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1.
JASA Express Lett ; 2(10): 105201, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36319212

RESUMO

Self-sustained vocal fold vibration is possible with either or both of two mechanisms: (1) a mucosal wave propagating along the medial surface of the vocal folds and (2) a vocal tract that offers inertive reactance. A quantitative comparison shows the mucosal wave mechanism has a lower threshold pressure and a higher glottal efficiency, but the supraglottal inertance mechanism can assist in the oscillation and is effective in optimizing the two mechanisms. It is concluded that optimal parameters are a mucosal wave velocity on the order of 1 m/s and a diameter of the larynx canal (epilarynx tube) on the order of 0.8 cm.


Assuntos
Laringe , Prega Vocal , Membrana Mucosa , Glote , Registros
2.
JASA Express Lett ; 2(10): 105203, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36319211

RESUMO

Near-infrared (NIR) photoglottography (PGG) is a non-invasive method for monitoring glottal activities which retains functionality of conventional PGG using visible light with more convenient accessibility. This paper is to investigate its performance in comparison with simultaneously recorded electroglottography (EGG) signals. Results showed that NIR PGG detects continuous transillumination for glottal aperture and vocal-fold contact. Glottal timing markers known as glottal closure and opening instants are detectable agreeing to the corresponding EGG-based instants. Further, it was inferred that variations of glottal waveforms based on NIR PGG reflect vertical vocal-fold edge motions.


Assuntos
Glote , Procedimentos Cirúrgicos Reconstrutivos , Prega Vocal , Luz , Movimento (Física)
3.
Oral Oncol ; 134: 106088, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36087502

RESUMO

INTRODUCTION: CO2 transoral laser microsurgery (CO2-TOLMS) has pushed the indications of partial surgery of the larynx regardless the age of the patient. OBJECTIVE: To evaluate the complications and the oncologic and functional outcomes of CO2-TOLMS in patients older and younger than 70 years. METHODS: Retrospective analysis of 1244 consecutive laryngeal carcinomas treated with CO2-TOLMS. Complications, length of hospitalization, functional and survival outcomes were evaluated. RESULTS: The mean age was 64.2 ±â€¯11.1 years (20-96). Four hundred and sixteen patients were older than 70 years and 104 older than 80 years. The main location was the glottis (912), followed by the supraglottis (332). There were no differences in pT classification between the age groups. No differences were observed in voice outcomes. A higher rate of signs of aspiration at the glottic location was observed for those older than 70 years (2.1 % vs 5 %, p = 0.027). The need for definitive gastrostomy in supraglottic tumours was higher in those older than 70 years (0 % vs 6.5 %, p: 0.001). In the glottis, no differences in tracheostomy or gastrostomy rates were observed. Five-year overall survival was lower in the older than 70 years. No differences in disease-specific survival were observed in early stages for both locations, but a lower survival was observed in stage III glottic cancer for the older than 70 years. CONCLUSIONS: CO2-TOLMS is a valid treatment for laryngeal carcinomas in the elderly, with a reduced number of complications and good functional and oncologic outcomes.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Terapia a Laser , Idoso , Dióxido de Carbono , Carcinoma de Células Escamosas/patologia , Glote/patologia , Glote/cirurgia , Humanos , Neoplasias Laríngeas/patologia , Laringectomia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento
4.
Sci Rep ; 12(1): 15215, 2022 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-36075958

RESUMO

We aimed to determine the correlation between mid-glottic transverse diameter/subglottic diameter and outer diameter of endotracheal tube (ETT) by ultrasonography in children. Ninety-five patients aged 1-8 years who underwent general anesthesia were included. Ultrasonography of glottic/subglottic transverse diameter was performed by two investigators after patients were anesthetized and when the train of four showed ≤ 4. The subglottic diameter was measured at the mid cricoid cartilage. The mid-glottic transverse diameter was measured at the mid-point of true vocal fold triangle whereas the distance between arytenoids was considered as the glottic transverse diameter. Linear regression models and correlation coefficients (r) were used to determine the best formula of glottic/subglottic transverse diameter to predict the outer diameter of ETT. The predicted outer diameter of ETT formula for subglottic diameter, mid-glottic transverse diameter, and glottic transverse diameter were 5.7 + (subglotticmm/3) with an r of 0.45, 5.5 + (midglotticmm/2) with an r of 0.47, and 5.7 + (glotticmm/4) with an r of 0.46, respectively. The correlation between subglottic diameter and mid-glottic transverse diameter was 0.50. Subglottic/mid-glottic/glottic transverse diameter formulae had moderate correlations with the outer diameter of ETT. The glottic/mid-glottic transverse diameter can be used alternatively to predict the ETT size.Trial registration: Thai Clinical Trial Registry: TCTR20191022002 Registered 22/10/2019-Prospectively registered, https://www.thaiclinicaltrials.org/# TCTR20191022002.


Assuntos
Intubação Intratraqueal , Traqueia , Criança , Glote/diagnóstico por imagem , Humanos , Estudos Prospectivos , Traqueia/diagnóstico por imagem , Ultrassonografia
5.
J Speech Lang Hear Res ; 65(10): 3789-3797, 2022 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-36083832

RESUMO

PURPOSE: The aims of this study were to analyze and characterize the irrintzi (a folkloric shout emitted in a single breath used by the Basque people) acoustically and to describe the mechanism by which it is emitted. METHOD: Thirty-six sound samples of 12 female volunteers were analyzed. Acoustic analysis included primarily fundamental frequency (f o), spectral analysis in the time domain with a narrowband filter, and the use of linear predictive coding (LPC). Laryngeal and pharyngeal movements while emitting an irrintzi were studied by fiberoptic nasal endoscopy. Postural and mandible movements were observed and video recorded. Movements of the larynx and the vocal tract were also studied by lateral pharyngo-laryngeal radioscopy. RESULTS: The central part of an irrintzi spectrogram contains a peculiar, repeated M-shaped motif unseen in the spectrogram of any other human vocal emission, and intensity was over 90 dB SPL in all cases. f o was very high (1487 Hz) especially at the end of the irrintzi. Fiberoptic nasal endoscopy consistently revealed considerable elevation of the glottis, with the larynx swinging forward and retraction of the ventricular bands. Lateral radioscopy showed a very high larynx and a high tongue dorsum. CONCLUSIONS: The irrintzi is a sound emitted in a single breath and characterized by its shrillness and loudness, qualities that make it audible in noisy environments and over large distances and the vocal technique observed when it is produced can be explained by the Estill voice model (Steinhauer et al., 2017). The use of this technique may help in the treatment of voice disorders and improve efficiency in singers, teachers, actors, and people who use their voice at high volume or at high frequency. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20779405.


Assuntos
Laringe , Distúrbios da Voz , Voz , Acústica , Estudos de Viabilidade , Feminino , Glote , Humanos , Laringe/diagnóstico por imagem , Distúrbios da Voz/terapia
6.
J Speech Lang Hear Res ; 65(10): 3695-3708, 2022 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-36130065

RESUMO

PURPOSE: This study examined the relationship between voice quality and glottal geometry dynamics in patients with adductor spasmodic dysphonia (ADSD). METHOD: An objective computer vision and machine learning system was developed to extract glottal geometry dynamics from nasolaryngoscopic video recordings for 78 patients with ADSD. General regression models were used to examine the relationship between overall voice quality and 15 variables that capture glottal geometry dynamics derived from the computer vision system. Two experts in ADSD independently rated voice quality for two separate voice tasks for every patient, yielding four different voice quality rating models. RESULTS: All four of the regression models exhibited positive correlations with clinical assessments of voice quality (R 2s = .30-.34, Spearman rho = .55-.61, all with p < .001). Seven to 10 variables were included in each model. There was high overlap in the variables included between the four models, and the sign of the correlation with voice quality was consistent for each variable across all four regression models. CONCLUSION: We found specific glottal geometry dynamics that correspond to voice quality in ADSD.


Assuntos
Disfonia , Voz , Computadores , Disfonia/diagnóstico , Glote , Humanos , Qualidade da Voz
7.
Forensic Sci Med Pathol ; 18(4): 554-556, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36136290

RESUMO

An 86-year-old woman with Alzheimer disease collapsed in her nursing home and was not able to be resuscitated. At autopsy, the major findings were in the larynx where a pedunculated oncocytic cystadenoma had occluded the glottis. Oncocytic cysts or cystadenomas of the larynx are rare histologically benign lesions that account for only 0.1-1% of laryngeal lesions. While the usual presentation is of a sensation of a mass in the throat, hoarseness, or stridor, very occasionally, there may be acute airway compromise and sudden death. Oncocytic cystadenoma should, therefore, be included in the differential diagnosis of potentially lethal obstructive laryngeal lesions.


Assuntos
Cistadenoma , Doenças da Laringe , Neoplasias Laríngeas , Laringe , Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Laringe/patologia , Cistadenoma/diagnóstico , Cistadenoma/patologia , Glote/patologia , Morte Súbita/etiologia , Doenças da Laringe/patologia
8.
Am J Otolaryngol ; 43(6): 103629, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36166881

RESUMO

OBJECTIVES: Endoscopic laser wedge excision (LWE) is an effective treatment option for idiopathic subglottic stenosis (iSGS); however, data regarding complications following LWE are limited. The aim of the following analysis was to provide a review of frequency and type of complications that occur with LWE in patients with iSGS. STUDY DESIGN: Retrospective review. METHODS: Patients with iSGS undergoing LWE between January 2002 and September 2021 were performed. Demographic data were recorded. Complications were stratified into major and minor categories. The frequency of these complications and the respective treatment for them was analyzed. RESULTS: 212 patients within the study period underwent a total of 573 LWE procedures. All but two patients were female, with a median age of 54 years at time of LWE. Of these patients, 43 (20 %) patients experienced a complication. Of these, only 7 (15 %) of the reported complications were considered major while the rest were minor in nature. Major complications included 3 cases of post-operative hemoptysis, 1 case of tracheitis, and 3 cases of reduced vocal fold hypomobility with concurrent glottic stenosis. Minor complications consisted of 2 cases of tooth fracture and 34 cases of tongue paresthesia post-operatively that was self-limited. There were no mortalities. CONCLUSION: Major complications occur in <5 % of LWE procedures based off the analysis. All major complications were managed without significant long-term morbidity. Minor complications with the LWE are self-limited in nature. Our data supports the LWE as a safe treatment option for iSGS.


Assuntos
Laringoestenose , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Constrição Patológica , Laringoestenose/etiologia , Laringoestenose/cirurgia , Endoscopia/métodos , Glote/cirurgia , Lasers
9.
PLoS One ; 17(9): e0266989, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36129922

RESUMO

Deep Learning has a large impact on medical image analysis and lately has been adopted for clinical use at the point of care. However, there is only a small number of reports of long-term studies that show the performance of deep neural networks (DNNs) in such an environment. In this study, we measured the long-term performance of a clinically optimized DNN for laryngeal glottis segmentation. We have collected the video footage for two years from an AI-powered laryngeal high-speed videoendoscopy imaging system and found that the footage image quality is stable across time. Next, we determined the DNN segmentation performance on lossy and lossless compressed data revealing that only 9% of recordings contain segmentation artifacts. We found that lossy and lossless compression is on par for glottis segmentation, however, lossless compression provides significantly superior image quality. Lastly, we employed continual learning strategies to continuously incorporate new data into the DNN to remove the aforementioned segmentation artifacts. With modest manual intervention, we were able to largely alleviate these segmentation artifacts by up to 81%. We believe that our suggested deep learning-enhanced laryngeal imaging platform consistently provides clinically sound results, and together with our proposed continual learning scheme will have a long-lasting impact on the future of laryngeal imaging.


Assuntos
Laringe , Sistemas Automatizados de Assistência Junto ao Leito , Artefatos , Glote/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Laringe/diagnóstico por imagem , Redes Neurais de Computação
12.
Acta Otolaryngol ; 142(7-8): 627-633, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36131532

RESUMO

INTRODUCTION: Squamous cell carcinoma (SCC) of the vocal cord in stages I or II can be treated with radiotherapy (RT) or transoral CO2 laser microsurgery (TLM), with good oncological results. OBJECTIVES: To study the survival of patients with SCC of the vocal cord in early stages, treated with RT or TLM, in a tertiary hospital. MATERIAL AND METHODS: Disease-free survival (DFS), specific survival (SS), and overall survival (OS) were studied in patients diagnosed with stage I and II SCC of the vocal cord, for a span of 10 years of follow-up, based on sociodemographic characteristics of the patient and the primary treatment (TLM or RT). RESULTS: Both treatments achieved good survival rates. However, long-term SS was greater in patients treated with TLM compared to those treated with RT (91.7% vs. 50%, respectively, p = .001). In addition, patients treated with TLM presented a higher OS in the short term than those treated with RT (99.0% vs. 89.1%, respectively. p = .004). CONCLUSIONS AND SIGNIFICANCE: Primary treatment with TLM obtained better results than RT in the survival of patients with SCC of the vocal cord in the early stages.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Terapia a Laser , Dióxido de Carbono , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Intervalo Livre de Doença , Glote/patologia , Glote/cirurgia , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Terapia a Laser/métodos , Microcirurgia/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento
13.
Eur Rev Med Pharmacol Sci ; 26(16): 5763-5773, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36066150

RESUMO

OBJECTIVE: Cases of obesity are rising in parallel with the number of obese patients scheduled for anesthesia in which difficult airway is encountered. Video laryngoscopes (VL) have emerged as a popular device for the management of patients with difficult airway. The present study compares the success rate of intubation in obese patients using stylet in the ramped position using either a McGrath or C-MAC VLs. PATIENTS AND METHODS: Class II/III obese patients who were intubated with either McGrath (Group M, n=50) or C-MAC (Group C, n=50) laryngoscopes were assessed for the presence of difficult airway using the Difficult Airway Assessment tool, the Airway Difficulty Score and the Total Airway Score. The intubation attempts were made after the best glottic view, direct and indirect Cormack-Lehane (CL) score, and intubation time were recorded. In the event of failure, a further intubation attempt was made using a styled, and the intubation time was again recorded. If the intubation failed again, a third attempt was made using a C-MAC D-Blade. The Intubation Difficulty Scale score was recorded after the intubation. RESULTS: There was no statistically significant difference between groups in terms of demographic data, the number of patients with decreased CL score, the number of attempts required for intubation, or the first and second intubation time. The ADS Score, TAS Score, CL Score DL, and CL Score IN were found to be important risk factors for a second intubation requirement, and the cut-off value was found to be 8.50 for the ADS Score and 4.50 for the TAS Score in these patients. In the 38 patients who required a second intubation attempt, the procedure was successful in all, but one patient required a third attempt of intubation with C-MAC D-blade. CONCLUSIONS: Both McGrath and C-MAC were effective and comparable for best glottic view with no failed intubation. It was concluded that regardless of the type of video laryngoscope used, the use of a stylet in the first intubation attempt increases the success of intubation.


Assuntos
Laringoscópios , Glote , Humanos , Intubação Intratraqueal , Laringoscópios/efeitos adversos , Laringoscopia/métodos , Obesidade/etiologia , Gravação em Vídeo
14.
Sci Rep ; 12(1): 16263, 2022 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-36171474

RESUMO

There are no studies evaluating the effect of left paratracheal pressure (PP) on difficulty of intubation using Pentax Airway Scope (Pentax), so we conducted this study to show that PP was not inferior to cricoid pressure (CP) in intubation time using the Pentax. Patients aged 19-70 years, with an American Society of Anesthesiologists physical status 1 or 2, and undergoing otorhinolaryngological, gynecological surgery, and cholecystectomy at a single university hospital were enrolled. Intubation was performed using the Pentax under PP or CP of 30 N. The primary outcome was intubation time, and the secondary outcomes were tube advancement difficulty and glottis view. The mean difference in intubation time (PP group - CP group) was - 4.19 s (95% CI - 8.24 to - 0.15), which was within the non-inferiority margin of 6.5 s, thus proving non-inferiority of the PP compared with the CP group. However, the score for tube advancement difficulty was significantly lower in the PP group than in the CP group (p = 0.02). PP did not prolong the intubation time and showed comparable intubation conditions to CP in intubation using the Pentax. Therefore, PP may be a good alternative maneuver to prevent gastric regurgitation during intubation using the Pentax.


Assuntos
Laringoscópios , Glote , Humanos , Intubação Intratraqueal , Laringoscopia , Sistema Respiratório
15.
Head Neck ; 44(11): 2513-2521, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35950338

RESUMO

BACKGROUND: We report outcomes among patients with T2 and select T3 glottic squamous cell carcinoma (SCC) treated with radiotherapy. METHODS: We reviewed T2 and T3 (only paraglottic space invasion) N0 M0 glottic SCC patients treated with curative-intent hypofractionated larynx radiotherapy, with or without concurrent systemic therapy. RESULTS: Of 71 patients, those who received concurrent chemotherapy (23/71; 32%) had worse prognostic factors, including impaired cord mobility (70% vs. 40%, p = 0.02) and larger median gross tumor volume (3.0 vs. 1.6 cm3 , p = 0.003). Over a median follow-up of 3.8 years, 2-year local control among patients with impaired cord mobility appeared higher for those who received chemotherapy (88% vs. 61%, p = 0.12), but the difference was not statistically significant. Acute and late toxicity rates were not higher among patients who received chemotherapy. CONCLUSIONS: The addition of concurrent platinum-based chemotherapy to hypofractionated larynx radiotherapy among patients with early-stage glottic SCC with impaired cord mobility appears safe and worthy of additional investigation.


Assuntos
Neoplasias Laríngeas , Laringe , Glote/patologia , Humanos , Neoplasias Laríngeas/patologia , Laringe/patologia , Hipofracionamento da Dose de Radiação , Prega Vocal/patologia
16.
Am J Otolaryngol ; 43(6): 103551, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36029621

RESUMO

BACKGROUND: The oncologic outcomes between transoral laser microsurgery (TLM) and open partial laryngectomy (OPL) using comprehensive analysis in one clinical center is rare. The purpose of this study was to evaluate the oncologic outcomes of TLM in patients with early stage glottic carcinoma, and to compare the results with OPL. SUBJECTS AND METHODS: Records of 425 glottic carcinoma patients with T1 - T2 stage treated with TLM, vertical partial laryngectomy (VPL), and cricohyoidoepiglottopexy (CHEP) from 2005 to 2010 were retrospectively analyzed. The overall survival (OS), disease-specific survival (DSS), and laryngeal function preservation (LFP) of these three treatments were assessed. RESULTS: One hundred and twenty-two patients were treated with TLM. Regarding OPL, 167 patients underwent VPL, and 136 patients underwent CHEP. The mean age was 59.7 years, with men accounting for 97.2 % of all cases. The OS, DSS, and LFP rates of patients with anterior commissure (AC) involvement undergoing TLM were worse than those of patients without AC involvement, but these differences were not statistically significant. The 5-year OS, DSS, and LFP of patients undergoing TLM were 88.4 %, 89.9 %, and 83.5 %, respectively, and the oncologic outcomes of patients undergoing TLM, VPL, and CHEP were not statistically different. CONCLUSION: Glottic carcinoma patients with early stage treated with TLM experience satisfactory oncologic outcomes. No compelling difference in oncologic outcomes among three treatments of TLM, VPL and CHEP, as well as VPL and CHEP can be alternatives to patients who are not suitable for receiving TLM.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Terapia a Laser , Masculino , Humanos , Pessoa de Meia-Idade , Laringectomia/métodos , Glote/cirurgia , Glote/patologia , Microcirurgia/métodos , Estudos Retrospectivos , Carcinoma de Células Escamosas/patologia , Resultado do Tratamento , Neoplasias Laríngeas/patologia , Terapia a Laser/métodos , Lasers , Estadiamento de Neoplasias
17.
Sci Rep ; 12(1): 14292, 2022 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-35995933

RESUMO

Glottis segmentation is a crucial step to quantify endoscopic footage in laryngeal high-speed videoendoscopy. Recent advances in deep neural networks for glottis segmentation allow for a fully automatic workflow. However, exact knowledge of integral parts of these deep segmentation networks remains unknown, and understanding the inner workings is crucial for acceptance in clinical practice. Here, we show that a single latent channel as a bottleneck layer is sufficient for glottal area segmentation using systematic ablations. We further demonstrate that the latent space is an abstraction of the glottal area segmentation relying on three spatially defined pixel subtypes allowing for a transparent interpretation. We further provide evidence that the latent space is highly correlated with the glottal area waveform, can be encoded with four bits, and decoded using lean decoders while maintaining a high reconstruction accuracy. Our findings suggest that glottis segmentation is a task that can be highly optimized to gain very efficient and explainable deep neural networks, important for application in the clinic. In the future, we believe that online deep learning-assisted monitoring is a game-changer in laryngeal examinations.


Assuntos
Glote , Laringe , Endoscopia , Glote/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Gravação em Vídeo
18.
J Speech Lang Hear Res ; 65(8): 2829-2845, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35914018

RESUMO

PURPOSE: The goal of this study was to experimentally evaluate how compensating for the adverse acoustic effects of a posterior glottal opening (PGO) by increasing subglottal pressure and changing supraglottal compression, as have been associated with vocal hyperfunction, influences the risk of vocal fold (VF) trauma. METHOD: A self-oscillating synthetic silicone model of the VFs with an airflow bypass that modeled a PGO was investigated in a hemilaryngeal flow facility. The influence of compensatory mechanisms on collision pressure and dissipated collision power was investigated for different PGO areas and supraglottal compression. Compensatory behaviors were mimicked by increasing the subglottal pressure to achieve a target sound pressure level (SPL). RESULTS: Increasing the subglottal pressure to compensate for decreased SPL due to a PGO produced higher values for both collision pressure and dissipated collision power. Whereas a 10-mm2 PGO area produced a 12% increase in the peak collision pressure, the dissipated collision power increased by 122%, mainly due to an increase in the magnitude of the collision velocity. This suggests that the value of peak collision pressure may not fully capture the mechanisms by which phonotrauma occurs. It was also found that an optimal value of supraglottal compression exists that maximizes the radiated SPL, indicating the potential utility of supraglottal compression as a compensatory mechanism. CONCLUSIONS: Larger PGO areas are expected to increase the risk of phonotrauma due to the concomitant increase in dissipated collision power associated with maintaining SPL. Furthermore, the risk of VF damage may not be fully characterized by only the peak collision pressure.


Assuntos
Doenças da Laringe , Laringe , Glote , Humanos , Fonação , Silicones , Prega Vocal
19.
J Speech Lang Hear Res ; 65(8): 2881-2895, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35930680

RESUMO

PURPOSE: This exploratory study aims to investigate variations in voice production in the presence of background noise (Lombard effect) in individuals with nonphonotraumatic vocal hyperfunction (NPVH) and individuals with typical voices using acoustic, aerodynamic, and vocal fold vibratory measures of phonatory function. METHOD: Nineteen participants with NPVH and 19 participants with typical voices produced simple vocal tasks in three sequential background conditions: baseline (in quiet), Lombard (in noise), and recovery (5 min after removing the noise). The Lombard condition consisted of speech-shaped noise at 80 dB SPL through audiometric headphones. Acoustic measures from a microphone, glottal aerodynamic parameters estimated from the oral airflow measured with a circumferentially vented pneumotachograph mask, and vocal fold vibratory parameters from high-speed videoendoscopy were analyzed. RESULTS: During the Lombard condition, both groups exhibited a decrease in open quotient and increases in sound pressure level, peak-to-peak glottal airflow, maximum flow declination rate, and subglottal pressure. During the recovery condition, the acoustic and aerodynamic measures of individuals with typical voices returned to those of the baseline condition; however, recovery measures for individuals with NPVH did not return to baseline values. CONCLUSIONS: As expected, individuals with NPVH and participants with typical voices exhibited a Lombard effect in the presence of elevated background noise levels. During the recovery condition, individuals with NPVH did not return to their baseline state, pointing to a persistence of the Lombard effect after noise removal. This behavior could be related to disruptions in laryngeal motor control and may play a role in the etiology of NPVH. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20415600.


Assuntos
Prega Vocal , Voz , Acústica , Glote , Humanos , Fonação
20.
Artigo em Chinês | MEDLINE | ID: mdl-35822366

RESUMO

Objective:To test the feasibility of a rigid curved video laryngoscope in laryngeal microsurgery of patients with difficult laryngeal exposure. Methods:Thirteen patients with difficult laryngeal exposure underwent microlayngeal surgery using a new-design rigid curved video laryngoscope. The clinical data were collected and analyzed. Results:In all of the 13 patients with difficult laryngeal exposure,the fully exposure rate of glottis was 100% using a new-design rigid curved laryngoscope.But only 7 precise surgeries using our rigid curved instruments were completed successfully. Conclusion:Rigid curved laryngoscope is a useful tool to in treating patients with difficult laryngeal exposure in microlaryngeal surgery. Satisfactory glottis exposure, magnified surgical field and precise maneuver of the lesions could be achieved. But manipulation of this tool is challenging, which warrants further investigation..


Assuntos
Laringoscópios , Laringe , Glote/cirurgia , Humanos , Laringoscopia , Laringe/cirurgia , Microcirurgia
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