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2.
Rev Med Suisse ; 16(709): 1845-1848, 2020 Oct 07.
Artigo em Francês | MEDLINE | ID: mdl-33026725

RESUMO

The surgical management of unilateral and bilateral vocal cord paralysis depends on the severity of the condition, the potential for spontaneous recovery, the patient's age and vocal expectations. Standardized re-innervation surgeries, unilateral non-selective and bilateral selective, are viable alternatives to static procedures currently under evaluation in prospective studies. Neurorraphy of the ansa cervicalis loop to the recurrent laryngeal nerve allows lasting vocal recovery and potentially superior results to medialization and thyroplasty, by maintaining the visco-elastic properties of the vocal cord and preventing its atrophy. Selective bilateral reinnervation shows potential for recovery of inspiratory abduction with improved respiratory function without vocal deterioration.


Assuntos
Laringe/cirurgia , Nervo Laríngeo Recorrente/cirurgia , Paralisia das Pregas Vocais/cirurgia , Prega Vocal/cirurgia , Humanos , Estudos Prospectivos
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2167-2172, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018436

RESUMO

Vocal folds (VFs) play a critical role in breathing, swallowing, and speech production. VF dysfunctions caused by various medical conditions can significantly reduce patients' quality of life and lead to life-threatening conditions such as aspiration pneumonia, caused by food and/or liquid "invasion" into the windpipe. Laryngeal endoscopy is routinely used in clinical practice to inspect the larynx and to assess the VF function. Unfortunately, the resulting videos are only visually inspected, leading to loss of valuable information that can be used for early diagnosis and disease or treatment monitoring. In this paper, we propose a deep learning-based image analysis solution for automated detection of laryngeal adductor reflex (LAR) events in laryngeal endoscopy videos. Laryngeal endoscopy image analysis is a challenging task because of anatomical variations and various imaging problems. Analysis of LAR events is further challenging because of data imbalance since these are rare events. In order to tackle this problem, we propose a deep learning system that consists of a two-stream network with a novel orthogonal region selection subnetwork. To our best knowledge, this is the first deep learning network that learns to directly map its input to a VF open/close state without first segmenting or tracking the VF region, which drastically reduces labor-intensive manual annotation needed for mask or track generation. The proposed two-stream network and the orthogonal region selection subnetwork allow integration of local and global information for improved performance. The experimental results show promising performance for the automated, objective, and quantitative analysis of LAR events from laryngeal endoscopy videos.Clinical relevance- This paper presents an objective, quantitative, and automatic deep learning based system for detection of laryngeal adductor reflex (LAR) events in laryngoscopy videos.


Assuntos
Laringoplastia , Laringe , Humanos , Laringoscopia , Laringe/diagnóstico por imagem , Qualidade de Vida , Prega Vocal
5.
PLoS One ; 15(9): e0239544, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966339

RESUMO

Injection laryngoplasty (IL) has been used to treat various types of glottal insufficiency. The precise volume and location of the injected materials impact the outcomes. However, exactly how increasing volumes of material are distributed is unknown. In fact, the amount of IL material required to medialize a vocal cord tends to be determined empirically. Thus, the goal of this study was to investigate the pattern of IL material distribution by checking serial micro-computed tomography (MCT) and pressure changes during ILs. This experimental study used 10 excised canine larynges. Experimental devices included the IL syringe, pressure sensor, infusion pump, fixed frame, and monitoring system. We injected calcium hydroxyapatite in the thyroarytenoid muscle; whenever 0.1 mL of material was injected, we obtained an MCT scan while simultaneously measuring the pressure. After the experiments, we performed histologic analyses. MCT analyses showed that materials initially expanded centrifugally and then expanded in all directions within the muscle. The pressure initially increased rapidly but then remained relatively constant until the point at which the materials expanded in multiple directions. Histologic analyses showed that the IL material tended to expand within the epimysium of the thyroarytenoid muscle. However, in some cases, the MCT revealed that there were leakages to the surrounding space with a corresponding pressure drop. If the IL material passes through the epimysium, leakage can occur in the surrounding space, which can account for the reduction in resistance during ILs.


Assuntos
Laringoplastia/métodos , Animais , Materiais Biocompatíveis/administração & dosagem , Cães , Durapatita/administração & dosagem , Técnicas In Vitro , Injeções/efeitos adversos , Injeções/instrumentação , Injeções/métodos , Músculos Laríngeos/diagnóstico por imagem , Músculos Laríngeos/cirurgia , Laringe/diagnóstico por imagem , Laringe/cirurgia , Modelos Animais , Pressão , Prega Vocal/diagnóstico por imagem , Prega Vocal/cirurgia , Microtomografia por Raio-X
6.
Artigo em Chinês | MEDLINE | ID: mdl-32791777

RESUMO

Objective: To investigate whether laryngopharyngeal reflux(LPR) is an independent risk factor for vocal fold polyps and to analyze the potential mechanism. Methods: Case control survey was designed. Subjects who came to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Chongqing Medical University from September 2018 to December 2019, including 152 cases with vocal fold polyps and 176 cases with normal vocal folds, were selected. All the subjects filled in a questionnaire and were assessed by the reflux symptom index (RSI) and the reflux finding score (RFS) scale. RSI>13 and(or) RFS>7 were classified as LPR. Chi-square test, univariate and multivariate unconditional logistic regression models were used for statistical analysis. Results: The incidence of LPR and throat clearing in vocal fold polyps group (47.37%, 73.68%) was significantly higher than that in control group (27.27%, 59.09%), with statistically significant difference (P<0.001, P=0.005, respectively). The incidence of troublesome cough, indigestion or stomach acid coming up was no difference between the two groups(P=0.672, P=0.099). Multivariate unconditional logistic regression analysis showed that LPR (OR=1.815, 95%CI:1.061-3.103), occupational exposure(OR=2.655, 95%CI:1.397-5.042), spicy food(OR=1.958, 95%CI:1.142-3.355) were risk factors for vocal fold polyps. Conclusion: LPR, occupational exposure, spicy food are independent risk factors for vocal fold polyps. Frequent throat clearing caused by LPR may be the main cause of vocal ford polyps. In order to prevent vocal fold polyps, we need to take action to treat laryngopharyngeal reflux disease actively.


Assuntos
Doenças da Laringe , Refluxo Laringofaríngeo , Pólipos , Prega Vocal/patologia , Estudos de Casos e Controles , Humanos , Doenças da Laringe/etiologia , Doenças da Laringe/patologia , Refluxo Laringofaríngeo/complicações , Pólipos/patologia , Fatores de Risco , Inquéritos e Questionários
7.
Wilderness Environ Med ; 31(3): 332-336, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32800447

RESUMO

We report a case of a 42-y-old female patient who sustained a sting to the neck from a Trachinus draco fish. She subsequently developed complications including arytenoid membrane edema secondary to either the local anesthetic agent administered to the wound or the dracotoxin itself. The patient was examined in the emergency department after the sting. Local anesthesia with lidocaine was administered to the areas of injury at another hospital before presenting to our hospital emergency department. The patient reported that her pain partially decreased but hoarseness developed and she had difficulty breathing after the local anesthetic was administered. Laryngeal examination by our hospital's otolaryngologist revealed edema of the patient's right arytenoid membrane without evidence of vocal cord swelling. Computed tomography of the neck revealed edema in the right arytenoid membrane on the side of the neck where the local anesthetic had been injected. The patient, who was given supplementary treatment, was discharged without any complications on the seventh day of hospitalization. The principle treatment for these types of stings includes immersion in hot water, analgesic therapy, and observation for signs of local and systemic envenomation. We recommend using caution when injecting local anesthetic agents in the neck because of underlying vital structures.


Assuntos
Analgésicos/efeitos adversos , Mordeduras e Picadas/patologia , Edema/tratamento farmacológico , Venenos de Peixe/efeitos adversos , Manejo da Dor , Prega Vocal/patologia , Adulto , Analgésicos/uso terapêutico , Animais , Mordeduras e Picadas/tratamento farmacológico , Edema/induzido quimicamente , Edema/diagnóstico , Feminino , Peixes , Humanos , Injeções Subcutâneas
8.
HNO ; 68(9): 666-677, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32833057

RESUMO

Tumors of the larynx can substantially impair vocal function, breathing and also swallowing. The primary goal of reconstructive surgical treatment of laryngeal tumors is to sufficiently resect the tumor while minimizing the effects of the treatment on the voice, breathing and swallowing. In general, primary reconstructions in primary laryngeal surgery have many advantages. The tissue at this point in time is soft because the scarring process has not yet been initiated. A better prerequisite for a sufficient glottic closure can also be expected through the immediate adjustment of the volume of the vocal folds; however, reconstructive treatment can also be carried out secondarily. Different methods of reconstructive surgery for laryngeal carcinoma are presented and discussed.


Assuntos
Neoplasias Laríngeas , Laringe , Procedimentos Cirúrgicos Reconstrutivos , Deglutição , Humanos , Neoplasias Laríngeas/cirurgia , Laringe/cirurgia , Prega Vocal
9.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 34(3): 218-222;226, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32791586

RESUMO

Objective:To explore the feasibility and effectiveness of medialization thyroplasty for the treatment of unilateral vocal fold immobility (UVFI). Method:Eight UVFI patients were performed medialization thyroplasty under local anesthesia. We made a window in the thyroid cartilage under local anesthesia, then insert the preformed silicone implant. The paralyzed vocal fold was medialized to make the glottis closed. Fibrolaryngoscope video recording, subjective voice analysis and CT thin slice scan of larynx were done before and after surgery to evaluate closure of vocal cords, improvement of voice and position of implantation. Result:The preoperative and postoperative voice handicap index 30(VHI-30) of the 8 patients were 91.5(64.5, 97.5) and 22.5(5.0, 47.5) respectively, which showed statistical difference(P<0.05). GRBAS results: The postoperative G, R, B, A were all smaller than preoperative ones, which showed statistical difference(P<0.05); the pre and postoperative S was both 0. The fibrolaryhgoscope recording showed the preoperative and postoperative score of incomplete glottis closure was 1.0(1.0, 1.0) and 4.0(2.5, 5.0) respectively, which showed statistical difference(P<0.05). Postoperative laryngeal CT showed significant vocal cord medialization on the affected side. Aspiration was significantly improved in 4 patients who were suffered from this symptom before the surgery. No complication occurred with the 8 patients during 5 to 48 months follow up. Conclusion:Medialization thyroplasty can effectively improve vocalization and quality of life in patients with UVFI.


Assuntos
Laringoplastia , Paralisia das Pregas Vocais/cirurgia , Glote , Humanos , Qualidade de Vida , Prega Vocal
10.
Artigo em Chinês | MEDLINE | ID: mdl-32791621

RESUMO

Objective:To explore the ability of narrowband imaging to predict the nature of leukoplakia of the vocal cords Method:In 46 patients with leukoplakia of the vocal cords, laryngoscopy was performed simultaneously with white light and narrow-band imaging modes. Type the images and compare with the postoperative pathological results. The receiver operating characteristic curve and the area under the curve are used to judge the diagnostic accuracy of different examination methods. Result:The AUC in white light mode is 0.642, which predicts the sensitivity of early vocal cord cancer is 41.67%, and the specificity is 97.06%; For NBI mode, the AUC is 0.896(P<0.05) and its sensitivity and specificity is 58.33% and 97.06%, respectively. Conclusion:Compared with white light mode, NBI mode is more sensitive and accurate in identification of benign and malignant vocal cord lesions.


Assuntos
Leucoplasia , Prega Vocal , Endoscópios , Humanos , Imagem de Banda Estreita , Prognóstico , Sensibilidade e Especificidade
11.
Artigo em Chinês | MEDLINE | ID: mdl-32842185

RESUMO

Objective:To study the clinical characteristics and common etiology of vocal cord leukoplakia, and explore the treatment principle. Method:One hundred and fifty-seven patients with vocal cord leukoplakia were recruited in this study. They were assessed by routine laryngoscope, narrow band imaging (NBI), stroboscope, reflux finding score (RFs) and reflux symptom index (RSI), and given conservative treatment (smoking cessation, alcohol, acid suppression, sound cessation, etc.) and/or surgical treatment. Result:Among 157 patients with leukoplakia of vocal cord, 109 (69.4%) had basically improved or cured after conservative treatment. Forty-eight cases underwent operation. The postoperative pathological diagnosis was mild dysplasia in 2 cases (1.3%), moderate dysplasia in 15 cases (9.6%), severe dysplasia or carcinoma in situ in 19 cases (12.1%), and invasive carcinoma in 12 cases (7.6%). Conclusion:NBI and stroboscopic laryngoscopy showed that most of the leukoplakia of vocal cord was non-malignant in nature, which was not in accordance with the indication of operation. Conservative treatment is effective. Biopsy or operation was indicated in only a few patients. Moreover, most of the patients are accompanied by laryngopharyngeal reflux, and the treatment of acid suppression is effective.


Assuntos
Doenças da Laringe , Refluxo Laringofaríngeo/cirurgia , Humanos , Laringoscopia , Leucoplasia , Imagem de Banda Estreita , Prega Vocal
12.
Artigo em Chinês | MEDLINE | ID: mdl-32842220

RESUMO

Objective:To explore the effect of vocal cord reconstruction with sternohyoid muscle flap pedicled with vertical anterior laryngectomy. Method:The clinical data of 43 cases of laryngeal carcinoma were analyzed retrospectively. According to whether the vocal cords were reconstructed, they were divided into vocal cord reconstruction group and non reconstruction group. Among them, 20 patients in the reconstruction group were reconstructed with pedicled sternohyoid muscle flap and 23 patients in non-reconstruction group. In the non reconstruction group, the external membrane of thyroid cartilage was used to repair the wounds. Postoperative respiratory function, swallowing function, pronunciation function, postoperative prognosis, complications, and recurrence rate were compared between the two groups. Reconstruction of glottis after vocal cord reconstruction was evaluated by electronic laryngoscope and CT scan. Result:①Patients in both groups survived during the follow-up period. One patient in the non-reconstructed group had recurrence, and the reconstituted group had no relapse, 3 cases with complications occurred in the reconstruction group, including 2 cases with granulation tissue in the glottic area, 1 case with laryngeal fistula, and 2 cases with aspiration pneumonia were found in the non-reconstruction group. ②1 year postoperative tracheal cannula removal rate, gastric tube removal and pronunciation quality: the tracheal cannula removal rate was 100% in the two groups after surgery; the gastric tube removal time in the reconstruction group was(13.2±2.8) days, and (16.6±5.3) days in the non-reconstruction group (P<0.05); reconstruction group had good pronunciation in 10 cases, moderate in 6 cases, and poor in 4 cases. Non-reconstructed group had good pronunciation in 4 cases, medium in 14 cases, and poor in 5 cases. Those with moderate or higher were compared no significant difference (P>0.05), and those with good pronunciation were statistically different (P<0.05). ③The transverse and anteroposterior diameter in reconstruction group was similar with the normal people (P>0.05); however, the transverse and anteroposterior diameter in the non-reconstructed group was significantly different with that of the normal people (P>0.05), the transverse diameter of the reconstructed group and the non-reconstructed group were compared with no significant difference (P>0.05), but there was significant difference in the anteroposterior diameter between the two groups (P<0.05). The area in both groups were different with the normal people (P<0.05); ④Glottic area morphology: the two groups of patients showed different degrees of swelling in the arytenoid cartilage area, the shape of the glottic region in the reconstructed group was approximately triangular, and the glottic morphology in the non-reconstructed group was approximately circular. Conclusion:After vocal cord reconstruction, there were increased rate of tracheal cannula extubation, well covered wallowing and phonation function, and the quality of life of patients was improved.


Assuntos
Neoplasias Laríngeas/cirurgia , Laringectomia , Glote , Humanos , Recidiva Local de Neoplasia , Qualidade de Vida , Estudos Retrospectivos , Prega Vocal
13.
PLoS One ; 15(7): e0236348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735560

RESUMO

Vocal folds are a viscoelastic multilayered structure responsible for voice production. Vocal fold epithelial damage may weaken the protection of deeper layers of lamina propria and thyroarytenoid muscle and impair voice production. Systemic dehydration can adversely affect vocal function by creating suboptimal biomechanical conditions for vocal fold vibration. However, the molecular pathobiology of systemically dehydrated vocal folds is poorly understood. We used an in vivo rabbit model to investigate the complete gene expression profile of systemically dehydrated vocal folds. The RNA-Seq based transcriptome revealed 203 differentially expressed (DE) vocal fold genes due to systemic dehydration. Interestingly, function enrichment analysis showed downregulation of genes involved in cell adhesion, cell junction, inflammation, and upregulation of genes involved in cell proliferation. RT-qPCR validation was performed for a subset of DE genes and confirmed the downregulation of DSG1, CDH3, NECTIN1, SDC1, S100A9, SPINK5, ECM1, IL1A, and IL36A genes. In addition, the upregulation of the transcription factor NR4A3 gene involved in epithelial cell proliferation was validated. Taken together, these results suggest an alteration of the vocal fold epithelial barrier independent of inflammation, which could indicate a disruption and remodeling of the epithelial barrier integrity. This transcriptome provides a first global picture of the molecular changes in vocal fold tissue in response to systemic dehydration. The alterations observed at the transcriptional level help to understand the pathobiology of dehydration in voice function and highlight the benefits of hydration in voice therapy.


Assuntos
Desidratação/genética , Músculos Laríngeos/metabolismo , Prega Vocal/metabolismo , Distúrbios da Voz/genética , Animais , Fenômenos Biomecânicos , Adesão Celular/genética , Proliferação de Células/genética , Desidratação/metabolismo , Desidratação/patologia , Modelos Animais de Doenças , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Regulação da Expressão Gênica/genética , Humanos , Junções Intercelulares/genética , Músculos Laríngeos/patologia , Membrana Mucosa/metabolismo , Membrana Mucosa/patologia , Coelhos , Prega Vocal/patologia , Distúrbios da Voz/patologia
14.
Rev. cient. odontol ; 8(2): e024-e024, mayo-ago. 2020. ilus, tab
Artigo em Espanhol | LILACS, LIPECS | ID: biblio-1119384

RESUMO

La identificación humana es uno de los objetivos principales de la odontología forense. Para llegar a esta identificación científica, el odontólogo debe encontrar propiedades tales como edad, sexo y características odontológicas individualizantes. La cavidad oral ofrece muchas posibilidades para la identificación, no solo a partir de los dientes y huesos de la cavidad craneal, sino también de los tejidos blandos orales; en consecuencia, ofrece un mayor campo de estudio.La rugoscopía, técnica basada en el estudio de las rugas palatinas, es un método de identificación muy poco explorado y de gran ayuda en la odontología forense para identificar personas. Las rugas palatinas son estructuras inmutables y perennes que, por su ubicación en la cavidad oral, están protegidas de cualquier trauma y no se alteran con la vecindad de las prótesis dentales ni por sustancias químicas. Ya que todos presentamos rugas diferentes en cuanto a su tamaño, posición, número y disposición (su forma no cambia desde el nacimiento hasta la muerte), las rugas constituyen elementos importantes en el proceso de identificación de personas en casos en los que las huellas dactilares son irrecuperables. Por tanto, el objetivo de esta investigación es revisar la reelevancia del análisis rugoscópico como un método efectivo y de bajo costo para la identificación de sujetos vivos, cadáveres recientes y cadáveres momificados o antiguos. (AU)


Human identification is one of the primary objectives of forensic dentistry. To achieve this scientific identification, dentists must find characteristics such as age, sex, and other individualizing dental traits. The oral cavity offers many possibilities for identification, not only based on teeth and the bones of the cranial cavity; but also on the oral soft tissues; thus, offering us a wider field of study.Rugoscopy, a technique based on the study of palatal rugae, is a little explored method of identification, but is of great utility in forensic dentistry. Palatal rugae are immutable and perennial structures, which, are protected from external trauma due to their location in the oral cavity and are not altered with the vicinity of dental prostheses or by erosion of chemical substances. Since all human beings present different rugae Since rugae differ among all humans in terms of size, position, number, and arrangement (their shape does not change from birth to death), they are important elements in the identification process of people from whom fingerprints are unrecoverable. Therefore, the aim of this study was to review the usefulness of rugoscopic analysis as an effective and low-cost method for identifying living subjects, recent corpses, and mummified or ancient corpses. (AU)


Assuntos
Humanos , Prega Vocal , Antropologia Forense , Ciências Forenses , Odontologia Legal
15.
Adv Clin Exp Med ; 29(7): 865-871, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620054

RESUMO

BACKGROUND: Short and long-term results of microsurgical treatment with the mini-microflap technique in patients with Reinke's edema (RE) were assessed based on the phonatory and ventilatory functions of the larynx. OBJECTIVES: To assess the short and long-term results of microsurgical treatment with the mini-microflap technique in patients with RE based on the phonatory and ventilatory functions of the larynx. MATERIAL AND METHODS: Twenty patients diagnosed with advanced stage of RE confirmed with laryngovideostroboscopy (LVS) were enrolled in the study. Phonatory function disturbances were additionally assessed on the basis of Maximum Phonation Time (MPT) measurement, Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-ROOL) questionnaires. Ventilatory function was assessed using spirometry. The aforementioned complex examinations were conducted prior to surgery and 1, 6 and 9 months following the surgery. RESULTS: Good postsurgical results were obtained in subjective and objective evaluation, which assessed the phonatory function and ventilatory parameters. Post-surgery increase in MPT, VHI and VQROL was noticed in all patients in 3 check points (p < 0.001). The results demonstrate postsurgical improvement for some LVS parameters, including assessment of glottis closure (p < 0.003) observed 6 months after the surgery. An improvement in most of the ventilation parameters was observed also 6 months after surgery (p < 0.001). For the spirometry flow parameter PEF, significant improvement was noted in each check point (p1 < 0.004, p6 < 0.001, p9 < 0.001). The study revealed a correlation between phonatory parameter - MPT and PEF observed 1 month after the procedure (p = 0.026), confirming the interdependence of ventilatory efficiency and phonatory condition of larynx. CONCLUSIONS: Mini-microflap surgery brings satisfactory clinical effect in patients with advanced stages of RE by optimization of phonatory and ventilatory functions of the larynx.


Assuntos
Microcirurgia , Qualidade de Vida , Edema/cirurgia , Humanos , Fonação , Resultado do Tratamento , Prega Vocal , Qualidade da Voz
16.
Arerugi ; 69(5): 353-357, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32684550

RESUMO

We present a case of a 17-year-old woman with a history of bronchial asthma since two years of age. She had daily asthma attacks from the age of fourteen, and the addition of oral corticosteroids and omalizumab to regular inhaled corticosteroid inhalation failed to relieve symptoms. She was referred to our hospital for detailed examination. On admission, physical examination was normal, but she had complained of dyspnea at the round. Monophonic wheezes and stridor were heard over the anterior neck, while no rales were audible over any part of the chest. Laryngoscopy revealed paradoxical movement of the vocal cords, and a diagnosis of vocal cord dysfunction (VCD) was made. The apparent severe asthma symptoms were considered to reflect VCD, and the treatment for bronchial asthma was stepped down without any recurrence of asthma attacks. Although the etiology of the VCD was unknown, VCD is more common in young women, so stress and personality factors are thought to be involved. It has been noted that childhood asthma often improves between childhood and adolescence, but refractory cases have been noted. In intractable bronchial asthma cases, it is necessary to consider the complications of other diseases, such as VCD, and to perform appropriate management.


Assuntos
Asma , Disfunção da Prega Vocal , Adolescente , Asma/diagnóstico , Asma/tratamento farmacológico , Diagnóstico Diferencial , Dispneia/diagnóstico , Feminino , Humanos , Sons Respiratórios , Disfunção da Prega Vocal/diagnóstico , Prega Vocal/fisiopatologia
17.
Vestn Otorinolaringol ; 85(3): 88-90, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32628390

RESUMO

During surgery on the thyroid gland, injury to the recurrent nerve is possible with the development of a clinical picture due to impaired mobility of the vocal fold. A disturbance of the mobility of the opposite vocal fold in the form of a paradoxical spasm may join these manifestations if the parathyroid glands were affected during surgery, followed by a decrease in the level of ionized calcium in the blood. Management of such patients presents certain difficulties. A clinical case of examination and treatment of a patient with bilateral impairment of mobility of the vocal folds resulting from thyroid surgery is presented. The peculiarity of this observation is that because of our treatment, we managed to stop the spasm of one vocal fold, and then restore the mobility of the other vocal fold, due to which a complete restoration of the respiratory and vocal function was achieved.


Assuntos
Hipoparatireoidismo , Paralisia das Pregas Vocais/cirurgia , Humanos , Glândula Tireoide , Tireoidectomia , Prega Vocal
18.
Ann Otol Rhinol Laryngol ; 129(11): 1063-1070, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32484033

RESUMO

OBJECTIVES: To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency. Secondary objectives included determining the complication/completion rates and if any factors were associated with improved voice outcomes. METHODS: Retrospective review of patients who received their first LEVFI from August 2017 to December 2018. Three- and six-month voice outcomes were assessed. Outcomes included voice handicap index-10 (VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy. RESULTS: Of the 121 eligible patients (55.4% male, age 63.7 years), 94 (77.7%) had complete 3-month data and 59 (48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7 ± 7.5 to 20.9 ± 10.9 at 3 months (P < .001) and to 19.1 ± 11.5 at 6 months (P < .001). MPT improved from 6.2 ± 5.4 seconds to 9.4 ± 7.1 seconds at 3 months (P < .001) and to 11.3 ± 8.2 seconds at 6 months (P < .001). GRBAS was improved in 74.8% of patients ([65.2, 82.8] 95% CI) at 3 months and 80.8% ([69.9, 89.1]) 95% CI) at 6 months. Stroboscopy showed a glottic gap improvement in 74.8% of patients ([65.8, 82.4] 95% CI) at 3 months and in 80.3% ([65.9, 88.5] 95% CI) at 6 months. Fundamental frequency was unchanged, as expected. Multivariate analysis reported that no factors were associated with better voice outcomes. Overall, 177/181 (97.8%) injections were completed. There were no complications. CONCLUSION: In-office LEVFI is an effective, novel technique to treat glottic insufficiency with improved voice outcomes, high completion rate, and no significant complications.


Assuntos
Eletromiografia/métodos , Ácido Hialurônico/administração & dosagem , Laringoplastia/métodos , Paralisia das Pregas Vocais/diagnóstico , Qualidade da Voz/fisiologia , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Viscossuplementos/administração & dosagem , Paralisia das Pregas Vocais/fisiopatologia , Paralisia das Pregas Vocais/terapia , Prega Vocal
19.
Gulf J Oncolog ; 1(33): 80-83, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32476655

RESUMO

Post chemoradiation vocal cord immobility is a rare complication and this maybe life threatening when patients present with severe aspiration and recurrent pneumonia or even worse if they have an upper airway obstruction. We report a case of nasopharyngeal carcinoma patient whom after receiving curative concurrent chemoradiotherapy, presented with episodes of shortness of breath and aspiration pneumonia finally diagnosed with bilateral vocal cord immobility. She had no evidence of tumour recurrence.


Assuntos
Quimiorradioterapia/efeitos adversos , Carcinoma Nasofaríngeo/complicações , Carcinoma Nasofaríngeo/terapia , Prega Vocal/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade
20.
J Vis Exp ; (159)2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32478747

RESUMO

The purpose of this tutorial is to describe the preparation of the rat vocal fold for histochemical neuromuscular study. This protocol outlines procedures for rat laryngeal dissection, flash-freezing, and cryosectioning of the vocal folds. This study describes how to cryosection vocal folds in both longitudinal and cross-sectional planes. A novelty of this protocol is the laryngeal tracking during cryosectioning that ensures accurate identification of the intrinsic laryngeal muscles and reduces the chance of tissue loss. Figures demonstrate the progressive cryosectioning in both planes. Twenty-nine rat hemi-larynges were cryosectioned and tracked from the emergence of the thyroid cartilage to the appearance of the first section that included the full vocal fold. The full vocal fold was visualized for all animals in both planes. There was high variability in the distance from the appearance of the thyroid cartilage to the appearance of the full vocal fold in both planes. Weight was not correlated to depth of laryngeal landmarks, suggesting individual variability and other factors related to tissue preparation may be responsible for the high variability in the appearance of landmarks during sectioning. This study details a methodology and presents morphological data for preparing the rat vocal fold for histochemical neuromuscular investigation. Due to high individual variability, laryngeal landmarks should be closely tracked during cryosectioning to prevent oversectioning tissue and tissue loss. The use of a consistent methodology, including adequate tissue preparation and awareness of landmarks within the rat larynx, will assist with consistent results across studies and aid new researchers interested in using the rat vocal fold as a model to investigate laryngeal neuromuscular mechanisms.


Assuntos
Prega Vocal/anatomia & histologia , Animais , Estudos Transversais , Ratos
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