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1.
Ann Otol Rhinol Laryngol ; 129(10): 983-987, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32456446

RESUMO

OBJECTIVE: Chronic rhinosinusitis (CRS) has long been associated with vocal dysfunction. However, studies quantifying the presence of voice dysfunction in CRS patients or the effects of functional endoscopic sinus surgery (FESS) are sparse. The goal of this study was to determine the voice-related quality of life in patients undergoing FESS for CRS using the validated Voice Related Quality of Life Survey (VRQL). We correlated the preoperative VRQL scores to the Sino-Nasal Outcome Test (SNOT-22) scores, and we determined the effect of FESS on postoperative VRQL scores. METHODS: Consecutive patients undergoing FESS were preoperatively administered both the VRQL and the SNOT-22 surveys. Spearman (ρ) and Pearson (r) correlation coefficients were calculated. The VRQL was mailed to patients postoperatively between 3 and 6 months. The paired t-test was used to compare pre- and post-FESS scores. RESULTS: A total of 102 patients were enrolled, and 81 patients completed the two surveys. A total of 51 (62.9%) patients had raw VRQL score ≥ 10, signifying presence of significant vocal symptoms. The mean ± standard deviation (SD) raw VRQL score of the entire study population was 12.4 ± 4.6, and the mean SNOT-22 score was 37.8 ± 19.2. The Spearman correlation coefficient between VRQL and the total SNOT-22 score was 0.34 (P =.002), and the Pearson correlation coefficient was 0.36 (P = .001). Both correlations were similar, demonstrating that increasing severity of CRS symptoms correlates with decreasing voice-related quality of life (QOL). Seventy patients completed the postoperative survey for an 86% retention rate. Thirty-six of these patients had abnormal preoperative VRQL scores, and these patients improved significantly after FESS. The mean preoperative versus postoperative raw scores were 15.2 ± 5.6 versus 12.5 ± 4.1, respectively (P = .003). CONCLUSION: This study demonstrates the increasing presence of vocal complaints with increasing severity of CRS. It also demonstrates that VRQL scores improve after FESS in those patients with preoperative vocal complaints. LEVEL OF EVIDENCE: IV.


Assuntos
Qualidade de Vida , Rinite/cirurgia , Sinusite/cirurgia , Distúrbios da Voz/fisiopatologia , Doença Crônica , Endoscopia , Rouquidão/etiologia , Rouquidão/fisiopatologia , Rouquidão/psicologia , Humanos , Procedimentos Cirúrgicos Otorrinolaringológicos , Rinite/complicações , Rinite/fisiopatologia , Índice de Gravidade de Doença , Teste de Desfecho Sinonasal , Sinusite/complicações , Sinusite/fisiopatologia , Voz , Distúrbios da Voz/etiologia , Distúrbios da Voz/psicologia
2.
Ann Otol Rhinol Laryngol ; 129(10): 1020-1029, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32468832

RESUMO

OBJECTIVES: To investigate the psychometric properties of the reflux symptom index (RSI) as short screening approach for the diagnostic of laryngopharyngeal reflux (LPR) in patients with confirmed diagnosed regarding the 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH). METHODS: From January 2017 to December 2018, 56 patients with LPR symptoms and 71 healthy individuals (control group) were prospectively enrolled. The LPR diagnosis was confirmed through MII-pH results. All subjects (n = 127) fulfilled RSI and the Reflux Finding Score (RFS) was performed through flexible fiberoptic endoscopy. The sensitivity and the specificity of RSI was assessed by ROC (Receiver Operating Characteristic) analysis. RESULTS: A total of 15 LPR patients (26.8%) of the clinical group met MII-pH diagnostic criteria. Among subjects classified as positive for MII- pH diagnoses, RSI and RFS mean scores were respectively 20 (SD ± 10.5) and 7.1 (SD ± 2.5), values not significantly different compared to the negative MII-pH group. The metric analysis of the items led to the realization of a binary recoding of the score. Both versions had similar psychometric properties, α was 0.840 for RSI original version and 0.836 for RSI binary version. High and comparable area under curve (AUC) values indicate a good ability of both scales to discriminate between individuals with and without LPR pathology diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for LPR pathology were ≥ 5 for RSI binary version and ≥ 15 for RSI original version. Both version overestimated LPR prevalence. The original version had more sensitivity and the RSI Binary version had more specificity. CONCLUSIONS: It would be necessary to think about modifying the original RSI in order to improve its sensitivity and specificity (RSI binary version, adding or changing some items), or to introduce new scores in order to better frame the probably affected of LPR patient.


Assuntos
Monitoramento do pH Esofágico , Esôfago/fisiopatologia , Refluxo Laringofaríngeo/diagnóstico , Manometria , Adulto , Estudos de Casos e Controles , Tosse/etiologia , Tosse/fisiopatologia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Feminino , Sensação de Globus/etiologia , Sensação de Globus/fisiopatologia , Azia/etiologia , Azia/fisiopatologia , Rouquidão/etiologia , Rouquidão/fisiopatologia , Humanos , Refluxo Laringofaríngeo/complicações , Refluxo Laringofaríngeo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
3.
Vasc Endovascular Surg ; 54(3): 288-291, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31896319

RESUMO

We present a case of an 87-year-old female with new-onset hoarseness of unclear etiology. Imaging demonstrated a penetrating aortic ulcer (PAU) in the proximal descending thoracic aorta with an associated pseudoaneurysm that enlarged to a depth of 32 mm over 2 years. This patient was diagnosed with hoarseness being secondary to left recurrent laryngeal nerve (LRLN) palsy, a variant of Ortner syndrome. Patient was treated with endovascular stent-grafting successfully covering of the PAU and pseudoaneurysm with zone 3 proximal landing zone. The patient had moderate improvement in hoarseness after 1 year of follow-up. Endovascular repair is indicated for symptomatic patients with PAUs complicated by enlarging pseudoaneurysms or rupture. Endovascular treatment is effective with low procedural morbidity and mortality. In this case, the PAU and associated pseudoaneurysm at the level of the ligamentum arteriosum caused compression on the LRLN, resulting in a nerve palsy and hoarseness. This case highlights the importance of vascular imaging for patients presenting with unclear etiology of hoarseness or other signs of LRLN palsy. Therefore, aortic arch abnormalities, a variant of Ortner syndrome, even though rare, should be on the differential diagnosis of new onset hoarseness.


Assuntos
Falso Aneurisma/complicações , Aneurisma da Aorta Torácica/complicações , Rouquidão/etiologia , Úlcera/complicações , Paralisia das Pregas Vocais/etiologia , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Humanos , Recuperação de Função Fisiológica , Resultado do Tratamento , Úlcera/diagnóstico por imagem , Úlcera/cirurgia , Paralisia das Pregas Vocais/diagnóstico por imagem , Paralisia das Pregas Vocais/fisiopatologia , Qualidade da Voz
4.
J Voice ; 34(1): 162.e1-162.e3, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30243668

RESUMO

The etiology of laryngeal granuloma can typically be attributed to endotracheal intubation, vocal abuse, or gastroesophageal reflux disease. There is a strong male predominance, except in cases due to intubation, where incidence is higher in women. We report a case of spontaneous development of multiple granulomas in a female with no history of intubation who presented with hoarseness and massive bilateral supraglottic masses obscuring her glottis. The disparity between the massive lesions and asymptomatic reflux highlights the need for further research in the pathophysiology of laryngeal granulomas.


Assuntos
Granuloma Laríngeo/complicações , Rouquidão/etiologia , Idoso , Feminino , Granuloma Laríngeo/diagnóstico por imagem , Granuloma Laríngeo/cirurgia , Rouquidão/fisiopatologia , Humanos , Laringoscopia , Resultado do Tratamento , Qualidade da Voz
5.
Ned Tijdschr Geneeskd ; 1632019 09 05.
Artigo em Holandês | MEDLINE | ID: mdl-31556494

RESUMO

An 82-year-old woman attended our outpatient clinic because of a swollen right arm and hoarseness. Upon raising both arms, the patient developed a red and swollen face (Pemberton's sign). An MRI of the thorax showed a large intrathoracic goitre, which compressed venous structures and limited blood flow even when she lowered her arms.


Assuntos
Bócio Subesternal/diagnóstico por imagem , Rouquidão/diagnóstico por imagem , Doenças Vasculares Periféricas/diagnóstico por imagem , Idoso de 80 Anos ou mais , Braço/irrigação sanguínea , Braço/diagnóstico por imagem , Constrição Patológica , Feminino , Bócio Subesternal/fisiopatologia , Rouquidão/etiologia , Rouquidão/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Doenças Vasculares Periféricas/complicações , Doenças Vasculares Periféricas/fisiopatologia , Pressão , Tórax/diagnóstico por imagem , Veias/patologia
6.
J Otolaryngol Head Neck Surg ; 48(1): 38, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31426857

RESUMO

BACKGROUND: The natural history of patients diagnosed with Eisenmenger's Syndrome typically revolve around the pediatric population. Medical advances have allowed these patients to live longer and present with a different subset of symptoms as a result of the progression of their disease process. CASE PRESENTATION: In this case report, we discuss a 77-year-old Caucasian female with Eisenmenger's Syndrome presenting with hoarseness. Clinical and imaging studies reveal a left vocal cord paralysis secondary to a progressively enlarging patent ductus arteriosus (PDA) and dilation of pulmonary arteries causing mass effect on the left recurrent laryngeal nerve. CONCLUSION: From a clinical perspective, this case highlights the need for otolaryngologists to be aware of the pathophysiology of Eisenmenger's Syndrome as it progresses with age.


Assuntos
Complexo de Eisenmenger/fisiopatologia , Rouquidão/fisiopatologia , Idoso , Complexo de Eisenmenger/diagnóstico por imagem , Feminino , Rouquidão/diagnóstico por imagem , Humanos
7.
Int J Pediatr Otorhinolaryngol ; 122: 82-88, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30981945

RESUMO

PURPOSE: Vocal fold nodules are usually caused by voice overuse or vocal hyperfunction, and their symptoms include persistent hoarseness - a disturbance in the vocal fold vibrations which results in a turbulent passage of air in the glottis, manifested as a raspy, rough voice. The aim of the study was to present data concerning voice quality in patients with vocal nodules and to compare electroglottographic analysis (EGG) with acoustic analysis. METHODS: The study examined 57 children with vocal fold nodules (Group 1). Each patient underwent a phoniatric evaluation of the vocal tract, a videolaryngoscopic examination, and a voice quality assessment, employing electroglottographic and acoustic analyses. The control group consisted of 37 healthy children (Group 2). The following parameters were analyzed: Closed Quotient (EGG signal), Peak Slope, Normalized Amplitude Quotient and Cepstral Peak Prominence (acoustic signal - waveform). RESULTS: Changes in the EGG signal could be detected in 95% of the patients with vocal nodules, indicating the occurrence of vocal nodules and glottal insufficiency. The acoustic analysis confirmed breathy phonation in 63% of the patients. The Closed Quotient parameter proved to be more effective than Peak Slope. Closed Quotient, Peak Slope and Normalized Amplitude Quotient allowed for the differentiation of the EGG signal and the acoustic signal in groups 1 and 2 in a statistically significant way. CONCLUSIONS: The results of electroglottographic and acoustic analysis show incorrect voice parameters in patients with vocal nodules with reference to the control group. At the same time, the EGG analysis proved to be more effective than the analysis of the acoustic signal.


Assuntos
Eletrodiagnóstico/métodos , Glote/fisiopatologia , Rouquidão/diagnóstico por imagem , Rouquidão/fisiopatologia , Prega Vocal/diagnóstico por imagem , Qualidade da Voz , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Rouquidão/etiologia , Humanos , Laringoscopia , Masculino , Fonação , Acústica da Fala
8.
Ann Vasc Surg ; 57: 275.e9-275.e12, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30711499

RESUMO

We present the case of an 89-year-old man with 3-month history of hoarseness and no other significant clinical manifestations. Flexible laryngoscopy revealed a paralyzed left vocal cord, and contrast-enhanced computed tomography showed a thoracic dissecting aortic aneurysm of the distal aortic arch and proximal descending aorta. The aortic aneurysm was repaired through implantation of an endovascular stent graft, and the patient was discharged uneventfully after a week. The false lumen was completely thrombosed, and the patient had a partial resolution of hoarseness at the 1-year follow-up.


Assuntos
Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Rouquidão/etiologia , Síndromes de Compressão Nervosa/etiologia , Nervo Laríngeo Recorrente/fisiopatologia , Prega Vocal/inervação , Idoso de 80 Anos ou mais , Aneurisma Dissecante/complicações , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma da Aorta Torácica/complicações , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aortografia/métodos , Prótese Vascular , Implante de Prótese Vascular/instrumentação , Angiografia por Tomografia Computadorizada , Procedimentos Endovasculares/instrumentação , Rouquidão/fisiopatologia , Humanos , Laringoscopia , Masculino , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/fisiopatologia , Desenho de Prótese , Recuperação de Função Fisiológica , Stents , Síndrome , Resultado do Tratamento , Voz
9.
J Voice ; 33(3): 357-362, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29242051

RESUMO

OBJECTIVES: Bamboo nodes are band-like submucosal deposits of the middle third of the vocal fold. They are often related to connective tissue disorders, but can also precede them. The aim of this study was to report our experience with conservative treatment of those rare lesions. METHODS: This is a retrospective series of 15 patients consulting for hoarseness and presenting bamboo nodes from 2010 to 2016. RESULTS: All patients were women of mean age of 38 years with a moderate or high degree of daily vocal effort. Nine patients (60%) presented with known autoimmune disease at the phoniatric appointment. The other patients (40%) benefited from a systematic biological research for autoimmune disease, which retrieved two poorly symptomatic connective tissue disorders. Patients were clinically improved by speech therapy (53%) or by an optimization or introduction of immunosuppressive treatment (46%). A spontaneous improvement was observed for three patients after voice rest (one after retirement, one after professional change, and last one after resuming professional singing). In our series, no phonosurgery was performed. The vocal profile at last appointment found a moderate Voice Handicap Index at 35.3/120, a low maximum time of phonation at 13.6 seconds, and a high jitter at 1.4, sign of instability of the vibrator. CONCLUSION: This series emphasizes the importance of diagnosing bamboo nodes in middle-aged female presenting an autoimmune disease. Vice versa for each patient with bamboo nodes, a systematic autoimmune check-up has to be realized to detect a biological asymptomatic autoimmune disease.


Assuntos
Doenças Autoimunes/patologia , Rouquidão/patologia , Doenças da Laringe/patologia , Prega Vocal/patologia , Doenças Autoimunes/imunologia , Doenças Autoimunes/fisiopatologia , Doenças Autoimunes/terapia , Rouquidão/imunologia , Rouquidão/fisiopatologia , Rouquidão/terapia , Humanos , Imunossupressores/uso terapêutico , Doenças da Laringe/imunologia , Doenças da Laringe/fisiopatologia , Doenças da Laringe/terapia , Laringoscopia , Paris , Fonação , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fonoterapia , Resultado do Tratamento , Prega Vocal/imunologia , Prega Vocal/fisiopatologia , Qualidade da Voz
10.
J Voice ; 33(5): 642-648, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29801970

RESUMO

OBJECTIVE: The 'VA' Windows program that we developed in 2011 for analyzing voice quality quantitatively uses zerocross picking to find individual basic pitch periods. It has a simple and user-friendly user interface and high accuracy. This program determines the fundamental frequency, jitter, shimmer, PPQ, APQ, and signal-to-noise ratio (Ra). It needs only a general-purpose Windows PC, USB audio interface and a microphone. The aim of this study is to improve the version of the VA Windows program in English and to develop a VA smart phone program to allow wider use of objective acoustic analysis. STUDY DESIGN: Cross-sectional study. METHODS: Sustained vowel /a/ sounds from 40 subjects without evident vocal problems, and 40 subjects with slight hoarseness, were examined. We compared the analyzed data with data from other software (MDVP and Praat). For a comparison between VA for Windows and VA for a smart phone, sustained vowel /a/ sounds from six subjects without hoarseness were recorded with each system simultaneously. RESULTS: The normal voice and slightly hoarse voice data analyzed with VA showed a high correlation with most parameters from both MDVP and Praat. There was a strong correlation between the Windows and smart phone versions of VA in terms of the fundamental frequency and Ra. CONCLUSIONS: The results showed that the VA software was not inferior to the other acoustic analysis software tested. The simple and easy to use smart phone version may facilitate our goal of creating an objective, widely available method to evaluate hoarseness.


Assuntos
Acústica/instrumentação , Rouquidão/diagnóstico , Aplicativos Móveis , Processamento de Sinais Assistido por Computador , Smartphone , Acústica da Fala , Medida da Produção da Fala/instrumentação , Qualidade da Voz , Adulto , Algoritmos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Rouquidão/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Espectrografia do Som , Fatores de Tempo , Adulto Jovem
11.
J Voice ; 33(5): 812.e9-812.e14, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29773323

RESUMO

INTRODUCTION: Primary laryngeal tuberculosis is a chronic bacterial infection of the larynx by Mycobacterium tuberculosis without affecting the lungs. It is a rare type of extrapulmonary tuberculosis seen in clinical practice. OBJECTIVES: This study aimed to evaluate the clinical presentation, diagnosis, and treatment of primary laryngeal tuberculosis at a tertiary care teaching hospital in eastern India. MATERIALS AND METHODS: This is a retrospective study of 11 cases of primary laryngeal tuberculosis managed between December 2013 and January 2018. The detailed clinical presentations, investigations, and treatment of primary laryngeal tuberculosis of the patients were studied. RESULTS: Primary laryngeal tuberculosis is common in men with mean age of 38.63 years. Hoarseness of the voice is the most common symptom, and the most common site for primary laryngeal tuberculosis is the vocal fold with ulcerative lesion. Endoscopic examinations of the larynx in laryngeal tuberculosis are nonspecific and are to be confused with laryngeal cancer. Histopathological and bacteriological examinations are confirmatory tests for the diagnosis. After confirmation of the diagnosis, all patients had taken antitubercular therapy for 6 months, which gave excellent outcome. CONCLUSIONS: Delayed diagnosis or untreatable laryngeal tuberculosis will lead to high morbidity and mortality of the patient. Although primary laryngeal tuberculosis has nonspecific clinical presentations, it is very important to have a high index of suspiciousness to rule out tubercular lesion in the larynx as this disease is curable.


Assuntos
Antituberculosos/uso terapêutico , Rouquidão/tratamento farmacológico , Hospitais de Ensino , Centros de Atenção Terciária , Tuberculose Laríngea/tratamento farmacológico , Prega Vocal/efeitos dos fármacos , Qualidade da Voz/efeitos dos fármacos , Adulto , Antituberculosos/efeitos adversos , Diagnóstico Diferencial , Feminino , Rouquidão/diagnóstico , Rouquidão/microbiologia , Rouquidão/fisiopatologia , Humanos , Índia , Neoplasias Laríngeas/diagnóstico , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose Laríngea/diagnóstico , Tuberculose Laríngea/microbiologia , Tuberculose Laríngea/fisiopatologia , Prega Vocal/microbiologia , Prega Vocal/fisiopatologia , Adulto Jovem
12.
J Voice ; 33(5): 801.e21-801.e25, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29506899

RESUMO

OBJECTIVES: Health-related factors are part of the multifactorial background of dysphonia in children. Respiratory tract infections affect the same systems and structures that are used for voice production. The purpose of this study was to investigate if the number of respiratory tract infections or the viral etiology were significant predictors for a more hoarse voice quality. METHODS: The participants were 4-year-old children who participated in the multidisciplinary STEPS study (Steps to the Healthy Development and Well-being of Children) where they were followed up from pregnancy or birth to 4 years of age. Data were collected through questionnaires and a health diary filled in by the parents. Some of the children were followed up more intensively for respiratory tract infections during the first 2 years of life, and nasal swab samples were taken at the onset of respiratory symptoms. Our participants were 489 of these children who had participated in the follow-up for at least 1 year and for whom data on respiratory tract infections and data on voice quality were available. RESULTS: The number of hospitalizations due to respiratory tract infections was a significant predictor for a more hoarse voice quality. Neither the number of rhinovirus infections nor the number of respiratory syncytial virus infections was statistically significant predictors for a more hoarse voice quality. CONCLUSIONS: Based on our results, we would suggest including questions on the presence of respiratory tract infections that have led to hospitalization in the pediatric voice anamnesis. Whether the viral etiology of respiratory tract infections is of importance or not requires further research.


Assuntos
Rouquidão/etiologia , Infecções por Picornaviridae/complicações , Infecções por Vírus Respiratório Sincicial/complicações , Infecções Respiratórias/complicações , Qualidade da Voz , Fatores Etários , Pré-Escolar , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Hospitalização , Humanos , Masculino , Infecções por Picornaviridae/diagnóstico , Infecções por Picornaviridae/terapia , Infecções por Picornaviridae/virologia , Prognóstico , Estudos Prospectivos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/terapia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/patogenicidade , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/terapia , Infecções Respiratórias/virologia , Rhinovirus/patogenicidade , Medição de Risco , Fatores de Risco
13.
Auris Nasus Larynx ; 46(2): 193-195, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30120006

RESUMO

OBJECTIVE: Otorhinolaryngologic examinations at an early stage, particularly those conducted by vocal specialists, can make potentially important contributions to the diagnosis of bulbar-onset ALS patients. METHODS: We analyzed 2623 patients (2010-2017) visited the ENT Voice Clinic, National Hospital Organization Tokyo Medical Center, with the primary complaint of speech or vocal dysfunction at the initial visit. Among those, 12 patients visited the voice clinic after consultations with other physicians but before receiving a diagnosis and we initially suspected bulbar-onset ALS due to slow, slurred speech (SSS). We analyzed the detail of those suspected ALS cases. RESULTS: Every patient suspected ALS patients consulted an average of 2.2 physicians before visiting the voice clinic and a total of 3.2 physicians before receiving the final diagnosis. The mean speech symptom duration before visiting the vocal clinic was 7.83 months in ALS, 24 months in MSA patients. The duration until final diagnosis after we referred them to neurologists was 2.16 months and 15.3 months, respectively. CONCLUSION: Otolaryngologists and primary care physicians to consider the possibility of ALS when patients present even with an only symptom of SSS. They should then refer such patients to neurologists for definitive diagnoses, leading to early detection and treatment of ALS.


Assuntos
Esclerose Amiotrófica Lateral/fisiopatologia , Disartria/fisiopatologia , Rouquidão/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Esclerose Amiotrófica Lateral/complicações , Esclerose Amiotrófica Lateral/diagnóstico , Tosse/etiologia , Tosse/fisiopatologia , Disartria/etiologia , Fasciculação/etiologia , Fasciculação/fisiopatologia , Feminino , Rouquidão/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Atrofia de Múltiplos Sistemas/complicações , Atrofia de Múltiplos Sistemas/diagnóstico , Atrofia de Múltiplos Sistemas/fisiopatologia , Distúrbios da Fala/etiologia , Distúrbios da Fala/fisiopatologia , Língua/fisiopatologia
14.
J Voice ; 33(2): 155-158, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30385011

RESUMO

Lipoid proteinosis is a rare cause of voice problems. Hoarseness is often the first clinical manifestation of this disorder and can present years before any other symptom. Therefore, it is very important as an otorhinolaryngologist to be familiar with the main characteristics of this disease. We present a case report and a review of current literature to provide a concise overview of this frequently missed diagnosis.


Assuntos
Glote/fisiopatologia , Rouquidão/etiologia , Proteinose Lipoide de Urbach e Wiethe/complicações , Qualidade da Voz , Adulto , Feminino , Tecnologia de Fibra Óptica , Glote/patologia , Rouquidão/patologia , Rouquidão/fisiopatologia , Humanos , Laringoscopia , Proteinose Lipoide de Urbach e Wiethe/genética , Proteinose Lipoide de Urbach e Wiethe/patologia , Proteinose Lipoide de Urbach e Wiethe/fisiopatologia , Prognóstico
15.
Ann Otol Rhinol Laryngol ; 127(9): 653-656, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30047792

RESUMO

OBJECTIVES: To increase awareness of vocal fold mobility impairment secondary to laryngeal mask airway (LMA) use in the operating room. METHODS: We report 2 cases of bilateral vocal fold mobility impairment after LMA use within 7 months of each other. One patient is a 52-year-old female who developed this complication after orthopedic elbow surgery. The second case is a 75-year-old male who presented after undergoing inguinal hernia repair. RESULTS: The patient from the first case required a 7-day hospital stay in the SICU due to airway compromise with spontaneous resolution of right-sided vocal fold immobility and improvement of symptoms. The 75-year-old male required direct laryngoscopy and bilateral true vocal fold injection medialization to correct his bilateral vocal fold paresis causing dysphonia and aspiration of liquids. CONCLUSIONS: Bilateral vocal fold immobility secondary to LMA use is likely an underreported phenomenon of which otolaryngologists and anesthesiologists should be aware. Presentation may be severe, requiring hospitalization or operative intervention.


Assuntos
Rouquidão/etiologia , Laringoscopia/efeitos adversos , Tireoidectomia/efeitos adversos , Paralisia das Pregas Vocais/complicações , Prega Vocal/lesões , Idoso , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Humanos , Máscaras Laríngeas , Masculino , Pessoa de Meia-Idade , Paralisia das Pregas Vocais/diagnóstico , Paralisia das Pregas Vocais/fisiopatologia , Prega Vocal/diagnóstico por imagem , Prega Vocal/fisiopatologia
16.
Anesth Prog ; 65(2): 129-130, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29952646

RESUMO

More than 100,000 general anesthetic procedures are conducted in United Kingdom every year for dental interventions, according to large survey of the National Health Services. 1 The risk of mortality has reduced considerably in the past few decades because of the use of safe and effective techniques. However, adverse effects still exist and are dependent on patient, environmental, and operator factors. We present an uncommon complication of intubation that merits due awareness.


Assuntos
Disfonia/etiologia , Rouquidão/etiologia , Traumatismos do Nervo Hipoglosso/etiologia , Intubação Intratraqueal/efeitos adversos , Dente Serotino/cirurgia , Extração Dentária , Traumatismos do Nervo Vago/etiologia , Disfonia/diagnóstico , Disfonia/fisiopatologia , Disfonia/terapia , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Rouquidão/terapia , Humanos , Traumatismos do Nervo Hipoglosso/diagnóstico , Traumatismos do Nervo Hipoglosso/fisiopatologia , Traumatismos do Nervo Hipoglosso/terapia , Masculino , Recuperação de Função Fisiológica , Fatores de Risco , Síndrome , Resultado do Tratamento , Traumatismos do Nervo Vago/diagnóstico , Traumatismos do Nervo Vago/fisiopatologia , Traumatismos do Nervo Vago/terapia , Adulto Jovem
17.
Laryngorhinootologie ; 97(9): 630-635, 2018 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-29635679

RESUMO

OBJECTIVE: Acoustics might have the potential to objectify voice quality (eg, hoarseness and breathiness). The Acoustic Voice Quality Index (AVQI) and the Acoustic Breathiness Index (ABI) revealed sufficient valid and reliable results in the evaluation of voice quality. The aim of the present study is to validate the recent version of AVQI 03.01 and ABI in their internal validation. The responsiveness of change is evaluated on the hoarseness and breathiness severity after voice therapy. MATERIALS AND METHODS: In total, 84 voice samples of continuous speech and sustained vowel [a:] before and after a voice therapy were used. All 42 subjects presented organic and nonorganic voice disorders and various degrees of dysphonia severity before and after behavioral voice therapy. The voice samples were judged by three voice experts using the RBH-scale, which is based on the GRBAS-scale. RESULTS: The intra-rater reliability was high for hoarseness (mean kappa = 0.76) and breathiness (mean kappa = 0.69).The inter-rater reliability was lower for both voice quality characteristics and ranged between kappa = 0.27 to 0.29. A strong correlation was identified between the perceived rating of hoarseness and breathiness and AVQI and ABI before and after voice therapy (r = 0.715, p < 0.01, and r = 0.712, p < 0.01, respectively). Additionally, no significant differences were revealed. CONCLUSION: The present results showed that AVQI version 03.01 und ABI had a high internal validity to assess voice changes after voice therapy. AVQI and ABI are two valid and robust voice measures to objectify hoarseness and breathiness.


Assuntos
Medida da Produção da Fala/métodos , Medida da Produção da Fala/normas , Qualidade da Voz/fisiologia , Adolescente , Adulto , Idoso , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
18.
Eur Arch Otorhinolaryngol ; 275(6): 1569-1577, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29687184

RESUMO

OBJECTIVE: To verify possible relations between vocal disability and aerodynamic measures in selected Parkinson's disease (PD) patients with low/moderate-grade dysphonia. METHODS: Fifteen idiopathic dysphonic PD male patients were examined and compared with 15 euphonic subjects. Testing included the following measures: Voice Handicap Index (VHI), maximum phonation time (MPT), mean estimated subglottal pressure (MESGP), mean sound pressure level (MSPL), mean phonatory power (MPP), mean phonatory efficiency (MPE) and mean phonatory resistance (MPR). RESULTS: Statistical analysis showed: a significant reduction in MPR and MSPL in PD subjects compared to the healthy ones; a significant positive correlation between VHI score and MSPL, MPR, MPP, MESGP and a significant negative correlation between VHI and MTP within PD subjects. Test for multiple linear regression showed a significant correlation between VHI score, MPT, MPR and MSPL. CONCLUSIONS: A relationship between VHI and aerodynamic measures was shown in the present study. Compensatory mechanisms may aggravate vocal disability in PD subjects.


Assuntos
Disfonia/etiologia , Rouquidão/etiologia , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Fonação/fisiologia , Adulto , Idoso , Avaliação da Deficiência , Disfonia/diagnóstico , Disfonia/fisiopatologia , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Som , Qualidade da Voz
19.
Ann Otol Rhinol Laryngol ; 127(5): 317-326, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29490478

RESUMO

OBJECTIVE: The aim of this study was to validate the Acoustic Voice Quality Index 03.01 (AVQIv3) and the Acoustic Breathiness Index (ABI) in the Spanish language. METHOD: Concatenated voice samples of continuous speech (cs) and sustained vowel (sv) from 136 subjects with dysphonia and 47 vocally healthy subjects were perceptually judged for overall voice quality and breathiness severity. First, to reach a higher level of ecological validity, the proportions of cs and sv were equalized regarding the time length of 3 seconds sv part and voiced cs part, respectively. Second, concurrent validity and diagnostic accuracy were verified. RESULTS: A moderate reliability of overall voice quality and breathiness severity from 5 experts was used. It was found that 33 syllables as standardization of the cs part, which represents 3 seconds of voiced cs, allows the equalization of both speech tasks. A strong correlation was revealed between AVQIv3 and overall voice quality and ABI and perceived breathiness severity. Additionally, the best diagnostic outcome was identified at a threshold of 2.28 and 3.40 for AVQIv3 and ABI, respectively. CONCLUSIONS: The AVQIv3 and ABI showed in the Spanish language valid and robust results to quantify abnormal voice qualities regarding overall voice quality and breathiness severity.


Assuntos
Disfonia/fisiopatologia , Acústica da Fala , Medida da Produção da Fala , Qualidade da Voz/fisiologia , Adulto , Estudos de Casos e Controles , Disfonia/diagnóstico , Feminino , Rouquidão/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença
20.
J Voice ; 32(2): 239-243, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28624315

RESUMO

OBJECTIVE: The study aimed (1) to evaluate the prevalence of sulcus vocalis (SV) coexisting with vocal fold polyp (SV-VFP), and (2) to determine the effect of their coexistence on voice quality. STUDY DESIGN: This is a retrospective cohort study in a tertiary referral center. METHODS: The medical records of all patients who underwent micro direct laryngoscopy due to VFPs between January 2013 and April 2015 were reviewed. Patients with SV-VFP were identified and data of their demographics, medical history, habits, preoperative and intraoperative laryngeal findings, and pre- and postoperative GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) score, and compared with the data of patients with solitary VFPs (S-VFPs). RESULTS: Eighty-nine patients were diagnosed with VFPs, 14 (15.7%) of whom were diagnosed with SV-VFPs. Patients with SV-VFPs had significantly lower incidence of concurrent leukoplakia (P = 0.01), higher incidence of contralateral vocal fold lesions (P = 0.04), increased voice roughness score postoperatively (P = 0.01) on the GRBAS score, and had a lower rate of cigarette smoking (P = 0.02) compared with patients with S-VFPs. CONCLUSIONS: The possibility of a hidden SV should be considered when detecting VFPs, particularly in patients with contralateral vocal fold lesions and without cigarette smoking history. Because the group of patients with SV-VFP presented with unique features, we suspect that the coexistence of VFPs and SVs is not incidental and that SVs may contribute to the formation of VFPs, possibly by alternating glottic airflow.


Assuntos
Rouquidão/epidemiologia , Doenças da Laringe/epidemiologia , Pólipos/epidemiologia , Prega Vocal/fisiopatologia , Qualidade da Voz , Adulto , Feminino , Rouquidão/diagnóstico por imagem , Rouquidão/fisiopatologia , Rouquidão/cirurgia , Humanos , Incidência , Israel/epidemiologia , Doenças da Laringe/diagnóstico por imagem , Doenças da Laringe/fisiopatologia , Doenças da Laringe/cirurgia , Laringoscopia/métodos , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Pólipos/diagnóstico por imagem , Pólipos/fisiopatologia , Pólipos/cirurgia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Centros de Atenção Terciária , Resultado do Tratamento , Prega Vocal/diagnóstico por imagem , Prega Vocal/cirurgia
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