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Sample records for adductor spasmodic dysphonia

  1. Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

    Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

    2004-01-01

    This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

  2. Adductor spasmodic dysphonia and botulinum toxin treatment : The effect on well-being

    Langeveld, TPM; Luteijn, F; van Rossum, M; Drost, HA; De Jong, RJB

    2001-01-01

    Adductor spasmodic dysphonia (AdSD) is a controversial and enigmatic voice disorder. It is generally accepted that it has a neurologic, although undetermined, cause, and it is accompanied by much psychological and physical distress. In this prospective study, standardized psychometric tests were use

  3. Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task.

    Sapienza, Christine M.; Walton, Suzanne; Murry, Thomas

    1999-01-01

    Acoustic phonatory events were identified in 14 women diagnosed with adductor spasmodic dysphonia (ADSD), a focal laryngeal dystonia that disturbs phonatory function, and compared with those of 14 age-matched women with no vocal dysfunction. Findings indicated ADSD subjects produced more aberrant acoustic events than controls during tasks of…

  4. Adductor spasmodic dysphonia: Relationships between acoustic indices and perceptual judgments

    Cannito, Michael P.; Sapienza, Christine M.; Woodson, Gayle; Murry, Thomas

    2003-04-01

    This study investigated relationships between acoustical indices of spasmodic dysphonia and perceptual scaling judgments of voice attributes made by expert listeners. Audio-recordings of The Rainbow Passage were obtained from thirty one speakers with spasmodic dysphonia before and after a BOTOX injection of the vocal folds. Six temporal acoustic measures were obtained across 15 words excerpted from each reading sample, including both frequency of occurrence and percent time for (1) aperiodic phonation, (2) phonation breaks, and (3) fundamental frequency shifts. Visual analog scaling judgments were also obtained from six voice experts using an interactive computer interface to quantify four voice attributes (i.e., overall quality, roughness, brokenness, breathiness) in a carefully psychoacoustically controlled environment, using the same reading passages as stimuli. Number and percent aperiodicity and phonation breaks correlated significanly with perceived overall voice quality, roughness, and brokenness before and after the BOTOX injection. Breathiness was correlated with aperidocity only prior to injection, while roughness also correlated with frequency shifts following injection. Factor analysis reduced perceived attributes to two principal components: glottal squeezing and breathiness. The acoustic measures demonstrated a strong regression relationship with perceived glottal squeezing, but no regression relationship with breathiness was observed. Implications for an analysis of pathologic voices will be discussed.

  5. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

    Michael P Cannito

    2008-03-01

    Full Text Available Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age.Keywords: vocal aging, adductor spasmodic dysphonia, botulinum toxin, voice quality, speech fluency

  6. Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

    Abiola Jesuloba

    2009-10-01

    Full Text Available Abstract Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale, length of response and duration of complications (breathiness, cough, dysphagia and total voice loss. Injections were performed under electromyography (EMG guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.

  7. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin

    Dejonckere, P. H.; Neumann, K. J.; Moerman, M. B. J.; Giordano, A.; Manfredi, C.; Martens, J.P.

    2012-01-01

    Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were perform

  8. Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia.

    Suppa, A; Marsili, L; Giovannelli, F; Di Stasio, F; Rocchi, L; Upadhyay, N; Ruoppolo, G; Cincotta, M; Berardelli, A

    2015-08-01

    In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during 'linguistic' tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated 'linguistic' task-related cortical excitability modulation in patients with adductor-type spasmodic dysphonia (ASD), a speech-related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non-dominant M1 excitability at baseline, during 'linguistic' (reading aloud/silent reading/producing simple phonation) and 'non-linguistic' tasks (looking at non-letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the 'linguistic' tasks with different voice intensities. We also examined MEPs in HS and ASD during hand-related 'action-verb' observation. Patients were studied under and not-under botulinum neurotoxin-type A (BoNT-A). In HS, TMS over the dominant M1 elicited larger MEPs during 'reading aloud' than during the other 'linguistic'/'non-linguistic' tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased-amplitude MEPs during 'reading aloud' and 'syllabic phonation' tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing 'linguistic'/'non-linguistic' tasks. In HS and ASD, 'linguistic' task-related excitability changes were present regardless of the different voice intensities. During hand-related 'action-verb' observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT-A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to 'linguistic' tasks; BoNT-A returns these excitability changes to normal. PMID:26061279

  9. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    Jae Wook Kim

    2014-01-01

    Full Text Available Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group. Methods. Thirty patients with adductor spasmodic dysphonia (ADSD, who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05. There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

  10. Acoustic characteristics of adductor spasmodic dysphonia%内收型痉挛性发音障碍的语音特征

    杨扬; 王丽萍

    2008-01-01

    Objective To explore the acoustic characteristics of adductor spasmodic dysphonim Methods The acoustic characteristics,including acoustic signal of recorded voice,three-dimensional sonogranl patterns and subjective assessment of voice,between 10 patients(7 women,3 men)with adductor spasmodic dysphonia and 10 healthy volunteers(5 women,5 men),were compared.Results The main clinical manifestation of adductor spasmodic dysphonia included the disorders of sound quality,rhyme and fluency.It demonstrated the tension dysphonia when reading,acoustic jitter,momentary fluctuation of frequency and volume,voice squeezing,interruption,voice prolongation,and losing normal chime.Among 10 patients,there were l mild dysphonia(abnormal syllable number<25%),6 moderate dysphonia (abnormal syllable number 25%-49%),1 severe dysphonia(abnormal syllable number 50%-74%) and 2 extremely severe dysphonia (abnormal syllable number≥75%).The average reading time in 10 patients Was 49 S,with reading time extension and aphasia area interruption in acoustic signals,whereasc the average reading time in health control group was 30 S,without voice interruption.The aphasia ratio averaged 42%.The respective symptom syllable in different patients demonstrated in the three-dimensional sonograrm There were voice onset time prolongation,irregular,interrupted and even absent vowel formants. The consonant of symptom syllables displayed absence or prolongation of friction murmur in the block-friction murmur occasionally.Conclusions The acoustic characteristics of adductor spasmodic dysphonia is the disorders of sound quality,rhyme and fluency.The three-dimensional sonogTam of the symptom syllables show distinctive changes of proportional vowels or consonant phonemes.%目的 探讨内收型痉挛性发音障碍的语音特征.方法 采用嗓音和语音的声信号和三维语图分析及主观评价的方法对1O例内收型痉挛性发音障碍患者(女7例,男3例)的语音特征与10

  11. Abnormal Activation of the Primary Somatosensory Cortex in Spasmodic Dysphonia: An fMRI Study

    Simonyan, Kristina; Ludlow, Christy L.

    2010-01-01

    Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and d...

  12. Qualidade de Vida em Voz: estudo na doença de Parkinson idiopática e na disfonia espasmódica adutora Quality of life in voice: a study in Parkinson's disease and in adductor spasmodic dysphonia

    Bárbara Pereira Lopes

    2013-04-01

    Full Text Available OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV dos pacientes com doença de Parkinson (DP idiopática e com disfonia espasmódica adutora (DEA. MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância PURPOSE: to evaluate the impact of voice disorders on quality of life of patients with idiopathic Parkinson's disease and with adductor spasmodic dysphonia. METHOD: the study consisted of 56 females, 28 in the control group; 14, the adductor spasmodic dysphonia group in the period prior to treatment with botulinum toxin; and 14, the group of idiopathic Parkinson's disease. The participants filled in the Voice-Related Quality of life (V-RQOL questionnaire validated for Brazilian Portuguese. To check the difference between averages of the groups it was used the method of analysis of variance by Kruskal-Wallis and Tamhane test for multiple comparisons, with significance <0.05. RESULTS: the average age of the groups were 66.18 for the control group, 67.21 for the Parkinson's disease group and 59.7 for the adductor spasmodic dysphonia group, with no statistical difference between the groups. In the V-RQOL protocol the mean domain social-emotional, physical functioning and total score were higher in the control group, followed by group of Parkinson's disease and, finally, the group of adductor spasmodic dysphonia with statistically significant difference between them. In addition, there was statistical difference for each pair of groups

  13. Qualidade de Vida em Voz: estudo na doença de Parkinson idiopática e na Disfonia Espasmódica Adutora Quality of life in voice: a study in Parkinson's disease and in adductor spasmodic dysphonia

    Bárbara Pereira Lopes

    2012-01-01

    Full Text Available OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV dos pacientes com doença de Parkinson (DP idiopática e com disfonia espasmódica adutora (DEA. MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância PURPOSE: to evaluate the impact of voice disorders on quality of life of patients with idiopathic Parkinson's disease and with adductor spasmodic dysphonia. METHOD: the study consisted of 56 females, 28 in the control group; 14, the adductor spasmodic dysphonia group in the period prior to treatment with botulinum toxin; and 14, the group of idiopathic Parkinson's disease. The participants filled in the Voice-Related Quality of life (V-RQOL questionnaire validated for Brazilian Portuguese. To check the difference between averages of the groups it was used the method of analysis of variance by Kruskal-Wallis and Tamhane test for multiple comparisons, with significance <0.05. RESULTS: the average age of the groups were 66.18 for the control group, 67.21 for the Parkinson's disease group and 59.7 for the adductor spasmodic dysphonia group, with no statistical difference between the groups. In the V-RQOL protocol the mean domain social-emotional, physical functioning and total score were higher in the control group, followed by group of Parkinson's disease and, finally, the group of adductor spasmodic dysphonia with statistically significant difference between them. In addition, there was statistical difference for each pair of groups

  14. Disfluency in Spasmodic Dysphonia: A Multivariate Analysis.

    Cannito, Michael P.; Burch, Annette Renee; Watts, Christopher; Rappold, Patrick W.; Hood, Stephen B.; Sherrard, Kyla

    1997-01-01

    This study examined visual analog scaling judgments of disfluency by normal listeners in response to oral reading by 20 adults with spasmodic dysphonia (SD) and nondysphonic controls. Findings suggest that although dysfluency is not a defining feature of SD, it does contribute significantly to the overall clinical impression of severity of the…

  15. A STUDY OF VOICE CHANGES IN SPASMODIC DYSPHONIA AFTER BOTULINUM THERAPY

    Sanajeet Kumar

    2016-03-01

    Full Text Available BACKGROUND Spasmodic dysphonia is a neurological disorder, which can give the voice a strained quality. There is currently no cure for spasmodic dysphonia. The most common treatment for spasmodic dysphonia is the injection of botulinum toxin. METHODS Botulinum toxin A injection was performed in 10 patients with adductor spasmodic dysphonia. Voice handicap index scoring and voice analysis was done pre- and post-injection. Fundamental frequency, standard deviation of fundamental frequency, jitter, shimmer, mean phonation time and voice noise energy was studied in voice analysis. These voice parameters were measured from sustained phonation of vowel /a/. RESULTS Results of study indicated, a Spasmodic dysphonia patients had high mean values for voice handicap index score and all voice parameters. b All parameters were reduced significantly post botulinum therapy, but remained higher than their normal value. c All voice parameters except jitter showed strong positive correlation with voice handicap index in all domains. Jitter showed moderate positive correlation with total score, physical and emotional domain and strong positive correlation with functional domain. CONCLUSION Botulinum toxin A injection improves voice in cases of spasmodic dysphonia, significantly still post procedure voice does not return to normal.

  16. 发音中断分析用于内收性痉挛性发音障碍和肌紧张性发音障碍的鉴别诊断%Differential diagnosis of adductor spasmodic dysphonia and musde tension dysphonia using phonatory break analys

    Roy N; 郭颖

    2011-01-01

    @@ 内收性痉挛性发声障碍(adductor spasmodic dysphonia,ADSD)是一种神经源性的、活动引起的喉局部肌张力失调,患者在说话时会感受到声带不自主地过度内收,从而导致无力的发音中断和言语挤卡、发抖.当前,内收性痉挛性发声障碍的诊断几乎完全依靠其听觉特征,发音中断常被认为是诊断ADSD的绝对必要条件.

  17. Adductor Spasmodic Dysphonia Treated by Injecting of Botulinum Toxin A into Vocal Cords%A型肉毒毒素声带注射 治疗内收型痉挛性发声障碍

    刘波; 屈季宁; 李再香; 袁琨

    2001-01-01

    Objective To investigate the effect of botulinum toxin A(BTA) injected into vocal cords for the treatment of adductor spasmodic dysphonia (SD) by direct lanyngoscopy.Methods 11 patients with adductor SD were treated by injection on both vocal cords each with 2.5U of BTA by direct laryngoscopy.Results All patient's phonation improved within the first 24 hours,with sustained improvement from 12 to 21 weeks with an average of 16.2 weeks.The local side effect included breathy voice in all cases and mild choking sensation when drinking fluids in 5 cases,dysphagia in 3 cases.No systemic adverse reactions were noted.Conclusion The injection of BTA on both vocal cords by direct laryngoscopy is an effective,safe and simple method for the treatment of adductor SD.%目的探讨双侧声带注射A型肉毒毒素治疗内收性痉挛性发声障碍疗效。方法在直接喉镜下于双侧声带近外侧甲杓肌处注射A型肉毒毒素各2.5U治疗内收性痉挛性发声障碍11例。结果均在注射后24h即显效,发声改善平均持续时间16.2wk,不良反应有暂时过度呼吸音11例、饮水呛咳5例,吞咽困难3例,未发现A型肉毒毒素全身毒副作用。结论直接喉镜下A型肉毒毒素双侧声带注射是治疗内收性痉挛性发声障碍有效、安全、简便的方法。

  18. Impacto na qualidade vocal da miectomia parcial e neurectomia endoscópica do músculo tireoaritenóideo em paciente com disfonia espasmódica de adução Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia

    Domingos Hiroshi Tsuji

    2006-04-01

    Full Text Available A disfonia espasmódica de adução é um distúrbio vocal grave, caracterizado por espasmos dos músculos laríngeos durante a fonação, produzindo voz quebrada, tensa, forçada e estrangulada. Seus sintomas decorrem da contração intermitente e involuntária dos músculos tireoaritenóideos durante a fonação, o que resulta em pregas vocais tensas, pressionadas uma contra a outra, e no aumento da resistência glótica. OBJETIVO: Apresentar os resultados preliminares do impacto na qualidade vocal da cirurgia de Neurectomia do ramo tireoaritenóideo do laríngeo inferior, via endoscópica, associada à miectomia parcial do músculo tireoaritenóideo com laser de CO2. MATERIAL E MÉTODO: A cirurgia foi realizada em 7 pacientes (6 mulheres e 1 homem, com idades variando entre 22 e 75 anos, com diagnóstico de disfonia espasmódica de adução. Os pacientes foram submetidos ao VHI (Voice Handicap Index no pré e pós-operatório. RESULTEDOS E CONCLUSÃO: A melhora vocal foi conseguida em todos os pacientes estudados não ocorrendo deterioração da qualidade vocal ao longo do período pós-operatório. Houve uma diferença evidente no VHI antes e após a cirurgia. Essa técnica cirúrgica mostrou-se eficaz e inovadora no tratamento da disfonia espasmódica de adução.Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia the adductor spasmodic dysphonia is a severe vocal disorder characterized by muscle laryngeal spasms during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms come from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold strain, pressed one against another and increased glottic resistance. AIM: report the results in the impact in vocal quality in neurectomy of the thyroarytenoid branch of the inferior laryngeal nerve by endoscopic route associated with

  19. Spasmodic dysphonia in an adolescent patient with an autoimmune neurologic disorder.

    Boseley, Mark E; Gherson, Shirley; Hartnick, Christopher J

    2007-01-01

    Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) has been primarily described in the neurology and psychiatry literature. The symptoms of this syndrome typically are a range of obsessive compulsive disorders and neuromuscular tics. The otolaryngologist occasionally becomes involved with these children when it is deemed that chronic tonsil infections are the source. We report here on a child diagnosed with PANDAS who presented with severe ventricular hyperfunction and adductor spasmodic dysphonia. She was treated with botulinum toxin, which resulted in a significant improvement in subjective voice as well as reduced jitter and shimmer on objective voice measurements. PMID:17362824

  20. Alterations in CNS Activity Induced by Botulinum Toxin Treatment in Spasmodic Dysphonia: An H[subscript 2][superscript 15]O PET Study

    Ali, S. Omar; Thomassen, Michael; Schulz, Geralyn M.; Hosey, Lara A.; Varga, Mary; Ludlow, Christy L.; Braun, Allen R.

    2006-01-01

    Speech-related changes in regional cerebral blood flow (rCBF) were measured using H[subscript 2][superscript 15]O positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest…

  1. Abnormal Striatal Dopaminergic Neurotransmission during Rest and Task Production in Spasmodic Dysphonia

    Simonyan, Kristina; Berman, Brian D.; Herscovitch, Peter; Hallett, Mark

    2013-01-01

    Spasmodic dysphonia is a primary focal dystonia characterized by involuntary spasms in the laryngeal muscles during speech production. The pathophysiology of spasmodic dysphonia is thought to involve structural and functional abnormalities in the basal ganglia–thalamo-cortical circuitry; however, neurochemical correlates underpinning these abnormalities as well as their relations to spasmodic dysphonia symptoms remain unknown. We used positron emission tomography with the radioligand [11C]rac...

  2. Anatomic considerations in botulinum toxin type A therapy for spasmodic dysphonia.

    Castellanos, P F; Gates, G A; Esselman, G; Song, F; Vannier, M W; Kuo, M

    1994-06-01

    Chemodenervation by injection of botulinum toxin type A into the vocal fold(s) has become the preferred treatment for patients with adductor spasmodic dysphonia. Injection may be done either perorally or transcutaneously; each method has its advocates and advantages. The authors have used the transcutaneous transcricothyroid membrane route exclusively with satisfactory results in more than 50 patients. Temporary breathliness and aspiration are common. The preferred injection site should be as close as possible to the motor end plates of the affected muscle. The thyroarytenoid muscle end plates are distributed throughout the muscle, whereas in the lateral cricoarytenoid muscle they are located in band in the center of the muscle. The transcutaneous injection site is below and posterior to the midpoint of the vibrating vocal fold as visualized by indirect laryngoscopy. The proximity of this site to the lateral cricoarytenoid muscle suggests that postinjection breathiness and aspiration may be related to spread of botulinum toxin type A to the lateral cricoarytenoid muscle. However, it is likely that thyroarytenoid muscle paresis is mainly responsible for this side effect and that the rapid clearing of the breathy dysphonia in the face of prolonged relief of spasmodic dysphonia symptoms suggests the action of an adaptive neural response, such as axonal sprouting. Further research of this subject is warranted. PMID:8196438

  3. Emotional Considerations in Spasmodic Dysphonia: Psychometric Quantification.

    Cannito, Michael P.

    1991-01-01

    This study examined emotional characteristics of 18 female spasmodic dysphonic subjects in comparison to matched normal controls across psychometric measures of depression, anxiety, and somatic complaints. Statistically significant differences were noted between groups for all measures and over half of the dysphonic subjects exhibited clinically…

  4. Spasmodic dysphonia: description of the disease and associated neurologic disorders

    Coelho, Marina Serrato

    2010-06-01

    Full Text Available Introduction: Spasmodic dysphonia (SD is a problem that affects speech and vocalization, one of the most devastating disorders of oral communication. It is characterized by vocal quality tensaestrangulada, harshly and / or interspersed with abrupt vocal attack and a great tension in the vocal tract. The etiology of spasmodic dysphonia is unclear. Some authors point to psychogenic causes, neurological or even unknown. Objective: To assess the prevalence of muscular dystonias and other neurological symptoms in patients with ED. Method: A retrospective study of 10 cases with diagnosis of ED for symptoms and neurological disorders associated. Results: There was a significant predominance of the disease in females (9:1. The average age of onset of symptoms was 32 years, ranging between 14 and 60 years. The mean disease duration was 10 years. Among the patients, 87.5% had a diagnosis of disorders of movement made by a neurologist, including orofacial dystonias (50%, essential tremor (50% and spastic paraparesis (12%. Conclusion: The presence of movement disorders followed almost all cases of spasmodic dysphonia. More studies are needed to clarify the pathophysiological basis of disease.

  5. Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

    Mor, Niv; Tang, Christopher; Blitzer, Andrew

    2016-09-01

    Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD. PMID:27143711

  6. Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

    Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

    2015-09-01

    Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time. PMID:25966878

  7. Aplicação da técnica de emissão em tempo máximo de fonação em paciente com disfonia espasmódica adutora: relato de caso Applying the technique of sustained maximum phonation time in a female patient with adductor spasmodic dysphonia: case report

    Luiz Alberto Alves Mota

    2012-01-01

    Full Text Available A Disfonia Espasmódica Adutora é uma desordem neurológica do processamento motor central, caracterizada por contrações involuntárias e inapropriadas da musculatura fonatória, produzindo uma hiperadução das pregas vocais, o que promove uma voz trêmula, entrecortada e tensa-estrangulada. O objetivo deste estudo foi descrever os parâmetros vocais, acústicos e laríngeos pré e pós-tratamento fonoaudiológico realizado por meio da aplicação da Técnica de Emissão em Tempo Máximo de Fonação (TETMF em paciente com Disfonia Espasmódica de Adução. Esta técnica tem como objetivo promover o aumento da resistência glótica, melhorar a estabilidade fonatória e adequar a coaptação glótica. Participou deste estudo de caso uma paciente de 66 anos de idade, gênero feminino, com Disfonia Espasmódica Adutora. A paciente foi submetida à avaliação otorrinolaringológica e fonoaudiológica pré e pós-aplicação da TETMF. Foi verificada modificação de parâmetros vocais, acústicos e laríngeos, tais como a classificação da disfonia de G3R1B1A0S3I3 para G2R1B1A0S2I2, pitch de grave a adequado, traçado espectrográfico instável para mais estável e expressivo aumento da frequência fundamental média e da intensidade vocal média, além da melhora da eficiência glótica com o fechamento da fenda glótica anteroposterior. A terapia fonoaudiológica com a aplicação da TETMF foi considerada uma adequada opção de tratamento para o caso, tendo em vista os resultados alcançados, com destaque para a qualidade vocal e estabilidade fonatória. Ressalta-se a importância de novos estudos para comprovação da eficácia da técnica no tratamento da Disfonia Espasmódica Adutora.Adductor Spasmodic Dysphonia (ASD is a neurological disorder of central motor processing, characterized by involuntary and inappropriate contractions of the phonatory muscles, producing hyperadduction of the vocal folds, which causes a tremulous, faltering

  8. Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun; Kim, Tae Uk

    2015-01-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) we...

  9. Focal white matter changes in spasmodic dysphonia: a combined DTI and neuropathological study

    Simonyan, Kristina; Tovar-Moll, Fernanda; Ostuni, John; Hallett, Mark; Kalasinsky, Victor F.; Lewin-Smith, Michael R.; Rushing, Elisabeth J.; Vortmeyer, Alexander O.; Ludlow, Christy L.

    2007-01-01

    Spasmodic dysphonia (SD) is a neurological disorder characterized by involuntary spasms in the laryngeal muscles during speech production. Although clinical symptoms of SD are well characterized, the pathophysiology of this voice disorder is unknown. We describe here, for the first time to our knowledge, disorder-specific brain abnormalities in SD patients as determined by a combined approach of diffusion tensor imaging (DTI) and postmortem histopathology. We used DTI to identify brain change...

  10. The Consequences of Spasmodic Dysphonia on Communication-Related Quality of Life: A Qualitative Study of the Insider's Experiences

    Baylor, C.R.; Yorkston, K.M.; Eadie, T.L.

    2005-01-01

    The purpose of this study was to explore the biopsychosocial consequences of spasmodic dysphonia (SD) as experienced by people with SD. Qualitative research methods were used to investigate the insider's perspective of living with SD. Six adults with SD participated in face-to-face phenomenological interviews. The results are summarized in a model…

  11. Mutations in THAP1 (DYT6) and generalised dystonia with prominent spasmodic dysphonia: a genetic screening study

    Djarmati, Ana; Schneider, Susanne A; Lohmann, Katja;

    2009-01-01

    -onset generalised dystonia with spasmodic dysphonia. This combination of symptoms might be a characteristic feature of DYT6 dystonia and could be useful in the differential diagnosis of DYT1, DYT4, DYT12, and DYT17 dystonia. In addition to the identified mutations, a rare non-coding substitution in THAP1 might...

  12. Spasmodic Dysphonia

    ... version Order free publications Find organizations Related Topics Autism Spectrum Disorder: Communication Problems in Children Hoarseness Taking ... NIH… Turning Discovery Into Health ® National Institute on Deafness and Other Communication Disorders 31 Center Drive, MSC ...

  13. Focal white matter changes in spasmodic dysphonia: a combined DTI and neuropathological study

    Simonyan, Kristina; Tovar-Moll, Fernanda; Ostuni, John; Hallett, Mark; Kalasinsky, Victor F.; Lewin-Smith, Michael R.; Rushing, Elisabeth J.; Vortmeyer, Alexander O.; Ludlow, Christy L.

    2008-01-01

    Spasmodic dysphonia (SD) is a neurological disorder characterized by involuntary spasms in the laryngeal muscles during speech production. Although clinical symptoms of SD are well characterized, the pathophysiology of this voice disorder is unknown. We describe here, for the first time to our knowledge, disorder-specific brain abnormalities in SD patients as determined by a combined approach of diffusion tensor imaging (DTI) and postmortem histopathology. We used DTI to identify brain changes in SD and to target those brain regions for neuropathological examination. DTI showed rightsided decrease of fractional anisotropy in the genu of the internal capsule and bilateral increase of overall water diffusivity in the white matter along the corticobulbar/corticospinal tract in 20 SD patients compared to 20 healthy subjects. In addition, water diffusivity was bilaterally increased in the lentiform nucleus, ventral thalamus, and cerebellar white and gray matter in SD patients. These brain changes were substantiated with focal histopathological abnormalities presented as a loss of axonal density and myelin content in the right genu of the internal capsule and clusters of mineral depositions containing calcium, phosphorus and iron in the parenchyma and vessel walls of the posterior limb of the internal capsule, putamen, globus pallidus, and cerebellum in the postmortem brain tissue from one SD patient compared to three controls. The specificity of these brain abnormalities is confirmed by their localization limited only to the corticobulbar/corticospinal tract and its main input/output structures. We also found positive correlation between the diffusivity changes and clinical symptoms of SD (r = 0.509, p = 0.037). These brain abnormalities may alter the central control of voluntary voice production and, therefore, may underlie the pathophysiology of SD. PMID:18083751

  14. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

    Cannito, Michael

    2008-01-01

    Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botu...

  15. Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica Medical treatment and speech therapy for spasmodic dysphonia: a literature review

    Eliana Maria Gradim Fabron

    2013-01-01

    from 2006 to 2010. The speech therapy and medical treatments described are: botulinum toxin injection, myectomy, neurectomy, denervation and reinnervation selective laryngeal adductor, thyroplasty, radiofrequency thyroarytenoid myothermy, injection of lidocaine, homeopathy and speech therapy. The use of botulinum toxin injection showed results that indicated the satisfaction of the patients who were treated, although some of the articles presented the frequent need of reapplication of the toxin as a disadvantage. The surgical procedures were considered long-lasting and indicated to patients who didn't want to get botulinum toxin injections. The studies, however, presented a restricted contingency of patients, and the outcomes in many studies were based in the patient's own judgment on his/her voice quality. The treatments using lidocaine and homeopathy had positive results in relation to the voice quality of the patients and were suggested as an option for those who wouldn't like to undergo surgical treatment or have botulinum toxin injection. The few studies which discourse on voice therapy presented good results in association with botulinum toxin injection, showing the shortage of information in this field. A study on the literature review pointed out the need of developing researches to help us understand the neurological functioning in spasmodic dysphonia. Future study involving speech therapy in the treatment of ED is still necessary.

  16. 心理疗法并呼吸训练治疗痉挛性发声障碍%Psychotherapy combined with breathing training on the treatment of spasmodic dysphonia

    周涛; 雷培香; 屈季宁; 曹永茂

    2005-01-01

    背景:目前痉挛性发声障碍病因不明,缺乏统一明确的诊断标准,故治疗较为困难,关于该病的治疗有限的报道主要是喉部肉毒杆菌毒素注射,喉返神经切断,发声语言训练等,其中后一种方法无副作用及并发症,是较为理想的治疗及辅助治疗手段之一.目的:探讨发声训练治疗痉挛性发声障碍的意义,为该病的临床治疗提供一种简便易行的方法.设计:以患者为研究对象,病例分析、验证性研究.单位:一所大学医院的耳鼻咽喉-头颈外科.对象:1985-02/2002-12武汉大学人民医院耳鼻咽喉科确诊的36例痉挛性发声障碍患者为治疗对象.方法:采用心理疗法和呼吸及发声功能训练使患者呼吸器官随意运动协调,变高位呼吸和逆呼吸为正常的胸腹联合式呼吸,降低喉肌张力,以发声正常、好转、无效为疗效判定标准,全部病例随访一两年.主要观察指标:疗效评估结果.结果:36例痉挛性发声障碍患者,经上述发声康复训练后,均取得满意的效果,其中30例患者发声恢复正常,6例好转.结论:心理疗法和呼吸及发声功能训练是痉挛性发声障碍康复训练较理想的方法.%BACKGROUND: The mechanism of spasmodic dysphonia(SD) is still unclear and lacks of confirmed diagnostic standards. Limited reports on the treatment mainly focused on botulinum toxin infiltration; recurrent laryngeal nerve section, and voice training, amongst which voice training has been considered as one of the ideal complementary therapeutic means for SD because of less side effects and complications.OBJECTIVE: To investigate the significance of voice training in the treatment of SD and provide a method for the clinical treatment.DESIGN: Clinical case analysis and retrospective study based on patients.SETTING: Department of otolaryngology and cerebral surgery in a university hospital.PARTICIPANTS: Thirty-six confirmed SD patients in Wuhan College affiliated Renmin

  17. Análise vocal em pacientes com disfonia espasmódica nos momentos pré e pós tratamento com toxina Botulínica A Vocal analysis in patients with spasmodic dysphonia before and after treatment with Botulinum toxin A

    Ana Cristina Côrtes Gama

    2012-10-01

    Full Text Available OBJETIVO: avaliar de forma objetiva e subjetiva a voz de pacientes com disfonia espasmódica nos momentos pré e pós aplicação de toxina botulínica A. MÉTODO: as emissões vocais de onze pacientes do sexo feminino foram registradas antes e após (15 dias o tratamento. As amostras vocais foram analisadas por duas fonoaudiólogas com experiência em voz por meio da análise perceptivo-auditiva (escala GRBASI e da análise espectrográfica. RESULTADOS: na análise perceptivo-auditiva com vogal sustentada os parâmetros que alteraram após o tratamento foram o grau de severidade, tensão e instabilidade, enquanto na fala encadeada foram o grau de severidade e a tensão. Na análise espectrográfica ocorreu melhora do traçado após o tratamento sem significância estatística entre os parâmetros. CONCLUSÃO: ocorreu melhora significante dos aspectos perceptivo-auditivos após o tratamento e, portanto, as injeções de toxina botulínica A mostraram-se eficazes no tratamento da disfonia espasmódica no grupo estudado.PURPOSE: to analyze in an objective and subjective manner the voice of patients with spasmodic dysphonia in the moments before and after botulinum toxin A. METHOD: the vocal emissions of eleven women patients were recorded before and after (15 days treatment. The vocal samples were analyzed by two experienced speech therapists through the perceptual analysis (GRBASI scale and spectrographic analysis. RESULTS: in the perceptual analysis with subtended vowel, the altered parameters were degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. In the perceptual analysis with sustained vowel, the parameters that have changed, were the degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. The spectrographic analysis was improved after treatment with no statistical significance found among

  18. 内收型痉挛性发声障碍元音音长及语长研究%A study on vowel duration and word length of adductor spasmodic dysphonia

    陈志鹏; 葛平江

    2016-01-01

    目的:了解内收型痉挛性发声障碍(SD)元音音长和语句朗读时程与正常人之间的区别,为临床诊疗提供思路.方法:以29例内收型SD患者为痉挛组,31例正常人为对照组.所有研究对象自填嗓音障碍指数表(VHI).所有患者发/a/音测试最长发声时间(MPT)和最响最长发声时间(MLPT),并让其朗读《父母心》标准汉语普通话文,录音后采用Praat 5.0软件测量其所需时间.比较痉挛组与对照组各参数之间的差异及相关性.结果:痉挛组、对照组VHI分别为89.0±12.0、15.0±16.0(P<0.01).痉挛组、对照组MPT分别为(16.9±9.8)s、(25.3±10.0)s(P<0.01).痉挛组、对照组MLPT分别为(15.7±7.6)s、(26.5±11.4) s(P<0.01).标准句朗读时程痉挛组、对照组分别为(55.0±14.2)s、(37.8±4.8)s(P<0.01).MPT与MLPT在痉挛组具有相关性(r=0.697,P<0.01),其余各测试指标之间无明显相关.结论:SD患者嗓音障碍情况明显差于正常人,与正常人比较,其发持续元音不能持久,同时朗读句子的能力也明显差于正常人,需要更长时间完成朗读任务.MLPT与MPT有明显相关性,可以作为替代MPT的方法.

  19. National Spasmodic Torticollis Association

    ... with: » One years subscription of the ST Quarterly Magazine (Four issues are published a year) » Member prices for "Helpful Products" including literature such as the Spasmodic Torticollis Handbook and Living ...

  20. O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica: estudo preliminar com doze pacientes Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia: preliminary study of twelve patients

    Hélio A. G. Teive

    2001-03-01

    Full Text Available A distonia laríngea (disfonia espasmódica é distúrbio do movimento caracterizado por contrações involuntárias da musculatura laríngea envolvida no processo de vocalização. A utilização da toxina botulínica no tratamento da distonia laríngea trouxe consideráveis benefícios clínicos. Descrevemos os resultados preliminares do uso terapêutico da toxina botulínica no tratamento da distonia laríngea em 12 pacientes. Após investigação clínica, os pacientes foram submetidos a videolaringoestroboscopia para confirmação diagnóstica e as injeções de toxina botulínica foram realizadas através de punção da membrana cricotireóidea em direção ao músculo tireoaritenóideo, com uso de eletromiografia. A maioria dos pacientes submetidos ao tratamento com toxina botulínica apresentou melhora significativa da distonia laríngea (83% dos casos, com duração média do efeito de quatro meses, sem efeitos colaterais significativos.Laryngeal dystonia (spasmodic dysphonia is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%, with effects lasting for four months in average and without important side effects.

  1. Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

    Lohmann, Katja; Wilcox, Robert A.; Winkler, Susen; Ramirez, Alfredo; Rakovic, Aleksandar; Park, Jin-Sung; Arns, Bjoern; Lohnau, Thora; Kasten, Meike; Brueggemann, Norbert; Hagenah, Johann; Schmidt, Alexander; Kaiser, Frank J.; Kumar, Kishore R.; Zschiedrich, Katja; Alvarez-Fischer, Daniel; Altenmueller, Eckart; Ferbert, Andreas; Lang, Anthony E.; Muenchau, Alexander; Kostic, Vladimir; Simonyan, Kristina; Agzarian, Marc; Ozelius, Laurie J.; Langeveld, Antonius P. M.; Sue, Carolyn M.; Tijssen, Marina A. J.; Klein, Christine; Groen, Justus

    2013-01-01

    Objective A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family. Methods Genome-wide linkage analysis was carried

  2. Social phobia in spasmodic torticollis

    Gundel, H; Wolf, A; Xidara, V; Busch, R.; Ceballos-Baumann, A

    2001-01-01

    OBJECTIVES—To study the prevalence of psychiatric comorbidity assessed by the use of a structured clinical interview in a large, representative sample of patients with spasmodic torticollis (ST) and to test the hypothesis that social phobia would be highly prevalent.
METHODS—In a consecutive cohort of 116 patients with ST treated with botulinum toxin overall psychiatric comorbidity was studied prospectively with the structured clinical interview (SCID) for DSM-IV axis I d...

  3. Spasmodic torticollis: the dental connection.

    Sims, Anthony B; Stack, Brendan C; Demerjian, G Gary

    2012-07-01

    Spasmodic torticollis or cervical dystonia (CD) is the most common form of focal dystonia and is characterized by sustained abnormal muscle contractions in the head and neck area resulting in abnormal positioning or posturing of the head. The dystonic muscle spasms associated with spasmodic torticollis may affect any combination of neck muscles. Three cases are reported of spasmodic torticollis that were treated by a dental appliance with individual varying occlusal heights to open the maxillomandibular vertical dimension. Upon increasing the vertical dimension of occlusion, there was a slowing and/or discontinuance of the symptoms of cervical dystonia. The proposed hypothesis for this reversal is that there may be neuritis of the auriculotemporal branch of the trigeminal nerve, which has direct input into the reticular formation (RF), and it may activate the cells of the pontine region of the RF known for the control and deviation of head posture. There is growing clinical evidence that temporomandibular joint (TMJ) dysfunction may be a factor in this neurological and painful disorder when it coexists. PMID:22916671

  4. Dysphonia risk screening protocol

    Katia Nemr

    2016-03-01

    Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

  5. Vocal therapy of hyperkinetic dysphonia

    Mumović Gordana

    2014-01-01

    Full Text Available Introduction. Hyperkinetic (hyperfunctional dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice were also obtained by computer analysis. Results. The subjective acoustic analysis revealed a significant (p<0.01 reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100 of adult patients and 29% (29/100 had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025 in all dysphonia parameters except SD F0 and jitter %. In children, the acoustic parameters SD F0, jitter % and NNE (normal noise energy were significantly improved (p=0.003-0.03. Pathological voice qualities were also improved in adults and children (p<0.05. Conclusion. Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affecting diverse acoustic parameters.

  6. Imaging of adductor-related groin pain.

    Pesquer, L; Reboul, G; Silvestre, A; Poussange, N; Meyer, P; Dallaudière, B

    2015-09-01

    Groin pain is a common condition in athletes and results from various causes. Osteitis pubis, adductor dysfunction, inguinal hernia, or a combination of all three entities, generally explains the onset of symptoms. Adductor longus tendinopathy is the main cause of adductor-related groin pain. It leads to a significant reduction of sports participation and can require surgical management. Diagnosis is based on ultrasonography and magnetic resonance imaging. Asymptomatic findings (tendinosis, calcifications, cortical erosions) are common in athletes and care should be taken when assessing groin pain. The most specific sign of tendinopathy is an intratendinous tear of the adductor longus. PMID:25823982

  7. Developing the Communicative Participation Item Bank: Rasch Analysis Results from a Spasmodic Dysphonia Sample

    Baylor, Carolyn R.; Yorkston, Kathryn M.; Eadie, Tanya L.; Miller, Robert M.; Amtmann, Dagmar

    2009-01-01

    Purpose: The purpose of this study was to conduct the initial psychometric analyses of the Communicative Participation Item Bank--a new self-report instrument designed to measure the extent to which communication disorders interfere with communicative participation. This item bank is intended for community-dwelling adults across a range of…

  8. Dysphonia after Bevacizumab Rechallenge: A Case Report

    Corey A. Carter

    2015-10-01

    Full Text Available Inhibition of vascular endothelial growth factor (VEGF signaling, an initiator of tumor angiogenesis, inhibits tumor growth and invasion. Bevacizumab, a monoclonal antibody to VEGF, in common use as an adjunct to standard chemotherapy like irinotecan in advanced colorectal cancer, also affects the normal (nontumor vasculature. Dysphonia or voice changes have been anecdotally reported in patients that have been exposed to antiangiogenics. In this case report, we present an occurrence of severe dysphonia in a 60-year-old male with metastatic colorectal cancer after reintroduction of irinotecan and bevacizumab. To our knowledge, this is the first case of dysphonia associated with bevacizumab rechallenge.

  9. Vocal dose in teachers: correlation with dysphonia.

    Gama, Ana Cristina Côrtes; Santos, Juliana Nunes; Pedra, Elisângela de Fátima Pereira; Rabelo, Alessandra Terra Vasconcelos; Magalhães, Max de Castro; Casas, Estevam Barbosa de Las

    2016-04-01

    Teachers are professionals with high prevalence of dysphonia, whose main risk factors are the large work hours in classrooms with the presence of background noise. The purpose of the study was to calculate the phonation time and the cycle dose of teachers with dysphonia and teachers without voice disorders during the class. There were two groups analyzed: five teachers with functional dysphonia were the first group and five teachers without voice disorders were the second group. For the data was used the VoxLog® dosimeter and the parameters were: intensity; fundamental frequency; phonation time and cycle dose. The statistical analysis used ANOVA, Student's T-test, and Kruskal-Wallis test. Dysphonic teachers showed major values of phonation time and cycle dose compared with teachers without voice disorders. The dysphonia is related to extended period of speech time and greater exposure of the tissue of the vocal fold to phonotrauma. PMID:27191884

  10. Etiological factors for muscle tension dysphonia

    Kušar, Rozalija

    2012-01-01

    This thesis discusses muscle tension dysphonia and etiological factors for its emergence. Muscle tension dysphonia is a consequence of irregular formation of the sound and is connected to increased and unnecessary muscle tension and phonation, and is usually without any anatomical and peripheral neurological irregularities and also without any changes on the mucous membrane. In the theoretical part of this thesis voice disorders and various classifications of voice disorders that occur in the...

  11. Proton MR spectroscopy in idiopathic spasmodic torticollis

    Federico, F.; Lucivero, V.; Simone, I.L.; Defazio, G.; De Salvia, R.; Mezzapesa, D.M.; Petruzzellis, M.; Tortorella, C.; Livrea, P. [Dept. of Neurology and Psychiatry, Bari (Italy)

    2001-07-01

    Single-voxel proton magnetic resonance spectroscopy ({sup 1}H-MRS), localised to the basal ganglia, was used to determine changes in metabolite levels in idiopathic spasmodic torticollis (IST). We examined nine patients and 13 healthy subjects. The mean values ({+-} SD) of peak area ratios were: IST: N-acetyl-aspartate (NAA)/choline-containing compounds (Cho) 1.79 {+-} 0.39, NAA/creatine and phosphocreatine compounds (Cr) 1.61 {+-} 0.38, Cho/Cr 0.91 {+-} 0.19; controls: NAA/Cho 2.07 {+-} 0.35, NAA/Cr 1.82 {+-} 0.31, Cho/Cr 0.89 {+-} 0.12. Statistical analysis showed that NAA/Cho and NAA/Cr were significantly lower in patients than in controls (P = 0.0304 and 0.0431, respectively). These results indicate a reduction in NAA, and suggest striatal involvement in the pathogenesis IST. (orig.)

  12. Proton MR spectroscopy in idiopathic spasmodic torticollis

    Single-voxel proton magnetic resonance spectroscopy (1H-MRS), localised to the basal ganglia, was used to determine changes in metabolite levels in idiopathic spasmodic torticollis (IST). We examined nine patients and 13 healthy subjects. The mean values (± SD) of peak area ratios were: IST: N-acetyl-aspartate (NAA)/choline-containing compounds (Cho) 1.79 ± 0.39, NAA/creatine and phosphocreatine compounds (Cr) 1.61 ± 0.38, Cho/Cr 0.91 ± 0.19; controls: NAA/Cho 2.07 ± 0.35, NAA/Cr 1.82 ± 0.31, Cho/Cr 0.89 ± 0.12. Statistical analysis showed that NAA/Cho and NAA/Cr were significantly lower in patients than in controls (P = 0.0304 and 0.0431, respectively). These results indicate a reduction in NAA, and suggest striatal involvement in the pathogenesis IST. (orig.)

  13. The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves.

    Takizawa, Megumi; Suzuki, Daisuke; Ito, Hajime; Fujimiya, Mineko; Uchiyama, Eiichi

    2014-07-01

    The hip adductor group, innervated predominantly by the obturator nerve, occupies a large volume of the lower limb. However, case reports of patients with obturator nerve palsy or denervation have described no more than minimal gait disturbance. Those facts are surprising, given the architectural characteristics of the hip adductors. Our aim was to investigate which regions of the adductor magnus are innervated by the obturator nerve and by which sciatic nerve and to consider the clinical implications. Twenty-one lower limbs were examined from 21 formalin-fixed cadavers, 18 males and 3 females. The adductor magnus was dissected and was divided into four parts (AM1-AM4) based on the locations of the perforating arteries and the adductor hiatus. AM1 was supplied solely by the obturator nerve. AM2, AM3, and AM4 received innervation from both the posterior branch of the obturator nerve and the tibial nerve portion of the sciatic nerve in 2 (9.5%), 20 (95.2%), and 6 (28.6%) of the cadavers, respectively. The double innervation in more than 90% of the AM3s is especially noteworthy. Generally, AM1-AM3 corresponds to the adductor part, traditionally characterized as innervated by the obturator nerve, and AM4 corresponds to the hamstrings part, innervated by the sciatic nerve. Here, we showed that the sciatic nerve supplies not only the hamstrings part but also the adductor part. These two nerves spread more widely than has generally been believed, which could have practical implications for the assessment and treatment of motor disability. PMID:23813615

  14. A Rare Case of Adductor Longus Muscle Rupture

    R. J. L. L. van de Kimmenade

    2015-01-01

    Full Text Available An adductor longus muscle rupture is a rare injury. This case report describes a 32-year-old patient with an adductor longus rupture. The trauma mechanism was a hyperabduction movement during a soccer game. Nonoperative treatment was initiated. After a follow-up of 4 years, the patient was without pain but a small swelling was still visible. This report describes the anatomy, pathophysiology, and evidence-based treatment of adductor longus rupture.

  15. Laryngeal Function Features of Spasmodic Dysphonia%痉挛性发音障碍的喉功能特点

    王丽萍; 张玉富; 张澍; 杨式麟

    2001-01-01

    目的为了探讨痉挛性发音障碍的喉功能特点及其发音障碍的表现形式.方法对24例痉挛性发音障碍患者(男6例,女18例)的发病诱因、发音障碍特征、喉镜所见、喉肌电及喉空气动力学改变进行了分析.结果痉挛性发音障碍主要表现为音韵及声音的流畅性障碍,主观听觉上以紧张性发音障碍为特点;喉镜检查可看到痉挛性发音时声带过度内收,室带不同程度的内收超越,重者声带强烈内收,会厌、室带以及整个喉呈闭锁状态;典型的喉肌电图所见为束发性放电;喉呼气流率明显减少.结论痉挛性发音障碍伴随着紧张性发音的同时声带或整个喉强烈内收痉挛,同时伴有呼气流率下降,典型病例可看到喉肌电的改变.

  16. Functional dysphonia: strategies to improve patient outcomes

    Behlau M; Madazio G; Oliveira G

    2015-01-01

    Mara Behlau, Glaucya Madazio, Gisele Oliveira Voice Department, Centro de Estudos da Voz – CEV, São Paulo, Brazil Abstract: Functional dysphonia (FD) refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal be...

  17. Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

    M. Jahanshahi

    1990-01-01

    Full Text Available Eighty-five patients with idiopathic spasmodic torticollis were compared with an equally chronic group of 49 cervical spondylosis sufferers in terms of body concept, depression, and disability. The torticollis patients were significantly more depressed and disabled and had a more negative body concept. Depression had different determinants in the two groups. Extent of disfigurement was a major predictor of depression in torticollis. Neuroticism accounted for the greatest proportion of the variance of depression in cervical spondylosis.

  18. Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

    M. Jahanshahi; Marsden, C D

    1990-01-01

    Eighty-five patients with idiopathic spasmodic torticollis were compared with an equally chronic group of 49 cervical spondylosis sufferers in terms of body concept, depression, and disability. The torticollis patients were significantly more depressed and disabled and had a more negative body concept. Depression had different determinants in the two groups. Extent of disfigurement was a major predictor of depression in torticollis. Neuroticism accounted for the greatest proportion of the var...

  19. The origin and innervation of the adductor pollicis muscle.

    Chang, L.; Blair, W. F.

    1985-01-01

    A gross dissection of twenty human adductor pollicis muscles indicated an extensive origin of both the transverse and oblique heads. The origins included the second, third, and fourth metacarpal bones and the capitate, trapezoid, and trapezium bones. Soft tissue origins included intermetacarpal ligaments and the anterior fascia of palmar interosseous muscles. An interfascicular dissection of the deep branch of the ulnar nerve within the substance of the adductor pollicis muscle revealed three...

  20. Factors Associated with Dysphonia in High School Cheerleaders.

    Campbell, Shari L.; And Others

    1988-01-01

    Questionnaire responses from 146 high school cheerleaders indicated that acute, cheering-related dysphonia may be preceded or accompanied by a set of clinical signs that could be incorporated easily into a screening protocol for prospective cheerleaders. (Author/DB)

  1. Functional dysphonia: strategies to improve patient outcomes

    Behlau M

    2015-12-01

    Full Text Available Mara Behlau, Glaucya Madazio, Gisele Oliveira Voice Department, Centro de Estudos da Voz – CEV, São Paulo, Brazil Abstract: Functional dysphonia (FD refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal behavior itself. The assessment of voice disorders should be multidimensional. In addition to the clinical examination, auditory-perceptual, acoustic, and self-assessment analyses are very important. Self-assessment was introduced in the field of voice 25 years ago and has produced a major impact in the clinical and scientific scenario. The choice of treatment for FD is vocal rehabilitation by means of direct therapy; however, compliance has been an issue, except for cases of functional aphonia or when an intensive training is administered. Nevertheless, there are currently no controlled studies that have explored the different options of treatment regimens for these patients. Strategies to improve patient outcome involve proper multidisciplinary diagnosis in order to exclude neurological and psychiatric disorders, careful voice documentation with quantitative measurement and qualitative description of the vocal deviation for comparison after treatment, acoustic evaluation to gather data on the mechanism involved in voice production, self-assessment questionnaires to map the impact of the voice problem on the basis of the patient's perspective, referral to psychological evaluation in cases of suspected clinical anxiety and/or depression, identification of dysfunctional coping strategies, self-regulation data to assist patients with their vocal load, and direct and intensive vocal rehabilitation to reduce psychological resistance and to reassure patient's recovery. An

  2. 75 FR 76020 - Prospective Grant of Exclusive License: Devices for Treating Dysphagia and Dysphonia

    2010-12-07

    ... Treating Dysphagia and Dysphonia AGENCY: National Institutes of Health, Public Health Service, HHS ACTION... limited to devices for treating dysphagia and dysphonia. DATES: Only written comments and/or...

  3. The precision and torque production of common hip adductor squeeze tests used in elite football

    Light, N; Thorborg, K

    2016-01-01

    OBJECTIVES: Decreased hip adductor strength is a known risk factor for groin injury in footballers, with clinicians testing adductor strength in various positions and using different protocols. Understanding how reliable and how much torque different adductor squeeze tests produce will facilitate...

  4. Clinical recovery of two hip adductor longus ruptures

    Thorborg, Kristian; Petersen, Jesper; Nielsen, Michael Bachmann;

    2013-01-01

    was evaluated using hip-strength assessments, self-report and ultrasonography until complete muscle-strength recovery of the hip adductors had occurred. The player was able to participate in a full soccer training session without experiencing pain 15 weeks after the first rupture, and 12 weeks after...

  5. Adductor pollicis muscle: potential anthropometric parameter in hospitalized individuals

    Teresa Cristina Abranches Rosa

    2015-07-01

    Full Text Available This study evaluated the measurement of adductor pollicis muscle thickness as a parameter for the assessment of nutritional status in patients admitted to a University Hospital in Campo Grande, Mato Grosso do Sul State. This is a prospective cross-sectional study with 64 adults and elderly patients. We evaluated the percentage of weight loss based on the usual weight, arm circumference, triceps skinfold thickness, arm muscle circumference, laboratory parameters and measurement of adductor pollicis muscle thickness. The measurements were performed only once, in the first 72 hours of hospitalization. Data were analyzed using statistical software BioEstat 5.0, with a significance level of 0.05. The average thickness of the adductor pollicis muscle was 17.5 + 5.3 mm. We found a significant negative association of muscle with age. There was a significant association between the measure of muscle and parameters such as body mass index, arm circumference, arm muscle circumference, albumin and nutritional status assessed by physical examination. The adductor pollicis muscle allows easy measurement, direct assessment, fast results, low cost and good correlation with anthropometric parameters. However, further studies should be conducted to validate this new method.

  6. Functional dysphonia: strategies to improve patient outcomes.

    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

    Functional dysphonia (FD) refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal behavior itself. The assessment of voice disorders should be multidimensional. In addition to the clinical examination, auditory-perceptual, acoustic, and self-assessment analyses are very important. Self-assessment was introduced in the field of voice 25 years ago and has produced a major impact in the clinical and scientific scenario. The choice of treatment for FD is vocal rehabilitation by means of direct therapy; however, compliance has been an issue, except for cases of functional aphonia or when an intensive training is administered. Nevertheless, there are currently no controlled studies that have explored the different options of treatment regimens for these patients. Strategies to improve patient outcome involve proper multidisciplinary diagnosis in order to exclude neurological and psychiatric disorders, careful voice documentation with quantitative measurement and qualitative description of the vocal deviation for comparison after treatment, acoustic evaluation to gather data on the mechanism involved in voice production, self-assessment questionnaires to map the impact of the voice problem on the basis of the patient's perspective, referral to psychological evaluation in cases of suspected clinical anxiety and/or depression, identification of dysfunctional coping strategies, self-regulation data to assist patients with their vocal load, and direct and intensive vocal rehabilitation to reduce psychological resistance and to reassure patient's recovery. An international multicentric effort, involving a large population of voice-disordered patients with no physical pathology, could produce enough data for

  7. Psychosocial Aspects of Adolescent Dysphonia: An Approach to Treatment.

    Beery, Quinter C.

    1991-01-01

    This paper presents an approach to voice therapy with adolescents, emphasizing the importance of psychosocial and family influences as they relate to vocal behavior. The goals of therapy for the adolescent with dysphonia usually follow an orderly sequence, first dealing with individual behavior and later with family and peer group influences. (JDD)

  8. Aerodynamic Profiles of Women with Muscle Tension Dysphonia/Aphonia

    Gillespie, Amanda I.; Gartner-Schmidt, Jackie; Rubinstein, Elaine N.; Abbott, Katherine Verdolini

    2013-01-01

    Purpose: In this study, the authors aimed to (a) determine whether phonatory airflows and estimated subglottal pressures (est-P[subscript sub]) for women with primary muscle tension dysphonia/aphonia (MTD/A) differ from those for healthy speakers; (b) identify different aerodynamic profile patterns within the MTD/A subject group; and (c) determine…

  9. Comprehensive Management of Psychogenic Dysphonia: A Case Illustration

    Sudhir, Paulomi M.; Chandra, Prabha S.; Shivashankar, N.; Yamini, B. K.

    2009-01-01

    Psychogenic dysphonia refers to the loss of voice, in the absence of apparent structural or neurological pathology. It is a disorder seen more often in women and is usually associated with significant life events and emotional difficulties that may lead to conflict over speaking. Therapeutic interventions in voice disorders recommend the adoption…

  10. Exploring Genetic and Environmental Effects in Dysphonia: A Twin Study

    Simberg, Susanna; Santtila, Pekka; Soveri, Anna; Varjonen, Markus; Sala, Eeva; Sandnabba, N. Kenneth

    2009-01-01

    Purpose: To explore the existence of genetic effects as well as the interaction between potential genetic effects and a voice-demanding occupation on dysphonia. Method: One thousand seven hundred and twenty-eight Finnish twins (555 male; 1,173 female) born between 1961 and 1989 completed a questionnaire concerning vocal symptoms and occupation.…

  11. Dysphonia Detected by Pattern Recognition of Spectral Composition.

    Leinonen, Lea; And Others

    1992-01-01

    This study analyzed production of a long vowel sound within Finnish words by normal or dysphonic voices, using the Self-Organizing Map, the artificial neural network algorithm of T. Kohonen which produces two-dimensional representations of speech. The method was found to be both sensitive and specific in the detection of dysphonia. (Author/JDD)

  12. [Incidence of dysphonia in teaching staff of schools].

    Bellia, S; Serafino, L; Luca, N; Farruggia, E; Bellia, M

    2007-01-01

    Some categories of workers (actors, teachers, singers) use a particular working tool: their voice. In order to assess the spread of dysphonia and its possible causes across a specific class of workers--the teachers of some schools in the city of Catania--we have set up a ad hoc questionnaire. A special database has been subsequently arranged, aimed at the statistical analysis of the responses obtained. The analysis of the responses shows that the phenomenon is more present in female than male teachers, 48% versus 30%. The dysphonia occurs mainly at the end of the working day, lasts throughout the school year and improves in summer, demonstrating the importance of teaching activity in its pathogenesis. One aspect especially stands out: dysphonia occurs exclusively in those individuals suffering from diseases with possible alterations of the voice, such as allergopathies, tireopathies and gastropathies. Therefore, work activity alone does not seem able to cause a chronic dysphonia, whereas the presence of diseases causing disability of vocal cords appears to play an important role. PMID:18409864

  13. Visual assessment of voice disorders in patients with occupational dysphonia

    Bożena Kosztyła-Hojna

    2014-11-01

    Full Text Available [b]introduction[/b]. In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. [b]objective[/b]. The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG and digital stroboscopy (DS with a high resolution module. [b]material and methods[/b]. The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the ‘e’ vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany. Vocal folds vibrations were registered at the rate of 4,000 frames per second. [b]results[/b]. HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations. [b]conclusions[/b]. HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment.

  14. Optimal volume of local anaesthetic for the adductor canal block

    Jæger, P.; Jenstrup, M. T.; Lund, J.;

    2015-01-01

    Background: Theoretically, the ideal volume of local anaesthetic for adductor canal block (ACB) would ensure sufficient filling ofthe canal and avoid proximal spread to the femoral triangle. In this dose-finding study, we aimed to investigate the minimaleffective volume for an ACB needed to fill...... the adductor canal distally in at least 95% of patients (ED95). Methods: We performed a blinded trial, enrolling 40 healthy men. All subjects received an ACB with lidocaine 1%. Volumes wereassigned sequentially to the subjects using the continual reassessment method followed by Bayesian analysis to...... baseline) and sensory block. Results: The ED95 was 20 ml, with an estimated probability of sufficiently filling the canal of 95.1% (95% credibility interval: 0.91–0.98). Proximal spread to the femoral triangle was seen in 0/4 (0%), 7/12 (58%), 4/8 (50%), and 8/16 (50%) subjects with the 5, 10, 15,and 20 ml...

  15. Neurophysiology and Clinical Implications of the Laryngeal Adductor Reflex

    Domer, Amanda S.; Kuhn, Maggie A.; Belafsky, Peter C.

    2013-01-01

    The laryngeal adductor reflex (LAR) is an involuntary protective response to stimuli in the larynx. The superior laryngeal nerve (SLN) acts as the afferent limb and the recurrent laryngeal nerve (RLN) as the efferent limb of this reflex, which is modulated by the central nervous system. Perhaps the most clinically significant application of the LAR is its use in laryngopharyngeal (LP) sensory discrimination testing. Importantly, aberrations in the LAR may predict dysphagia or portend clinical...

  16. Scaling and Accommodation of Jaw Adductor Muscles in Canidae.

    Penrose, Fay; Kemp, Graham J; Jeffery, Nathan

    2016-07-01

    The masticatory apparatus amongst closely related carnivoran species raises intriguing questions about the interplay between allometry, function, and phylogeny in defining interspecific variations of cranial morphology. Here we describe the gross structure of the jaw adductor muscles of several species of canid, and then examine how the muscles are scaled across the range of body sizes, phylogenies, and trophic groups. We also consider how the muscles are accommodated on the skull, and how this is influenced by differences of endocranial size. Data were collected for a suite of morphological metrics, including body mass, endocranial volume, and muscle masses and we used geometric morphometric shape analysis to reveal associated form changes. We find that all jaw adductor muscles scale isometrically against body mass, regardless of phylogeny or trophic group, but that endocranial volume scales with negative allometry against body mass. These findings suggest that head shape is partly influenced by the need to house isometrically scaling muscles on a neurocranium scaling with negative allometry. Principal component analysis suggests that skull shape changes, such as the relatively wide zygomatic arches and large sagittal crests seen in species with higher body masses, allow the skull to accommodate a relative enlargement of the jaw adductors compared with the endocranium. Anat Rec, 299:951-966, 2016. © 2016 The Authors The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology Published by Wiley Periodicals, Inc. PMID:27103346

  17. Is dysphonia permanent or temporary after anterior cervical approach?

    Kahraman, Serdar; Sirin, Sait; Erdogan, Ersin; Atabey, Cem; Daneyemez, Mehmet; Gonul, Engin

    2007-01-01

    The rate, causes and prognosis of dysphonia after anterior cervical approach (ACA) were investigated in our clinical series. During a 10-year interval, 235 consecutive patients with cervical disc disease underwent surgical treatment using anterior approach. Retrospective chart reviews showed recurrent laryngeal nerve (RLN) injury in 3 (1.27%) patients. All three patients were men and only one patient had multilevel surgery. These patients had RLN injury after virgin surgery. Laryngoscopic exa...

  18. Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

    Paulauskienė Iveta

    2016-01-01

    Full Text Available Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis or functional (functional dysphonia, laryngeal conversion disorder, paradoxical vocal folds motion conditions. Rarely systemic diseases as amyloidosis, sarcoidosis, Wegener’s granulomatosis or tuberculosis can cause vocal dysfunction too. That is why laryngeal tuberculosis is often forgotten in case of persistent hoarseness. In this article, we present a case of a young previously healthy woman, complaining of persistent hoarseness with no other leading symptoms. Though endoscopic image suggested a malignancy, histology showed granulomatous lesion. Detailed examination revealed laryngeal and pulmonary tuberculosis resistant to rifampicin. Conclusion: Dysphonia can be the only one symptom of laryngeal tuberculosis. The disease should be taken into consideration when a patient complains of persistent hoarseness in order to avoid delays in treatment and spread of infection.

  19. 痉挛性发声障碍的康复训练%The vocal rehabilitation training for patients with spasmodic dysphonia

    雷培香; 屈季宁; 周涛; 曹永茂

    2003-01-01

    目的探讨康复训练治疗痉挛性发声障碍的疗效及意义. 方法采用心理疗法、针灸疗法、呼吸及发声功能训练等综合手段促使患者呼吸器官随意性运动协调,变高位呼吸、逆呼吸为正常的胸腹联合式呼吸,降低患者喉肌张力. 结果 36例痉挛性发声障碍患者经过上述综合康复训练后,均取得了满意效果,其中30例患者痊愈,6例患者好转,治愈率达83.3%. 结论综合应用心理疗法、针灸疗法、呼吸及发声功能训练等是痉挛性发声障碍患者较理想的康复训练方法.

  20. Adolescent Spasmodic Torticollis Treated by Moxibustion——A Report on 30 Cases

    Zhou Liwu

    2007-01-01

    @@ Spasmodic torticollis is characterized by involuntary contraction of the cervical muscles and the patient will have uni-directional paroxysmal vibration of the neck. The author has treated the disease by applying moxibustion and achieved quite satisfactory therapeutic effects. A report follows.

  1. Ultrasonographic features of an adductor longus tear: case report

    Muscle strain of the lower extremities is among the most common injuries in sports. Excessive force, rather than direct trauma, causes disruption of the muscle-tendon unit, usually at the myotendinous junction, and improper rest and rehabilitation of a minor strain can often lead to a far more disabling injury. High-resolution ultrasonography is useful for direct imaging of muscle injuries. We present a case where ultrasonography was used to detect, treat and follow-up an adductor longus tear in a soccer player. (author)

  2. Obturator neurolysis using 65% alcohol for adductor muscle spasticity

    Anju Ghai

    2012-01-01

    Full Text Available Spasticity is motor alteration characterized by muscle hypertonia and hyperreflexia. It is an important complication of spinal cord injury, traumatic brain injury, cerebral palsy, and multiple sclerosis. If uncorrected, fibrosis and eventually bony deformity lock the joint into a fixed contracture. Chemical neurolysis using various agents is one of the therapeutic possibilities to alleviate spasticity. We are, hereby, reporting 3 patients in whom 65% alcohol was used as neurolytic agent for the treatment of hip adductor spasticity, and the effect lasted for a variable period.

  3. The spread of injectate during saphenous nerve block at the adductor canal

    Andersen, H L; Andersen, S L; Tranum-Jensen, J

    2015-01-01

    comparative dissections of the same limbs. RESULTS: The spread of the injectates was determined by the fascial limits and the muscles surrounding the adductor canal. The anteromedial limit of the adductor canal (the roof) was found to be a continuous fascia, with a thin proximal part and a thicker distal part...

  4. The Effect of Listener Experience and Anchors on Judgments of Dysphonia

    Eadie, Tanya L.; Kapsner-Smith, Mara

    2011-01-01

    Purpose: To determine the effect of auditory anchors on judgments of overall severity (OS) and vocal effort (VE) in dysphonic speech when judgments are made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia (speaker-listeners). Method: Twenty individuals with dysphonia and 4 normal controls provided…

  5. Toward the Development of an Objective Index of Dysphonia Severity: A Four-Factor Acoustic Model

    Awan, Shaheen N.; Roy, Nelson

    2006-01-01

    During assessment and management of individuals with voice disorders, clinicians routinely attempt to describe or quantify the severity of a patient's dysphonia. This investigation used acoustic measures derived from sustained vowel samples to predict dysphonia severity (as determined by auditory-perceptual ratings), for a diverse set of voice…

  6. Dystonias

    ... and speech and swallowing can be affected. Spasmodic dysphonia, also called laryngeal dystonia, involves the muscles that ... be quite helpful for some affected by spasmodic dysphonia. Physical therapy, the use of splints, stress management, ...

  7. Taking Care of Your Voice

    ... of the larynx Neurological diseases (such as spasmodic dysphonia or vocal fold paralysis ) Psychological trauma. Most voice ... conditions such as vocal fold paralysis and spasmodic dysphonia, which can damage the voice. It may also ...

  8. Symphysis Pubis Osteomyelitis with Bilateral Adductor Muscles Abscess

    Saad M. Alqahtani

    2014-01-01

    Full Text Available Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA, which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain.

  9. The Isolated Effect of Adductor Canal Block on Quadriceps Femoris Muscle Strength After Total Knee Arthroplasty

    Sørensen, Johan Kløvgaard; Jæger, Pia; Dahl, Jørgen Berg;

    2016-01-01

    BACKGROUND: Using peripheral nerve block after total knee arthroplasty (TKA), without impeding mobility, is challenging. We hypothesized that the analgesic effect of adductor canal block (ACB) could increase the maximum voluntary isometric contraction (MVIC) of the quadriceps femoris muscle after...

  10. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty

    Jaeger, Pia; Zaric, Dusanka; Fomsgaard, Jonna Storm; Hilsted, Karen Lisa; Bjerregaard, Jens; Gyrn, Jens; Mathiesen, Ole; Larsen, Tommy; Dahl, J�rgen Berg

    2013-01-01

    Femoral nerve block (FNB), a commonly used postoperative pain treatment after total knee arthroplasty (TKA), reduces quadriceps muscle strength essential for mobilization. In contrast, adductor canal block (ACB) is predominately a sensory nerve block. We hypothesized that ACB preserves quadriceps...... muscle strength as compared with FNB (primary end point) in patients after TKA. Secondary end points were effects on morphine consumption, pain, adductor muscle strength, morphine-related complications, and mobilization ability....

  11. Adductor tendinopathy in a hockey player with persistent groin pain: a case report

    Avrahami, Daniel; Choudur, Hema N.

    2010-01-01

    Groin pain may stem from a variety of different causes. Adductor tendinopathy is a common but infrequently recognised cause of chronic groin pain especially in athletes. This case report describes a case of clinically suspected adductor tendinopathy in an amateur athlete confirmed by MRI (Magnetic Resonance Imaging). Relevant literature on musculotendinous injuries of the groin along with differential diagnosis for groin pain is discussed. There are several differential diagnoses for athletes...

  12. Current concepts of inguinal-related and adductor-related groin pain.

    Dimitrakopoulou, Alexandra; Schilders, Ernest

    2016-05-14

    Groin pain encompasses a number of conditions from the lower abdomen, inguinal region, proximal adductors, hip joint, upper anterior thigh and perineum. The complexity of the anatomy, the heterogeneous terminology and the overlapping symptoms of different conditions that may co-exist epitomise the challenges in diagnosis and treatment. Inguinal-related and adductor-related pain is the most common cause of groin pain and will be discussed in this article. PMID:27174069

  13. Relationship between adductor pollicis muscle thickness and subjective global assessment in a cardiac intensive care unit

    Karst, Fernanda Pickrodt; Vieira, Renata Monteiro; Barbiero, Sandra

    2015-01-01

    Objective To verify the relationship between the adductor pollicis muscle thickness test and the subjective global assessment and to correlate it with other anthropometric methods. Methods This observational cross-sectional study was conducted in the intensive care unit of a cardiology hospital in the state of Rio Grande do Sul, Brazil. The hospitalized patients underwent subjective global assessment and adductor pollicis muscle thickness tests on both hands, along with measurement of the rig...

  14. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-01-01

    Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscu...

  15. Surgical management of a completely avulsed adductor longus muscle in a professional equestrian rider.

    Quah, Conal; Cottam, Andrew; Hutchinson, James

    2014-01-01

    Avulsion injuries of the adductor longus muscle tendon are rare and a challenge to manage especially in athletes. There has been little published literature on the outcome of conservative and operative treatment for these injuries. We report the first case of an acute adductor longus avulsion injury which was surgically repaired in a professional equestrian rider. Return to full preinjury function was achieved at 3 months with surgical repair using 3 suture anchors. PMID:24711943

  16. Surgical Management of a Completely Avulsed Adductor Longus Muscle in a Professional Equestrian Rider

    Conal Quah; Andrew Cottam; James Hutchinson

    2014-01-01

    Avulsion injuries of the adductor longus muscle tendon are rare and a challenge to manage especially in athletes. There has been little published literature on the outcome of conservative and operative treatment for these injuries. We report the first case of an acute adductor longus avulsion injury which was surgically repaired in a professional equestrian rider. Return to full preinjury function was achieved at 3 months with surgical repair using 3 suture anchors.

  17. Effects of Omeprazole Over Voice Quality in Muscle Tension Dysphonia Patients With Laryngopharyngeal Reflux

    Kandogan, Tolga; Aksoy, Gökce; Dalgic, Abdullah

    2012-01-01

    Backround Laryngopharyngeal reflux (LPR) is the backflow of stomach contents above upper esophageal sphincter, into the pharynx, larynx, and upper aerodigestive system. Objectives In this study, effects of omeprazole over voice quality in muscle tension dysphonia with laryngopharyngeal reflux was ınvestigated. Patients and Methods Nine patients, 7 males and 2 females, aged between 27-43 (mean age:31) were included to this study. The diagnosis of muscle tension dysphonia with LPR was establish...

  18. Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.

    Hopp, Sascha; Tumin, Masjudin; Wilhelm, Peter; Pohlemann, Tim; Kelm, Jens

    2014-11-01

    We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting. PMID:25055756

  19. Hip adductor activations during run-to-cut maneuvers in compression shorts: Implications for return to sport after groin injury

    CHAUDHARI, AJIT M. W.; JAMISON, STEVEN T.; McNally, Michael P.; Pan, Xueliang; SCHMITT, LAURA C.

    2014-01-01

    Athletes at high risk of groin strains in sports such as hockey and soccer often choose to wear shorts with directional compression to aid in prevention or recovery from hip adductor strains. Large eccentric contractions are known to result in or exacerbate strain injuries, but it is unknown if these shorts have a beneficial effect on hip adductor muscle activity. In this study, surface electromyography of the adductor longus and ground reaction force (GRF) data were obtained simultaneously o...

  20. Agreement between visual and goniometric assessments of adductor and popliteal angles in infants

    Thejus T Jayakrishnan

    2013-01-01

    Full Text Available Context: Amiel-Tison method is a commonly used technique for assessing tone and neurological status of infants. There is a paucity of data on the reliability of visual assessment of angles, a component of this method. Subjects and Methods: We compared the visual and the goniometric assessment of adductor and popliteal angles in infants with hypertonia and neurologically normal controls. A total of 16 infants with hypertonia and 15 normal infants underwent blinded assessment of the adductor and popliteal angles. Statistical Analysis: The mean and standard deviation for the difference between visual and goniometric measurements were calculated for popliteal and adductor angles. Results: The mean differences between visual and goniometric measurements for the popliteal angle were 4.94 (SD3.40 and 8.73 (SD6.10 degrees for the cases and controls respectively. Similarly, the values for adductor angle measurements were 8.94 (SD8.23 and 14.47 (SD8.47 degrees respectively. Conclusion: The deviation of visual assessment from goniometric measurement was found to be less for popliteal angle measurement as compared to adductor angle measurements. It was note-worthy that the difference was less for the measurements of children with spasticity.

  1. Eccentric strengthening effect of hip-adductor training with elastic bands in soccer players

    Jensen, Jesper; Hölmich, Per; Bandholm, Thomas;

    2014-01-01

    BACKGROUND: Soccer players with weak hip-adductor muscles are at increased risk of sustaining groin injuries. Therefore, a simple hip-adductor strengthening programme for prevention of groin injuries is needed. OBJECTIVE: We aimed to investigate the effect of an 8-week hip-adductor strengthening...... programme, including one hip-adduction exercise, on eccentric and isometric hip-adduction strength, using elastic bands as external load. METHODS: Thirty-four healthy, sub-elite soccer players, mean (±SD) age of 22.1 (±3.3) years, were randomised to either training or control. During the mid-season break...... IHAD, IHAB or the IHAD/IHAB ratio existed (p>0.05). CONCLUSIONS: 8 weeks of hip-adduction strength training, using elastic bands, induce a relevant increase in eccentric hip-adduction strength in soccer players, and thus may have implications as a promising approach towards prevention of groin injuries...

  2. Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

    Regina Helena Garcia Martins

    2014-12-01

    Full Text Available Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men were assessed. Their occupations included: housekeeper (n = 17, teacher (n = 4, salesclerk (n = 4, nurse (n = 1, retired (n = 1, and psychologist (n = 1. Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

  3. Does bony hip morphology affect the outcome of treatment for patients with adductor-related groin pain?

    Hölmich, Per; Thorborg, Kristian; Nyvold, Per;

    2014-01-01

    BACKGROUND: Adductor-related groin pain and bony morphology such as femoroacetabular impingement (FAI) or hip dysplasia can coexist clinically. A previous randomised controlled trial in which athletes with adductor-related groin pain underwent either passive treatment (PT) or active treatment (AT...

  4. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes

    Hölmich, P; Uhrskou, P; Ulnits, L;

    1999-01-01

    Groin pain is common among athletes. A major cause of long-standing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with a physiotherapy treatment without active training (PT) in the treatment of adductor-rela...

  5. EXTRA WORKING FACTORS IN DYSPHONIA PATHOGENESIS OF TEACHERS

    Salvatore Biondi

    2007-01-01

    Full Text Available Objective: to estimate the incidence of teacher dysphonic disease in order to subsequently delineate prevention programs. Methods: a representative sample of teachers from different institutes in Catania, i.e. nursery, elementary, secondary and high school, were admitted to a test program. Results: The analysed cards were 379. 46-% of teachers frequently showed an alteration of the characters of the voice, 43% rarely showed it while only 11% did not show such alteration. The dysphonic disease was present in teachers that reported one or more of following pathologies: allergies, gastric disturb and thyroid pathologies. Onthe contrary this disease was not present in those who were not suffering from such a pathologies. 24% of teachers have reported to have been absent from school because of dysphonia. Conclusions: this study puts in evidence that teacher vocal sickness is only partially referable to the specific professional activity, but it is largely due to a psycho-physics predisposition. More studies are however necessary in order to specify the role of working and extra working factors in this group of voice practitioners.

  6. Effects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty

    Jenstrup, M T; Jæger, P; Lund, J; Fomsgaard, J S; Bache, S; Mathiesen, O; Larsen, T K; Dahl, J B

    2012-01-01

    Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We...

  7. Radiological findings in symphyseal and adductor-related groin pain in athletes

    Branci, Sonia; Thorborg, Kristian; Nielsen, Michael Bachmann;

    2013-01-01

    Long-standing symphyseal and adductor-related groin pain is a common problem for many athletes, and requires a multidisciplinary approach. Radiological evaluation of symptomatic individuals is a cornerstone in the diagnostic workup, and should be based on precise and reliable diagnostic terms and...... terminology is confusing, and the interpretation of radiological findings would benefit from imaging studies using a more systematic approach....

  8. Timing of tracheal intubation: monitoring the orbicularis oculi, the adductor pollicis or use a stopwatch?

    Koscielniak-Nielsen, Z J; Horn, A; Sztuk, F; Eriksen, K; Skovgaard, L T; Viby-Mogensen, J

    1996-01-01

    response of the adductor pollicis to ulnar nerve stimulation (group 2; n = 30), or after waiting 3 min (group 3; n = 30), or 4 min (group 4; n = 30). There were no significant differences in intubation scores between the four groups of patients. Loss of response to train-of-four stimulation occurred...

  9. Extraction and Identification of the Pigment in the Adductor Muscle Scar of Pacific Oyster Crassostrea gigas.

    Shixin Hao

    Full Text Available In this study, UV (ultraviolet and IR (infrared radiation spectral analysis were integrated to identify the pigment in the adductor muscle scar of the Pacific oyster Crassostrea gigas. The pigment was extracted from the adductor muscle scars of cleaned oyster shells that were pulverized, hydrolyzed in hot hydrochloric acid, purified with diethyl ether, and dissolved in 0.01 mL/L NaOH. The maximum absorption of the pigment in the UV absorption spectrum within the range of 190-500 nm was observed between 210-220 nm. The UV absorbance decreased with increasing wavelength which was consistent with the UV spectral absorption characteristics of melanin. In addition, Fourier transform infrared spectroscopy scanning revealed characteristic absorption peaks that emerged near 3440 cm-1 and 1630 cm-1, which was consistent with infrared scanning features of eumelanin (a type of melanin. This study has demonstrated for the first time that the pigment in the adductor muscle scar of the Pacific oyster is melanin, hinting that the adductor muscle could be another organ pigmenting the mollusc shell with melanin other than mantle.

  10. Articulatory Changes in Muscle Tension Dysphonia: Evidence of Vowel Space Expansion Following Manual Circumlaryngeal Therapy

    Roy, Nelson; Nissen, Shawn L.; Dromey, Christopher; Sapir, Shimon

    2009-01-01

    In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic…

  11. Functional Dysphonia during Mental Imagery: Testing the Trait Theory of Voice Disorders

    van Mersbergen, Miriam; Patrick, Christopher; Glaze, Leslie

    2008-01-01

    Purpose: Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. Method: Twelve participants with FD, 19 participants…

  12. Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

    Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

    2009-01-01

    The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

  13. Articulatory Changes Following Treatment of Muscle Tension Dysphonia: Preliminary Acoustic Evidence

    Dromey, Christopher; Nissen, Shawn L.; Roy, Nelson; Merrill, Ray M.

    2008-01-01

    Purpose: Primary muscle tension dysphonia (MTD), a voice disturbance that occurs in the absence of structural or neurological pathology, may respond to manual circumlaryngeal techniques, which ostensibly alter the posture of the larynx and/or the configuration of the vocal folds without directly targeting supralaryngeal articulatory structures.…

  14. The interobserver and test-retest variability of the dysphonia severity index

    M.M. Hakkesteegt (Marieke); M.H. Wieringa (Marjan); M.P. Brocaar (Michael); P.G.H. Mulder (Paul); L. Feenstra (Louw)

    2008-01-01

    textabstractObjective: The purpose of this study was to investigate the interobserver variability and the test-retest variability of the Dysphonia Severity Index (DSI), a multiparametric instrument to assess voice quality. Methods: The DSI was measured in 30 nonsmoking volunteers without voice compl

  15. Anterior-posterior and medial compression of the supraglottis : Signs of nonorganic dysphonia or normal postures?

    Behrman, A; Dahl, LD; Abramson, AL; Schutte, HK

    2003-01-01

    Two vocal tract postures commonly identified as hallmarks of nonorganic dysphonia are anterior-posterior and medial compression of the supraglottis. However, insufficient data exist to support their diagnostic utility. The purpose of this study was to compare these two postures in patients with nono

  16. Early Motor Unit Disease Masquerading as Psychogenic Breathy Dysphonia: A Clinical Case Presentation

    Aronson, Arnold E.

    1971-01-01

    Presented is a study of a 20-year-old girl with mild, breathy dysphonia, previously diagnosed as psychogenic. In actuality, her voice change was a sign of early myasthenia gravis. It is pointed out that voice changes can be a first and only sign of early neurologic disease. (Author/KW)

  17. Ultrasound-guided continuous adductor canal block for analgesia after total knee replacement

    Zhang Wei; Hu Yan; Tao Yan; Liu Xuebing; Wang Geng

    2014-01-01

    Background There are several methods for postoperative analgesia for knee surgery.The commonly utilized method is multimodal analgesia based on continuous femoral nerve block.The aim of this study was to investigate the application of continuous adductor canal block for analgesia after total knee replacement and compare this method with continuous femoral nerve block.Methods Sixty patients scheduled for total knee replacement from June 2013 to March 2014 were randomly divided into a femoral group and an adductor group.Catheters were placed under the guidance of nerve stimulation in the femoral group and under the guidance of ultrasound in the adductor group.Operations were performed under combined spinal and epidural anesthesia.After the operations,0.2% ropivacaine was given at a speed of 5 ml/h through catheters in all patients.Visual analogue scale (VAS) pain scores at rest and while moving were noted at 4,24,and 48 hours after the operation,and quadriceps strength was also assessed at these time-points.Secondary parameters such as doses of complementary analgesics and side effects were also recorded.Results There were no significant differences between the groups in VAS pain scores at rest or while moving,at 4,24,or 48 hours after the operation (P >0.05).At these time-points,mean quadriceps strengths in the adductor group were 3.0 (2.75-3.0),3.0 (3.0-4.0),and 4.0 (3.0-4.0),respectively,all of which were significantly stronger than the corresponding means in the femoral group,which were 2.0 (2.0-3.0),2.0 (2.0-3.0),and 3.0 (2.0-4.0),respectively (P <0.05).There were no significant differences between the groups in doses of complementary analgesics or side effects (P >0.05).X-ray images of some patients showed that local anesthetic administered into the adductor canal could diffuse upward and reach the femoral triangle.Conclusions Continuous adductor canal block with 0.2% ropivacaine could be used effectively for analgesia after total knee replacement

  18. Surgical treatment of the adductor longus muscle's distal tendon total rupture in a soccer player.

    Masionis, P; Popov, K; Kurtinaitis, J; Uvarovas, V; Porvaneckas, N

    2016-09-01

    Only a few cases of adductor longus tendon ruptures have been reported in the literature and - there are no clear criteria for conservative or surgical treatment. A case of traumatic rupture of the right distal adductor longus tendon is presented in an elite soccer player, which was surgically repaired. The condition was managed conservatively primarily. However, after 2 months, a palpable mass remained on the medial side of the thigh, and the patient had pain after moderate everyday load and insufficient strength of the right leg during physical exercise. It was decided to explore ruptured tendon surgically and reattach to the femur. Full function of the right leg was achieved at 3 months after surgical repair. At 6 months postoperatively, the patient had returned to soccer at the same level. PMID:27132783

  19. Adductor canal block for postoperative pain treatment after revision knee arthroplasty

    Jæger, Pia; Koscielniak-Nielsen, Zbigniew J; Schrøder, Henrik M;

    2014-01-01

    arthroplasty in general anesthesia into this blinded, placebo-controlled, randomized trial. Patients were allocated to an adductor canal block via a catheter with either ropivacaine or placebo; bolus of 0.75% ropivacaine/saline, followed by infusion of 0.2% ropivacaine/saline. Clinicaltrials.gov ID: NCT......BACKGROUND: Revision knee arthroplasty is assumed to be even more painful than primary knee arthroplasty and predominantly performed in chronic pain patients, which challenges postoperative pain treatment. We hypothesized that the adductor canal block, effective for pain relief after primary total...... difference found between groups was in the primary endpoint: pain during knee flexion at 4 h. However, due to a larger than anticipated dropout rate and heterogeneous study population, the study was underpowered. TRIAL REGISTRATION: Clinicaltrials.gov NCT01191593....

  20. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review.

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-04-01

    Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289

  1. Adductor insertion avulsion syndrome with stress fracture of femoral shaft: MRI findings

    Full text: Chronic vague hip pain may be caused by stress-related injury in the proximal or mid-femoral diaphysis. This has been described as an entity called adductor insertion avulsion syndrome, or thigh splints. In the appropriate clinical setting, the radiologist interpreting the magnetic resonance imaging must be aware of this condition as its imaging findings are subtle. The diagnosis will help the clinician plan the appropriate management. Magnetic resonance imaging can also depict the complications such as stress fracture

  2. Spasmodic Torticollis—A Multicentre Study on Behavioural Aspects IV: Psychopathology

    C. E. Scheidt

    1996-01-01

    Full Text Available The GSI (General Symptom Index of the Symptom Checklist 90 R (SCL 90 R (as a global indicator of the severity of psychiatric symptoms of 27% of the spasmodic torticollis (ST sample fell outside the 95% range of the normal control group (two standard deviations. Patients with a higher GSI were younger, more functionally disabled and subject to higher psychosocial stress due to the illness. The highest scores were reached on the subscales of somatization, interpersonal sensitivity and depression. On the depression scale, 23% of the patients' scores were abnormal. This scale correlated significantly with the neurological signs, particularly the TSUI-index and laterocollis. A statistically significant correlation also existed between psychiatric morbidity and a family history of mental disorder. More than 50% of the patients reported that stressful life events had triggered their illness. In order of frequency, a death came first, followed by marital strife, changes in employment and family arguments. The data suggest that psychopathology in ST should generally be considered as a result of a variety of interacting factors, biological, psychological and social.

  3. Anterior Cervical Osteophytes Causing Dysphagia and Paradoxical Vocal Cord Motion Leading to Dyspnea and Dysphonia

    Seo, Joon Won; Park, Ji Woong; Jang, Jae Chil; Kim, Jae Wook; Lee, Yang Gyun; Kim, Yun Tae; Lee, Seok Min

    2013-01-01

    Anterior cervical osteophytes are common and usually asymptomatic in elderly people. Due to mechanical compressions, inflammations, and tissues swelling of osteophytes, patients may be presented with multiple complications, such as dysphagia, dysphonia, dyspnea, and pulmonary aspiration. Paradoxical vocal cord motion is an uncommon disease characterized by vocal cord adductions during inspiration and/or expiration. This condition can create shortness of breath, wheezing, respiratory stridor o...

  4. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on videolaryngoscopy

    Keyvan Kiakojury

    2014-07-01

    Full Text Available Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action.   Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software.   Results: A total of 197 patients (mean age, 40.72 ±15.17 years participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes.   Conclusion:  Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.

  5. CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF WINDSTROKE-CAUSED DYSPHAGIA-DYSPHONIA SYNDRONE

    HAN Jianhua; DONG Yingli; ZHANG Ru

    2002-01-01

    Objective: To observe the therapeuticeffect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp-acupunoture in the treatment of wind stroke. Methods: A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp-point Dingzhongxian (MS 5), Dingnie Houxiexian (MS 7), Dingpangxian Ⅱ (MS 9) and Dingnie Qianxiexian (MS 6). Before and after acupuncture treatment, clinical symptoms of dysphagia and dysphonia were compared, and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter. Results: Following two courses (4 weeks) of scalp-acupuncture treatment, of the 38 cases, 23 had their dysphagia and dysphonia cured (60.5%), 10 (25.3%) had remarkable improvement, 3(7.9% ) experienced improvement and 2 (5.3%) had no apparent changes. Simultaneously, MBFS of ACA, MCA and PCA increased significantly in comparison with that of pre-treatment (P < 0.01 ). Additionally, results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain. Conclusion: Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating cerebral blood flow.

  6. Electroacupuncture Treatment for Constipation Due to Spasmodic Syndrome of the Pelvic Floor- A Report of 36 Cases

    2001-01-01

    @@Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows. Clinical Data There were 36 cases in this series, 12 males and 24 females, ranging in age from 25 to 76 years, averaging 42 years. The course of disease ranged from 6 months to 22 years, with an average of 6 years. All the 36 cases were previously treated by purgative and emollient cathartic for promoting the bowl movement.

  7. Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings

    To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman's correlation. Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist (P=0.009). All other features showed no significant correlation (P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present (n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium (P=0.048 and P=0.023) but not non-gadolinium sequences (P>0.05). The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes' current symptoms in chronic adductor-related groin pain. (orig.)

  8. Recurrent Myonecrosis Involving Adductor Muscle Group Bilaterally: A Rare Complication of Diabetes Mellitus

    Manzoor Bhat

    2014-11-01

    Full Text Available Diabetic myonecrosis is a rare and underdiagnosed complication of long-standing, uncontrolled diabetes. It usually occurs in patients with long-standing diabetes in the presence of microvascular complications. Thigh muscles are more commonly affected and the usual presentation is thigh swelling with or without pain, systemic features being rare. Magnetic resonance imaging is the gold standard for diagnosis. Most patients recover spontaneously with bed rest, adequate analgesia and good glycemic control. We present a case of recurrent myonecrosis of adductor muscles of the thigh in a patient with long standing type 2 diabetes mellitus who recovered with conservative management.

  9. CONTROL OF EROSION PROCESSES RESULTING FROM DISRUPTION OF ADDUCTOR IN THE SERRA DA MANTIQUEIRA, SP, BRAZIL

    Admilson Clayton Barbosa; Helio Nobile Diniz

    2010-01-01

    In the southern escarpment of the Serra da Mantiqueira, northeast geographic divider between the State of São Paulo and Minas Gerais, there was an environmental accident caused by the disruption of an adductor whose purpose is to lead the water from a reservoir located at an altitude of 1820 m to the machine house where there is an electric generator located at 750 m.  This accident resulted in the formation of a scar on the hillside forest, with removal of soil and vegetation. To reverse the...

  10. Effect of adductor canal block on pain in patients with severe pain after total knee arthroplasty

    Grevstad, Jens Ulrik; Mathiesen, Ole; Lind, T;

    2014-01-01

    category compared with placebo. METHODS: Fifty patients with severe pain, defined as having a visual analogue scale (VAS) pain score of >60 during active flexion of the knee on the first or the second postoperative day after TKA, were included in this randomized, double-blind, placebo-controlled trial. All......BACKGROUND: Total knee arthroplasty (TKA) is associated with varying degrees of pain. A considerable proportion (25-40%) of patients experience severe pain, despite a comprehensive multimodal analgesic regimen. We hypothesized that adductor canal block (ACB) would reduce pain in this patient...... moderate, movement-related pain. Clinical trial registration www.clinicaltrials.gov, NCT01549704....

  11. The study of the adductor muscle-shell interface structure in three Mollusc species

    ZHU Yaoyao; SUN Chengjun; SONG Yingfei; JIANG Fenghua; YIN Xiaofei; TANG Min; DING Haibing

    2016-01-01

    The adductor muscle scar (AMS) is the fixation point of adductor muscle to the shell. It is an important organic-inorganic interface and stress distribution area. Despite recent advances, our understanding of the structure and composition of the AMS remain limited. Here, we report study on the AMS of three bivalves:Mytilus coruscus, Chlamys farreri andRuditapes philippinarum. Results showed that there were significant differences among their AMS structures. BothM. coruscus andC. farreri were found to have a columnar layer above the nacreous platelet shell structure at the AMS and this layer was more organized inM. coruscus. There was no distinguishable two-layer structure inR. philippinarum. Atomic force microscopy (AFM) and Fourier transform infrared spectroscopy (FT-IR) results showed that the AMS was much smoother than the nacreous inner shell in all the three species and the AMS had minor different compositions from the nacreous shell layer. SDS-PAGE (sodium dodecyl-sulfate polyacrylamide gel electophoresis) study of the proteins isolated from the interface indicated that there was a 70 kDa protein which seemed to be specifically located to the highly organized columnar AMS structure inMytilus coruscus. Further analysis of this protein showed it contained high level of Asx (Asp+Asn), Glx (Glu+Gln) and Gly. The special structure and composition of the AMS might play important roles in the stability, adhesion and function at this stress distribution site.

  12. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    Seyyedeh Maryam Khoddami

    2013-01-01

    Full Text Available The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD. The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

  13. Species and tissue-specificity of prokinetic, laxative and spasmodic effects of Fumaria parviflora

    Najeeb-ur-Rehman

    2012-03-01

    Full Text Available Abstract Background Fumaria parviflora Linn. (Fumariaceae, is a small branched annual herb found in many parts of the world including Saudi Arabia and Pakistan. This study was designed to provide pharmacological basis for the medicinal use of Fumaria parviflora in gut motility disorders. Methods The in-vivo prokinetic and laxative assays were conducted in mice. Isolated intestinal preparations (ileum and jejunum from different animal species (mouse, guinea-pig and rabbit were separately suspended in tissue baths containing Tyrode's solution bubbled with carbogen and maintained at 37°C. The spasmogenic responses were recorded using isotonic transducers coupled with PowerLab data acquisition system. Results The aqueous-methanol extract of Fumaria parviflora (Fp.Cr, which tested positive for the presence of alkaloids, saponins, tannins and anthraquinones showed partially atropine-sensitive prokinetic and laxative activities in the in-vivo in mice at 30 and 100 mg/kg. In the in-vitro studies, Fp.Cr (0.01-1 mg/ml caused a concentration-dependent atropine-sensitive stimulatory effect both in mouse tissues (jejunum and ileum, and rabbit jejunum but had no effect in rabbit ileum. In guinea-pig tissues (ileum and jejunum, the crude extract showed a concentration-dependent stimulatory effect with higher efficacy in ileum and the effect was partially blocked by atropine, indicating the involvement of more than one types of gut-stimulant components (atropine-sensitive and insensitive. This could be a plausible reason for the greater efficacy of Fp.Cr in gut preparations of guinea-pig than in rabbit or mouse. Conclusions This study shows the prokinetic, laxative and spasmodic effects of the plant extract partially mediated through cholinergic pathways with species and tissue-selectivity, and provides a sound rationale for the medicinal use of Fumaria parviflora in gut motility disorders such as, indigestion and constipation. This study also suggests using

  14. Comparison of Perceptual Signs of Voice before and after Vocal Hygiene Program in Adults with Dysphonia

    Seyyedeh Maryam khoddami

    2011-12-01

    Full Text Available Background and Aim: Vocal abuse and misuse are the most frequent causes of voice disorders. Consequently some therapy is needed to stop or modify such behaviors. This research was performed to study the effectiveness of vocal hygiene program on perceptual signs of voice in people with dysphonia.Methods: A Vocal hygiene program was performed to 8 adults with dysphonia for 6 weeks. At first, Consensus Auditory- Perceptual Evaluation of Voice was used to assess perceptual signs. Then the program was delivered, Individuals were followed in second and forth weeks visits. In the last session, perceptual assessment was performed and individuals’ opinions were collected. Perceptual findings were compared before and after the therapy.Results: After the program, mean score of perceptual assessment decreased. Mean score of every perceptual sign revealed significant difference before and after the therapy (p≤0.0001. «Loudness» had maximum score and coordination between speech and respiration indicated minimum score. All participants confirmed efficiency of the therapy.Conclusion: The vocal hygiene program improves all perceptual signs of voice although not equally. This deduction is confirmed by both clinician-based and patient-based assessments. As a result, vocal hygiene program is necessary for a comprehensive voice therapy but is not solely effective to resolve all voice problems.

  15. Effective dysphonia detection using feature dimension reduction and kernel density estimation for patients with Parkinson's disease.

    Shanshan Yang

    Full Text Available Detection of dysphonia is useful for monitoring the progression of phonatory impairment for patients with Parkinson's disease (PD, and also helps assess the disease severity. This paper describes the statistical pattern analysis methods to study different vocal measurements of sustained phonations. The feature dimension reduction procedure was implemented by using the sequential forward selection (SFS and kernel principal component analysis (KPCA methods. Four selected vocal measures were projected by the KPCA onto the bivariate feature space, in which the class-conditional feature densities can be approximated with the nonparametric kernel density estimation technique. In the vocal pattern classification experiments, Fisher's linear discriminant analysis (FLDA was applied to perform the linear classification of voice records for healthy control subjects and PD patients, and the maximum a posteriori (MAP decision rule and support vector machine (SVM with radial basis function kernels were employed for the nonlinear classification tasks. Based on the KPCA-mapped feature densities, the MAP classifier successfully distinguished 91.8% voice records, with a sensitivity rate of 0.986, a specificity rate of 0.708, and an area value of 0.94 under the receiver operating characteristic (ROC curve. The diagnostic performance provided by the MAP classifier was superior to those of the FLDA and SVM classifiers. In addition, the classification results indicated that gender is insensitive to dysphonia detection, and the sustained phonations of PD patients with minimal functional disability are more difficult to be correctly identified.

  16. De novo FUS P525L mutation in Juvenile amyotrophic lateral sclerosis with dysphonia and diplopia.

    Leblond, Claire S; Webber, Alina; Gan-Or, Ziv; Moore, Fraser; Dagher, Alain; Dion, Patrick A; Rouleau, Guy A

    2016-04-01

    Juvenile amyotrophic lateral sclerosis (jALS) is characterized by progressive upper and lower motor neuron degeneration leading to facial muscle spasticity, spastic dysarthria, and spastic gait with an early onset (before 25 years old). Unlike adult-onset amyotrophic lateral sclerosis (ALS), patients with jALS tend to have slower progression of motor neuron disease and prolonged survival to a normal life expectancy. Mutations in FUS gene have been reported in jALS,(1) including p.P525L mutation that has been consistently associated with early onset and aggressive presentation.(2) Here, we report a patient carrying p.P525L FUS mutation and experiencing an aggressive course of ALS presenting with dysphonia and diplopia. PMID:27123482

  17. Inharmonicity Analysis: A Novel Physical Method for Acoustic Screening of Dysphonia

    Matteson, Sam; Lu, Fang-Ling

    2008-10-01

    In the United States 6.8% of men, women, and children report current voice problems and approximately 29% will report some problems during their lifetime. Often this dysphonia is due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that shows promise of detecting physiological abnormalities of the vocal folds from an analysis of the Fourier spectrum of spoken ``tokens.'' The underlying principle maintains that the normal human vocal fold is a linear oscillator that emits overtones that are very nearly precise integral values of the fundamental. Physiological problems of the vocal folds, however, introduce mechanical non-linearities that manifest themselves as frequency deviations from the ideal harmonic (that is, integral) values. The authors quantify this inharmonicity, describing and illustrating how one can obtain and analyze such data. They outline, as well, a proposed program to assess the clinical sensitivity and significance of the analysis discussed in this work.

  18. MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls

    Branci, Sonia; Thorborg, Kristian; Bech, Birthe Højlund;

    2015-01-01

    BACKGROUND: Soccer players are commonly affected by long-standing adductor-related groin pain (ARGP), but the clinical significance of MRI findings in these athletes is largely unknown. Our aims were (1) to evaluate whether MRI findings are associated with long-standing ARGP in soccer players, (2......) to assess MRI findings in asymptomatic soccer players and non-soccer playing controls. METHODS: This cross-sectional study included 28 male soccer players with long-standing ARGP, 17 male asymptomatic soccer players and 20 male asymptomatic non-soccer playing athletes of matching age and athletic exposure...... soccer players displayed different positive MRI findings, and asymptomatic soccer players had significantly higher odds (OR ranging from 6.3 to 13.3) for BMO, adductor tendinopathy and degenerative changes than non-soccer players. CONCLUSIONS: ARGP in soccer players was associated with central disc...

  19. Adductor canal blockade for moderate to severe pain after arthroscopic knee surgery

    Espelund, M; Grevstad, U; Jaeger, P;

    2014-01-01

    BACKGROUND: The analgesic effect of the adductor canal block (ACB) after knee surgery has been evaluated in a number of trials. We hypothesized that the ACB would provide substantial pain relief to patients responding with moderate to severe pain after arthroscopic knee surgery. METHODS: Fifty...... opposite study medication, according to randomization. Primary outcome was pain during 45 degrees active flexion of the knee at 45 min after the first block, assessed on a 0-100 mm visual analogue scale. Secondary outcome measures were: pain at rest and during flexion of the knee, worst pain experienced...... subjects with moderate to severe pain after arthroscopic knee surgery were enrolled in this placebo-controlled, blinded trial. All subjects received two ACBs; an initial ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 25) (R group) or saline (n = 25) (C group) and after 45 min a second ACB with the...

  20. Misdiagnosis of dysphonia plicae ventricularis%室性发音障碍的误诊分析

    张帅; 谢常宁; 刘勇; 吴平; 郭莹; 唐瑶云

    2012-01-01

    目的 总结室性发音障碍的临床特征及误诊原因.方法 回顾性分析10例被误诊的室性发音障碍病例的性别、年龄、职业、临床嗓音表现、检查结果及治疗方法.结果 10例被误诊的病例中,代偿型8例,被误诊为声带炎、慢性喉炎及声带闭合不全等;肥厚型2例被误诊为慢性喉炎和声带息肉.通过发音治疗、手术治疗及药物治疗后室性发音障碍均消失.结论 室性发音障碍在临床上不多见,临床症状也不典型,容易被误诊为其他嗓音疾病,需要做详细的喉镜检查和嗓音分析.%Objective To study the clinical characteristics of ventricular bands dysphonia and the reasons for misdiagnosis. Methods The clinical data of 10 patients suffering from ventricular bands dysphonia which was misdiagnosed as other diseases was analyzed retrospectively. Results Eight cases of compensatory type were misdiagnosed as chorditis, chronic laryngitis and two of hypertrophic type were misdiagnosed as chronic laryngitis and vocal polyp. Ventricular bands dysphonia in all cases disappeared after various therapeutic measures including voice therapy, surgical and drug treatment. Conclusion The clinical manifestations of ventricular bands dysphonia are untypical. It can easily be misdiagnosed as other voice diseases. Meticulous voice assessment, and laryngeal videostroboscopy should be considered.

  1. CONTROL OF EROSION PROCESSES RESULTING FROM DISRUPTION OF ADDUCTOR IN THE SERRA DA MANTIQUEIRA, SP, BRAZIL

    Admilson Clayton Barbosa

    2010-12-01

    Full Text Available In the southern escarpment of the Serra da Mantiqueira, northeast geographic divider between the State of São Paulo and Minas Gerais, there was an environmental accident caused by the disruption of an adductor whose purpose is to lead the water from a reservoir located at an altitude of 1820 m to the machine house where there is an electric generator located at 750 m.  This accident resulted in the formation of a scar on the hillside forest, with removal of soil and vegetation. To reverse the erosion processes, a methodology was developed consisting of the use of four barriers (numbered I to IV formed by seedlings of Bambusa mutiplex (Lour., whose purpose was to divert the water runoff in order to provide the regeneration of native vegetation. Stalks of bamboo intercropped with Bambusa multiplex were used to contain debris in two gullies formed by erosion. The development of vegetation was monitored for 18 months and evaluated by the application of a Leopold Matrix composed of 5 points, which are: erosion, regeneration of vegetation, success of bamboo planting, installed conservation structures and functionality. The purpose of the matrix was to demonstrate the effectiveness of interventions using bamboo. The result of the classification matrix enabled the quantitative and qualitative classification of the interventions, resulting in five levels, where the barriers I, II and IV were considered to be of very high efficiency, and barrier III was considered to be of high efficiency. The contention of the gully was considered to be of medium to very high efficiency.

  2. The adductor magnus ''mini-hamstring'': MRI appearance and potential pitfalls

    Broski, Stephen M.; Murthy, Naveen S.; Collins, Mark S. [Department of Radiology, Mayo Clinic, Rochester, MN (United States); Krych, Aaron J. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Obey, Mitchel R. [Mayo School of Graduate Medical Education, Rochester, MN (United States)

    2016-02-15

    To examine the anatomic MRI characteristics of the adductor magnus mini hamstring (AMMH) and explore its involvement in cases of hamstring avulsion. An IRB-approved retrospective review of patients undergoing ''hamstring protocol'' MRI between March 2009 and June 2014 was performed. Two musculoskeletal radiologists recorded multiple AMMH anatomic characteristics and involvement in cases of hamstring avulsion. Seventy-six AMMHs were analyzed in 66 patients [35 females and 31 males, mean age 49.3 ± 15.2 years (range 17-81)]. Eleven percent of AMMHs were poorly visualized, 51 % visualized, and 37 % well visualized. Seven percent demonstrated round, 73 % ovoid, and 21 % flat/lenticular tendon morphologies. Most (88 %) demonstrated typical origins. Average cross-sectional area (CSA) was 22.4 ± 10.6 mm{sup 2} (range 6-56), diameter was 7.2 ± 2.5 mm (range 2.9-15), medial distance from the semimembranosus tendon was 7.5 ± 2.5 mm (range 3-14), and tendon length was 6.8 ± 3.3 cm (range 1.2-14.1). There was no gender difference in AMMH anatomic measurements or correlation between age and CSA or diameter. Of 17 complete hamstring avulsion cases, the AMMH was intact in 13, partially torn in 3, and completely torn in 1. The AMMH is a constant finding with variable anatomic characteristics. It is visualized or well visualized by MRI in 88 % of cases and is a sizable tendon located in close proximity to the semimembranosus tendon. Because it is uncommonly completely torn (6 %) in cases of complete hamstring avulsion, radiologists should be aware of its presence and appearance to avoid diagnostic confusion. (orig.)

  3. CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF EINDSTROKE—CAUSED DYSKPHAGIA—DYSPHONIA SYNDRONE

    韩舰华; 董颖丽; 等

    2002-01-01

    Objective:To observe the therapeutic effect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp-acupuncture in the treatment of wind strokek.Methods:A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp-point Dingzhougxian (MS 5),Dingnie Houxiexian (MS 7),Dingpangxian Ⅱ (MS 9) and Dingnie Qianxiexian (MS 6).Before and after acupuncture treatment,clinical symptoms of dysphadia and dyskphonia sere compared,and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA),middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter.Results:Following two courses (4 weeks) of scalp-acupuncture treatment,of the 38 cases,23 had their dysphagia and dyskphonia cured (60.5%),10 (25.3%) had remarkable improvement,3(7.9%) experienced improvement and 2(5.3%) had no apparent changes.Simultaneously.MBFS of ACA,MCA and PCA increased significantly in comparison with that of pre-treatment (P<0.01).Additionally,results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain.Conclusion:Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating carebral blood flow.

  4. Distonia laríngea: relato de caso e tratamento com toxina botulínica Laryngeal dystonia: case report and treatment with botulinum toxin

    Victor José Barbosa Santos

    2006-06-01

    Full Text Available Distonia laríngea, ou disfonia espasmódica, é caracterizada por contrações involuntárias e inapropriadas da musculatura responsável pela fonação, sendo a do tipo adutora a mais comum. Caracteriza-se por quebras fonatórias, sendo seu diagnóstico confirmado por videolaringoestroboscopia. O tratamento de escolha é feito com a aplicação direta de toxina botulínica nos músculos responsáveis pelo movimento incoordenado. O objetivo desse trabalho é relatar o caso de uma paciente com diagnóstico de distonia laríngea do tipo adutora, tratada com toxina botulínica e discutir as vantagens e observações descritas na literatura a respeito desse tratamento.Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and innapropiate spasms of vocal muscles, having the adductor type as the most common one. It is chacterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature.

  5. Comparison of catheter tip migration using flexible and stimulating catheters inserted into the adductor canal in a cadaver model.

    Webb, Christopher A J; Kim, T Edward; Funck, Natasha; Howard, Steven K; Harrison, T Kyle; Ganaway, Toni; Keng, Heidi; Mariano, Edward R

    2015-06-01

    Use of adductor canal blocks and catheters for perioperative pain management following total knee arthroplasty is becoming increasingly common. However, the optimal equipment, timing of catheter insertion, and catheter dislodgement rate remain unknown. A previous study has suggested, but not proven, that non-tunneled stimulating catheters may be at increased risk for catheter migration and dislodgement after knee manipulation. We designed this follow-up study to directly compare tip migration of two catheter types after knee range of motion exercises. In a male unembalmed human cadaver, 30 catheter insertion trials were randomly assigned to one of two catheter types: flexible or stimulating. All catheters were inserted using an ultrasound-guided short-axis in-plane technique. Intraoperative knee manipulation similar to that performed during surgery was simulated by five sequential range of motion exercises. A blinded regional anesthesiologist performed caliper measurements on the ultrasound images before and after exercise. Changes in catheter tip to nerve distance (p = 0.547) and catheter length within the adductor canal (p = 0.498) were not different between groups. Therefore, catheter type may not affect the risk of catheter tip migration when placed prior to knee arthroplasty. PMID:25510467

  6. Cross-innervation of the thyroarytenoid muscle by a branch from the external division of the superior laryngeal nerve.

    Nasri, S; Beizai, P; Ye, M; Sercarz, J A; Kim, Y M; Berke, G S

    1997-07-01

    The neuroanatomy of the larynx was explored in seven dogs to assess whether there is motor innervation to the thyroarytenoid (TA) muscle from the external division of the superior laryngeal nerve (ExSLN). In 3 animals, such innervation was identified. Electrical stimulation of microelectrodes applied to the ExSLN resulted in contraction of the TA muscle, indicating that this nerve is motor in function. This was confirmed by electromyographic recordings from the TA muscle. Videolaryngostroboscopy revealed improvement in vocal fold vibration following stimulation of the ExSLN compared to without it. Previously, the TA muscle was thought to be innervated solely by the recurrent laryngeal nerve. This additional pathway from the ExSLN to the TA muscle may have important clinical implications in the treatment of neurologic laryngeal disorders such as adductor spasmodic dysphonia. PMID:9228862

  7. Quantifying Dysphonia Severity Using a Spectralcepstral-Based Acoustic Index: Comparisons with Auditory-Perceptual Judgements from the CAPE-V

    Awan, Shaheen N.; Roy, Nelson; JettE, Marie E.; Meltzner, Geoffrey S.; Hillman, Robert E.

    2010-01-01

    This study investigated the relationship between acoustic spectral/cepstral measures and listener severity ratings in normal and disordered voice samples. CAPE-V sentence samples and the vowel /[script]/were elicited from eight normal speakers and 24 patients with varying degrees of dysphonia severity. Samples were analysed for measures of the…

  8. Adductor Canal Block With 10 mL Versus 30 mL Local Anesthetics and Quadriceps Strength

    Jæger, Pia; Koscielniak-Nielsen, Zbigniew J; Hilsted, Karen Lisa;

    2015-01-01

    BACKGROUND AND OBJECTIVES: Adductor canal block (ACB) is predominantly a sensory nerve block, but excess volume may spread to the femoral triangle and reduce quadriceps strength. We hypothesized that reducing the local anesthetic volume from 30 to 10 mL may lead to fewer subjects with quadriceps...... weakness. METHODS: We performed a paired, blinded, randomized trial including healthy men. All subjects received bilateral ACBs with ropivacaine 0.1%; 10 mL in 1 leg and 30 mL in the other leg. The primary outcome was the difference in number of subjects with quadriceps strength reduced by more than 25...... and 30 mL did not have a statistically significant or clinically relevant impact on quadriceps strength....

  9. Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Mobilization, and Pain After Total Knee Arthroplasty

    Grevstad, Jens Ulrik; Mathiesen, Ole; Valentiner, Laura Risted Staun;

    2015-01-01

    strength. METHODS: We included 50 TKA patients with severe movement-related pain; defined as having visual analog scale pain score of greater than 60 mm during active flexion of the knee. The ACB group received an ACB with ropivacaine 0.2% 30 mL and a femoral nerve block (FNB) with 30 mL saline. The FNB......BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA) is often associated with severe pain. Different regional anesthetic techniques exist, all with varying degrees of motor blockade. We hypothesized that pain relief provided by the adductor canal block (ACB) could increase functional muscle...... ambulate and changes in pain scores (Clinicaltrials.gov identifier NCT01922596). RESULTS: After block, the quadriceps maximum voluntary isometric contraction increased to 193% (95% confidence interval [CI], 143-288) of the baseline value in the ACB group and decreased to 16% (95% CI, 3-33) in the FNB group...

  10. Real-time ultrasound-guided comparison of adductor canal block and psoas compartment block combined with sciatic nerve block in laparoscopic knee surgeries

    Messeha, Medhat M.

    2016-01-01

    Background: Lumbar plexus block, combined with a sciatic nerve block, is an effective locoregional anesthetic technique for analgesia and anesthesia of the lower extremity. The aim of this study was to compare the clinical results outcome of the adductor canal block versus the psoas compartment block combined with sciatic nerve block using real time ultrasound guidance in patients undergoing elective laparoscopic knee surgeries. Patients and Methods: Ninety patients who were undergoing electi...

  11. Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

    Corinne Fredouille

    2009-01-01

    Full Text Available This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists. The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices, rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0–3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

  12. Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

    Fredouille, Corinne; Pouchoulin, Gilles; Ghio, Alain; Revis, Joana; Bonastre, Jean-François; Giovanni, Antoine

    2009-12-01

    This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists). The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices), rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0-3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

  13. Botulinum toxin injection - larynx

    Injection laryngoplasty; Botox-larynx: spasmodic dysphonia-BTX; Essential voice tremor (EVT)-btx; Glottic insufficiency; Percutaneous electromyography-guided botulinum toxin treatment; Percutaneous indirect laryngoscopy-guided botulinum toxin Treatment; ...

  14. Spectrophotometric determination of some anti-tussive and anti-spasmodic drugs through ion-pair complex formation with thiocyanate and cobalt(II) or molybdenum(V)

    El-Shiekh, Ragaa; Zahran, Faten; El-Fetouh Gouda, Ayman Abou

    2007-04-01

    Two rapid, simple and sensitive extractive specrophotometric methods has been developed for the determination of anti-tussive drugs, e.g., dextromethorphan hydrobromide (DEX) and pipazethate hydrochloride (PiCl) and anti-spasmodic drugs, e.g., drotaverine hydrochloride (DvCl) and trimebutine maleate (TM) in bulk and in their pharmaceutical formulations. The proposed methods depend upon the reaction of cobalt(II)-thiocyanate (method A) and molybdenum(V)-thiocyanate ions (method B) with the cited drugs to form stable ion-pair complexes which extractable with an n-butnol-dichloromethane solvent mixture (3.5:6.5) and methylene chloride for methods A and B, respectively. The blue and orange red color complexes are determined either colorimetrically at λmax 625 nm (using method A) and 467 or 470 nm for (DEX and PiCl) or (DvCl and TM), respectively (using method B). The concentration range is 20-400 and 2.5-50 μg mL -1 for methods A and B, respectively. The proposed method was successfully applied for the determination of the studied drugs in pure and in pharmaceutical formulations applying the standard additions technique and the results obtained in good agreement well with those obtained by the official method.

  15. Dysphonia in geriatric cases always needs fiberoptic laryngoscopy/bronchoscopy: Spindle cell carcinoma of larynx, a rare entity

    Shivaji Patil

    2016-01-01

    Full Text Available Spindle cell (sarcomatoid carcinoma is a rare variant of squamous cell carcinoma (SCC. It compromises of 2–3% of laryngeal cancers. Tumor arises from the oral cavity, tonsil larynx, and pharynx. Tumor is majority times misdiagnosed as reactive lesions or mesenchymal malignancies. It is considered to be a biphasic tumor that is composed of an SCC (in situ or invasive and spindle cell carcinoma (SpCC with sarcomatous appearance. In this case report, 61-year-male with minimal throat pain and acute onset dysphonia misdiagnosed and treated as a case of bronchial asthma with gastroesophageal reflux confirmed to have exophytic laryngeal growth is the cause for clinical presentation. We performed fiberoptic laryngoscopy and diagnosed to have SpCC of larynx. High index of suspicion is a must in geriatric cases with documented history of smoking and fiberoptic laryngoscopy/bronchoscopy found to be crucial in the evaluation. Histopathology expertise in surgical oncology is essential while planning treatment.

  16. Proposta de modelo de atendimento multidisciplinar para disfonias relacionadas ao trabalho: estudo preliminar Multidisciplinary protocol proposal for professional dysphonia: preliminary study

    Erica Ortiz

    2004-10-01

    Full Text Available A disfonia tem recebido um enfoque ocupacional crescente e torna-se necessário, ao otorrinolaringologista, atualizar a abordagem clínica dos trabalhadores que usam a voz como instrumento de trabalho, onde novas catagorias profissionais têm surgido e, com elas, as disfunções vocais conseqüentes às condições de trabalho. Hoje, há grandes preocupações com o prejuízo econômico e produtivo que o ditúrbio vocal possa gerar. Sabe-se que a disfunção vocal tem como característica a multicausalidade e, por isso, a avaliação, conclusão e emissão de relatórios médicos tornam-se incertos. OBJETIVO: Para melhor avaliar estes profissionais e garantir um atendimento com respaldo científico adequado, estabeleceu-se um protocolo multidisciplinar, que consiste em anamnese dirigida, exame físico, endoscopia laríngea, análise perceptiva da voz e aplicação do Voice Handicap Index (VHI. FORMA DE ESTUDO: Coorte histórica transversal. MATERIAL E MÉTODO: Para testar o uso do método, em caráter preliminar, o protocolo foi aplicado em 15 profissionais que usavam a voz para trabalhar. Então, realizou-se um estudo retrospectivo com estes pacientes. RESULTADO: Demonstrou-se que 13,3% dos profissionais apresentaram performance vocal normal; 33,3%, disfonia funcional e 46%, disfonia orgânico-funcional. A disfunção vocal foi relacionada ao exercício do trabalho em 40% dos pacientes e em 46,6% ela foi descartada. CONCLUSÃO: Concluiu-se que o método é suficientemente abrangente e pode ser de utilidade ao otorrinolaringologista, para a avaliação clínico-ocupacional deste grupo de pacientes.Dysphonia has an occupational view nowadays. A shift in the voice-oriented professional's clinical approach has been required. New voice-oriented job categories have emerged and, as a result, the voice disorder in the professional enviroment has increased. The economic and productivity harm due to voice disorders are a preocupation. Dysphonia has

  17. Artikulacija in govorne navade oseb z mišično tenzijsko disfonijo: Articulation and speech habits in patients with muscle tension dysphonia:

    Hočevar-Boltežar, Irena; Jarc, Ana; Trpkov, Klara

    2008-01-01

    Background Muscle tension dysphonia (MTD) is a functional voice disorder characterized by irregular phonatory musclesć activity. It is a cause for hoarseness in almost one half of dysphonic patients. We wanted to find out whether there are particularities in voice-speech production in patients with MTD, which are not observed in subjects without voice disorders or appear in alesser extent. Methods There were 30 subjects with MTD (27 women, 3 men) and 30 control subjects of the same age and ge...

  18. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352. PMID:27374014

  19. Comparison of Adductor Canal Block and Femoral Nerve Block for Postoperative Pain in Total Knee Arthroplasty: A Systematic Review and Meta-analysis.

    Dong, Cui-Cui; Dong, Shu-Ling; He, Fu-Cheng

    2016-03-01

    A total knee arthroplasty (TKA) has always been associated with moderate-to-severe pain. A systematic review of randomized controlled trials (RCTs) and non-RCTs was performed to evaluate the efficacy and safety of pain control of adductor canal block (ACB) and femoral nerve block (FNB) after TKA.Relevant literatures about the ACB and FNB after TKA for reducing pain were searched from Medline (1996-January, 2015), Embase (1980-January, 2015), PubMed (1980-January, 2015), Web of Science (1980-January, 2015), and The Cochrane Central Register of Controlled Trials. High-quality RCTs and non-RCTs were picked to evaluate the visual analogue scale (VAS) and other outcome. This systematic review and meta-analysis were performed according to the PRISMA statement criteria. The software RevMan 5.30 was used for the meta-analysis.Eight literatures fitted into the inclusion criteria. There were no significant differences in VAS score with rest or mobilization at 4, 24, and 48 h between ACB group and FNB group. There were also no significant differences in the strength of quadriceps and adductor, the length of hospital stay, and complications of vomiting and nausea.Present meta-analysis indicated that ACB shows no superiority than FNB group. Both of them can reduce the pain score after TKA. As referred to which method to adopt, it is determined by the preference of the surgeons and anesthesiologists. PMID:27015172

  20. Differential proteomic responses in hepatopancreas and adductor muscles of the green-lipped mussel Perna viridis to stresses induced by cadmium and hydrogen peroxide

    This study aimed to reveal the proteomic responses in the hepatopancreas and adductor muscle of a common biomonitor, Perna viridis after 14-day exposure to two model chemicals, cadmium (Cd; a toxic metal) and hydrogen peroxide (H2O2; a pro-oxidant), using two-dimensional gel electrophoresis coupled with multivariate statistical analyses. Unique sets of tissue-specific protein expression signatures were revealed corresponding to the two treatment groups. In the hepatopancreas, 15 and 2 spots responded to Cd and H2O2 treatments respectively. 6 and 7 spots were differentially expressed in the adductor muscle for Cd and H2O2 treatments, respectively. 15 differentially expressed spots were successfully identified by MALDI-TOF/TOF MS analysis. These proteins are involved in glycolysis, amino acid metabolism, energy homeostasis, oxidative stress response, redox homeostasis and protein folding, heat-shock response, and muscle contraction modulation. This is the first time, to have demonstrated that Cd exposure not only leads to substantial oxidative stress but also results in endoplasmic reticulum stress in hepatopancreas of the mussel. Such notable stress responses may be attributable to high Cd accumulation in this tissue. Our results suggested that investigations on these stress-associated protein changes could be used as a new and complementary approach in pollution monitoring by this popular biomonitor species.

  1. NMR-Based Metabolomic Investigations on the Differential Responses in Adductor Muscles from Two Pedigrees of Manila Clam Ruditapes philippinarum to Cadmium and Zinc

    Junbao Yu

    2011-09-01

    Full Text Available Manila clam Ruditapes philippinarum is one of the most important economic species in shellfishery in China due to its wide geographic distribution and high tolerance to environmental changes (e.g., salinity, temperature. In addition, Manila clam is a good biomonitor/bioindicator in “Mussel Watch Programs” and marine environmental toxicology. However, there are several pedigrees of R. philippinarum distributed in the marine environment in China. No attention has been paid to the biological differences between various pedigrees of Manila clams, which may introduce undesirable biological variation in toxicology studies. In this study, we applied NMR-based metabolomics to detect the biological differences in two main pedigrees (White and Zebra of R. philippinarum and their differential responses to heavy metal exposures (Cadmium and Zinc using adductor muscle as a target tissue to define one sensitive pedigree of R. philippinarum as biomonitor for heavy metals. Our results indicated that there were significant metabolic differences in adductor muscle tissues between White and Zebra clams, including higher levels of alanine, glutamine, hypotaurine, phosphocholine and homarine in White clam muscles and higher levels of branched chain amino acids (valine, leucine and isoleucine, succinate and 4-aminobutyrate in Zebra clam muscles, respectively. Differential metabolic responses to heavy metals between White and Zebra clams were also found. Overall, we concluded that White pedigree of clam could be a preferable bioindicator/biomonitor in marine toxicology studies and for marine heavy metals based on the relatively high sensitivity to heavy metals.

  2. "King archie, who was quite grouchy" - a vocal dysphonia health education project O rei Sebastião que era muito resmungão

    Maria Rosário Dias

    2012-01-01

    Full Text Available PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

  3. Presurgical evaluation of hemifacial spasm and spasmodic torticollis caused by a neurovascular conflict from AICA with 3T MRI integrated by 3D drive and 3D TOF image fusion: A case report and review of the literature

    Concetta Alafaci

    2014-01-01

    Full Text Available Background: Hemifacial spasm (HS and spasmodic torticollis (ST are well-known disorders that are caused by a neurovascular conflict. HS is characterized by irregular, involuntary muscle contractions on one side of the face due to spasms of orbicularis oris and orbicularis oculi muscles, and is usually caused by vascular compression of the VII cranial nerve. ST is an extremely painful chronic movement disorder causing the neck to involuntary turn to the side, upward and/or downward. HS is usually idiopathic but it is rarely caused by a neurovascular conflict with the XI cranial nerve. Case Description: We present a case of a 36-year-old woman with a 2-year history of left hemifacial spasm and spasmodic torticollis. Pre-surgical magnetic resonance imaging MRI examination was performed with 3TMRI integrated by 3Ddrive and 3DTOF image fusion. Surgery was performed through a left suboccipital retrosigmoid craniectomy. The intraoperative findings documented a transfixing artery penetrating the facial nerve and a dominant left anteroinferior cerebellar artery (AICA in contact with the anterior surface of the pons and lower cranial nerves. Microvascular decompression (MVD was performed. Postoperative course showed the regression of her symptoms. Conclusions : Transfixing arteries are rarely reported as a cause of neurovascular conflicts. The authors review the literature concerning multiple neurovascular conflicts.

  4. CO2激光治疗室带肥厚导致的发音障碍%Treatment of hypertrophic ventricular dysphonia with CO2 laser

    宋维杰; 杜建群

    2015-01-01

    目的:探讨显微支撑喉镜下CO2激光治疗室带肥厚导致的发音障碍的临床疗效。方法2011年12月~2013年12月因室带肥厚导致发音障碍就诊于我科的40例经保守治疗无效的患者,所有患者均经动态喉镜和嗓音分析检查(包括基频、基频微扰、振幅微扰和谐燥比),并在全身麻醉下行显微支撑喉镜CO2激光手术切除肥厚的室带,术后再次查动态喉镜和嗓音分析,并与术前进行对比。结果40例患者术后声嘶明显改善,室带恢复正常水平,基频微扰、振幅微扰均降低,基频和谐燥比升高,声带黏膜波恢复正常,无并发症发生。结论显微支撑喉镜CO2激光治疗室带肥厚导致的发音障碍是安全、可靠的,实用性强。%[ABSTRACT]OBJECTIVETo study the clinical effect of CO2 laser in the treatment of hypertrophic ventricular dysphonia.METHODSFrom December 2011 to December 2013, 40 patients with hypertrophic ventricular dysphonia were treated in our department. Conservative treatment had no valid for all of them. All the patients were examined with strobolaryngoscope and voice analysis (including fundamental frequency, jitter, shimmer and harmonic to noise). After general anesthesia, the hypertrophic ventricular cords were excised with CO2 laser under suspension laryngoscope.RESULTS The Hoarseness were better in all the patients after operation. The ventricular cord and mucosal waves of the vocal cord were normal. The jitter and shimmer were lower than that before operation, but the fundamental frequency and harmonic to noise were higher than that before operation. There were no complications. CONCLUSIONThe treatment of hypertrophic ventricular dysphonia with CO2 laser under suspension laryngoscope is safe, reliable and practical.

  5. The influence of spasmodic torticollis on the clinical prognosis of patients with neurogenic dysphagia%神经源性吞咽障碍伴痉挛性斜颈的临床治疗观察

    郭钢花; 王国胜; 李哲

    2012-01-01

    目的 观察痉挛性斜颈对神经源性吞咽障碍患者康复预后的影响及不同治疗方法的疗效比较.方法 选取神经源性吞咽障碍患者103例,其中伴有痉挛性斜颈患者82例,采用随机数字表法分为单纯训练组(21例,仅给予常规吞咽康复训练)、药物训练组(21例,给予常规吞咽康复训练及药物治疗)、支持训练组(20例,给予常规吞咽康复训练及一般性支持治疗)及联合治疗组(20例,给予常规吞咽康复训练、药物及一般性支持治疗),余21例无痉挛性斜颈的神经源性吞咽障碍患者则归入无斜颈组(给予常规吞咽康复训练).于治疗前、治疗2个月对各组患者吞咽功能改善情况进行评定.结果 治疗前药物训练组、支持训练组、联合治疗组和单纯训练组吞咽功能均显著低于无斜颈组(P<0.05);各组患者分别经2个月治疗后,发现5组患者吞咽功能均较治疗前显著改善(P<0.05),其中药物训练组、支持训练组、联合治疗组和无斜颈组吞咽功能均显著优于单纯训练组(P<0.05);联合治疗组吞咽功能亦显著优于药物训练组及支持训练组(P<0.05);联合治疗组和无斜颈组吞咽功能组间差异无统计学意义(P>0.05).结论 痉挛性斜颈能影响神经源性吞咽障碍患者吞咽功能恢复,对痉挛性斜颈进行治疗可明显提高神经源性吞咽障碍患者吞咽功能.%Objective To observe the influence of spasmodic torticollis on the rehabilitation prognoses of patients with neurogenic dysphagia.Methods One hundred and three dysphagic patients were recruited,of which 82 had spasmodic torticollis and 21 did not.The subjects with spasmodic torticollis were divided randomly into a medication therapy group (21 cases) which accepted medication plus swallowing training,a common therapy group (20 cases) accepting common support treatment plus swallowing training,a combined therapy group (20 cases) accepting common support treatment

  6. Comparação do corticoide inalatório e oral no tratamento da disfonia aguda Use of inhaled versus oral steroids for acute dysphonia

    Andréa Moreira Veiga de Souza

    2013-04-01

    Full Text Available A disfonia aguda é um quadro comum na prática clínica. Seu tratamento, principalmente em adultos, não é bem definido na literatura. O corticoide é o tratamento medicamentoso mais recomendado. Os estudos existentes, entretanto, não são suficientes para a determinação da superioridade entre diferentes corticoides e a melhor forma de administração. OBJETIVO: Este estudo clínico prospectivo teve como objetivo comparar o efeito do corticoide inalatório na forma de pó seco com o efeito do corticoide oral, no tratamento da disfonia aguda. MÉTODO: Foram avaliados 32 pacientes adultos, divididos em dois grupos de 16 pacientes para cada um dos tratamentos, antes e após sete dias do uso da medicação. Os pacientes foram submetidos à videolaringosocpia e avaliação perceptiva e acústica da voz. RESULTADOS: O tratamento inalatório e oral reduziram significativamente a hiperemia, o edema e melhorou o movimento muco-ondulatório; entretanto, a redução do edema foi estatisticamente mais significativa (p = 0,012 nos pacientes tratados com a forma inalatória. A comparação dos valores da análise perceptiva auditiva e das medidas acústicas após tratamento entre os grupos, entretanto, não apresentou significância estatística. CONCLUSÃO: Houve melhora significativa da laringite aguda nas avaliações realizadas, em todos os pacientes estudados, com os dois tratamentos. O tratamento com corticoide inalatório foi significativamente mais efetivo na redução do edema.Acute dysphonia is a frequent condition in clinical practice. Its treatment, especially in adults, is not well established in the literature. Steroids are the most recommended drug treatment. However, the existing studies are not enough to establish superiority among the different steroids and the best route of administration. OBJECTIVE: This prospective clinical study aimed at comparing the effect of inhaling steroids as a dry powder with the effect of oral steroids to

  7. Disfonias: relação S/Z e tipos de voz Dysphonias: S/Z ratio and types of voice

    Carla Aparecida Cielo

    2008-12-01

    Full Text Available OBJETIVO: verificar o resultado da relação s/z e do tipo de voz em pacientes com diagnóstico de disfonias orgânico-funcionais (DOF e disfonias funcionais por uso incorreto da voz (DFUIV, bem como a ocorrência das diferentes patologias dentro das DOF. MÉTODOS: 70 indivíduos, de ambos os sexos, entre cinco e 65 anos de idade, atendidos numa clínica-escola, cadastrados em Banco de Dados, entre 1998 e 2006, com DOF e DFUIV, ambos classificados em três subgrupos: casos em que a relação s/z indicava hipercontração, normalidade, e falta de coaptação das pregas vocais durante a fonação. Os tipos de voz foram classificados conforme a ocorrência em: sem alteração; ruidosa; ruidosa, comprimida e/ou apresentando alteração de f0h; ruidosa e/ou apresentando alteração de f0h; e comprimida. RESULTADOS: ocorrência significativa de DOF e de DOF com nódulos vocais; nas DOF e DFUIV, ocorrência significante de relação s/z normal com tempos isolados de /s/ e /z/ abaixo do normal e voz ruidosa. CONCLUSÕES: O resultado da relação s/z foi estatisticamente significativo a favor da faixa de normalidade estabelecida, tanto nos pacientes com diagnóstico de DOF, quanto naqueles com DFUIV, sendo que, em ambos os grupos de pacientes, a voz ruidosa foi a mais freqüente. Dentro das DOF, os nódulos vocais foram significativamente mais freqüentes do que as demais patologias.PURPOSE: to check the result of s/z ratio and types of voice in patients with diagnosis of organic-functional dysphonias (DOF and functional dysphonias by incorrect use of voice (DFUIV, as well as the occurrence of the various pathologies within the DOF. METHODS: 70 subjects of both genders, between 5 and 65 years old, seen in a clinic-school, registered in a data bank from 1998 to 2006, with DOF and DFUIV, both classified in three sub-groups: cases in which the s/z ratio indicated hypercontraction, normality and lack of coaptation of the vocal folds during phonation

  8. The Effectiveness of Voice Training for 30 Patients with Functional Dysphonia%嗓音训练治疗30例功能性嗓音障碍的疗效观察

    谭嘉升; 祁斌时; 刘中良

    2014-01-01

    Objective To observe the effectiveness of voice training for patients with functional dysphonia.Methods The voice therapy (voice health education, improvement of respiration and resonance enhancement) was performed for 30 patients who were diagnosed with functional dysphonia. The patients were assessed before and after the treatment to observe the effectiveness.Results The voice handicap index(VHI) decreased from 67.8±10.1 to 30.7±8.2 after the voice training and the difference was significant(P<0.01). The functional, physiological and emotional scores decreased significantly after the training. The maximum phonation time(MPT) increased significantly from 9.2±2.6 s to 13.5±3.1 s, jitter decreased was from 0.59%±0.07% to 0.42%±0.05%,shimmer decreased from 2.23±0.45 to 1.78±0.27 and noise-to-harmonic ratio (NHR) decreased from 0.185±0.088 to 0.142±0.065,all showing significant differences(P<0.05).Conclusion Voice training can effectively reduce the severity of voice dysphonia and enhance the voice quality of patients with functional dysphonia. This therapy can also improve the communicative and emotional skills of the patients so that they will be confident in daily communication.%目的:观察嗓音训练治疗功能性嗓音障碍的疗效。方法对30例诊断为功能性嗓音障碍的患者进行嗓音治疗(嗓音卫生教育、改善呼吸及增强共鸣),并在治疗前后进行评估。结果30例功能性嗓音障碍患者接受训练后嗓音障碍指数值(Voice Handicap Index,VHI)由67.8±10.1分降至30.7±8.2分,差异有统计学意义(P<0.01),患者在功能、生理和情感上均有明显改善;同时最长发声时间(Maximum Phonation Time,MPT)由9.2±2.6秒延长至13.5±3.1秒,基频微扰由0.59%±0.07%降至0.42%±0.05%,振幅微扰由2.23±0.45降至1.78±0.27,噪谐比由0.185±0.088降至0.142±0.065,差异有统计学意义(P<0.05)。结论嗓音训练能够降低嗓音障碍程度,改善嗓

  9. Estudo epidemiológico de disfonias em crianças de 4 a 12 anos Epidemiological study of dysphonia in 4-12 year-old children

    Elaine Lara Mendes Tavares

    2011-12-01

    Full Text Available Estudos sobre disfonias infantis apontam incidência entre 4,4 a 30,3% das crianças. OBJETIVOS: Determinar a prevalência de disfonia em crianças, baseando-se nos julgamentos dos pais, nas ava-liações vocais perceptivas e acústicas, analisar sintomas associados, fatores de risco e achados vide-olaringoscópicos. CASUÍSTICA E MÉTODOS: Os pais de 2.000 crianças responderam questionário sobre qualidade vocal do filho. As crianças foram submetidas às avaliações vocais perceptiva, acústicas e videolaringoscopias. RESULTADOS: Participaram 1.007 meninos e 993 meninas. Sintomas esporádicos foram reportados por 206 pais e permanentes, por 123. Na avaliação perceptiva, o parâmetro G (Grau de disfonia recebeu escore 0 em 694 vozes, 1 em 1065 e 2 em 228. Houve diminuição de f0 com a idade e os demais parâmetros acústicos mostraram-se mais elevados nas crianças com escore de G em 2. Nas videolaringoscopias, destacaram-se nódulos, espessamentos e inflamação. CONCLUSÕES: O julgamento dos pais indicou prevalência de disfonia em 6,15%, e as análises perceptivas em 11,4%. Os sintomas vocais relacionaram-se à sobrecarga fonatória. Quadros nasossinusais, abuso vocal e ruído foram importantes fatores de risco. As análises acústicas mantiveram relação direta com as perceptivo-auditivas. Lesões laríngeas foram detectadas nas videolaringoscopias, destacando nódulos, espessamentos e inflamação.Children dysphonia studies have reported an incidence of 4.4 to 30.3%. GOALS: To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. MATERIALS AND METHODS: The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. RESULTS: We had 1,007 boys and 993 girls

  10. A Qualitative Study of Interference with Communicative Participation across Communication Disorders in Adults

    Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

    2011-01-01

    Purpose: To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Method: Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering,…

  11. Effects of spaceflight in the adductor longus muscle of rats flown in the Soviet Biosatellite COSMOS 2044. A study employing neural cell adhesion molecule (N-CAM) immunocytochemistry and conventional morphological techniques (light and electron microscopy)

    D'Amelio, F.; Daunton, N. G.

    1992-01-01

    The effects of spaceflight upon the "slow" muscle adductor longus were examined in rats flown in the Soviet Biosatellite COSMOS 2044. The techniques employed included standard methods for light microscopy, neural cell adhesion molecule (N-CAM) immunocytochemistry and electron microscopy. Light microscopic observations revealed myofiber atrophy and segmental necrosis accompanied by cellular infiltrates composed of macrophages, leukocytes and mononuclear cells. Neural cell adhesion molecule immunoreactivity (N-CAM-IR) was seen on the myofiber surface and in regenerating myofibers. Ultrastructural alterations included Z band streaming, disorganization of myofibrillar architecture, sarcoplasmic degradation, extensive segmental necrosis with apparent preservation of the basement membrane, degenerative phenomena of the capillary endothelium and cellular invasion of necrotic areas. Regenerating myofibers were identified by the presence of increased amounts of ribosomal aggregates and chains of polyribosomes associated with myofilaments. The principal electron microscopic changes of the neuromuscular junctions showed axon terminals with a decrease or absence of synaptic vesicles replaced by microtubules and neurofilaments, degeneration of axon terminals, vacant axonal spaces and changes suggestive of axonal sprouting. The present observations suggest that alterations such as myofibrillar disruption and necrosis, muscle regeneration and denervation and synaptic remodeling at the level of the neuromuscular junction may take place during spaceflight.

  12. Considerações teóricas sobre a relação entre respiração oral e disfonia Theoretical considerations on the relationship between mouth breathing and dysphonia

    Juliana Gomes Tavares

    2008-01-01

    Full Text Available Sabe-se que a respiração oral pode ocasionar diversas alterações ósseas, posturais, musculares e funcionais, como também, alterações na qualidade e/ou comportamento vocal. Estas alterações podem comprometer a comunicação oral, na qual a voz não consegue desempenhar seu papel básico de transmissão da mensagem verbal e emocional do indivíduo. O indivíduo com respiração oral pode apresentar ressonância nasalizada e a voz pode apresentar alterações no traço de sonoridade, hiper ou hiponasal, ou rouca. A partir de pesquisa nas bases de dados LILACS, SciELO, livros, revistas especializadas sobre o tema, buscamos fazer uma revisão na literatura sobre a relação entre respiração oral e disfonia, analisando a influência das alterações causadas pela respiração oral na qualidade e/ou comportamento vocal. No entanto, foi possível observar que a respiração oral promove uma série de alterações estruturais significativas que refletem nas funções estomatognáticas, interferindo também na fonação. Contudo, poucos autores relatam a possível correlação entre esses dois parâmetros (respiração oral e disfonia.It is known that mouth breathing can lead to several bone, postural, muscular and functional alterations, and also changes on vocal quality and/or vocal behavior. These alterations can compromise oral communication, in which the voice cannot perform its basic role on the transmission of an individual's verbal and emotional message. Individuals with mouth breathing can present hiper or hiponasal resonance, changes on voicing features and hoarseness. From researches on LILACS and SciELO databases, books and specialized magazines about the subject, it was carried a literature review about the relationship between mouth breathing and dysphonia, analyzing the influence of alterations caused by mouth breathing on vocal quality and/or vocal behavior. It was possible observe that mouth breathing promotes several

  13. The Voice Aerodynamic Analysis of 21 Patients with Muscular Tension Dysphonia%肌紧张性发声障碍患者发声空气动力学特点分析

    张碧茹; 龚坚; 郑亿庆; 梁茂金; 彭解人

    2010-01-01

    目的 分析肌紧张性发声障碍(muscular tension dysphonia,MTD)患者发声空气动力学特性,探讨该方法在MTD诊治中的应用价值.方法 采用言语发声空气动力学测试系统分别测量21例肌紧张性发声障碍患者及20例正常成人舒适发声时的声门下压、声门阻力、平均气流率及最长声时,并进行统计学分析.结果 与正常成人比较,MTD患者声门下压和声门阻力升高,平均气流率下降.最长声时缩短,差异有统计学意义(P<0.05或0.01).结论 空气动力学分析能有效评估MTD患者的发声功能,可用于MTD疾病的诊断和疗效观察.

  14. The Application of Dysphonia Severity Index to Patients with Vocal Cord Polys%声带息肉患者的嗓音障碍客观指数测定

    毛兔峰; 王一鸣; 王建波; 滕尧树

    2012-01-01

      目的研究嗓音障碍客观指数(dysphonia severity index,DSI)测试在声带息肉患者嗓音分析中的临床应用.方法对31例声带息肉患者和12例正常受试者分别进行主观自我评估和客观嗓音声学检测.主观自我评估采用嗓音障碍指数(voice handicap index,VHI)量表进行评估,客观声学检测采用德国XION公司生产的嗓音分析软件DiVAS进行测试.结果声带息肉患者组DSI均低于正常对照组,差别有统计学意义(P<0.05);VHI高于正常对照组,结果具有统计学差异(P<0.05).声带息肉患者的DSI与VHI之间没有显著相关性.结论嗓音障碍客观指数(DSI)能够客观评估声带息肉患者的嗓音障碍程度.%10.3969/j.issn.1672-4933.2012.05.005

  15. 马氏珠母贝红色闭壳肌 F1代的家系选育及家系评定%Recearch on Family Selection and Evaluation of Pinctada martensi with Red Adductor Muscle

    彭张明; 陶后全; 刘锦上; 刘冠; 刘志刚

    2015-01-01

    从马氏珠母贝 F6代选育系中挑选红色闭壳肌雌雄亲本,构建了12个全同胞家系,利用 Kung 育种值与综合评定值 Pi 对家系进行了评定。结果表明,幼虫期阶段 R2和 R6家系的累积存活率显著高于其他家系(P<0.05), R2和 R6是壳长、壳高生长速率最快的两支家系。养成期阶段,各家系4个生长性状的生长速率差异显著(P<0.05), R6、R2是生长性状最优的两支家系;R2、R6家系累积存活率显著大于对照组以及其余家系。红色闭壳肌 F1代家系闭壳肌颜色表型率为 R2、R6家系最高,分别为51%、50%。R2、R6家系的综合评定值 Pi 为最大,为两支性状优良家系。%To select red adductor muscle families of excellent comprehensive characters,12 full sibs families were constructed, which based on selection strain(F6). Furthermore,we evaluated the families with the Kung breeding value and overall comprehensive value Pi.The results indicated that, in the larval stage, the R2 and R6 families of cumulative survival rate were significantly higher than others (P<0.05)and with the largest growth rate of shell length and shell height. In the breeding stage, the growth rate of four growth traits were significantly differences (P<0.05) and the R2,R6 families were with the largest growth rate of economic traits. The cumulative survival rate of the R2 and R6 families were significantly greater than the control group, the control group was significantly greater than the rest of the families. The adductor muscle phenotype rate of the R2 and R6 families were the highest, and the dates respectively were 51% , 50%. The overall comprehensive value Pi of the R2 and R6 families were the best, indicated the two families with excellent traits.

  16. Espessura do músculo adutor do polegar: um método rápido e confiável na avaliação nutricional de pacientes cirúrgicos Adductor pollicis muscle thickness: a fast and reliable method for nutritional assessment in surgical patients

    Rosalia Bragagnolo

    2009-10-01

    Full Text Available OBJETIVO: Determinar se a medida da espessura do músculo adutor do polegar é confiável para avaliação nutricional de pacientes cirúrgicos e se correlaciona bem com outros parâmetros antropométricos, bioquímicos e clínicos. MÉTODOS: Estudo de corte transversal, com avaliação de 87 pacientes candidatos à procedimento cirúrgico de grande porte no trato gastrointestinal. Eles foram submetidos à avaliação nutricional através da avaliação subjetiva global, antropometria (circunferência do braço, prega cutânea triciptal, e circunferência muscular do braço, albumina sérica, linfocitometria e pela medida da espessura do músculo adutor do polegar em ambas as mãos. RESULTADOS: A média da espessura da mão dominante (direita foi de 12,64 ± 3,19 mm e da mão não dominante 12,23 ± 2,9 mm. Para desnutrição, a sensibilidade da espessura do músculo adutor do polegar direita foi de 72,37% e da esquerda de 77,33% para os pontos de cortes encontrados com a curva Receiver Operating Characteristic (13,4 e 13,1 mm respectivamente. Para ambas as mãos a especificidade foi de 100%. Encontrou-se correlação significativa (pOBJECTIVE: Investigate whether the right adductor pollicis muscle thickness is a reliable method to evaluate the nutritional status of surgical patients and whether it correlates or not correlate to other anthropometric, biochemical, and clinical parameters. METHODS: Cross-sectional study evaluating 87 patients candidates to major operations of the gastrointestinal tract. All were submitted to global subjective evaluation, traditional anthropometry (arm circumpherence ; triceps skin fold; and arm muscle circumpherence, serum albumin, lymphocytes and measurement of in both hands. RESULTS: The mean right adductor pollicis muscle thickness in dominant hand was 12,64 ± 3,19 mm and in non-dominant hand (EMAPND 12,23 ± 2,9 mm. Sensitivity was 72,37% for left adductor pollicis muscle and 77,33% for left adductor pollicis

  17. Observation of the dysphonia severity index in evaluating curative effect of vocal cord polyp surgery%嗓音障碍严重指数评价声带息肉手术疗效的研究

    周舟; 葛平江; 刘倩; 刘明; 张伟

    2015-01-01

    目的 应用嗓音障碍严重指数(dysphonia severity index,DSI)对声带息肉患者手术治疗效果进行评估,讨论DSI评估嗓音障碍程度的有效性和可靠性.方法 本研究选取正常人(34名)与声带息肉患者(70例),分别进行嗓音障碍指数(voice handicap index,VHI)评估、GRBAS评分、纤维电子喉镜检查,测量最大声时(maximum phonatory time,MPT)、jitter、shimmer及DSI值.运用方差分析DSI值在两组及手术前后组间的差异,并用VHI、GRBAS评分、shimmer与DSI值做相关性分析.结果 70例患者术前DSI值均值为(-2.92±1.59),术后均值(1.87±1.33),正常组均值为(2.30±2.16),术前与术后的DSI值,以及正常组与患者术前DSI均值比较差异均有统计学意义(P<0.05).通过Pearson相关分析,得到DSI值与VHI值(r=-0.632),G值(r=-0.740),R值(r=-0.756),shimmer(r=-0.500)之间有相关关系(P<0.01).结论 DSI可有效地评估声带息肉患者的病理嗓音障碍程度,可作为一个独立使用的评估嗓音障碍程度的多参数方法,并可对声带息肉的手术疗效进行客观评价.%Objective To investigate the applicability of the eysphonia severity index (DSI) in evaluating effects of surgery between before and after groups of vocal polyp patients.Methods Analyses of measurement data pre and pro-surgery of 70 vocal polyp patients and 35 no voice disorders volunteers(control group).The voice quality was measured subjectively with the voice handicap index(VHI),the GRBAS and fiber electronic laryngoscopy.Measures of maximum phonation time (MPT),shimmer and jitter were obtained for each subject by using DiVAS 2.30 (XION,Germany).The DiVAS 2.30 had spotanenously calculate the scores of DSI.Using SPSS 17.0 to find the differences of DSI scores among the three groups by one-way ANOVA variance analysis.And finding out of the correlation with DSI scores and VHI scores,GRBAS,MPT,jitter and shimmer.Results DSI improved significantly after surgery in the vocal polyps

  18. Clinical Characteristics and Acoustics Evaluation in Patients with Muscular Tension Dysphonia%肌紧张性发声障碍的临床特征及嗓音声学评估

    徐洁洁; 陆美萍; 陈曦; 王娟

    2008-01-01

    目的 观察肌紧张性发声障碍(muscular tension dysphonia,MTD)患者的临床特点,探讨喉镜检查及计算机嗓音声学检测技术在此类发声障碍诊断中的应用价值.方法 观察46例MTD患者发声特点及颈部体征,采用电子喉镜和计算机嗓音声学测试系统对46例MTD患者和40例正常成人进行检查.分析评估MTD患者临床表现、喉镜图像及嗓音声学特征.结果 MTD患者发声呈过强、挤压、粗糙、嘶哑等特点;发声时呼吸表浅、颈部肌肉紧张、颈静脉怒张、喉结上移.喉镜显示喉腔缩小、声门前后径缩短、声门暴露差等,声带外观正常,张力增加,闭合过紧,假声带代偿性内收.嗓音声学检测显示患者嗓音具有正常和病理声学特征交替出现的特点.其特征为频率微扰(jitter)、振幅微扰(shimmer)数值较正常升高(P0.05),声谱图高频区谐波及第2、3共振峰不规则、不连续、波纹抖动或消失.结论 MTD患者发声过强及颈部肌肉紧张.喉镜检查声门过度闭合、声带正常.能检测到正常jitter、shimmer,NNE及声谱图.

  19. 早期声带息肉患者嗓音障碍调查与对策%Investigation of subjective and objective dysphonia on patients with early vocal cord polyp and corresponding nursing interventions

    姜宇英; 王珊; 诸葛盼; 尤慧华

    2015-01-01

    目的 了解早期声带息肉患者主客观嗓音障碍的临床特征,为进一步实施综合干预,改善患者的发音质量提供依据.方法 对实验组66例早期声带息肉患者及对照组31例健康志愿者进行动态喉镜检查;应用中文版嗓音障碍指数量表(Voice Handicap Index,VHI)评估主观嗓音障碍,包括功能(F)、生理(P)、情感(E)3部分,计算总分(T);应用DiVAS嗓音分析软件分析最长发声时间(maximum phonation time,MPT)、基频微扰(Jitter)、最高基频(highest frequency,F0-High)、最低音强(lowest intensity,I-Low),计算嗓音障碍严重指数(Dysphonia Severity Index,DSI)评估客观嗓音障碍.结果 实验组15例(22.7%)患者存在声门闭合不全,而对照组为2例(6.5%).独立样本t检验结果显示,实验组与对照组间E、F、P、T差异存在统计学意义(t值分别为2.31,P值<0.05;3.79、8.55、5.02,P值均<0.01);2组MPT、Jitter、I-Low、DSI差异存在统计学意义(t值分别为-7.86、3.97、4.20、-9.22,P值均<0.01).结论 动态喉镜、VHI、DSI可以反应出早期声带息肉患者嗓音障碍特征,医护人员应根据患者嗓音障碍的临床特征,进行嗓音的健康教育及心理疏导,进而改善患者的发音质量.

  20. Clinical study of the influence of laryngopharyngeal reflux on quality of life in patients with dysphonia%咽喉反流对嗓音疾病患者生活质量影响的临床研究

    王宇光; 张立红; 余力生; 李晶兢; 李进让; 赵一馨; 曹杰

    2015-01-01

    definitely.2 643 volunteers were recruited to fill in the RSI scale through physical examination, outpatient , the ward and web survey.Results 46.46% (59/127) patients were diagnosed with LPR definitely.1 241 of 2 643 volunteer, who filled in the RSI, score more than zero in the first entry of hoarseness or dysphonia, 65.0% (807/1 241) of them, scoring 13 points or higher, were diagnosed with clinically suspected LPR.Based on the 24-hour ambulatory double pH monitoring, VHI total scores and subscores in the emotional domains were higher in positive group than in negative group.There was no statistical difference (P > 0.05) in functional and physical domains.The SF-36 scale was used to evaluate the quality of life of the patients.The difference of 6 dimensionality, scoreshad statistical significance(P < 0.05) , including role-physical, general health, validity, social function, role-emotional and mental health.There was no statistical difference in dimensionalities of rolephysical and bodily pain.Conclusions The volunteers who were diagnosed with hoarseness or dysphonia had the higher morbidity rate of LPR.At the time of treatment, more attention should be paid to the quality of life.

  1. Vertebrobasilar Dolichoectasia Presented with Dysphagia and Dysphonia: a Report of Two Cases%以吞咽困难和言语含糊为表现的椎基底动脉延长扩张症2例报告及文献复习

    黄纯臣; 王钦; 马昱; 毛悦时; 刘骏桢; 张宇浩

    2012-01-01

    Objective: To improve the understanding of vertebrobasilar dolichoectasia (VBD). Methods: The clinical features,imaging findings,diagnosis,treatment and follow-up data of two cases of VBD presented with dysphagia and dysphonia were analyzed retrospectively,and the literatures were reviewed. Results; As a cerebrovascular disease,the main characteristics of VBD were the marked elongation,widening and tortuosity of the intracranial vertebral and basilar arteries. The clinical manifestations of VBD included not only cerebral ischemia or hemorrhage of brainstem,subarachnoid hemorrhage,compression symptoms of brainstem and hydrocephalus,but also dysphagia and dysphonia. The diagnosis of VBD mostly depended on imaging examinations. The treatment of VBD was still unclear,and anticoagulation therapy might be effective for some patients,but the risk of bleeding must be noticed. Conclusion: The VBD mainly presenting with dysphagia and dysphonia is easily misdi-agnosed and missed. Enough attention should be payed to this type of VBD.%目的:通过个案报告及文献复习,企盼提高对椎基底动脉延长扩张症(vertebrobasilar dolichoectasia,VBD)的认识.方法:分析2例以吞咽困难和言语含糊为主要表现的VBD患者的临床资料并复习相关文献.结果:VBD是一种以椎基底动脉的增长、增粗及扭曲为主要特点的脑血管病,其临床表现除了脑干缺血或出血、蛛网膜下腔出血、脑干压迫所引起的症状以及脑积水以外,还包括吞咽困难和言语含糊.VBD的诊断主要依靠影像学检查,目前尚无理想的治疗方法,抗凝治疗对部分患者可能有效,但有出血风险.结论:以吞咽困难和言语含糊为主要表现的VBD易被误诊和漏诊,临床医师应注意提高对VBD的认识.

  2. A型肉毒毒素治疗痉挛性发音障碍

    胡兴越; 范正刚; 蒋红; 章士正; 邵宇权

    2002-01-01

    @@ 痉挛性发音障碍(spasmodic dysphonia,SD)又称局灶性喉肌肌张力障碍(focal laryngeal dystonia)为一种中枢运动信息处理程序障碍所致的慢性神经系统疾病,以讲话诱发声带痉挛为特征,表现为讲话时痉挛性发音.

  3. 痉挛性发音障碍的临床特征

    杨扬; 王丽萍

    2006-01-01

    痉挛性发音障碍(spasmodic dysphonia,SD)是耳鼻咽喉科的疑难病之一,发病率有逐渐上升的趋势.本文总结分析了国内、外近5年来的研究成果,主要对SD的临床特征、评价标准进行了详述.

  4. Tardive Dystonia: Clinical Spectrum and Novel Manifestations

    R. Jeffrey Davis

    1988-01-01

    Full Text Available Tardive dystonia was identified in 25 patients: involvement of the face and neck was most common; truncal and limb dystonia were also observed. There were 3 cases of laryngospasm and 2 of spasmodic dysphonia. The latter has not been previously reported as a manifestation of tardive dystonia. In all cases, movements typical of classic tardive dyskinesia could be demonstrated. This group illustrates the variety of dystonic disorders that may occur in conjunction with tardive dyskinesia.

  5. Articulatory changes in muscle tension dysphonia:Evidence of vowel space expansion following manual circumlaryngeal therapy%肌紧张性发声障碍患者的言语改变:喉部手法治疗后元音间距延长

    Roy N; 王刚

    2010-01-01

    @@ 肌紧张性发声障碍(muscle tension dysphonia,MTD)是一种与喉及喉外肌肉张力过强有关的发声障碍,不但影响发声质量,同时也影响发音清晰度.目前,尽管其机制尚不明确,但大量临床资料证据显示,言语矫治可使原发性MTD患者的发声质量得到快速而持久的改善.本研究通过元音声学参数测量探讨喉部手法治疗对MTD患者元音发音清晰度改善的效果.

  6. Closing and opening phase variability in dysphonia

    Fourcin, A; Ptok, M.

    2003-01-01

    Four examples of the use of vocal fold contact phase measurement are discussed for unilateral paresis. In each case this aspect of voice quality is of greater importance than the physical measurement of loudness and pitch related parameters. For three of the cases electro-stimulation has been used as a main part of the treatment. Phonation in both connected speech and, for comparison, in sustained sound production has been used with electro-laryngograph / egg signals providing the basis for m...

  7. Comparison of clinical characteristics of patients with adductor laryngeal dystonia in the focal and segmental types Comparação entre características clínicas de pacientes com distonia laríngea de adução nas formas focal e segmentar

    Gustavo Polacow Korn

    2011-08-01

    Full Text Available Dystonia is a central motor processing neurological disorder characterized by abnormal, often action-induced, involuntary movements or uncontrolled spasms. AIM: To compare patients with the diagnoses of focal and segmental adductor laryngeal dystonia at the Neurolarynx Outpatient Clinic of the Federal University of São Paulo. MATERIALS AND METHODS: A clinical retrospective study of data collected from patient registries from 2003 to 2009. RESULTS: Of 34 patients, 25 presented focal dystonia and 9 presented segmental dystonia. There were 30 females (88. 2% and 4 males (11. 8%. A relation with a traumatic event was reported in 11 cases (32. 4%. Vocal tremor was observed in 21 patients (61. 8%. The mean age at onset, the age at diagnosis, and time between the onset and the diagnosis were respectively 55, 61. 3 and 6. 3 years. There was no statistical difference between patients with focal laryngeal adductor dystonia and segmental dystonia in the study data. CONCLUSIONS: There were no statistical differences among patients with focal adductor laryngeal dystonia and segmental dystonia relating to age of onset, age of diagnosis, gender, time between onset and diagnosis, presence of associated tremor, and relation to traumaA distonia é um transtorno neurológico do processamento motor central caracterizado por movimentos involuntários ou espasmos incontroláveis, induzidos por atividade. OBJETIVO: Comparar pacientes com o diagnóstico de distonia laríngea nas formas focal e distonia segmentar do Ambulatório de Neurolaringe. MATERIAL E MÉTODO: Estudo clínico retrospectivo a partir de levantamento dos prontuários entre 2003 e 2009. RESULTADOS: Dos 34 pacientes, 25 apresentaram distonia focal e 9 apresentaram distonia segmentar. Do total da amostra, 30 (88,2% eram do sexo feminino e 4 (11,8% do sexo masculino. A relação com situação traumática estava presente em 11 (32,4%. O tremor associado esteve presente em 21 pacientes (61,8%. A média da

  8. 小切口第一跖骨远端截骨术联合拇收肌切断治疗重度拇外翻%Correction of severe hallux valgus by distal osteotomy of the first metatarsal through mini-incision with cutting thumb adductor

    姬东硕; 赵延勇

    2013-01-01

    Objective To investigate the effect of correcting severe hallux valgus by distal osteotomy of the first metatarsal through mini-incision with cutting the conjoint tendon of adductor pollicis. Methods Distal osteotomy of the first metatarsal through mini-incision with cutting the conjoint tendon of adductor pollicis was performed on 19 cases with hallux varus (37 feet) , the therapeutic effects were analyzed and evaluated through AOFAS score and the imaging results using matching t test for statistical analysis before and after surgery. Results All patients were followed up for 6 to 24 ( average 16) months of , Thumb valgus angle (HVA) was corrected from 47. 5 ±3.8 to 12. 0 ± 3. 3 ( t = 62. 5 , P < 0. 01) , the intermetatasal angle was corrected from 22. 1 ±3.2 to 9.7 ±1.2 ( t = 27.6, P<0.01) , AOFAS score was enhanced from 34. 1 ±5.2 to 89. 1 ±2.4 ( t = 57. 9, P < 0. 01) . One foot appeared thumb varus deformity, another one appeared slightly metastatic pain of under the second metatarsal bone. Conclusion Correction of severe hallux valgus by distal osteotomy of the first metatarsal through mini-incision with cutting the conjoint tendon of adductor pollicis is reliable and stable, it has clinical application value.%目的 探讨小切口第一跖骨远端截骨术联合拇收肌联合腱切断矫正重度拇外翻畸形的疗效.方法 对19例拇外翻患者(37足)行小切口第一跖骨远端截骨加拇收肌联合腱切断矫正术,通过对手术前后AOFAS前足评分及影像学检查结果采用配对t检验进行统计学分析,进而评估手术治疗效果.结果 对所有患者随访6~24(平均16)个月,拇外翻角(HVA)由术前47.5±3.8矫正到12.0±3.3(t =62.5,P <0.01),第一二跖间角(IMA)由术前22.1±3.2 矫正到9.7±1.2(t =27.6,P <0.01).AOFAS 评分由术前34.1±5.2 提高到89.1±2.4(t =57.9,P <0.01).1足出现拇内翻畸形,1足出现轻度转移性第二跖骨头下疼痛.结论 小切口第一跖骨远端截骨术联合

  9. [Spasm of the adductor muscles, pre-dislocations and dislocations of the hip joints in children and adolescents with cerebral palsy. Clinical observations on aetiology, pathogenesis, therapy and rehabilitation. Part II. The importance of the iliopsoas tendon, its tenotomy, of the coxa valga antetorta, and correction through osteotomy turning the hip into varus (author's transl)].

    Fettweis, E

    1979-02-01

    The following factors besides spasm and contraction of the adductor muscles contribute to the occurrence of dislocations of the hip in spastic paralysis: Spasm and contraction of the iliopsoas muscle and enhanced valgus position and antetorsion. The author holds the opinion that in case of malformation of the proximal end of the femur, it is not only the indirect action of the spastic musculature via the proximal femur-epiphyseal cartilage which is responsible for this phenomen in accordance with the law on functional adaption through longitudinal growth (Pauwels), but also the direct traction of the iliopsoas tendon. A clue in this direction is the often very pronounced elongation or enlargement of the trochanter minor. The author demonstrates the pathogenetic importance of iliopsoas contracture and malpositioning of the neck of the femur by means of analyses of the course in two patients. The following principles of treatment are postulated for spastic dislocation of the hip: Elimination of the pathogenetic factors through myotenotomy of the adductor muscles and complete resection of the obturator nerve, with observation of strict aftertreatment criteria, tenotomy of the iliopsoas, repositioning and osteotomy with turning into varus. Osteotomy without previous elimination of the pathogenetically acting muscular forces does not appear useful. Likewise, permanent re-positioning by means of muscle-relaxing operation cannot be sufficiently safe-guarded without additional osteotomy once the dislocation has taken place. In twelve patients with spastic dislocation of the hip, treated in accordance with these guidelines (two without osteotomy) aged 6 6/12 and 19 5/12 years, a roentgenologically good result was obtained in half of the cases, whereas the functional result was satisfactory not only with these patients but also with part of the other patients. If surgical treatment is instituted early enough, and if the experiences described here are taken into consideration

  10. Brain mechanism of semantic processing by native Chinese speaker with dysphonia%母语为汉语者言语障碍的语义加工及其脑区机制

    赵鸣; 杨亦鸣; 王梅; 刘红; 方环海; 方环非

    2007-01-01

    BACKGROUND:The brain mechanism of semantic processing is one of the focus problems in cognitive neuroscience.With the research technologies plentiful and diversified, the brain mechanism of semantic processing is gradually distinct.However, at present, the related researches on Chinese semantic processing are not enough. The brain mechanism of semantic processing by Chinese language obstacle should be studied more deeply.OBJECTIVE: To further identify the neuropsychological significance of clinical diagnosis, treatment and rehabilitation by concluding the study fruits on the brain mechanism of semantic processing by native Chinese speaker with dysphonia and analyze the relationship between the related brain mechanism and the local brain system of semantic processes as well as brain anatomical parts.RETRIEVE STRATEGY: The retrieve staffs are the research personnel for this paper. The range of retrieve time focuses since 1984. A computer-based online search was conducted in CNKI for literatures related to basic neuropsychology and its clinical application published between January 1994 and May 2006, in Elsevier for articles between January 1984 and May 2006, in Academic Source Premier and MEDLINE of EBSCOhost for studies between January 1984 and May 2006 with the key words of "semantic processing", and the language was limited to English. Meanwhile, relevant data were searched manually. The number of total retrieved articles was 264, among which 43 enrolled studies were in accordance with the inclusion criteria and excluded articles involving semantic processing or encephalic region but without their relationship. The unpublished articles were only used for references LITERATURE EVALUATION: The literatures are selected from related works, collected analyses, reports from single case or research. Evaluated persons are related research staffs.DATA SYNTHESIS: Processing of Chinese semantic relied primarily on the left superior temporal region, middle temporal gyrus, the

  11. Experiment K-7-18: Effects of Spaceflight in the Muscle Adductor Longus of Rats Flown in the Soviet Biosatellite Cosmos 2044. Part 1; A Study Employing Neural Cell Adhesion Molecules (N-CAM) Immunocytochemistry and Conventional Morphological Techniques (Light and Electron Microscopy)

    Daunton, N. G.; DAmelio, F.; Wu, L.; Ilyina-Kakueva, E. I.; Krasnov, I. B.; Hyde, T. M.; Sigworth, S. K.

    1994-01-01

    The effects of spaceflight upon the 'slow' muscle adductor longus was examined in rats flown in the Soviet Biosatellite COSMOS 2044. Three groups - synchronous, vivarium and basal served as controls. The techniques employed included standard methods for light microscopy, N-CAM immunocytochemistry and electron microscopy. Light microscopic observations revealed myofiber atrophy, contraction bands and segmental necrosis accompanied by cellular infiltrates composed of macrophages, leucocytes and mononuclear cells. N-CAM immunoreactivity was seen (N-CAM-IR) on the myofiber surface, satellite cells and in regenerating myofibers reminiscent of myotubes. Ultrastructural alterations included Z band streaming, disorganization of myofibrillar architecture, sarcoplasmic degradation, extensive segmental necrosis with preservation of the basement membrane, degenerative phenomena of the capillary endothelium and cellular invasion of necrotic areas. Regenerating myofibers were identified by the presence of increased amounts of ribosomal aggregates and chains of polyribosomes associated with myofilaments that displayed varied distributive patterns. The principal electron microscopic changes of the neuromuscular junctions consisted of a decrease or absence of synaptic vesicles, degeneration of axon terminals, increased number of microtubules, vacant axonal spaces and axonal sprouting. The present observations indicate that major alterations such as myofibrillar disruption and necrosis, muscle regeneration and denervation and synaptic remodeling at the level of the neuromuscular junction may take place during spaceflight.

  12. The Effects of Phonosurgery Combined with Voice Therapy for Vocal Polyps Accompanied with Muscle Tension Dysphonia%手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效分析

    高晓葳; 黄永望; 刘丽燕; 李超; 牛俊涛; 傅德慧; 欧阳杰

    2015-01-01

    Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia (MTD) .Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD .All the patients were divided into two groups ac‐cording to the different remedies:the surgery group (n=57) ,and the combination group (n=60) .The Xion acous‐tic analysis was carried out on the two groups before and after therapy .We compared the results in each group ,the results of post-therapy between two groups ,and that of post-therapy with the control group(n=50) .The acous‐tic parameters were jitter percent (jitter) ,shimmer percent (shimmer) ,dysphonia severity index (DSI) .Results The results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group(P0 .05) .Conclusion As for vocal polyps accompanied with M TD ,successful phonosurgical treatment and voice therapy can improve patients’ voice quality .%目的:探讨手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效。方法117例伴肌紧张性发声障碍的声带息肉患者分为单纯手术组(手术组,57例)和手术联合嗓音训练组(联合组,60例),另随机选取50例无嗓音疾患的正常人作为正常对照组。采用Xion声学分析软件对正常对照组及手术组、联合组患者治疗前后的嗓音基频微扰(jitter)、振幅微扰(shimmer)、嗓音障碍指数(DSI)进行测试并比较。结果手术组、联合组治疗后jitter和shimmer值均较治疗前明显降低,DSI明显升高(P<0.05),而联合组的jitter和shimmer值更低,DSI值更高(P<0.05);手术组治疗后的jitter和shimmer值高于正常组,DSI值低于正常组(P<0.05);联合组治疗后jit‐ter和shimmer与正常组比较

  13. 声带息肉患者手术前后VHI量表主观评估和 DSI 嗓音检测结果分析%The Significance of the Self -assessments of Voice Handicap Index and the Detection of Dysphonia Severity Index in Polyp of Vocal Cord

    张武宁; 唐安洲; 徐志文; 吴铖林; 李永湘; 钟晖; 毛海燕

    2013-01-01

    Objective To explore the significance of the Self -assessments of Voice Handicap Index (VHI) and The objective detection of Dysphonia Severity Index (DSI) in polyp of vocal cord perioperatively .Methods The Self -assessments of VHI had been completed in 28 patients with polyp of vocal cord before the operation and one week after the operation ,including function(F) ,physiological(P) ,emotion(E) ,and the sum denoted by T .In the meantime ,The DSI had been completed in these patients by acoustic analysis of DIVAS 2 .5 .After one month ,19 pa-tients had been re -examined .Results The DSI value was increasing ,but there was no significant difference be-tween pre-operation and one week after the operation(P>0 .05) ,indicating that the function of vocal cord was not recovered .In VHI scale ,the parameters were significantly different between the time preoperatively and one week postoperatively in F ,E and T(P0 .05) ,indicating that the function of vocal cord was not completely recovered as same as the result of DSI .After one month ,there were significant differences in DSI and VHI ,which showed a full recovery of vocal cord fanction .Conclusion The Self -assessments of VHI and The objective detection of DSI in polyp of vocal cord can evaluate simultaneouly the function of laryngeal .Additionally ,there was a good correlation between the DSI and the VHI score .%目的探讨声带息肉患者手术前后嗓音障碍指数(voice handicap index ,VHI)量表自我评估和嗓音障碍严重指数(dysphonia severity index ,DSI)评估的价值。方法对28例声带息肉患者手术前及手术后1周、术后1月(19例)进行VHI量表自我评估,并运用DIVAS2.5声学分析软件评估DSI ,分析其结果。结果与术前比较,声带息肉患者术后1周DSI值升高,但差异无统计学意义(P>0.05);VHI量表中,功能F、情感E、总分T得分较术前降低,差异有统计学意义(P<0.05),而生理P得分

  14. 单侧声带麻痹患者的嗓音主观RBH评估与DSI的相关性研究%Correlation Between Dysphonia Severity Index (DSI) and Voice Perceptual Evaluation RBH System in Patients with Unilateral Vocal Cord Paralysis

    李燕; 郑宏良

    2012-01-01

    目的:探讨嗓音主观RBH 评估与发音障碍严重指数(dysphonia severity index,DSI) 用于单侧声带麻痹患者的临床意义及其相关性,并进一步验证DSI 的实用性.方法:对45 例单侧声带麻痹患者( 患者组) 及13 例嗓音正常人( 对照组) 进行主观RBH 评估和DSI 测定.主观RBH 评估分四个等级;DSI 测定由公式DSI=0.13×MPT+0.0053×F(0)-High-0.26×I-Low-1.18×Jitter(%)+12.4 计算得来,也分四个等级.比较单侧声带麻痹患者RBH 分级和DSI 分级间差异.结果:患者组的R、B、H 均高于对照组,差异有统计学意义(P<0.05) ;患者组DSI 的平均值0.35±0.74,而正常组的平均值为4.23±0.81,两组比较差异有统计学意义(P<0.05).单侧声带麻痹患者主观RBH 评估与DSI 分级之间相关性显著.结论:选择DSI 作为嗓音障碍评估的客观参数,应用于单侧声带麻痹患者具有较好的临床应用价值,其与主观评估参数R、B、H 具有很好的相关性.

  15. Laryngeal electromyography in movement disorders: preliminary data

    Kimaid Paulo A.T.

    2004-01-01

    Full Text Available This study describes preliminary laryngeal electromyography (LEMG data and botulinum toxin treatment in patients with dysphonia due to movement disorders. Twenty-five patients who had been clinically selected for botulinum toxin administration were examined, 19 with suspected laryngeal dystonia or spasmodic dysphonia (SD, 5 with vocal tremor, and 1 with Gilles de la Tourette syndrome (GTS. LEMG evaluations were performed before botulinum toxin administration using monopolar electrodes. Electromyography was consistent with dystonia in 14 patients and normal in 5, and differences in frequency suggesting essential tremor in 3 and Parkinson tremors in 2. The different LEMG patterns and significant improvement in our patients from botulinum toxin therapy has led us to perform laryngeal electromyography as a routine in UNICAMP movement disorders ambulatory.

  16. RESULTS OF ADDUCTORS MUSCLE TENOTOMY IN SPASTIC CEREBRAL PALSY

    Guglielmetti, Luiz Gabriel Betoni; Santos, Ruy Mesquita Maranhao; Mendonça, Rodrigo Góes Medea de; Yamada, Helder Henzo; Assumpçao, Rodrigo Montezuma César de; Fucs, Patricia Maria de Moraes Barros

    2015-01-01

    Objective: Radiographic evaluation of the evolution of hips that underwent soft-tissue release. Methods: This was a retrospective evaluation on 101 spastic cerebral palsy patients who underwent soft-tissue release between 1991 and 2006. Forty-four patients met the inclusion criteria: 23 boys and 21 girls; 34 diparetic and 10 quadriparetic. Functionally, 29 were non-walkers, five were able to walk at home and 10 were able to walk within the community. Reimers' index (RI) and the acetabular ind...

  17. Measurement of the thickness of the adductor pollicis muscle as a predictor of outcome in critically ill patients La medición del espesor del músculo aductor del pulgar como un predictor de resultados en pacientes críticamente enfermos

    F. S. Caporossi

    2012-04-01

    Full Text Available Objective: Malnutrition is associated with complications and prolonged hospital stay in critically ill patients. We assessed whether the measurement of the thickness of the adductor pollicis muscle (TAPM, a new tool to assess malnutrition is a valuable prognostic indicator in critically ill patients. Methods: Open cohort study including 248 patients admitted for either medical or surgical intensive care treatment in a tertiary hospital. Two were discharged for having age below 18 years-old and therefore 246 subjects of both sexes completed the entire analysis. Subjective global assessment and APACHE II scores were used to score the patients. TAPM of both hands was measured at admission with a caliper and correlated with mortality, days of mechanical ventilation, and length of hospital stay (LOS. Results: There was a significant correlation (R = 0.84, p Objetivo: La desnutrición se asocia con complicaciones y estancia hospitalaria prolongada en pacientes críticamente enfermos. Se evaluó si la medición del espesor del músculo aductor del pulgar (TAPM, una nueva herramienta para evaluar la desnutrición es valioso como indicador pronóstico en los pacientes críticamente enfermos. Métodos: Estudio abierto de cohorte que incluyó 248 pacientes ingresados para tratamiento de atención médica o quirúrgica intensiva en un hospital de tercer nivel. Dos de ellos fueron excluidos por tener menos de 18 años de edad y por lo tanto 246 sujetos de ambos sexos completaron todo el análisis. La valoración subjetiva global y puntuaciones de APACHE II se utilizaron en los pacientes. El TAPM de ambas manos se midió al ingreso con una pinza y se correlacionó con la mortalidad, los días de ventilación mecánica, y la duración de la estancia hospitalaria (LOS. Resultados: Se encontró una correlación significativa (r = 0,84, p < 0,001 entre TAPM de la mano derecha y la mano izquierda. Los pacientes con desnutrición severa mostraron TAPM tanto de la

  18. Qualidade de vida em voz: o impacto de uma disfonia de acordo com gênero, idade e uso vocal profissional Voice-related quality of life: the impact of a dysphonia according to gender, age and occupational use of voice

    Daniele de Souza Putnoki

    2010-12-01

    were observed for individuals with ages between 20 and 29 years (total 82.2; physical 77.8; socio-emotional 89.2. CONCLUSION: The self-reported impact of a vocal disorder in the quality of life was similarly noticed by men and women. The subjects aged between 20 and 29 years had different perceptions regarding the impact of dysphonia in their quality of life when compared to individuals of the other age ranges. Vocal disorders caused less impact on the quality of life of elite vocal performers.

  19. Praat软件及DSI对改良杓状软骨内收术治疗单侧声带麻痹的疗效评估%Objective Evaluation of Modified Arytenoid Adduction in the Treatment of Unilateral Vocal Cord Paralysis using Praat Software and Dysphonia Severity Index (DSI)

    吴红敏; 王伟; 郑宏良; 李玎; 李孟

    2011-01-01

    Objective To assess the effectiveness of modified arytenoid adduction in the treatment of unilateral vocal cord paralysis using Praat software and Dysphonia Severity Index (DSI). Methods Six-five vocal cord paralysis patients treated with modified arytenoid adduction were retrospectively studied between Feb 2001 and Dec 2010. Parameters including fundamental frequency (F0), intensity, NHR, jitter local,jitter local absolute,jitter ppq5,shimmer local,shimmer local dB, shimmer apq5,were compared before, 3 and 12 months after treatment using Praat software. DSI was also compared before, 3 and 12 months after treatment. Results F0, jitter local, jitter local absolute,jitter ppq5,shimmer local,shimmer local dB, shimmer apq5,NHR decreased significantly 3 and 12 months after surgery compared with those of before surgery(P<0. 05). There was no significant difference in intensity before, 3 and 12 months after surgery. DSI increased significantly3 and 12 months after surgery(P<0. 05), There was no significant difference in all the parameters between 3 and 12 months groups. Conclusion Modified arytenoid adduction, as a treatment for unilateral vocal cord paralysis, is of long-term stable results. Applcation Praat software and DSI for assessment of the treatment of voice disorder is effecive, convenient and reliable.%目的 探讨Praat软件及嗓音障碍严重程度指数(dysphonin severity index,DSI)对改良杓状软骨内收术治疗单侧声带麻痹疗效评估的意义.方法 65例单侧声带麻痹患者均于患侧行改良杓状软骨内收术.全部病例于手术前及术后3月、12月分别行DSI分析及以praat软件分析基频(fundamental frequency,F0)、声音强度(intensity)、噪谐比(NHR)、基频微扰[包括:局部基频微扰(jitter local)、局部绝对基频微扰(jitter local absolute)、基频微扰间期系数5(jitter ppq5)]、振幅微扰[包括:局部振幅微扰(shimmer local)、局部振幅微扰dB(shimmer local dB

  20. 嗓音训练前后对女性肌紧张性发声障碍患者发声空气动力学结果分析%Influence of Voice Therapy on Vocal Aerodynamic Characteristics in Female Patients with Muscular Tension Dysphonia

    梁发雅; 杨金珊; 蔡谦; 梅祥胜; 张碧茹; 王雅静; 关中; 龚坚; 彭解人

    2014-01-01

    目的 分析嗓音训练治疗女性肌紧张性发声障碍(muscular tension dysphonia,MTD)前后患者发声空气动力学的变化,探讨空气动力学检测对噪音训练治疗MTD疗效评估的意义.方法 对19例诊断为MTD的女性患者(病例组)进行12周嗓音训练,训练内容包括凸腹凹腹气息练习、凸腹控制膈肌练习、快速呼吸练习、放松舌根和喉部肌肉练习及诵读发声练习,于训练前、训练12周后采用言语发声空气动力学测试系统分别检测病例组的肺活量、舒适发声时的声门下压、空气动力能、平均气流率、声门阻力及最长声时,并与19例正常成年女性(对照组)进行对比分析.结果 病例组训练前的中位声门下压(10.80 cmH2O)、声门阻力[108.01 cm H2O/(Lit/Sec)]及空气动力能(0.15 watts)较正常对照组升高,中位肺活量(2.7 L)及最长声时(12.51 s)缩短,差异有统计学意义(P<0.05);训练12周后患者组中位声门下压(7.87 cmH2O)、声门阻力[67.25 cm H2 O/(Lit/Sec)]及空气动力能(0.08 watts)较训练前下降,中位肺活量(3.0 L)及最长声时(20.85 s)较训练前增加,差异有统计学意义(P<0.05);训练12周后病例组上述各指标与正常对照组相比差异均无统计学意义(P>0.05).结论 嗓音训练可降低MTD患者发声时的声门下压、声门阻力及空气动力能,增大肺活量,延长最长声时;通过发声空气动力学检测能定量评估嗓音训练治疗女性MTD的效果.

  1. Reliability and Applicability of Aerodynamic Measures in Dysphonia Assessment

    Yiu, Edwin M.-L.; Yuen, Yuet-Ming; Whitehill, Tara; Winkworth, Alison

    2004-01-01

    Aerodynamic measures are frequently used to analyse and document pathological voices. Some normative data are available for speakers from the English-speaking population. However, no data are available yet for Chinese speakers despite the fact that they are one of the largest populations in the world. The high variability of aerodynamic measures…

  2. Role of Laryngological Consultation in the Intervention of Dysphonia

    Stone, Ed.; And Others

    1978-01-01

    Described and provided is a laryngology consult form that has been found useful by speech therapists in obtaining information important to the diagnosis and management of children with voice disorders. (CL)

  3. EXTRA WORKING FACTORS IN DYSPHONIA PATHOGENESIS OF TEACHERS

    Salvatore Biondi; Luca La Manna; Carlo Sciacchitano; Maria Zappalà

    2007-01-01

    Objective: to estimate the incidence of teacher dysphonic disease in order to subsequently delineate prevention programs. Methods: a representative sample of teachers from different institutes in Catania, i.e. nursery, elementary, secondary and high school, were admitted to a test program. Results: The analysed cards were 379. 46-% of teachers frequently showed an alteration of the characters of the voice, 43% rarely showed it while only 11% did not show such alteration. The dysphonic disease...

  4. Isolated subglottic lymphoma: an interesting cause of dysphonia.

    Yardley, M P; Chui, P

    1993-01-01

    Isolated laryngeal lymphomas are exceedingly rare tumours: they tend to be greyish submucosal swellings and to respond well to radiotherapy. A case of subglottic lymphoma is presented, along with a review of previously reported cases of subglottic lymphomas. PMID:8461251

  5. Isolation of peridininol, an anti-spasmodic carotenoid pigment, from Zoanthus sp.

    Parameswaran, P.S.; Achuthankutty, C.T.

    as these compounds readily decompose in alkaline medium. Recently, a new method involving acetone-methanol extraction of powdered dry alga followed by chromatography over silica gel column and crystallization have been reported for isolation of these compounds...

  6. Magnetically Controlled Spasmodic Accretion During Star Formation. I. Formulation of the Problem and Method of Solution

    Tassis, K; Tassis, Konstantinos; Mouschovias, Telemachos Ch.

    2004-01-01

    We formulate the problem of the late accretion phase of the evolution of an isothermal magnetic disk surrounding a forming star. The evolution is described by the six-fluid MHD equations, accounting for the presence of neutrals, atomic and molecular ions, electrons, and neutral, positively, and negatively charged grains. Only the electron fluid is assumed to be attached to the magnetic field, in order to investigate the effect of the detachment of the ions from the magnetic field lines that begins at densities as low as 10^8 cm^-3. The "central sink approximation" is used to circumvent the problem of describing the evolution inside the opaque central region for densities greater than 10^11 cm^-3. In this way, the structure and evolution of the isothermal disk surrounding the forming star can be studied at late times without having to implement the numerically costly radiative transfer required by the physics of the opaque core. The mass and magnetic flux accumulating in the forming star arecalculated , as are...

  7. 痉挛性发声障碍的脑干病理学

    王刚

    2011-01-01

    @@ 痉挛性发声障碍(spasmodic dysphonia,SD)是一种原因不明的原发性局部张力障碍,其特征为言语产生时喉肌不自主的痉挛.由于尸体组织难以获取,对SD和其他原发性局部张力异常性疾病的神经病理学研究极少.既往研究在Meige综合征、头颈部张力障碍患者中发现了黑质、蓝斑、中缝背核、顶盖及齿状核中神经元的缺失,黑质、基底核、疑核中可见罕见的Lewy小体.

  8. 肉毒毒素对内收型痉挛性喉发音障碍的治疗

    刘雪莱

    2015-01-01

    痉挛性喉发音障碍(spasmodic dysphonia,SD)是一种局部肌张力障碍疾病,对该病的研究已持续50余年,但对其病因、诊断及治疗仍处于探索阶段,目前尚无系统、客观的标准或指南可供参考.本病的治疗现状主要以对症治疗为主.肉毒毒素作为一种安全、有效的治疗方式,现已广泛应用于临床.本文就肉毒毒素对该病的治疗现状做一综述.

  9. Brain studies may alter long-held concepts about likely causes of some voice disorders

    1989-02-17

    Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem.

  10. Brain studies may alter long-held concepts about likely causes of some voice disorders

    Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem

  11. High-throughput mutational analysis of TOR1A in primary dystonia

    Xiao, Jianfeng; Bastian, Robert W; Perlmutter, Joel S; Racette, Brad A; Tabbal, Samer D; Karimi, Morvarid; Paniello, Randal C; Blitzer, Andrew; Batish, Sat Dev; Wszolek, Zbigniew K; Uitti, Ryan J; Hedera, Peter; Simon, David K; Tarsy, Daniel; Truong, Daniel D; Frei, Karen P; Pfeiffer, Ronald F; Gong, Suzhen; Zhao, Yu; LeDoux, Mark S

    2009-01-01

    Background Although the c.904_906delGAG mutation in Exon 5 of TOR1A typically manifests as early-onset generalized dystonia, DYT1 dystonia is genetically and clinically heterogeneous. Recently, another Exon 5 mutation (c.863G>A) has been associated with early-onset generalized dystonia and some ΔGAG mutation carriers present with late-onset focal dystonia. The aim of this study was to identify TOR1A Exon 5 mutations in a large cohort of subjects with mainly non-generalized primary dystonia. Methods High resolution melting (HRM) was used to examine the entire TOR1A Exon 5 coding sequence in 1014 subjects with primary dystonia (422 spasmodic dysphonia, 285 cervical dystonia, 67 blepharospasm, 41 writer's cramp, 16 oromandibular dystonia, 38 other primary focal dystonia, 112 segmental dystonia, 16 multifocal dystonia, and 17 generalized dystonia) and 250 controls (150 neurologically normal and 100 with other movement disorders). Diagnostic sensitivity and specificity were evaluated in an additional 8 subjects with known ΔGAG DYT1 dystonia and 88 subjects with ΔGAG-negative dystonia. Results HRM of TOR1A Exon 5 showed high (100%) diagnostic sensitivity and specificity. HRM was rapid and economical. HRM reliably differentiated the TOR1A ΔGAG and c.863G>A mutations. Melting curves were normal in 250/250 controls and 1012/1014 subjects with primary dystonia. The two subjects with shifted melting curves were found to harbor the classic ΔGAG deletion: 1) a non-Jewish Caucasian female with childhood-onset multifocal dystonia and 2) an Ashkenazi Jewish female with adolescent-onset spasmodic dysphonia. Conclusion First, HRM is an inexpensive, diagnostically sensitive and specific, high-throughput method for mutation discovery. Second, Exon 5 mutations in TOR1A are rarely associated with non-generalized primary dystonia. PMID:19284587

  12. High-throughput mutational analysis of TOR1A in primary dystonia

    Truong Daniel D

    2009-03-01

    Full Text Available Abstract Background Although the c.904_906delGAG mutation in Exon 5 of TOR1A typically manifests as early-onset generalized dystonia, DYT1 dystonia is genetically and clinically heterogeneous. Recently, another Exon 5 mutation (c.863G>A has been associated with early-onset generalized dystonia and some ΔGAG mutation carriers present with late-onset focal dystonia. The aim of this study was to identify TOR1A Exon 5 mutations in a large cohort of subjects with mainly non-generalized primary dystonia. Methods High resolution melting (HRM was used to examine the entire TOR1A Exon 5 coding sequence in 1014 subjects with primary dystonia (422 spasmodic dysphonia, 285 cervical dystonia, 67 blepharospasm, 41 writer's cramp, 16 oromandibular dystonia, 38 other primary focal dystonia, 112 segmental dystonia, 16 multifocal dystonia, and 17 generalized dystonia and 250 controls (150 neurologically normal and 100 with other movement disorders. Diagnostic sensitivity and specificity were evaluated in an additional 8 subjects with known ΔGAG DYT1 dystonia and 88 subjects with ΔGAG-negative dystonia. Results HRM of TOR1A Exon 5 showed high (100% diagnostic sensitivity and specificity. HRM was rapid and economical. HRM reliably differentiated the TOR1A ΔGAG and c.863G>A mutations. Melting curves were normal in 250/250 controls and 1012/1014 subjects with primary dystonia. The two subjects with shifted melting curves were found to harbor the classic ΔGAG deletion: 1 a non-Jewish Caucasian female with childhood-onset multifocal dystonia and 2 an Ashkenazi Jewish female with adolescent-onset spasmodic dysphonia. Conclusion First, HRM is an inexpensive, diagnostically sensitive and specific, high-throughput method for mutation discovery. Second, Exon 5 mutations in TOR1A are rarely associated with non-generalized primary dystonia.

  13. Temporal discrimination thresholds in adult-onset primary torsion dystonia: an analysis by task type and by dystonia phenotype.

    Bradley, D

    2012-01-01

    Adult-onset primary torsion dystonia (AOPTD) is an autosomal dominant disorder with markedly reduced penetrance. Sensory abnormalities are present in AOPTD and also in unaffected relatives, possibly indicating non-manifesting gene carriage (acting as an endophenotype). The temporal discrimination threshold (TDT) is the shortest time interval at which two stimuli are detected to be asynchronous. We aimed to compare the sensitivity and specificity of three different TDT tasks (visual, tactile and mixed\\/visual-tactile). We also aimed to examine the sensitivity of TDTs in different AOPTD phenotypes. To examine tasks, we tested TDT in 41 patients and 51 controls using visual (2 lights), tactile (non-painful electrical stimulation) and mixed (1 light, 1 electrical) stimuli. To investigate phenotypes, we examined 71 AOPTD patients (37 cervical dystonia, 14 writer\\'s cramp, 9 blepharospasm, 11 spasmodic dysphonia) and 8 musician\\'s dystonia patients. The upper limit of normal was defined as control mean +2.5 SD. In dystonia patients, the visual task detected abnormalities in 35\\/41 (85%), the tactile task in 35\\/41 (85%) and the mixed task in 26\\/41 (63%); the mixed task was less sensitive than the other two (p = 0.04). Specificity was 100% for the visual and tactile tasks. Abnormal TDTs were found in 36 of 37 (97.3%) cervical dystonia, 12 of 14 (85.7%) writer\\'s cramp, 8 of 9 (88.8%) blepharospasm, 10 of 11 (90.1%) spasmodic dysphonia patients and 5 of 8 (62.5%) musicians. The visual and tactile tasks were found to be more sensitive than the mixed task. Temporal discrimination threshold results were comparable across common adult-onset primary torsion dystonia phenotypes, with lower sensitivity in the musicians.

  14. The clinical spectrum of laryngeal dystonia includes dystonic cough: observations of a large series.

    Payne, Susannah; Tisch, Stephen; Cole, Ian; Brake, Helen; Rough, Judy; Darveniza, Paul

    2014-05-01

    Laryngeal dystonia is a movement disorder of the muscles within the larynx, which most commonly manifests as spasmodic dysphonia (SD). Rarer reported manifestations include dystonic respiratory stridor and dyscoordinate breathing. Laryngeal dystonia has been treated successfully with botulinum neurotoxin (BTX) injections since 1984. We reviewed prospectively collected data in a consecutive series of 193 patients with laryngeal dystonia who were seen at St. Vincent's Hospital between 1991 and 2011. Patient data were analyzed in Excel, R, and Prism. Laryngeal dystonia manifested as SD (92.7%), stridor (11.9%), dystonic cough (6.2%), dyscoordinate breathing (4.1%), paroxysmal hiccups (1.6%), and paroxysmal sneezing (1.6%). There were more women (68.4%) than men (31.6%), and the average age at onset was 47 years. A positive family history of dystonia was present in 16.1% of patients. A higher incidence of extra-laryngeal dystonia (ie, torticollis and blepharospasm) and concurrent manifestations of laryngeal dystonia were present in patients with dystonic cough, dyscoordinate breathing, paroxysmal sneezing, and hiccups than in other patients (P = 0.003 and P Technical failures were rare (1.1%). Dysphonia secondary to vocal cord paresis followed 38.7% of treatments. Laryngeal dystonia manifests predominantly as SD, but other manifestations include stridor, dyscoordinate breathing, paroxysmal cough, hiccups, and sneezing. BTX injections are very effective across all subgroups. Severe adverse events are rare. PMID:24753288

  15. The efficacy of adductor canal blockade after minor arthroscopic knee surgery

    Espelund, M; Fomsgaard, J S; Haraszuk, J; Dahl, J B; Mathiesen, O

    2014-01-01

    for minor knee surgery were enrolled in this placebo-controlled, blinded trial. The patients were randomised to receive an ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 36) or saline (n = 35) in addition to a basic analgesic regimen with paracetamol and ibuprofen. Primary outcome measure was pain...... observed for any other outcome. CONCLUSION: No significant analgesic effect of the ACB could be detected after minor arthroscopic knee surgery with a basic analgesic regimen with acetaminophen and ibuprofen, except from a minor reduction in immediate requirements for supplemental opioids. Clinicaltrials...

  16. The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes

    Branci, Sonia; Thorborg, Kristian; Bech, Birthe Højlund;

    2015-01-01

    radiologists developed an 11-element MRI evaluation protocol defined according to precise criteria and illustrated in a pictorial atlas. Eighty-six male athletes (soccer players and non-soccer players) underwent standardised 3 Tesla MRI of the pelvis. Two external musculoskeletal radiologists were trained to...... use the protocol and pictorial atlas during two sessions of 2-4 h each. Each radiologist rated all 86 MRI independently. One radiologist evaluated the scans once, the other twice 2 months apart. Cohen κ statistics were used to determine intraobserver and interobserver agreement. RESULTS: The main...

  17. Adductor laryngeal breathing dystonia in NBIA treated with botulinum toxin-A

    Vinod Rai

    2013-01-01

    Full Text Available We report a rare case of neurodegeneration with brain iron accumulation (NBIA presented with episodic inspiratory stridor. A 10-year-old boy presented with 3-year history of gradually progressive spastic gait and generalized dystonia (involving all four limbs, neck, jaw, and speech. MRI brain showed "Eye of Tiger" sign. He recently developed severe inspiratory stridor associated with almost gasping respiration. Direct video laryngoscopy showed paradoxical vocal cord closure during inspiration. He was treated with EMG-guided botulinum toxin-A injection given into bilateral thyroarytenoid muscles, resulting in dramatic response with complete disappearance of the stridor within a week. The effect lasted 18 months.

  18. Prevalence of saphenous nerve injury after adductor-canal-blockade in patients receiving total knee arthroplasty

    Henningsen, Maja; Jæger, Pia; Hilsted, K L;

    2013-01-01

    of the saphenous nerve), as well as the anterior, posterior, lateral and infrapatellar part of the affected and contralateral lower leg. Sensory function was tested with pinprick (sharp and blunt needle), temperature discrimination (cold disinfectant swabs) and light brush. RESULTS: We included 97...... patients. None of the patients [0-5.3% (99% confidence interval)] had sensory changes related to temperature or light brush corresponding to the medial crural branch of the saphenous nerve, but 10 patients could not discriminate between blunt and sharp stimulation with a needle. In the infrapatellar area...... of the operated knee, 76 patients could not discriminate between blunt and sharp stimulation with a needle, 81 patients could not discriminate between cold and warmth, and 82 patients displayed an altered sensation to light brush. CONCLUSION: We found no indications of saphenous nerve injury caused...

  19. Acoustic and Perceptual Analysis of Modal and Falsetto Registers in Females with Dysphonia

    Li, Nicole Y. K.; Yiu, Edwin M-L.

    2006-01-01

    Modal and falsetto registers are the basic vocal qualities used in female speaking voices. The purpose of this study was to identify the frequency at which modal register changed to falsetto register and the frequency range of each modal and falsetto register produced under three loudness levels: soft, comfortable and loud phonations in normal and…

  20. Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

    Awan, Shaheen N.; Roy, Nelson

    2009-01-01

    Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

  1. Objective Dysphonia Measures in the Program Praat: Smoothed Cepstral Peak Prominence and Acoustic Voice Quality Index

    Y. Maryn; D. Weenink

    2015-01-01

    Purpose A version of the "smoothed cepstral peak prominence" (ie, CPPS) has recently been implemented in the program Praat. The present study therefore estimated the correspondence between the original CPPS from the program SpeechTool and Praat's version of the CPPS. Because the CPPS is the main fac

  2. Evaluation of Voice Disorders: Dysphonia Severity Index and Voice Handicap Index

    M.M. Hakkesteegt (Marieke)

    2009-01-01

    textabstractThe voice is arguable still the most important tool of communication despite the growing importance of e-mails and text messaging (SMS) in daily contact. Indeed in modern society people are probably even more dependent on their voice than in the rural societies of old. Approximately one

  3. [Dysarthria across Parkinson's disease progression. Natural history of its components: dysphonia, dysprosody and dysarthria].

    Pinto, S; Ghio, A; Teston, B; Viallet, F

    2010-10-01

    Dysarthria refers to a collective name for a group of neurologic motor speech disorders, resulting from central and/or peripheral nervous system abnormalities. Speech alteration in Parkinson's disease, so-called hypokinetic dysarthria, presents with prosodic insufficiency, related to a monotony of pitch and intensity, a reduction of accentuation, variable speech rate and possible phoneme imprecision. In most cases, voice is harsh and breathy. This symptom can affect both voice and speech quality, as well as prosody and intelligibility. As a consequence, many patients complain about speech impairments, which affect their communication in daily living activities. Perceptual and instrumental assessments require different and numerous investigation methods, which use may help to further understand the specific dysarthria pathophysiology. This is of importance in order to adjust treatments for dysarthria; as a matter of fact, dopa-therapy, functional neurosurgery or even behavioural speech therapy have variable effects on voice and speech quality in Parkinson's disease. PMID:20800250

  4. An Unusual Cause of Dysphonia with Hemoptysis: A Laryngeal Live Leech

    Mohsen Rajati

    2014-07-01

    Full Text Available Introduction: Foreign bodies in the upper airway are one of the most challenging otolaryngology emergencies and have various presentations depending on their physical properties and location. Leeches are blood-sucking hermaphroditic worms that vary in color, length, and shape. They usually reside in fresh-water streams and lakes. When rural untreated water is drunk, leeches may localize in the nose, pharynx, and esophagus, or rarely in the larynx. CaseReport: This case is a man who was referred to our otolaryngology clinic with a complaint of hemoptysis and mild respiratory distress. The patient’s symptoms were all relieved post operatively and he was discharged on the second day following the procedure.     Conclusion: Leeches should be suspected as an airway foreign body in patients with a recent history of drinking stream water.     

  5. 痉挛性发音障碍研究进展

    刘玮

    2015-01-01

    痉挛性发音障碍(Spasmodic dysphonia ,SD)是一种中枢运动神经系统病变,发音时喉部肌肉非随意运动。病因和发病机理不明,流行病学调查提示女性多发,该病根据喉部肌肉痉挛时声带开放、关闭位置不同主要分为三种类型:内收型、外展型、混合型。诊断主要依靠病态声音特征的感性判断,需神经科医师、嗓音医师、耳鼻喉科医师联合组成诊疗小组共同工作。临床上这种疾病的治疗方案基本是对症治疗,缓解声带痉挛状态,尚无一长期根治方法。

  6. Comparing Voice-Therapy and Vocal-Hygiene Treatments in Dysphonia Using a Limited Multidimensional Evaluation Protocol

    Rodriguez-Parra, Maria J.; Adrian, Jose A.; Casado, Juan C.

    2011-01-01

    Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. Method: Forty-two participants with voice disorders were…

  7. Irony in Tennyson's "Little Hamlet".

    Harrison, Antony H.

    1981-01-01

    Points out similarities between the events and characters of Tennyson's "Maud" and Shakespeare's "Hamlet." Identifies traits which "Maud" shares with Spasmodic poetry. Argues that Tennyson consciously employed these similarities to expose the deficiencies of the Spasmodic school. (DMM)

  8. Functional electrical stimulation of laryngeal adductor muscle restores mobility of vocal fold and improves voice sounds in cats with unilateral laryngeal paralysis.

    片田, 彰博; Nonaka, S.; Adachi, M; Kunibe, I; Arakawa, T.; Imada, M; Hayashi, T.; Zealear, DL; Harabuchi, Y

    2004-01-01

    Elsevier, Katada, Akihiro ; Nonaka, Satoshi ; Adachi, Masaaki ; Kunibe, Isamu ; Arakawa, Takuya ; Imada, Masanobu ; Hayashi, Tatsuya ; Zealear, David L. ; Harabuchi, Yasuaki, Neuroscience Research, 50(2), 2004, 153-159.author

  9. Adductor muscle pyo-myositis simulating appendicitis: CT and MR imaging findings; Pyomyosite des mulcles adducteurs mimant une appendicite aigue: aspects tomodensitometriques et IRM

    Coumbaras, M.; Le Hir, P.; Jomaah, N.; Arrive, L.; Tubiana, J.M. [Hopital Saint Antoine, 75 - Paris (France)

    2001-04-01

    Pyo-myositis is a primary bacterial infection of skeletal muscle. This infection tends to occur in the large muscles of the lower extremity. Pyo-myositis of the proximal muscles of the thigh can simulate acute abdominal disease. Early diagnosis improves the outcome. Delayed diagnosis may lead to septicemia and shock. We report the CT and MRI findings in a patient with pyo-myositis of the proximal muscles of the thigh. (authors)

  10. Eccentric and Isometric Hip Adduction Strength in Male Soccer Players With and Without Adductor-Related Groin Pain An Assessor-Blinded Comparison

    Thorborg, Kristian; Branci, Sonia; Nielsen, Peter Martin;

    2014-01-01

    .5 ± 2.5 years, and the mean age of the asymptomatic controls was 22.9 ± 2.4 years. Isometric hip strength (adduction, abduction, and flexion) and eccentric hip strength (adduction) were assessed with a handheld dynamometer using reliable test procedures and a blinded assessor. RESULTS: Eccentric hip...

  11. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias

    Waugh, Jeff L.; Kuster, John K.; Levenstein, Jacob M.; Makris, Nikos; Multhaupt-Buell, Trisha J.; Sudarsky, Lewis R.; Breiter, Hans C.; Sharma, Nutan; Blood, Anne J.

    2016-01-01

    Background Dystonia, a debilitating movement disorder characterized by abnormal fixed positions and/or twisting postures, is associated with dysfunction of motor control networks. While gross brain lesions can produce secondary dystonias, advanced neuroimaging techniques have been required to identify network abnormalities in primary dystonias. Prior neuroimaging studies have provided valuable insights into the pathophysiology of dystonia, but few directly assessed the gross volume of motor control regions, and to our knowledge, none identified abnormalities common to multiple types of idiopathic focal dystonia. Methods We used two gross volumetric segmentation techniques and one voxelwise volumetric technique (voxel based morphometry, VBM) to compare regional volume between matched healthy controls and patients with idiopathic primary focal dystonia (cervical, n = 17, laryngeal, n = 7). We used (1) automated gross volume measures of eight motor control regions using the FreeSurfer analysis package; (2) blinded, anatomist-supervised manual segmentation of the whole thalamus (also gross volume); and (3) voxel based morphometry, which measures local T1-weighted signal intensity and estimates gray matter density or volume at the level of single voxels, for both whole-brain and thalamus. Results Using both automated and manual gross volumetry, we found a significant volume decrease only in the thalamus in two focal dystonias. Decreases in whole-thalamic volume were independent of head and brain size, laterality of symptoms, and duration. VBM measures did not differ between dystonia and control groups in any motor control region. Conclusions Reduced thalamic gross volume, detected in two independent analyses, suggests a common anatomical abnormality in cervical dystonia and spasmodic dysphonia. Defining the structural underpinnings of dystonia may require such complementary approaches. PMID:27171035

  12. Art and dystonia.

    Garcia-Ruiz, Pedro J; Slawek, Jaroslaw; Sitek, Emilia J; Martinez Castrillo, Juan Carlos

    2015-09-15

    Dystonia has a recent history in medicine. Focal dystonia was described in the 19th century by classic authors including Gowers, whilst generalized dystonia was described at the turn of the century. However, it is possible to find precise descriptions of dystonia in art, centuries before the medical definition. We have reviewed several pieces of art (sculpture, painting and literature) across the history that might represent descriptions of dystonia, from ancient period to nowadays. In classic times, the first reference to abnormal postures can be tracked back to the new Empire of Egypt (equinus foot), not to mention some recently described examples of dystonia from the Moche sculptures in Peru or Veracruz culture from Mexico. In Middle Ages it is possible to find many examples of sculptures in European cathedrals representing peasants with dramatic, presumably dystonic postures that coexist with amputation of limbs. This unique combination of dystonia and limb amputation probably represents ergotism. The painters Brueghel, Ribera and Velazquez also represented figures with postures likely to be dystonic. Literature is also a source of precise pre-neurological descriptions, especially during the 19th century. In David Copperfield, Dickens depicts characters with generalized dystonia (Uriah Heep), cervical dystonia (Mr. Sharp) and spasmodic dysphonia (Mr Creakle). Finally, even in modern Art (19th and 20th centuries), there are dramatic descriptions of abnormal postures that are likely to be dystonic, such as painful cervical dystonia (Brancusi), cervical dystonia with sensory trick (Modigliani) and upper limb dystonia (Wyspianski). However some postures presented in works of art may simply be a form of artistic expression and only bear unintentional resemblance to the dystonic postures. Art may be a source of neurological information, and that includes primary and secondary dystonia. PMID:26139341

  13. Sporadic adult onset primary torsion dystonia is a genetic disorder by the temporal discrimination test.

    Kimmich, Okka

    2012-02-01

    Adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance; patients with sporadic adult-onset primary torsion dystonia are much more prevalent than familial. The temporal discrimination threshold is the shortest time interval at which two stimuli are detected to be asynchronous and has been shown to be abnormal in adult-onset primary torsion dystonia. The aim was to determine the frequency of abnormal temporal discrimination thresholds in patients with sporadic adult-onset primary torsion dystonia and their first-degree relatives. We hypothesized that abnormal temporal discrimination thresholds in first relatives would be compatible with an autosomal dominant endophenotype. Temporal discrimination thresholds were examined in 61 control subjects (39 subjects <50 years of age; 22 subjects >50 years of age), 32 patients with sporadic adult-onset primary torsion dystonia (cervical dystonia n = 30, spasmodic dysphonia n = 1 and Meige\\'s syndrome n = 1) and 73 unaffected first-degree relatives (36 siblings, 36 offspring and one parent) using visual and tactile stimuli. Z-scores were calculated for all subjects; a Z > 2.5 was considered abnormal. Abnormal temporal discrimination thresholds were found in 1\\/61 (2%) control subjects, 27\\/32 (84%) patients with adult-onset primary torsion dystonia and 32\\/73 (44%) unaffected relatives [siblings (20\\/36; 56%), offspring (11\\/36; 31%) and one parent]. When two or more relatives were tested in any one family, 22 of 24 families had at least one first-degree relative with an abnormal temporal discrimination threshold. The frequency of abnormal temporal discrimination thresholds in first-degree relatives of patients with sporadic adult-onset primary torsion dystonia is compatible with an autosomal dominant disorder and supports the hypothesis that apparently sporadic adult-onset primary torsion dystonia is genetic in origin.

  14. 脑卒中言语障碍患者心理分析及护理对策%Psychoanalysis and nursing countermeasure for dysphonia sufferers after stroke

    唐惠兰

    2007-01-01

    目的 通过分析50例脑卒中言语障碍患者的心理变化特点,指导制定相应护理对策以协助患者达到最佳康复效果.方法 采用综合医院焦虑/抑郁(HAD)情绪测定表和自制调查问卷对50例脑卒中言语障碍患者进行心理特点分析,比较不同性别、年龄和文化程度患者的心理变化特点,制定相应护理对策.结果 本组焦虑情绪占46%,抑郁情绪占38%.因病导致性格改变的比例表现出随年龄增长而增大的趋势.患者均表现出不同程度运动迟滞和动作不协调.男性患者有行为异常表现的比例高于女性患者(89.5%>58.1%).结论 卒中后女性患者较男性患者易产生焦虑和抑郁;60岁以上患者易出现抑郁情绪和情绪波动,60岁以上男性患者易出现性格改变和行为异常.应及时准确掌握患者心理特点,制定相应的护理对策.

  15. Treatment with Acupuncture and Psychological Counseling Hysterical Dysphonia%针刺配合心理疏导治疗癔症性发声障碍26例

    邓荣瑛; 李巧玉

    2010-01-01

    目的:观察推广针刺配合心理疏导治疗癔症性发声障碍的治疗效果.方法:采用针刺配合心理疏导治疗本病26例.结果:治疗总有效率84.6%.结论:本法对本病具有宣畅气机,疏肝解郁之功效.

  16. Objective multi-parameters analysis of the voice dysphonia%成人女性嗓音障碍的客观多参数分析

    于萍; 王国建; 韩冰; 杨伟炎; 韩东一

    2004-01-01

    目的:探讨嗓音客观多参数分析与主观听感知评估的相关性,建立嗓音客观多参数评估模型,实现嗓音评估的客观化和数据化.方法:声音样本采自83例嗓音障碍患者和40例嗓音正常者,全部受试者均为女性.客观检测采用Dr.Speech Science for Windows嗓音评估软件,在长元音/α:/上测试下列参数:基频、基频微扰(jitter)、振幅微扰(shimmer)、基频标准差、基频震颤、振幅震颤、标准化噪声能量(NNE)、谐噪比(HNR)、信噪比和最大发声时间(MPT).主观听感知评估参数采用日本言语音声学会声音嘶哑评估GRBAS系统中的总嘶哑度,4级评估标准.结果:应用逐步判别分析方法,建立了5个参数(MPT、jitter、NNE、HNR和shimmer)的嗓音客观评估模型.客观评估结果与主观评估结果的一致性达到79.8%.结论:嗓音的客观评估是多参数的;嗓音的客观多参数评估模型与主观听感知结果有较好的一致性.

  17. Optimization and Selection of Feature Parameters in Dysphonia Recognition%病态噪声识别特征参数的优化选择

    彭策; 熊屹; 陈文西; 万柏坤

    2007-01-01

    为提高病态嗓声识别效率,本研究首次采用主分量分析方法对目前常用的27个噪声特征参数进行了优化分析,考察了仅用少数主分量参数的识别效果及其分量数对结果的影响;同时根据参数对病态噪声信息敏感程度,使用正交试验法优选出9个较优特征参数,其识别率即可达到原27个参数的识别结果.经两种方法对参数进行优选后识别率分别达到97.23%和98.10%,显著高于未经优选、使用全部27个参数的92.10%识别率.研究结果表明:原27个参数中,2/3的参数不能很好地反映嗓声的病态变化特征,使用优选的含有大量病态嗓声信息的少量特征参数即可大幅提高病态嗓声识别效率.

  18. 不同嗓音样本对嗓音听感知评估的影响%Choice of Voice Material in Perceptive Evaluation of Dysphonia

    于萍; 黄冬雁; Revis Joana; Giovanni Antoine

    2004-01-01

    目的探讨不同声样对嗓音障碍听感知评估结果的影响,指导嗓音研究中语音材料的选择.方法受试者为60例嗓音障碍患者和20名嗓音正常者.对所有受试者录制3类声样:话语声、完整长元音/α:/、平稳段长元音/α:/.所有声样随机排列3次,共进行9次评估(3个声样×3次).评估参数为日本言语语音学会制定的嗓音嘶哑评估标准GRBAS系统中的总嘶哑度(G)、粗糙度(R)、气息音(S).计算统计学上的Kappa系数值确定听评委评估结果的一致性.根据听评委对每一受试者评估的平均值比较3类声样的差异性.结果评委自身和评委之间评估结果的一致性好;评估参数以总嘶哑度(G)的一致性和稳定性最好;不同声样类型对评委评估的一致性无影响.3类声样的评估结果有高度的相关性(P<0.001);话语声与完整长元音/α:/对嗓音障碍的评估结果基本一致,平稳段长元音/α:/有过低评估嗓音障碍的倾向,且随着嗓音障碍程度的加重而更加明显.结论平稳段长元音对嗓音障碍的评估程度过低,完整长元音与话语声对嗓音障碍的评估基本一致.建议嗓音障碍的听感知分析选择话语声作为嗓音材料,客观检测选择完整长元音作为嗓音材料.

  19. 原发性肌紧张性发音障碍患者的嗓音矫治%Voice Therapy for Patients with Primary Muscle Tension Dysphonia

    2016-01-01

    目的 评价一种治疗原发性肌紧张性发音障碍的综合嗓音矫治方法.方法 回顾性分析17例采用嗓音矫治方法治疗的患者,使用声学分析、语图、电子喉镜评估治疗前后的声音质量、喉腔发音状态,对声学分析参数基频(F0)、频率微扰(jitter)、振幅微扰(shimmer)进行统计分析.结果 嗓音矫治后,jitter、shimmer值明显降低,语图显示声音信号的噪音成分减少,电子喉镜显示声门闭合、声门上收缩情况改善.结论 该综合嗓音矫治方法明显改善了患者的嗓音质量,可用于肌紧张性发音障碍患者的临床治疗.

  20. MR imaging of ulnar nerve entrapment secondary to an anomalous wrist muscle

    MR imaging of an anomalous hypothenar adductor muscle causing isolated deep ulnar nerve branch compression and producing a purely motor neuropathy is presented. The muscle appears to represent a type 1 variant of the intrinsic anomalous hypothenar adductor muscle. (orig.)

  1. Some Personality Variables in Functional Neurological Disorders

    Mary M. Robertson

    1988-01-01

    Full Text Available Patients with spasmodic torticollis, writer's cramp and the Gilles de la Tourette Syndrome (GTS were given rating scales to assess personality dimensions, especially hostility and obsessionality. The data have been compared with age and sex matched controls. Significant differences arose, especially for hostility for the GTS and writer's cramp patients, whereas those with spasmodic torticollis do not differ from controls.

  2. Análise visual de parâmetros espectrográficos pré e pós-fonoterapia para disfonias Visual analysis of spectrographic parameters before and after dysphonia therapy

    Marcela Guimarães Côrtes; Ana Cristina Côrtes Gama

    2010-01-01

    OBJETIVO: Avaliar os efeitos da fonoterapia nos distúrbios da voz por meio de diferentes parâmetros acústicos pré e pós-fonoterapia. MÉTODOS: Trata-se de estudo experimental retrospectivo no qual se analisou as gravações de vozes de 67 indivíduos submetidos à reabilitação vocal. Os espectrogramas pré e pós-terapia fonoaudiológica foram julgados por quatro fonoaudiólogas. Os parâmetros para análise foram: forma do traçado, grau de escurecimento dos harmônicos, estabilidade do traçado dos harmô...

  3. 神经外科意识障碍病人躁动原因分析及对策%Causes of Neurosurgery Consciousness Barrier Patient's Dysphonia and the Countermeasures

    郑巧; 段辉菊; 吴洁

    2011-01-01

    目的 分析65例神经外科意识障碍病人躁动原因及来取的对策.方法 按照病人入院时间编号,GCS评分评定意识障碍,查找原因,分析危害,观察解决效果.结果 65例病人分别采取医疗手段和护理手段,消除或减轻因不同躁动原因所致的危害.结论 对于意识障碍病人而言,准确判断其躁动原因,积极来取预防措施,对于保证病人安全、避免医疗纠纷、促进病人康复至关重要.

  4. 以发声困难为首发症状的重症肌无力患者的临床特点%Clinical characteristics of myasthenia gravis with dysphonia as the initial symptom

    孙文海; 刘华敏; 梁大鹏; 万秀明; 丛志强; 王海萍

    2006-01-01

    目的 探讨以发声困难为首发症状的重症肌无力患者的临床特征,提高早期诊断率,减少误诊.方法 报告以发声困难为首发症状的重症肌无力患者31例,观察和分析其临床症状和体征以及疾病的发展和转归过程.结果 患者早期症状包括发声无力9例,不能发高音1例,不能维持正常的音量或音调3例,声音嘶哑18例,均有病态性发声疲劳反复发作.纤维喉镜检查喉部表现为一侧或双侧声带内收、外展受限,声带松弛,声带麻痹,声门不能完全闭合,梨状窝积液等.新斯的明试验发声困难症状及喉部体征均有改善.19例患者检测血液中乙酰胆碱受体抗体,5例高于正常参考值.所有患者经过治疗其症状均改善或消失,但在疾病的进程中,均相继出现全身肌无力和球肌麻痹症状.结论 嗓音变化可能是某些重症肌无力患者早期惟一症状,对临床具有晨轻暮重,病态疲劳性发声困难的患者应注意采用新斯的明试验或检测血液中乙酰胆碱受体抗体,以除外重症肌无力.

  5. 发音障碍严重指数在25例声带息肉患者中的应用%The detection of dysphonia severity index and its significance in 25 patients with polyp of vocal cord

    张武宁; 吴铖林; 李永湘; 钟晖; 毛海燕

    2014-01-01

    目的 探讨发音障碍严重指数(DSI)在声带息肉患者中的应用价值.方法 通过DIVAS2.5声学分析软件对25例声带息肉患者(病例组)术前及术后1周、2周、3周进行DSI检测及嗓音声学分析,与30例正常者(对照组)进行比较,分析DSI的特征及可靠性.结果 声带息肉患者术前均有较高的基频微扰、振幅微扰及较低的DSI,结果均能提示嗓音功能受损.声带息肉患者术后1周与术前比较,基频微扰、振幅微扰无明显改变,差异无统计学意义;DSI升高,差异有统计学意义(P0.05),而DSI差异仍有统计学意义(P0.05),提示嗓音完全恢复.结论 在25例声带息肉患者中,DSI较扰动分析能够更敏感地反映嗓音变化情况.

  6. Ectopic thyroid gland causing dysphonia: imaging and molecular studies%异位甲状腺引发的发音困难:影像学及分子研究

    柴维敏

    2011-01-01

    @@ 一 8.5岁临床甲状腺功能正常的女孩因发现舌部肿块、发音困难及偶发呼吸困难而前来就诊.于就诊后3天行先天性甲状腺功能低下筛查呈阳性[TSH 37 mU/L(正常<15),总T4112 nmol/L(正常值86~260)],但就诊后18天复查未见明显异常[TSH 12 mU/L(正常<15),总T4 99 nmol/L(正常值86~260)],因此未能予以作出明确诊断.

  7. Application of Laryngoscopy and Acoustic Analysis by Computer in the Diagnosis of Functional Dysphonia%功能性发声障碍的喉镜检查及计算机声学分析

    黄卫; 徐洁洁; 陈曦; 陆美萍

    2003-01-01

    目的观察功能性发声障碍的临床特征、嗓音声学参数和声谱图特征,探讨喉镜检查及计算机声学分析在功能性发声障碍诊断中的应用价值.方法采用喉镜和计算机声学测试系统对71例功能性发声障碍患者和50例正常人进行喉镜检查及嗓音元音/a:/进行测试,分析各项声学参数特点并行统计学分析.结果高功能性发声障碍患者基频较正常升高;低功能性发声障碍患者基频较正常降低;基频微扰、振幅微扰、NNE较正常增高,最大发声时间缩短.均有统计学意义.90.14%(64/71) 功能性发声障碍患者的嗓音信号中可发现正常声学特征.声谱图特征为谐波及共振峰不规则、断裂甚至消失,噪声成分增加等.结论应用计算机声学分析对功能性发声障碍患者的声学特征进行客观分析,有助于功能性发声障碍的诊断.

  8. 嗓音的客观多参数分析与主观听觉分析相关性的研究%Correlation Between Objective Multi- parametric Analysis and Perceptual Analysis for Dysphonia

    于萍; Giovanni Antoine

    2003-01-01

    目的探讨嗓音的客观多参数检测与主观听觉评估的相关性,建立嗓音客观多参数评估模式,实现嗓音评估的客观化、数据化.方法声音样本采自135例声音嘶哑患者和29例嗓音正常者.客观检测采用法国开发的"EVA"嗓音工作站,测试对象发长元音/α:/时,检测下列参数:基频(F0)、音强(intensity)、基频微扰(jitter)、信噪比(signal-to-noise ratio,SNR)、Lyapunov系数、口腔气流量(oral airflow,OAF)、音域(range)及最大发声时间(maximumphonatory time,MPT);发/pα/音时,检测声门下压(estimated subglottic pressure,ESGP).主观听觉评估采用日本言语语音学会声音嘶哑评估GRBAS系统中的总嘶哑度(grade,G)4级评估标准.所有受试者以自然的音调及音强读一段统一的标准文字,听评委由4名嗓音学家组成.结果应用判别分析方法,建立了7参数客观评估模式(音域、Lya-punov系数、声门下压、最大发声时间、口腔气流量、信噪比和基频).客观评估结果与主观评估结果的一致性达到84%.结论嗓音的客观检测是多参数的,客观评估能够反映出主观听觉印象.

  9. Clinical observation on muscle tension dysphonia treated with acupuncture and moxibustion therapy%针灸及推拿治疗肌紧张性发音障碍临床观察

    陈陆泉; 王翰菁; 支楠; 马小丽; 王军

    2011-01-01

    目的 观察针灸及推拿治疗肌紧张性发音障碍的临床疗效.方法 将35例肌紧张性发音障碍患者随机分成治疗组和声休组.治疗组18例,选择针刺疗法治疗,并配合颈周穴位推拿,共治疗3周.声休组17例,患者休息,无特殊治疗.观察3周后2组声道不适指数(VTD)评分、嗓音障碍指数(VHI)评分和嗓音主观评分(GRABS)等变化.结果 治疗组治疗后VTD程度和频率评分较治疗前比较差异有统计学意义(P<0.05);对照组治疗前后VTD程度评分无显著差异,频率评分治疗前后比较差异有统计学意义(P<0.05);治疗组VHI分值治疗前后比较,差异有统计学意义(P<0.01),对照组治疗前后无显著差异.治疗组GRBAS评分治疗前后比较差异有统计学意义(P<0.01),对照组治疗前后无显著差异.结论 针灸及推拿治疗肌紧张性发音障碍疗效优于声音休息方法.

  10. Disfonia e bulimia: avaliação dos sintomas e sinais vocais e laríngeos Dysphonia and bulimia: evaluation of vocal and laryngeal signs and symptoms

    Cynthia Priscila Ferreira

    2009-01-01

    Full Text Available OBJETIVO: Descrever os sintomas e sinais vocais e laríngeos de pacientes com diagnóstico de bulimia. MÉTODOS: Estudo transversal, descritivo, randomizado, com experimento cego. Avaliou-se 11 indivíduos com diagnóstico de bulimia, com o subtipo purgativo, do sexo feminino e idade variando de 18 a 34 anos, que foram submetidas à avaliação fonoaudiológica e otorrinolaringológica. RESULTADOS: Os sintomas laríngeos e vocais mais relatados foram: o pigarro e a sensação de globus faríngeo relatados por dez sujeitos (90,9%. Na avaliação perceptivo-auditiva, os escores de maior ocorrência foram de grau leve em todos os parâmetros analisados. Os achados laríngeos de maior ocorrência foram os acúmulos de secreção espessa na laringe em cinco paciente (45,4%, seguido de fenda triangular médio-posterior e espessamento de mucosa na região interaritenoidea, ambos, ocorrendo em quatro sujeitos (36,3%. CONCLUSÃO: Os achados laringológicos e perceptivo-auditivos foram menos expressivos que os sintomas vocais e laríngeos relatados pelas pacientes.PURPOSE: To describe vocal and laryngeal signs and symptoms in patients with bulimia. METHODS: A blind, descriptive, randomized, transversal study was carried out. Eleven female subjects with the diagnosis of purgative bulimia nervosa and ages ranging from 18 to 34 years underwent otorhinolaryngological and vocal evaluations. RESULTS: The most common vocal and laryngeal symptoms were throat clearing and globus faringeus, related by 10 subjects (90.9%. In the auditory-perceptive evaluation, the most common scores were characterized as light in all analyzed parameters. The accumulation of thick mucus over the larynx occurred in five patients (45.4%, followed by median-posterior triangular glottic chink and mucosal thickening at the interaytenoid region, in four patients (36.3%. CONCLUSION: The laryngeal and perceptual findings were less expressive than vocal and laryngeal complaints.