of the four best acoustic features were nonlinear, showing the importance of nonlinear dynamics for clinical practice. The model parameters were applied to the predictors of the lecturers so as to assign them to the different risk groups, leading to 60.8% (73 out of 120) of the lecturers in the low-risk group, 29.2% (35 out of 120) in the medium-risk group, and 10% (12 out of 120) in the high-risk group. The prevention levels were assigned on the basis of this classification and the medical history and laryngological evaluation of some specific subjects. A statistically significant association was found between the voice status and the assigned prevention level (P < 0.001), with there being a clear dependence relationship (Cramér's V = 0.630). CONCLUSION: It is feasible to develop and apply a preventive voice program for university lecturers that is aided by features automatically extracted from voice recordings. As the program progresses, it is expected that the information automatically provided for the assignment to prevention levels will become ever more precise. The method proposed can be extended to other voice professionals and other voice disorders.

Patient-specific bolus for range shifter air gap reduction in intensity-modulated proton therapy of head-and-neck cancer studied with Monte Carlo based plan optimization.

BACKGROUND & PURPOSE: Intensity-modulated proton therapy (IMPT) of superficial lesions requires pre-absorbing range shifter (RS) to deliver the more shallow spots. RS air gap minimization is important to avoid spot size degradation, but remains challenging in complex geometries such as in head-and-neck cancer (HNC). In this study, clinical endpoints were investigated for patient-specific bolus and for conventional RS solutions, making use of a Monte Carlo (MC) dose engine for IMPT optimization. METHODS AND MATERIALS: For 5 oropharyngeal cancer patients, IMPT spot maps were generated using beamlets calculated with MC. The plans were optimized for three different RS configurations: 3D printed on-skin bolus, snout- and nozzle-mounted RS. Organ-at-risk (OAR) doses and late toxicity probabilities were compared between all configuration-specific optimized plans. RESULTS: The use of bolus reduced the mean dose to all OARs compared to snout and nozzle-mounted RS. The contralateral parotid gland and supraglottic larynx received on average 2.9Gy and 4.2Gy less dose compared to the snout RS. Bolus reduced the average probability for xerostomia by 3.0%. For dysphagia, bolus reduced the probability by 2.7%. CONCLUSIONS: Quantification of the dosimetric advantage of patient-specific bolus shows significant reductions compared to conventional RS solutions for xerostomia and dysphagia probability. These results motivate the development of a patient-specific bolus solution in IMPT for HNC.

Correlations Between Serum Apolipoprotein A-I and Formation of Vocal Cord Polyp.

OBJECTIVE: This study aims to investigate the correlations between serum apolipoprotein A-I (ApoA-I) and the formation of vocal cord polyps (VCPs). STUDY DESIGN: This study used the nonmatched case-control study method. METHODS: The serum total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, ApoA-I, apolipoprotein B (ApoB), and ApoA-I/ApoB levels of 89 VCP patients and 87 normal volunteers were compared. Additionally, such VCP-related factors as excessive vocal use, vocal abuse, smoking, drinking, and the size of VCPs were analyzed. RESULTS: The two groups did not significantly differ with regard to triglyceride, low-density lipoprotein cholesterol, ApoB, and ApoA-I/ApoB levels (P > 0.05), whereas they did significantly differ with regard to TC, HDL-C, and ApoA-I levels (P < 0.05) according to independent t tests. Logistic regression analysis showed that excessive vocal use and vocal abuse were risk factors for VCPs (P < 0.05), with odds ratio values of 5.675 and 12.781, respectively. The ApoA-I level was negatively associated with VCPs (P < 0.05), with an odds ratio of 0.511; however, TC and HDL-C were not associated with the formation of VCPs (P > 0.05). The size of VCPs in females was negatively correlated with the serum ApoA-I level (r = -0.349, P = 0.032), whereas that in males was not (P > 0.05). CONCLUSIONS: As the serum ApoA-I level was negatively correlated with the formation of VCPs, ApoA-I may reduce the risk of VCPs. These findings may facilitate the prevention and treatment of VCPs.

Prevention of anterior glottis web with hyaluronic acid derivatives in rabbit model.

OBJECTIVES/HYPOTHESIS: Validating an antiadhesive strategy to prevent anterior glottic web (AGW) development. STUDY DESIGN: Prospective animal study in rabbits. METHODS: Fifteen New Zealand white rabbits were randomly divided into three equal groups (five rabbits each), applying either HyFence (HF: 0.1 g/vocal fold), an antiadhesive test agent; mitomycin-C (MMC: 1 mg/ml, 4 min) as reference therapy; or saline (control group) to AGWs induced by laryngofissure technique (previously reported by us). At week 8, the extent of AGW was measured to assess preventive effects of HF and MMC, and laryngeal specimens were sampled for high-speed recording and histologic analysis. RESULTS: AGW induction was successful in all five (100%) control rabbits, each demonstrating fibroconnective tissue and collagen fibers at anterior commissure, with AGW ratio averaging 0.57 ± 0.052. An AGW was seen in 100% of the rabbits survived in the MMC group (n = 2) with the 60% (n = 3) of the MMC rabbits expired due to postprocedure infections. The average AGW ratio was 0.28 ± 0.070 in the MMC group. AGW formation rate was 50% in HF group with one rabbit expired from infection. Mean AGW ratio was lowest in the HF group (0.23 ± 0.10; P = 0.013). Microscopically, AGW induction sites in HF-treated rabbits displayed significantly fewer collagen fibers (P = 0.009) by comparison. CONCLUSION: This is the first reported use of a cross-linked hyaluronic acid gel that may prevent AGW formation. LEVEL OF EVIDENCE: N/A. Laryngoscope, 126:2320-2324, 2016.

Abordaje de la vigilancia de la salud en trabajadores con uso profesional de la voz / Protocol of health examination on voice professional

OBJETIVO: El principal objetivo de este trabajo es realizar una propuesta de reconocimiento preventivo de salud para trabajadores de la voz. Material y MÉTODOS: La patología de la voz tiene su incidencia más elevada en aquellos colectivos que utilizan la voz como elemento clave de su actividad profesional, especialmente en docentes y teleoperadores. Según estudios, la prevalencia de puede oscilar de un 18% a 57% en docentes y aproximadamente 13 % en teleoperadores. La necesidad de valorar y prevenir las patologías en todos los elementos que intervienen en la producción de la voz, así como la obligación de prevenir y detectar nódulos de las cuerdas vocales en profesionales con riesgo, justifican la elaboración de este protocolo.RESULTADOS: Proponemos un protocolo con un contenido específico conteniendo historia clínico laboral que recoja la información con anamnesis, hábitos, situación actual e historia laboral, que debemos conocer para la adecuada valoración de estos trabajadores, una valoración subjetiva de la voz y una exploración específica aerodinámicacomplementada con el test Índice de incapacidad vocal VOICE HANDICAP INDEX (VHI). CONCLUSIONES:Este protocolo es fácil de hacer por los profesionales sanitarios y no es caro para las empresas

OBJECTIVE: The principal objective of this work is to determinate a propose of preventive health screenings on voice workers. MATERIALS AND METHODS:Voice disorders mainly affect groups of people who use their voice is a key element as part of their work, especially teachers and telemarketers. According to studies, the prevalence may vary between 18 and 57% in teachers and approximately 13% of telemarketers. The need to assess and prevent diseases in all elements involved in voice production, and the obligation to prevent and detect nodules of the vocal chords in professionals at risk, justify the development of this protocol. RESULTS: We propose a protocol with specific content including past medical history, habits, current situation and occupational history, which we need to be aware of in order to assess these patients properly, and a subjective evaluation of the voice and specific aerodynamic examination complemented by the Voice Handicap Index (VHI). CONCLUSIONS:This is a protocol very easy to use in medical evaluation y not expensive for the company

[Endoscopic diagnosis, treatment and prevention of intubation related injuries of the larynx and trachea in neurosurgical patients].

The goal of the study was to assess of efficacy of endoscopic diagnosis, prevention and treatment of intubation related larynx and tracheal injuries in patients with acute neurosurgical pathology and prolonged mechanical ventilation. 199 patients with different neurosurgical pathology were enrolled in the study group. Mean age was 50 +/- 14. Control group consisted of 399 patient. Mean age was 43 +/- 12. Clinical state of patient from both group were similar. Endoscopic method in the study group included revision of airways via nasal route with tracheostomy tube inserted. Larynx and tracheal injuries by endoscopy were identified in 42 patients (33.6%) in the study group and in 12 patients (7.6) in the control group. Such injuries weren't mentioned in 83 patients in study group and in 146 patients of the control group. Tracheal stenosis was developed in the study group in 0,8% of patients, which is by 7,9 times lower than in the control group (6.3%). We consider that this result was achieved due to our approach to treatment and prevention of tracheal stenosis.

Estado de los profesionales de la voz en Colombia / State of the professional voice in Colombia

Objetivos: Evaluar las características patológicas más frecuentes en los profesionales de la voz colombianos. Mostrar los factores de riesgo en esta población, individualizándolos según cada profesión. Diseño: Estudio observacional descriptivo, de corte transversal. Métodos: Revisión de historias clínicas y estroboscopias realizadas entre los años 2006 y 2010. Encuestas personales, para preguntar sobre las características de la población evaluada. Se hallaron medidas de tendencia central para las variables cuantitativas y porcentajes para las cualitativas. Resultados: 825 pacientes, 39% hombres y 60,1% mujeres, dentro de los cuales el 22,4% eran profesores; 9% tuvieron entrenamiento vocal; 80,4% presentaron disfonía como síntoma principal. El hallazgo estroboscópico más frecuente fue tensión muscular supraglótica. El 72% no conocen el término “profesional de la voz”, el 78% trabajan con su voz entre un 70-100%, y los pacientes esperan alrededor de seis meses para ser valorados por laringología. Conclusión: Los profesionales de la voz en Colombia tienen una alta prevalencia de trastornos de la voz, similares a los reportados en la literatura mundial, que se correlacionan con la ausencia de entrenamiento vocal y atención tardía...

Objectives: Evaluation of a specific professional voice user’s population in Colombia. Determine the professions more often related to voice issues, their most frequent clinical and stroboscopic findings, preference in gender, lack of voice training, knowledge on voice care and the proficiency in medical attention in the context of a 3rd world country. We propose the potentially related risk factors in each job. Design: Descriptive observational study. Cross sectional. Methods: Data was extracted from the principal author’s patient database. Interviews and stroboscopies made between January 2006 and December 2010. Medical attention perspectives and knowledge on voice care was obtained form a survey conducted in 100 professional voice users included in the study. Results: 1334 patients were included. 825 of them were professional voice users, 39% males and 60.1% females. Teachers represented 22.4% of the population. 9% of the patients had professional voice training. 80.4 % presented with dysphonia as their principal symptom. The most frequent stroboscopic finding was augmented suppraglotic activity. Surveys shows 72% of the patients were not familiarized with the term “professional voice user”. 78% of the patients use their voice 70-100% of their work time. Most patients waited over 6 months to have consultation with a laryngologist. Conclusions: There is a higher prevalence of voice disorders among voice professional users in Colombia with numbers similar to those reported worldwide. There is a correlation with the lack of voice training, delayed health care, lack of knowledge on voice training and voice hygiene and voice disorders...

Topical measles-mumps-rubella vaccine in the treatment of recurrent respiratory papillomatosis: results of a preliminary randomized, controlled trial.

We conducted a study to test the hypothesis that the measles-mumps-rubella (MMR) vaccine can either prevent further recurrences of recurrent respiratory papillomatosis (RRP) or prolong its remission. Our study population was made up of 26 children with RRP. All patients underwent surgical excision of their lesions. After the lesions were removed, half of these patients were prospectively randomized to receive a topical coating of the MMR vaccine on the site of their excised lesion (intervention group); the other half were treated with excision alone (control group). The patients in the intervention group experienced a longer period of recurrence-free remission than did those in the control group (median: 160 and 133 days, respectively), but the difference was not statistically significant. Therefore, it appears that topical MMR vaccine as an adjunct to routine surgical management may not be beneficial in preventing or slowing the return of RRP. However, we believe that further studies with larger patient populations are warranted.

Respiratory health of elite athletes - preventing airway injury: a critical review.

Elite athletes, particularly those engaged in endurance sports and those exposed chronically to airborne pollutants/irritants or allergens, are at increased risk for upper and lower airway dysfunction. Airway epithelial injury may be caused by dehydration and physical stress applied to the airways during severe exercise hyperpnoea and/or by inhalation of noxious agents. This is thought to initiate an inflammatory cascade/repair process that, ultimately, could lead to airway hyperresponsiveness (AHR) and asthma in susceptible athletes. The authors review the evidence relating to prevention or reduction of the risk of AHR/asthma development. Appropriate measures should be implemented when athletes exercise strenuously in an attempt to attenuate the dehydration stress and reduce the exposure to noxious airborne agents. Environmental interventions are the most important. Non-pharmacological strategies can assist, but currently, pharmacological measures have not been demonstrated to be effective. Whether early prevention of airway injury in elite athletes can prevent or reduce progression to AHR/asthma remains to be established.

A novel treatment for dynamic laryngeal collapse associated with poll flexion: the modified checkrein.

REASONS FOR PERFORMING THE STUDY: Dynamic laryngeal collapse (DLC) associated with poll flexion is a performance limiting dynamic upper airway disorder commonly diagnosed in Coldblooded trotters. An inspiratory obstruction occurs when affected horses are driven with tension on the reins, inducing poll flexion. To date, surgical treatment and conservative management have failed to improve racing performance in affected horses. OBJECTIVES: To test the efficacy of an external device, the modified checkrein, in limiting poll flexion, diminishing laryngeal collapse and improving airway mechanics when horses are driven on a treadmill with tension on the reins and test the hypothesis that the modified checkrein will limit poll flexion thereby improving endoscopic appearance of the larynx and reduce airway obstruction in harness racehorses affected with DLC. METHODS: Fourteen Norwegian Coldblooded trotter (NCT) racehorses previously diagnosed with DLC associated with poll flexion exercised on a high-speed treadmill at speeds that resulted in heart rate >200 beats/min. Upper airway videoendoscopy recordings, tracheal pressures and video recordings of the head and neck position were collected while horses exercised with the conventional checkrein on Day 1 and the modified checkrein on Day 2. RESULTS: The modified checkrein successfully limited poll flexion as measured by no change in head position parameters between phases of no rein tension and phases of rein tension. Endoscopic scores were significantly improved (arytenoids cartilage collapse P<0.0001; vocal fold collapse P<0.0001) and tracheal peak inspiratory pressures were significantly less negative (P = 0.0162) when horses were fitted with the modified checkrein compared to the conventional checkrein. CONCLUSIONS AND POTENTIAL RELEVANCE: The modified checkrein successfully limited poll flexion and also prevented upper airway obstruction in NCT horses affected with DLC associated with poll flexion. The modified checkrein seems promising in offering a method of conservative management in harness racehorses affected with this disorder.

Management and prevention of endotracheal intubation injury in neonates.

PURPOSE OF REVIEW: To summarize the diagnosis, pathology, and management of glottic, subglottic, and tracheal injuries secondary to endotracheal intubation in neonates. RECENT FINDINGS: Published reports of intubation-related injuries include laryngeal stenosis, subglottic stenosis (SGS), tracheal rupture, subglottic cysts, and pharyngoesophageal perforation. Such injuries are multifactorial, with risk factors including patient size and weight, use of cuffed versus uncuffed endotracheal tubes, and fragility of the mucosa. In addition, the skill and awareness of the person performing the intubation may also influence risk of intubation-related injuries. Studies on fetal cricoid anatomy demonstrate differences in the configuration of cricoids lumen between premature infants and the adult larynx. Most recently reported airway injuries due to intubation have history of prematurity as a common risk factor, with increasing incidence associated with decreasing gestational age and weight. Prematurity and prolonged intubations remain the top risk factors for development of subglottic cysts. Management of above-mentioned complications includes endoscopy versus open laryngotracheoplasty for SGS, using balloon or traditional dilatation or augmentation with cartilage grafts, respectively; bridging injured area with endotracheal tube versus open resection and primary closure for tracheal rupture; and use of laser or cold techniques for removal of cysts. SUMMARY: Although intubation-related injuries may occur in anyone, neonates are at increased risk due to their small airway lumen and cricoids cartilage morphology. Endoscopic and open reconstructive techniques increase treatment options to treat glottic and SGS.

[Preventing laryngeal anterior commissure adhesion after operation: a study in canines].

OBJECTIVE: To explore the better operational methods by the laser surgery to treat diseases involving the laryngeal anterior commissure. It can excise the diseases as well as avoid anterior commissure adhesion, laryngostenosis and dyspnea after operations. METHOD: Twelve dogs were divided into 4 groups at random. There were three dogs in one group. A: excising experimental dog's anterior commissure by twice operations, the interval time was two weeks; B: excising experimental dog's anterior commissure in one time, at the same time suturing the silica gel sheet on the anterior commissure; C: excising experimental dog's anterior commissure in one time and then applying MMC on the wound of the anterior commissure; D: excising experimental dog's anterior commissure in one time, without any treatment. RESULT: All of the dog's surgery were completed successfully by laser. Four weeks later, we observed the raw surfaces. A: the neonatal membrane covered the wound, inflammatory reaction slight, we could not see obvious adhesion in the anterior commissure. B: the membrane covered the wound, appearing the dark chronic inflammation, we could see the adhesion in the anterior commissure slight. C: the membrane covered the wound, edematization, we could see the moderate adhesion in the anterior commissure. D: edematization, we could see the adhesion in the anterior commissure obviously. Four groups were all appeared hoarsenesses, the most slightly in group A, secondly in B and C, the worst in D. The analysis of vocal cord length of 4 groups, we used matched-pairs t-test, A, B, C groups' P>0.05, the vocal cord length didn't become shorter than before obviously. Group D's P<0.01, that meant the vocal cord length became shorter obviously. Between each group,we used reiterature-measurement analysis of variance (P<0.05), the change of vocal cord length had disparity in different groups. The comparison in two groups suggested that group A is the best. B and C are inferior ,but no disparity between them. The analysis of glottis area of 4 groups, as the same method above, A,B groups' P>0.05, the glottis area didn't shrink than before obviously. C and D groups' P<0.05, that meant having statistical significance and glottis area shrinked obviously. Between each group, we used reiterature-measurement analysis of variance (P>0.05), we could not think that the changes of four groups have disparity. CONCLUSION: Excising the experimental dog's anterior commissure by laser, compared the 4 different operation methods, group A is the best method. B and C are inferior. The results are valuable in clinic when we perform operations by laser to treat the disease involving the anterior commissure.

[Laryngeal alterations following endotracheal intubation and use of larynx masks]. / Laryngeale Veränderungen nach endotrachealer Intubation und Anwendung der Larynxmaske.

After endotracheal intubation patients most frequently report pharyngolaryngeal complaints. Subsequent impairment of vocal performance might lead to general impairment of communication and job-related performance. Most prevalently, swollen mucosa, hematomas, granuloma and edema in the larynx can be observed after intubation. Limitations of respiratory vocal fold mobility appear less frequently. Knowledge of the pathophysiological aspects and causative factors associated with laryngopharyngeal morbidity are essential cornerstones of quality assurance in perioperative respiratory tract management. This review describes the effects of endotracheal intubation and application of larynx masks in relation to laryngeal morbidity.

Patología benigna de laringe en docentes y cantantes / Benign diseases of larynx in teachers and singers

La disfonía es uno de los motivos de consulta más frecuente en docentes y cantantes, quienes presentan un índice alto de patología de voz. Son muy pocos los estudios en nuestro medio acercade la patología laríngea en la población descrita a pesar de conocerse su alta probabilidad de lesiones laríngeas. Objetivo: Describir las características estroboscópicas y factores de riesgoasociados en pacientes con abuso de voz (cantantes y docentes) que consultaron entre agosto de 2006 y noviembre de 2009 por disfonía crónica y se encontraron con lesiones benignas de laringe. Materiales y métodos: Se realizó un estudio de corte transversal, de tipo retrospectivo. Resultados:365 pacientes fueron incluidos en el estudio, 302 docentes y 63 cantantes. Se describen la distribución de género, la frecuencia fundamental, los hallazgos glóticos la periodicidad, la simetría, ondamucosa y factores de riesgo asociados. Conclusión: La frecuencia de presentación de patología laríngea en pacientes con abuso vocal, en nuestro medio es muy alta. Encontramos cambios asociados a RGE y los nódulos vocales como principales diagnósticos en este grupo de pacientes. De igualmanera es mayor la presencia de patología laríngea en personas con varios años de desarrollo de laprofesión. Factores como exposición a polvo de tiza, cigarrillo, estrés, falta de educación vocal, periodos prolongados de sobreesfuerzo vocal, llevan a un aumento en la presentación de este tipo de patología.

The dysphonia is one of the most common reasons for consultation on teachers and singers, who have a high index of voice pathology. There are very few studies in our country about laryngeal pathology in this population in spite of knowing their high probability of laryngeal lesions. Objective: Todescribe the stroboscopic features and associated risk factors in patients with voice abuse (singers and teachers) who consulted between August 2006 and November 2009 for chronic dysphonia and being found with benign lesions of the larynx. Materials and methods: We conducted a cross-sectional,retrospective study. Results: 365 patients were included in the study, 302 teachers and 63 singers. We describe the gender distribution, the fundamental frequency, the glottis findings, periodicity, symmetry, mucosal wave and associated risk factors. Conclusion: The frequency of laryngeal pathology insingers and teachers in our area is very high. We found changes associated with GERD and vocal nodules as primary diagnosis in this patient group. Similarly, we found that there is a greater presence of laryngeal pathology in people with several years of development of the profession. Factors such as chalk dust exposure, smoking, stress, lack of vocal education, prolonged periods of vocal overuse, leadto an increase in the presence of this type of pathology.

[Vocal care: question of prevention and health]. / Cuidados vocais: questão de prevenção e saúde.

Planned by Brazilian doctors, the National Week of the Voice (Semana Nacional da Voz) conquered the world due to the huge reached success. This study has the objective to demonstrate the results reached during the 9th National Week of the Voice (9ª Semana Nacional da Voz) that took place in the Hospital das Clínicas of the Federal University of Goiás. During the event, 125 patients had been selected by the phonoaudiology team and manually filled a questionnaire elaborated for the campaign in the validity of possible pharyngolaryngeal alterations. The patients had been examined by the otorhinolaryngologist using indirect laryngoscopy and, when necessary, submitted to videolaryngoscopy. After medical evaluation, it was observed that 52 people (41.6%) had presented alterations in the speech organs or in proximal regions, in one patient paralysis of left vocal fold was detected and one patient presented tumoral injury. Considering all the patients attended, only one presented malignant neoplasm (squamous cell carcinoma), confirmed later by biopsy.

Cuidados vocais: questão de prevenção e saúde / Vocal care: question of prevention and health

Idealizada por médicos brasileiros, a Semana Nacional da Voz conquistou o mundo devido ao enorme sucesso alcançado. Este estudo tem por objetivo demonstrar resultados obtidos durante a 9ª Semana Nacional da Voz, realizada no Hospital das Clínicas da Universidade Federal de Goiás (UFG). Durante o evento, 125 pacientes foram triados pela equipe de fonoaudiologia, preencheram manualmente um questionário elaborado para a campanha, na vigência de possíveis alterações laringofaríngeas. Os pacientes foram examinados pelo otorrinolaringologista por meio da laringoscopia indireta e, quando necessário, submetidos à videolaringoscopia. Após avaliação médica, observou-se que 52 pessoas (41,6 por cento) apresentaram alterações no aparelho fonador ou em regiões proximais, em um paciente foi detectada paralisia de prega vocal esquerda e em outra lesão tumoral. Do total de pacientes atendidos, apenas um apresentou neoplasia maligna (carcinoma escamoso), confirmada posteriormente por meio de biopsia.

Planned by Brazilian doctors, the National Week of the Voice (Semana Nacional da Voz) conquered the world due to the huge reached success. This study has the objective to demonstrate the results reached during the 9th National Week of the Voice (9ª Semana Nacional da Voz) that took place in the Hospital das Clínicas of the Federal University of Goiás. During the event, 125 patients had been selected by the phonoaudiology team and manually filled a questionnaire elaborated for the campaign in the validity of possible pharyngolaryngeal alterations. The patients had been examined by the otorhinolaryngologist using indirect laryngoscopy and, when necessary, submitted to videolaryngoscopy. After medical evaluation, it was observed that 52 people (41,6 percent) had presented alterations in the speech organs or in proximal regions, in one patient paralysis of left vocal fold was detected and one patient presented tumoral injury. Considering all the patients attended, only one presented malignant neoplasm (squamous cell carcinoma), confirmed later by biopsy.