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1.
Artigo em Chinês | MEDLINE | ID: mdl-36603863

RESUMO

Objective: To investigate the long-term outcomes of patients with unilateral vocal fold paralysis resulting in dysphonia treated with lateral vocal fold autologous fat injection. To analyze the factors that may affect the long-term efficacy of the procedure. Methods: From July 2003 to June 2020, 163 patients (86 males and 77 females), aged 9-73 years (mean (34.50±12.94) years) with unilateral vocal fold paralysis resulting in dysphonia underwent transoral laryngoscopic injection of autologous fat into the lateral vocal folds. Subjective auditory perception assessment (GRBAS scale), objective acoustic assessment, voice handicap index (VHI) evaluation and stroboscopic laryngoscopy were compared before and after the surgery. Patients were followed up for 1 to 18 years, with median follow-up time of 6 years. SPSS 22.0 software was used for statistical analysis. Results: Of 163 patients, 17 patients (10.4%) had mild hoarseness (G1) and 146 patients (89.6%) had moderate to severe hoarseness (G2-3). Stroboscopic laryngoscopy revealed an arch-shaped vocal fold on the affected side, fixed in the paramedian position or abduction position, with obvious glottic closure fissure. Postoperatively, voice recovered to normal (G0) in 139 patients (85.3%), mild hoarseness (G1) in 18 patients (11.0%) and moderate hoarseness (G2) in 6 patients (3.7%). Of these, 131 patients (80.4%) showed significant improvement in hoarseness, 29 patients (17.8%) showed mild improvement and 3 patients (1.8%) showed no significant improvement in hoarseness. Objective acoustic parameters of Jitter, Shimmer, NHR and MPT improved significantly, as did VHI scores. Stroboscopic laryngoscopy showed medialization of the affected vocal folds, improved vocal fold closure and normal or nearly normal vocal fold mucosal waves. With a fat injection volume of 3.0-4.5 ml, the patient's subjective auditory perception scores of G, R, B and A improved more significantly within 3 months after surgery, and both VHI and MPT were significantly better since 1 year after surgery. With bilateral vocal fold injection, the B and A scores improved significantly from 1 month postoperatively compared to unilateral injections(unilateral vs. bilateral injection 1 month post-operation, tB scores=1.42,tA scores=1.51,P<0.05). Conclusions: The long-term efficacy of autologous fat injection in the paraglottic space for the treatment of unilateral vocal fold paralysis was stable. The efficacy of the surgery was related to the amount of fat injected, unilateral or bilateral of the injection.


Assuntos
Disfonia , Paralisia das Pregas Vocais , Masculino , Feminino , Humanos , Prega Vocal/cirurgia , Disfonia/cirurgia , Rouquidão , Resultado do Tratamento , Paralisia das Pregas Vocais/cirurgia
2.
J Speech Lang Hear Res ; 66(1): 1-15, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36603545

RESUMO

PURPOSE: Bilateral vocal fold paralysis (BVFP) is a severe disorder that can result in respiratory, swallowing, and voice-related problems. Most surgical treatments do not restore laryngeal function and often need to compromise voice quality to preserve respiratory function. Laryngeal reinnervation (LR) may offer a solution to this problem, but literature on longitudinal outcomes of this procedure is scarce. This study aims to report the longitudinal vocal outcomes of BVFP after LR and subsequent voice therapy. METHOD: The case of a 23-year-old man with BVFP after a traumatic dissection of both recurrent laryngeal nerves is described. Selective bilateral LR of both adductors and abductors was performed 5 months after the onset of BVFP. Voice therapy was provided after the LR procedure. Multidimensional voice assessments, including acoustic, perceptual, and patient-reported outcome measures (PROMs), were conducted 2, 5, 6.5, 8, and 31 months after LR. RESULTS: An improvement of vocal capabilities and voice quality was noticed 6.5 months after LR, after 4.5 months of voice therapy, with normative values after 2.5 years. PROMs showed an improvement of voice-related quality of life, but some limitations to activities of daily living were still present. Inspiratory arytenoid abduction was not observed on laryngeal videostroboscopic findings in this patient, but tracheostomy was not required. CONCLUSIONS: Voice therapy after LR helps establish healthy and efficient voice use without increasing compensatory hyperfunctional behavior. More research is needed to examine potential merits of voice therapy in the rehabilitation of vocal and respiratory functions after LR.


Assuntos
Laringe , Paralisia das Pregas Vocais , Distúrbios da Voz , Masculino , Humanos , Adulto Jovem , Adulto , Prega Vocal , Qualidade de Vida , Atividades Cotidianas , Laringe/cirurgia , Paralisia das Pregas Vocais/etiologia , Paralisia das Pregas Vocais/cirurgia , Resultado do Tratamento
3.
Sci Rep ; 13(1): 878, 2023 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-36650265

RESUMO

The entire glottis has mostly been the focus in the tracking of the vocal folds, both manually and automatically. From a treatment point of view, the various regions of the glottis are of specific interest. The aim of the study was to test if it was possible to supplement an existing convolutional neural network (CNN) with post-network calculations for the localization and quantification of posterior glottal gaps during phonation, usable for vocal fold function analysis of e.g. laryngopharyngeal reflux findings. 30 subjects/videos with insufficient closure in the rear glottal area and 20 normal subjects/videos were selected from our database, recorded with a commercial high-speed video setup (HSV with 4000 frames per second), and segmented with an open-source CNN for validating voice function. We made post-network calculations to localize and quantify the 10% and 50% distance lines from the rear part of the glottis. The results showed a significant difference using the algorithm at the 10% line distance between the two groups of p < 0.0001 and no difference at 50%. These novel results show that it is possible to use post-network calculations on CNNs for the localization and quantification of posterior glottal gaps.


Assuntos
Aprendizado Profundo , Laringe , Humanos , Prega Vocal/diagnóstico por imagem , Glote/diagnóstico por imagem , Fonação , Vibração
4.
J Proteomics ; 270: 104734, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36174951

RESUMO

BACKGROUND: A considerable body of clinical evidence suggests that systemic dehydration can negatively affect voice production, leading to the common recommendation to rehydrate. Evidence for the corrective benefits of rehydration, however, is limited with mixed conclusions, and biological data on the underlying tissue changes with rehydration is lacking. In this study, we used a rabbit model (n = 24) of acute (5 days) water restriction-induced systemic dehydration with subsequent rehydration (3 days) to explore the protein-level changes underlying the molecular transition from euhydration to dehydration and following rehydration using LC-MS/MS protein quantification in the vocal folds. We show that 5-day water restriction led to an average 4.3% decrease in body weight with relative increases in anion gap, Cl-, creatinine, Na+, and relative decreases in BUN, iCa2+, K+, and tCO2 compared to control (euhydrated) animals. A total of 309 differentially regulated (p < 0.05) proteins were identified between the Control and Dehydration groups. We observed a noteworthy similarity between the Dehydration and Rehydration groups, both well differentiated from the Control group, highlighting the distinct timelines of resolution of the clinical symptoms of systemic dehydration and the underlying molecular changes. SIGNIFICANCE: Voice disorders are a ubiquitous problem with considerable economic and psychological impact. Maintenance of proper hydration is commonly prescribed as a general vocal hygiene practice. There is evidence that dehydration negatively impacts phonation, but our understanding of the state of vocal folds in the context of systemic dehydration are limited, particular from a molecular perspective. Further, ours is a novel molecular study of the short-term impact of rehydration on the tissue. Given the relatively minimal difference in vocal fold proteomic profiles between the Dehydration and Rehydration groups, our data demonstrate a complex physiological response to acute systemic dehydration, and highlight the importance of considering persistent underlying molecular pathology despite the rapid resolution of clinical measures. This study sets a foundation for future research to confirm the nature of potential beneficial outcomes of clinical recommendations related to hydration.


Assuntos
Desidratação , Prega Vocal , Animais , Coelhos , Prega Vocal/metabolismo , Desidratação/metabolismo , Proteômica , Cromatografia Líquida , Espectrometria de Massas em Tandem , Hidratação , Água/metabolismo
5.
Eur Arch Otorhinolaryngol ; 279(2): 817-823, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34581854

RESUMO

PURPOSE: Optical image enhancement techniques are widely used in endoscopy to improve the visualization of blood vessels for diagnostic and therapeutic purposes. These techniques are monitor-based and therefore not available for direct microscopy. In this study, a novel optical microscope filter, Hemoglobin absorption spectral imaging (H.A.S.I.) was tested for use in microlaryngoscopy. METHODS: A novel dichroic filter was designed to improve contrast in small blood vessels by highlighting transmission in the spectrum range of hemoglobin absorption maxima. A surgical microscope equipped with the novel H.A.S.I. filter was installed in one operating room in our institution. 68 consecutive patients referred to our ENT department for endoscopy were examined using white light and the novel H.A.S.I. filter during microlaryngoscopy. Surgeons described the blood vessels of the vocal cords using a classification chart and assessed for suspected malignancy using both white light and H.A.S.I. RESULTS: 77 consecutive microlaryngoscopies were performed on 68 patients. 142 vocal cords were visualized in microlaryngoscopy and the blood vessels classified according to the chart. With white light, 152 blood vessel characteristics were documented and 157 with H.A.S.I. Notably, pathologies like benign horizontal blood vessel changes, leukoplakia, and vertical blood vessel changes like dots and loops were seen more frequently with H.A.S.I. Finally, seven lesions were treated by transoral laser microsurgery (TLM) with H.A.S.I. to test the practicability of the method for microlaryngoscopic laser surgery. CONCLUSION: This is the first study describing H.A.S.I. as an optical staining method for microlaryngoscopy. In our experience, the method was practical and improved the evaluation of vocal cord blood vessels. In some cases, the use of H.A.S.I. led to a change in diagnosis and treatment. Also, H.A.S.I. was found to be helpful in microlaryngeal laser surgery for demarcating resection margins. This is, to our knowledge, the first optical staining method integrated into a surgical microscope and can be conveniently used during microlaryngeal laser surgery and does not require further equipment.


Assuntos
Laringoscopia , Prega Vocal , Endoscopia , Hemoglobinas , Humanos , Microcirurgia , Coloração e Rotulagem , Prega Vocal/diagnóstico por imagem , Prega Vocal/cirurgia
6.
J Acoust Soc Am ; 152(5): 2557, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36456298

RESUMO

While the glottal flow is often simplified as one-dimensional (1D) in computational models of phonation to reduce computational costs, the 1D flow model has not been validated in left-right asymmetric vocal fold conditions, as often occur in both normal and pathological voice production. In this study, we performed three-dimensional (3D) and 1D flow simulations coupled to a two-mass model of adult male vocal folds and compared voice production at different degrees of left-right stiffness asymmetry. The flow and acoustic fields in 3D were obtained by solving the compressible Navier-Stokes equations using the volume penalization method with the moving vocal fold wall as an immersed boundary. Despite differences in the predicted flow pressure on vocal fold surface between the 1D and 3D flow models, the results showed reasonable agreement in vocal fold vibration patterns and selected voice outcome measures between the 1D and 3D models for the range of left-right asymmetric conditions investigated. This indicates that vocal fold properties play a larger role than the glottal flow in determining the overall pattern of vocal fold vibration and the produced voice, and the 1D flow simplification is sufficient in modeling phonation, at least for the simplified glottal geometry of this study.


Assuntos
Glote , Prega Vocal , Adulto , Humanos , Masculino , Fonação , Acústica , Vibração
7.
JASA Express Lett ; 2(11): 111201, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36456367

RESUMO

The vocal membrane, i.e., an extended part of the vocal fold, is observed in a wide range of species including bats and primates. A theoretical study [Mergell, Fitch, and Herzel (1999). J. Acoust. Soc. Am. 105(3), 2020-2028] predicted that the vocal membranes can make the animal vocalizations more efficient by lowering the phonation threshold pressure. To examine this prediction, a synthetic model of the vocal membrane was developed, and its oscillation properties were examined. The experiments revealed that the phonation threshold pressure was lower in the vocal membrane model compared to that in a model with no vocal membrane. Chaotic oscillations were observed as well.


Assuntos
Quirópteros , Fonação , Animais , Prega Vocal , Membranas , Equipamentos Médicos Duráveis , Exame Físico
8.
Artigo em Chinês | MEDLINE | ID: mdl-36543405

RESUMO

Objective:To investigate the clinical features of electronic laryngoscope in the diagnosis of senile voice diseases. Methods:Elderly patients who visited the outpatient department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital from September 2014 to September 2018 were collected. All patients came in with hoarseness. All patients were routinely diagnosed by electronic laryngoscopy and the results were analyzed. Results:A total of 1330 elderly patients aged 60 years and over were enrolled in this study, including 924 males and 406 females. There are significant differences in the distribution of various voice diseases in different genders(P<0.05). Among male elderly patients, the top three were: 239 cases of throat malignant tumor(25.87%), 182 cases of vocal cord benign proliferative disease(19.70%), 147 cases of vocal cord leukoplakia(15.91%). Among female elderly patients, the top three diseases were: 183 cases(45.07%) of vocal cord benign proliferative disease, 70 cases(17.24%) of laryngitis, 66 cases(16.26%) of vocal cord paralysis. There were significant differences in the distribution of different voice disorders among the three different age groups of elderly patients. The top three elderly patients aged 60-69 years were: 298 cases(35.06%) of vocal cord benign proliferative diseases, 132 cases(15.53%) of laryngopharyngeal malignant tumors, 104 cases(12.24%) of vocal cord paralysis. The top three elderly patients aged 70-79 years were: 91 cases(24.20%) of laryngopharyngeal malignant tumors, 57 cases(15.16%) of vocal cord benign proliferative diseases, 55 cases(14.63%) of vocal cord paralysis. The top three elderly patients aged 80 years and above were: 25 cases(24.04%) of laryngopharyngeal malignant tumors, 21 cases(20.19%) of vocal cord paralysis, 16 cases(15.38%) of the vocal cords are not closed completely. There were also significant differences in the distribution of various voice diseases among smokers(P<0.05). Conclusion:With the acceleration of the aging of society, we should pay more attention to the voice of the elderly. The most common disease in elderly women with hoarseness is benign hyperplastic vocal cord disease. The high incidence of laryngeal malignant tumors in elderly male hoarseness patients who smoke should be paid special attention to. Electronic laryngoscope plays an important role in the diagnosis of voice diseases in elderly patients.


Assuntos
Neoplasias Laríngeas , Laringoscópios , Paralisia das Pregas Vocais , Distúrbios da Voz , Voz , Idoso , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Rouquidão/etiologia , Paralisia das Pregas Vocais/diagnóstico , Laringoscópios/efeitos adversos , Prega Vocal , Laringoscopia/métodos , Neoplasias Laríngeas/diagnóstico
9.
J Acoust Soc Am ; 152(6): 3245, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36586828

RESUMO

Laryngeal mucus hydrates and lubricates the deformable tissue of the vocal folds and acts as a boundary layer with the airflow from the lungs. However, the effects of the mucus' viscoelasticity on phonation remain widely unknown and mucus has not yet been established in experimental procedures of voice research. In this study, four synthetic mucus samples were created on the basis of xanthan with focus on physiological frequency-dependent viscoelastic properties, which cover viscosities and elasticities over 2 orders of magnitude. An established ex vivo experimental setup was expanded by a reproducible and controllable application method of synthetic mucus. The application method and the suitability of the synthetic mucus samples were successfully verified by fluorescence evidence on the vocal folds even after oscillation experiments. Subsequently, the impact of mucus viscoelasticity on the oscillatory dynamics of the vocal folds, the subglottal pressure, and acoustic signal was investigated with 24 porcine larynges (2304 datasets). Despite the large differences of viscoelasticity, the phonatory characteristics remained stable with only minor statistically significant differences. Overall, this study increased the level of realism in the experimental setup for replication of the phonatory process enabling further research on pathological mucus and exploration of therapeutic options.


Assuntos
Laringe , Suínos , Animais , Laringe/fisiologia , Prega Vocal/fisiologia , Fonação/fisiologia , Muco , Acústica
10.
Cir. Esp. (Ed. impr.) ; 100(12): 755-761, dic. 2022. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-212487

RESUMO

Introducción: La ecografía cervical (EC) ha surgido como una herramienta prometedora en los últimos años para la evaluación de las cuerdas vocales (CV) en pacientes sometidos a cirugía de tiroides. Nuestro objetivo es valorar la fiabilidad de la EC una vez implementada en una unidad de cirugía endocrina y realizada por los propios cirujanos. Método: Se incluyeron 86 participantes sin antecedentes de enfermedad laríngea ni cirugía cervical a los que se les realizó una EC por parte de 3 cirujanos endocrinos independientes. Se analizaron las estructuras laríngeas y específicamente las CV. Para considerar la exploración como diagnóstica debían visualizarse las CV de manera estática y durante la fonación. También se analizó el tiempo de realización de la técnica y la variabilidad interobservador. Resultados: De los 86 participantes el 51,2% fueron varones y la edad media fue de 43 años. El rango de exploraciones diagnósticas entre los cirujanos fue de 60-68%, con una concordancia sustancial entre los 3 exploradores (valor K de Fleiss's=0,714). El sexo masculino y la edad avanzada fueron factores asociados a la no evaluabilidad de la técnica. El tiempo medio del procedimiento fue de 72segundos. Conclusión: La EC es una herramienta rápida, no invasiva, viable a pie de cama y útil para la evaluar las CV antes de la cirugía tiroidea, principalmente en mujeres jóvenes. (AU)


Introduction: Cervical ultrasound (CE) has emerged as a promising tool in recent years for vocal cord (VC) assessment in patients undergoing thyroid surgery. Our aim is to assess the reliability of CE once implemented in an endocrine surgery unit and performed by the surgeons themselves. Method: 86 participants with no history of laryngeal pathology or cervical surgery underwent CE by three independent endocrine surgeons. Laryngeal structures and specifically the VCs were analysed. To consider the examination as diagnostic, the VCs had to be visualised statically and during phonation. The time taken to perform the technique and the interobserver variability were also analysed.Results: Of the 86 participants, 51.2% were male with a mean age of 43 years. The range of diagnostic examinations between surgeons was 60-68%, with substantial agreement between the 3 explorers (Fleiss's K-value=.714). Male sex and advanced age were factors associated with non-assessability of the technique. The mean procedure time was 72s. Conclusion: CE is a fast, non-invasive, feasible bedside tool useful for the assessment of VCs prior to thyroid surgery, mainly in young women. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Ultrassonografia , Prega Vocal , Estudos Prospectivos , Laringoscopia , Cartilagem Tireóidea
11.
PLoS One ; 17(12): e0279338, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36580467

RESUMO

INTRODUCTION: Currently there is no consistent and widely accepted approach to the diagnosis of vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO). Harmonised diagnostic methods are vital to enable optimal diagnosis, advance management and enable research. We aim to obtain consensus on how expert clinicians recognise and diagnose VCD/ILO. METHODS AND ANALYSIS: Two-round modified Delphi, with workshop validation. ETHICS AND DISSEMINATION: Institutional Board Review was obtained from the Monash Health Human Research Ethics Committee. The dissemination plan is for presentation and publication. REGISTRATION DETAILS: Registered at Australia and New Zealand Clinical Trials Registry ACTRN12621001520820p.


Assuntos
Obstrução das Vias Respiratórias , Doenças da Laringe , Disfunção da Prega Vocal , Humanos , Técnica Delfos , Disfunção da Prega Vocal/diagnóstico , Obstrução das Vias Respiratórias/diagnóstico , Laringoscopia , Prega Vocal
12.
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 , Prega Vocal , Luz , Movimento (Física)
13.
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
14.
Tissue Cell ; 79: 101965, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36371843

RESUMO

PURPOSE: To explore the regulation of SOCS3 in the JAK2/STAT3 pathway during vocal fold fibroblast activation after vocal fold injury. METHODS: Normal vocal fold fibroblasts (VFFs), injured VFFs, and simulated injured VFFs (normal VFFs supplemented with transforming growth factor beta [TGF-ß]) were treated with a JAK2 inhibitor (AG490), and SOCS3 was overexpressed in each group. Type I collagen (COL1), α-smooth muscle actin (α-SMA), SOCS3, JAK2, and STAT3 were detected using immunofluorescence, quantitative real-time polymerase chain reaction (qRT-PCR), and western blotting. RESULTS: Compared with normal VFFs, expression of SOCS3 was lower, but p-JAK/p-STAT3 and JAK2/STAT3 were higher in injured and simulated injured VFFs. After the addition of AG490, COL1 and α-SMA expressions did not change significantly in normal VFFs but was significantly decreased in the other two groups. The protein and mRNA expression levels of SOCS3 were significantly increased, while those of p-JAK/p-STAT3 and JAK2/STAT3 were significantly decreased. When SOCS3 was overexpressed, the COL1 and α-SMA expression levels in normal VFFs were not altered significantly, whereas they were significantly decreased in injured and simulated injured VFFs. The expression of p-JAK2/p-STAT3 significantly decreased when SOCS3 was overexpressed in injured and simulated injured VFFs. CONCLUSION: SOCS3 may regulate the activation of JAK2/STATA3 pathway after vocal fold injury. In addition, SOCS3 may inhibit excessive activation of vocal fold fibroblasts by downregulating JAK2/STAT3 in the early stages of vocal fold injury.


Assuntos
Tirfostinas , Prega Vocal , Fibroblastos , Fator de Crescimento Transformador beta
15.
Cell Mol Life Sci ; 79(12): 591, 2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36376494

RESUMO

Mechanoreceptors are implicated as functional afferents within mucosa of the airways and the recent discovery of mechanosensitive channels Piezo1 and Piezo2 has proved essential for cells of various mechanically sensitive tissues. However, the role for Piezo1/2 in vocal fold (VF) mucosal epithelia, a cell that withstands excessive biomechanical insult, remains unknown. The purpose of this study was to test the hypothesis that Piezo1 is required for VF mucosal repair pathways of epithelial cell injury. Utilizing a sonic hedgehog (shh) Cre line for epithelial-specific ablation of Piezo1/2 mechanoreceptors, we investigated 6wk adult VF mucosa following naphthalene exposure for repair strategies at 1, 3, 7 and 14 days post-injury (dpi). PIEZO1 localized to differentiated apical epithelia and was paramount for epithelial remodeling events. Injury to wildtype epithelium was most appreciated at 3 dpi. Shhcre/+; Piezo1loxP/loxP, Piezo2 loxP/+ mutant epithelium exhibited severe cell/nuclear defects compared to injured controls. Conditional ablation of Piezo1 and/or Piezo2 to uninjured VF epithelium did not result in abnormal phenotypes across P0, P15 and 6wk postnatal stages compared to heterozygote and control tissue. Results demonstrate a role for Piezo1-expressing VF epithelia in regulating self-renewal via effects on p63 transcription and YAP subcellular translocation-altering cytokeratin differentiation.


Assuntos
Proteínas Hedgehog , Queratinas , Proteínas Hedgehog/metabolismo , Queratinas/genética , Prega Vocal/metabolismo , Células Epiteliais/metabolismo , Epitélio/metabolismo
16.
BMC Genomics ; 23(1): 762, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36411412

RESUMO

BACKGROUND: Older adults are more prone to develop systemic dehydration. Systemic dehydration has implications for vocal fold biology by affecting gene and protein expression. The objective of this study was to quantify vocal fold protein changes between two age groups and hydration status, and to investigate the interaction of age and hydration status on protein expression, which has not been investigated in the context of vocal folds before. Comparative proteomics was used to analyze the vocal fold proteome of 6.5-month-old and > 3-year-old rabbits subjected to water ad libitum or water volume restriction protocol. RESULTS: Young and older adult rabbits (n = 22) were either euhydrated (water ad libitum) or dehydrated by water volume restriction. Dehydration was confirmed by body weight loss of - 5.4% and - 4.6% in young and older groups, respectively, and a 1.7-fold increase of kidney renin gene expression in the young rabbits. LC-MS/MS identified 2286 proteins in the rabbit vocal folds of young and older adult rabbits combined. Of these, 177, 169, and 81 proteins were significantly (p ≤ 0.05) affected by age, hydration status, or the interaction of both factors, respectively. Analysis of the interaction effect revealed 32 proteins with opposite change patterns after dehydration between older and young rabbit vocal folds, while 31 proteins were differentially regulated only in the older adult rabbits and ten only in the young rabbits in response to systemic dehydration. The magnitude of changes for either up or downregulated proteins was higher in the older rabbits. These proteins are predominantly related to structural components of the extracellular matrix and muscle layer, suggesting a disturbance in the viscoelastic properties of aging vocal fold tissue, especially when subjected to systemic dehydration. CONCLUSIONS: Water restriction is a laboratory protocol to assess systemic dehydration-related changes in the vocal fold tissue that is translatable to human subjects. Our findings showed a higher number of proteins differentially regulated with a greater magnitude of change in the vocal folds of older adult rabbits in the presence of systemic dehydration compared to younger rabbits. The association of these proteins with vocal fold structure and biomechanical properties suggests that older human subjects may be more vulnerable to the effects of systemic dehydration on vocal function. The clinical implications of these protein changes warrant more investigation, but age should be taken into consideration when evaluating vocal treatment recommendations that interfere with body fluid balance.


Assuntos
Desidratação , Prega Vocal , Animais , Coelhos , Humanos , Idoso , Lactente , Pré-Escolar , Prega Vocal/fisiologia , Proteômica , Cromatografia Líquida , Espectrometria de Massas em Tandem , Água , Envelhecimento
17.
ACS Appl Mater Interfaces ; 14(46): 51669-51682, 2022 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-36367478

RESUMO

Repeated mechanical and chemical insults cause an irreversible alteration of extracellular matrix (ECM) composition and properties, giving rise to vocal fold scarring that is refractory to treatment. Although it is well known that fibroblast activation to myofibroblast is the key to the development of the pathology, the lack of a physiologically relevant in vitro model of vocal folds impedes mechanistic investigations on how ECM cues promote myofibroblast differentiation. Herein, we describe a bio-orthogonally cross-linked hydrogel platform that recapitulates the alteration of matrix adhesiveness due to enhanced fibronectin deposition when vocal fold wound healing is initiated. The synthetic ECM (sECM) was established via the cycloaddition reaction of tetrazine (Tz) with slow (norbornene, Nb)- and fast (trans-cyclooctene, TCO)-reacting dienophiles. The relatively slow Tz-Nb ligation allowed the establishment of the covalent hydrogel network for 3D cell encapsulation, while the rapid and efficient Tz-TCO reaction enabled precise conjugation of the cell-adhesive RGDSP peptide in the hydrogel network. To mimic the dynamic changes of ECM composition during wound healing, RGDSP was conjugated to cell-laden hydrogel constructs via a diffusion-controlled bioorthognal ligation method 3 days post encapsulation. At a low RGDSP concentration (0.2 mM), fibroblasts residing in the hydrogel remained quiescent when maintained in transforming growth factor beta 1 (TGF-ß1)-conditioned media. However, at a high concentration (2 mM), RGDSP potentiated TGF-ß1-induced myofibroblast differentiation, as evidenced by the formation of an actin cytoskeleton network, including F-actin and alpha-smooth muscle actin. The RGDSP-driven fibroblast activation to myofibroblast was accompanied with an increase in the expression of wound healing-related genes, the secretion of profibrotic cytokines, and matrix contraction required for tissue remodeling. This work represents the first step toward the establishment of a 3D hydrogel-based cellular model for studying myofibroblast differentiation in a defined niche associated with vocal fold scarring.


Assuntos
Miofibroblastos , Fator de Crescimento Transformador beta1 , Humanos , Fator de Crescimento Transformador beta1/farmacologia , Prega Vocal/metabolismo , Hidrogéis/farmacologia , Hidrogéis/metabolismo , Cicatriz/metabolismo , Adesividade , Fibroblastos
18.
J Healthc Eng ; 2022: 4248938, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36353680

RESUMO

The use of high-speed video-endoscopy (HSV) in the study of phonatory processes linked to speech needs the precise identification of vocal fold boundaries at the time of vibration. The HSV is a unique laryngeal imaging technology that captures intracycle vocal fold vibrations at a higher frame rate without the need for auditory inputs. The HSV is also effective in identifying the vibrational characteristics of the vocal folds with an increased temporal resolution during retained phonation and flowing speech. Clinically significant vocal fold vibratory characteristics in running speech can be retrieved by creating automated algorithms for extracting HSV-based vocal fold vibration data. The best deep learning-based diagnosis and categorization of vocal fold abnormalities is due to the usage of HSV (ODL-VFDDC). The suggested ODL-VFDDC technique starts with temporal segmentation and motion correction to identify vocalized regions from the HSV recording and gathers the position of movable vocal folds across frames. The attributes gathered are fed into the deep belief network (DBN) model. Furthermore, the agricultural fertility algorithm (AFA) is used to optimize the hyperparameter tuning of the DBN model, which improves classification results. In terms of vocal fold disorder classification, the testing results demonstrated that the ODL-VFDDC technique beats the other existing methodologies. The farmland fertility algorithm (FFA) is then used to accurately determine the glottal limits of vibrating vocal folds. The suggested method has successfully tracked the speech fold boundaries across frames with minimum processing cost and high resilience to picture noise. This method gives a way to look at how the vocal folds move during a connected speech that is completely done by itself.


Assuntos
Aprendizado Profundo , Paralisia das Pregas Vocais , Prega Vocal , Humanos , Endoscopia/métodos , Fonação , Gravação em Vídeo/métodos , Prega Vocal/diagnóstico por imagem
19.
Sci Rep ; 12(1): 20554, 2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36446830

RESUMO

Creation of sub-epithelial voids within scarred vocal folds via ultrafast laser ablation may help in localization of injectable therapeutic biomaterials towards an improved treatment for vocal fold scarring. Several ultrafast laser surgery probes have been developed for precise ablation of surface tissues; however, these probes lack the tight beam focusing required for sub-surface ablation in highly scattering tissues such as vocal folds. Here, we present a miniaturized ultrafast laser surgery probe designed to perform sub-epithelial ablation in vocal folds. The requirement of high numerical aperture for sub-surface ablation, in addition to the small form factor and side-firing architecture required for clinical use, made for a challenging optical design. An Inhibited Coupling guiding Kagome hollow core photonic crystal fiber delivered micro-Joule level ultrashort pulses from a high repetition rate fiber laser towards a custom-built miniaturized objective, producing a 1/e2 focal beam radius of 1.12 ± 0.10 µm and covering a 46 × 46 µm2 scan area. The probe could deliver up to 3.8 µJ pulses to the tissue surface at 40% transmission efficiency through the entire system, providing significantly higher fluences at the focal plane than were required for sub-epithelial ablation. To assess surgical performance, we performed ablation studies on freshly excised porcine hemi-larynges and found that large area sub-epithelial voids could be created within vocal folds by mechanically translating the probe tip across the tissue surface using external stages. Finally, injection of a model biomaterial into a 1 × 2 mm2 void created 114 ± 30 µm beneath the vocal fold epithelium surface indicated improved localization when compared to direct injection into the tissue without a void, suggesting that our probe may be useful for pre-clinical evaluation of injectable therapeutic biomaterials for vocal fold scarring therapy. With future developments, the surgical system presented here may enable treatment of vocal fold scarring in a clinical setting.


Assuntos
Terapia a Laser , Prega Vocal , Animais , Suínos , Prega Vocal/cirurgia , Cicatriz/cirurgia , Materiais Biocompatíveis , Injeções
20.
Ugeskr Laeger ; 184(47)2022 11 21.
Artigo em Dinamarquês | MEDLINE | ID: mdl-36426831

RESUMO

Injection augmentation of the vocal cords is a recognized treatment modality in patients with glottal closure deficiency caused by paresis or paralysis of the vocal cord. The treatment can improve voice quality and also quality of life. It is preferable to minimize waiting time for the procedure for patients with lung cancer and mediastinal involvement, because the one-year mortality is above 40%, as argued in this review.


Assuntos
Neoplasias Pulmonares , Prega Vocal , Humanos , Qualidade de Vida , Mediastino , Cuidados Paliativos
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