[Functional results after cordectomy in laryngeal fissure and in microlaryngoscopy with CO2 laser]. / Risultati funzionali dopo cordectomia in laringofissura e in microlaringoscopia con laser CO2.

Videolaryngostroboscopy, psychoacoustic and spectrographic analyses were performed to evaluate vocal function in two groups of male patients who had undergone CO2Laser (n = 23) and laryngofissure cordectomy (n = 21) for the treatment of T1a glottic carcinoma. None of the patients used their voices professionally. This study revealed a good correlation between the anatomical features and voice quality. Psychoacoustic and spectrographic analysis showed that the functional results were significantly worse in the patients treated by laryngofissure (p < 0.003). In this group videolaryngostroboscopy showed a higher rate of compensation in both ventricular folds than shown in the laser-treated group (p < 0.02). The authors conclude that the functional results obtained after cordectomy depend on the various combinations of scarring patterns and compensatory hyperkinesia of the ventricular or vocal folds. The better anatomical and functional results achieved following laser cordectomy may be explained by the fact that such procedures result in better, more rapid healing processes.

[Medical-legal evaluation of laryngeal dysfunction to determine disability]. / Valutazione medico-legale delle disfunzioni laringee in ambito di invalidità civile.

The "New Table indicating the percentage of disability resulting from injury and disabling diseases" approved by the Italian Ministerial Decree dated February 5, 1992 gives a superficial, highly disorganized handling of laryngeal pathologies. This Table only considers phonatory function disorders which are included in a special section; it totally neglects dyspnea and dysphagia of laryngeal origin. This omission cannot even be overcome on the basis of similarities since there are no analogous items listed for reference. In fact, the parameters applied to evaluate dyspnea (CV, VEMS, O2 consumption) apply to ventilation disorders of a pulmonary nature and cannot, therefore, be used in cases of laryngeal dyspnea. Moreover, the Table does not deal with dysphagia at all. In addition, the basis for the Table--the concept of permanent functional damage--is not always adhered to in giving indications for evaluation of phonatory tract damage. The purpose of the present work is not, however, to propose a different way to determine the percentages for the individual items in the tables; rather, the aim is to suggest a different, highly standardized procedure for evaluating laryngeal dysfunctions which is easy to apply.

Latency of the auditory brainstem response (ABR) and head size. Evidence of the relationship by means of radiographic data.

The role of head size to determine the inter-subject variability of the auditory brainstem response (ABR) was investigated in 32 normally hearing adults (19 females, 13 males, aged 18 to 52). The ABRs were evaluated in respect to the absolute latency of waves I, III and V and the interpeak latencies I-III, III-V and I-V. Plain films of the skull (3 views) were also taken of each subject and several measures were calculated in order to obtain an evaluation of the dimensions of both the most rostral parts of the skull and of the posterior fossa. The radiographic data as well as the ABR parameters showed significantly shorter values in females than in males. There was a strong positive correlation between the two variables when a linear regression procedure was applyed. The highest value of the correlation coefficient (r = 0.8) was found in the relationship between the wave V latency and the posterior fossa measures. High r values and similar factors in the regression equation were also found after considering the subjects separately according to sex. These results show that the ABR latencies linearly increase together with the skull size as it appears in the X-rays, regardless of the subject's sex. We can consequently deduce that the length of the neural pathway is the main factor of inter-sex variability of the response.