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2.
Artigo em Chinês | MEDLINE | ID: mdl-32086926

RESUMO

Objective:The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux (LPR), the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. Method:From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A (18-<40 years, n=86), group B (40-<60 years, n=107) and group C (≥60 years, n=65). The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Result:Among the three groups, group C had the highest diagnostic rate(93.85%). There was no significant difference in RFS score among the three groups (P>0.05), RSI score was significantly different (P<0.05), RSI score of group A and group B was higher than that of group C (P<0.05). According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. Conclusion:The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.


Assuntos
Fatores Etários , Refluxo Laringofaríngeo/diagnóstico , Adolescente , Adulto , Idoso , Humanos , Laringe/fisiopatologia , Pessoa de Meia-Idade , Faringe/fisiopatologia , Adulto Jovem
3.
Codas ; 32(4): e20190074, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049106

RESUMO

PURPOSE: To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. METHODS: 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). RESULTS: The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. CONCLUSION: The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.


Assuntos
Laringe/fisiopatologia , Fonação/fisiologia , Acústica da Fala , Qualidade da Voz/fisiologia , Treinamento da Voz , Idoso , Envelhecimento/fisiologia , Feminino , Ventilação de Alta Frequência/métodos , Humanos , Julgamento , Doenças da Laringe/complicações , Pessoa de Meia-Idade , Autoimagem , Autorrelato , Patologia da Fala e Linguagem/métodos , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia
4.
Jpn J Clin Oncol ; 50(2): 185-192, 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-31711185

RESUMO

BACKGROUND: Long-term side effects after radiotherapy for organ preservation 'could deteriorate' the laryngeal function. This study intended to identify the incidence of severe late dysphagia following the multimodal treatment for stage III/IV laryngeal and hypopharyngeal cancer 'to evaluate the function of larynx'. METHODS: The medical records of patients successfully treated for laryngeal and hypopharyngeal cancer with a multimodal approach, including radiotherapy, were retrospectively analyzed. 'Functional larynx was defined as tolerable oral diet without severe late dysphagia or tracheostoma'. RESULTS: The study included 99 patients with a median follow-up period of 72 months. 'Tracheostomy during the follow-up period was required in only one patient due to aspiration pneumonia, and dysphagia is the main determinant for functional larynx'. The probability of maintaining functional larynx was 63% for 10 years, when the treatment was started with radiotherapy or concurrent chemoradiotherapy. In upfront surgery (operation first and adjuvant radiotherapy/concurrent chemoradiotherapy) group, 37% of patients required total laryngectomy as primary treatment and 43% of patients could maintain laryngeal function for 10 years. And severe late dysphagia in the latter group developed mainly after laryngeal preservation surgery. The patients aged ≥65 years showed significantly higher incidence of dysphagia. Severe late dysphagia was very rare in laryngeal cancer successfully cured with radiotherapy/concurrent chemoradiotherapy (1/25, 4%); however, it gradually increased over time in hypopharyngeal cancer patients showing a statistically significant difference from laryngeal cancer patients (P = 0.040). CONCLUSION: Severe late dysphagia occurred in 19.2% of patients treated for laryngeal and hypopharyngeal cancers, regardless of whether treatment started with radiotherapy/concurrent chemoradiotherapy or surgery.


Assuntos
Transtornos de Deglutição/etiologia , Neoplasias Hipofaríngeas/terapia , Neoplasias Laríngeas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia/efeitos adversos , Terapia Combinada/efeitos adversos , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Neoplasias Hipofaríngeas/fisiopatologia , Neoplasias Hipofaríngeas/radioterapia , Neoplasias Hipofaríngeas/cirurgia , Neoplasias Laríngeas/fisiopatologia , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirurgia , Laringectomia/efeitos adversos , Laringectomia/métodos , Laringe/fisiopatologia , Laringe/cirurgia , Masculino , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/efeitos adversos , Radioterapia Adjuvante/efeitos adversos , Estudos Retrospectivos , Fatores de Risco
5.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(12): 912-918, 2019 Dec 07.
Artigo em Chinês | MEDLINE | ID: mdl-31887817

RESUMO

Objective: To establish a New Zealand rabbit animal model of laryngopharyngeal reflux disease (LPRD) using esophageal balloon together with metal internal stent dilation and to investigate the changes of mucosa. Methods: 20 New Zealand rabbits were randomly divided into experimental group and control group, with 10 in each group. Balloon dilatation and metal internal stent dilation were carried out in experimental group to reproduce the animal model of LPRD.The middle of balloon was placed at the lower esophageal sphincter (LES) while the stent was placed at the upper esophageal sphincter (UES). The guide wire was placed in the control group, but the balloon was not expanded and the stent was not placed. The general condition, pH value of hypopharynx, laryngeal histopathology and changes of pepsin content of New Zealand rabbits were observed regularly. The difference between experimental group and control group was compared. Results: The 24-hour Dx-pH monitoring results showed that the number of reflux episodes(20.0[9.5, 35.0], 13.0[6.5, 22.0]), and the percent time below pH 5.5 (1.36%[0.60%, 4.57%], 1.36%[0.43%, 2.77%]) in the experimental group at the 2nd and 4th week were significantly different from those in the control group (0[0,3.0], 1.0[0.5, 3.8]; 0[0, 0.01%], 0[0, 0], respectively, all P<0.01), suggesting that the experimental group New Zealand rabbits developed LPRD. Compared with the control group under microscope, lymphocytes infiltration and submucosal gland hyperplasia increased in the mucosa of the throat of the experimental group. The results of pepsin immunohistochemical staining between the two groups were statistically significant (P=0.014). Conclusion: The use of balloon dilatation of the LES combined with metal stent dilatation of the UES can successfully establish a laryngopharyngeal reflux model, and lesions in the throat tissue can be observed.


Assuntos
Modelos Animais de Doenças , Refluxo Laringofaríngeo , Laringe , Animais , Esfíncter Esofágico Inferior , Monitoramento do pH Esofágico , Laringe/fisiopatologia , Pepsina A , Coelhos
6.
Sci Adv ; 5(12): eaay3210, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31853500

RESUMO

Successful rehabilitation of oropharyngeal swallowing disorders (i.e., dysphagia) requires frequent performance of head/neck exercises that primarily rely on expensive biofeedback devices, often only available in large medical centers. This directly affects treatment compliance and outcomes, and highlights the need to develop a portable and inexpensive remote monitoring system for the telerehabilitation of dysphagia. Here, we present the development and preliminarily validation of a skin-mountable sensor patch that can fit on the curvature of the submental (under the chin) area noninvasively and provide simultaneous remote monitoring of muscle activity and laryngeal movement during swallowing tasks and maneuvers. This sensor patch incorporates an optimal design that allows for the accurate recording of submental muscle activity during swallowing and is characterized by ease of use, accessibility, reusability, and cost-effectiveness. Preliminary studies on a patient with Parkinson's disease and dysphagia, and on a healthy control participant demonstrate the feasibility and effectiveness of this system.


Assuntos
Técnicas Biossensoriais , Transtornos de Deglutição/diagnóstico , Monitorização Fisiológica , Doença de Parkinson/diagnóstico , Análise Custo-Benefício , Deglutição/fisiologia , Transtornos de Deglutição/fisiopatologia , Transtornos de Deglutição/reabilitação , Feminino , Humanos , Laringe/fisiopatologia , Masculino , Modelos Teóricos , Movimento/fisiologia , Doença de Parkinson/fisiopatologia
7.
Curr Opin Otolaryngol Head Neck Surg ; 27(6): 482-488, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31567493

RESUMO

PURPOSE OF REVIEW: The larynx is a complex organ that houses some of the most intricate structures of the human body. Owing to its delicate nature, the larynx is affected by different medications to varying degrees. Many of these effects manifest in subjective complaints in one's voice or swallow. This review article invokes the present available literature to describe the effects different medical agents have on the functionality of the laryngeal structures. RECENT FINDINGS: Multiple available studies explore the effects of inhaled corticosteroids on the larynx. While laryngeal candidiasis is a well known complication of chronic steroid use, other rarer fungal infections have also demonstrated themselves as risks. Among anesthetics, the literature suggests that sevoflurane in standard and high doses does not appear to significantly reduce the risk of laryngospasm. The use of topical and intravenous lidocaine appear to have conflicting evidence regarding their use in laryngospasm prevention, whereas postoperative sore throat, hoarseness, and cough may be prevented with preinduction nebulization of ketamine and magnesium sulfate or budesonide. SUMMARY: Further study is warranted to explore the effects that these and other classes of agents, such as antibiotics, have on the structure and function of the larynx.


Assuntos
Laringe/efeitos dos fármacos , Analgésicos/efeitos adversos , Anestésicos/efeitos adversos , Glucocorticoides/efeitos adversos , Humanos , Laringe/fisiopatologia
8.
Arq. bras. med. vet. zootec. (Online) ; 71(5): 1477-1482, set.-out. 2019. ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1038664

RESUMO

Recurrent laryngeal neuropathy (RLN) etiology can be acquired, iatrogenic or idiopathic. There are no previous reports of RLN caused by recurrent laryngeal nerve compression by melanomas. This report describes a horse presenting severe dyspnea and progressive weight loss. Physical exam demonstrated tachycardia, tachypnea, inspiratory dyspnea at rest, neck extension and mydriasis. Temporary tracheotomy was performed and videoendoscopic examination diagnosed grade IV laryngeal paralysis. The animal came suddenly to death by suppurative bacterial pneumonia. At necropsy, it was possible to observe multiple melanotic epithelioid melanoma nodules compressing the recurrent laryngeal nerve, alongside with lung and parotid metastasis. This finding emphasizes the importance of establishing a differential diagnosis for tumor mass compression in the etiology of RLN, especially melanomas in gray horses, with or without cutaneous manifestations of masses.(AU)


A neuropatia laríngea recorrente (NLR) pode apresentar etiologia adquirida, iatrogênica ou idiopática. Não há relatos prévios da ocorrência da NLR causada pela compressão do nervo laríngeo recorrente por melanomas. Este relato descreve um equino apresentando dispneia grave e perda de peso progressiva. O exame físico demonstrou taquicardia, taquipneia, dispneia inspiratória em repouso, extensão do pescoço e midríase. Foi realizada traqueotomia temporária e exame videoendoscópico, mediante o qual se diagnosticou paralisia laríngea grau IV. O animal veio a óbito por pneumonia bacteriana supurativa. Na necropsia, foi possível observar múltiplos nódulos de melanoma epitelioide amelanótico comprimindo o nervo laríngeo recorrente, juntamente com metástases pulmonares e parotídeas. Este achado enfatiza a importância de estabelecer um diagnóstico diferencial nos casos de NLR, pensando-se na compressão nervosa por massas tumorais, especialmente melanomas em cavalos tordilhos, com ou sem manifestações cutâneas de massas.(AU)


Assuntos
Animais , Masculino , Cavalos , Laringe/fisiopatologia , Melanócitos/patologia , Melanoma/fisiopatologia , Melanoma/veterinária
9.
Eur Arch Otorhinolaryngol ; 276(11): 3159-3164, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31485732

RESUMO

PURPOSE: Ultra-high-resolution computed tomography (UHRCT) is an emerging imaging technology that is able to achieve simultaneous 160 slices with super-thin 0.25 mm thickness. The purpose of this study was to assess the feasibility of UHRCT to visualize laryngeal structure and kinetics. METHODS: Three normal volunteers and three patients with unilateral vocal fold paralysis (UVFP) were incorporated in this case series. First, images were taken under five conditions in normal volunteers. Five tasks consisted of (1) air inspiration through the nose (IN), (2) breath holding (BH), (3) sustained vowel /i:/ phonation (IP), (4) humming phonation (HP), and (5) forced glottic closure during exhalation (FC). Three-dimensional CT images of arytenoid and cricoid cartilages, as well as virtual laryngoscopic images, were reconstructed using UHRCT data. Reconstructed images were compared among five conditions to assess the best tasks to picture laryngeal kinetics. Second, pre- and post-phonosurgical images were examined in UVFP patients to evaluate potential role of UHRCT to assess laryngeal pathology in hoarse patients. RESULTS: Among the five conditions, IN and IP conditions were considered suitable to visualize laryngeal structure at rest and during phonation, respectively. Kinetic abnormalities including asymmetric motion of arytenoid cartilages were elucidated in UVFP patients, and virtual endoscopy visualized the clinically invisible posterior three-dimensional glottic chinks. Furthermore, UHRCT was useful to understand changes in laryngeal structure achieved by phonosurgery. CONCLUSIONS: UHRCT is an emerging imaging technology that can be used for minimally invasive visualization and assessment of laryngeal structure and kinetics. Future studies to assess more number of patients with laryngeal dysfunction are warranted.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Laringe , Tomografia Computadorizada Multidetectores/métodos , Paralisia das Pregas Vocais , Adulto , Cartilagem Aritenoide/diagnóstico por imagem , Feminino , Humanos , Cinética , Laringoplastia/métodos , Laringoscopia/métodos , Laringe/diagnóstico por imagem , Laringe/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fonação/fisiologia , Reprodutibilidade dos Testes , Paralisia das Pregas Vocais/diagnóstico , Paralisia das Pregas Vocais/fisiopatologia , Paralisia das Pregas Vocais/cirurgia
10.
Int. arch. otorhinolaryngol. (Impr.) ; 23(3): 331-337, July-Sept. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1040030

RESUMO

Abstract Introduction Sulcus vocalis is defined as a longitudinal depression on the vocal cord, parallel to its free border. Its most marked characteristic is breathlessness, caused by incomplete glottal closure, in addition to roughness, due to the decrease in mucosal wave amplitude of the vocal cords. Vocal acoustic aspects, such as fundamental voice frequency, jitter, and shimmer, may also be altered in individuals with this type of laryngeal disorder. To assess the voice of individuals with sulcus vocalis, studies generally include a sample of subjects with vocal symptoms, excluding asymptomatic persons. To better characterize the vocal characteristics of individuals with sulcus vocalis, their asymptomatic counterparts must also be included. Objective Characterize the larynx and voice of asymptomatic adults with sulcus vocalis. Method A total of 26 adults, 13 with sulcus vocalis (experimental group) and 13 without (control group) were assessed. All the participants were submitted to suspension microlaryngoscopy, voice self-assessment, auditory perception and acoustic evaluation of the voice. Results Among the individuals with sulcus vocalis, 78% of the sulci were type I and 22% type II. Auditory perception assessment obtained statistically significant lower scores in individuals with sulcus vocalis compared with the control group, and a slight difference in the overall degree of hoarseness and roughness. No statistically significant intergroup diferences were found in self-reported voice or acoustic assessment. Conclusion Type I was the predominant sulcus vocalis observed in individuals without voice complaints, who may also exhibit slight changes in vocal quality and roughness.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Prega Vocal/fisiopatologia , Doenças da Laringe/fisiopatologia , Laringe/fisiopatologia , Percepção Auditiva , Acústica da Fala , Qualidade da Voz , Estudos Transversais
11.
Int J Lang Commun Disord ; 54(6): 894-901, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31364256

RESUMO

BACKGROUND: Oropharyngeal dysphagia and laryngeal dysfunction are two lesser known complications after lung and heart transplantation. The presence of these features places this immunocompromised population at high risk of pulmonary complications and subsequent medical deterioration. Early identification of swallowing and voice dysfunction would be beneficial to optimize management. AIMS: To examine the association between patient risk factors and postoperative outcomes with referral to speech pathology (SP) following signs of swallowing and voice dysfunction. METHODS & PROCEDURES: A retrospective review was conducted on demographic data, patient risk factors and postoperative course in 284 patients following lung and/or heart transplantation between 2010 and 2013. Variables were analysed for any association between pre- and postoperative factors and SP referral. OUTCOMES & RESULTS: A total of 24% were referred to SP with a mean age of 47 years. Binary logistic regression identified a statistically significant association between the number of intubations (odds ratio (OR) = 2.066, p = 0.028), intubation duration (OR = 1.004, p < 0.01), length of stay in the intensive care unit (ICU) (OR = 1.068, p < 0.01), and number of ICU admissions (OR = 1.384, p = 0.046) and SP referral. Intubation time and the total days in ICU were greater for patients referred to SP. Mortality also increased for these variables and for the numbers of reintubations and readmissions. Analysis of pre-operative risk factors revealed cerebrovascular disease to be a significant predictor of SP referral (OR = 6.747, p = 0.032). CONCLUSIONS & IMPLICATIONS: This study demonstrates significant clinical indicators for referral to SP for the management of oropharyngeal dysphagia and laryngeal dysfunction in patients after lung or heart transplantation. Further studies are needed to investigate the most efficacious intervention approaches to manage swallowing and voice dysfunction in these patients.


Assuntos
Transtornos de Deglutição/etiologia , Transplante de Coração/efeitos adversos , Laringe/fisiopatologia , Transplante de Pulmão/efeitos adversos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Fonoterapia , Distúrbios da Voz/etiologia , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/terapia , Adulto Jovem
12.
Rev Esp Salud Publica ; 932019 Aug 09.
Artigo em Espanhol | MEDLINE | ID: mdl-31395851

RESUMO

OBJECTIVE: The voice in the academic context is a determining factor in the life of the teaching staff. The objective of this study was to evaluate the index vocal inability of in-service teachers and check your involvement the occupational conditions. METHODS: For it, a descriptive-inferential study is done of cross-section to 480 teachers (average age: 45.14 ± 9.22), applying the questionnaire of vocal disability index (HIV-30). Using descriptive statistical techniques (mean and standard deviation) and inferential techniques (ANOVA). Statistical analysis was performed using SPSS v.23.0. RESULTS: When applying the Voice Handicap Index (VHI-30) evidenced that teachers present a moderate vocal disability (41.2 rating), with increased risk in physical ability and own vocal function. Moreover, it was found that gender, educational stage, teaching load, antique, daily and weekly hours, student ratio and level of noise in the classroom, significantly affect the disturbance of the voice. It also shows more presence of dysphonia in teachers who perceive a progressive worsening of her voice throughout the day or week, and is absent in the work due to disorders of the voice. CONCLUSIONS: In conclusion, teachers attributed their laryngeal discomfort mainly to factors of the teaching context.


Assuntos
Disfonia/diagnóstico , Disfonia/etiologia , Ensino , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/etiologia , Qualidade da Voz , Adulto , Docentes , Feminino , Humanos , Laringe/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Espanha , Estudantes , Inquéritos e Questionários
13.
Zhonghua Zhong Liu Za Zhi ; 41(7): 535-539, 2019 Jul 23.
Artigo em Chinês | MEDLINE | ID: mdl-31357842

RESUMO

Objective: To analyze the long-term outcome of patients with pyriform sinus squamous cell carcinoma treated with planned preoperative (chemo-) radiotherapy plus laryngeal function sparing surgery. Methods: Patients with stage Ⅲ/Ⅳ pyriform sinus squamous cell carcinoma treated with planned preoperative (chemo-) radiotherapy plus laryngeal function sparing surgery during 1999 to 2000 were retrospectively analyzed. Data including concurrent chemotherapy or not, postoperative pathological diagnosis, postoperative complications, recurrence and survival were collected. Twenty patients were treated with preoperative radiotherapy while 14 patients with preoperative chemo-radiotherapy. Results: Among 31 cases of postoperative pathological diagnosed as pyriform sinus, 12 (38.7%) cases without tumor residue, 7 (22.5%) cases with severe radiation response and 12 (38.7%) cases with tumor residue. The 5-year cumulative local recurrence rate, regional recurrence rate and distant metastasis rate was 14.5%, 13.7% and 23.5%, respectively. Five-year cumulative overall survival rate and recurrence-free survival rate were 69.6% and 65.4%, respectively. Nine deaths were attributed to distant metastasis (8 cases) and regional recurrence (1 case). Conclusion: Most patients with pyriform sinus squamous cell carcinoma acquire long-term survival after treated with planned preoperative (chemo-) radiotherapy plus laryngeal function sparing surgery, and distant metastasis is the main cause of death.


Assuntos
Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/métodos , Terapia Combinada/métodos , Neoplasias Hipofaríngeas/patologia , Neoplasias Hipofaríngeas/terapia , Laringe/fisiopatologia , Seio Piriforme/patologia , Radioterapia Adjuvante , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Humanos , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Faringectomia/métodos , Complicações Pós-Operatórias , Seio Piriforme/efeitos da radiação , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
14.
Artigo em Chinês | MEDLINE | ID: mdl-31315361

RESUMO

Objective: To compare the carcinogenic abilities of CD133(+)CD44(+) laryngeal cancer stem cells and general laryngeal cancer stem cells and to identify the mechanism underlying the action of miRNAs. Methods: Solid tumor-derived laryngeal carcinoma stem cells and Hep-2-derived laryngeal carcinoma stem cells were cultured, and CD133(+)CD44(+) laryngeal cancer stem cells were sorted by flow cytometry. Boden chamber invasion assay, cell migration assay and tumor formation assay were then performed to compare the invasion, migration and tumorigenic abilities of CD133(+)CD44(+) laryngeal cancer stem cells and general laryngeal cancer stem cells. And then, miRNAs isolated from two laryngeal cancer stem cells were detected and analysed with miRNA chip. Results: (1)In Boyden chamber invasion assay, the cell invasion rate of CD133(+)CD44(+) laryngeal cancer stem cells was obviously higher (80.2%±2.3% vs. 63.9%±3.2%, t=5.011, P=0.027); (2)CD133(+)CD44(+) laryngeal cancer stem cells also had higher mobility in cell migration assay (82.9%±1.1% vs. 70.9%±0.6%, t=4.514, P=0.031); (3)In tumor formation assay, the tumor formation rate of CD133(+)CD44(+) laryngeal cancer stem cells was also higher (80% vs. 50%). What's more, we identified 15 miRNAs that were significantly upregulated in CD133(+)CD44(+) laryngeal cancer stem cells and 3 miRNAs that were significantly downregulated in CD133(+)CD44(+) laryngeal cancer stem cells, compared with normal laryngeal cancer stem cells. Conclusions: CD133(+)CD44(+) laryngeal cancer stem cells have stronger invasion, migration and tumorigenic abilities compared with normal laryngeal cancer stem cells, and the difference of miRNAs' expression is one of the possible causes.


Assuntos
Neoplasias Laríngeas/fisiopatologia , MicroRNAs/biossíntese , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Antígeno AC133/biossíntese , Carcinogênese/metabolismo , Linhagem Celular Tumoral , Movimento Celular/fisiologia , Humanos , Receptores de Hialuronatos/biossíntese , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/patologia , Laringe/metabolismo , Laringe/patologia , Laringe/fisiopatologia , Invasividade Neoplásica/fisiopatologia , Processos Neoplásicos
15.
Otolaryngol Pol ; 73(3): 11-15, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-31249146

RESUMO

Vestibular voice includes participation of larynx structures which are absent in physiological process. Vestibular phonation may be desired when vocal folds are damaged as in paralytic dysphonia, or undesired in marginal hyperfunction. Vestibular voice may result from psychogenic dysphonia - phononeurosis. The aim of the study is perceptive evaluation of vestibular voice, objective larynx visualization, acoustic and aerodynamic examination. The study included 40 patients: 20 with vestibular voice, 20 with euphonic voice. Voice quality has been evaluated using perceptual GRBAS scale. Endoscopic and stroboscopic larynx examination used Endo-STROB-EL-Xion GmbH with visual tract. High-Speed Digital Imaging (HSDI) and High Speed (HS) camera registered true vocal folds vibrations. Acoustic evaluation of voice with DiagnoScope Specjalista, DiagNova Technologies included analysis of F0, Jitter, Shimmer, NHR, nonharmonic components. MPT has been analyzed. In examined group, hoarseness (95%), roughness (75%) and voice strain (55%) have been recorded. Endoscopy revealed edema of vestibular folds with dilation of vessels covering glottis. Stroboscopy and HSDI confirmed coexistence of hyperfunctional (95%) or paralytic (5%) dysphonia. Acoustic assessment revealed increase in Jitter, Shimmer, NHR and decrease in F0 and MPT. The vestibular voice is observed most frequently in women with hyperfunctional dysphonia (phononeuroses) or in paralytic dysphonia. Visualization techniques confirm the coexistence of vestibular folds hypertrophy and edema with vibration disorders. In the perceptual assessment, vestibular voice was hoarse, rough and strained. Acoustic examination showed increase of Jitter, Shimmer, NHR, presence of nonharmonic components and decrease of F0 and MPT.


Assuntos
Prega Vocal/fisiopatologia , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/fisiopatologia , Qualidade da Voz , Adulto , Feminino , Humanos , Laringe/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fonação , Adulto Jovem
16.
Otolaryngol Clin North Am ; 52(4): 617-625, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31072642

RESUMO

Presbyphonia is defined as aging of the voice, and its growing attention as a medical concern parallels the continuing increase of the geriatric population worldwide. It results from physiologic changes to several laryngeal structures, including the musculature, surrounding cartilage, and lamina propria of the vocal folds. Characterized by glottic insufficiency, dysphonia in the elderly typically presents as a deterioration of voice quality, altered pitch and fundamental frequency, vocal fatigue, and strain. Fortunately, there are multiple treatment options that have proven successful in improving quality of life and restoring vocal stability for these patients.


Assuntos
Disfonia/diagnóstico , Disfonia/terapia , Qualidade da Voz , Idoso , Envelhecimento/patologia , Disfonia/fisiopatologia , Humanos , Laringoplastia , Laringe/fisiopatologia , Qualidade de Vida , Acústica da Fala , Estroboscopia , Engenharia Tecidual , Treinamento da Voz
17.
Pulm Pharmacol Ther ; 56: 108-115, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31004747

RESUMO

The larynx is one of the most highly innervated organs in humans, adapted to simultaneously deliver several key respiratory functions including airway protection, swallowing and phonation. In some individuals the larynx can adopt a state that could be considered 'dysfunctional' or maladaptive; resulting in or contributing to a range of clinical disorders such as chronic refractory cough, inducible laryngeal obstruction (previously termed paradoxical vocal fold movement or vocal cord dysfunction), muscle tension dysphonia and globus pharyngeus. These disorders appear to display significant overlap in clinical symptomology and in many cases have features of concomitant or allied sensory dysfunction; often described as laryngeal hypersensitivity. The recognition and accurate assessment of both laryngeal dysfunction±hypersensitivity is important to ensure accurate diagnosis and effective delivery of targeted treatment and therapeutic monitoring. Accordingly, there is increasing in the methodologies proposed to assess laryngeal function. These range from simple questionnaires to targeted investigation(s), assessing both sensory function and the laryngeal motor response, under both resting and provoked situations. This review provides a brief overview of the current state of knowledge in the field of laryngeal dysfunction and hypersensitivity assessment.


Assuntos
Doenças da Laringe/fisiopatologia , Laringe/fisiologia , Animais , Tosse/etiologia , Tosse/fisiopatologia , Disfonia/etiologia , Disfonia/fisiopatologia , Sensação de Globus/fisiopatologia , Humanos , Doenças da Laringe/diagnóstico , Doenças da Laringe/terapia , Laringe/fisiopatologia
18.
Artigo em Alemão | MEDLINE | ID: mdl-30866025

RESUMO

Independent of the type of critical illness, tracheostomized patients have a high risk of developing a dysphagia. This is potentially life-threatening as it can lead to aspiration and pneumonia. It is therefore essential to perform swallowing diagnostics by means of a bolus dyeing test and/or FEES before oral feeding. Since a physiological airflow through the larynx and adequate subglottic pressure are key components of an effective swallowing act, oralisation should be avoided as far as possible with a blocked tracheal cannula.


Assuntos
Transtornos de Deglutição , Laringe , Respiração Artificial , Traqueia , Traqueotomia , Deglutição , Transtornos de Deglutição/etiologia , Humanos , Laringe/fisiopatologia , Respiração Artificial/efeitos adversos , Traqueia/fisiopatologia , Traqueotomia/efeitos adversos
19.
NeuroRehabilitation ; 44(2): 231-238, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30856123

RESUMO

BACKGROUND: Despite the importance of understanding penetration-aspiration (PA) in patients with stroke, the pathophysiology of PA remains unclear. OBJECTIVES: This study aimed to investigate the temporal characteristics of PA in post-stroke patients in terms of the timing of the PA event and hyolaryngeal incoordination. METHODS: Fifty-eight swallows (38 stroke patients), showing PA when swallowing a thin liquid, were included. The timing of PA was classified kinematically as before or during the swallow. The movement sequence of vertical laryngeal elevation, horizontal hyoid excursion, and epiglottic rotation were compared with healthy controls. Spatiotemporal measurements, videofluoroscopic dysphagia scale parameters were compared between subgroups. RESULTS: Thirteen swallows (22.4%) were classified as PA before the swallow and 45 were classified as PA during the swallow (77.6%). Among the PA during the swallow, 26 (57.8%) swallows exhibited abnormal sequences of hyolaryngeal movements and 19 (42.2%) swallows showed normal sequences of hyolaryngeal movements compared with healthy controls. The onset time of horizontal hyoid excursion (P = 0.028), the time to maximal horizontal hyoid excursion (P = 0.010), and maximal epiglottic rotation (P = 0.030) were significantly more delayed in the PA during the swallow group than in the PA before the swallow group. In the swallows with abnormal sequential movements, the onset of horizontal hyoid excursion occurred significantly later than the onset of epiglottic rotation (P < 0.001). Pyriform sinus residue was observed significantly more often in the swallows with abnormal sequences (P = 0.030) than in the swallows with normal sequences. CONCLUSIONS: The timing of PA can be classified as before and during the swallow with significantly different temporal characteristics. The horizontal movement of hyoid is the most important factor associated with the pathophysiology of PA in stroke patients.


Assuntos
Transtornos de Deglutição/fisiopatologia , Deglutição , Laringe/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Fenômenos Biomecânicos , Transtornos de Deglutição/etiologia , Feminino , Humanos , Osso Hioide/fisiopatologia , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações
20.
Pediatr Clin North Am ; 66(2): 475-488, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30819349

RESUMO

Stridor in the newborn period may result from numerous causes, both congenital and acquired. Its presentation is diverse, and understanding the subtleties of that diversity is the key to determining the likely cause of the stridor, as well as the urgency for specialist evaluation. This article presents a framework for evaluating the quality of stridor in the newborn, as well as a review of the characteristics of stridor associated with entities commonly encountered in the neonatal airway.


Assuntos
Doenças da Laringe/diagnóstico , Sons Respiratórios/etiologia , Doenças da Traqueia/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Laringe/fisiopatologia , Masculino , Sons Respiratórios/diagnóstico , Traqueia/fisiopatologia
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