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Sample records for abductor spasmodic dysphonia

  1. Botulinum toxin therapy for abductor spasmodic dysphonia.

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    Woodson, Gayle; Hochstetler, Heidi; Murry, Thomas

    2006-03-01

    Botulinum toxin has been widely accepted as an effective therapy for controlling the symptoms of adductor spasmodic dysphonia (ADSD). Reported experience with botulinum treatment for abductor spasmodic dysphonia (ABSD) has been less impressive. Factors that may impair outcomes for ABSD include differences in the pathophysiology of ADSD and ABSD and limitation of maximal dose from airway restriction with posterior cricoarytenoid muscle (PCA) weakness. We report our experience with botulinum injection of the PCA with an asymmetric dose escalation protocol, based on clinical observations that in ABSD, abductor spasms are often stronger on one side, usually the left. The nondominant side was injected with 1.25 units. Dominant side dose began at 5 units, with step-wise increments of 5 units per week until one of three endpoints was reached: Elimination of breathy voice breaks, complete abductor paralysis of the dominant side, or airway compromise. Fourteen of 17 patients achieved good or fair voice, with dominant-side doses ranging from 10 to 25 units. Exercise intolerance limited PCA dose in two patients. One patient had persisting breathiness that improved with medialization thyroplasty. Asymmetric botulinum toxin injection into PCA muscles can suppress abductor spasm in patients with ABSD, but breathiness may persist, because of inadequate glottal closure.

  2. Spasmodic dysphonia.

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    Schaefer, S D; Freeman, F J

    1987-02-01

    Few speech disorders have been more controversial as to etiology and treatment as spasmodic dysphonia. This article reviews the historical background and origins of spasmodic dysphonia theories and the legacy of their implications on the current treatment of afflicted patients. The evolution and impact of "organic theories" is discussed and a personal perspective on the central nervous system investigations performed by the authors is briefly elucidated and their practical experience in managing spasmodic dysphonia patients is offered for the reader's consideration.

  3. Neurologic aspects of spasmodic dysphonia.

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    Rosenfield, D B; Donovan, D T; Sulek, M; Viswanath, N S; Inbody, G P; Nudelman, H B

    1990-08-01

    We discuss the etiology of 100 spasmodic dysphonia patients. Seventy-one patients had underlying essential tremor, 25 had Meige's syndrome, 12 were hypothyroid, and 27 had either a functional disturbance or focal dystonia. Six patients had intermittent breathy dysphonia. A large corpus of spasmodic dysphonia patients have organic neurolaryngeal disease.

  4. [Analysis of phonosurgical methods of treatment in spasmodic dysphonia].

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    Kosztyła-Hojna, Bożena; Berger, Greta; Zdrojkowski, Maciej

    2017-02-20

    Spasmodic dysphonia (SD) is rather a rare voice disorder. It is most often seen in woman aged 40-50. The disease is caused by deep emotional and neurological disorders of extrapyramidal system. Two main clinical forms of SD are distinguished: about 90% of cases - adductor spasmodic dysphonia and abductor spasmodic dysphonia roughly 10%. Conservative therapy does not always yield sufficient effects. Botulinum toxin - type A injections into the thyroarytenoid muscle are also used in therapy. Though results are temporary and reversible. Among phonosurgical methods thyroplasty type II according to Isshiki and tyroarytenoid muscle myectomy (TAM) should be also mentioned among phonosurgical methods. The aim of the work is to evaluate results of conservative and phonosurgical treatment of SD. Spasmodic dysphonia markedly restricts communication process of patients and public relations both social and occupational.

  5. Disfluency in Spasmodic Dysphonia: A Multivariate Analysis.

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    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…

  6. Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

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    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…

  7. Consideration of genetic contributions to the risk for spasmodic dysphonia.

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    Sharma, Nutan; Franco, Ramon A

    2011-09-01

    Spasmodic dysphonia, a form of the neurologic condition known as dystonia, results from involuntary spasms of the larynx, producing interruptions of speech and changes in voice quality. The pathogenesis of spasmodic dysphonia is not well understood. However, several genetic mutations have been identified that cause different forms of dystonia. In some individuals, these genetic mutations result in spasmodic dysphonia, either with no other signs of dystonia or as part of a broader dystonia phenotype. Thus, research in the growing field of dystonia genetics may help to inform our understanding of the pathogenesis of spasmodic dysphonia.

  8. Spasmodic dysphonia: let's look at that again.

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    Murry, Thomas

    2014-11-01

    G. Paul Moore influenced the study of spasmodic dysphonia (SD) with his 1960 publication that examined the neurological, medical, and vocal fold behavior in a group of patients with adductor spasmodic dysphonia (ADSD). This review of advances in the diagnosis and treatment of SD follows a time line of research that can be traced in part to the early work of Moore et al. This article reviews the research in ADSD over the past 50 plus years. The capstone events that brought SD to its present day level of management by laryngologists and speech-language pathologists are highlighted. A look to the future to understand more of the disorder is offered for this debilitating disorder.

  9. Recurrent laryngeal nerve pathology in spasmodic dysphonia.

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    Bocchino, J V; Tucker, H M

    1978-08-01

    Since it was first described in 1871, spasmodic (spastic) dysphonia has been considered a disease of psychogenic origin. Unsupported theories of possible organic etiology have appeared sporadically in the literature. In 1976 sectioning of the recurrent laryngeal nerve for patients with this disease was reported with resultant improvement in voice production. This was attempted because the spasmodic dysphonic has, in effect, already compensated vocal cords bilaterally. It was reasoned, therefore, that if one of these was paralyzed the patient would immediately be converted to a state approximating that of well-compensated unilateral vocal cord paralysis which situation, as is well known, usually carries with it a fairly good voice. A controlled study to evaluate the efficacy of this surgical approach has been undertaken at the Cleveland Clinic during the past year. In an attempt to elucidate the possible organic etiology of spasmodic dysphonia, a section of nerve was removed in every case and examined by both light and electron microscopy. Special stains for myelin were also used on the light microscopy specimens. Demyelinization has been found in most of the cases examined by electron microscopy. Possible correlation between this disease entity and other cranial nerve syndromes of unknown etiology is noted. Such conditions as trigeminal neuralgia, glossopharyngeal neuralgia, belpharospasm, hemifacial spasm, and even possibly Bell's palsy may exhibit a similar etiology.

  10. DIFFERENTIAL DIAGNOSIS OF ADDUCTOR SPASMODIC DYSPHONIA AND MUSCLE TENSION DYSPHONIA USING ACOUSTIC PARAMETERS

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    Swapna Sebastian

    2014-10-01

    Full Text Available Objective:The study aimed at differentiating Adductor Spasmodic Dysphonia (ADSD from Muscle Tension Dysphonia (MTD using acoustic measurements . Method: Perceptual as well as acoustic analysis of the voice was done on 12 patients of Adductor Spasmodic dysphonics and Muscle tension dysphonics each. The age of these patients ranged between 30 to 64 years . Results: Adductor spasmodic dysphonics statistically differed from muscle tension dysphonia in the acoustic parameters of voice break, harmonic to noise ratio, and jitter. The parameters which showed maximum significance of differences were voice break which was presented only by the adductor spasmodic dysphonics and harmonic to noise ratio which was affected in muscle tension dysphonia. Conclusion: Voice breaks were found to be more sensitive in discriminating adductor spasmodic dysphonia from muscle tension dysphonia in the present study. Percentage of voice break correlated with perceptual assessment of severity.

  11. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study.

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    Simonyan, Kristina; Ludlow, Christy L

    2010-11-01

    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 decreased activation extent in the basal ganglia, thalamus, and cerebellum during asymptomatic tasks. Increased activation intensity in SD patients was found only in the primary somatosensory cortex during symptomatic voice production, which showed a tendency for correlation with ADSD symptoms. Both SD groups had lower correlation of activation intensities between the primary motor and sensory cortices and additional correlations between the basal ganglia, thalamus, and cerebellum during symptomatic and asymptomatic tasks. Compared with ADSD patients, ABSD patients had larger activation extent in the primary sensorimotor cortex and ventral thalamus during symptomatic task and in the inferior temporal cortex and cerebellum during symptomatic and asymptomatic voice production. The primary somatosensory cortex shows consistent abnormalities in activation extent, intensity, correlation with other brain regions, and symptom severity in SD patients and, therefore, may be involved in the pathophysiology of SD.

  12. Comparing health locus of control in patients with Spasmodic Dysphonia, Functional Dysphonia and Nonlaryngeal Dystonia.

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    Haselden, Karen; Powell, Theresa; Drinnan, Mike; Carding, Paul

    2009-11-01

    Locus of Control (LoC) refers to an individuals' perception of whether they are in control of life events. Health Locus of Control refers to whether someone feels they have influence over their health. Health Locus of Control has not been studied in any depth in voice-disordered patients. The objective of this study was to examine Health Locus of Control in three patient groups: (1) Spasmodic Dysphonia, (2) Functional Dysphonia and (3) a nondysphonic group with Nonlaryngeal Dystonia. LoC was measured and compared in a total of 57 patients using the Multidimensional Health Locus of Control Scales (diagnostic specific) Form C. Internal, Chance, and Powerful others LoC were measured and comparisons were made using one-way analysis of variance. Contrary to expectations Internal LoC was found to be significantly higher in the Functional Dysphonia group when compared to the other two groups. There was no significant difference between the groups in Chance or Powerful others LoC. The two organic groups, Spasmodic Dysphonia and Nonlaryngeal Dystonia, were more alike in Internal Health Locus of Control than the Functional Dysphonia group. The diagnostic nature of the groups was reflected in their LoC scores rather than their voice loss. These results contribute to the debate about the etiology of Spasmodic Dysphonia and will be of interest to those involved in the psychology of voice and those managing voice-disordered patients.

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

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    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.

  14. Emotional Considerations in Spasmodic Dysphonia: Psychometric Quantification.

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    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…

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

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    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.

  16. Parry-Romberg syndrome (progressive hemifacial atrophy) with spasmodic dysphonia--a rare association.

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    Mugundhan, K; Selvakumar, C J; Gunasekaran, K; Thiruvarutchelvan, K; Sivakumar, S; Anguraj, M; Arun, S

    2014-04-01

    Parry-Romberg syndrome is a rare clinical entity characterised by progressive hemifacial atrophy with appearance of 'saber'. Various neurological and otorhinolaryngological disorders are associated with this syndrome. The association of Parry -Romberg syndrome with Spasmodic dysphonia has rarely been reported. A 37 year old female presented with progressive atrophy of tissues of left side of face for 10 years and change in voice for 1 year. On examination, wasting and atrophy of tissues including tongue was noted on left side of the face. ENT examination revealed adductor spasmodic dysphonia. We report the rare association of Parry -Romberg syndrome with spasmodic dysphonia.

  17. Psychogenic spasmodic dysphonia: a case study with expert opinions.

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    Sapir, S

    1995-09-01

    Spasmodic (spastic) dysphonia (SD) is considered by some to be a neurologic syndrome and by others a symptom complex of multiple etiologies, neurologic and psychogenic. A case of a 26-year-old female psychiatric nurse with psychogenic SD (PSD) is presented. The dysphonia was alleviated within one session of voice therapy. Psychogenic etiology was established by the author, based on three diagnostic criteria--symptom incongruity, symptom reversibility, and symptom psychogenicity. Seven nationally recognized voice experts listened to audio-recorded samples of the patient's pre- and posttherapy voice during conversational speech. The experts agreed that the dysphonia was psychogenic and characterized it as staccato-like speech, effortful phonation, and interrupted flow of speech; six characterized it with intermittent voice arrests (voice stoppages); five with hoarse-harsh voice; and four with waxing and waning, strained-strangled phonation. These are often described as salient features of SD. Nevertheless, the experts disagreed among themselves as to whether the dysphonia was characteristic of SD and should be labeled as such. The author argues that as long as the voice characteristics and pathophysiologic findings that constitute SD are not well delineated, and as long as the diagnosis of SD is based on symptoms alone, patients with psychogenic or poorly understood voice disorders are likely to be misdiagnosed with organic (neurologic) SD and thus subjected to undue medical treatment. The author also argues that the debate over the etiology of SD can be resolved if SD is considered a neurologic syndrome, PSD a nonorganic phonatory disorder that mimics the syndrome, and if the voice symptoms and pathophysiologic characteristics of SD are well defined and agreed on.

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

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    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.

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

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    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

  20. Diagnosis of spasmodic dysphonia manifested by swallowing difficulty in videofluoroscopic swallowing study.

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

    2015-04-01

    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) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.

  1. Abnormal striatal dopaminergic neurotransmission during rest and task production in spasmodic dysphonia.

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

    2013-09-11

    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 [(11)C]raclopride (RAC) to study striatal dopaminergic neurotransmission at the resting state and during production of symptomatic sentences and asymptomatic finger tapping in spasmodic dysphonia patients. We found that patients, compared to healthy controls, had bilaterally decreased RAC binding potential (BP) to striatal dopamine D2/D3 receptors on average by 29.2%, which was associated with decreased RAC displacement (RAC ΔBP) in the left striatum during symptomatic speaking (group average difference 10.2%), but increased RAC ΔBP in the bilateral striatum during asymptomatic tapping (group average difference 10.1%). Patients with more severe voice symptoms and subclinically longer reaction time to initiate the tapping sequence had greater RAC ΔBP measures, while longer duration of spasmodic dysphonia was associated with a decrease in task-induced RAC ΔBP. Decreased dopaminergic transmission during symptomatic speech production may represent a disorder-specific pathophysiological trait involved in symptom generation, whereas increased dopaminergic function during unaffected task performance may be explained by a compensatory adaptation of the nigrostriatal dopaminergic system possibly due to decreased striatal D2/D3 receptor availability. These changes can be linked to the clinical and subclinical features of spasmodic dysphonia and may represent the neurochemical basis of basal ganglia alterations in this disorder.

  2. Effects of type II thyroplasty on adductor spasmodic dysphonia.

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    Sanuki, Tetsuji; Yumoto, Eiji; Minoda, Ryosei; Kodama, Narihiro

    2010-04-01

    Type II thyroplasty, or laryngeal framework surgery, is based on the hypothesis that the effect of adductor spasmodic dysphonia (AdSD) on the voice is due to excessively tight closure of the glottis, hampering phonation. Most of the previous, partially effective treatments have aimed to relieve this tight closure, including recurrent laryngeal nerve section or avulsion, extirpation of the adductor muscle, and botulinum toxin injection, which is currently the most popular. The aim of this study was to assess the effects of type II thyroplasty on aerodynamic and acoustic findings in patients with AdSD. Case series. University hospital. Ten patients with AdSD underwent type II thyroplasty between August 2006 and December 2008. Aerodynamic and acoustic analyses were performed prior to and six months after surgery. Mean flow rates (MFRs) and voice efficiency were evaluated with a phonation analyzer. Jitter, shimmer, the harmonics-to-noise ratio (HNR), standard deviation of the fundamental frequency (SDF0), and degree of voice breaks (DVB) were measured from each subject's longest sustained phonation sample of the vowel /a/. Voice efficiency improved significantly after surgery. No significant difference was found in the MFRs between before and after surgery. Jitter, shimmer, HNR, SDF0, and DVB improved significantly after surgery. Treatment of AdSD with type II thyroplasty significantly improved aerodynamic and acoustic findings. The results of this study suggest that type II thyroplasty provides relief from voice strangulation in patients with AdSD. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  3. Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients.

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    van Esch, Babette F; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

    2017-02-01

    Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.

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

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    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…

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

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    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

  6. Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

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    Svetel Marina

    2007-01-01

    Full Text Available Background/Aim. Spasmodic dysphonia (DS is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80−100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. Methods. The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12−16 units each. In our study we applied indirect technique originally developed by Hočevar and Pirtošek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. Results. The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index − (VHI that was rated as rather significant one (t = 3.562; p = 0.006. Conclusion. Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.

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

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    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

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

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

    2012-04-01

    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 performed on voices of 19 patients diagnosed with adductor spasmodic dysphonia (SD), before and after treatment with Botulinum toxin. The speech material consisted of 40 short sentences phonetically selected for constant voicing. Seven perceptual parameters (traditional and dedicated) were blindly rated by a panel of experienced clinicians. Nine acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals and validated with synthesized deviant voices. Patients also filled in a VHI-questionnaire. Significant improvement is shown by all three approaches. The traditional GRB perceptual parameters appear to be adequate for these patients. Conversely, the special acoustic analysis program is successful in objectivating the improved regularity of vocal fold vibration: the basic jitter remains the most valuable parameter, when reliably quantified. The VHI is well suited for the voice-related quality of life. Nevertheless, when considering pre-therapy and post-therapy changes, the current study illustrates a complete lack of correlation between the perceptual, acoustic, and self-assessment dimensions. Assessment of SD-voices needs to be tridimensional.

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

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    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.

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

    Science.gov (United States)

    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. Cortical dysfunction of the supplementary motor area in a spasmodic dysphonia patient.

    Science.gov (United States)

    Hirano, S; Kojima, H; Naito, Y; Tateya, I; Shoji, K; Kaneko, K; Inoue, M; Nishizawa, S; Konishi, J

    2001-01-01

    The etiology of spasmodic dysphonia (SD) is still unknown. In the present study, cortical function of a 59-year-old male patient with adductor type SD was examined during phonation with positron emission tomography (PET). Magnetic resonance imaging showed no organic abnormality in the brain. However, PET showed remarkable activities during phonation in the left motor cortex, Broca's area, the cerebellum, and the auditory cortices, whereas the supplementary motor area (SMA) was not activated. The SMA is known to function for motor planning and programming and is usually activated in normal phonation. Several previous reports have shown that the damage of the SMA caused a severe disturbance of voluntary vocalization. In the present case, it was suggested that the functional deficit of the SMA might be related to SD.

  12. Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia.

    Science.gov (United States)

    Gandhi, Sachin; Remacle, Marc; Mishra, Prasun; Desai, Vrushali

    2014-12-01

    Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

  13. [A study on vowel duration and word length of adductor spasmodic dysphonia].

    Science.gov (United States)

    Chen, Zhipeng; Ge, Pingjiang

    2016-03-01

    To understand the vowel duration and statement reading of the adductor spasmodic dysphonia (ADSD) patients compared with their normal controls, and provide ideas for clinical diagnosis and treatment. Twenty-nine ADSD patients were included in the research, with 31 normal controls. All subjects filled in form voice handicap index (VHI) by themselves. Maximum phonetic time (MPT) and maximum loudness phonetic time(MLPT) were tested on /a/ sound for all patients. Also, all the patients were required to read aloud a standard mandarin assay named , duration were measured with Praat5. 0 software after sounds were collected. A one-way t-test was performed to compare spasmodic group with control group on VHI, MPT, MLPT and duration for reading standard sentences. Pearson/Spearman correlation was tested. Result: The VHI of the 29 ADSD patients is 89±12, and their normal controls 15±16, indicating that the VHI in ADSD group is significantly higher than in the control group(Preading of the ADSD group is (55.0±14. 2)s, and the control group is (37. 8±4. 8)s, indicating that the duration of standard sentence reading in the ADSD group is significantly longer than the control group (Pvowels are not lasting compared with normal people. In the meantime, their ability to read sentences is worse than normal people, needing longer time to complete the reading task. There is a significant correlation between MLPT and MPT, which can be used as an alternative to MPT.

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

    Science.gov (United States)

    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.

  15. Evaluation of voice quality in adductor spasmodic dysphonia before and after botulinum toxin treatment.

    Science.gov (United States)

    Langeveld, T P; van Rossum, M; Houtman, E H; Zwinderman, A H; Briaire, J J; Baatenburg de Jong, R J

    2001-07-01

    In this prospective study, the efficacy of botulinum toxin (Botox) injections in patients with adductor spasmodic dysphonia (AdSD) was assessed by 3 different modalities: perceptual and acoustic analyses and subjective self-assessment. This was done by comparing AdSD patients' pretreatment and posttreatment values and comparing these values with those of normal control speakers. In contrast to most other studies, the posttreatment status was defined as the optimal voice quality as judged by the patient. The aim of the study was to assess to what extent Botox injections actually improve voice quality and function. The AdSD subjects rated a significantly improved voice quality and function after Botox treatment. However, the results were never within normal limits. Perceptually, the characteristic and severely impaired AdSD voice improved, but another "type" of pathological voice was detected after Botox treatment. Acoustic analyses demonstrated a significant improvement, as well. Nevertheless, the "optimally" treated AdSD voice still remained significantly deviant as compared to normal voice production. Currently, Botox injection is the therapy of first choice for AdSD. Although significant improvement could be measured in our study perceptually, acoustically, and subjectively, the optimal voice that was achieved never fully matched normal voice quality or function.

  16. The Effect of Information and Severity on Perception of Speakers With Adductor Spasmodic Dysphonia.

    Science.gov (United States)

    Eadie, Tanya L; Rajabzadeh, Reyhaneh; Isetti, Derek D; Nevdahl, Martin T; Baylor, Carolyn R

    2017-05-17

    The purpose of this study was to examine the effect of severity of adductor spasmodic dysphonia (ADSD) and information about it on unfamiliar listeners' attitudes about speakers' personal characteristics, perceived vocal effort, and listener comfort on the basis of ratings of speech recordings. Fifteen women with ADSD and 5 controls provided speech samples. Forty-five unfamiliar listeners were randomized into 3 groups. Listeners in Group 1 received no information, listeners in Group 2 were told that some speakers had voice disorders or had no voice concerns, and listeners in Group 3 were provided diagnostic labels for each speaker and information about ADSD. Listeners then rated speech samples for attitudes, perceived vocal effort, and listener comfort. Speakers with ADSD were judged significantly worse than controls for attitudes related to "social desirability" and "intellect." There was no effect of severity on "personality" attributes. However, provision of a diagnostic label resulted in significantly more favorable personality ratings than when no label was provided. Perceived vocal effort and comfort became significantly more negative as ADSD severity increased. Finally, most listener ratings were unaffected by provision of additional information about ADSD. Listeners' perceptions about speakers with ADSD are difficult to change. Directions for counseling and public education need future study.

  17. Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

    Science.gov (United States)

    Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

    2015-01-01

    Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD.

  18. Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia.

    Science.gov (United States)

    Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Yanagida, Saori; Nishizawa, Noriko; Oridate, Nobuhiko; Fukuda, Satoshi; Homma, Akihiro

    2017-02-22

    Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

  19. Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability.

    Science.gov (United States)

    Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

    2014-02-07

    The purpose of this study was to compare cortical inhibition in the hand region of the primary motor cortex between subjects with focal hand dystonia (FHD), adductor spasmodic dysphonia (AdSD), and healthy controls. Data from 28 subjects were analyzed (FHD n=11, 53.25 ± 8.74 y; AdSD: n=8, 56.38 ± 7.5 y; and healthy controls: n=941.67 ± 10.85 y). All subjects received single pulse TMS to the left motor cortex to measure cortical silent period (CSP) in the right first dorsal interosseus (FDI) muscle. Duration of the CSP was measured and compared across groups. A one-way ANCOVA with age as a covariate revealed a significant group effect (p<0.001). Post hoc analysis revealed significantly longer CSP duration in the healthy group vs. AdSD group (p<0.001) and FHD group (p<0.001). These results suggest impaired intracortical inhibition is a neurophysiologic characteristic of FHD and AdSD. In addition, the shortened CSP in AdSD provides evidence to support a widespread decrease in cortical inhibition in areas of the motor cortex that represent an asymptomatic region of the body. These findings may inform future investigations of differential diagnosis as well as alternative treatments for focal dystonias.

  20. Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia.

    Science.gov (United States)

    Kirke, Diana N; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

    2016-02-03

    Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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…

  4. Multidimensional assessment of strongly irregular voices such as in substitution voicing and spasmodic dysphonia: a compilation of own research.

    Science.gov (United States)

    Moerman, Mieke; Martens, Jean-Pierre; Dejonckere, Philippe

    2015-04-01

    This article is a compilation of own research performed during the European COoperation in Science and Technology (COST) action 2103: 'Advance Voice Function Assessment', an initiative of voice and speech processing teams consisting of physicists, engineers, and clinicians. This manuscript concerns analyzing largely irregular voicing types, namely substitution voicing (SV) and adductor spasmodic dysphonia (AdSD). A specific perceptual rating scale (IINFVo) was developed, and the Auditory Model Based Pitch Extractor (AMPEX), a piece of software that automatically analyses running speech and generates pitch values in background noise, was applied. The IINFVo perceptual rating scale has been shown to be useful in evaluating SV. The analysis of strongly irregular voices stimulated a modification of the European Laryngological Society's assessment protocol which was originally designed for the common types of (less severe) dysphonia. Acoustic analysis with AMPEX demonstrates that the most informative features are, for SV, the voicing-related acoustic features and, for AdSD, the perturbation measures. Poor correlations between self-assessment and acoustic and perceptual dimensions in the assessment of highly irregular voices argue for a multidimensional approach.

  5. Alterations in CNS activity induced by botulinum toxin treatment in spasmodic dysphonia: an H215O PET study.

    Science.gov (United States)

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

    2006-10-01

    Speech-related changes in regional cerebral blood flow (rCBF) were measured using H(2)(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 and during production of continuous narrative speech and whispered speech. Speech was recorded during scan acquisition for offline quantification of voice breaks, pitch breaks, and percentage aperiodicity to assess correlations between treatment-related changes in rCBF and clinical improvement. Results demonstrated that speech-related responses in heteromodal sensory areas were significantly reduced in persons with ADSD, compared with volunteers, before the administration of BTX. Three to 4 weeks after BTX injection, speech-related responses were significantly augmented in these regions and in left hemisphere motor areas commonly associated with oral-laryngeal motor control. This pattern of responses was most strongly correlated with the objective measures of clinical improvement (decreases in the frequency of voice breaks, pitch breaks, and percentage aperiodicity). These data suggest a pathophysiological model for ADSD in which BTX treatment results in more efficient cortical processing of sensory information, making this information available to motor areas that use it to more effectively regulate laryngeal movements.

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

    Science.gov (United States)

    Djarmati, Ana; Schneider, Susanne A; Lohmann, Katja; Winkler, Susen; Pawlack, Heike; Hagenah, Johann; Brüggemann, Norbert; Zittel, Simone; Fuchs, Tania; Raković, Aleksandar; Schmidt, Alexander; Jabusch, Hans-Christian; Wilcox, Robert; Kostić, Vladimir S; Siebner, Hartwig; Altenmüller, Eckart; Münchau, Alexander; Ozelius, Laurie J; Klein, Christine

    2009-05-01

    DYT6 is a primary, early-onset torsion dystonia; however, unlike in DYT1 dystonia, the symptoms of DYT6 dystonia frequently involve the craniocervical region. Recently, two mutations in THAP1, the gene that encodes THAP (thanatos-associated protein) domain-containing apoptosis-associated protein 1 (THAP1), have been identified as a cause of DYT6 dystonia. We screened THAP1 by sequence analysis and quantitative real-time polymerase chain reaction (PCR) in 160 white patients of European ancestry who had dystonia with an early age at onset (n=64), generalised dystonia (n=35), a positive family history of dystonia (n=56), or facial or laryngeal dystonia. Another 160 patients with dystonia were screened for reported and novel variants in THAP1. 280 neurologically healthy controls were screened for the newly identified and previously reported changes in THAP1 and these and an additional 75 controls were screened for a rare non-coding mutation. We identified two mutations in THAP1 (388_389delTC and 474delA), respectively, in two (1%) German patients from the 160 patients with dystonia. Both mutation carriers had laryngeal dystonia that started in childhood and both went on to develop generalised dystonia. Thus, two of three patients with early-onset generalised dystonia with orobulbar involvement had mutations in THAP1. One of the identified patients with DYT6 dystonia had two family members with subtle motor signs who also carried the same mutation. A rare substitution in the 5'untranslated region (-236_235GA-->TT) was found in 20 of 320 patients and in seven of 355 controls (p=0.0054). Although mutations in THAP1 might have only a minor role in patients with different, but mainly focal, forms of dystonia, they do seem to be associated with early-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

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

    Institute of Scientific and Technical Information of China (English)

    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

  8. 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

    Directory of Open Access Journals (Sweden)

    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

  9. 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

    Directory of Open Access Journals (Sweden)

    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

  10. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. 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

    Directory of Open Access Journals (Sweden)

    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

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

  13. 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

    Directory of Open Access Journals (Sweden)

    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

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

    NARCIS (Netherlands)

    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

  15. 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

    Directory of Open Access Journals (Sweden)

    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.

  16. [Dysphonia following glyphosate exposition].

    Science.gov (United States)

    Ptok, M

    2009-11-01

    Glyphosate is a commonly used nonselective herbicide which inhibits plant growth through interference with the production of essential aromatic amino acids. Toxicity for humans has been reported after suicidal ingestion. Here we describe a 26-year-old teacher who used glyphosate correctly but suffered from severe dysphonia after some hours. Laryngostroboscopy revealed decreased vocal fold mobility suggesting innervation impairment. The symptoms resolved spontaneously 6 weeks later and vocal fold mobility returned to normal. Glyphosate neurotoxicity has been discussed in the literature therefore, the dysphonia observed here may have been due to an intermittent neuropraxia of the laryngeal nerve. However, to our knowledge a similar case has not been reported in literature.

  17. [Dysphonia in children].

    Science.gov (United States)

    Nicollas, R; Giovanni, A; Triglia, J-M

    2008-06-01

    Dysphonia is a frequent reason for consultation in children. Most of the time, this presentation is the consequence of a vocal abuse, however, the physician has to be aware that an organic lesion, such as laryngeal papillomatosis can exist and so perform a flexible laryngoscopy. In case of laryngeal papillomatosis, surgery and several medical treatments will be proposed for a long time. In other cases, speech therapy, sometimes associated with surgery, will be performed.

  18. Dysphonia risk screening protocol

    Directory of Open Access Journals (Sweden)

    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.

  19. [Classification of dysphonia. Vocal dysfunction].

    Science.gov (United States)

    Crevier-Buchman, L; Monfrais-Pfauwadel, M C; Laccourreye, O; Menard, M; Brasnu, D

    1993-01-01

    A review of functional dysphonia is presented, pointing out the frequent association with organic dysphonia as a releasing or an aggravating factor. Each pathology is described with its psychopathological and histological features, its clinical and psychophysiological symptoms and its treatment, most of the time based on voice therapy.

  20. Vocal therapy of hyperkinetic dysphonia

    Directory of Open Access Journals (Sweden)

    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.

  1. Spasmodic torticollis: the dental connection.

    Science.gov (United States)

    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.

  2. Vocal therapy of hyperkinetic dysphonia

    OpenAIRE

    Mumović Gordana; Veselinović Mila; Arbutina Tanja; Škrbić Renata

    2014-01-01

    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...

  3. Vocal therapy of hyperkinetic dysphonia.

    Science.gov (United States)

    Mumović, Gordana; Veselinović, Mila; Arbutina, Tanja; Škrbić, Renata

    2014-01-01

    Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. 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. 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. The subjective acoustic analysis revealed a significant (pdysphonia 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 FO and jitter %. In children, the acoustic parameters SD FO, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (pdysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

  4. Dysphonia in children.

    Science.gov (United States)

    Martins, Regina Helena Garcia; Hidalgo Ribeiro, Caio Bosquê; Fernandes de Mello, Bruno Marcos Zeponi; Branco, Anete; Tavares, Elaine Lara Mendes

    2012-09-01

    Vocal symptoms are common among the pediatric population and are often caused by vocal abuse. Laryngoscopy is essential for their diagnosis because it helps differentiate several laryngeal lesions, leading to a decision for suitable treatments considering each case. This study aims to present the clinical characteristics, and the laryngoscopic diagnosis of a dysphonic child population. The parents of 304 children, aged from 4 to 18 years and presenting prolonged hoarseness, answered a questionnaire about their children's voice, and all children were subjected to videolaryngostroboscopy. Male children aged from 7 to 12 years (64%) were predominant. Vocal abuse (n-162) and nasal obstruction symptoms (n-10) were the most frequent associated symptoms. The vocal symptoms had a chronic evolution (over 1 year) and were reported by most parents (n-200). The most commonly diagnosed lesions in the laryngoscopic exams were vocal nodules (n-175) and epidermal cysts (n-47). Furthermore, there was an association of some lesions, especially minor structural alterations. In the present study, dysphonia occurred mainly in children aged from 7 to 12 years, predominantly males. Vocal abuse and nasal obstruction symptoms were frequently reported. Vocal nodules and cysts were the most commonly diagnosed laryngeal lesions in the laryngoscopic exams. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  5. Clinical evaluation of functional dysphonia.

    Science.gov (United States)

    Monday, L A

    1983-10-01

    Functional dysphonia is a voice impairment without any organic lesion of the phonating system. It may be classified into two categories: functional dysphonia itself where no lesions are found and functional laryngopathies where vocal cord lesions may be attributed to vocal abuse or misuse. The clinical evaluation of a dysphonic patient is performed in three steps: history taking, vocal evaluation, and examination. History taking helps the diagnosis and may be considered also as a therapeutic procedure. Vocal evaluation is oriented toward the voice itself and how it is produced. Then an ENT examination is performed with special attention to the larynx. In functional dysphonia, usually, everything looks normal but there may be signs of inflammation, hyperkinetism, hypokinetism, excessive laryngeal movements, etc. Functional laryngopathies include vocal nodules, laryngitis, polyps, and contact ulcer.

  6. The hip abductors at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, A., E-mail: adrienne.hoffmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland); Pfirrmann, C.W.A., E-mail: christian.pfirrmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland)

    2012-12-15

    Imaging of the hip abductors plays an increasing role for the evaluation of greater trochanteric pain in patients with and without total hip arthroplasty. This review article addresses the anatomy of the hip abductors and their intervening bursae. It highlights different possible imaging appearances such as tendinopathy or partial and full thickness tears of the gluteal tendons. Muscle atrophy or fatty degeneration of the gluteal muscles is an important reason for limping. Inflammatory diseases such as hydroxyapatite crystal deposition disease or spondylarthritis have to be considered. Knowledge of these different entities is important to achieve optimal treatment and outcomes.

  7. A rare anomaly of abductor digiti minimi.

    Science.gov (United States)

    Sañudo, J R; Mirapeix, R M; Ferreira, B

    1993-06-01

    Two cases with anomalous fascicles in abductor digiti minimi, noted in the course of dissecting 62 adult postmortem forearms, are described. Both fascicles arose from the flexor retinaculum and the antebrachial fascia; one was inserted into abductor digiti minimi and the other on the proximal phalanx of the 5th finger. The anomalous muscles crossed the ulnar nerve and in 1 case also the median nerve. In the 2nd case the palmar nerve to the 5th finger was seen to penetrate the anomalous muscle. The ontogeny, morphology and clinical significance of this anomaly are discussed in relation to previously described anomalies of the hypothenar muscles.

  8. Spasmodic torticollis: a behavioral perspective

    Energy Technology Data Exchange (ETDEWEB)

    Martin, P.R.

    1982-06-01

    The literature on spasmodic torticollis is critically reviewed. The currently most popular etiological hypothesis characterizes torticollis as an extrapyramidal disorder, the symptoms of which are aggravated by stress, but there is no unequivocal evidence available to support this view. Psychological mechanisms have been suggested but not elaborated or tested in any detail. A wide range of treatments has been advocated but controlled studies have not been reported, and the problems of assessing outcome have never been tackled adequately. Behavioral treatments have been evaluated more rigorously than other approaches (particularly EMG feedback training), and the literature suggests that they benefit some patients. It is argued that psychologists have the potential for making a very significant contribution to the understanding and management of torticollis. In discussing outcome measures, the more promising techniques that have been used are summarized and a list is presented of the factors which must be considered when assessing torticollis symptoms. Directions for future research are outlined and priorities suggested.

  9. Lesion of the hip abductor mechanism

    Directory of Open Access Journals (Sweden)

    Caviglia Horacio

    2016-01-01

    Full Text Available Introduction: The disruption of the abductor muscles of the hip after hip revision surgery often causes limping, pain, and instability of the implant. The purpose of our paper is to describe a mesh technique to repair hip abductor mechanism injuries after hip revision. Patients and methods: Forty-six patients with hip abductor damage after prosthetic revision were treated. Inclusion criteria were: patients presenting with prosthetic loosening, complaint of pain, and with a positive Trendelenburg sign due to deficient abductor muscle mechanisms. Thirty-one were women (67.39% with an average age of 64 years (34–82 years. The number of previous revision surgeries was three (two to seven. The Merle d’Aubigné score and variants before and after treatment were also reported. Results: In the postoperative follow-up after hip revision with the mesh technique, the Merle d’Aubigné score improved and the Trendelenburg sign was negative in 78.3% of the patients (p < 0.001. Also, the Trendelenburg test with the knee flexed was negative in 60.9% (p < 0.001 and the stair-climbing test was negative in 60.9% of cases (p < 0.001. The gluteus medius test in the lateral position was negative in 52.2% of patients, and in the lateral position with the knee flexed it was negative in 47.8% of patients (p < 0.001. Discussion: Repair of the abductor mechanism with the mesh technique has proven effective for both partial and total lesions.

  10. [Dysphonia in children and adolescents].

    Science.gov (United States)

    Fuchs, M; Meuret, S; Stuhrmann, N C; Schade, G

    2009-06-01

    Hoarseness is the leading symptom of dysphonia among children and adolescents. The incidence is evaluated internationally to be 6-25%. In an overview the hereditary and acquired organic and functional causes including secondary organic lesions of the vocal folds, the pathomechanisms and the symptoms typical for this age group are presented. In clinical routine, symptoms of dysphonia in children and adolescents should be consciously looked for and any long-term hoarseness should be examined by specialized physicians, even in this age group, using methods suitable to the age group and the developmental stage. When the appropriate indications are present all therapeutic options currently available should be taken into consideration. Furthermore, this paper provides information for the parents concerning the imminent phoniatric examination.

  11. [Clinical features of spastic dysphonia].

    Science.gov (United States)

    Vasilenko, Iu S; Golubev, V L; Debrianskaia, M B

    1995-01-01

    Clinical, neurological, endoscopic, psychological findings, questionnaire data on vegetative sphere, diaphragm x-ray, articulation test and Viene test system evidence obtained on 25 patients with phonic spasm confirm organic neurological nature of spastic dysphonia as focal muscular dystonia. This condition can be accompanied with tremor, rotatory, winking and writers' spasms, oromandibular dystonia. As indicated by positive treatment outcomes, combined treatment of phonic spasm with GABA-ergic drugs of clonazepam (antelepsin) and baclofen, orthophonic voice correction, physiotherapy is pathogenetically justified.

  12. Management of dysphonia in children.

    Science.gov (United States)

    Connelly, A; Clement, W A; Kubba, H

    2009-06-01

    Dysphonia is common in children, but practice varies considerably regarding what, if any, investigations are performed and how the condition is managed. Although childhood dysphonia is mostly due to non-serious causes such as voice misuse, very serious pathology such as papillomatosis or malignancy needs occasionally to be excluded, and treatable congenital anomalies such as webs and cysts can be missed. Voice clinics and voice therapy services are now well established in most adult health services in the developed world, but equivalent services for children are less common, at least in the UK. We retrospectively reviewed the records of all children presenting to our large children's hospital with a primary complaint of dysphonia between January 2001 and October 2007, in order to determine their management, investigations and final diagnosis. We identified 142 children. Case records were found for 137 (97 per cent). Eight-three children were male (61 per cent) and 54 female (39 per cent). Ages ranged from two months to 15 years (median 5.3 years). In 10 children (7 per cent), hoarseness was congenital, presenting as a hoarse, weak cry at birth. In 15 children (11 per cent), onset of hoarseness was related to a specific surgical procedure. The larynx was visualised by mirror alone in 23 children (17 per cent), by awake fibre-optic laryngoscopy in 27 (20 per cent) and by microlaryngoscopy-bronchoscopy under anaesthesia in 42 (31 per cent). Forty children (29 per cent) did not undergo laryngeal visualisation at any time and were diagnosed based on history alone. A further five (4 per cent) were scheduled for direct laryngoscopy but this was not performed due to resolution of symptoms. Voice abuse accounted for 62 (45 per cent) of all diagnoses. Childhood dysphonia accounts for a large number of referrals. There is considerable variation in how these children are managed. A more structured approach to diagnosis and investigation would be beneficial, perhaps within the

  13. Multiple tendons of abductor pollicis longus

    Directory of Open Access Journals (Sweden)

    Mansur DI

    2010-02-01

    Full Text Available Anatomic variations of the tendons of the abductor pollicis longus (APL and its knowledge is important to assess the diseased and traumatized hand and when considering tendons for repair or graft. During routine dissection of a 63-year-old male cadaver, in the Department of Anatomy, Kasturba Medical College, Mangalore, Karnataka, India we came across an unusual APL in the right upper limb. The muscle had altogether 9 tendons and they were inserted to the lateral and anterolateral sides of the base of the 1st metacarpal bone, opponens pollicis (two tendons each, the abductor pollicis brevis, trapezium and thenar fascia (one tendon each. The number of accessory tendons of APL has functional significance in the development of de Quervain’s syndrome.

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

    Science.gov (United States)

    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…

  15. Assessment of chronic childhood dysphonia.

    Science.gov (United States)

    Mornet, E; Coulombeau, B; Fayoux, P; Marie, J-P; Nicollas, R; Robert-Rochet, D; Marianowski, R

    2014-11-01

    Chronic childhood dysphonia is a common condition in the school-age period. Perceived functional disorder is subjective and the alert is usually given by a person not belonging to the child's immediate environment. History-taking often suggests a malformation or acquired lesion. Functional assessment helps measure and diagnose the vocal impairment. Physical and endoscopic assessment in consultation is the key examination: it is only rarely impossible in children and can often found diagnosis. Additional examinations are sometimes necessary. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. Spasmodic Muscle Cramps and Wilson Disease

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-12-01

    Full Text Available Investigators at Ann & Robert H. Lurie Children's Hospital of Chicago report a case of Wilson disease (WD in a 10-year-old-boy presenting with 3 months of increasingly severe spasmodic muscle cramps and weakness in lower extremities, upper extremities, and cramps in face and chest.

  17. Vocal dose in teachers: correlation with dysphonia.

    Science.gov (United States)

    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.

  18. Section four: laryngitis and dysphonia.

    Science.gov (United States)

    Hueston, William J; Kaur, Dipinpreet

    2013-12-01

    Acute laryngitis is most often caused by viral illnesses through direct inflammation of the vocal cords or from irritation due to postnasal drainage. Bacterial infections, such as acute epiglottitis, also can cause dysphonia but typically have other systemic symptoms as well as respiratory distress. Chronic laryngitis is characterized by symptoms lasting more than 3 weeks. Chronic vocal cord issues can be related to overuse or stress on the vocal cords resulting in nodules or polyps. Individuals in certain occupations, such as singers, school teachers, and chemical workers, are at greater risk of chronic laryngitis. The diagnostic approach to chronic laryngitis should include visualization of the vocal cords to rule out potential malignant lesions. For acute and chronic overuse symptoms, the best treatment is vocal rest. The use of antibiotics or decongestants should be discouraged.

  19. Cerebral glucose metabolism in patients with spasmodic torticollis

    NARCIS (Netherlands)

    MagyarLehmann, S; Antonini, A; Roelcke, U; Maguire, RP; Missimer, J; Leenders, KL

    1997-01-01

    The pathophysiology of spasmodic torticollis is not clear. Basal ganglia dysfunction has been suggested to underlie this clinical syndrome. We studied resting cerebral glucose metabolism in 10 spasmodic torticollis patients and 10 healthy controls by using positron-emission tomography and [F-18]2-fl

  20. Vestibular hyperreactivity in patients with idiopathic spasmodic torticollis.

    OpenAIRE

    Huygen, P.L.; Verhagen, W I; Hoof, J.J. van; Horstink, M W

    1989-01-01

    Ocular motor tests performed on 14 patients with idiopathic spasmodic torticollis were normal. The vestibulo-ocular reflex tested in eight patients showed a significant high level in seven. It is suggested that this phenomenon is secondary rather than the cause of spasmodic torticollis.

  1. Attitudes of children with dysphonia.

    Science.gov (United States)

    Connor, Nadine P; Cohen, Stacy B; Theis, Shannon M; Thibeault, Susan L; Heatley, Diane G; Bless, Diane M

    2008-03-01

    Because voice disorders in childhood may have a negative impact on communicative effectiveness, social development, and self-esteem, the objective was to determine the impact of voice disorders on lives of children from the perspective of chronically dysphonic children and their parents. This study consisted of focused interviews with chronically dysphonic children and their caregivers. Focused interviews were conducted with 10 children in each of the following age groups: Toddler (2-4 years old), Young Child (5-7 years old), School-Aged Child (8-12 years old), and Adolescent (13-18 years old). Interview questions were formulated to elicit attitudes in the following conceptual domains: emotional, social/functional, and physical. Interviews were transcribed and subjected to systematic qualitative analyses that identified common themes within each age group for each conceptual domain. For Toddlers, interviews relied heavily on parents and the biggest concerns were found in the physical and functional domains. Young Children expressed that their biggest issues related to voice were physical ("run out of air," "sometimes voice does not work"). Ninety percent of Young Children were repeatedly asked to use a quieter voice. Emotional factors and physical factors were prominent in the interviews of School-Aged Children and Adolescents. Children and Adolescents often felt that their dysphonic voice received undue attention and also limited their participation in important events. Anger, sadness, and frustration were also expressed. Chronic dysphonia negatively affects the lives of children. This work will serve as the basis for development of a valid, reliable, and age-appropriate measure of voice-related quality of life in children.

  2. Parkinson's disease detection based on dysphonia measurements

    Science.gov (United States)

    Lahmiri, Salim

    2017-04-01

    Assessing dysphonic symptoms is a noninvasive and effective approach to detect Parkinson's disease (PD) in patients. The main purpose of this study is to investigate the effect of different dysphonia measurements on PD detection by support vector machine (SVM). Seven categories of dysphonia measurements are considered. Experimental results from ten-fold cross-validation technique demonstrate that vocal fundamental frequency statistics yield the highest accuracy of 88 % ± 0.04. When all dysphonia measurements are employed, the SVM classifier achieves 94 % ± 0.03 accuracy. A refinement of the original patterns space by removing dysphonia measurements with similar variation across healthy and PD subjects allows achieving 97.03 % ± 0.03 accuracy. The latter performance is larger than what is reported in the literature on the same dataset with ten-fold cross-validation technique. Finally, it was found that measures of ratio of noise to tonal components in the voice are the most suitable dysphonic symptoms to detect PD subjects as they achieve 99.64 % ± 0.01 specificity. This finding is highly promising for understanding PD symptoms.

  3. Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

    Science.gov (United States)

    Jung, Soo Yeon; Park, Hae Sang; Bae, Hasuk; Yoo, Jeong Hyun; Park, Hyung Jun; Park, Kee Duk; Kim, Han Su; Chung, Sung Min

    2017-04-01

    To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment. A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded. Among them, patients with normal EMG findings were included in this study. The patients who reported voice symptom improvement after LEMG without further treatment were placed in laryngeal MPS (LMPS) group and the other patients were placed in non-laryngeal MPS (non-MPS) group. Predisposing factors, voice symptom, symptom-duration, and stroboscopic findings of these patients were reviewed. Among the 16 patients, LEMG findings were normal, five (31%) were included in the LMPS group and the other 11 patients (69%) were included in the non-MPS group. All LMPS group patients had a history of voice abuse and reported odynophonia. The Korean Voice Handicap Index-10 score decreased significantly after US-guided LEMG without additional treatment in the LMPS group. The stroboscopic findings revealed that vocal fold hypomobility was the most common finding in the LMPS group, and two patients showed a muscle tension dysphonia pattern. The LMPS groups showed improvement of vocal fold mobility on 1-week stroboscopic evaluation. LMPS is a potential diagnosis for patients with vocal fold hypomobility finding on stroboscopic findings but with normal EMG results. Diagnosis of LMPS could be considered in patients who showed symptom and vocal fold movement improvement after LEMG. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Proton MR spectroscopy in idiopathic spasmodic torticollis

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  5. Recurrent laryngeal nerve histopathology in spastic dysphonia: a preliminary study.

    Science.gov (United States)

    Dedo, H H; Izdebski, K; Townsend, J J

    1977-01-01

    Spastic dysphonia is a severe voice disorder ordinarily described as psychogenic. Organic-neurologic changes secondary to central or peripheral nervous system involvement have also been postulated and led recently to the surgical treatment of spastic dysphonia by unilateral section of the recurrent laryngeal nerve (RLN). This study reports the histologic findings from these resections of the RLN from patients with an average 9.5 years duration of spastic dysphonia. Thirty percent of the RLNs examined demonstrated significant abnormalities as compared to age-matched controls. Although no reactive changes were noted by light microscopy, groups of fibers which did not stain for myelin or axons were found in RLNs from patients with spastic dysphonia. A preliminary ultrastructural study of these areas in one RLN revealed sheets of unmyelinated axons. These findings suggest an organic basis for spastic dysphonia at least in some patients.

  6. Exploration on the underlying mechanism of female predominance in spasmodic dysphonia: an anatomical study of nodose ganglion in rats.

    Science.gov (United States)

    Xu, Zengrui; Li, Ge; Feng, Xin

    2014-01-01

    To study the gender differences of amount of neurons in the nodose ganglions of rats. Fourteen Sprague-Dawley rats (7 males and 7 females) were selected. Bilateral nodose ganglions were dissected and serial sections of nodose ganglion were cut in a cryostat, followed by Cresyl-violet staining for neurons. Eight to ten consecutive sections from mid-portion of each nodose ganglion sample, which represent the most neuron number per section, were counted and averaged. Gender difference in the amount of neurons in the nodose ganglions was compared. No gender difference of neuron numbers was found in either side of nodose ganglion (p > 0.05). However, average neuron number of nodose ganglions on the left side of male (654 ± 60) and female (616 ± 37) were significantly more than that on the right side of male (470 ± 22) and female (453 ± 40) respectively (p < 0.05). There is no gender difference in total neuron number of nodose ganglions between male and female rat. However, the neuron number in the left nodose ganglion is greater than that in the right one. The difference may be due to the fact that left and right nodose ganglion is receiving different visceral sensory impulses separately, which is associated with different physiological functions. Further work should be carried out with retrograde tracing on neurons of nodose ganglions in an animal model, which are directly related to laryngeal sensory transmission, in order to determine the gender difference in the neuron number and morphology related to laryngeal functions.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    on to develop generalised dystonia. Thus, two of three patients with early-onset generalised dystonia with orobulbar involvement had mutations in THAP1. One of the identified patients with DYT6 dystonia had two family members with subtle motor signs who also carried the same mutation. A rare substitution...... increase the risk of dystonia. FUNDING: Deutsche Forschungsgemeinschaft; Volkswagen Foundation; Dystonia Medical Research Foundation; University of Lübeck....

  8. Distally Based Abductor Hallucis Adipomuscular Flap for Forefoot Plantar Reconstruction.

    Science.gov (United States)

    Lee, Sanglim; Kim, Min Bom; Lee, Young Ho; Baek, Jeong Kook; Baek, Goo Hyun

    2015-09-01

    Soft tissue and bone defects of the lower leg, ankle, and heel region often require coverage by local or distant flaps. The authors successfully used the distally based adipomuscular abductor hallucis flap for the treatment of 7 patients with soft tissue defect on the plantar forefoot after diabetic ulcer (n = 2), excision of melanoma at the medial forefoot (n = 3), and posttraumatic defects of the plantar forefoot (n = 2). The size of the defects ranged from 6 to 36 cm. All defects were covered successfully without major complications. The distally based adipomuscular flap from the abductor hallucis muscle provides a reliable coverage for small and moderate defects of the plantar and medial forefoot. This flap is often preferable to the use of free flaps because the surgery is rapidly performed and does not require microsurgical expertise.

  9. Rationale for Treatment of Hip Abductor Pain Syndrome

    OpenAIRE

    Bewyer, Dennis C; Bewyer, Kathryn J

    2003-01-01

    Patients with lower back or buttock pain that radiates into the posterior or lateral leg are often referred to physical therapy with a diagnosis of sciatica. Often the physical exam does not reveal neurologic findings indicative of radiculopathy. Instead, there is hip abductor muscle pain and weakness. This syndrome involves muscle imbalances that result in overuse strain of the gluteus medius and gluteus minimus muscles, myofascial trigger points, and trochanteric bursitis. This paper descri...

  10. Current evidence for the organic etiology of spastic dysphonia.

    Science.gov (United States)

    Dedo, H H; Townsend, J J; Izdebski, K

    1978-01-01

    For over 100 years it has been universally assumed in the literature that spastic dysphonia is a functional or psychoneurotic voice disorder. In the last few years, new data have accumulated that support the concept that spastic dysphonia is caused by an organic, rather than a functional, abnormality. Histologic examination of segments of the recurrent laryngeal nerve removed from patients with spastic dysphonia has revealed myelin abnormalities in 30% of the nerves examined. Neurologic examination indicated brain stem or basal ganglia disturbances in some patients who had no apparent nerve disease.

  11. Abductor weakness and stresses around acetabular components of total hip arthroplasty: a finite element analysis

    OpenAIRE

    Sutherland, A. G.; D’Arcy, S.; Smart, D; Ashcroft, G. P.

    1999-01-01

    Abductor weakness, and the resulting Trendelenburg gait, after total hip arthroplasty is believed to be associated with a poor long-term outcome. We have constructed a two-dimensional finite element analysis using load cases to mimic this abductor weakness. The finite element analysis demonstrates slightly increased stresses, particularly at the bone-cement interface in the DeLee-Charnley zone I, which does not seem sufficient to explain the adverse effect of abductor weakness.

  12. Comparison of Hip Abductor and Adductor Muscle Strength in Taekwondo and Non-taekwondo Practitioners

    OpenAIRE

    Seet Jia Sheng; Fachry Ambia Tandjung; Marietta Shanti Prananta

    2016-01-01

    Background: Taekwondo is an empty hand combat that entails the use of the whole body. Spinning and turning kicks are the proper way of kicking in taekwondo which allow one to maximally perform the hip abductor and adductor muscles simultaneously. To measure the hip abductor and adductor muscles of Taekwondo and Non-taekwondo practitioners, Hand-Held Dynamometer (HHD) is used. This study aimed to compare the hip abductor and adductor muscles strength in Taekwondo and Non-taekwondo practitioner...

  13. Surgical repair of chronic tears of the hip abductor mechanism.

    Science.gov (United States)

    Davies, Hywel; Zhaeentan, Sohelia; Tavakkolizadeh, Adel; Janes, Gregory

    2009-01-01

    Lateral sided hip pain frequently presents to the orthopaedic clinic. The most common cause of this pain is trochanteric bursitis. This usually improves with conservative treatment. In a few cases it doesn't settle and warrants further investigation and treatment. We present a series of 28 patients who underwent MRI scanning for such pain, 16 were found to have a tear of their abductors. All 16 underwent surgical repair using multiple soft tissue anchors inserted into the greater trochanter of the hip to reattach the abductors. There were 15 females and 1 male. All patients completed a self-administered questionnaire pre-operatively and 1 year post-operatively. Data collected included: A visual analogue score for hip pain, Charnley modification of the Merle D'Aubigne and Postel hip score, Oxford hip score, Kuhfuss score of Trendelenburg and SF36 scores.Of the 16 patients who underwent surgery 5 had a failure of surgical treatment. There were 4 re ruptures, 3 of which were revised and 1 deep infection which required debridement. In the remaining 11 patients there were statistically significant improvements in hip symptoms. The mean change in visual analogue score was 5 out of 10 (p=0.0024) The mean change of Oxford hip score was 20.5 (p=0.00085). The mean improvement in SF-36 PCS was 8.5 (P=0.0020) and MCS 13.7 (P=0.134). 6 patients who had a Trendelenburg gait pre-surgery had normal gait 1 year following surgery.We conclude that hip abductor mechanism tear is a frequent cause of recalcitrant trochanteric pain that should be further investigated with MRI scanning. Surgical repair is a successful operation for reduction of pain and improvement of function. However there is a relatively high failure rate.

  14. Hip abductor moment arm - a mathematical analysis for proximal femoral replacement

    Directory of Open Access Journals (Sweden)

    Temple H Thomas

    2011-01-01

    Full Text Available Abstract Background Patients undergoing proximal femoral replacement for tumor resection often have compromised hip abductor muscles resulting in a Trendelenberg limp and hip instability. Commercially available proximal femoral prostheses offer several designs with varying sites of attachment for the abductor muscles, however, no analyses of these configurations have been performed to determine which design provides the longest moment arm for the hip abductor muscles during normal function. Methods This study analyzed hip abductor moment arm through hip adduction and abduction with a trigonometric mathematical model to evaluate the effects of alterations in anatomy and proximal femoral prosthesis design. Prosthesis dimensions were taken from technical schematics that were obtained from the prosthesis manufacturers. Manufacturers who contributed schematics for this investigation were Stryker Orthopaedics and Biomet. Results Superior and lateral displacement of the greater trochanter increased the hip abductor mechanical advantage for single-leg stance and adduction and preserved moment arm in the setting of Trendelenberg gait. Hip joint medialization resulted in less variance of the abductor moment arm through coronal motion. The Stryker GMRS endoprosthesis provided the longest moment arm in single-leg stance. Conclusions Hip abductor moment arm varies substantially throughout the hip's range of motion in the coronal plane. Selection of a proximal femur endoprosthesis with an abductor muscle insertion that is located superiorly and laterally will optimize hip abductor moment arm in single-leg stance compared to one located inferiorly or medially.

  15. Objective Voice Parameters and Self-Perceived Handicap in Dysphonia

    OpenAIRE

    Hummel, Christina; Scharf, Manuela; Schützenberger, Anne; Graessel, Elmar; Rosanowski, Frank

    2013-01-01

    Objective: This study focuses on the relation between objective voice quality and the self-perception of a voice handicap. Patients and Methods: The study group consisted of 86 German-speaking patients (51 women, 35 men) suffering from benign dysphonia. The test persons completed the German version of the Voice-Related Quality of Life (V-RQOL) Questionnaire without prior information about their diagnosis and underwent voice analysis with the Dysphonia Severity Index (DSI) being the parameter ...

  16. Defining the psychiatric role in spastic dysphonia.

    Science.gov (United States)

    Ginsberg, B I; Wallack, J J; Srain, J J; Biller, H F

    1988-03-01

    The authors evaluated 11 surgically-treated patients with spastic dysphonia, a phonation disorder of unclear etiology. The results indicate that the illness does not appear to be a somatoform disorder, but that stress may play a role in its expression, and that there may be secondary depression and anxiety. The experience of spastic dysphonics suggests that psychiatric treatments may be inappropriately applied to an illness without clear organic etiology, whereas, conversely, a proper psychiatric role may be rejected when effective medical or surgical treatment is available. The authors recommend that psychiatrists evaluating patients with illnesses of unclear etiology should be cautious in making a primary psychiatric diagnosis unless DSM-III criteria are met.

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

    Directory of Open Access Journals (Sweden)

    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. SELECTIVE LARYNGEAL ABDUCTOR REINNERVATION IN CATS USING A PHRENIC-NERVE TRANSFER AND ORG-2766

    NARCIS (Netherlands)

    MAHIEU, HF; VANLITHBIJL, JT; GROENHOUT, C; TONNAER, JADM; DEWILDE, P

    1993-01-01

    Reinnervation of the recurrent laryngeal nerve following nerve injury often leads to laryngeal synkinesis. Selective reinnervation of adductor and abductor muscles might be able to avoid synkinesis. This study presents the results of selective abductor reinnervation in cats, using a phrenic nerve tr

  19. [Diagnosis of non-organic dysphonia in adult].

    Science.gov (United States)

    Crevier-Buchman, L; Tessier, Ch; Sauvignet, A; Brihaye-Arpin, S; Monfrais-Pfauwadel, M-Cl

    2005-01-01

    Non organic dysphonia or functional voice disorders are the consequence of a vocal misuse or overuse with inefficient oral communication. Any stage of voice production can be altered. A review of physiopathological, aerodynamic and biomechanical mechanisms will help to understand the onset of dysphonia. Organic lesions as a consequence of functional voice disorders are frequent but the link is not easy to establish. It is important to look for various physiologic, anatomic, environmental, behavioural and infectious factors that could induce or aggravate non organic dysphonia, as they can benefit from specific treatment. A thorough functional and organic assessment is the first step of the rehabilitation process, taking into account the patient's expectations about his voice handicap.

  20. [Functional dysphonia: relation with personality and ICD-10 criteria].

    Science.gov (United States)

    Carvajal, C; Sanfuentes, M T; Eva, P; Jara, C; Lolas Stepke, F

    1992-03-01

    The International Classification of Diseases, 10th. revision (ICD-10) in the category F45 defines the somatoform disorder as a mental disease characterized by the reiterative presentation of somatic symptoms in absence of an organic disease, or the somatic pathology being insufficient to explain the intensity of the symptoms as well as the discomfort and preoccupation of the patient. Fifteen female teachers with functional dysphonia were studied by means of a semistructured interview and psychometric evaluations. Considering dysphonia as the principal symptom, the most frequent diagnosis, in accordance with ICD-10 was "Other somatoform disorder" (F-45.8)(9/15). Five patients were diagnosed as motor dissociative disorder (F-44.4). All the patients had some abnormality of personality (5 with personality disorder and 10 with exacerbation of personality traits). The criteria of ICD-10 to classify the functional dysphonia as Somatoform disorder are discussed. It is suggested that certain personality traits are facilitators for somatization.

  1. Functional dysphonia: strategies to improve patient outcomes

    Science.gov (United States)

    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

  2. Dysphonia in extremely preterm children: A longitudinal observation.

    Science.gov (United States)

    Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel

    2016-12-01

    Dysphonia is a potential long-term complication of preterm birth. Childhood voice disorders caused by vocal hyperfunction resolve with pubertal changes to the vocal mechanism in many cases. In extremely preterm children, whose voice quality is affected by supraglottic hyperfunction adapted secondary to underlying structural laryngeal pathology sustained during neonatal intubation, the prognosis is unknown. A pilot study was conducted to assess the incidence and severity of dysphonia in children born at dysphonia severity scores were significantly lower on repeat assessment, but no differences were observed in objective or quality of life scores. Individual variation was observed: the difference in CAPE-V scores ranged from -36 to + 1. No participant presented with normal voice quality on repeat assessment. Analysis of group data masked individual variability in this series. Mechanisms underlying such individual variation are currently unknown. These data suggest that dysphonia is persistent in extremely preterm children. Further investigation is warranted to elucidate the progression of voice disorders in extremely preterm children, to inform prognostic predictors and treatment decisions.

  3. Late repair of abductor avulsion after the transgluteal approach for hip arthroplasty.

    Science.gov (United States)

    Miozzari, Hermes H; Dora, Claudio; Clark, John M; Nötzli, Hubert P

    2010-04-01

    The abductor release sometimes does not heal after a transgluteal approach for hip arthroplasty. Factors influencing the success of subsequent repair are unclear. We used magnetic resonance imaging (MRI) to compare the condition of the gluteus medius with clinical outcome after late repair of abductor dehiscence in 12 total hip patients. Evaluation included a pain rating, gait evaluation, Trendelenburg test, strength grading, and Harris Hip Score. Most had both prerepair and postrepair MRI studies to assess the repair and to grade abductor muscle fatty degeneration. Two repairs without MRI were explored surgically. Although average pain, limp, and strength scores improved significantly, rerupture occurred in 4 subjects and fatty degeneration in the gluteus medius did not improve, even with intact repair. Nine patients were satisfied; 7 of these had an intact repair. Magnetic resonance imaging and operative observations suggest that chronic degeneration in the abductor mechanism is the major impediment to successful repair.

  4. Laser Posterior Cordotomy: Is it a Good Choice in Treating Bilateral Vocal Fold Abductor Paralysis?

    National Research Council Canada - National Science Library

    Khalil, Mahmoud A; Abdel Tawab, Hazem M

    2014-01-01

    .... To assess the efficacy of CO2 laser unilateral posterior cordotomy in cases with bilateral abductor paralysis as regards improvement of dyspnea with preservation of satisfactory voice and swallowing after the operation...

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Hip abductor weakness is not the cause for iliotibial band syndrome.

    Science.gov (United States)

    Grau, S; Krauss, I; Maiwald, C; Best, R; Horstmann, T

    2008-07-01

    Muscular deficits in the hip abductors are presumed to be a major factor in the development of Iliotibial Band Syndrome in runners. No definite relationship between muscular weakness of the hip abductors and the development of Iliotibial Band Syndrome or different ratios between hip adduction to abduction have been reported so far. Isokinetic measurements were taken from 10 healthy runners and 10 runners with Iliotibial Band Syndrome. Primary outcome variables were concentric, eccentric, and isometric peak torque of the hip abductors and adductors at 30 degrees/s, and a concentric endurance quotient at the same angle velocity. Differences in muscle strength of the hip abductors between healthy (CO) and injured runners (ITBS) were not statistically significant in any of the muscle functions tested. Both groups showed the same strength differences between hip adduction and abduction, and increased strength in hip adduction. Weakness of hip abductors does not seem to play a role in the etiology of Iliotibial Band Syndrome in runners, since dynamic and static strength measurements did not differ between groups, and differences between hip abduction and adduction were the same. Strengthening of hip abductors seems to have little effect on the prevention of Iliotibial Band Syndrome in runners.

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

    Digital Repository Service at National Institute of Oceanography (India)

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

    A C37 carotenoid pigment, peridininol, isolated from a marine Zoanthus sp. exhibited promising anti-spasmodic activity against nicotine and serotonin in in vitro studies using guinea pig ileum. Its purification and structure are presented along...

  8. Laryngeal Reinnervation for Paralytic Dysphonia in Children Younger Than 10 Years

    National Research Council Canada - National Science Library

    Smith, Marshall E; Roy, Nelson; Houtz, Dan

    2012-01-01

    OBJECTIVE To study the effectiveness of ansa–recurrent laryngeal nerve laryngeal reinnervation to improve glottal incompetence causing dysphonia and dysphagia for children with unilateral vocal fold paralysis...

  9. [Dysphonia in children due to congenital laryngeal web. Case series].

    Science.gov (United States)

    Rodríguez, Hugo; Cuestas, Giselle; Zanetta, Adrián

    2013-01-01

    Dysphonia is common in children. Its main cause is the abuse or misuse of the voice. Congenital, neoplastic, infectious, neurological or iatrogenic causes are less frequent. The laryngeal web is a rare congenital anomaly resulting from an incomplete recanalization of the primitive larynx. This condition should be suspected in any newborn with dysphonic cry with or without stridor and respiratory distress. The diagnosis is confirmed by endoscopic examination. Therapy depends on the extent and thickness of the membrane and the severity of the symptoms. We describe our experience with 8 patients suffering this condition, and we emphasize the need to recognize voice disorders and to evaluate the airway for accurate diagnosis and appropriate treatment in every newborn, infant or child with persistent dysphonia.

  10. Managing dysphonia in paediatric patients with complex airway conditions.

    Science.gov (United States)

    Ojha, S; Setlur, J; Bunting, G; Hartnick, C J

    2015-08-01

    To suggest a phonosurgical management strategy that can be used for children who have previously undergone laryngotracheal reconstruction. This cases series describes three children who presented with complex, multi-level airway stenosis and marked dysphonia. Phonosurgical intervention involved endoscopic and open approaches, and was combined with voice therapy. A phonosurgical reconstruction management algorithm is suggested for evaluating and treating these complex conditions. Pre-operative assessment is critical, and should involve voice analysis and glottal anatomy assessment using office laryngoscopy and stroboscopy. The risks must be weighed up against the benefit of vocal improvement. Surgical intervention should involve combined endoscopic and open approaches. Voice restoration after paediatric airway reconstruction is a complex challenge. Surgical intervention should be conducted in a step-by-step manner to reduce the risk of worsening dysphonia and airway compromise. The risks and benefits must be carefully explored and discussed.

  11. [Epidemiological survey of dysphonia in children at primary school entry].

    Science.gov (United States)

    Lecoq, M; Drape, F

    1996-01-01

    The study of 259 children in primary school revealed a prevalence of dysphonia of 10%, often undiagnosed, untreated or considered as benign. It would seem desirable to draw attention to this symptom, which may be an indication of organic pathology or of psychological problems, the early treatment of which may avoid later sequelae. It is sometimes necessary to allow a period for reflection in order to gain the cooperation of the child and his parents.

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

    OpenAIRE

    Bożena Kosztyła-Hojna; Diana Moskal; Anna Kuryliszyn-Moskal; Ryszard Rutkowski

    2014-01-01

    [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...

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

    OpenAIRE

    Paulauskienė Iveta; Mickevičienė Vaiva

    2016-01-01

    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 (functio...

  14. Vocal nodules in a colombian teachers group with dysphonia

    Directory of Open Access Journals (Sweden)

    Andrés Felipe Alvarado Díaz

    2013-12-01

    Full Text Available Objectives: This study determined the prevalence of vocal nodules associated with dysphonia in teachers aged from 35 to 65 years, taking into consideration both individual and occupational variables. Methodology: Descriptive study that included the information contained in 262 medical records of teachers diagnosed with dysphonia in occupational health consultations at the institutions that provide health services in Bogotá, Colombia from March 2009 to March 2012. The presence of laryngeal nodules was based on the findings of a nasofibrolaryngoscopy procedure. Results: Nodules were found in 67 teachers, which corresponded to a rate of 25.5%, being apparently (highest observed rates associated primarily with the following variables: females, ages from 45 to 54 years, bilateral nodules, and teaching position (preschool and physical education. Of the teachers with nodules, 76.1% had fewer than five doctor's appointments, and 75% had more than 90 days of sick leave. Conclusion: A high percentage of teachers have vocal nodules associated with dysphonia. This may be apparently related to different variables such as sex, type of nodule, area and teaching position. Was observed only a statistically significant association among presence of nodules and age (p=0.018. In addition this disorder generates a large number of incapacities and employee absenteeism.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Treatment of spastic dysphonia by recurrent laryngeal nerve section.

    Science.gov (United States)

    Barton, R T

    1979-02-01

    The problem of management of patients with spastic dysphonia has been complicated by a general resistance to speech therapy, psychotherapy, hypnotherapy, and drug therapy. Dedo introduced the concept of recurrent laryngeal nerve section in an attempt to eliminate the hyperfunction and excessive adduction of the vocal folds. Eleven patients were treated by RLN section with satisfactory results in 8 and some improvement in the other 3. The operation was found to be generally uncomplicated and required on average 4 days of hospitalization. Dedo's theory that spastic dysphonia is caused by a neurotropic viral-induced proprioceptive nerve deficit represents a new search for organic cause. His most recent report of finding unmyelinated fibres in one-third of the resected recurrent laryngeal nerves is of questionable significance. The evidence of deep emotional conflict and/or compulsive life-style is found in the majority of the patients, but the syndrome is not typical of an hysterical or conversion neurosis. Regardless of etiologic theory, RLN section is an effective treatment in selected, long-standing, and resistant instances of spastic dysphonia.

  17. The prevalence of childhood dysphonia: a cross-sectional study.

    Science.gov (United States)

    Carding, Paul N; Roulstone, Sue; Northstone, Kate

    2006-12-01

    There is only very limited information on the prevalence of voice disorders, particularly for the pediatric population. This study examined the prevalence of dysphonia in a large cohort of children (n = 7389) at 8 years of age. Data were collected within a large prospective epidemiological study and included a formal assessment by one of five research speech and language therapists as well as a parental report of their child's voice. Common risk factors that were also analyzed included sex, sibling numbers, asthma, regular conductive hearing loss, and frequent upper respiratory infection. The research clinicians identified a dysphonia prevalence of 6% compared with a parental report of 11%. Both measures suggested a significant risk of dysphonia for children with older siblings. Other measures were not in agreement between clinician and parental reports. The clinician judgments also suggested significant risk factors for sex (male) but not for any common respiratory or otolaryngological conditions that were analyzed. Parental report suggested significant risk factors with respect to asthma and tonsillectomy. These results are discussed in detail.

  18. Self-reported impact of dysphonia in a primary care population: an epidemiological study.

    Science.gov (United States)

    Cohen, Seth M

    2010-10-01

    This study's objectives are to 1) to assess the prevalence of dysphonia in the primary care community, 2) evaluate the severity of dysphonia, 3) explore potential risk factors for dysphonia, 4) examine the treatment of dysphonic patients, and 5) assess treatment-related barriers. The hypotheses are that 1) dysphonia is common in the primary care community, 2) it adversely impacts patients' quality of life (QOL), and 3) patients are underevaluated and experience obstacles with respect to seeking treatment. Cross-sectional, practice-based study in the primary care population. English-speaking patients 18 years of age and older were recruited from a primary care research network. Patients presenting to their primary care practices were given a packet of questionnaires to complete that documented demographic information, risk factors, presence of dysphonia, prior treatment, and reasons for not seeking treatment. The Voice-Related Quality of Life (VRQOL) and Center for Epidemiological Studies-Depression Scale (CES-D) served as quality-of-life outcome measures. A priori sample size calculations were performed indicating a sample size of 780. Univariate analyses, descriptive statistics, odds ratios and 95% confidence intervals, and multivariate analyses were performed. A total of 789 patients with a mean age of 49.9 years and range of 18 to 94 years participated. Lifetime prevalence of dysphonia was 29.1%, point prevalence of dysphonia 7.5%, and 4.3% had had dysphonia for >4 weeks. Of those with current dysphonia, only 46% had not missed work. Of those with current dysphonia, 73.3% had had dysphonia more than once. Patients with dysphonia had lower VRQOL scores and higher CES-D scores (t test, P ≤.001). Risk factors for dysphonia and impaired VRQOL on multivariate analysis included neurologic disease, dry mouth, family history of dysphonia, college or postgraduate level education, allergies or sinus problems, neck pain, medication for depression/anxiety, more than three

  19. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Tan Jixiang; Chen Hong; Chen Cheng; Liang Xi; Huang Wei

    2014-01-01

    Objective:To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA) patients undergoing anterolateral minimally invasive (ALMI) approach,and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF) patients than in non-femoral neck fracture (nFNF) patients.Methods:A total of 48 patients were enrolled in this study.Each patient underwent a clinical examination preoperatively and 6,12,24 and 48 weeks postoperatively.The abductor torque,Trendelenburg's sign,gait velocity,Harris hip score,Oxford hip score,Westren Ontario and McMaster Universities (WOMAC) score and visual analog scale pain score were recorded.Statistical evaluation was performed with SPSS software version 18.0.The significance level was set at P<0.05.Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up.Gait velocity,Harris hip score,Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively.In the FNF group,the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively,however,as time passed,this trend tended to disappear.Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis,rheumatoid arthritis,avascular necrosis of the femoral head could be significantly improved following ALMI THA.

  20. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Tan Jixiang

    2014-04-01

    Full Text Available Objective: To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA patients undergoing anterolateral minimally invasive (ALMI approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF patients than in non-femoral neck fracture (nFNF patients. Methods:A total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg's sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities (WOMAC score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P<0.05. Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear. Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA. Key words: Arthroplasty, replacement, hip; Surgical procedures, minimally invasive; Recovery of function

  1. Isolated bilateral absence of abductor pollicis brevis and opponens pollicis muscles: A case report

    Directory of Open Access Journals (Sweden)

    Cihan Sahin

    2016-04-01

    Full Text Available We report a rare case of a 21-year-old man with a bilateral absence of abductor pollicis brevis and opponens pollicis muscles, which has not been previously reported. He presented with weakness in both of his hands. On physical examination there was atrophy on the thenar eminences of both of his hands and there was an absence of gross functional impairment in his hand functions. On magnetic resonance imaging, abductor pollicis brevis and opponens pollicis muscles were bilaterally absent. [Hand Microsurg 2016; 5(1.000: 29-31

  2. Magnetically Controlled Spasmodic Accretion during Star Formation. II. Results

    Science.gov (United States)

    Tassis, Konstantinos; Mouschovias, Telemachos Ch.

    2005-01-01

    The problem of the late accretion phase of the evolution of an axisymmetric, isothermal magnetic disk surrounding a forming star has been formulated in a companion paper. The ``central sink approximation'' is used to circumvent the problem of describing the evolution inside the opaque central region for densities greater than 1011 cm-3 and radii smaller than a few AU. Only the electrons are assumed to be attached to the magnetic field lines, and the effects of both negatively and positively charged grains are accounted for. After a mass of 0.1 Msolar accumulates in the central cell (forming star), a series of magnetically driven outflows and associated outward-propagating shocks form in a quasi-periodic fashion. As a result, mass accretion onto the protostar occurs in magnetically controlled bursts. We refer to this process as spasmodic accretion. The shocks propagate outward with supermagnetosonic speeds. The period of dissipation and revival of the outflow decreases in time, as the mass accumulated in the central sink increases. We evaluate the contribution of ambipolar diffusion to the resolution of the magnetic flux problem of star formation during the accretion phase, and we find it to be very significant albeit not sufficient to resolve the entire problem yet. Ohmic dissipation is completely negligible in the disk during this phase of the evolution. The protostellar disk is found to be stable against interchange-like instabilities, despite the fact that the mass-to-flux ratio has temporary local maxima.

  3. Magnetically Controlled Spasmodic Accretion During Star Formation. II. Results

    CERN Document Server

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

    2004-01-01

    The problem of the late accretion phase of the evolution of an axisymmetric, isothermal magnetic disk surrounding a forming star has been formulated in a companion paper. 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 and radii smaller than a few AUs. Only the electrons are assumed to be attached to the magnetic field lines, and the effects of both negatively and positively charged grains are accounted for. After a mass of 0.1 solar mass accumulates in the central cell (forming star), a series of magnetically driven outflows and associated outward propagating shocks form in a quasi-periodic fashion. As a result, mass accretion onto the protostar occurs in magnetically controlled bursts. We refer to this process as spasmodic accretion. The shocks propagate outward with supermagnetosonic speeds. The period of dissipation and revival of the outflow decreases in time, as the mass accumulated in ...

  4. De Quervain disease caused by abductor pollicis longus tenosynovitis: a report of three cases.

    Science.gov (United States)

    Maruyama, Masahiro; Takahara, Masatoshi; Kikuchi, Noriaki; Ito, Kazuo; Watanabe, Tadayoshi; Ogino, Toshihiko

    2009-01-01

    De Quervain disease is caused by a stenosing tenosynovitis in the first dorsal compartment, and the main aetiology is extensor pollicis brevis (EPB) tenosynovitis. We encountered three cases in which EPB tenosynovitis was absent and abductor pollicis longus (APL) tenosynovitis was confirmed during operation. In the treatment of de Quervain disease, APL tenosynovitis should be paid as much attention as EPB tenosynovitis.

  5. [Personality and coping with stress in patients with functional dysphonia].

    Science.gov (United States)

    Freidl, W; Egger, J; Friedrich, G

    1989-08-01

    The study was done to prove the etiopathogenetical power of some personality traits, proceeding life events, and strain effects when exposed to an experimental work-stress. 20 functional dysphonics, 14 individuals suffering from organic voice disorders and a group of 20 control persons were examined. The results show that the group of functional dysphonics produced a significant more positive self-evaluation regarding their personality with a clear tendency to restraint. Compared to the control group they showed a higher level of state anxiety in situations causing stress. Furthermore the influence of proceeding life events for the etiopathogenesis of functional dysphonia has become clear.

  6. Resisted side-stepping: the effect of posture on hip abductor muscle activation

    Science.gov (United States)

    Berry, Justin W.; Lee, Theresa S.; Foley, Hanna D.; Lewis, Cara L.

    2016-01-01

    Study Design Controlled laboratory study, repeated-measures design. Objectives To compare hip abductor muscle activity and hip and knee joint kinematics in the moving limb to the stance limb during resisted side-stepping and also to determine if muscle activity was affected by the posture (upright standing versus squat) used to perform the exercise. Background Hip abductor weakness has been associated with a variety of lower extremity injuries. Resisted side-stepping is often used as an exercise to increase strength and endurance of the hip abductors. Exercise prescription would benefit from knowing the relative muscle activity level generated in each limb and for different postures during the side-stepping exercise. Methods Twenty-four healthy adults participated in this study. Kinematics and surface electromyographic (EMG) data from the gluteus maximus, gluteus medius, and tensor fascia lata (TFL) were collected as participants performed side-stepping with a resistive band around the ankle while maintaining each of 2 postures: 1) upright standing and 2) squat. Results Mean normalized EMG signal amplitude of the gluteus maximus, gluteus medius, and TFL was higher in the stance limb than the moving limb (P≤.001). Gluteal muscle activity was higher, while TFL muscle activity was lower, in the squat posture compared to the upright standing posture (P<.001). Hip abduction excursion was greater in the stance limb than in the moving limb (P<.001). Conclusions The 3 hip abductor muscles respond differently to the posture variations of side-stepping exercise in healthy individuals. When prescribing resisted side-stepping exercises, therapists should consider the differences in hip abductor activation across limbs and variations in trunk posture. PMID:26161629

  7. Abductor tendon tears are associated with hypertrophy of the tensor fasciae latae muscle.

    Science.gov (United States)

    Sutter, Reto; Kalberer, Fabian; Binkert, Christoph A; Graf, Nicole; Pfirrmann, Christian W A; Gutzeit, Andreas

    2013-05-01

    To evaluate the association between hypertrophy of the tensor fasciae latae muscle and abductor tendon tears. Thirty-five patients who underwent MRI of the abductor tendons of the hip were included in this retrospective study. A subgroup of 18 patients was examined bilaterally. The area of the tensor fasciae latae muscle and the area of the sartorius muscle (size reference) were quantified at the level of the femoral head, and a ratio was calculated. Two radiologists assessed the integrity of the gluteus medius and minimus tendon in consensus. Data were analyzed with a Mann-Whitney U test. Sixteen out of 35 patients (46 %) had a tear of the gluteus medius or minimus tendon. The ratio of the area of the tensor fasciae latae to the sartorius muscle was significantly higher (p = .028) in the group with an abductor tendon tear (median 2.25; Interquartile Range [IQR] = 1.97-3.21) compared to the group without any tears (median 1.91; IQR = 1.52-2.26). The bilateral subanalysis showed that in patients without a tear, the ratio of the two areas did not differ between each side (p = .966), with a median of 1.54 (primary side) and 1.76 (contralateral side). In patients with an abductor tendon tear the ratio was significantly higher (p = .031) on the side with a tear (median 2.81) compared to the contralateral healthy side (1.67). Patients with abductor tendon tears showed hypertrophy of the tensor fasciae latae muscle when compared to the contralateral healthy side and to patients without a tear.

  8. EFFECT OF HIP ABDUCTOR STRENGTHENING AMONG NON-PROFESSIONAL CYCLISTS WITH ILIOTIBIAL BAND FRICTION SYNDROME

    Directory of Open Access Journals (Sweden)

    Jayanta Nath

    2015-02-01

    Full Text Available Background and Objectives: The study was carried out to find out the effect of hip abductor strengthening among non-professional cyclists with iliotibial band friction syndrome. Subjects: 40 non-professional cyclists with ipsilateral ITBFS subject including male and female age between 18 to 50 with positive ober’s and nobble test were included in this study. Methods: 40 subject were selected according to the inclusion criteria and they were assessed pre and post for ROM (hip adduction, IR, hip abductor strength and pain using goniometer,sphygmomanometer and VAS. Subject were assign experimental group(group A 20 subject who received IT band stretching,US,and hip abductor strengthening exercise and control group (group B 20 subject who received same treatment except hip abductor strengthening. Data Analysis and Results: Based on statistical analysis using Wilcoxon test to compare the pre and post test pain in both group,Mann- whitney U- test to compare the post test pain scores of between groups ,Paired t - test to compare the pre and post ROM and strength in both groups, Unpaired t – test to compare post test ROM in between groups showed that pre post difference within group A there was significant difference for adduction ROM (p value <.0001,IR (p value <.0001,VAS(p value <.0001,and strength improve pre mean 40.80 to post mean 66.30 (p value <.0001.However in group B adduction ROM and VAS were found to be significant. In comparision in difference between groups it was found that adduction ROM,IR ROM,VAS and strength all were significant. Baseline data for outcome variable were not statistically significant. Conclusion: Based on outcome variable there was significant difference of hip abductor strengthening among non-professional cyclist with iliotibial band friction syndrome.

  9. [Persistent dysphonia showing a laryngeal foreign body in a child].

    Science.gov (United States)

    Hammoudi, K; Bakhos, D; Bakhos-Merieau, E; Pondaven, S; Lescanne, E

    2011-07-01

    Inhalation of a laryngotracheobronchial foreign body is a common pediatric emergency situation. It is a source of morbidity and even mortality, especially among children under 3 years of age. A 14-month-old child presented suddenly combining bitonal dysphonia and dyspnea. Given the persistence of symptoms after 1.5 months and the normality of examinations requested by his doctor (pH, cervical ultrasonography, cervical and thoracic radiography), an ENT opinion was sought. An aerodigestive tract endoscopy was carried out in the emergency setting, finding a glottic foreign body associated with subglottic granulomas. The foreign body extraction led to the immediate disappearance of dyspnea. Dysphonia gradually improved under Budesonide aerosols. The lack of penetration syndrome in the interrogation and non specific symptoms may lead to an important diagnosis and treatment delay with dramatic consequences in case of airway foreign body. Endoscopy under general anesthesia must be practiced if there is any doubt for a thorough examination of the airways. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  10. 痉挛性斜颈的治疗%Summary Treatment of Spasmodic Torticollis

    Institute of Scientific and Technical Information of China (English)

    吴赞华

    2014-01-01

    Spasmodic torticol is has a complex pathogenesis, clinical manifestations are diverse characteristics, in order to al eviate the patient's condition, the clinic should actively explore ef ective methods of treatment. This paper analyzes the dif erential diagnosis of spasmodic torticol is method, and also focuses on the treatment of spasmodic torticol is status quo, including Botox injections and surgical treatment of the status quo status quo, the cur ent injection of botulinum toxin for spasmodic torticol is is stil the main method of treatment , surgical method to be further improved.%痉挛性斜颈具有发病机制复杂、临床表现多样的特点,为了缓解患者的病情,则临床上应积极探索有效的治疗方法。本文分析了痉挛性斜颈的鉴别诊断方法,并同时重点探讨了痉挛性斜颈的治疗现状,包括肉毒素注射治疗现状与手术治疗现状,目前肉毒素注射依然为治疗痉挛性斜颈的主要方法,外科手术方法还有待进一步完善。

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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. IDIOPATHIC SPASMODIC TORTICOLLIS - A SURVEY OF THE CLINICAL SYNDROMES AND PATIENTS EXPERIENCES

    NARCIS (Netherlands)

    VANHERWAARDEN, GMFM; ANTEN, HWM; HOOGDUIN, CAL; NIEWOLD, JUR; ROOS, RAC; SPEELMAN, JD; VANWEERDEN, TW; HORSTINK, MWIM

    1994-01-01

    We evaluated the medical and psychosocial experiences of 59 patients with idiopathic spasmodic torticollis (ST) by means of a structured questionnaire. The results generally corresponded with those of other studies in the literature. Diagnosis is delayed in many patients, and ST negatively influence

  13. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome

    National Research Council Canada - National Science Library

    Ferber, Reed; Kendall, Karen D; Farr, Lindsay

    2011-01-01

    .... To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Cohort study...

  14. Abductor hallucis muscle flap with circular external fixation for Charcot foot osteomyelitis: a case report

    OpenAIRE

    Zgonis, Thomas; Ramanujam, Crystal L.; Facaros, Zacharia

    2011-01-01

    Complicated soft tissue defects of the diabetic foot often call for alternative methods to traditional primary closure. Despite the popularity of microvascular free flaps, local muscle flaps can offer reliable reconstruction for these challenging wounds with shorter surgical times and reduced complication rates. In this article, the authors describe the successful use of the abductor hallucis muscle flap and external fixation for soft tissue reconstruction of a chronic Charcot foot wound and ...

  15. Abductor hallucis muscle flap with circular external fixation for Charcot foot osteomyelitis: a case report

    Directory of Open Access Journals (Sweden)

    Crystal L. Ramanujam

    2011-05-01

    Full Text Available Complicated soft tissue defects of the diabetic foot often call for alternative methods to traditional primary closure. Despite the popularity of microvascular free flaps, local muscle flaps can offer reliable reconstruction for these challenging wounds with shorter surgical times and reduced complication rates. In this article, the authors describe the successful use of the abductor hallucis muscle flap and external fixation for soft tissue reconstruction of a chronic Charcot foot wound and osteomyelitis in a diabetic patient.

  16. Bilateral variations of abductor pollicis longus and extensor pollicis brevis: Surgical significance

    OpenAIRE

    2013-01-01

    Abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscles are known to exhibit numerous variations. Aims: We would like to put across an accidental unusual finding of APL and EPB muscles. Materials and Methods: During routine cadaveric dissection of a 52 year old female cadaver, we found an unusual APL and EPB muscles variations bilaterally. Results: Duplication of APL tendon was noted, one showing normal attachment and the additional one on trapezium. EPB muscle had an ...

  17. Posturographic analysis in patients with dysfunctional dysphonia before and after speech therapy/rehabilitation treatment

    National Research Council Canada - National Science Library

    Nacci, A; Fattori, B; Mancini, V; Panicucci, E; Matteucci, J; Ursino, F; Berrettini, S

    2012-01-01

    The relationship between voice and posture has been previously investigated. The aim of this study was to evaluate postural alterations in subjects with dysfunctional dysphonia and to analyse their variations after rehabilitation...

  18. The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain

    Directory of Open Access Journals (Sweden)

    Nourbakhsh Mohammad R

    2010-01-01

    Full Text Available Abstract Background Shortening of the iliotibial band (ITB has been considered to be associated with low back pain (LBP. It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. However, no study has clinically examined this theory. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP. Methods A total of 300 subjects with and without LBP between the ages of 20 and 60 participated in this cross-sectional study. Subjects were categorized in three groups: LBP with ITB tightness (n = 100, LBP without ITB tightness (n = 100 and no LBP (n = 100. Hip abductor muscle strength was measured in all subjects. Results Analysis of Covariance (ANCOVA with the body mass index (BMI as the covariate revealed significant difference in hip abductor strength between three groups (P Conclusion The relationship between ITB tightness and hip abductor weakness in patients with LBP is not supported as assumed in theory. More clinical studies are needed to assess the theory of muscle imbalance of hip abductor weakness and ITB tightness in LBP.

  19. Observation on the efficacy of acupuncture at key acupoints combined with rehabilitation therapy for spasmodic hemiplegia after cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    佟帅

    2013-01-01

    Objective To assess the clinical efficacy of acupuncture at key acupoints combined with the routine rehabilitation training of limb function on spasmodic hemiplegia after cerebral infarction.Methods Eighty-six cases were randomized into an acupuncture combined with

  20. Effects of perioperative factors and hip geometry on hip abductor muscle strength during the first 6 months after anterolateral total hip arthroplasty

    Science.gov (United States)

    Ikeda, Takashi; Jinno, Tetsuya; Aizawa, Junya; Masuda, Tadashi; Hirakawa, Kazuo; Ninomiya, Kazunari; Suzuki, Kouji; Morita, Sadao

    2017-01-01

    [Purpose] The importance and effect of hip joint geometry on hip abductor muscle strength are well known. In addition, other perioperative factors are also known to affect hip abductor muscle strength. This study examined the relative importance of factors affecting hip abductor muscle strength after total hip arthroplasty. [Subjects and Methods] The subjects were 97 females with osteoarthritis scheduled for primary unilateral THA. The following variables were assessed preoperatively and 2 and 6 months after surgery: isometric hip abductor strength, radiographic analysis (Crowe class, postoperative femoral offset (FO)), Frenchay Activities Index, compliance rate with home exercise, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and demographic data. Factors related to isometric hip abductor muscle strength 2 and 6 months after surgery were examined. [Results] Significant factors related to isometric hip abductor muscle strength at 2 and 6 months after surgery were, in extraction order: 1. isometric hip abductor muscle strength in the preoperative period; 2. BMI; and 3. the JHEQ mental score at 2 and 6 months after surgery. [Conclusion] Preoperative factors and postoperative mental status were related to postoperative isometric hip abductor strength. FO was not extracted as a significant factor related to postoperative isomeric hip abductor strength. PMID:28265161

  1. Outcomes of Open Versus Endoscopic Repair of Abductor Muscle Tears of the Hip: A Systematic Review.

    Science.gov (United States)

    Chandrasekaran, Sivashankar; Lodhia, Parth; Gui, Chengcheng; Vemula, S Pavan; Martin, Timothy J; Domb, Benjamin G

    2015-10-01

    To compare the outcome of open versus endoscopic gluteal tendon repair. An extensive review of PubMed was conducted by 2 independent reviewers for articles containing at least 1 of the following search terms: gluteus medius, gluteus medius tear, gluteus medius tendinopathy, gluteus medius repair, hip abductors, hip abductor tears, hip abductor repair, hip rotator cuff, hip rotator cuff repair, trochanteric bursa, trochanteric bursitis, trochanteric bursectomy, peritrochanteric procedures, peritrochanteric repair, and peritrochanteric arthroscopy. This yielded 313 articles. Of these articles, 7 satisfied the following inclusion criteria: description of an open or endoscopic gluteal repair with outcomes consisting of patient-reported outcome scores, patient satisfaction, strength scores, pain scores, and complications. Three studies on open gluteal repairs and 4 on endoscopic gluteal repairs met the inclusion criteria. In total, there were 127 patients who underwent open procedures and 40 patients who underwent endoscopic procedures. Of the 40 patients who underwent endoscopic procedures, 15 had concomitant intra-articular procedures documented, as compared with 0 in the open group. The modified Harris Hip Score was common to 1 study on open repairs and 3 studies on endoscopic repairs. The scores were similar for follow-up periods of 1 and 2 years. Visual analog pain scale scores were reported in 1 study on open gluteal repairs and 1 study on endoscopic repairs and were similar between the 2 studies. Improvement in abductor strength was also similarly reported in selected studies between the 2 groups. The only difference between the 2 groups was the reported incidence of complications, which was higher in the open group. Open and endoscopic gluteal repairs have similar patient-reported outcome scores, pain scores, and improvement in abduction strength. Open techniques have a higher reported complication rate. Randomized studies of sufficient numbers of patients are

  2. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome.

    Science.gov (United States)

    Ferber, Reed; Kendall, Karen D; Farr, Lindsay

    2011-01-01

    Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running. To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Cohort study. University-based clinical research laboratory. Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated. The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not. The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance. At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline. A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.

  3. Correlative analysis of MRI-evident abductor hip muscle degeneration and power after minimally invasive versus conventional unilateral cementless THA.

    Science.gov (United States)

    Vasilakis, Ioannis; Solomou, Ekaterini; Vitsas, Vasilis; Fennema, Peter; Korovessis, Panagiotis; Siamblis, Dimitrios K

    2012-12-01

    The 2 main null hypotheses of this study were: (1) the 4-year surgical trauma-related degeneration within the hip abductor muscles after a minimally invasive approach to total hip arthroplasty would be similar to that following a conventional approach; and (2) no differences in perioperative blood loss or postoperative hip pain would be observed between the minimally invasive and conventional approaches.In 40 consecutive randomly selected adult patients with unilateral primary hip osteoarthritis, a cementless Zweymüller-Plus THA (Smith & Nephew Orthopaedics, Baar, Switzerland) was implanted by a single surgeon in 1 institution during the same period. Twenty patients underwent a minimally invasive approach (group A), and 20 patients underwent a conventional anterolateral approach (group B). Four years postoperatively, the operated and contralateral nonoperated hips of 37 available patients from both groups were examined with magnetic resonance imaging to show any changes in the gluteus medius and tensor fascia latae. Simultaneously, hip abductor power was measured bilaterally in both groups. Anthropometric data, blood loss, Short Form 36 self-assessment questionnaire, visual analog pain score, and walking distance were also analyzed.The reliability of magnetic resonance imaging and hip abductor power measurements was high. No difference was found in hip abductor power on the operated side between the 2 groups, whereas hip abductor power on the nonoperated side was significantly higher in both groups. This study revealed no mechanical and functional benefits in favor of patients undergoing minimally invasive vs conventional total hip arthroplasty.

  4. [Neuronal mechanisms of motor signal transmission in thalamic Voi nucleus in spasmodic torticollis patients].

    Science.gov (United States)

    Sedov, A S; Raeva, S N; Pavlenko, V B

    2014-01-01

    Neural mechanisms of motor signal transmission in ventrooral (Voi) nucleus of motor thalamus during the realization-of voluntary and involuntary abnormal (dystonic) movements in patients with spasmodic torticollis were investigated by means of microelectrode technique. The high reactivity of the cellular Voi elements to various functional (mainly motor) tests was proved. Analysis of neuronal activity showed: (1) the difference of neural mechanisms of motor signal transmission in the realization of voluntary movement with and without the involvement of the pathological axial neck muscles, as well as passive and abnormal involuntary dystonic movements; (2) significance of sensory component in the mechanisms of sensorimotor interactions during realization of voluntary and involuntary dystonic head and neck movements, causing the activation of the axial neck muscles; (3) important role of the rhythmic and synchronized neuronal activity in motor signal transmission during the realization of active and passive movements. Participation of Voi nucleus in pathological mechanisms of spasmodic torticollis was shown. The data obtained can be used for identificatiori of Voi thalamic nucleus during stereotactic neurosurgical operations in patients with spasmodic torticollis for selection the optimum destruction (stimulation) target and reduction of postoperative effects.

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

    Science.gov (United States)

    Martins, Regina Helena Garcia; Tavares, Elaine Lara Mendes; Ranalli, Paula Ferreira; Branco, Anete; Pessin, Adriana Bueno Benito

    2014-01-01

    Psychogenic dysphonia is a functional disorder with variable clinical manifestations. To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. 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. 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. 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. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Probing glycine receptor stoichiometry in superficial dorsal horn neurones using the spasmodic mouse.

    Science.gov (United States)

    Graham, B A; Tadros, M A; Schofield, P R; Callister, R J

    2011-05-15

    Inhibitory glycine receptors (GlyRs) are pentameric ligand gated ion channels composed of α and β subunits assembled in a 2:3 stoichiometry. The α1/βheteromer is considered the dominant GlyR isoform at 'native' adult synapses in the spinal cord and brainstem. However, the α3 GlyR subunit is concentrated in the superficial dorsal horn (SDH: laminae I-II), a spinal cord region important for processing nociceptive signals from skin, muscle and viscera. Here we use the spasmodic mouse, which has a naturally occurring mutation (A52S) in the α1 subunit of the GlyR, to examine the effect of the mutation on inhibitory synaptic transmission and homeostatic plasticity, and to probe for the presence of various GlyR subunits in the SDH.We usedwhole cell recording (at 22-24◦C) in lumbar spinal cord slices obtained from ketamine-anaesthetized (100 mg kg⁻¹, I.P.) spasmodic and wild-type mice (mean age P27 and P29, respectively, both sexes). The amplitude and decay time constants of GlyR mediated mIPSCs in spasmodic micewere reduced by 25% and 50%, respectively (42.0 ± 3.6 pA vs. 31.0 ± 1.8 pA, P spasmodic GlyRs (EC50 =130 ± 20 μM vs. 64 ± 11 μM, respectively; n =8 and 15, respectively). Differential agonist sensitivity and mIPSC decay times were subsequently used to probe for the presence of α1-containing GlyRs in SDHneurones.Glycine sensitivity, based on the response to 1-3 μM glycine, was reduced in>75% of neurones tested and decay times were faster in the spasmodic sample. Together, our data suggest most GlyRs and glycinergic synapses in the SDH contain α1 subunits and few are composed exclusively of α3 subunits. Therefore, future efforts to design therapies that target the α3 subunit must consider the potential interaction between α1 and α3 subunits in the GlyR.

  8. [Application of acoustic analysis of the voice to diagnosis and treatment of functional dysphonia].

    Science.gov (United States)

    Chernobel'skiĭ, S I

    2009-01-01

    Acoustic analysis of the voice was used to facilitate diagnosis and to objectively evaluate results of the treatment of psychogenic dysphonia (PD) in 20 women. The control group comprised 20 women showing no signs of laryngeal pathology. The following parameters were measure: jitter, shimmer, signal to noise ratio, and response in the voicing test. Other methods applied included laryngoscopy, videolaryngoscopy, and laryngostroboscopy. It was shown that hoarseness in patients with PD results from the disturbances of mechanisms controlling stability of phonation. This observation is confirmed by the results of the acoustic test. It is concluded that dysphonia confirmed in the acoustic test in the absence of organic changes in the larynx is caused by psychogenic factors. Acoustic analysis of the voice is indicated to objectively evaluate results of the treatment of psychogenic dysphonia.

  9. Usefulness of acoustic studies on the differential diagnostics of organic and functional dysphonia.

    Science.gov (United States)

    Pruszewicz, A; Obrebowski, A; Swidziński, P; Demeńko, G; Wika, T; Wojciechowska, A

    1991-01-01

    Phoniatric and acoustic examinations were carried out in a group of 30 patients with dysphonia, including 15 with organic type and 15 with functional type. A complex phoniatric assessment offered the possibility to differentiate between these two groups of pathological voices. This was achieved also on the basis of acoustic analysis of the voice by extracting characteristics such as: formant frequency, Fo and its range, percentage of noise in the analysed verbal text, mean and maximum values of jitter. The possibility of differential diagnosis of these two different types of dysphonia in acoustic studies was confirmed by clinical examinations. The acoustic studies presented can be regarded as a new approach to a fast and sufficiently precise method in the screening diagnostics of dysphonia conditioned by growth of the vocal fold mass.

  10. Multiple cervical levels: increased risk of dysphagia and dysphonia during anterior cervical discectomy.

    Science.gov (United States)

    Danto, Joseph; DiCapua, John; Nardi, Dominic; Pekmezaris, Renee; Moise, Gregory; Lesser, Martin; Dimarzio, Paola

    2012-10-01

    Anterior cervical discectomy (ACD) is widely used for symptomatic cervical spine pathologies. The most common complications associated with this type of surgery are dysphagia and dysphonia; however, the risk factors associated with them have not been adequately elucidated. The purpose of this study is to assess the incidence of self-reported dysphagia and dysphonia and the associated risk factors after ACD. This study used a retrospective chart review of 149 patients who underwent ACD at a tertiary care facility operating in the New York metropolitan area over a period of 2½ years. Charts for ACD patients were reviewed by 6 trained researchers. Incidence rates for self-reported dysphagia and dysphonia were calculated using 95% exact confidence intervals (CI). Risk factors such as age, sex, surgical hours, number of disc levels, airway class, American Society of Anesthesiologists class, fiberoptic intubation, and intubation difficulty were assessed using logistic regression. The incidence of self-reported dysphagia was 12.1% (95% exact CI, 7.3%-18.4%); for dysphonia the self-reported incidence was 5.4% (95% exact CI, 2.3%-10.3%). Patients who underwent surgery at ≥4 cervical levels had a significant 4-fold increased risk (odds ratio=4; 95% CI, 1.1-13.8) of developing dysphonia and/or dysphagia compared with patients who underwent surgery at a single surgical level. This study confirms previous findings that the risk of developing dysphagia and/or dysphonia increases with the number of surgical levels, with multiple cervical levels representing a significantly higher postoperative risk, as compared with surgery at 1 level.

  11. The Influence of Hip Abductor Weakness on Frontal Plane Motion of the Trunk and Pelvis in Patients with Cerebral Palsy

    Science.gov (United States)

    Krautwurst, Britta K.; Wolf, Sebastian I.; Heitzmann, Daniel W. W.; Gantz, Simone; Braatz, Frank; Dreher, Thomas

    2013-01-01

    Trendelenburg walking pattern is a common finding in various disorders, including cerebral palsy (CP), where it is seen in children and adults. Clinically, this deviation is viewed as a consequence of hip abductor weakness resulting in pelvic obliquity. Trunk lean to the ipsilateral side is a common compensatory mechanism to counteract pelvic…

  12. Effects of hip joint center location and femoral offset on abductor muscle strength after total hip arthroplasty.

    Science.gov (United States)

    Tezuka, Taro; Inaba, Yutaka; Kobayashi, Naomi; Ike, Hiroyuki; Kubota, So; Kawamura, Masaki; Saito, Tomoyuki

    2015-07-01

    The purposes of this study were 1) to examine the changes in the hip joint center (HJC) position and the femoral offset (FO) after total hip arthroplasty (THA) and 2) to investigate the effects of the HJC and FO on isometric abductor muscle strength. We evaluated 51 patients who underwent unilateral primary THA. The FO, and horizontal and vertical distances from the HJC to the tip of the teardrop were measured and isometric hip abductor muscle strength was measured. The HJC of the affected side moved medially postoperatively compared with that of the unaffected side (p < 0.05), and the FO was reconstructed similarly to the unaffected side. There were significant negative correlations between the changes in the horizontal distance from the HJC and FO to the tip of the teardrop. An increase in the FO and infero-medial cup position optimized hip abductor muscle strength. The HJC was reconstructed medially and superiorly, and the change in the FO after THA was influenced by the change in the horizontal distance of the HJC. Multiple regression analysis revealed that the medial and inferior HJC and increase in the FO constitute an effective procedure for restoring abductor strength.

  13. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function☆

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; Silva, Ana Paula de Moura Campos Carvalho e; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2016-01-01

    Objective To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS). Methods This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA) of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. Results The q-angle did not present any significant correlation with severity of knee pain (r = −0.29; p = 0.19), functional capacity (r = −0.08; p = 0.72), FPPA (r = −0.28; p = 0.19) or isometric peak torque of the abductor muscles (r = −0.21; p = 0.35). Conclusion The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS. PMID:27069887

  14. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function

    Directory of Open Access Journals (Sweden)

    Gabriel Peixoto Leão Almeida

    2016-04-01

    Full Text Available OBJECTIVE: To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS. METHODS: This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. RESULTS: The q-angle did not present any significant correlation with severity of knee pain (r = -0.29; p = 0.19, functional capacity (r = -0.08; p = 0.72, FPPA (r = -0.28; p = 0.19 or isometric peak torque of the abductor muscles (r = -0.21; p = 0.35. CONCLUSION: The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS.

  15. Basal joint osteoarthritis of the thumb: comparison of suture button versus abductor pollicis longus suspensionplasty.

    Science.gov (United States)

    Avant, Kristopher R; Nydick, Jason A; White, Brian D; Vaccaro, Lisa; Hess, Alfred V; Stone, Jeffrey D

    2015-03-01

    Our purpose was to compare the outcomes of patients with severe basilar thumb osteoarthritis treated with trapeziectomy and suspensionplasty using abductor pollicis longus (APL) tendon versus a suture button device. A retrospective study was performed for patients undergoing trapeziectomy and suspensionplasty with APL tendon or suture button fixation. Outcome measures included disabilities of the arm, shoulder, and hand (DASH); visual analog score (VAS); grip strength; key pinch; tip pinch; and thumb opposition. Radiographic measurements, surgical times, and complications were recorded. Thirty-three patients in the APL tendon group and 27 patients in the suture button group had a minimum 6-month follow-up. VAS, DASH, and functional measurements improved after surgery for both groups. Mean operative time was 68 min for the APL tendon group and 48 min for the suture button group. Complications were similar between groups. The use of suture button fixation when compared to APL tendon suspensionplasty offers similar clinical outcomes. Therapeutic III.

  16. Discharge properties of motor units of the abductor hallucis muscle during cramp contractions.

    Science.gov (United States)

    Minetto, Marco A; Holobar, Ales; Botter, Alberto; Farina, Dario

    2009-09-01

    We analyzed individual motor units during electrically elicited cramp contractions with the aim of characterizing the variability and degree of common oscillations in their discharges. Intramuscular and surface electromyographic (EMG) signals were detected from the abductor hallucis muscle of 11 healthy subjects (age 27.0+/-3.7 yr) during electrically elicited cramps. In all, 48 motor units were identified from the intramuscular EMG. These motor units were active for 23.6+/-16.2 s, during which their average discharge rate was 14.5+/-5.1 pulses/s (pps) and their minimum and maximum rates were, respectively, 6.0+/-0.8 and 25.0+/-8.0 pps (Pcramps showed a range of discharge rates similar to that observed during voluntary contractions but larger ISI variability, probably due to large synaptic noise. Moreover, the discharge rates of the active motor units showed common oscillations.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  19. Dysphonia as a sign of HPV laryngeal infection: a case report.

    Science.gov (United States)

    Longubuco, Carlos Eduardo Gama; dos Reis, Helena Lucia Barroso; Cavalcante, Fernanda Sampaio; de Pinho, Carla Renata Petillo; Oliveira, Nathalia Silva; Nicol, Alcina Frederica; Zamolyi, Renata Quintella; Ferreira, Dennis de Carvalho

    2014-12-11

    Voice dysfunction or dysphonia may be associated with several clinical conditions. Among these, laryngeal human papillomavirus (HPV)-induced lesions should be considered as a possible causative factor. We report a case of dysphonia in a patient presenting with an HPV laryngeal lesion. We also discuss the clinical features of the disease, its histopathological findings, and treatment and rigorous follow-up. We report a case of laryngeal papilloma in a 29-year-old, Afro-descendant, male patient with dysphonia. He was a non-smoker and was not a drug user. Videolaryngostroboscopy revealed signs suggestive of pharyngolaryngeal reflux. The right vocal fold presented with a papillomatous aspect in the posterior third, which underwent excision. Histopathological examination showed a nodular lesion of the right vocal fold, conclusive of squamous papilloma with absence of malignancy. Patients presenting with persistent voice dysfunction or dysphonia should be investigated for possible laryngeal HPV infection. Diagnostic confirmation by HPV genotyping is important for follow-up of potential recurrence.

  20. Spasmodic growth during the rapid solidification of undercooled Ag-Cu eutectic melts

    Science.gov (United States)

    Clopet, C. R.; Cochrane, R. F.; Mullis, A. M.

    2013-01-01

    A melt fluxing technique has been used to undercool Ag-Cu eutectic alloy by 10-70 K and the subsequent recalescence has been studied using high speed imaging. Spasmodic growth of the solidification front was observed, in which the growth front would make a series of quasi-periodic jumps separated by extended periods during which time growth appeared to arrest. Evidence of this previously unreported mode of growth is presented. The high speed images and microstructural evidence support the theory that anomalous eutectics form by the growth and subsequent remelting of eutectic dendrites.

  1. Spasmodic Torticollis—A Multicentre Study on Behavioural Aspects III: Psychosocial Changes and Coping

    Directory of Open Access Journals (Sweden)

    T. Nickel

    1996-01-01

    Full Text Available Psychosocial changes in spasmodic torticollis (ST affect predominantly social life, professional life and psychological well-being. Concerning social life, 84.6% of the patients felt that they attracted considerable public attention due to their neurological illness and 65% had reduced participation in social events. A substantial number of patients had retired from professional activities; others felt severely impaired in their working capacity. The psychosocial sequelae in ST, however, seemed to depend less on the neurological signs per se than on the physical symptoms and on coping. Depressive coping in particular emerged as a predictor of psychosocial distress.

  2. Increase of glucose consumption in basal ganglia, thalamus and frontal cortex of patients with spasmodic torticollis

    Energy Technology Data Exchange (ETDEWEB)

    Grassi, F.; Bressi, S.; Antoni, M. [Univ. of Milan (Italy)] [and others

    1994-05-01

    The pathophysiology of spasmodic torticollis, a focal dystonia involving neck muscles, is still unclear. Positron emission tomography (PET) studies showed either an increase as well as a decrease of regional cerebral metabolic rate of glucose (rCMRglu) in basal ganglia. In the present study, [18F]FDG and PET was used to measure rCMRglu in 10 patients with spasmodic torticollis (mean age 50.37 {plus_minus} 11.47) and 10 age matched controls. All cases with a short disease duration, were untreated. A factorial analysis of variance revealed a significant bilateral increase of glucose consumption in caudate nucleus and pallidum/putamen complex (p>0.004) and in the cerebellum (p>0.001). The rCMRglu increase in the motor/premotor cortex and in the thalamus reached a trend towards significance (p<0.05). These preliminary data show enhanced metabolism in basal ganglia and cerebellum as the functional correlate of focal dystonia. A recently proposed model suggests that dystonia would be the consequence of a putaminal hyperactivity, leading to the breakdown of the pallidal inhibitory control on thalamus and thalamo-cortical projections.

  3. Anatomical variation of abductor pollicis longus in Indian population: A cadaveric study

    Science.gov (United States)

    Tewari, Jerina; Mishra, Pravash Ranjan; Tripathy, Sujit Kumar

    2015-01-01

    Background: Many authors have reported the anatomical variation of abductor pollicis longus (APL) around the wrist and its association with de Quervain tenosynovitis (DQT), first carpo-metacarpal arthritis, and trapezio-metacarpal subluxation. From Indian subcontinent, there is only one original article and a few case reports on the variability of APL tendon insertion. Materials and Methods: Fifty formaldehyde preserved cadaveric wrists were dissected to look for the anatomical variation of APL in the Indian population. Results: The APL was found with single tendon in 2, double in 31, triple in 8, and quadruple in 8 extremities. A maximum of 6 tendon-slips were found in one cadaveric wrist. In all hands, the APL had at least one attachment to first metacarpal bone and in 46 hands (92%), there was second insertion to the trapezium bone. Of all tendon-slips of APL (n = 126), 44% of tendons (68 tendons) were inserted into the base of the first metacarpal bone. This was followed by the insertion into the trapezium in 42% tendons (52 tendons). Conclusion: Bi-tendinous APL is commonly observed on the dorsal compartment of the wrist in Indian population and these tendon-slips are commonly attached to the first metacarpal base and trapezium. This variation must be understood by the Indian Orthopedic surgeons as the response to treatment of DQT and reason for first carpo-metacarpal arthritis can be dependent on this anatomical variation. PMID:26538762

  4. System identification of evoked mechanomyogram from abductor pollicis brevis muscle in isometric contraction.

    Science.gov (United States)

    Uchiyama, Takanori; Sakai, Hiroaki

    2013-12-01

    The purpose of this study is to verify the applicability of a sixth-order model to the mechanomyogram (MMG) system of the parallel-fibered muscle, which was identified from the MMG of the pennation muscle. The median nerve was stimulated, and an MMG and torque of the abductor pollicis brevis muscle were measured. The MMGs were detected with either a capacitor microphone or an acceleration sensor. The transfer functions between stimulation and the MMG and between stimulation and torque were identified by the singular value decomposition method. The torque and the MMG, which were detected with a capacitor microphone, DMMG, were approximated with a second- and a third-order model, respectively. The natural frequency of the torque, reflecting longitudinal mechanical characteristics, did not show a significant difference from that of the DMMG. The MMG detected with an acceleration sensor was approximated with a fourth-order model. The natural frequencies of the AMMG reflecting the muscle and subcutaneous tissue in the transverse direction were obtained. Both DMMG and AMMG have to be measured to investigate the model of the MMG system for parallel-fibered muscle. The MMG system of parallel-fibered muscle was also modeled with a sixth-order model.

  5. Eccentric hip abductor weakness in patients with symptomatic external snapping hip

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Thorborg, Kristian; Søballe, K;

    2012-01-01

    Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength is decre......Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength...... is decreased in patients with external snapping hip compared with healthy matched controls, and to examine isometric hip abduction, adduction, extension, flexion, internal rotation, and external rotation in patients with external snapping hip and matched controls. Thirteen patients with external snapping hip....... Eccentric hip abduction strength was 16% lower in patients with external snapping hip compared with healthy matched controls (1.50 ± 0.47 Nm/kg versus 1.82 ± 0.48 Nm/kg, P = 0.01). No other strength differences were measured between patients and controls (P > 0.05). Eccentric hip abductor weakness...

  6. Primary abductor hip contracture as diagnostic, prognostic and therapeutic problem in child hip pathology

    Directory of Open Access Journals (Sweden)

    Pajić Miloš

    2007-01-01

    Full Text Available Coxa obliqua represents a special functional entity in the pathology of the child hip. Authors have confirmed the results of S.L. Weissman and B. Strinovic which claimed that the abductor contracture of the hip was a primary congenital condition that developed as a result of intrauterine malposition, leading later to the contralateral adductor contracture. Critical period for the development of complications was between 6 and 8 month after birth, adductor contracture might keep persisting together with the development of acetabular dysplasia, and later on with ipsilateral subluxation. This malformation has usually been diagnosed within 3 and 6 months of age. It could be connected with some other signs of malposition, such as plagiocephaly, torticollis or infantile thoracic C scoliosis. For the diagnosis of coxa obliqua, the examination of hips in the prone position was very important and the ultrasonic and radiological examinations were crucial. The applied treatment used to be exclusively physical rehabilitation. Wide diapering has been contraindicated. In this study, we included 2,500 newborns, 1,300 boys and 1,200 girls (5,000 hips. In 22 cases of coxa obliqua (10‰, the excellent results were obtained in 96% of cases. In two unsuccessfully treated cases, a contralateral dysplasia developed, and in one untreated, subluxation. The authors are advocating a systematic and early detection and treatment of the primary coxa obliqua. .

  7. Isokinetic imbalance of adductor-abductor hip muscles in professional soccer players with chronic adductor-related groin pain.

    Science.gov (United States)

    Belhaj, K; Meftah, S; Mahir, L; Lmidmani, F; Elfatimi, A

    2016-11-01

    This study aims to compare the isokinetic profile of hip abductor and adductor muscle groups between soccer players suffering from chronic adductor-related groin pain (ARGP), soccer players without ARGP and healthy volunteers from general population. Study included 36 male professional soccer players, who were randomly selected and followed-up over two years. Of the 21 soccer players eligible to participate in the study, 9 players went on to develop chronic ARGP and 12 players did not. Ten healthy male volunteers were randomly selected from the general population as a control group. Comparison between the abductor and adductor muscle peak torques for players with and without chronic ARGP found a statistically significant difference on the dominant and non-dominant sides (p muscle significantly stronger than the adductor muscle. In the group of healthy volunteers, the adductor muscle groups were significantly stronger than the abductor muscle groups on both dominant and non-dominant sides (p muscle strength was also significantly decreased on the affected side. This imbalance appears to be a risk factor for adductor-related groin injury. Therefore, restoring the correct relationship between these two agonist and antagonist hip muscles may be an important preventative measure that should be a primary concern of training and rehabilitation programmes.

  8. An evaluation study of voice therapy in non-organic dysphonia.

    Science.gov (United States)

    Carding, P N; Horsley, I A

    1992-01-01

    Thirty patients diagnosed as suffering from non-organic dysphonia were assigned to one of three treatment groups: direct therapy, indirect and no treatment for a period of 8 weeks. Therapeutic outcome was evaluated by independent judges, patient self-evaluation, electrolaryngograph ratings and measures of fundamental frequency. The direct treatment group showed the most significant improvement in the return to normal voice functioning followed by the indirect treatment group. One patient in the control group showed improvement without any intervention. This study provides evidence in support of the effectiveness of both direct and indirect therapy in the treatment of non-organic dysphonia and raises questions concerning individual patient responses to these approaches.

  9. Is an organic/functional distinction psychologically meaningful in patients with dysphonia?

    Science.gov (United States)

    Millar, A; Deary, I J; Wilson, J A; MacKenzie, K

    1999-06-01

    Dysphonia (hoarseness) is a common clinical condition and, if persistent, patients are referred to otolaryngology clinics for clinical examination. During the examination, a clinical distinction is often made among three types of patients: (1) those with a clear organic basis for dysphonia (cancer, vocal cord palsy): (2) those with some degree of organic pathology; and (3) those with an apparently functional etiology. Functional patients are often characterized as having a psychogenic disorder. This study assessed the psychological validity of the functional category in 204 out-patients (aged 17 to 87 years) with persistent hoarseness of types (2) and (3). Following clinical examination, a consultant otolaryngologist categorized patients as having functional or organic etiology. Subjects were then compared on measures of personality and psychological distress. Dysphonic subjects showed marked psychological distress compared with norms, and reported significantly more previous psychosomatic symptoms than norms, but there were no differences in personality or psychological distress between organic and functional subgroups of dysphonics.

  10. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial

    OpenAIRE

    MacKenzie, K.; Millar, A; Wilson, J. A.; Sellars, C.; Deary, I. J.

    2001-01-01

    OBJECTIVES: To assess the overall efficacy of voice therapy for dysphonia. DESIGN: Single blind randomised controlled trial. SETTING: Outpatient clinic in a teaching hospital. Participants: 204 outpatients aged 17-87 with a primary symptom of persistent hoarseness for at least two months. INTERVENTIONS: After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to thi...

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

    OpenAIRE

    Seyyedeh Maryam Khoddami; Noureddin Nakhostin Ansari; Farzad Izadi; Saeed Talebian Moghadam

    2013-01-01

    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 physio...

  12. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on Videolaryngoscopy

    OpenAIRE

    Keyvan Kiakojury; Mehdi Dehghan; Fateme Hajizade; soraya khafri

    2014-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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.      

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

    OpenAIRE

    Keyvan Kiakojury; Mehdi Dehghan; Fateme Hajizade; soraya khafri

    2014-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot

    Science.gov (United States)

    Goo, Young-Mi; Kim, Tae-Ho; Lim, Jin-Yong

    2016-01-01

    [Purpose] The purpose of the present study is to examine the effects of abductor hallucis and gluteus maximus strengthening exercises on pronated feet. [Subjects and Methods] The present study was conducted with 18 adults without no history of surgery on the foot or ankle. One group performed both gluteus maximus strengthening exercises and abductor hallucis strengthening exercises, while the other group performed only abductor hallucis strengthening exercises five times per week for four weeks. [Results] The group that performed both gluteus maximus and abductor hallucis strengthening exercises showed smaller values in the height of navicular drop than the group that performed only abductor hallucis strengthening exercises. The muscle activity of the gluteus maximus and the vastus medialis increased during heel-strike in the group that added gluteus maximus exercises, and the muscle activity of the abductor hallucis significantly increased in both groups. [Conclusion] Given the results of the present study, it can be suggested that strengthening the gluteus maximus while also performing exercises to correct the pronated foot is an effective method for achieving normal gait. PMID:27134383

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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Cross-cultural adaptation of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS to Brazilian Portuguese

    Directory of Open Access Journals (Sweden)

    F A Sekeff-Sallem

    2011-01-01

    Full Text Available Cervical dystonia (CD is a prevalent and incapacitating movement disorder which needs a thorough clinical evaluation of every patient to better tailor treatment strategies. In Brazil, there are no validated CD scales that measure the burden of dystonia. The aim of our study was to translate and adapt the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS to Brazilian Portuguese. After translation and back-translation according to international methods, a pre-test was carried out with 30 patients. Patients under 8 years of formal schooling had severe difficulty in understanding the whole scale. The scale went through a remodeling process, without loss of its conceptual and semantic properties. The new scale was tested in 15 patients, with good understanding scores. We are now in the process of validation of the adapted scale.

  19. Spasmodic Torticollis—A Multicentre Study on Behavioural Aspects II: Signs, Symptoms and Course

    Directory of Open Access Journals (Sweden)

    F. Heinen

    1996-01-01

    Full Text Available This paper deals with signs, symptoms and course in spasmodic torticollis (ST. Two hundred and fifty-six patients were included in the study, 59.3% women, 40.7% men. The mean age was 49.1 years. Rotating torticollis out-numbered latero- and antero-retrocollis. A family history of ST occurred in 3.1% of the total sample. First degree relatives were affected in 2.3%. Thirty-four per cent of the patients had additional dystonic symptoms. Most frequently these affected the upper extremities (13%, and less often the legs. Of the patients 19.1% had experienced a period of complete remission. The correlations between the severity of the signs and the neurological symptoms are surprisingly weak.

  20. Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

    Science.gov (United States)

    Lee, Hyun-Joo; Kim, Poong-Taek; Deslivia, Maria Florencia; Lee, Suk-Joong; Nam, Sang-Jin

    2015-01-01

    Background Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results. PMID:26330961

  1. [Observation on the efficacy of acupuncture at key acupoints combined with rehabilitation therapy for spasmodic hemiplegia after cerebral infarction].

    Science.gov (United States)

    Tong, Shuai; Su, Li; Lü, Hai-Bo; Liu, Jian-Qiao

    2013-05-01

    To assess the clinical efficacy of acupuncture at key acupoints combined with the routine rehabilitation training of limb function on spasmodic hemiplegia after cerebral infarction. Eighty-six cases were randomized into an acupuncture combined with rehabilitation group (group A, 44 cases) and a rehabilitation group (group B, 42 cases). In group A, the key acupoints were selected from head, face, chest, abdomen, shoulder, back, hands, feet and ankles such as Cuanzhu (BL 2), Danzhong (CV 17), Jianyu (LI 15) and Yanglao (SI 16) were stimulated with acupuncture. In combination, the routine limb rehabilitation training was applied, once every day. In group B, the routine limb rehabilitation training was applied alone. In both groups, 10 treatments made one session and 2 sessions were required totally. Before and after treatment, Fugl-Meyer scale and functional independent measurement (FIM) scale were adopted to assess the limb motor level and the activity of daily life in the patients respectively. The modified Ashworth scale was used to assess the effect of anti-spasm. The total effective rate of anti-spasm was 90.9% (40/44) in the group A, which was superior to 73.8% (32/42) in the group B (P rehabilitation therapy effectively relieves the spasmodic condition of the patients with post-stroke spasmodic hemiplegia, improves the limb function and the life activity of the patients.

  2. A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength.

    Science.gov (United States)

    Palmer, Kathryn; Hebron, Clair; Williams, Jonathan M

    2015-05-03

    Dynamic knee valgus and internal femoral rotation are proposed to be contributory risk factors for patellofemoral pain and anterior cruciate ligament injuries. Multimodal interventions including hip abductor strengthening or functional motor control programmes have a positive impact of pain, however their effect on knee kinematics and muscle strength is less clear. The aim of this study was to examine the effect of isolated hip abductor strengthening and a functional motor control exercise on knee kinematics and hip abductor strength. This prospective, randomised, repeated measures design included 29 asymptomatic volunteers presenting with increase knee valgus and femoral internal rotation. Participants completed either isolated hip abductor strengthening or a functional motor control exercise for 5 weeks. Knee kinematics were measured using inertial sensors during 2 functional activities and hip abductor strength measured using a load cell during isometric hip abduction. There were no significant differences in dynamic knee valgus and internal rotation following the isolated hip abductor or functional motor control intervention, and no significant differences between the groups for knee angles. Despite this, the actual magnitude of reduction in valgus was 10° and 5° for the functional motor control group and strengthening group respectively. The actual magnitude of reduction in internal rotation was 9° and 18° for the functional motor control group and strengthening group respectively. Therefore there was a tendency towards clinically significant improvements in knee kinematics in both exercise groups. A statistically significant improvement in hip abductor strength was evident for the functional motor control group (27% increase; p = 0.008) and strengthening group (35% increase; p = 0.009) with no significant difference between the groups being identified (p = 0.475). Isolated hip strengthening and functional motor control exercises resulted in

  3. Variations in abductor pollicis longus and extensor pollicis brevis tendons in the Quervain syndrome: a surgical and anatomical study.

    Science.gov (United States)

    Kulthanan, Teerawat; Chareonwat, Boonsong

    2007-01-01

    Eighty-two wrists of Thai cadavers and the wrists of 66 patients with de Quervain syndrome were studied, and the variation in the number of tendons and the fibro-osseous tunnel in the first extensor compartment were recorded. The abductor pollicis longus had more than one tendon in 73 of the cadavers (89%) and in 32 of the patients (49%) (p Quervain syndrome (p = 0.01). The results indicate that the number of fibro-osseous tunnels and multiple compartments in the first extensor compartment may be associated with a predisposition to de Quervain syndrome.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. The assessment methods of laryngeal muscle activity in muscle tension dysphonia: a review.

    Science.gov (United States)

    Khoddami, Seyyedeh Maryam; Nakhostin Ansari, Noureddin; Izadi, Farzad; Talebian Moghadam, Saeed

    2013-11-04

    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.

  6. [Personality and coping with stress in patients suffering from functional dysphonia].

    Science.gov (United States)

    Freidl, W; Friedrich, G; Egger, J

    1990-01-01

    The examination covers the personality of 20 functional dysphonics, 14 individuals suffering from organic voice disorders and a group of 20 control persons when exposed to stress and its working up. In examining the group of functional dysphonics a significant positive self-assessment regarding their personality with a clear tendency to restraint has become clear. In comparison with the control persons an intensified anxiety state in situations causing stress is the result. Thus the influence of life events has been shown to have an important effect on the etiopathogenesis of functional dysphonia.

  7. "King archie, who was quite grouchy" - a vocal dysphonia health education project

    OpenAIRE

    Maria Rosário Dias; Cátia da Silva Pedrosa

    2013-01-01

    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. RES...

  8. High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis.

    Science.gov (United States)

    Low, T H; Hales, P F

    2014-10-01

    We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication. © The Author(s) 2013.

  9. [Typical Patterns of Neuronal Activity in Relay and Nonspecific Thalamic Nuclei in Patients with Spasmodic Torticollis].

    Science.gov (United States)

    Devetiarov, D A; Semenova, U N; Butiaeva, L I; Sedov, A S

    2015-01-01

    Neuronal activity of 50 neurons in nonspecific (Rt, MD) and relay (Voi, Voa) thalamic nuclei was analyzed. Data were obtained by microelectrode technique during 14 stereotactic operations in patients with spasmodic torticollis. Application of Poincare maps and Gap-statistics allowed to reveal 3 main patterns of neuronal activity: irregular single spikes, low-threshold Ca(2+)-dependent rhythmic (3-5 Hz) bursts and combination of bursts and single spikes. In some cases, grouping (in Voi and Rt nuclei) and long burst (in Voa nucleus) patterns were observed. Grouping pattern consist of low-density groups of spikes with tendency to periodicity in range 1-1.5 Hz. Long burst pattern consist of long dense groups of spikes with random length and invariant interburst intervals. Main numerical estimations of 3 most spread patterns of neuronal activity were obtained by parametric analysis. In results, investigated thalamic nuclei significantly distinguished from each other by characteristics of burst activity but average firing rate of these nuclei hadn't significant differences. These data may be useful for functional identification of thalamic nuclei during stereotactic neurosurgery operation in patients with movement disorders.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Spasmodic muscle cramps and weakness as presenting symptoms in Wilson disease.

    Science.gov (United States)

    Rosen, John M; Kuntz, Nancy; Melin-Aldana, Hector; Bass, Lee M

    2013-10-01

    Wilson disease (WD) is an autosomal-recessive disorder of hepatic copper metabolism that has tremendous variability in its presentation. Phenotypic diversity of the disease can lead to delayed diagnosis. We describe a case of WD in a 10-year-old boy presenting with 3 months of increasingly intense, spasmodic lower extremity muscle cramps. Physical examination revealed tenderness on calf palpation and dark flat lesions over his ankles, knees, and elbows. Initial testing revealed creatine kinase of 302 IU/L (normal 24-248 IU/L), hemoglobin of 8.9 g/dL (11.5-15.5 g/dL), aspartate aminotransferase of 114 IU/L (16-52 IU/L), alanine aminotransferase of 54 IU/L (2-30 IU/L), and myoglobinuria. Extensive evaluation of his myopathy, including MRI and muscle biopsy, was negative. Additional laboratory tests revealed a prothrombin time of 21.3 seconds (11.8-15.5 seconds), total bilirubin of 1.4 mg/dL (muscle weakness. In patients with unexplained musculoskeletal symptoms and hepatic abnormalities, a diagnosis of WD should be considered and appropriate evaluation initiated.

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  13. [Proposal of a rating scale of posture for simple dysfunctional dysphonia: "S-TRAV"].

    Science.gov (United States)

    Lobryeau-Desnus, C; Lamy, A; Amiel, J

    2011-01-01

    This work aims to create a scale to evaluate posture, quick and easy to perform during the assessment of voice in patients with simple dysfunctional dysphonia. The "S-TRAV" scale was evaluated on 60 subjects with dysphonia and 60 control subjects. It assesses "the overall severity" of the alteration of posture, the "Tension", the "Breathing", the "Ground anchoring" and the "Verticality" both quantitatively (score 0-3) and qualitatively. The patient also assesses his voice disorder and his posture. Postural observation was carried out in five conditions: at rest, conversational voice, reading, projected voice and singing voice. The comparison between the dysphonic subjects and control subjects was used to assess the sensitivity of this tool. Two reviewers rated the scale to determine its reproducibility. The scale is sensible for the majority of criteria with a significance coefficient less than 0.05. The most discriminate criteria relate to the cervical spine, the overall score of postural severity assessed by the therapist and verticality. All criteria have a low level of variability between the reviewers under all conditions. Most criteria are correlated with the criterion "Overall Severity" of postural alterations under all conditions. Non-sensible criteria were eliminated from the final scale). This tool is sensitive, reproducible and relevant in assessing the severity of postural alterations and their location. Further studies will validate the scale on a consistent population.

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

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    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.

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

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    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.

  16. Dysphonia as the primary complaint in a case of myasthenia gravis: diagnosis and speech therapy.

    Science.gov (United States)

    Nemr, Nair Kátia; Simões-Zenari, Marcia; Ferreira, Tainá Soares; Fernandes, Heloisa Regina; Mansur, Letícia Lessa

    2013-01-01

    Myasthenia gravis is an autoimmune disease, manifested by progressive muscular weakness and fatigue. There are frequent ocular and bulbar symptoms, among them, dysphonia. This article reports a case of dysphonia that contributed to the diagnosis of myasthenia gravis through a speech evaluation. The patient sought speech therapy with the ENT diagnosis of presbyphonia. The perceptual voice assessment and acoustic analysis pointed out respiration, glottal voice source and resonance affections. Considering that some of the data obtained from anamnesis and vocal assessments were not directly related to presbyphonia, the speech therapist discussed the case with the physician and they both concluded it was necessary to refer the patient to a neurological evaluation. The neurologist then raised the diagnostic hypotheses of myasthenia gravis and requested further examinations. The patient underwent speech therapy and drug treatment. A vocal reassessment, which occurred two months after the initial treatment, showed improvement in voice quality, with great impact on quality of life. This article shows the importance of detailed clinical speech evaluation and participation of a speech therapist in an interdisciplinary team.

  17. Beneficial response of cervical dystonia spasmodic torticollis to cidofovir, an acyclic phosphonate analog (s-1-3-hydroxy-2- phosphonylmethoxypropyl of cytosine

    Directory of Open Access Journals (Sweden)

    Lerner AM

    2014-09-01

    Full Text Available A Martin Lerner,1 Safedin Beqaj21Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA; 2Pathology Inc., Torrance, CA, USAAbstract: We report the case of a 23-year-old healthy man who had sudden onset of cervical dystonia spasmodic torticollis in October 2012. He was treated with intravenous cidofovir, which was started on February 20, 2013, followed by oral valganciclovir and famciclovir. Pulling of the neck and tilt of the head far to the left is no longer present (as at April 22, 2014. Human herpesvirus 6 total antibody titers fell from 11.27 (negative <1 on January 15, 2013 to 1.89 on August 5, 2013. To our knowledge, this is the first case of improvement in cervical dystonia spasmodic torticollis with treatment.Keywords: cidofovir, spasmodic torticollis, cervical dystonia

  18. A Case of Spasmodic Torticollis Mainly Treated with Massage%推拿为主治疗痉挛性斜颈1例

    Institute of Scientific and Technical Information of China (English)

    戴丽红; 罗凛

    2013-01-01

    This paper, with analyzing a case of spasmodic torticollis mainly treated with massage successfully, discusses the etiology and pathogene-sis of spasmodic torticollis and mechanism of massage therapy. It is simple and effective in massage treating spasmodic torticollis, easily accepted by patients, for future in-depth study to provide clinical guidelines.%本文分析以推拿手法为主成功治疗痉挛性斜颈1例,探讨痉挛性斜颈的病因病机,及推拿为主治疗的机理。推拿为主治疗痉挛性斜颈简便有效,患者易接受,为日后深入研究提供临床指引。

  19. Dysphonia: medical treatment and a medical voice hygiene advice approach. A prospective randomised pilot study.

    Science.gov (United States)

    Pedersen, M; Beranova, A; Møller, S

    2004-07-01

    For many years all patients with dysphonia referred to in the literature as resulting from non-organic (functional) voice disorders were sent to speech therapy. Medical diagnoses were not taken into account. In our earlier Cochrane review on vocal cord nodules we discovered that evidence-based research in the area of benign voice disorders with dysphonia, and with or without slight benign swellings including nodules on the vocal cords, was lacking at that time. Therefore, a prospective randomised pilot study based on our Cochrane review has been made on dysphonic patients with non-organic (function provoked?) voice disorders as the basis for further evidence-based studies. Medical treatment was based on the scientific approach that once a micro-organic disorder caused by reflux, infection, allergy or environmental irritatants (e.g., dust or noise in the workplace) was discovered by very careful anamnesis and systematic objective routine analyses and was treated effectively, with documentation, the non-organic voice disorder disappeared, as, e.g., in the case of a diagnosis and treatment of helicobakter pylori. The reason is that the mucosal swelling/dysfunction of the vocal cords is secondary. In order to try to understand why the recommendation to all these patients for many years was only voice therapy, which the speech therapists "felt to be effective", updated voice-hygiene advice (for posture, accents of the diaphragm, intonation pattern and resonance) was given by experienced laryngologists, randomised with the updated medical diagnosis/therapy in order to elucidate what effect the training might have. No evidence-based studies in the literature document any effect. The crucial point seemed to be that doctors mostly did not examine any other diagnoses other than the "dysphonia" and did not dig down to any of the medical reasons when the vocal fold diagnosis of "non- organic disorders" was made. This should be changed in the future. This pilot study was based

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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. Brainstem auditory evoked potentials in a case of 'Manto syndrome', or spasmodic torticollis with thoracic outlet syndrome.

    Science.gov (United States)

    Disertori, B; Ducati, A; Piazza, M; Pavani, M

    1982-12-01

    A case of spasmodic torticollis with thoracic outlet syndrome observed for over 18 months is presented and discussed. Maximal head rotation (determining backward gaze) was associated with compression of the brachial plexus between the scaleni muscles and motor, sensory and trophic troubles in the hand. This new syndrome is called after the diviner Manto, quoted by Dante Alighieri in his 'Divina Commedia' (Inferno, XX, 52-56). The etiology was ascribed to subacute toxic effects of methylparathion. Brainstem Auditory Evoked Potentials (BAEPs) demonstrated severe brainstem involvement, maximal in the mesencephalic structures. Clinical and neurophysiological data improved on treatment with L-5-hydroxytryptophan. Finally, BAEPs returned to normal.

  2. Association between hip abductor function, rear-foot dynamic alignment, and dynamic knee valgus during single-leg squats and drop landings

    Directory of Open Access Journals (Sweden)

    Yoshinori Kagaya

    2015-06-01

    Conclusion: Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.

  3. [Obese woman presenting as vocal cord abductor paralysis and floppy arytenoid associated with early signs of multiple system atrophy].

    Science.gov (United States)

    Sakuta, Hideki; Miyamoto, Masayuki; Suzuki, Keisuke; Miyamoto, Tomoyuki; Nakajima, Itsuo; Nakamura, Toshiki; Hirata, Koichi

    2012-01-01

    In multiple system atrophy (MSA), sleep-related breathing disorders are commonly observed, including vocal cord abductor paralysis (VCAP), which can cause sudden death. In its early stage, VCAP occurs only during sleep, but as the disease progresses, it appears when both awake and asleep. We encountered a 59-year-old obese woman who had been under continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea syndrome (OSAS) for approximately one year but later developed acute respiratory failure because of VCAP. VCAP was the predominant finding that led to the diagnosis of MSA in our patient. On laryngoscopic examination, the movement of the patient's larynx was normal during wakefulness, but VCAP, paradoxical movements of the vocal cord and a floppy arytenoid were observed during drug-induced sleep. We suggest that detection of VCAP and laryngopharyngeal abnormalities such as floppy arytenoid in the early stage of MSA is important for determining treatment options.

  4. Sexual Well-Being in Patients with Blepharospasm, Spasmodic Torticollis, and Hemifacial Spasm: A Pilot Study

    Science.gov (United States)

    Perozzo, Paola; Salatino, Adriana; Cerrato, Paolo; Ricci, Raffaella

    2016-01-01

    Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson’s disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available. PMID:27761118

  5. Spasmolytic and anti-spasmodic action of Trachyspermum ammi essence on rat′s ileum contraction

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Hejazian

    2014-01-01

    Full Text Available Background: Trachyspermum ammi is a plant of umbelliferae family and has been traditionally used in the treatment of many gastrointestinal disorders such as indigestion, colic, and diarrhea. Our previous study demonstrated that aqueous extract of Trachyspermum ammi reduced the contractile activity of rat′s ileum. Aims: This study was designed to examine the effect of Trachyspermum ammi essence on acetylcholine-induced contraction in isolated rat′s ileum. Materials and Methods: In this experimental procedure, the tissue samples were suspended from the transducer lever and mounted on the organ bath containing Tyrode′s solution. Isotonic responses were recorded by using an isotonic transducer and the amplitude of contractions. This process was induced by cumulative logarithmic concentrations of acetylcholine before and after exposing tissue by saline and different concentrations of essence. Results: The chemical constituents of the essence from distillate extract of Trachyspermum ammi seeds were studied by gas chromatography mass spectrometry (GC-MS and the chemical analysis showed many components in which thymol was the main constituent. Our findings showed that the essence derived from the extract in all concentrations used in this study (0.002, 0.005, and 0.01% V/V significantly reduced acetylcholine-induced contractions (47.34, 60.46, and 86%, respectively, P < 0.05. The same concentrations of the essence also exhibit a significant anti-spasmodic action on acetylcholine-induced contractions (0.1,88.3, and 90.7%, respectively, P < 0.05. Conclusion: Since thymol was the major constituent of our samples of Trachyspermum ammi, the relaxant effect observed in this study is probably due to this agent which can exert an anti-cholinergic property.

  6. Sexual Well-Being in Patients with Blepharospasm, Spasmodic Torticollis, and Hemifacial Spasm: A Pilot Study.

    Science.gov (United States)

    Perozzo, Paola; Salatino, Adriana; Cerrato, Paolo; Ricci, Raffaella

    2016-01-01

    Mood, anxiety, and other psychological symptoms are common in dystonic patients suffering from blepharospasm (BSP) and spasmodic torticollis (ST). Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N = 30), ST (N = 30), and in a control group of patient with Hemifacial spasm (HFS; N = 30), undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory, a reduced form of the Golombok Rust Inventory, previously employed in patients with Parkinson's disease. Depression (Beck Depression Inventory) and anxiety (STAI-X1/X2) were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e., altered activity of cortico-striato-thalamic-cortical circuits). Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST, and HFS, and comparable data are not available.

  7. Sexual well-being in patients with blepharospasm, spasmodic torticollis and hemifacial spasm: a pilot study

    Directory of Open Access Journals (Sweden)

    Paola Perozzo

    2016-10-01

    Full Text Available Mood, anxiety and other psychological symptoms are common in dystonic patients suffering from blepharospam (BSP and spasmodic torticollis (ST. Since sexual well-being is an important aspect of mental health, here, we investigated whether these patients may also experience a worsening of their sexual life. In particular, quality of sexual life was evaluated in patients suffering from BSP (N=30, ST (N=30, and in a control group of patient with Hemifacial spasm (HFS; N=30, undergoing botulinum toxin type A therapy. A group of 30 age-matched healthy volunteers constituted an additional control group. Patients were evaluated just before the periodic injection of botulinum toxin. Sexual functioning was assessed using the Sexual Functioning Inventory (SFI, a reduced form of the Gollombok Rust Inventory, previously employed in patients with Parkinson’s disease. Depression (Beck Depression Inventory and anxiety (STAI-X1/X2 were also assessed. Results revealed that sexual functioning was significantly affected in patients with BSP, ST, and HFS with respect to healthy controls. Dystonic patients manifested more sexual dysfunction than patients with HFS. Overall, females had a poorer quality of sexual life than males and, among females, women with BSP were the most dysfunctional. Psychological symptoms were present in patients with dystonia, but not in patients with HFS. As discussed in the paper, several factors might be taken into account to explain worse quality of sexual life in patients with dystonia compared to patients with hemifacial spasm. Among them an important role might be played by the central origin of dystonia pathophysiology (i.e. altered activity of cortico-striato-thalamic-cortical circuits. Future investigations are necessary to further explore these preliminary findings, considering that this is the first time that sexual well-being is evaluated in patients with BSP, ST and HFS, and comparable data are not available.

  8. Use of topical lidocaine in the treatment of muscle tension dysphonia.

    Science.gov (United States)

    Dworkin, J P; Meleca, R J; Simpson, M L; Garfield, I

    2000-12-01

    This investigation explored the potential usefulness of topical lidocaine in the treatment of muscle tension dysphonia. Three patients with this disorder, who were previously unresponsive to standard voice therapy, were treated with lidocaine. In each case, the outcome was prompt, clinically significant, and sustained. Persistently high-pitched and shrill vocal quality was converted to near normal voice patterns within 15 minutes after transcricothyroid membrane lidocaine injection. We suggest that this temporary and simple laryngeal and tracheal anesthetic technique may have helped to break the perverse cycle of hyperactive glottal and supraglottal muscle contractions evident in each of these patients during phonation efforts. We discuss the possible sensorimotor mechanism of action of this therapeutic technique.

  9. Non-organic dysphonia. II. A comparison of subglottal pressures in normal and pathological voices.

    Science.gov (United States)

    Gramming, P

    1989-01-01

    In previous investigations, typical phonetogram differences have been revealed between healthy and pathological voices: the average maximum and minimum sound pressure levels that a patient suffering from non-organic dysphonia can produce at different fundamental frequencies deviate significantly from the corresponding values for a healthy voice. The subglottal pressure, being the primary tool for regulating the sound pressure level of voice, was estimated from the oral pressure during the voiceless stop/p/in 10 female and 10 male subjects with normal voices and in 10 female and 10 male non-organic dysphonic patients. In loud phonation, the female patients had significantly lower values than the female healthy subjects, while no corresponding significant difference was seen between the male subjects. In soft phonation, the male patients had significantly higher values than the normal healthy subjects, while the females showed no significant difference.

  10. The use of anti-spasmodics in the treatment of irritable bowel syndrome: focus on otilonium bromide.

    Science.gov (United States)

    Forte, E; Pizzoferrato, M; Lopetuso, L; Scaldaferri, F

    2012-01-01

    Aim of this review is to summarize the studies carried out, with particular interest in those who dealt with otilonium bromide in treatment of IBS. Irritable bowel syndrome (IBS). IBS is a frequent gastrointestinal disease, characterized by a combination of several symptoms including abdominal pain or discomfort, flatulence and problems related to bowel habits (constipation and/or diarrhea). It affects about 15% of the western population, with a negative impact on the quality of life and also on health care costs. Face to such important complexity and negative impact, therapeutic options are still very limited and most of the pharmacological compounds mostly validated for short term use, are only partially controlling symptoms. Among those, anti-spasmodics are commonly used in clinical settings. Despite a discrete literature in support of these drugs, systematic collections of clinical evidence to support the use of anti-spasmodics and in particular the use of otilonium bromide in course of IBS are scarce. Otilonium bromide is a systemically poorly absorbed antispasmodic, which has shown clear efficacy compared to placebo, in controlling symptoms related to IBS. Otilonium bromide was effective also in comparison to other drugs, such as pinaverium bromide and mebeverine, with a favorable tolerability profile. Further studies are necessary to better define duration of treatment and maximum therapeutic dose.

  11. Laryngeal reinnervation for paralytic dysphonia in children younger than 10 years.

    Science.gov (United States)

    Smith, Marshall E; Roy, Nelson; Houtz, Dan

    2012-12-01

    To study the effectiveness of ansa-recurrent laryngeal nerve laryngeal reinnervation to improve glottal incompetence causing dysphonia and dysphagia for children with unilateral vocal fold paralysis. DESIGN We reviewed a series of consecutive cases treated from January 1, 2006, through December 31, 2011. Otolaryngology division of a children's hospital. PATIENTS Thirteen children with unilateral vocal fold paralysis. Surgical complications, parent surrogate quality-of-life measures, global overall assessment of improvement, and auditory perceptual assessment. Thirteen children underwent laryngeal reinnervation. Ages ranged from 2.2 to 8.8 years (mean [SD] age, 5.3 [2.6] years). No major complications were identified. Nine children had preoperative and 6- to 12-month postoperative data on voice and swallowing. Mean parental global voice rating (0 indicates no voice; 100%, normal voice) changed from 43% (range, 20%-65%) preoperatively to 79% (range, 50%-100%) postoperatively. Regarding perceptual assessment, the mean GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) Rating Scale sum score (0 indicates normal voice; 15, profoundly abnormal voice) improved from 6.3 to 2.9. Parental assessment of dysphagia with liquids also improved for all children with preoperative symptoms and worsened for none. Our early experience suggests that ansa-recurrent laryngeal nerve laryngeal reinnervation is a safe and effective treatment for unilateral vocal fold paralysis with symptomatic dysphonia and dysphagia in young children. The procedure has advantages compared with other treatments. This option should be discussed with parents when the paralysis is identified. The child should be observed for several years in the event that voice and swallowing symptoms from glottal incompetence do not improve.

  12. Comparison of cepstral coefficients to other voice evaluation parameters in patients with occupational dysphonia

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    Ewa Niebudek-Bogusz

    2013-12-01

    Full Text Available Background: Special consideration has recently been given to cepstral analysis with mel-frequency cepstral coefficients (MFCCs. The aim of this study was to assess the applicability of MFCCs in acoustic analysis for diagnosing occupational dysphonia in comparison to subjective and objective parameters of voice evaluation. Materials and Methods: The study comprised 2 groups, one of 55 female teachers (mean age: 45 years with occupational dysphonia confirmed by videostroboscopy and 40 female controls with normal voice (mean age: 43 years. The acoustic samples involving sustained vowels "a" and four standardized sentences were analyzed by computed analysis of MFCCs. The results were compared to acoustic parameters of jitter and shimmer groups, noise to harmonic ratio, Yanagihara index evaluating the grade of hoarseness, the aerodynamic parameter: maximum phonation time and also subjective parameters: GRBAS perceptual scale and Voice Handicap Index (VHI. Results: The compared results revealed differences between the study and control groups, significant for MFCC2, MFCC3, MFCC5, MFCC6, MFCC8, MFCC10, particularly for MFCC6 (p < 0.001 and MFCC8 (p < 0.009, which may suggest their clinical applicability. In the study group, MFCC4, MFCC8 and MFCC10 correlated significantly with the major objective parameters of voice assessment. Moreover, MFCC8 coefficient, which in the female teachers correlated with all eight objective parameters, also showed the significant relation with perceptual voice feature A (asthenity of subjective scale GRBAS, characteristic of weak tired voice. Conclusions: The cepstral analysis with mel frequency cepstral coefficients is a promising tool for evaluating occupational voice disorders, capable of reflecting the perceptual voice features better than other methods of acoustic analysis. Med Pr 2013;64(6:805–816

  13. Observation on the clinical efficacy of spasmodic torticollis treated with matrix needling technique and acupuncture at “Wuxin points” mainly

    Institute of Scientific and Technical Information of China (English)

    徐彦龙

    2013-01-01

    Objective To compare the difference in the efficacy on spasmodic torticollis between matrix needling technique combined with puncturing"Wuxin points"and the local injection of botox type A.Methods Forty-two cases were randomized into an acupuncture group and a botox

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

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    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

  15. Abductor Hallucis: Anatomical Variation and Its Clinical Implications in the Reconstruction of Chronic Nonhealing Ulcers and Defects of Foot

    Science.gov (United States)

    Chittoria, Ravi Kumar; Pratap, Harsha; Yekappa, Suma Hottigoudar

    2015-01-01

    Abductor hallucis (AH) is an intrinsic muscle of sole of the foot. It is commonly used in the coverage of ankle and heel defects and chronic nonhealing ulcers of the foot; its use is reported to have a favorable long-term outcome. The muscle's apt bulk and size, its simple surgical isolation, absence of donor-site defect, unvaried anatomy, and long neurovascular pedicle are some of the advantages that make it a promising muscle flap. During routine cadaver dissection in the Department of Anatomy of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, we identified an anatomical variation in AH in both feet of a 45-year-old embalmed male Indian cadaver. The variant muscle had innumerable proximal attachments, a majority of them arising atypically in the form of tough tendinous slips from the medial intermuscular septum at the junction of central and tibial components of plantar aponeurosis, the medial surface of first metatarsal and the intermuscular septum separating AH from the flexor hallucis brevis. The tendon: muscle ratio was 1.76, higher than the normal reported ratio of 0.56±0.07. This article highlights the variation noted and its implication for clinicians. On Internet search, we did not come across the variations described in our article. Findings of the anatomical variation reported in this article could benefit surgeons who decide to use AH flaps in the future. PMID:26634184

  16. An examination of variations in the cepstral spectral index of dysphonia across a single breath group in connected speech.

    Science.gov (United States)

    Watts, Christopher R; Awan, Shaheen N

    2015-01-01

    The purpose of this study was to use spectral and cepstral analyses of speech to investigate whether underlying physiological changes in voice result in changes in acoustic estimates of dysphonia severity in continuous speech contexts within a single breath group. The effect of dysphonia on acoustic estimates of dysphonia severity, frequency, relative intensity, and vocalization time across initial and terminal segments of a single breath group using a common clinical stimulus was investigated. Prospective quasi-experimental controlled design. Digitized recordings of the Consensus Auditory-Perceptual Evaluation of Voice sentence "We were away a year ago" were obtained from 20 treatment-seeking dysphonic individuals (females, mean age = 39 years) and 20 normal controls (females, mean age = 39 years). Each recorded sample was separated into the first four syllables ("We were away … ") and second four syllables ("…a year ago.") of the breath group. Cepstral and spectral measures, intensity measures, and temporal analyses were obtained and used in calculations of the Cepstral Spectral Index of Dysphonia (CSID, an acoustic estimate of dysphonia severity), fundamental frequency (F0), vocalization time, and relative vocal intensity (dB SLP). Statistical analyses were applied to calculations of change (delta [Δ]) in these measures from one breath group segment to the next. Results revealed a significant effect of group on measures of CSID and F0, but not relative intensity or vocalization time. Dysphonic speakers exhibited a significant increase in the CSID from the first to second breath group segment and limited variation in F0 compared with controls. These results may support the hypothesis that voice impairment increases in severity toward the termination of a breath group even within a short temporal frame (i.e., 2 seconds or less of connected speech), and that this portion of the breath group may be an important determinant of perceptual impressions. Further

  17. Short-term spasmodic switching of volcanic tremor source activation in a conduit of the 2011 Kirishima eruption

    Science.gov (United States)

    Matsumoto, S.; Shimizu, H.; Matsushima, T.; Uehira, K.; Yamashita, Y.; Nakamoto, M.; Miyazaki, M.; Chikura, H.

    2012-04-01

    Volcanic tremors are seismic indicators providing clues for magma behavior, which is related to volcanic eruptions and activity. Detection of spatial and temporal variations of volcanic tremors is important for understanding the mechanism of volcanic eruptions. However, temporal variations of tremor activity in short-term than a minute have not been previously detected by seismological observations around volcanoes. Here, we show that volcanic tremor sources were activated at the top of the conduit (i.e. the crater) and at its lower end by analyzing seismograms from a dense seismic array during the 2011 Kirishima eruption. We observed spasmodic switching in the seismic ray direction during a volcanic tremor sequence. Such fine volcanic tremor structure suggests an interaction between tremor sources located in both deep and shallow depths. Our result suggests that seismic array observations can monitor the magma behavior and contribute to the evaluation of the activity's transition.

  18. The Comparison of the Effects of Trigger Points Pressure Release and Kinesio Taping on Pain and Hip Abductor Muscles Strength in Patients with Patellofemoral Pain Syndrome

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    Vahid Mazloum

    2016-10-01

    Full Text Available Background & objectives: Hip muscles insufficiency plays a significant role in deterioration of patellofemoral pain syndrome (PFPS, which can be manifested as myofascial trigger point (MTrPs in hip muscles. Then, our purpose was to determine the prevalence of MTrPs in the gluteus medius (GMe and quadratus lumborum (QL muscles and to investigate the effect of a therapeutic intervention on pain intensity and hip abductor muscles isometric strength in patients with PFPS. Methods: Forty volunteer subjects (20 patients and 20 healthy participated in the study. Latent MTrPs in GMe and QL were evaluated and a handheld dynamometer was used to measure peak isometric strength test (PIST for hip abductors. Patients with PFPS having MTrPs in GMe were randomly divided into either a treatment group (Mean age±SD: 23.2±4.3 years or control (Mean age±SD: 24.4±4.6 years. The therapeutic intervention included trigger point pressure release (TrPPR and Kinesio Taping® (KT. Pain intensity and PIST for hip abductors were assessed at baseline and after intervention in both groups. Results: There is more significant patients with PFPS having latent MTrPs in GMe and QL than the healthy counterparts (p0.05. Conclusion: Concomitant using of TrPPR therapy and KT method can decrease pain intensity in individuals with PFPS. Further studies are required to understand the underlying mechanisms.

  19. Assessment of Grade of Dysphonia and Correlation With Quality of Life Protocol.

    Science.gov (United States)

    Spina, Ana Lúcia; Crespo, Agrício Nubiato

    2017-03-01

    The main objective of this study is to check the correlation between vocal self-assessment and results of the Voice-Related Quality of Life (V-RQOL) protocol, and whether there is a correlation between perceptual vocal assessment made by voice therapists and the results from the V-RQOL protocol. The study included 245 subjects with vocal complaints. This was a prospective analytical clinical study. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by self-assessment made by the subjects themselves, and the application of the V-RQOL protocol. The results have shown poor level of agreement between vocal assessment made by the voice therapists and self-assessment made by the subjects. The statistical analysis indicated that the results of V-RQOL protocol showed significant correlation with the vocal assessment made by the voice therapists and the self-assessment by the subjects. The agreement between the assessments was low and variable; age, gender, professional voice use, and clinical laryngoscopic diagnosis did not influence the agreement level. Protocol V-RQOL is sensitive to vocal assessment made by the voice therapists and self-assessment made by the patient. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. Correlation between female sex and allergy was significant in patients presenting with dysphonia.

    Science.gov (United States)

    Lauriello, M; Angelone, A M; Businco, L Di Rienzo; Passali, D; Bellussi, L M; Passali, F M

    2011-06-01

    Aim of the present study was to investigate the prevalence of allergy in patients affected by both organic and/or functional vocal fold disorders. The secondary aim was to assess the correlation between sex and allergy in dysphonic patients. A retrospective chart review was performed on dysphonic patients. A total of 76 patients underwent fiberoptic endoscopy to assess the objective picture. Logistic regression analyses have been conducted to assess the association between sex and the outcome variables. The laryngoscopic examination revealed the presence of poor glottic closure in 32.9%, hyperkinesias in 11.8%, redness in 11.84%, polyps in 5.3%, oedema in 3.95%, vocal fold hypertrophy in 5.3%, nodules in 42.1%, cordectomy in 2.6%. Allergic rhinitis was present in 56.6%, milk intolerance in 13.2%, asthma in 9.2%, atopic dermatitis in 3.9%, drugs intolerance in 11.8%. A total of 76.32% patients presenting with dysphonia were allergic. A statistically significant association was found between female sex and presence of allergy. In conclusion, allergy testing should be performed routinely on female professional voice users. Mild respiratory disorders must be taken into serious consideration in female professional voice users, who may primarily complain of vocal dysfunction rather than upper and lower respiratory diseases.

  2. The effectiveness of voice therapy for patients with non-organic dysphonia.

    Science.gov (United States)

    Carding, P N; Horsley, I A; Docherty, G J

    1998-08-01

    Forty-five patients diagnosed as having non-organic dysphonia were assigned in rotation to one of three groups. Patients in one group received no treatment and acted as a control group. Patients in the other two groups received a programme of either 'indirect' therapy or 'direct with indirect' therapy, respectively. A self-report questionnaire of vocal performance, observed ratings of voice quality, and computer-derived acoustic measurements (signal-to-noise ratio, pitch perturbation and amplitude perturbation) were carried out on all patients before and after treatment to evaluate the changes in voice quality over time. There was a significant difference between the three groups on the self-report questionnaire, voice quality ratings and pitch perturbation measurements (P = < 0.05). Thirteen out of 15 control patients showed no significant change on any of the measures. Seven patients who received indirect treatment showed significant improvement in voice quality following treatment. Fourteen out of 15 patients who received direct treatment showed significant improvement in voice quality.

  3. Parents' Evaluations of Their Children's Dysphonia: The Mamas and the Papas.

    Science.gov (United States)

    Amir, Ofer; Wolf, Michael; Mick, Liron; Levi, Omer; Primov-Fever, Adi

    2015-07-01

    This study aimed to evaluate the validity and reliability of a Hebrew translation of the Pediatric Voice Handicap Index (pVHI). It also examined differences between mothers and fathers in evaluating their child's dysphonia. Observational design. The pVHI was first translated and adapted to Hebrew. The translated version was, then, administered to a group of 141 parents of children aged younger than 14 years. Fifty-eight parents had a dysphonic child, and 83 had a nondysphonic child. Based on the parents' responses to the pVHI, statistical analyses were performed, evaluating validity and reliability, as well as group differences. Following, a subset of the participants, in which only cases where the responses of both parents were available, was examined for evaluating differences between the responses of mothers (n = 46) and fathers (n = 46). Statistical analyses revealed high reliability of the Hebrew version of the pVHI (Cronbach alpha = .97). Parents of the dysphonic children rated their children significantly higher than parents of the nondysphonic group (P  0.05). The Hebrew version of the pVHI is a reliable tool for quantifying parents' perception of their child's voice handicap. Mothers of dysphonic children evaluate their children's voice handicap more severely than fathers, whereas both parents of nondysphonic children perform this evaluation similarly. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  4. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Chundru, Usha [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Liebeskind, Amy; Beltran, Javier [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Seidelmann, Frank; Franklin, Peter [Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Fogel, Joshua [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Brooklyn College, Department of Economics, Brooklyn, NY (United States)

    2008-06-15

    To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA. Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, p < 0.001), presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), calcaneal edema (15.0% vs 3.0%, P = 0.005), calcaneal spur (48.0% vs 7.0%, P < 0.001), plantar fasciitis (52.5% vs 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001). After multivariate logistic regression analysis, only age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03, 1.09], calcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant. Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy. (orig.)

  5. The association between lifetime cigarette smoking and dysphonia in the Korean general population: findings from a national survey

    Directory of Open Access Journals (Sweden)

    Haewon Byeon

    2015-04-01

    Full Text Available This study aims to investigate the relationship between current smoking and lifetime amount smoked and the incidence of dysphonia using data from a national cross-sectional survey that represents the Korean population. Subjects were 3,600 non-institutionalised civilian adults over the age of 19 (1,501 males and 2,099 females who completed the laryngeal examination of the 2008 Korea National Health and Nutrition Examination Survey (KNHANES. For lifetime amount smoked, subjects were classified as light smokers (≤26.7 pack years, medium smokers (26.7–40.5 pack years, heavy smokers (40.5–55.5 pack years, and very heavy smokers (55.5–156 pack years based on pack years (packs smoked per day × years as a smoker. The odds ratio (OR for the statistical test was presented using hierarchical logistic regression. When adjusted for covariates (age, gender, level of education, income, occupation, alcohol consumption and pain/discomfort during the last two weeks, current smokers had a 1.8 times (OR = 1.77, 95% CI [1.17–2.68] higher risk for self-reported voice problems than non-smokers. Moreover, current smokers had a 1.6 times (OR = 1.56, 95% CI [1.02–2.38] higher risk of laryngeal disorder (p < 0.05. In terms of pack years, very heavy smokers were significantly more likely to have laryngeal disorder, while self-reported voice problems were significantly more likely for heavy smokers but not very heavy smokers. The results of this study imply that chronic smoking has a significant relationship with dysphonia. Longitudinal studies are required in future work to verify the causality between lifetime smoking amount and dysphonia.

  6. Combining Voice Therapy and Physical Therapy: A Novel Approach to Treating Muscle Tension Dysphonia

    Science.gov (United States)

    Craig, Jennifer; Tomlinson, Carey; Stevens, Kristin; Kotagal, Kiran; Fornadley, Judith; Jacobson, Barbara; Garrett, C. Gaelyn; Francis, David O.

    2015-01-01

    Objective This study investigated the role of a specialized physical therapy program for muscle tension dysphonia patients as an adjunct to standard of care voice therapy. Study Design Retrospective Cohort Study Methods Adult MTD patients seen between 2007 and 2012 were identified from the clinical database. They were prescribed voice therapy and, if concomitant neck pain, adjunctive physical therapy. In a pragmatic observational cohort design, patients underwent one of four potential treatment approaches: voice therapy alone (VT), voice therapy and physical therapy (VT+PT), physical therapy alone (PT), or incomplete/no treatment. Voice handicap outcomes were compared between treatment approaches. Results Of 153 patients meeting criteria (Median age 48 years, 68% female, and 30% had fibromyalgia, chronic pain, chronic fatigue, depression, and/or anxiety), there was a similar distribution of patients with moderate or severe pre-treatment VHI scores across treatment groups (VT 45.5%, VT+PT 43.8%, PT 50%, no treatment 59.1%; p=0.45). Patients treated with VT alone had significantly greater median improvement in VHI than those not treated: 10-point vs. 2-point (p=0.02). Interestingly, median VHI improvement in patients with baseline moderate-severe VHI scores was no different between VT (10), VT+PT (8) and PT alone (10; p=0.99). Conclusions Findings show voice therapy to be an effective approach to treating MTD. Importantly, other treatment modalities incorporating physical therapy had a similar, albeit not significant, improvement in VHI. This preliminary study suggests that physical therapy techniques may have a role in the treatment of a subset of MTD patients. Larger, comparative studies are needed to better characterize the role of physical therapy in this population. PMID:26012419

  7. Reliability of speaking and maximum voice range measures in screening for dysphonia.

    Science.gov (United States)

    Ma, Estella; Robertson, Jennie; Radford, Claire; Vagne, Sarah; El-Halabi, Ruba; Yiu, Edwin

    2007-07-01

    Speech range profile (SRP) is a graphical display of frequency-intensity occurring interactions during functional speech activity. Few studies have suggested the potential clinical applications of SRP. However, these studies are limited to qualitative case comparisons and vocally healthy participants. The present study aimed to examine the effects of voice disorders on speaking and maximum voice ranges in a group of vocally untrained women. It also aimed to examine whether voice limit measures derived from SRP were as sensitive as those derived from voice range profile (VRP) in distinguishing dysphonic from healthy voices. Ninety dysphonic women with laryngeal pathologies and 35 women with normal voices, who served as controls, participated in this study. Each subject recorded a VRP for her physiological vocal limits. In addition, each subject read aloud the "North Wind and the Sun" passage to record SRP. All the recordings were captured and analyzed by Soundswell's computerized real-time phonetogram Phog 1.0 (Hitech Development AB, Täby, Sweden). The SRPs and the VRPs were compared between the two groups of subjects. Univariate analysis results demonstrated that individual SRP measures were less sensitive than the corresponding VRP measures in discriminating dysphonic from normal voices. However, stepwise logistic regression analyses revealed that the combination of only two SRP measures was almost as effective as a combination of three VRP measures in predicting the presence of dysphonia (overall prediction accuracy: 93.6% for SRP vs 96.0% for VRP). These results suggest that in a busy clinic where quick voice screening results are desirable, SRP can be an acceptable alternate procedure to VRP.

  8. [Diagnostics and therapy of dysphonia suitable for the ages and developmental stages of children and adolescents (part 2)].

    Science.gov (United States)

    Fuchs, M

    2008-02-01

    The incidence of dysphonia among children and adolescents is evaluated internationally at 6 % to 25 %. Nonetheless, hoarseness as a leading symptom among children is often insufficiently recognized by their parents/attachment figures, by the young patients themselves, and even by physicians. In an overview, the hereditary and acquired organic and functional causes - including secondary organic lesions of the vocal folds - their pathomechanisms and the symptoms typical for this age group are presented. For diagnostics suitable for these age groups and developmental stages, modern methods of laryngoscopy (including stoboscopy and real-time laryngoscopy), of functional diagnostics of vocal capacity and quality as well as anamnestic and psychometric procedures for the investigation of possible psychosomatic genesis are available. Frequent therapeutic measures are vocal hygienic counseling and psycho- and family dynamic therapies. Vocal exercise treatments are particularly employed for the consequences of laryngeal surgery and with voice techniques unfavorable as a precondition for increased vocal activity. Operative measures in the sound-producing areas of the vocal apparatus and in the framework of plastic reconstruction concentrate on the optimizing of vocal capacity and quality. In clinical routine, symptoms of dysphonia in children and adolescents should be consciously registered, and any long-term hoarseness, in this age group as well, should be examined by specialized physicians using the methods suitable to the age group and the developmental stage. When the appropriate indications are present, all of the therapeutic options currently available should be discussed.

  9. Laryngeal manual therapy palpatory evaluation scale: A preliminary study to examine its usefulness in diagnosis of occupational dysphonia

    Directory of Open Access Journals (Sweden)

    Ewelina Woźnicka

    2017-04-01

    Full Text Available Background: The aim of this study has been to assess the larynx and soft tissue around the vocal tract in a group of people with healthy voice, and in a group of patients with occupational dysphonia using the new laryngeal manual therapy palpatory evaluation scale (LMTPE. Material and Methods: The examinations were performed in a study (dysphonic group of professional voice users who had developed voice disorders (N = 51 and in the control group of normophonic subjects (N = 50. All the participants underwent perceptual voice assessment and examination by means of the LMTPE scale. Additionally, phoniatric examination including VHI (Voice Handicap Index questionnaire, GRBAS (the Grade of hoarseness, Roughness, Breathiness, Asthenic, Strained perceptual evaluation, maximum phonation time (MPT measurement and videostroboscopy was performed in the study group. Results: The comparison of the LMTPE total score showed that the results of the study group were significantly poorer than those of controls (p < 0.001. In the study group, correlations were found between the LMTPE results and the VHI scores (p < 0.05, perceptual evaluation by the GRBAS (p < 0.05 and the objective parameter MPT (p < 0.05. Conclusions: The study has proven that the LMTPE scale is characterized by the high score of Cronbach’s α ratio estimating the reliability of the test. The results have confirmed that the LMTPE scale seems to be a valuable tool, useful in diagnostics of occupational dysphonia, particularly of hyperfunction origin. Med Pr 2017;68(2:179–188

  10. The association between lifetime cigarette smoking and dysphonia in the Korean general population: findings from a national survey.

    Science.gov (United States)

    Byeon, Haewon

    2015-01-01

    This study aims to investigate the relationship between current smoking and lifetime amount smoked and the incidence of dysphonia using data from a national cross-sectional survey that represents the Korean population. Subjects were 3,600 non-institutionalised civilian adults over the age of 19 (1,501 males and 2,099 females) who completed the laryngeal examination of the 2008 Korea National Health and Nutrition Examination Survey (KNHANES). For lifetime amount smoked, subjects were classified as light smokers (≤26.7 pack years), medium smokers (26.7-40.5 pack years), heavy smokers (40.5-55.5 pack years), and very heavy smokers (55.5-156 pack years) based on pack years (packs smoked per day × years as a smoker). The odds ratio (OR) for the statistical test was presented using hierarchical logistic regression. When adjusted for covariates (age, gender, level of education, income, occupation, alcohol consumption and pain/discomfort during the last two weeks), current smokers had a 1.8 times (OR = 1.77, 95% CI [1.17-2.68]) higher risk for self-reported voice problems than non-smokers. Moreover, current smokers had a 1.6 times (OR = 1.56, 95% CI [1.02-2.38]) higher risk of laryngeal disorder (p lifetime smoking amount and dysphonia.

  11. Controlling the processes of impact interaction of a tool with rocks in the region of spasmodic destruction frequencies

    Energy Technology Data Exchange (ETDEWEB)

    Dzidziguri, A.A.; Sepiashvili, A.D.; Yamanidze, T.Sh.

    1983-01-01

    A working hypothesis is described which made it possible to take into consideration the wave processes occurring in the drilling tool, and the discrete nature of crushing of rocks in limits of a single impact. A mathematical model is given for the process of impact interaction of the drilling tool with the rock. It is indicated that the nonlinear elastic link with assigned rigid characteristics under conditions of single-frequency harmonic effect result in excitation of the highest odd harmonics. It follows from this that the contact region which is a nonlinear fluctuating contour in the same way as the wave reflector can create with definite conditions polyresonance modes of oscillations of the working end of the drilling tool, and promote intensification of the processes of spasmodic crushing of rocks in systems of direct impact or impact through the drilling machine. Practical realization of the optimal nonlinear elastic bond in the region of contact of crushing tool with the rock is possible by optimizing form, dimensions and elastic properties of the crushing tool.

  12. Nursing of spasmodic torticollis during the perioperative period%痉挛性斜颈围术期的护理

    Institute of Scientific and Technical Information of China (English)

    万承群; 邹光莉; 刘春容; 周南开

    2008-01-01

    目的 总结痉挛性斜颈(spasmodic torticollis,ST)围术期的护理经验.方法 在合理选择手术方式的基础上,加强术前心理护理、完善术前准备,术后精心护理,针对每一位患者的具体情况制订个体化的康复和训练计划并认真实施,出院指导应详细、具体,并加强电话回访和门诊随访.结果 本组痊愈 18例(67%),显效 6例(22%),进步3 例(11%),无死亡,无致残.结论 手术方式的合理选择、围术期的护理和康复训练、出院指导和电话随访是治疗痉挛性斜颈的重要环节.

  13. Surgical treatment of rotational spasmodic torticollis%旋转型痉挛性斜颈的手术治疗

    Institute of Scientific and Technical Information of China (English)

    熊左隽; 王潞; 姬绍先; 周国俊; 陈信康

    2005-01-01

    目的 研究旋转型痉挛性斜颈(rotational spasmodic torticollis,RoST)的临床分型和手术治疗.方法 对RoST按痉挛肌肉范围,姿态,肌肉痉挛的方式,病情程度分型.手术治疗:采用下列术式或二至三种术式组合.术式一:面部旋向侧颈后痉挛肌肉选择性切除术.术式二:同侧颈神经1-6(C1-6)后支选择性切断术.术式三:对侧副神经切断术(或加胸锁乳突肌切除术).结果 术后6个月评定疗效,全组423例,斜颈症状消失292例(69%),显效78例(18.4%),进步42例(10%),无效11例(2.6%).无死亡,无并发症.结论 采用颈部痉挛肌肉和神经选择性切断术治疗RoST创伤小、操作简便,安全无残疾.

  14. Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study

    Science.gov (United States)

    2016-01-01

    Objective To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). Methods Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. Results There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. Conclusion The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI. PMID:27606266

  15. Hip abductors and thigh muscles strength ratios and their relation to electromyography amplitude during split squat and walking lunge exercises

    Directory of Open Access Journals (Sweden)

    Petr Stastny

    2015-06-01

    Full Text Available Background: The hip abductors (HAB, quadriceps (Q and hamstrings (H reciprocal strength ratios are predictors of electromyography (EMG amplitude during load carrying walking at moderate intensity. Therefore, these strength ratios might predict also the EMG during the exercises as walking lunge (WL or split squat (SSq at submaximal intensity. Objective: To determine whether the EMG amplitude of vastus mediali (VM, vastus laterali (VL, biceps femoris (BF and gluteus medius (Gmed is associated with muscle strength ratio during SSqs and WLs. To determine whether the EMG amplitude differs between individuals with HAB/H ratio above and below one and between individuals with H/Q or HAB/Q ratio above and below 0.5 during SSqs and WLs. Methods: 17 resistance-trained men (age 29.6 ± 4.6 years with at least 3 years of strength training performed in cross-sectional design 5 s maximal voluntary isometric contractions (MVIC on an isokinetic dynamometer for knee extension, knee flexion, and hip abduction. The MVIC was used to normalize the EMG signal and estimate the individual strength ratios. Than participants performed WL and SSq for a 5 repetition maximum, to find out muscle activity at submaximal intensity of exercise. Results: The H/Q ratio was associated by Kendall's tau (τ with VM (τ = .33 and BF (τ = -.71 amplitude, HAB/Q ratio was associated with BF (τ = -.43 and Gmed (τ = .38 amplitude, as well as HAB/H was associated with VM (τ = -.41 and Gmed (τ = .74 amplitude. ANOVA results showed significant differences between SSq and WL (F(4, 79 = 10, p < .001, ηp2 = .34 in Gmed amplitude, where WL resulted in higher Gmed amplitude compared to SSq. Other significant differences were found between H/Q groups (F(4, 29 = 3, p = .04, ηp2 = .28 in VM and Gmed amplitude, where group with H/Q > 0.5 showed higher VMO amplitude and lower Gmed amplitude. Furthermore, significant difference was found

  16. Queixas vocais e grau de disfonia em professoras do ensino fundamental Vocal complaints and degree of dysphonia in elementary school teachers

    Directory of Open Access Journals (Sweden)

    Luciana Lemos de Azevedo

    2009-01-01

    Full Text Available OBJETIVO: Realizar o levantamento das queixas vocais e grau de disfonia encontradas em professoras de uma Escola Municipal da Cidade de Betim. MÉTODOS: Foi realizada coleta de dados de 13 professoras do ensino fundamental, com idade entre 20 a 50 anos (média de 36 anos e carga horária mínima de 20 horas semanais, por meio de questionário aplicado e gravação de voz, no programa de análise acústica GRAM 5.7. Os dados foram analisados e as vozes classificadas por três fonoaudiólogas com experiência clínica na área, mínima de cinco anos. RESULTADOS: Das professoras incluídas no estudo, 30,77% apresentaram qualidade vocal sem alteração, 23,08% apresentaram disfonia discreta, 46,15% disfonia moderada e nenhuma apresentou disfonia severa. Intervalos de confiança de 95% estimaram proporções mínimas de 6,6% de professoras com disfonia discreta e 22,39% com disfonia moderada na população de referência. Independentemente do tipo de queixa vocal, o número total de queixas entre as professoras com disfonia moderada foi significantemente maior do que entre professoras sem alterações de voz. Não houve, no entanto, diferenças entre os grupos na distribuição das queixas específicas, quando estas foram analisadas isoladamente. CONCLUSÃO: A maioria dos professores da amostra apresentou qualidade vocal alterada, sendo o grau moderado o mais frequente. Queixas específicas parecem se distribuir igualmente entre professoras com e sem alteração de voz. Os resultados apontam a importância de projetos de saúde vocal para esta população.PURPOSE: The aim of this study was to survey vocal complaints and degree of dysphonia among teachers from a public elementary school at Betim, MG (Brazil. METHODS: Thirteen elementary school teachers with ages between 20 and 50 years (mean of 36 years old, who taught at least 20 hours a week, participated in the study. Data were obtained using a questionnaire and voice recording, analyzed on the

  17. Assessment of dysphonia due to benign vocal fold lesions by acoustic and aerodynamic indices: a multivariate analysis.

    Science.gov (United States)

    Cantarella, Giovanna; Baracca, Giovanna; Pignataro, Lorenzo; Forti, Stella

    2011-04-01

    The goal was to identify acoustic and aerodynamic indices that allow the discrimination of a benign organic dysphonic voice from a normal voice. Fifty-three patients affected by dysphonia caused by vocal folds benign lesions, and a control group were subjected to maximum phonation time (MPT) measurements, GRB perceptual evaluations and acoustic/aerodynamic tests. All analyzed variables except the airflow variation coefficient were significantly different between the two groups. The unique significant factors in the discrimination between healthy and dysphonic subjects were the aerodynamic indices of MPT and Glottal efficiency index, and the acoustic index Shimmer. These results show that a combination of three parameters can discriminate a voice deviance and highlight the importance of a multidimensional assessment for objective voice evaluation.

  18. Effect of Dynamic Platform Lateral Step-Up versus Stable Platform Lateral Step-Up Weight Bearing Exercise in Hip Abductor Strengthening on Healthy Male Volunteers - Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jagatheesan Alagesan

    2011-07-01

    Full Text Available Objective & Background: To determine the effect of the dynamic platform lateral step-up and stable platform lateral step-up weight bearing standing exercise in strengthening of hip abductor. Many researchers have reported that strengthening of hip muscles as important component especially hip abductors in lower extremity rehabilitation program. Study Design: Single blinded randomized comparative clinical trial. Methodology: Sixty five healthy college going male subjects (Age group of 18 – 24 years volunteered for this study. They were randomly assigned to one of the 2 groups. One group received the dynamic platform lateral step-up and the other received stable platform lateral step-up weight bearing standing exercise. The strength measurements were recorded using hand held dynamometer. Results: The results indicate that both groups had a positive effect on the outcome measures. The strength of hip abductors in dynamic platform group improved from a mean value (SD of 19.47(3.59 to 26.93(3.19 and in stable platform group from 19.07(2.32 to 22.67(2.46. Significant difference is also observed between the two groups at p value .05. Conclusion: The study shows that dynamic platform lateral step-up exercise is more beneficial than stable platform lateral step-up weight bearing standing exercise in improving hip abductor muscle strength.

  19. Operative outcome of partial plantar fasciectomy and neurolysis to the nerve of the abductor digiti minimi muscle for recalcitrant plantar fasciitis.

    Science.gov (United States)

    Conflitti, Joseph M; Tarquinio, Thom A

    2004-07-01

    A retrospective review was conducted of 23 patients (26 feet) to assess operative outcome of partial plantar fasciectomy and neurolysis to the nerve of the abductor digiti minimi muscle for recalcitrant plantar fasciitis. Nonsurgical treatment was implemented in all patients with no relief of symptoms (average 20.8 months) prior to surgery. Using a visual analog pain scale (0-10), the average preoperative pain was 9.2 (range, 8-10). Prior to surgery, 65.2% of patients had severe limitations of activity, and 34.8% of patients had moderate limitations of activity. An average 25.3-month follow-up (range, 8-51) was performed by telephone interview. Average postoperative pain decreased to 1.7 using the same visual analog scale. Thirteen patients (57%) had no functional limitations postoperatively and nine patients (39%) had minimal functional limitations postoperatively. One patient (4%) had moderate functional limitations postoperatively. Twenty patients (87%) were completely satisfied with the surgery, two patients (9%) were satisfied with reservations, and one patient (4%) was unsatisfied with the surgery. The average period before return to work or daily activities was 1.5 months. Two patients had minor complications of partial wound dehiscence that healed uneventfully and mild dorsal midfoot pain which required temporary use of a boot walker. While the majority of patients with plantar fasciitis can be managed with nonoperative treatment, those patients with recalcitrant plantar fasciitis can be effectively treated with partial plantar fasciectomy and neurolysis to the nerve of the abductor digiti minimi muscle.

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

    Science.gov (United States)

    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.

  1. [Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Białystok].

    Science.gov (United States)

    Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jan; Pepiński, Witold

    2004-01-01

    Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Białystok through the period of 1999-2001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character.

  2. Surgical Treatment for the Rotation Type Spasmodic Tortieollis%旋转型痉挛性斜颈的三联手术治疗

    Institute of Scientific and Technical Information of China (English)

    张章

    2008-01-01

    目的 探讨旋转型痉挛性斜颈(spasmodic torticollis,ST)的手术治疗方法及疗效.方法 对215例旋转型ST的不同术式进行分析.结果 全组215例中斜颈症状消失150例(69.8%);显效43例(20.0%);进步18例(8.4%):无效4例(1.8%).无1例死亡、残疾.结论 颈部痉挛肌肉选择性切除术、颈神经后支选择性切断术、副神经切断术(三联术)是治疗旋转型ST安全有效的方法.

  3. National Spasmodic Torticollis Association

    Science.gov (United States)

    ... conference will take place at the Long Beach Marriott, 4700 Airport Plaza Drive, Long Beach, California 90815. ... conference will take place at the Long Beach Marriott, 4700 Airport Plaza Drive, Long Beach, California 90815. ...

  4. [Spasmodic torticollis, substantiating Manto syndrome, of possible toxic aethiology, with alterations of brainstem acoustic evoked potentials (BAEPs). Treatment with L-5-hydroxytryptophan. Follow up of 18 months, during which high degree resolution of symptoms and normalization of BAEPs took place].

    Science.gov (United States)

    Disertori, B; Ducati, A; Piazza, M

    1982-01-01

    A case of very severe spasmodic torticollis observed for 18 months is presented and discussed. Head was so rotated that permitted only backward seeing and compressed brachial plexus between scaleni muscles with sensory, motor and trophic troubles in the hand. A toxic aethiology from parathion is likely. Brainstem Acoustic Evoked Potentials (BAEPs) showed in the beginning abnormal responses, especially as refers to waves originating in the mesencephalon. Therapy with L-5-hydroxytryptophan subdued neurological symptoms; a parallel normalization of BAEPs recording was observed. The Authors propose to call this syndrome (spasmodic torticollis with thoracic outlet syndrome) after the mythical diviner Manto, which Dante Alighieri refers to in his "Divina Commedia" (Inferno, XX, 55 e segg.).

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

    Directory of Open Access Journals (Sweden)

    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

  6. The applicability of the dysphonia severity index and the voice handicap index in evaluating effects of voice therapy and phonosurgery.

    Science.gov (United States)

    Hakkesteegt, Marieke M; Brocaar, Michael P; Wieringa, Marjan H

    2010-03-01

    The objective was to investigate the applicability of the Dysphonia Severity Index (DSI) and the Voice Handicap Index (VHI) in evaluating effects of intervention between groups of patients and for intrasubject differences and whether DSI and VHI are complementing measurements. Analyses of measurement data before and after intervention of 171 patients with voice disorders. The voice quality was measured objectively with the DSI. The perceived voice handicap was measured with the VHI. Three groups of patients were used: patients who had voice therapy, phonosurgery, or no intervention. DSI and VHI improved significantly after intervention in the voice therapy and the surgery group (median difference DSI 1.19 and 3.03, VHI -8 and -26, respectively). The intrasubject results were analyzed based on the test-retest variability of DSI and VHI. Significant better DSI and VHI scores after intervention were found in, respectively, 22% and 38% of the patients with voice therapy, and 56% and 78% of the patients with surgery. In the no intervention group, this was 11% and 12%. In 37% of the patients, the differences before and after intervention in DSI and VHI were in discordance. The DSI and VHI are able to show significant differences after intervention for voice disorders between groups of patients. The DSI and VHI can be used to determine a significant intrasubject result of intervention. The DSI and VHI measure each different aspects of the voice and are complementing measurements. The DSI is therefore applicable in clinical practice for objective evaluation of voice quality and the VHI for subjective evaluation of the perceived handicap by the patient self.

  7. Forms of Dystonia

    Science.gov (United States)

    ... muscles of the eyelids and brow. ► Cervical dystonia (spasmodic torticollis) : Dystonia that affects the neck and sometimes ... contractions of the face, jaw, and/or tongue. ► Spasmodic dysphonia (laryngeal dystonia) : Dystonia that affects the vocal ...

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

    Directory of Open Access Journals (Sweden)

    Maria Rosário Dias

    2013-02-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  11. 痉挛性斜颈患者的心理测评%Psychological evaluation of the patients with spasmodic torticollis

    Institute of Scientific and Technical Information of China (English)

    钱海; 周忠清; 石祥恩

    2010-01-01

    Objective To investigate the psychological factors in the spasmodic torticollis (ST) patients and find the possible relationship between mental disorder and the pathogenesis of spasmodic torticollis. Methods All the 21 ST patients admitted were asked to complete the SCL-90. The result was compared with the norm of Chinese. Results Somatization (1.67 ±0.59) scores, anxiety (1.95 ±0.74) scores, phobic (1.63 ±0.59) scores and psychotic (1.56 ±0.60) scores in ST patients, they were higher significantly than the norm of Chinese [ ( 1.37 ± 0.48 ), ( 1.39 ± 0.43 ), ( 1.23 ± 0.41 ), ( 1.29 ± 0.42) scores](P <0.05). No significant differences were found the other factors between the ST patients and norm of Chinese. Conclusion Somatization,anxiety,phobic and psychotic are correlated with ST,they may likely contribute to the pathogenesis of ST.%目的 对痉挛性斜颈患者的心理因素进行分析,研究其与本病发病机制的关联.方法 对21例痉挛性斜颈患者(斜颈组)采用症状自评量表(SCL-90)进行问卷调查,并与中国人常模(常模组)进行对比.结果 斜颈组躯体化因子(1.67±0.59)分、焦虑因子(1.95±0.74)分、恐怖因子(1.63±0.59)分及精神病性因子(1.56±0.60)分,均明显高于常模组[分别为(1.37±0.48)、(1.39±0.43)、(1.23±0.41)、(1.29±0.42)分](P<0.05).而两组强迫症状、人际关系敏感、抑郁、敌对及偏执因子评分比较差异无统计学意义(P>0.05).结论 痉挛性斜颈患者的心理因素中,躯体化、焦虑、恐怖及精神病性因子评分较正常人群有异常升高,提示本病伴有上述心理异常表现.心理因素是否与痉挛性斜颈发病机制有关尚待进一步研究.

  12. 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

    Directory of Open Access Journals (Sweden)

    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.

  13. 全髋关节置换术中恢复双下肢等长和外展偏心距的处理%Restoring the abductor offset and limb length in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    黄奎; 彭松明; 张记恩; 何晓斌

    2013-01-01

      目的探讨通过术前测量,应用一种简单、可靠的术中方法恢复全髋关节置换术后双下肢等长和外展偏心距.方法45例单侧髋关节疾病患者采用后路全髋关节置换术.通过术前测量,在术中参考股骨局部解剖标志及测量与股骨柄球头的距离以恢复全髋关节置换术中双下肢等长和外展偏心距.结果术前患侧外展偏心距为健侧外展偏心距的85%~100%,平均94%.术后患侧外展偏心距为健侧外展偏心距的85%~110%,平均95%.双下肢长度差异10 mm,89%的患者术后双下肢等长.结论在后路全髋关节置换术中应用这种简单、可靠的方法,可以有效的恢复双下肢等长和外展偏心距,并不需要额外的操作器械、切口暴露和术中X线片.%Objective To investigate A simple intraoperative technique to restoring the abductor offset and limb length in total hip arthroplasty. Methods According to measurement of abductor offset and limb length inequality in preoperative radiographs , a simple and undemanding means of reference fixed reference points within the Femur and measure the dis-tance between the reference points to femoral Components head centre was studied in 45 consecutive unilateral primary total hip arthroplasties. Results Preoperatively the median abductor offset on the affected side was 94% (range: 85 to 100) of that on the opposite side. After THR, Postoperative the abductor medial offset was 95% (range: 85 to 110) on the operated side as compared to the opposite side. The LLI<5mm difference defined as limb length equality. Preop-erative, 40 cases had short limbs with the range of LLI was-5 mm to-30 mm, mean-8mm. After the THR, 40 cases were less than 5 mm discrepancy, 4 cases were 5~10 mm discrepancy, only one case was 12 mm discrepancy, the limb length equalization were got in 40 (89%) patients. Conclusion This technique is a simple, accurate and undemanding intraoperative technique of restoring the fabductor offset

  14. Anti-spasmodic assessment of hydroalcoholic extract and essential oil of aerial part of Pycnocycla caespitosa Boiss. & Hausskn on rat ileum contractions

    Directory of Open Access Journals (Sweden)

    Hassan Sadraei

    2016-01-01

    Full Text Available Pycnocycla caespitosa is an essential oil-containing plant naturally growing in southwest of Iran. The extract of this plant has been used as remedy in traditional medicine. Another species of Pycnocyla (P. spinosa possessed antispasmodic activity. The pharmacological objective of this study was to look for relaxant effect of hydroalcoholic extract and essential oil of P. caespitosa on rat isolated ileum contractions for comparison with loperamide. The essential oil and the hydroalcoholic extract were prepared by hydrodistillation and percolation techniques, respectively. For antispasmodic studies a section of rat ileum was suspended in an organ bath containing Tyrode′s solution. The tissue was stimulated with electrical field stimulation (EFS, KCl (80 mM and acetylcholine (ACh 0.5 μM. The tissue was kept under 1 g tension at 37 °C and continuously gassed with O 2 . The essential oil content in the aerial parts of P. caespitosa was found to be 0.16 % ml/g. The essential oil was analyzed by gas chromatography and gas chromatography-mass spectrometry. Seventy constituents, representing 97 % of the oil were identified. The major components of the oil were carvacrol (7.1%, β-eudesmol (6.4 %, ρ-cymene (5.7%, caryophyllene oxide (3.6%, α-pinine (1.4% and α-phelandrene (1.1%. The hydroalcoholic extract of P. caespitosa inhibited the response to KCl (IC 50 = 48 ± 3 μg/ml, ACh (IC 50 = 61 ± 14.7 μg/ml and EFS (IC 50 = 77 ± 17 μg/ml in a concentration-dependent manner. The essential oil of P. caespitosa also inhibited rat ileum contractions. The IC 50 values for KCl, ACh and EFS were 9.2 ± 1.2 μg/ml, 7.6 ± 0.8 μg/ml and 6.4 ± 0.8 μg/ml, respectively. The inhibitory effect of both the essential oil and the extract were reversible. This research confirms the anti-spasmodic activity of both the essential oil and the extract of P. caespitosa on smooth muscle contraction of ileum.

  15. Etiology and Progress of Diagnosis and Treatment of Spasmodic Torticollis%痉挛性斜颈的病因及诊治进展

    Institute of Scientific and Technical Information of China (English)

    高旭光

    2001-01-01

    @@痉挛性斜颈(spasmodic torticollis,wry neck)或颈肌张力障碍(cervical dystonia)是最常见的限局性肌张力障碍。严格来讲称为颈肌张力障碍较为适宜,因为斜颈强调的是一种体征,不是诊断,并不能突出肌张力障碍的特点,痉挛性斜颈包括肌张力障碍性和非肌张力障碍性两种。特发性颈肌张力障碍(idiopathic cervical dystonia,ICD)是最常见的成人发病的限局性肌张力障碍。ICD的定义是:由于异常的不随意肌收缩引起的颈部不随意性扭曲和转动。因颈部肌肉不随意性持续强直或阵挛性收缩,产生头和颈部的异常姿势,例如旋颈、颈侧倾、颈前屈和颈后仰,或者几种异常的姿势混合在一起。因颈肌张力障碍对侧肌肉的拮抗作用,可出现周期性头颈短暂抽搐或震颤。颈肌张力障碍受累范围常扩大,超过颈区,但一般不发展成为全身性肌张力障碍。大约2/3的病人有颈痛,有时将手放在后头部或下颏部可以缓解斜颈的症状。大约10%的病人有缓解期,通常发生在起病的1年内。多数在缓解的数年之后复发,如不经治疗,症状往往持续不愈。

  16. Anti-spasmodic assessment of hydroalcoholic extract and essential oil of aerial part of Pycnocycla caespitosa Boiss. & Hausskn on rat ileum contractions.

    Science.gov (United States)

    Sadraei, Hassan; Asghari, Gholamreza; Alipour, Mahdi

    2016-01-01

    Pycnocycla caespitosa is an essential oil-containing plant naturally growing in southwest of Iran. The extract of this plant has been used as remedy in traditional medicine. Another species of Pycnocyla (P. spinosa) possessed antispasmodic activity. The pharmacological objective of this study was to look for relaxant effect of hydroalcoholic extract and essential oil of P. caespitosa on rat isolated ileum contractions for comparison with loperamide. The essential oil and the hydroalcoholic extract were prepared by hydrodistillation and percolation techniques, respectively. For antispasmodic studies a section of rat ileum was suspended in an organ bath containing Tyrode's solution. The tissue was stimulated with electrical field stimulation (EFS), KCl (80 mM) and acetylcholine (ACh 0.5 μM). The tissue was kept under 1 g tension at 37°C and continuously gassed with O2. The essential oil content in the aerial parts of P. caespitosa was found to be 0.16 % ml/g. The essential oil was analyzed by gas chromatography and gas chromatography-mass spectrometry. Seventy constituents, representing 97 % of the oil were identified. The major components of the oil were carvacrol (7.1%), β-eudesmol (6.4 %), ρ-cymene (5.7%), caryophyllene oxide (3.6%), α-pinine (1.4%) and α-phelandrene (1.1%). The hydroalcoholic extract of P. caespitosa inhibited the response to KCl (IC50 = 48 ± 3 μg/ml), ACh (IC50 = 61 ± 14.7 μg/ml) and EFS (IC50 = 77 ± 17 μg/ml) in a concentration-dependent manner. The essential oil of P. caespitosa also inhibited rat ileum contractions. The IC50 values for KCl, ACh and EFS were 9.2 ± 1.2 μg/ml, 7.6 ± 0.8 μg/ml and 6.4 ± 0.8 μg/ml, respectively. The inhibitory effect of both the essential oil and the extract were reversible. This research confirms the anti-spasmodic activity of both the essential oil and the extract of P. caespitosa on smooth muscle contraction of ileum.

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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

  18. Disfonia organofuncional e queixas de distúrbios alérgicos e/ou digestivos Organic-functional dysphonia and complains off allergic and/or digestive disturbance

    Directory of Open Access Journals (Sweden)

    Carla Aparecida Cielo

    2009-09-01

    Full Text Available OBJETIVO: verificar a ocorrência de queixas de distúrbios alérgicos e/ou digestivos em pacientes com disfonia organofuncional, atendidos no Setor de Voz de uma clínica-escola de Fonoaudiologia. MÉTODOS: este estudo caracteriza-se como estudo de série, retrospectivo e transversal. Realizou-se uma análise de 113 prontuários de pacientes com disfonia organofuncional que apresentavam queixas de distúrbios alérgicos e/ou digestivos, na faixa etária de cinco a 76 anos, sendo 41 do sexo masculino e 72 do feminino. O procedimento estatístico utilizado foi o Teste de Hipótese para Duas Proporções. RESULTADOS: houve significante frequência de queixas de distúrbios alérgicos e digestivos associados nos pacientes dos disfonia organofuncional; entre as queixas de distúrbios alérgicos, de distúrbios digestivos, e de ambas associadas, as queixas de distúrbios alérgicos foram significantemente mais frequentes nos pacientes com disfonia organofuncional. CONCLUSÃO: existe uma relação entre as queixas de distúrbios alérgicos e/ou digestivos e a disfonia, uma vez que esses são co-fatores para o estabelecimento da disfonia e da lesão laríngea. A alta freqüência de queixas de distúrbios alérgicos nos indivíduos com disfonia organofuncional, no presente estudo, pode ter relação com o clima do sul do Brasil.PURPOSE: to check the occurrence of the complains of allergic and digestive disturbance in patients with organic-functional dysphonia that were attended in Speech and Language Therapist School Clinic. METHODS: this study is a sequence, retrospective, transverse study. We have done an analysis of 113 patients' medical records with organic-functional dysphonia that had complains of allergic and/or digestive disturbance, from 05 to 76-years-old, 41 male and 72 female. The hypothesis test for 2 proportions was used for the statistic analysis of data. RESULTS: there was a significant relationship of complains on associated allergic

  19. Needling of SanYang Acupoints and Anti-spasmodic Traction in Treating 30 Cases of Hemiplegia%针刺三阳穴联合抗痉挛牵张技术治疗偏瘫30例

    Institute of Scientific and Technical Information of China (English)

    赵力生; 杨江霞; 王建文

    2013-01-01

    Objective:To observe the effects of SanYang acupoints needling and anti-spasmodic traction for hand function of hemiplegic patients with cerebral apoplexy. Method:Sixty patients were randomized into the obser-vation group and the control group. Both groups were given with anti-spasmodic traction, the observation group needling of SanYang acupoints and the control group routine acupuncture. Ten days were one course of treatment and the interval was two days, muscular tension, hand function and living ability were assessed after three consecu-tive courses of treatment. Result:Muscular tension, hand function and living ability were improved after treating in both groups (P<0.05), the observation group was superior to the control group obviously (P<0.05). Conclusion:Needling of SanYang acupoints and anti-spasmodic traction could improve hand function of hemiplegic patients with cerebral apoplexy remarkably.%目的:观察针刺三阳穴联合抗痉挛牵张技术对脑卒中偏瘫患者手功能的影响。方法:将60例患者随机分为观察组、对照组各30例。2组均运用抗痉挛牵张技术治疗,观察组同时针刺三阳穴,对照组给予常规针刺治疗。2组均以治疗10天为1个疗程,疗程间休息2天,连续治疗3个疗程后评定肌张力、手功能、生活能力。结果:肌张力、手功能、生活能力评分治疗后2组均明显改善(P<0.05),且观察组明显优于对照组(P<0.05)。结论:针刺三阳穴结合抗痉挛牵张技术能明显改善脑卒中偏瘫患者手功能。

  20. Efficacy of stellate ganglion block in the treatment of spasmodic torticollis%星状神经节阻滞治疗痉挛性斜颈的疗效

    Institute of Scientific and Technical Information of China (English)

    钱黎; 陈黔; 潘奇; 王大寿; 陈艳; 翟月

    2016-01-01

    Objective To observe the effect of stellate ganglion block in the treatment of spasmodic torticollis.Methods Twenty-six patients with spasmodic torticollis were treated by stellate ganglion block,once a day,seven times for a course.VAS,K 10 and Tsui score were recorded,and compared pretreatment and 1week,5 weeks,10 weeks during the treatment,and 1 week and 1 month after treatment.Results Compared with pretreatment,VAS and Tsui score decreased significantly at 1 week during treatment to 1 month after the treatment (P< 0.01).K10 scores reduced significantly at 5 weeks during treatment to 1 month after the treatment (P < 0.01).8 cases were excellent effect,14 cases good effect,4 cases effective,the total effective rate was 100%.Conclusion Stellate ganglion block can effectively improve the symptoms of spasmodic torticollis,attenuate patients' neck and shoulder pain and psychological burden.%目的 观察星状神经节阻滞治疗痉挛性斜颈的效果.方法 在我科治疗的痉挛性斜颈患者26例,给予星状神经节阻滞治疗,每日1次,并记录治疗前、持续治疗1周、5周、10周时,以及治疗结束后1周时与1个月时视觉模拟评分(VAS)、K10评分及Tsui评分,并进行比较.结果 与治疗前比较,患者治疗1周至停止治疗后1个月时VAS、Tsui评分显著降低(P<0.01),治疗5周至停止治疗后1个月时K10评分显著降低,差异均有统计学意义(P<0.01),治疗后优效患者8例,良效14例,可效4例,总有效率100%.结论 星状神经节阻滞可以有效治疗痉挛性斜颈,改善颈肩部疼痛及患者心理负担.

  1. A型肉毒毒素治疗痉挛性斜颈的临床研究%Clinical study of botulinum toxin type A in the treatment of spasmodic torticollis

    Institute of Scientific and Technical Information of China (English)

    陈军; 陈江君; 鲁雅琴; 杨奎; 刘宁

    2010-01-01

    目的 观察A型肉毒毒素(BTX-A)治疗痉挛性斜颈的效果.方法 对64例痉挛性斜颈患者在颈部肌肉多点注射BTX-A,分析评价其疗效.结果 痉挛性斜颈患者经BTX-A治疗后症状明显改善,BTX-A用量(120.37±25.26)U;注射点数(30.00±4.85)个;Tsui评分治疗前为(13.08±4.16)分,治疗后2周为(4.21±2.63)分,差异有统计学意义(P<0.01).完全缓解16例(25.0%),明显改善39例(60.9%),部分改善8例(12.5%),无效1例(1.6%),有效率85.9%(55/64);疗效维持时间为(16.86±4.57)周;重复治疗者复发症状减轻,治疗剂量下降,疗效仍良好.所有患者均未见严重不良反应.结论 BTX-A治疗痉挛性斜颈是一种安全有效、简便易行的治疗手段,可作为治疗痉挛性斜颈的首选药物.%Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)injection in the treatment of spasmodic torticollis.Methods Sixty-four patients with spasmodic torticollis underwent the treatment of intramuscular injection of BTX-A in neck muscles.As a result,the efficiency of BTX-A therapy could be evaluated successfully.Results Considerable improvement of symptoms for the spasmodic torticollis patients was observed with BTX-A treatment.The average dose of BTX-A was(120.37 ±25.26) U.Injection points were 30.00 ± 4.85.The Tsui scores before treatment were (13.08 ±4.16) scores,and 2 weeks after treatment were (4.21 ± 2.63) scores.The Tsui scores showed a significant reduction after BTX-A injections (P <0.01).After treatment complete remission rate was 25.0% (16/64),significant improvement rate was 60.9% (39/64),partial improvement rate was 12.5% (8/64),invalid rate was 1.6%(1/64) and efficient rate was 85.9% (55/64).Duration of effect was (16.86-4.57) weeks.Patients who received repeated injections also had good response,with symptoms improved and dosage of BTX-A reduced.No serious adverse events happened in treatments.Conclusion BTX-A therapy is simple and effective in the treatment of

  2. Secondary spasmodic torticollis and balance in hemiplegic stroke patients%痉挛性斜颈对脑卒中偏瘫患者平衡功能的影响及其治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    郭钢花; 王国胜; 李哲

    2013-01-01

    Objective To observe the influence of secondary spasmodic torticollis on the balance of hemiplegic stroke survivors and to compare the effects of different treatment protocols.Methods Fifty-six secondary spasmodic torticollis patients after stroke were randomly divided into three groups based on the type of treatment.The botulinum toxin (BTX) group received BTX-A injections and common support treatment plus rehabilitation training (n =19),the medication therapy group received oral baclofen and common support treatment plus rehabilitation training (n =18),and the routine rehabilitation group received only routine rehabilitation therapy (n =19).In addition,19 stroke cases without spasmodic torticollis served as a control group.They also were treated with routine rehabilitative treatment alone.Before and after 2 months of treatment,balance was assessed using Berg's balance scale,and spasmodic torticollis was evaluated using Tsui's scale.Results Before treatment the balance of the control group members was significantly better than that of the other three groups.After 2 months of therapy,balance function had improved significantly in all four groups.The balance of the botulinum toxin group was better than that of the medication and routine rehabilitation groups.After treatment,Tsui scale scores in the medication and botulinum toxin groups were significantly lower than before treatment,and the scores in the botulinum toxin group were significantly lower than in the medication and routine rehabilitation groups.There was no significant difference in Tsui scale scores before and after treatment in the control group.Conclusions Spasmodic torticollis inflaences the recovery of balance function in hemiplegic patients after stroke.Treating the spasmodic torticollis can improve their balance.Treatment with BTX-A combined with common support treatmcnt and rehabilitation training showed significant curativeeffect.%目的 观察继发痉挛性斜颈对脑卒中偏瘫患者平衡

  3. Surgical management of spasmodic torticollis

    African Journals Online (AJOL)

    Wael Fouad

    2011-08-23

    Aug 23, 2011 ... tion that responded well to antibiotics after culture and sensitivity. Postoperative .... to LS muscle was identified by electrostimulation and cut, the distal part of the nerve .... order of the C2 cutaneous region. Since the C1 and C2 ...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  6. CT Manifestations of Spasmodic Torticollis and Its Diagnostic Value%痉挛性斜颈的CT表现及其诊断价值

    Institute of Scientific and Technical Information of China (English)

    Syed Ahamed Madani; 潘冬梅; 范国华

    2014-01-01

    Objective To investigate the multi-slice spiral CT scan (MSCT) inspection methods of spasmodic torticollis (ST) and its clinical diagnosis value of spasm muscle responsibility positioning. Methods 18 cases with ST were retrospectively analyzed. Clinical types include rotational type (10 cases) and laterocollis (8 cases). Additionally, we set up 18 cases of healthy volunteers as control group, the same muscle body areas were measured and compared for left and right of cross-section, detecting distribution of hypertrophy muscle. Results 18 cases with ST mainly shows spasms muscles of neck were hypertrophied and muscle body area increased and related with torticollis clinical classification. The hypertrophied muscles in rotational type were distributed in the 1/4 posterolateral region of rotational side and the 1/4 anterolateral region of opposite side. Anteroposterior shows muscle body areas between hypertrophy spasms muscle and same contralateral muscles (sternocleidomastoid, splenius capitis muscle, levator scapulae muscle) were statistically significantly different in cross-section (P<0.05);The hypertrophied muscles in laterocollis were mainly distributed in the posterolateral and anterolateral region of same side. Anteroposterior showing muscle body areas between hypertrophy spasms muscle and same contralateral muscles (sternocleidomastoid, levator scapulae muscle, trapezius) were statistically significantly different in cross-section (P<0.05). Conclusion MSCT can show the shape change and distribution of hypertrophy muscle of ST. It helps to determine the responsibility muscle of spasm and targeted therapy, and it is the preferred noninvasive method.%目的:探讨痉挛性斜颈(ST)的多排螺旋CT(MSCT)检查方法及其对痉挛责任肌群的定位诊断价值。方法回顾性分析18例ST患者临床及CT资料,临床分型:旋转型10例,侧屈型8例;另选取年龄及性别匹配的健康志愿者18名作为对照组,均行颈部CT

  7. 针药并用治疗痉挛性斜颈临床观察%Clinical Observations on Combined Use of Acupuncture and Medicine for Treatment of Spasmodic Torticollis

    Institute of Scientific and Technical Information of China (English)

    李薇薇; 武连仲

    2015-01-01

    目的:观察针药并用治疗痉挛性斜颈的临床效果。方法将30例患者随机分成治疗组和对照组,每组15例。治疗组采用针药并用治疗,对照组采用单纯针灸治疗。结果临床观察1年,两组治疗后6个月、12个月Tsui评分与同组治疗前比较差异均有统计学意义(P<0.01),治疗后12个月与6个月比较差异均有统计学意义(P<0.01),即两组治疗后Tsui评分逐渐降低;两组治疗后12个月Tsui评分比较差异有统计学意义(P<0.05),结果表明治疗组治疗后12个月Tsui评分降低更显著。结论针药并用治疗痉挛性斜颈愈显率高于单纯针刺治疗,斜颈患者针刺治疗的疗程较长,需长期坚持。%Objective To investigate the clinical efficacy of combined use of acupuncture and medicine in treating spasmodic torticollis.Method Thirty patients were randomly allocated to a treatment group of 15 cases and a control group of 15 cases. The treatment group received combined use of acupuncture and medicine, and the control group, acupuncture alone.Result Clinical observation lasted one year. There was a statistically significant pre-/post-treatment difference in the Tsui score in the two groups at 6 and 12 months after treatment (P<0.01). There was a statistically significant difference in the Tsui score between at 6 and 12 months after treatment in the two groups (P<0.01); the Tsui score decreased gradually after treatment. There was a statistically significant post-treatment difference in the Tsui score between the two groups at 12 months after treatment (P<0.05); the Tsui score decreased more in the treatment group.Conclusion The cure and marked efficacy rate of combined use of acupuncture and medicine for spasmodic torticollis is higher than that of acupuncture alone. A longer course is needed for acupuncture treatment of spasmodic torticollis and the patient should persevere with the treatment.

  8. 显微神经外科手术治疗痉挛性斜颈137例分析%Microneurosurgery for Spasmodic Tortcollis(a Report of 137 cases)

    Institute of Scientific and Technical Information of China (English)

    刘江; 于炎冰; 张黎; 徐晓利; 许骏; 任鸿翔; 李放; 张哲

    2009-01-01

    目的 探讨显微神经外科手术治疗痉挛性斜颈(ST)的疗效.方法 对137例ST患者采用显微手术治疗,针对病例的不同情况分别采用改良Foerster-Dandy手术(126例)、副神经周围支切断及胸锁乳突肌选择性切除术(9例)、经颅副神经根切断术(2例)治疗.结果 全部患者术后平均随访44.9个月.100%病人术后立即感痉挛状态明显缓解,随访期间缓解率为93.4%(128/137).行改良Foerster-Dandy手术的126例术后均发生不同程度转颈无力、耸肩无力、双臂外展受限,随访期间有所好转,仅2例(1.6%)发生头颈部支撑困难;36例(28.6%)发生不同程度吞咽困难,随访期间恢复正常18例,明显好转11例,无明显变化7例(5.6%);颅内感染10例(7.9%),出院前均治愈.随访期间痉挛状态不同程度复发9例(6.6%).结论 选择合适病例、针对病例的不同情况采用不同手术方法、熟悉局部解剖、掌握显微手术技巧是保证显微外科手术治疗ST效果、减少并发症的关键.%Objective To explore the curative effect of microneurosurgery on spasmodic torticollis. Methods The microneurosur-gery including modified Foerster-Dandy operation(126 cases), the selective neurotomy of peripheral branches of the accessory nerves and cutting off the partial sternocleidomastoid muscles(9 cases), and intracranial neurotomy of accessory nerve roots(2 cases) was performed from July, 2001 to July, 2008 in 137 patients with spasmodic torticollis. Their clinical data were analyzed retrospectively. Results The spasticity was relieve immediately after the operation in all the patients. All the patients were averagely followed up for 44.9 months after the surgery. The relief rate of the spasticity was 93.4% (128/137) during the following-up period. Postoperative complications in 126 patients undergoing modified Foerster-Dandy operation included transient weakness of neck, arms and shoulder in 124 cases, their persistent severe weakness in 2 cases

  9. 感染性喉炎和痉挛性喉炎患儿血清中IL-4、IFN-γ和IgE水平检测的临床意义%Clinical significance of IL-4,IFN-γand IgE in children with acute infectious laryngitis and in children with spasmodic laryngitis

    Institute of Scientific and Technical Information of China (English)

    薛国昌; 任明星; 周静月; 沈琳娜; 宋月娟; 夏欢; 曹丽

    2014-01-01

    目的:探讨感染性喉炎和痉挛性喉炎患儿血清中IL-4、IFN-γ和IgE水平的变化及临床意义。方法采用ELISA双抗体夹心法检测26例感染性喉炎、31例痉挛性喉炎患儿入院时(急性期)、出院前(恢复期)及正常对照组儿童(25名)血清IL-4、IFN-γ水平;采用荧光酶联免疫法检测IgE水平,并进行比较。结果急性期感染性喉炎和痉挛性喉炎患儿血清IL-4、IgE水平明显高于对照组(P均"0.05);急性期感染性喉炎患儿血清IgE水平明显低于痉挛性喉炎患儿(P"0.05);恢复期感染性喉炎和痉挛性喉炎患儿血清IL-4、IgE水平较急性期明显降低(P均"0.05),恢复期感染性喉炎患儿血清IgE水平明显低于痉挛性喉炎患儿(P"0.05)。急性期感染性喉炎和痉挛性喉炎患儿血清IFN-γ水平明显低于对照组(P均"0.05);恢复期感染性喉炎和痉挛性喉炎患儿血清IFN-γ水平较急性期明显升高(P均"0.05)。结论感染性喉炎和痉挛性喉炎患儿存在免疫功能紊乱,IL-4、IFN-γ和IgE在患儿免疫病理机制中起重要作用,检测IgE水平有助于两种喉炎的鉴别。%Objective To investigate clinical significance and the change of serum IL-4,IFN-γand IgE levels and their clinical significance in children with acute infectious laryngitis and in children with spas-modic laryngitis. Methods Serum samples were obtained from 26 children with acute infectious laryngitis, 31 children with spasmodic laryngitis and 25 healthy children. The change of serum IL-4,IFN-γand IgE levels were observed detected by ELISA in serum when hospital admission (acute stage)were observed.Aand before discharge (convalescent stage). ELISA was used to determine the levels of serum IL-4,IFN-γin serum. Serum IgE level was determined with enzyme-linked fluoroimmuneassay. Results The levels of IL-4 and IgE in chil-dren with acute infectious laryngitis and in children with spasmodic

  10. 微侵袭手术治疗侧屈型痉挛性斜颈患者的护理%Perioperative nursing care for minimally invnsive neurosurgical treatment for lateral flexure spasmodic torticollis

    Institute of Scientific and Technical Information of China (English)

    胡玲; 方慧; 胡薇; 姬绍先

    2013-01-01

    Objective To study the perioperative nursing care of minimally invasive operation in the neurosurgical treatment of laterial flexure spasmodic torticollis (LaFST).Methods Minimally invasive operation was used to treat LaFST.The relationship of inducing factors and emotional factors with clinical manifestation of LaFST was investigated.To give perioperative psychological nursing,operation nursing and rehabilitation training and instruction.Results 72 cases were recovered (81.8%) among 88 cases.12 cases(13.6%) were markedly effective.4 cases(4.6%) showed progress.Conclusions The minimally invasive surgical treatrnent of selective resection of cervical spasmodic muscles and selective neurotomy of cervical nerve for LaFST is safe and effective.Strengthening of perioperative nursing and postoperative rehabilitation instruction is very important for patients' early recovery.%目的 探讨微侵袭手术治疗侧屈型痉挛性斜颈患者的围手术期护理干预.方法 采用微侵袭手术治疗88例侧屈型痉挛性斜颈(LaFST),调查患者起病诱因和情绪因素与临床表现的关系,加强对患者围手术期的心理护理、手术治疗护理、手术后的康复训练和指导.结果 全组88例,斜颈症状痊愈72例占81.8%,显效12例占13.6%,进步4例占4.6%.结论 颈部痉挛肌肉选择性切除和颈部神经选择性去神经术治疗侧屈型痉挛性斜颈,手术安全、创伤小、疗效满意.加强围手术期护理干预和手术后的康复指导是患者早日康复的重要措施.

  11. 小趾展肌神经与神经源性跟痛症关系的解剖学基础%Anatomic relationship of abductor digiti miniini nerve and neuragenic painful heel syndrome

    Institute of Scientific and Technical Information of China (English)

    冯成安; 孙俊; 刘宗良; 范炜; 张东葵; 陆地

    2012-01-01

    目的 探讨小趾展肌神经的局部解剖特点及其与神经源性跟痛症的关系,为临床诊断治疗提供解剖学依据.方法 32侧防腐成人尸体下肢标本,解剖观察小趾展肌神经的起源、分支、走行和分布特点.结果 小趾展肌神经81.25%起源于足底外侧神经,起点59.38%位于后上象限;起点与参考线的垂直深度,左侧( 10.81±0.96)mm,右侧(10.24±1.10)mm;小趾展肌神经发出1~3支骨膜支到达跟骨结节内侧突的骨膜;小趾展肌神经与跟骨结节内侧突该的水平距离左侧(19.95±1.82)mm,右侧(20.89±2.48)mm.结论 小趾展肌神经行经(足母)展肌和足底方肌内侧头之间,跟骨结节内侧突前可能被卡压,卡压或病变(特别是骨膜支)可能与足底腱膜炎发生有关;跟骨骨刺不一定会造成神经源性跟痛症.%Objective To investigate anatomic relationship between abductor digiti minimi nerve (ADMN) and neurogenic painful heel syndrome (NPHS) for clinical diagnosis and therapy. Methods 32 fixed adult lower limb specimens were used in the study. The ADMN was dissected for observing it's origin, course, branches and distribution. Results For cases of 81.25%, ADMN originated from the lateral plantar nerve, which consisted of 19 trunks (59.38%) located in the postcrosuperior quadrant. The vertical depth of the origin site to the reference line was (10.81±0.96)mm and (10.24±1.10) mm at left and right sides respectively. ADMN firstly issued 1-3 periosteum branches, which arrived the periosteum of medial process of calcaneal tuberosity. The horizontal distances from the site of medial process of calcaneal tuberosity to the left or right tuberosities were (19.95*1.82) mm and (20.89 ±2.48)mm, seperately. Conclusions ADMN is probably stamped when it goes through the abductor hallucis, the medial head of quadratus plantae and the medial process of calcaneal tuberosity. The stamp or lesion of ADMN (especially periosteum branch) is probably

  12. 功能性发声障碍的临床特征及预后分析%Clinical Characteristics and Prognosis of Functional Dysphonia

    Institute of Scientific and Technical Information of China (English)

    崔卫新; 徐文; 程丽宇

    2016-01-01

    目的:探讨功能性发声障碍的诱因、临床特征及预后。方法回顾性分析104例功能性发声障碍患者的临床资料和频闪喉镜检查结果,并对所有患者进行共鸣发声疗法和重音治疗法发声训练,治疗前后行VHI评估和GRBAS评分,分析疗效。结果104例中,无明显诱因34例(32.69%),诱发因素分别为上呼吸道感染29例(27.88%),情绪紧张22例(21.15%),用声过度10例(9.62%),其他因素9例(8.65%)。频闪喉镜检查见粘膜波正常43例(41.35%),黏膜波改变53例(50.96%,其中41例未引出黏膜波,12例黏膜波减弱),室带完全超越声带3例,不配合发声未引出黏膜波5例;发声时声门闭合不全65例(62.50%),声门上代偿性内收30例(28.85%),喉部挤压9例(8.65%)。随访67例,恢复正常53例(79.10%),其G评分、V H I评分均降为0分;6例发声明显好转但未完全恢复正常,G评分和VHI评分较治疗前降低;8例治疗后G评分和VHI评分无明显变化。结论功能性发声障碍诱因复杂,并非单一精神心理因素所致;喉镜检查多可见声带振动异常、声门闭合不良及声门上代偿;治疗可采取心理疏导、发声矫正和中医针灸相结合,多数患者预后较好。%Objective To investigate the cause ,clinical characteristics and prognosis of functional dysphonia . Methods The clinical data and the laryngostroboscopic examination of 104 patients with functional dysphonia were retrospectively analyzed .All the patients underwent the resonant therapy and the accent therapy ,and finished the voice handicap index (VHI) and GRBAS score before and after the treatment .Results Among the 104 patients ,34 cases (32 .69% ) had no apparent cause ,29 cases (27 .88% ) caused by upper respiratory tract infection ,22 cases (21 .15% ) by emotional tension ,10 cases (9 .62% ) by excessive

  13. Selective denervation and resection of cervical muscles for spasmodic torticollis%选择性颈部肌肉、神经切断术治疗痉挛性斜颈

    Institute of Scientific and Technical Information of China (English)

    周南开; 周波; 车善理; 邓宗锵

    2008-01-01

    目的 了解选择性颈部肌肉、神经切断(或切除)术治疗痉挛性斜颈(spasmodic torticollis,ST)的临床效果和并发症的防治.方法 回顾性分析本组治疗的25例痉挛性斜颈患者的资料,术前根据斜颈类型、CT/MRI、肌电图检查制定个体化的手术方案,采用两联或三联术治疗.结果 本组痊愈14例(56%),显效8例(32%),进步3例(12%);伤口皮下积液3例,枕颈部皮肤麻木感8例,颈部支撑乏力2例,无死亡病例.结论 选择性颈部肌肉、神经切断术治疗痉挛性斜颈安全有效,但是手术不能过度以防颈部支撑乏力.

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

    Directory of Open Access Journals (Sweden)

    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

  15. 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

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    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

  16. Clinical application of abductor hallucis flap in restoration of soft tissue defects in calcar pedis malignant%拇展肌肌皮瓣在足跟部恶性肿瘤软组织缺损修复中的应用

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    商冠宁; 孙平; 王玉名; 王巍; 赵岩

    2012-01-01

    目的 探讨拇展肌肌皮瓣修复足跟部恶性肿瘤软组织缺损的临床疗效.方法 采用带血管神经蒂的拇展肌肌皮瓣修复足跟部恶性肿瘤广泛切除术的软组织缺损26例,其中伴有溃疡出血者9例.皮肤缺损面积(2~6)cm×(5~9)cm,肌皮瓣切取面积(4~8)cm×(7~11)cm,深层拇展肌肌肉面积3 cm×7 cm,供区全部应用中厚皮片游离植皮.结果 术后26例肌皮瓣完全存活,创面Ⅰ期愈合.随访时间7~37个月,平均22个月,局部无复发;肌皮瓣质地优良,外观满意,行走正常,皮肤感觉恢复良好.结论 拇展肌肌皮瓣血运可靠,转移方便,是修复足跟部位恶性肿瘤广泛切除软组织缺损的良好选择.%Objective To evaluate the clinical application of the abductor hallucis flap in restoration of the soft-tissue defects in calcar pedis malignant. Methods We utilized abductor hallucis flap with neurovascular pedicle to restore soft-tissue defects in 26 cases of calcar pedis Malignant. Among these cases, 9 cases were combined with ulcer and bleeding, the sizes of skin defects being 2~6 cm ×5~9 cm, myocutaneous flap were 4~8 cm ×7 ~11 cm,muscular of abductor hallucis 3 cm ×7 cm. Intermediate thickness free skin grafts were used in donor site. Results All 18 cases of musculo cutaneous flap survived after surgery. Wound healing were stage Ⅰ. After 7 ~ 36 months of follow-up, we observed no complications or local recurrence. The muscle flaps maintained good quality with satisfactory appearance of satisfaction, proper walk, comfort feel of musculocutaneous flap. Conclusion The abductor hallucis flap has advantages, such as reliable blood supply and easy to transfer. It is a good choice in restoration of soft tissue defects in calcar pedis malignant.

  17. Behavioral management of pediatric dysphonia.

    Science.gov (United States)

    Hersan, R; Behlau, M

    2000-10-01

    Children's voice disorders may be functional or organic in cause and a thorough evaluation by the otolaryngologist and speech-language pathologist is necessary to obtain the proper diagnosis, to understand the underlying etiologic factors, and to prepare a plan of treatment that is appropriate for the child. Because voice disorders may be present with developmental communication problems, treatment must include all factors that affect growth and development of the child.

  18. 内镜辅助下选择性颈神经根切断术治疗痉挛性斜颈%Selective peripheral denervation for treatment of spasmodic torticollis(a report of 57 cases)

    Institute of Scientific and Technical Information of China (English)

    刘江; 于炎冰; 袁越; 徐晓利; 许骏; 刘红举; 张黎

    2011-01-01

    目的 探讨内镜辅助下选择性颈神经根切断术治疗痉挛性斜颈的疗效.方法 回顾性分析2008年1月至2009年6月显微手术治疗的57例痉挛性斜颈患者的临床资料.该显微手术,术中不咬除枕骨鳞部及枕大孔,在内镜辅助下行硬膜下双侧副神经根及颈1脊神经根切断.结果 全部患者平均随访7个月.100%病人术后立即感痉挛状态明显缓解;随访期间缓解率为94.7%(54/57),痉挛状态不同程度复发3例(5.3%).8例(14.0%)发生不同程度吞咽困难,随访期间恢复正常5例,明显好转2例,无明显变化而影响生活质量1例(该例仅随访1个月);颅内感染2例(3.5%),皮下积液伴长期发热1例(1.8%),均治愈出院;长期颈肩痛3例(5.3%).结论 在治疗痉挛性斜颈的该术式中不咬除枕骨鳞部及枕大孔,在神经内镜辅助下行硬膜下双侧副神经根及颈1神经根切断,在不降低疗效的前提下,可进一步减少手术创伤及手术并发症的发生.%Objective To explore the curative effect of selective peripheral denervation on spasmodic torticollis. Methods The clinical data of 57 patients with spasmodic torticollis, who were treated by selective peripheral denervation from January, 2008 to June, 2009, were analyzed retrospectively. The selective peripheral denervation was completed by modified Foerster-Dandy operation, in which the bilateral accessory roots and first cervical nerve roots were subdurally cut off under an endoscope without destruction of the occipital squama and foramen magnum. All the patients were following up for 1 to 18 months. Results The spasticity was relieved immediately after the operation in all the patients. The relief rate of the spasticity was 94.7% (54/57) during the following-up period. The spasticity recurred in 3 patients during the following up period. The postoperative complications included dysphagia in different degree in 8 patients (in whom, dysphagia disappeared in 5 cases, dysphagia was

  19. Modified Foerster-Dandy's operation for the treatment of spasmodic torticollis under endoscope-assisting%两次改良Foerster-Dandy手术治疗痉挛性斜颈的对比研究

    Institute of Scientific and Technical Information of China (English)

    刘江; 张黎; 袁越; 徐晓利; 许骏; 刘红举; 于炎冰

    2011-01-01

    Objective To study the microsurgical effectiveness of modified Foerster-Dandy's operation for the treatment of spasmodic torticollis under endoscope-assisted.Method 183 cases of spasmodic torticollis patients were treated by microsurgical modified Foerster-Dandy's operation from July 2001 to June 2009, which was randomly classified into group A and group B.Group A(126 cases) were treated by firstly modified Foerster-Dandy's operation.Group B(57 cases) were treated by microsurgical modified Foerster-Dandy's operation under endoscope-assisting.The other surgical steps were same with firstly modified Foerster-Dandy's operation.Results All the patients were averagely followed up for 33.4 months after the surgery.The spasticity was relieved immediately after the operation in all the patients.In group A, dysphagia in different degree in 36 cases, in whom, dysphagia was disappeared in 18 cases,dysphagia was significantly relieved in 11 , and unchanged in 7 during the following-up period.In group B,dysphagia was in different degree in 8 cases, in whom, dysphagia was disappeared in 5 cases, dysphagia was significantly relieved in 2, and unchanged in 1 ( follow-up only one month) ( P 0.05).A组36例发生不同程度吞咽困难,随访期间恢复正常18例,明显好转11例,无明显变化而影响生活质量7例;B组8例发生不同程度吞咽困难,随访期间恢复正常5例,明显好转2例,无明显变化而影响生活质量1例(该例仅随访1个月),差异有统计学意义(P<0.05).A组颅内感染10例(7.9%),B组颅内感染2例(3.5%),出院前均治愈,差异有统计学意义(P<0.05).B组手术时间较A组手术时间显著减少,差异有统计学意义(P<0.05).B组术中平均失血量较A组明显减少,差异有统计学意义(P<0.05).结论 硬性神经内镜辅助下二次改良的Foerster-Dandy手术,术中不咬除枕骨鳞部及枕大孔,在不降低疗效及不增加神经系统并发症的前提下,可进一步减少手术创伤,缩短手术时

  20. A型肉毒毒素注射联合康复干预治疗痉挛性斜颈的疗效观察%The effect of botulinum toxin type A combined with rehabilitation on spasmodic torticollis

    Institute of Scientific and Technical Information of China (English)

    郭钢花; 张秋珍; 李哲

    2014-01-01

    目的 观察局部注射A型肉毒毒素联合康复干预对痉挛性斜颈患者痉挛病情及生活质量的影响.方法 采用随机数字表法将38例痉挛性斜颈患者分为联合治疗组及对照组.2组患者均给予局部肌肉A型肉毒毒素注射,联合治疗组于A型肉毒毒素注射1周后给予康复干预.于治疗前、A型肉毒毒素注射1周后及注射8周后分别采用多伦多痉挛性斜颈评定量表(TWSTRS)、Tsui量表对患者疗效进行评定,采用健康调查量表(SF-36)对患者生活质量改善情况进行评估.结果 经A型肉毒毒素注射8周后,发现联合治疗组TWSTRS量表病情严重程度评分[(9.5±2.6)分]、残疾程度评分[(5.9±4.1)分]、躯体疼痛评分[(3.7±1.5)分]、SF-36量表生理职能评分[(68.3±19.5)分]、生理机能评分[(80.6±19.1)分]、活力评分[(76.3±20.3)分]、精神健康评分[(74.3±22.5)分]及Tsui量表评分[(3.2±1.6)分]均较治疗前明显改善(P<0.05),其中生理职能、躯体疼痛、活力、精神健康及Tsui评分与对照组间差异均具有统计学意义(P<0.05).对照组仅发现病情严重程度评分[(1 1.4±3.6)分]、Tsui量表评分[(5.8±1.7)分]与治疗前差异具有统计学意义(P<0.05).结论 在常规应用肉毒毒素基础上辅以康复训练治疗痉挛性斜颈具有协同疗效,能进一步缓解疼痛、降低伤残评分、提高患者生活质量.%Objective To observe the impact of an injection of botulinum toxin type A combined with rehabilitation on the quality of life (QOL) of patients with spasmodic torticollis.Methods Thirty-eight patients with spasmodic torticollis were randomly divided into a combined treatment group and control group.Both groups were given a local muscular injection of botulinum toxin type A.One week later the combined group was given rehabilitation training.Both groups were assessed using the Toronto torticollis rating scale (TWSTRS),Tsui's scale and a health survey (SF-36) one week

  1. Taking Care of Your Voice

    Science.gov (United States)

    ... folds, such as vocal nodules or laryngeal papillomatosis Cancer of the larynx Neurological diseases (such as spasmodic dysphonia or vocal ... lose water and make the vocal folds and larynx dry. Alcohol also irritates the ... irritates the vocal folds. Also, cancer of the vocal folds is seen most often ...

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

    Science.gov (United States)

    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,…

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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

  6. 电生理监测下改良Foerster- Dandy手术治疗痉挛性斜颈初探%Preliminary exploration of modified Foerster-Dandys operation for the treatmen t of spasmodic torticollis with intraoperative neurophysioigical monitoring

    Institute of Scientific and Technical Information of China (English)

    高进喜; 郑兆聪; 陈乃洁; 陈渊; 王守森

    2011-01-01

    目的 探讨电生理监测下改良Foerster-Dandy手术治疗痉挛性斜颈的安全性和疗效.方法 前瞻性研究2010年11月至2011年7月显微手术治疗的7例痉挛性斜颈病人,全部采用电生理监测下改良Foerster- Dandy手术,手术方法为枕后正中入路硬膜下双侧副神经根、C1脊神经根切断、C2-4脊神经前、后根选择性部分切断术.结果 全部病人术后立即感到痉挛状态明显缓解,随访期间缓解率为85.7% (6/7),生活质量提高率在随访期间为85.7%,术后6例发生不同程度转颈无力、耸肩无力,随访期间均有所好转,无吞咽困难和头颈部支撑困难病例,无严重并发症发生.随访期间1例斜颈复发,使用盐酸度洛西汀十苯海索治疗后症状显著改善.结论 电生理监测下改良Foerster-Dandy手术治疗痉挛性斜颈安全有效,熟悉局部解剖、掌握显微手术技巧是手术安全的基础;选择合适的病例、合理使用电生理监测技术、个体化制定神经根选择性切断的程度是手术疗效的保证.本研究只是改良Foerster-Dandy手术治疗痉挛性斜颈的初步探索,该术式大宗病例和长期随访资料尚需进一步积累完备.%Objective To observe the safety and effectiveness of modified Foerster-Dandy 's operation for the treatmen t of spasmodic torticollis with intraoperative neurophysiolgical monitoring. Methods Seven cases of spasmodic torticollis patients from November 2010 to July 2011 were studied prospectively. All the patients were treated by microsurgical modified Foerster- Dandy's operation with intraoperative neurophysiolgical monitoring. Selective neurotomy of bilateral accessory nerves,Cl spinal nerve,C2-4 ventral roots and dorsal roots was performed. Results Our study showed that all patients experienced disappearance or notable regression of the spas-ticity rightly after operation, and the percentage in follow-up duration was 85. 7%, and 85. 7% cases had a better life

  7. 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

    Institute of Scientific and Technical Information of China (English)

    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

  8. [Psychological classification of functional voice disorders].

    Science.gov (United States)

    Kiese-Himmel, C; Kruse, E

    1997-01-01

    In an explorative study the classification of a collective of patients with different voice disorders by discriminant and cluster analysis was tried. 21 variables, obtained from 128 patients with various diagnoses of voice disorders, were used. A first discriminant analysis on the basis of diagnoses-groups permitted no differentiation. A subsequent hierarchical cluster analysis indicated a four-cluster-solution. The clusters showed only little association with the phoniatric diagnoses. Cluster 1 is characterized by patients with non-organic voice disorders. Cluster 2 is marked by emotional unstable patients with organic dysphonia. Cluster 3 consists of patients with psychosomatic dysphonia by laryngeal contact granuloma, and cluster 4 contains emotional stable patients suffering from organic dysphonia and from spasmodic dysphonia. Thirteen psychological variables discriminated the clusters significantly: Anxiety about appearing in public, emotionality (neuroticism), life satisfaction, aggressiveness, anxiety, about physical injuries, extraversion.

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  10. Disfonia infantil: hábitos prejudiciais à voz dos pais interferem na saúde vocal de seus filhos? Children dysphonia: do harmful vocal habits by parents interfere in their children vocal health?

    Directory of Open Access Journals (Sweden)

    Carla Lucélia Bessani Paixão

    2012-08-01

    and speaking too quickly. Living in noisy familiar environments was significantly reported by children, fathers and mothers of SG when compared to those of the CG. CONCLUSION: despite the factors that explain dysphonia, dysphonic children as well as their fathers and mothers reported a higher incidence of harmful vocal habits and living in noisy familiar environments than children with no vocal alterations and their parents.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. Curative effect of combination treatment by ketorolac tromethamine and phloroglucinol on the acute spasmodic abdominal pain%酮咯酸氨丁三醇联合间苯三酚治疗急性痉挛性腹痛的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭聪芳

    2013-01-01

    Objective:To observe the clinical effect of the combination of ketorolac tromethamine and phloroglucinol on the acute spasmodic abdominal pain.Methods:Two hundred patients with acute spasmodic abdominal pain were divided randomly into four groups:group A (treatment of phloroglucinol),group B (treatment of anisodamine),group C (treatment of ketorolac tromethamine)and group D(combination of ketorolac tromethamine and phloroglucinol).The degrees of pain before and after the treatment were scored,the earliest time of pain relief and the pain relief rate in 30 min were recorded,the incidence of the adverse reaction such as the red face,dry mouth,palpitation,blurred vision,nausea were observed.Results:The time of pain relief was the earliest,and the pain relief rate in 30 rain was the highest in Group D.Compared with group A,B,C,there were statistical differences.Group A had the minimum incidence of the adverse reaction.Group B had the maximum incidence of the adverse reaction,compared with group C,D,the differences were statistically significant.Conclusion:The combination of ketorolac tromethamine and phloroglucinol in the remission of acute spasmodic abdominal pain is the best.%目的:观察间苯三酚联合酮咯酸氨丁三醇治疗急性痉挛性腹痛患者的临床疗效.方法:将200例急性痉挛性腹痛患者随机分为4组:间苯三酚组(A组)、山莨菪碱组(B组)、酮咯酸氨丁三醇组(C组)和间苯三酚+酮咯酸氨丁三醇组(D组),分别对各组进行治疗前后疼痛程度评分,记录用药至疼痛缓解的最早起效时间、30 min的疼痛缓解率;观察各组患者面红、口干、心悸、视力模糊、恶心等不良反应发生率.结果:D组疼痛缓解的起效时间最短,30 min疼痛缓解率最高,与A、B、C组比较差异均有统计学意义.A组不良反应最少,B组不良反应最多,B组与C、D组比较差异有统计学意义.结论:间苯三酚联合酮咯酸氨丁三醇治疗急性痉挛性腹痛疗效较好.

  13. Efficacy Observation of Spasmodic Infantile Cerebral Palsy Treated with Acupuncture at Fengfu(GV16)and Yamen(GV15)%以风府、哑门为主穴针刺治疗小儿痉挛型脑瘫疗效观察

    Institute of Scientific and Technical Information of China (English)

    王寒雪; 师强华; 李明磊

    2013-01-01

    Objective To observe the clinical efficacy on spasmodic infantile cerebral palsy treated with acupuncture at Fengfn( GV16 )and Yamen( GV15 ). Methods Sixty cases of spasmodic infantile cerebral palsy were selected and randomized into a treatment group and a control group, 30 cases in each one. They were treated with acupuncture mainly at Fengfn( GV16 )and Yamen( GV15 )and conventional western medicine respectively. Additionally,the rehabilitation training was combined in both groups. After three sessions of treatment,DQ value and limb spasm state were observed before and after treatment in each group. Results According to the standard of efficacy assessment,7 cases were markedly effective,22 cases were effective and 1 case was failed;the total effective rate was 96. 7% in the treatment group;3 cases were markedly effective, 21 cases were effective and 6 cases were failed; the total effective rate was 80. 0% in the control group. DQ value was all improved in both groups, presenting the significant difference in comparison between the treatment group and the control gronp( P <0. 05 ). Concerning to the limb spasm state,the result was improved in both groups, presenting the significant difference in comparison between the treatment group and the control gronp( P <0. 05 ). The survival quality in the treatment group was superior to the control group. Conclusion The research indicates that acupuncture at Fengfu( GV16)and Yamen( GV15 )as the chief acu-points in the prescription achieves the definite efficacy on spasmodic infantile cerebral palsy.%目的 观察以风府、哑门为主穴针刺治疗小儿痉挛型脑瘫的临床疗效.方法 选取小儿痉挛型脑瘫患者60例随机分为治疗组与对照组,每组30例.分别采用以风府、哑门为主穴针刺治疗和西医常规治疗加康复训练,3个疗程后观察各组治疗前后发育商DQ分值及肢体痉挛状态改变情况.结果 根据疗效判定标准,治疗组显效7例,有效22例,无效1

  14. 改良选择性腰骶段脊神经后根部分切断术治疗痉挛性截瘫的初步疗效报告%The preliminary report of modified selective posterior rhizotomy of lumbosacral region for relief of spasticity of lower limbs of spasmodic paraplegia

    Institute of Scientific and Technical Information of China (English)

    于炎冰; 张黎; 徐晓利; 许骏; 任鸿翔; 刘江; 李放

    2009-01-01

    Objective To study the preliminary effectiveness of modified seleetive posterior rhizotomy of lumbosacral region for relief of spasticity of lower limbs of spasmodic paraplegia. Method 21 cases of spasmodic paraplegia patients with spastieity of lower limbs were treated by modified selective posterior rhizotomy of lumbosaeral region from July 2002 to March 2008. Results At follow up evaluation (mean duration :26. 3 months), this study showed that 91% (19/21) eases experienced disappearance or notable regression of spasticity in follow-up duration. The improved motor capacities were found in 71% (15/21) cases. 95% (20/21) eases had better quality of life by follow-up studying. Postoperative complication included dysaesthesias of lower limbs(24% ,5/21), muscle weakness (14% ,3/21), transient uroschesis(5% ,1/21) ,and recurrence of spasticity(24% ,5/21). Conclusions The preliminary study showed that modified selective posterior rhizotomy of lumbosaeral region is an effective and safe microsurgical method for treatment of spastieity of lower limbs in spasmodic paraplegia patients. But its further effectiveness should be evaluated for a longer time.%目的 探讨改良选择性腰骶段脊神经后根部分切断术治疗痉挛性截瘫的初步疗效.方法 回顾分析2002年7月至2008年3月显微手术治疗的21例痉挛性截瘫患者下肢痉挛状态,全部采用改良选择性腰骶部脊神经后根部分切断术.结果 平均随访26.3个月.术后即刻痉挛状态缓解率为100%,随访期间痉挛状态缓解率为91%(19/21),步态功能改善率为71%(15/21),生活质量提高率为95%(20/21).24%(5/21)患者存在随访期间未完全缓解的下肢感觉障碍或异常,肌无力者占14%(3/21),术后发生一过性尿潴留1例(5%).随访期间无永久性二便障碍发生.术后下肢痉挛状态不同程度复发5例(24%),其中2例(10%)回复到术前的严重程度.结论 改良选择性腰骶部脊神经后根部分切断术治疗痉挛性截瘫

  15. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  16. 痉挛性发音障碍的临床特征

    Institute of Scientific and Technical Information of China (English)

    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.

  17. A型肉毒毒素治疗痉挛性发音障碍

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Tardive Dystonia: Clinical Spectrum and Novel Manifestations

    Directory of Open Access Journals (Sweden)

    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.

  19. Laryngeal lipoma: a rare cause of dysphonia.

    Science.gov (United States)

    Nada, Garrouche; Omezzine, Jerbi Saida; Maher, Dhifallah; Nouha, Ben Hamida; Hssine, Hamza

    2017-01-01

    Lipomas are the most common mesenchymal tumors. Laryngeal lipomas represent 1% of all lipomas but unlike other locations may cause life-threatening symptoms by obstruction of the respiratory tract. In this study, the case of a 32-year old woman with laryngeal lipoma is discussed. The lesion was detected on the left aryepiglottic fold, presented as a stalked and dynamic mass of 2 centimeters diameter. The imaging aspects of laryngeal lipoma cases, clinical evaluation, and approaches to treatment will be discussed.

  20. Diagnosis and management of ventricular dysphonia.

    Science.gov (United States)

    Von Hake, C P; Ganzman, I P; Mauer, T P

    1989-02-01

    Ventricular phonation may develop on a functional level, or it may occur as an alternative voice for the patient who has an organic disease of the true vocal folds. Three cases that represent iatrogenic, traumatic, and neurologic forms of the disorder are reported. Diagnosis, treatment, and guidelines for follow-up speech therapy are discussed.

  1. Ophthalmoplegia, Dysphonia and Tetraparesis Due to Guillain ...

    African Journals Online (AJOL)

    Guillain-Barre's syndrome (GBS) or inflammatory/post-infectious acute ... It usually begins in the legs and sometimes goes up to the respiratory muscles and cranial ... The gestation is a relative immunological rest period in which autoimmune ...

  2. 尼莫地平加小剂量阿司匹林治疗脑血管痉挛性头痛头晕的临床观察%Effect of nimodipine and aspirin in the treatment for brain arterial spasmodic headache and dizziness

    Institute of Scientific and Technical Information of China (English)

    赵秋明

    2001-01-01

    Objective:To investigate the efficacy of nimodipine and aspirin in the treatment for brain arterial spasmodic headache and dizziness.Methods: 80 cases of brain arterial spasmodin headache and dizziness were randomly divided into two groups:the study group(n=40) were given nimodipine (20mg.T.i.d)and aspirin(75mg q.d),the control group(n=40)were only given nimodipine(20ng.T.i.d).To investigate the efficacy after treatment lasted for 4 weeks.Results: Clinical effect:the study group's curative effect was 70% ,P< 0.05.TCD:the study group's curative effect was 70% ,the control group's curative effect was 42.5% P< 0.05.There was one brain ischemic case in the study group,but three cases in the control group.Conclusion: Nimodipine and aspirin in treatment for brain arterial spasmodic headache and dizziness was not only more efficacious nimodipine,but also prevented brain ischemia.%目的观察尼莫地平加小剂量阿司匹林治疗脑血管痉挛性头痛头晕的临床疗效。方法 80例脑血管痉挛性头痛头晕的病人,随机分为两组:对照组 40例,尼莫地平片 20mg,每天三次;治疗组 40例,尼莫地平片 20mg,每天三次,加服阿司匹林 75mg,每天一次;两组疗程均为四周后,观察疗效。结果临床疗效:治疗组总有效率 85%;对照组总有效率 60%; P<0 05。经颅多普勒检查脑血流改善情况:治疗组总有效率 70%;对照组总有效率 42 5%; P<0 05。治疗组有一例发生缺血性脑卒中;对照组有 3例发生缺血性脑卒中。结论尼莫地平加小剂量阿司匹林治疗脑血管痉挛性头痛头晕优于单用尼莫地平,并可预防缺血性脑卒中的发生。

  3. Clinical Study of Acupuncture Guided by Liugui 8 Methods Theory for Spasmodic Dysarthria Caused by Cerebrovascular Infarction%灵龟八法治疗急性脑梗塞痉挛性构音障碍的临床研究

    Institute of Scientific and Technical Information of China (English)

    樊莉; 朱晓平; 杨海芳; 曾令虹

    2012-01-01

    目的:对比观察灵龟八法与石氏醒脑开窍法对急性脑梗塞痉挛性构音障碍的临床疗效.方法:将受试者随机分为灵龟八法组、醒脑开窍组、灵龟加醒脑组3组,每组各31例,均进行3周治疗.结果:(1)治疗1周、2周、3周后,各组日本言语和嗓音医学学会GRBAS分级G项等级分布情况、Frenchay相关评分均较前1周有显著性差异(P<0.05);治疗3周后,灵龟加醒脑组较灵龟组、醒脑组有显著性差异(P<0.05).(2)治疗3周后,灵龟组总有效率71.0%,醒脑组74.2%,两组无显著性差异(P>0.05),灵龟加醒脑组93.5%,与前两组比较,均有显著性差异(P<0.05).结论:灵龟八法、醒脑开窍法对急性脑梗塞痉挛性构音障碍都有较好治疗效果,两者疗效相似,且联用后疗效明显优于任一单用疗法.灵龟八法取穴少而精,方便安全,刺激量小,值得临床推广运用.%Objective:To estimate the validity of acupuncture guided by Liugui 8 Methods Theory for Spasmodic Dysarthria caused by Cerebrovascular Infarction. Methods; 93 patients were randomly distributed into Lingui Group ( group A) , Xingnao Kaiqiao Group (group B) , Lingui plus Xingnao Kaiqiao Group (group C) ,with 31 cases in each group. Results:We used GRBAS and Frenchay Index as efficacy indexes. After 1,2 and 3 weeks,we found all groups showed significant changes compared with the beginning point(P<0.05). After 3 weeks,we found Group C earned better scores both in GRBAS and Frenchay Index compared with the other 2 groups (P <0. 05) . After 3 weeks'therapy ,Group A gained 71% efficacy, Group B gained 74. 2% ,and Group C 93.5%. Conclusion:Both Linagui Methods and Xingnao Kaiqiao showed satisfying similar effect on Spasmodic Dysarthria caused by Cerebrovascular Infarction,however,when the 2 methods were combined,better effects would be gained.

  4. Radiological diagnosis of abductor denervation after hip surgery

    Energy Technology Data Exchange (ETDEWEB)

    Roy, B.R.; Binns, M.S. [Dept. of Orthopaedics, Pontefract General Infirmary (United Kingdom); Horsfall, H. [Dept. of Radiology, Pontefract General Infirmary (United Kingdom)

    2001-02-01

    A case of total hip arthroplasty through a direct lateral approach is described. The patient had a markedly positive Trendelenburg test at follow-up. Radiographs showed features consistent with the denervation of the gluteus medius. This was confirmed on CT scan. The standard post-operative radiograph following a total hip replacement may suggest denervation of the gluteus medius. (orig.)

  5. 针刺脑清穴对痉挛型脑瘫患儿尖足畸形及智力发育的影响%Impacts on tiptoe deformity and intelligent development in spasmodic cerebral palsy treated with acupuncture at Naoqing Xue (Extra)

    Institute of Scientific and Technical Information of China (English)

    张勇; 兰瑞; 刘振寰

    2013-01-01

    Objective To assess the impacts on tiptoe deformity and intelligent development in spasmodic cerebral palsy treated with acupuncture at Naoqing Xue (Extra).Methods One hundred and forty-six children with spasmodic cerebral palsy were randomized into a Naoqing Xue group (74 cases) and a control group (72 cases).On the basic treatment (scalp acupuncture,sport therapy),in the Naoqing Xue group,acupuncture at Naoqing Xue (Extra) was applied.In the control group,acupuncture was given at Jiexi (ST 41),Yanglingquan (GB 34) and Sanyinjiao (SP 6).In the two groups,acupuncture was given once every two days,10 treatments made one session,at the interval of 15 days between two sessions.Three sessions of treatment were given continuously.Before treatment and after 3 sessions of treatment,the angle measurement of ankle passive dorsiflexion,comprehensive spasm scale (CSS) and Gesell intelligence test were adopted for the rehabilitation assessment.Additionally,30 min after the end of the first acupuncture treatment,the angle measurement of ankle passive dorsiflexion and CSS were applied to assess the immediate effect of the therapeutic methods of the two groups.Results The immediate effect of the angle measurement of ankle passive dorsiflexion and CSS as well as the effect after 3 sessions of treatment in the Naoqing Xue group were all superior to those in the control group (all P<0.05).In 3 sessions of treatment,the development quotients of social adaptive behavior and personal social activation function in Gesell intelligence test in the Naoqing Xue group were all higher than those in the control group (all P<0.05).The development quotients of major movement,fine motion and language were not different significantly as compared with those in the control group (P>0.05).Conclusion Acupuncture at Naoqing Xue (Extra) relieves tiptoe deformity and promotes intelligent development for the children with spasmodic cerebral palsy.%目的:评价针刺脑清穴对痉挛型脑瘫患

  6. An experimental study on enzyme and twitch muscle fiber in spasmodic muscle after cervical perivalcular sympathectomy%颈总动脉周交感神经网剥脱切除术后痉挛肌肉内酶与肌纤维结构的研究

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    目的 探讨交感神经切断后,痉挛肌肉内酶与肌纤维结构的改变。方法 将20只wistar大白鼠作成痉挛性模型,分成两组,随机选择1组行颈总动脉周交感神经网剥脱切除术,另1组作为对照,于术后第20天切取两组大鼠部分肱三头肌组织,采用(Ellman)爱尔蒙法及AU1000检测仪测定肌组织内乙酰胆碱酯酶活性和肌酸激酶含量,在IBAS图像分析仪上观察两组肌组织内快收缩肌纤维与慢收缩肌纤维的改变情况。结果 交感神经切断后,乙酰胆碱酯酶活性和肌酸激酶含量明显下降,分别从(3.37±1.01) U/g降至(2.15±1.42) U/g(P<0.01);(3 582.90±1 561.7) IU/L降至(420.10±73.55) IU/L(P<0.01),快肌纤维明显减少,从(275 727.31±98 240.23) μm2降至(96 554.35±43 345.35) μm2(P<0.01);慢肌纤维显著增加,由(42 710.78±28 858.37) μm2增至(27 0764.02±66 642.46) μm2(P<0.01)。结论 交感神经切断后痉挛肌肉兴奋性下降。%Objective To investigate the change of enzyme and twitch muscle fiber in spasmodic muscle after sympathectomy.  Methods Spasmodic model was developed in 20 wistar rats. The rats were divided into 2 groups: one group received cervical perivalcular sympathectomy and the other group served as a control. The AchE and CK in musculsus triceps brachii of rats in the 2 groups were tested by using Ellman and AU 1000. The fast twitch muscle fibers and slow twitch muscle in musculsus triceps brachii were examined by using IBAS graph device at 20th day after sympathectomy. Results After sympathectomy, the AchE, CK and the fast muscle fibers were obviously decreased from (3.37±1.01) U/g to (2.15±1.42) U/g (P<0.01), (3 582.90±1 561.7) IU/L to (420.10±73.55) IU/L (P<0.01) and from (275 727.31±98 240.23) μm2 to (96 554.35±43 345.35) μm2 (P<0.01), respectively, while the slow twitch muscle fibers significantly increased from

  7. Effect of botulinum toxin A combined with plaster cast on gross motor function of spasmodic double paralysis%A 型肉毒毒素联合石膏固定对痉挛型双瘫患儿粗大运动功能影响的疗效观察

    Institute of Scientific and Technical Information of China (English)

    蔡慧强; 彭桂兰; 胡恕香; 蔡淑英

    2016-01-01

    目的:观察 A 型肉毒毒素联合石膏固定对痉挛型双瘫患儿粗大运动功能的影响。方法2013年1月至2014年10月厦门市妇幼保健院儿童神经康复科收治住院的痉挛型双瘫患儿40例,随机分为观察组和对照组各20例。对照组单纯采用 A 型肉毒毒素注射后进行康复训练;观察组采用 A 型肉毒毒素注射联合石膏固定3周,拆除石膏后进行康复训练,分别于治疗前及治疗后1、3、6个月采用粗大运动功能量表(GMFM-88)D 区和 E 区进行评估。结果观察组治疗后1、3、6个月 GMFM-88 D 区、E 区与治疗前比较差异有统计学意义(P <0.01)。对照组治疗后3、6个月 GMFM-88 D 区、E 区与治疗前比较差异有统计学意义(P <0.01)。观察组治疗后1、3、6个月 GMFM-88 D 区、E 区与对照组比较差异有统计学意义(P <0.01)。结论A 型肉毒毒素注射联合石膏固定治疗痉挛型双瘫患儿尖足畸形,可降低肌张力,改善运动功能,有效提高粗大运动功能,比单纯采用 A 型肉毒毒素治疗疗效更好。%Objective To explore the effect of botulinum toxin A combined with plaster cast on the gross motor function of spasmodic double paralysis.Methods A total of 40 children with spasmodic double paralysis hospitalized in Xiamen Maternal and Child Healthcare Hospital from Jan.2013 to Oct.2014 were included in the study,and they were randomly divided into two groups:observation group(20 cases)and control group(20 cases).Control group was treated only with botulinum toxin A injection followed by reha-bilitation training.Observation group was given with botulinum toxin A combined with 3 weeks of plaster cast,and then rehabilitation training was carried out after removing the plaster.GMFM-88 was used to make evaluation of zone D and zone E before treatment and 1,3 and 6 months after treatment.Results Zone D and E was different 1,3 and 6 months after treatment by GMFM-88 in the observation group

  8. 经桡动脉路径介入治疗时应用经皮冠状动脉介入治疗导丝和球囊辅助指引导管成功跨越痉挛段33例分析%Feasibility study of guiding catheter passing through spasmodic vess els during percutaneous coronary intervention via radial artery access by the aid of PCI guiding wire and balloon

    Institute of Scientific and Technical Information of China (English)

    倪祝华; 迟永辉; 张大鹏; 邓俊萍; 王益民; 刘广军; 张小良; 赵建红; 张继强; 刘佳胜; 祁树莹; 王乐丰; 杨新春; 王红石; 徐立; 李惟铭; 夏昆; 刘宇; 何冀芳

    2016-01-01

    目的:探讨经桡动脉路径行经皮冠状动脉介入治疗( percutaneous coronary intervention , PCI)血管通路痉挛应用PCI导丝和球囊辅助跨越痉挛段血管的安全性和可行性。方法回顾性分析2014年1月至2015年6月首都医科大学附属北京朝阳医院、临汾市人民医院、晋城心脑血管病医院、临汾市第二人民医院和烟台海港医院经桡动脉路径PCI伴有桡动脉和(或)肱动脉痉挛应用PCI导丝和球囊辅助成功越过痉挛段的33例冠心病患者( A组),并与同期其他术者用常规方法处理痉挛的38例患者( B组)进行比较。观察两种方法指引导管通过痉挛段的成功率以及并发症的发生率等指标,以了解两种方法的优劣。结果两组患者痉挛部位比较,差异无统计学意义( P=0.150),但肱动脉痉挛的发生率均较桡动脉高。 A组指引导管通过率显著高于B组[33例(100.0%)比15例(39.5%),P=0.000];对于指引导管成功通过痉挛段的两组患者,A组较B组所需时间更短( P=0.000),A、B组指引导管通过时间≤5 min的患者分别为30例(90.9%)和2例(13.3%),5~15 min的患者分别为3例(9.1%)和7例(46.7%),>15 min的患者分别为0和6例(40.0%)。 A组患者前臂血肿发生率较B组降低[(2例(6.1%)比7例(18.4%)],但差异无统计学意义( P=0.113)。结论经桡动脉路径PCI血管痉挛应用PCI导丝和球囊辅助可非常安全有效地使指引导管跨越痉挛和(或)夹层段,较应用抗痉挛药物这一常规方法更为安全可行。%Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD

  9. Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series Treino excêntrico para abdutores do ombro melhora dor, função e desempenho isocinético em sujeitos com síndrome do impacto: série de casos

    Directory of Open Access Journals (Sweden)

    Paula R. Camargo

    2012-02-01

    Full Text Available BACKGROUND: Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS, such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS. OBJECTIVES: To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS. METHODS: Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°. The Disabilities of the Arm, Shoulder and Hand (DASH questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer. RESULTS: DASH scores, peak torque, total work and acceleration time improved (pCONTEXTUALIZAÇÃO: Tratamentos conservadores têm sido propostos para pessoas com síndrome do impacto (SI do ombro, como fortalecimento do manguito rotador e dos músculos escapulares e alongamento dos tecidos moles do ombro. No entanto, são escassos os estudos que analisaram a eficácia do treinamento excêntrico no tratamento da SI. OBJETIVOS: Avaliar os efeitos do treinamento excêntrico para abdutores do ombro na dor, função e desempenho isocinético durante a abdução concêntrica e excêntrica do ombro em indivíduos com SI. MÉTODOS: Vinte indivíduos (sete

  10. Observation on the clinical efficacy of spasmodic torticollis treated with matrix needling technique and acupuncture at “Wuxin points” mainly%矩阵针法结合“五心穴”为主治疗痉挛性斜颈

    Institute of Scientific and Technical Information of China (English)

    徐彦龙; 金钰钧; 张洪涛; 徐秀梅

    2013-01-01

    目的:比较矩阵针法结合“五心穴”针刺与A型肉毒毒素局部注射治疗痉挛性斜颈的疗效差异.方法:将42例患者随机分为针刺组、肉毒素组,每组21例.针刺组采用矩阵针法结合针刺治疗,取穴以风池、“五心穴”(水沟,双侧劳宫、涌泉)及局部阿是穴为主;肉毒素组采用A型肉毒毒素局部多点注射.两组均治疗1个月,比较两组每一周末的疗效及治疗后半年随访结果.结果:1周末肉毒素组愈显率、总有效率分别为42.8%(9/21)、90.5%(19/21),优于针刺组的4.8%(1/21)、28.6%(6/21)(均P<0.01);2周末肉毒素组愈显率、总有效率分别为71.4%(15/21)、95.2%(20/21),优于针刺组的19.1%(4/21)、61.9%(13/21)(均P<0.01);3周末肉毒素组愈显率、总有效率分别为66.7%(14/21)、95.2%(20/21),亦优于针刺组的38.1%(8/21)、71.4%(15/21)(均P<0.05);治疗1个月及治疗后半年随访两组愈显率与总有效率差异均无统计学意义(均P>0.05).针刺组未见不良反应,肉毒素组出现局部不良反应14例,其中颈肌无力9例,颈部肌肉疼痛5例.结论:矩阵针法结合“五心穴”为主治疗痉挛性斜颈疗效显著,虽然在起效上不如肉毒素局部注射,但矩阵针法治疗1个月后及半年随访与肉毒素疗效相当,且无不良反应.%Objective To compare the difference in the efficacy on spasmodic torticollis between matrix needling technique combined with puncturing “Wuxin points” and the local injection of botox type A.Methods Forty two cases were randomized into an acupuncture group and a botox group,21 cases in each one.In the acupuncture group,the matrix needling technique was used and acupuncture was adopted at Fengchi (GB 20),“Wuxin points” [Shuigou (GV 26),bilateral Laogong (PC 8) and bilateral Yongquan (KI 1)] and local Ashi points.In the botox group,botox type A was in jected at several spots of local region.The treatment course was 1 month in

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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

  12. A Therapeutic Trial on 12 Cases with Spasmodic Torticollis

    Institute of Scientific and Technical Information of China (English)

    Zhu Lishan

    2000-01-01

    Background: Spasnodic torticollis (ST) is generally regarded as a disease affccting extrapyramidal system, but the real cause is still unknown. In addition to ordinary medical and surgical therapy, intramuscular botulinum toxin injection (IBTI) into appropriate neck muscles was considered as the first choice. However, the therapeutic efficacy is maintained limitedly and the advcrse reactions can not be well tolerated by all patients. From Au8 1992 to Aug 1999, we attemped d to treat 12 cases of ST with the therapy by injection of 50% alcohol into affected neck muscles combined with oral administration with composit dopar continually for about 4 months. All the patients had failed to respond to treatment by both westem and Chinese traditional medicine, includir g accupucture or IBTI before the trial. Methods: All twelve patinets (8 men and 4 women age range, 17 to 45 gers mean age,28.5-9.8) had suffered from the disease over 1 montth (course range, 1.2 to 1l;mean SD,4.27±3.46)before the therapy. In each case ,thee invclved neck-musles that were chosen for being injected into their moter points with 50% alcohol 2ml were among the splenius capitis trapezins and stemocleidomastoid museds on both sides The injections were performed twice a week in the first two weeks, then once to end. generally, the whole course stretching from 5 to 12 weeks(mean±11.67±2.10). At the beginning of the injections, the composit dopars were also started with low dosage, then gradually increasing till the stage in which the head jecks or tremor attenuated; or up to the highest dosage in which MModopar reached of 250, three times dayty or Sinemet CR 250, twice dayly. The duration of the medieation exterted form-12 weeks to 21 weeks(mean±s, 15.58±3.48). Resents: All thc patients experienced a temporary pain in the injecled muscles(100%,12/12) during and after shooting,but could tolerate. Drukenness lasting abont 20 munites appeared in 4 cases (33.23%,1/12)and a numbmess occurred-at a small injected area behind right ear in l,not disappearing completely till two months late. The neck moved with slight stiffness and the involuntary movement sibsided from 1 to 5 days after an injection. A few patients felt tired at the initial composit dopar therapy, which usually persisted throughout two weeks. If the oral therapy tumed ineffective. we stopped it for a week and then resumed effect would show again. These patients had been followed up for one to six years (mean±s,2.58± 1.35)since the end of their coures.The data showed what the curative rate touched 66.7% (8/12),relieved 8.3%(l/12),ineffective 33.3%(4/12) and the overall effective 75%. Discussion: 50% alcohol injection into monar point in a muscle was induced by Okubo and Yanagisawa, which was used to relieve the low limb extensor spasn. It was assumed that the injection might influence the Ia afferent impulses among a motor neuron, Rensaw's cell,agonist and atagonist, which can inhibit muscular spasm without myasthenia. We tried to use this mechanism for improving the neck myospasm though the later may be different from the former. Furthermore we attempted to increase the level of dopamin in the brain to make balance of netturotransitter in certain area of central nervous system,especially in the extrapyramidal one. Although the therapy with BT is decleared effective,the curative durafion can generally maintain from one to tree monthas. Moreover there may be some serious side effects:fatigoe-local pain, dysphagia,neck weakness, upper cstremity weakness or numbness and hoarseness. Condusion: The preliminary outcome demonstrates that injection with 50% alcohol combined with oral medication with composit dopar ia a effective therapy for ST without serious side effect. When the effectiveness attenuated in the oral course,never abandon it, stop for a week, then resume and there may be a dramatic improvement except the course that has been over six months.

  13. An Overview of Laryngeal Muscle Single Fiber Electromyography.

    Science.gov (United States)

    Bertorini, Tulio E; Sharaf, Aboubakar G

    2015-08-01

    Needle electromyography is an important tool in the diagnosis of neuromuscular diseases and has also been applied successfully in the evaluation of the vocal cord paralysis. Laryngeal electromyography, initially described by Weddell, is used to determine the cause of vocal cord paralysis and to differentiate organic from nonorganic causes of speech disorders. This test allows the diagnosis of lower motor neuron and nerve paralysis as well as myopathies. Laryngeal electromyography also helps to determine the prognosis of paralysis caused by traumatic injury of the laryngeal nerves and is used for guidance during botulinum toxin injection in spasmodic dysphonias. Single fiber electromyography is used to diagnose abnormalities of neuromuscular transmission and is applied in the study the architecture of the motor unit in muscles. This article reviews the techniques of laryngeal muscles single fiber electromyography, provides limited informative data, and discusses its potential value in the evaluation of patients with dysphonia.

  14. Laryngeal electromyography in movement disorders: preliminary data

    Directory of Open Access Journals (Sweden)

    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.

  15. Japanese version of voice handicap index for subjective evaluation of voice disorder.

    Science.gov (United States)

    Taguchi, Aki; Mise, Kazuyo; Nishikubo, Kaori; Hyodo, Masamitsu; Shiromoto, Osamu

    2012-09-01

    Recently, the Voice Handicap Index (VHI), developed in the United States, has been highlighted as a means to assess a patient's perceptions of the severity of his or her voice disorder. The VHI is based on a self-administered questionnaire that quantifies the degree of a patient's disability related to his/her voice disorder. The questionnaire was translated into Japanese and applied to Japanese patients with various kinds of disordered voice or dysphonia. The results were analyzed and the usefulness discussed. In this study, 546 patients (281 males and 265 females) were included. Mean VHI scores were 36.2/120 in males and 44.1/120 in females. In the male patients, VHI scores were the highest among teens. However, VHI scores did not vary with age in the female patients. Patients with vocal fold paralysis, functional dysphonia, psychological dysphonia, and spasmodic dysphonia showed relatively high VHI scores, whereas those with laryngeal granuloma and laryngopharyngeal reflux disease showed low scores. In most diseases, functional and physiological scores were higher than emotional scores. In any treated patients, those with vocal nodule, vocal polyp, polypoid vocal fold, and recurrent laryngeal nerve paralysis, VHI scores decreased after therapeutic intervention. These findings suggest that the Japanese VHI is a useful tool for monitoring a patient's psychological status, choosing appropriate treatment, and assessing the therapeutic outcome.

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  17. 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

    Directory of Open Access Journals (Sweden)

    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.

  18. Proposal for progressive loading of the hip abductors under mechanically unstable conditions: An electromyography study

    Directory of Open Access Journals (Sweden)

    Nejc Sarabon

    2010-12-01

    Full Text Available The aim of this study was to test the effect of the stance width and asymmetry on muscle activation patterns during balancing on a tilt board. Eleven young healthy volunteers took part in the tests. After the standardized warm-up and customization protocol had been carried out, they balanced five times for 60 seconds on a tilt board, using a different foot position each time - (i wide symmetrical, (ii narrow symmetrical, (iii moderate asymmetrical, (iv extreme asymmetrical, and (v single leg. Pair of electromyographic electrodes was glued over the gluteus medius muscle on both sides from which signals were acquired. The average values of the pre-processed signals were normalized and quantified. Repeated measures analysis of variance and t-tests revealed a systematic effect of the foot positions on the amount of the gluteus medius activation. Its activation was significantly increased in both asymmetrical stances when the foot was moved closer to the tilt board`s axis of rotation and most prominently when the single leg stance was used. These results point out the importance of the foot positioning for the actual muscle function while balancing on a tilt board. We believe that different levels of feet positioning asymmetry should be used for gradual loading of the extremity and for provoking activity in hip side stabilizers.

  19. Responses of human hip abductor muscles to lateral balance perturbations during walking

    NARCIS (Netherlands)

    Hof, A. L.; Duysens, J.

    2013-01-01

    Lateral stability during gait is of utmost importance to maintain balance. This was studied on human subjects walking on a treadmill who were given 100-ms perturbations of known magnitude and timing with respect to the gait cycle by means of a computer-controlled pneumatic device. This method has th

  20. Responses of human hip abductor muscles to lateral balance perturbations during walking

    NARCIS (Netherlands)

    Hof, A. L.; Duysens, J.

    2013-01-01

    Lateral stability during gait is of utmost importance to maintain balance. This was studied on human subjects walking on a treadmill who were given 100-ms perturbations of known magnitude and timing with respect to the gait cycle by means of a computer-controlled pneumatic device. This method has th

  1. Anatomical variation of abductor pollicis longus in Indian population A cadaveric study

    Directory of Open Access Journals (Sweden)

    Jerina Tewari

    2015-01-01

    Conclusion: Bi-tendinous APL is commonly observed on the dorsal compartment of the wrist in Indian population and these tendon-slips are commonly attached to thefirst metacarpal base and trapezium. This variation must be understood by the Indian Orthopedic surgeons as the response to treatment of DQT and reason forfirst carpo-metacarpal arthritis can be dependent on this anatomical variation.

  2. Experimentally reduced hip abductor function during walking: Implications for knee joint loads

    DEFF Research Database (Denmark)

    Henriksen, Marius; Aaboe, Jens; Simonsen, Erik B;

    2009-01-01

    muscle was significantly reduced by pain (-39.6%). All other muscles were unaffected. Peaks in the frontal plane hip and knee joint moments were significantly reduced during pain (-6.4% and -4.2%, respectively). Lateral trunk lean angles and midstance hip joint adduction and knee joint extension angles......-dimensional trunk and lower extremity joint kinematics and kinetics. Surface electromyography (EMG) of the glutei, quadriceps, and hamstring muscles were also measured. The peak GM EMG activity had temporal concurrence with peaks in frontal plane moments at both hip and knee joints. The EMG activity in the GM...... were reduced by 1 degrees . Thus, the gait changes were primarily caused by reduced GM function. Walking with impaired GM muscle function due to pain significantly reduced the external knee adduction moment. This study challenge the notion that reduced GM function due to pain would lead to increased...

  3. Using modulation spectra for voice pathology detection and classification.

    Science.gov (United States)

    Markaki, Maria; Stylianou, Yannis

    2009-01-01

    In this paper, we consider the use of Modulation Spectra for voice pathology detection and classification. To reduce the high-dimensionality space generated by Modulation spectra we suggest the use of Higher Order Singular Value Decomposition (SVD) and we propose a feature selection algorithm based on the Mutual Information between subjective voice quality and computed features. Using SVM with a radial basis function (RBF) kernel as classifier, we conducted experiments on a database of sustained vowel recordings from healthy and pathological voices. For voice pathology detection, the suggested approach achieved a detection rate of 94.1% and an Area Under the Curve (AUC) score of 97.8%. For voice pathology classification, an average detection rate and AUC of 88.6% and 94.8%, respectively, was achieved in classifying polyp against keratosis leukoplakia, adductor spasmodic dysphonia and vocal nodules.

  4. 痉挛性发声障碍的脑干病理学

    Institute of Scientific and Technical Information of China (English)

    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.

  5. 肉毒毒素对内收型痉挛性喉发音障碍的治疗

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. [Spasmodic left waist pain in a six years old child--cat scratch disease].

    Science.gov (United States)

    Barkai, Galia; Gutman, Gabriel; Sherr-Lurie, Nir; Hoffmann, Chen; Schpirer, Zvi

    2012-08-01

    Cat scratch disease is caused by Bartonella henselae, a bacterium transmitted to humans from cats through a scratch or by fleas. In 90% of cases, the clinical presentation is that of classical cat scratch disease where an adjacent lymph node is infected. Atypical manifestations include prolonged fever, liver and spleen abscesses, infective endocarditis, central nervous system involvement etc. We present a 6 years old girl who suffered from L2 vertebral osteomyelitis and epidural abscess, initially presenting as colic left waist pain, with no back pain or high fevers. During the process of diagnosis, she recovered without surgical intervention or antibiotic treatment. A review of the literature indicates that among the wide spectrum of clinical manifestations of cat scratch disease, skeletal involvement is rare. However, in cases of osteomyelitis, vertebrae are a common site as well as formation of a contiguous phlegmon. Although no studies have investigated the efficacy of different treatment regimens, all patients presented were treated with antimicrobial combinations and recovery rates were high. In view of the patient presented here, it is questioned whether the high recovery rates are a result of efficient antibiotic treatment or due to a benign natural course of the disease.

  8. Spasmodic tremor and possible magma injection in Long Valley caldera, eastern California

    Energy Technology Data Exchange (ETDEWEB)

    Ryall, A.; Ryall, F.

    1983-03-25

    Intensive microearthquake swarms with the appearance of volcanic tremor have been observed in the southwest part of Long Valley caldera, southeastern California. This activity, possibly associated with magma injection, began 6 weeks after several strong (magnitude 6+) earthquakes in an area south of the caldera and has continued sporadically to the present time. The earthquake sequence and magmatic activity are part of a broad increase in tectonic activity in a 15,000-square-kilometer region surrounding the White Mountains seismic gap, an area with high potential for the next earthquake in the western Great Basin.

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

    CERN Document Server

    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...

  10. Case of spasmodic torticollis%痉挛性斜颈案

    Institute of Scientific and Technical Information of China (English)

    宋玉芳; 将荣民

    2011-01-01

    @@ 患者,男,30岁.初诊日期:2009年11月10日.主诉:头部侧屈向左侧,不能自持半月余.病史:2009年10月底无明显诱因突发头部持续向左侧屈曲,终日如此,不能自持,于他院就诊,查头颅CT、脑电图、血尿常规无异常,X线示颈椎生理曲度变直、侧弯,诊断为"痉挛性斜颈".

  11. Spasmodic versus spasmolytic activities of Euphorbia spinidens extract on rat isolated uterus.

    Science.gov (United States)

    Ghanadian, Mustafa; Sadraei, Hassan; Cheraghi, Zeinab

    2016-12-01

    Preterm contraction of uterus is a main cause of miscarriages and preterm labour. Euphorbia known as Ferphion in Iranian traditional medicine texts like Al-Hawi, is reported for prevention of preterm labour. Therefore, the objective of this research was to investigate the effect of Euphorbia spinidens Bornm. Ex Prokh. on motility of rat uterus. Uterine horns were isolated form non-pregnant female rats pretreated with estrogen. E. spinidens hydroalcoholic extract was examined on KCl (80 mM) induced and spontaneous periodic contraction in isolate uterine strips suspended in an organ bath and compared with nifedipine and ritodrine. In isolated rat uterine strips, E. spinidens extract (1-500 µg/mL) showed mixed effects. At lower concentrations, firstly potentiated the spontaneous periodic contraction, while in concentrations above 256 µg/mL the spontaneous periodic contractions were completely attenuated. These findings demonstrated that although lower concentrations of hydroalcoholic extract potentiated the spontaneous periodic contraction of rat uterine smooth muscle, but at higher concentrations it had inhibitory effect on rat uterus contraction.

  12. Magnetically Controlled Spasmodic Accretion during Star Formation. I. Formulation of the Problem and Method of Solution

    Science.gov (United States)

    Tassis, Konstantinos; Mouschovias, Telemachos Ch.

    2005-01-01

    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 108 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 1011 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 are calculated, as are their effects on the structure & evolution of the surrounding disk. The numerical method of solution first uses an adaptive grid and later, after a central region a few AU in radius becomes opaque, switches to a stationary but nonuniform grid with a central sink cell. It also involves an implicit time integrator, an advective difference scheme that possesses the transportive property, a second-order difference approximation of forces inside a cell, an integral approximation of the gravitational and magnetic fields, and tensor artificial viscosity that permits an accurate investigation of the formation and evolution of shocks in the neutral fluid.

  13. Spasmodic versus spasmolytic activities of Euphorbia spinidens extract on rat isolated uterus

    Directory of Open Access Journals (Sweden)

    Mustafa Ghanadian

    2016-01-01

    Full Text Available Preterm contraction of uterus is a main cause of miscarriages and preterm labour. Euphorbia known as Ferphion in Iranian traditional medicine texts like Al-Hawi, is reported for prevention of preterm labour. Therefore, the objective of this research was to investigate the effect of Euphorbia spinidens Bornm. Ex Prokh. on motility of rat uterus. Uterine horns were isolated form non-pregnant female rats pretreated with estrogen. E. spinidens hydroalcoholic extract was examined on KCl (80 mM induced and spontaneous periodic contraction in isolate uterine strips suspended in an organ bath and compared with nifedipine and ritodrine. In isolated rat uterine strips, E. spinidens extract (1-500 µg/mL showed mixed effects. At lower concentrations, firstly potentiated the spontaneous periodic contraction, while in concentrations above 256 µg/mL the spontaneous periodic contractions were completely attenuated. These findings demonstrated that although lower concentrations of hydroalcoholic extract potentiated the spontaneous periodic contraction of rat uterine smooth muscle, but at higher concentrations it had inhibitory effect on rat uterus contraction.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction.

    NARCIS (Netherlands)

    Stolk, J.; Verdonschot, N.J.J.; Huiskes, R.

    2001-01-01

    Using finite element analyses, we investigated which muscle groups acting around the hip-joint most prominently affected the load distributions in cemented total hip reconstructions with a bonded and debonded femoral stem. The purpose was to determine which muscle groups should be included in pre-cl

  18. New Perspective on Psychosocial Distress in Patients with Dysphonia: The Moderating Role of Perceived Control.

    Science.gov (United States)

    Misono, Stephanie; Meredith, Liza; Peterson, Carol B; Frazier, Patricia A

    2016-03-01

    Although an association between psychosocial distress (depression, anxiety, somatization, and perceived stress) and voice disorders has been observed, little is known about the relationship between distress and patient-reported voice handicap. Furthermore, the psychological mechanisms underlying this relationship are poorly understood. Perceived control plays an important role in distress associated with other medical disorders. The objectives of this study were to (1) characterize the relationship between distress and patient-reported voice handicap and (2) examine the role of perceived control in this relationship. This is a cross-sectional study in a tertiary care academic voice clinic. Distress, perceived stress, voice handicap, and perceived control were measured using established assessment scales. Association was measured with Pearson correlation coefficients; moderation was assessed using multiple hierarchical regression. A total of 533 patients enrolled. Thirty-four percent of the patients met criteria for clinically significant distress (ie, depression, anxiety, and/or somatization). A weak association (r = 0.13; P = 0.003) was observed between severity of psychosocial distress and vocal handicap. Present perceived control was inversely associated with distress (r = -0.41; P relationship between voice handicap and psychosocial distress was moderated by perceived control (b for interaction term, -0.15; P < 0.001); greater vocal handicap was associated with greater distress in patients with low perceived control. Severity of distress and vocal handicap were positively related, and the relation between them was moderated by perceived control. Vocal handicap was more related to distress among those with low perceived control; targeting this potential mechanism may facilitate new approaches for improved care. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Validation in Brazil of self-assessment protocols for dysphonia impact.

    Science.gov (United States)

    Behlau, Mara; Oliveira, Gisele; Santos, Luciana de Moraes Alves Dos; Ricarte, Adriana

    2009-01-01

    A patient's self-assessment of his/hers vocal problem and the analysis of the results of a treatment are means used to verify the effectiveness of an intervention and to develop directive procedures for clinical health practice. Psychometric instruments are the most common tools used to perform this task. Validation of self-assessment instruments may be carried out in several ways; however there should be clear and structured criteria involved in this process. To present the validation process of three voice self-assessment instruments for the Brazilian Portuguese language: Voice-Related Quality of Life--V-RQOL, Voice Handicap Index--VHI and, Voice Activity and Participation Profile--VAPP. These instruments received respectively the following names: Qualidade de Vida em Voz - QVV, Indice de Desvantagem Vocal--IDV and Perfil de Participação e Atividades Vocais--PPAV, emphasizing their specificities and the necessary adaptations for their use in Brazil. The three questionnaires were validated following the guidelines suggested by the Scientific Advisory Committee of Medical Outcomes Trust--SAC. The psychometric measures of validity, reliability, reproducibility and sensitiveness were statistically demonstrated for each instrument. The Brazilian versions of the V-RQOL, VHI and VAPP demonstrated to be valid, reliable and sensitive instruments that specifically assess patients who present voice problems. These instruments can be used in the assessment of the life quality related to voice, as well as for the analysis of treatment outcomes.

  20. [Functional dysphonia and benign vocal cord lesions in professional voice users].

    Science.gov (United States)

    de Las Casas Battifora, Rosa Maria; Ramada Rodillac, José Maria

    2012-01-01

    Objetivo: Examinar la frecuencia con que se presentan lesiones orgánicas benignas de las cuerdas vocales (LOB-CV) entre los pacientes diagnosticados de disfonía funcional (DF) y explorar sus asociaciones con el desempeño de un trabajo como usuario profesional de la voz (UPV). Métodos: Estudio realizado en una serie de 132 pacientes diagnosticados de DF. Las LOB-CV se objetivaron mediante fibrolaringoscopia. Se documentaron la ocupación, variables sociodemográficas y factores de riesgo no ocupacionales. Se realizó un análisis descriptivo de la muestra, que se estratificó por las variables de exposición laboral (UPV y no-UPV) y por sexo. Se exploraron las asociaciones bivariadas entre la presencia de LOB-VC y el resto de variables. Se utilizó el paquete estadístico SPSS versión 15. Resultados: Los pacientes fueron principalmente mujeres (58,3%), con una edad media de 48 años (DE±13). Un 40% eran usuarios profesionales de la voz (UPV). El 47% presentaron alguna LOB-CV, siendo la más prevalente los pólipos/nódulos (29%). Los UPV con disfonía funcional presentaron mayor prevalencia de LOB-CV (57%) frente a los no-UPV (40%). Ser UPV se asoció a mayor riesgo de padecer LOB-CV (odds ratio de prevalencia cruda, ORPc=1,48; IC95%=0,74- 2,98), principalmente pólipos/nódulos (ORPc=1,77; IC95%=0,82-3,78) y laringitis crónica (ORPc= 2,31; IC95%=0,37- 14,32), aunque sin alcanzar significación estadística. Fumar se asocio significativamente a mayor riesgo de presentar pólipos/nódulos en todos los pacientes (ORPc=2,95; IC95%=1,33-6,53). Conclusiones: Ser trabajador UPV se asoció a un mayor riesgo de LOB-CV, principalmente pólipos/nódulos de las cuerdas vocales y laringitis crónica. Los servicios de prevención deberían evaluar este riesgo laboral siempre que la voz sea una herramienta de trabajo primaria, con el fin de poder establecer medidas preventivas precoces.

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

    NARCIS (Netherlands)

    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

  2. Non-organic dysphonia. II. Phonetograms for normal and pathological voices.

    Science.gov (United States)

    Gramming, P; Akerlund, L

    1988-01-01

    The clinical usefulness of the phonetogram, i.e. a graph showing the sound pressure level (SPL) of softest and loudest possible phonation over the entire fundamental frequency range of a voice, was investigated. Phonetograms of 29 female non-organic dysphonic patients, 17 healthy female subjects, 18 non-organic dysphonic male patients and 12 healthy male subjects were compared. The female patients showed significantly lower SPL values for loudest phonation when compared with healthy female subjects, while no significant difference was seen in the male subjects in this regard. With respect to the SPL values for softest phonation, on the other hand, the male dysphonic patients showed significantly higher SPL values than the healthy male subjects, whereas no significant difference was seen in the female subjects. Spectrum analysis showed that the patients had a more dominating fundamental in loud phonation than did the healthy voices.

  3. Neurogenic stuttering as a manifestation of stroke and a mask of dysphonia.

    Science.gov (United States)

    Rao, P R

    1991-01-01

    R. L. was a 52-year-old man who was referred for an SLP consultation to determine the nature of his fluency disorder, whether or not treatment would be beneficial, and finally whether resumption of pre-trauma vocational status was feasible. The patient was involved in a motor vehicle accident with no resulting detectable trauma. However, shortly after the accident, R. L. developed a severe dysfluency that was later described as cortical stuttering. We reviewed the medical and rehabilitation work-up that attempted to determine whether the communication disorder was functional or organic in origin. Once the fluency disorder was determined to be caused by a suspected small, focal, hemispheric lesion, a five-month treatment program was undertaken that used a noval prosthetic approach to restore fluency. Once fluency was restored with the use of an artificial larynx, a residual anomia was detected and treated. The case of R. L. illustrates a stuttering that appeared to be caused by a combined neurogenic dyspraxic (vocal control), dysarthric (motor control), and dysnomic (word-finding) dysfluency. The literature on this issue was reviewed and the underlying mechanism of recovery was discussed.

  4. “Barnabé and his adventure”: a vocal health education project in childhood dysphonia

    OpenAIRE

    Dias, Maria do Rosário; Cruz, Catarina Vilarinho da; Carvalho, Ana Reis de

    2015-01-01

    "Os nódulos vocais, associados etiologicamente a um comportamento disfuncional de mau uso e abuso vocal, são os principais responsáveis pela disfonia crônica em crianças de ambos os gêneros. A disfonia infantil pode influenciar a sedimentação das relações sociais da criança disfônica e conduzir a processos de estigmatização e constrangimento por parte de seus pares. O presente instrumento de Educação para a Saúde tem como principal objetivo consciencializar a criança disfônica par...

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

    Science.gov (United States)

    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.

  6. 75 FR 76020 - Prospective Grant of Exclusive License: Devices for Treating Dysphagia and Dysphonia

    Science.gov (United States)

    2010-12-07

    ... cover a system, device and method for rehabilitating dysphagia due to stroke, ex-tubation or coronary..., olfactory stimulation, taste stimulation, or a combination of these. Upon activation a vibrator moves...

  7. Clinical Experiences of Dr. Wei Lifu in Treating Spasmodic Toricollism Spasmodic Wryneck by Acupuncture Therapy%韦立富针灸治疗痉挛性斜颈经验

    Institute of Scientific and Technical Information of China (English)

    潘小霞; 韦立富

    2006-01-01

    韦立富主任医师是全国著名老中医专家,是针灸学术界少数的神经学派专家之一。他认为对于机体运动、感觉、分泌机能亢进的病症,如疼痛、痉挛及精神运动兴奋状态等,采取抑制型的针刺手法治疗有缓解、抑制其亢进的作用,从而达到缓解疼痛或痉挛,治愈疾病的目的。现介绍韦立富主任医师运用独特的针刺手法治疗痉挛性斜颈的经验。

  8. Anti-spasmodic action of crude methanolic extract and a new compound isolated from the aerial parts of Myrsine africana

    Directory of Open Access Journals (Sweden)

    Ahmad Bashir

    2011-07-01

    Full Text Available Abstract Background Myrsine africana is an herbaceous plant that is traditionally used as appetizer and carminative. Locally, it is used for the treatment of pulmonary tuberculosis, rheumatism and diarrhea by healers. The aims of the current study were to screen the crude methanol extract obtained from the aerial parts (leaves and stem of M. africana, for antispasmodic actions on isolated tissues and further to subject the ethyl acetate (EtOAc fraction of plant to column chromatography for isolation of pure compounds. Methods The antispasmodic action of the crude methanol extract was measured on the spontaneous rabbit's jejunum preparations at concentration 0.01, 0.03, 0.1, 0.3, 1.0, 5.0 and 10.0 mg/ml. The crude extract was also applied, in similar concentrations, on KCl (80 mM induced contractions to explain its possible mode of action. Results A new compound Myrsigenin was isolated from the EtOAc fraction of M. africana. The structure of the compound was identified with the help of 13C-NMR, 1H-NMR, HMBC, HMQC, NOESY and COSY. The plant crude methanol extract showed a significant antispasmodic action on rabbit jejunum and abolished the tissue contraction completely at concentration of 5.0 mg/ml. Conclusion The study concludes that the methanol crude extract of aerial parts of M. africana has antispasmodic action possibly through the calcium channel blocking mechanisms. A new compound Myrsigenin was isolated from the EtOAc fraction of the plant.

  9. “Tratamiento de la Displasia Acetabular Pura mediante cojín de Frejka y aparato abductor tipo Rhino R”

    OpenAIRE

    Islas Picazo, José Luís

    2012-01-01

    La Displasia del desarrollo de la cadera tiene una incidencia de 1 x 1000 nacidos, lo cual la hace uno de los problemas más comunes del aparato locomotor en los niños. Su comportamiento es dinámico, razón ésta para que su término médico actual sea Displasia de la cadera en desarrollo (DCD) (1-5). El mejor pronóstico lo hace su detección temprana, lo cual motiva a divulgar e instruir ampliamente a nivel primario de atención, acerca de una excelente evaluación clínica y el rec...

  10. Correlation between the degree of neurogenic oropharyngeal dysphagia with the level of dysphonia in the elderly: analysis related

    Directory of Open Access Journals (Sweden)

    Domingos Sávio Ferreira de Oliveira

    2014-07-01

    Full Text Available Objetivo: Analisar a correlação dos resultados da avaliação entre os graus da disfagia neurogênica e da disfonia. Métodos: Trata-se de pesquisa clínica prospectiva. Participaram 45 idosos entre 60 a 85 anos, 9 com Parkinson, 22 com Acidente vascular encefálico e 14 com demência, e por apresentar queixas de alteração na deglutição e voz. Aplicadas as escalas de disfagia (O’Neil e disfonia (RASATI em dois momentos: avaliação inicial e final, após fonoterapia. Pesquisa e termo de consentimento livre e esclarecido aprovados pelo Comitê de Ética do Hospital Copa D’or, Rio de Janeiro/RJ, CAAE nº 11241113.00005249. Resultados: Observou-se melhora da disfagia em 73% dos pacientes, com média de idade de 79,4. A qualidade vocal melhorou em 62%, com média de idade de 78, 9, em 11,6 sessões. Conclusão: Os idosos com disfagia neurogênica e disfonia apresentaram melhora na evolução das escalas ao término da intervenção fonoaudiológica.

  11. Wavelet adaptation for automatic voice disorders sorting.

    Science.gov (United States)

    Erfanian Saeedi, Nafise; Almasganj, Farshad

    2013-07-01

    Early diagnosis of voice disorders and abnormalities by means of digital speech processing is a subject of interest for many researchers. Various methods are introduced in the literature, some of which are able to extensively discriminate pathological voices from normal ones. Voice disorders sorting, on the other hand, has received less attention due to the complexity of the problem. Although, previous publications show satisfactory results in classifying one type of disordered voice from normal cases, or two different types of abnormalities from each other, no comprehensive approach for automatic sorting of vocal abnormalities has been offered yet. In this paper, a solution for this problem is suggested. We create a powerful wavelet feature extraction approach, in which, instead of standard wavelets, adaptive wavelets are generated and applied to the voice signals. Orthogonal wavelets are parameterized via lattice structure and then, the optimal parameters are investigated through an iterative process, using the genetic algorithm (GA). GA is guided by the classifier results. Based on the generated wavelet, a wavelet-filterbank is constructed and the voice signals are decomposed to compute eight energy-based features. A support vector machine (SVM) then classifies the signals using the extracted features. Experimental results show that six various types of vocal disorders: paralysis, nodules, polyps, edema, spasmodic dysphonia and keratosis are fully sorted via the proposed method. This could be a successful step toward sorting a larger number of abnormalities associated with the vocal system. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy

    Directory of Open Access Journals (Sweden)

    Tsuji, Domingos Hiroshi

    2014-04-01

    Full Text Available Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia. The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.

  13. Improvement of vocal pathologies diagnosis using high-speed videolaryngoscopy.

    Science.gov (United States)

    Tsuji, Domingos Hiroshi; Hachiya, Adriana; Dajer, Maria Eugenia; Ishikawa, Camila Cristina; Takahashi, Marystella Tomoe; Montagnoli, Arlindo Neto

    2014-07-01

    Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.

  14. Clinical-pathomorphological correlation in patients with symptomatic dystonias

    Directory of Open Access Journals (Sweden)

    Ivanović Nataša

    2002-01-01

    Full Text Available Symptomatic dystonia can be the result of various metabolic, degenerative diseases, the consumption of certain medications or exposure to toxic agents. However, only symptomatic dystonia with focal structural lesion provides a significant "window" for, at least indirect, perception of aetiopa-thogenesis and pathomorphological substratum of idiopathic dystonia. Our study included 57 patients with symptomatic dystonia, which as a base had focal or multifocal lesions, of whom 7 patients had generalized dystonia, 18 hemidystonia, 6 segmental dystonia, 7 torticollis, 6 blepharospasm, 7 hand dystonia, 3 spasmodic dysphonia, and 3 had oromandibular dystonia. Stroke was highly statistically the most frequent cause of structural lesions (33/57 or 58%. Relevant pathomorphological changes were present in 50/57 (88% patients, of whom 25 (50% had lesion in the lenticular nucleus (including individual damage of the putamen and globus pallidus, 12/50 (24% had damage of the thalamus and 6/50 (12% had damage of the brainstem. Generalized dystonia was most frequently associated with bilateral lesion of the putamen, hemidystonia with lesion of contralateral putamen, torticollis with damage of the caudate nucleus, hand dystonia with lesion of the thalamus and blepharospasm with lesion of the upper brainstem.

  15. 痉挛性发音障碍研究进展

    Institute of Scientific and Technical Information of China (English)

    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。

  16. Treatment of Palatal Myoclonus with Botulinum Toxin Injection

    Directory of Open Access Journals (Sweden)

    Mursalin M. Anis

    2013-01-01

    Full Text Available Palatal myoclonus is a rare cause of pulsatile tinnitus in patients presenting to the otolaryngology office. Rhythmic involuntary contractions of the palatal muscles produce the pulsatile tinnitus in these patients. Treatment of this benign but distressing condition with anxiolytics, anticonvulsants, and surgery has been largely unsuccessful. A few investigators have obtained promising results with botulinum toxin injection into the palatal muscles. We present a patient with palatal myoclonus who failed conservative treatment with anxiolytics. Unilateral injection of botulinum toxin into her tensor veli palatini muscle under electromyographic guidance resolved pulsatile tinnitus in her ipsilateral ear and unmasked pulsatile tinnitus in the contralateral ear. A novel method of following transient postinjection symptoms using a diary is presented in this study. Botulinum toxin dose must be titrated to achieve optimal results in each individual patient, analogous to titrations done for spasmodic dysphonia. Knowledge of the temporal onset of postinjection side effects and symptomatic relief may aid physicians in dose titration and surveillance. We present suggestions on titrating the botulinum toxin dose to optimal levels. A review of the literature on the use of botulinum toxin for palatal myoclonus and some common complications are discussed.

  17. Looking outside the (voice)box.

    Science.gov (United States)

    Gartrell, Nanette; Rothblum, Esther

    2014-01-01

    Laura S. Brown, PhD, is a clinical and forensic psychologist in independent practice in Seattle, Washington. The bulk of her scholarly work has been in the fields of feminist therapy theory, trauma treatment, lesbian and gay issues, assessment and diagnosis, ethics and standards of care in psychotherapy, and cultural competence. She has authored or edited ten professional books, including the award-winning Subversive Dialogues: Theory in Feminist Therapy, as well as more than 140 other professional publications. She has also recently published her first book for general audiences, Your turn for care: Surviving the aging and death of the adults who harmed you. Laura has been featured in five psychotherapy training videos produced by the American Psychological Association. She was President of American Psychological Association Divisions 35 (Society for the Psychology of Women), 44 (Society for the Psychological Study of Lesbian, Gay and Bisexual Issues), and 56 (Trauma Psychology). Laura was also President of the Washington State Psychological Association. She is the founder and Director of the Fremont Community Therapy Project, a low-fee psychotherapy training clinic in Seattle. In the fall of 2000, she was the on-site psychologist for the reality show Survivor: The Australian Outback. In 1987, Laura lost her voice and was diagnosed with spasmodic dysphonia. In 1988, she found her voice again.

  18. Evaluation of the Cortical Silent Period of the Laryngeal Motor Cortex in Healthy Individuals

    Science.gov (United States)

    Chen, Mo; Summers, Rebekah L. S.; Goding, George S.; Samargia, Sharyl; Ludlow, Christy L.; Prudente, Cecília N.; Kimberley, Teresa J.

    2017-01-01

    Objective: This work aimed to evaluate the cortical silent period (cSP) of the laryngeal motor cortex (LMC) using the bilateral thyroarytenoid (TA) muscles with transcranial magnetic stimulation (TMS). Methods: In 11 healthy participants, fine-wire electromyography (EMG) was used to record bilateral TA muscle responses to single pulse TMS delivered to the LMC in both hemispheres. Peripheral responses to stimulation over the mastoid, where the vagus nerve exits the skull, were collected to verify the central origin of the cortical stimulation responses by comparing the latencies. Results: The cSP duration ranged from 41.7 to 66.4 ms. The peripherally evoked motor-evoked potential (MEP) peak occurred 5–9 ms earlier than the cortical responses (for both sides of TAs: p < 0.0001) with no silent period. The right TA MEP latencies were earlier than the left TA responses for both peripheral and cortical measures (p ≤ 0.0001). Conclusion: These findings demonstrate the feasibility of measuring cSP of LMC based on intrinsic laryngeal muscles responses during vocalization in healthy volunteers. Significance: The technique could be used to study the pathophysiology of neurological disorders that affect TA muscles, such as spasmodic dysphonia. Further, the methodology has application to other muscles of the head and neck not accessible using surface electrodes. PMID:28326007

  19. 侧屈型痉挛性斜颈病人围术期的护理%Perioperative Nursing Care of Laterocollis Spasmodic Torticollis

    Institute of Scientific and Technical Information of China (English)

    李艳; 田贵贞; 方慧

    2004-01-01

    对采用痉挛侧副神经切断、颈神经后支选择性切断及颈部肌肉选择性切除术(简称三联术)治疗侧屈型痉挛性斜颈的45例病人,实施手术前后护理及出院指导的全程护理.结果痊愈34例,显效9例,好转2例.提示科学的护理是侧屈型痉挛性斜颈围术期的重要一环.

  20. 浅谈百日咳痉咳期的治疗体会%Experiences on Treatment of Spasmodic Cough in Pertussis Patients

    Institute of Scientific and Technical Information of China (English)

    谢克正

    1999-01-01

    @@ 百日咳为小儿常见的呼吸道急性传染病.本病初期常伴有外感症状,但咳嗽尤为突出,并多干咳、呛咳,夜间尤甚,结合患儿的接触史,有无免疫接种史等流行病学特点,必要时查血,帮助诊断.但门诊患儿,往往一时难于确诊或漏诊,仅作一般外感咳嗽辨证施治,难于控制而发展为中期--痉咳期.笔者运用中药对本病痉咳期辨证施治,疗效颇佳,谨介绍于下.

  1. 脑卒中后痉挛性偏瘫的临床研究现状%Development of the clinical study on spasmodic palsy after cerebral apoplexy

    Institute of Scientific and Technical Information of China (English)

    林秀瑶; 陈立典

    2007-01-01

    对近年来临床治疗脑卒中后痉挛性偏瘫进行了综述.提示:中西医结合治疗本病具有良好的临床实用价值和发展前景,尤其针灸、康复治疗副作用小,疗效高,对提高患者的生活质量具有重要意义.

  2. 经筋论治脑卒中后痉挛状态%The Treatment of Spasmodic Apoplexy According Differentiation of meridian and Tendon

    Institute of Scientific and Technical Information of China (English)

    岳增辉; 刘伍立

    2001-01-01

    @@ 脑卒中大多发生在中老年人,据统计,目前其发病率为219/10万,患病率为719/10万,死亡率116/10万,复发率41%,致残率高达80%[1],严重影响患者的日常生活,也增加了家庭和社会的负担.

  3. 穴位磁场疗法治疗痉挛性斜颈%Acupoint magnetic therapy in the treatment of spasmodic torticollis

    Institute of Scientific and Technical Information of China (English)

    赵钧; 吴爽

    2014-01-01

    目的:观察磁针治疗痉挛性斜颈的临床疗效.方法:对20例痉挛性斜颈的患者采用穴位磁场疗法针刺风池、大椎、身柱等穴.每天1次,10次为一疗程,2疗程后总结疗效.结果:治愈6例,显效9例,有效3列,无效2例,治愈率30%,总有效率90%.结论:穴位磁场疗法治疗痉挛性斜颈有较好的临床疗效.

  4. The Acupuncture for Spasmodism and Urinary Incontinence%针灸治疗脑卒中后肢体痉挛及尿失禁

    Institute of Scientific and Technical Information of China (English)

    唐宏智; 李瑛

    2014-01-01

    尿失禁和肢体痉挛是脑卒中后中风恢复期常见症状,严重影响患者的生活质量,针灸疗法作为传统中医疗法的重要组成部分,治疗该病具有简、便、廉、验的特点,临床疗效满意.总结近几年来脑卒中后肢体痉挛和尿失禁的针灸治疗进展,以期为该病的临床治疗提供参考.

  5. 臀肌挛缩症的围手术期护理%Nursing of Intragluteal Spasmodic Contraction in the Perioperation

    Institute of Scientific and Technical Information of China (English)

    吴丽君

    2002-01-01

    @@ 臀肌挛缩症是儿童时期的臀部肌肉及筋膜发生纤维化挛缩引起的病症,继发引起髋关节外展、外旋畸形,严重者出现髋关节屈曲障碍,表现为蹲、坐及行走的异常姿态和步态[1].本科自1997~2000年共收住92例臀肌挛缩症患者,均行臀肌挛缩松解术,疗效满意.现就围手术期护理介绍如下.

  6. Treatment of spasmodic torticollis by differentiation of symptoms and signs%痉挛性斜颈的辨证治疗

    Institute of Scientific and Technical Information of China (English)

    武连仲; 王琪

    2008-01-01

    痉挛性斜颈属于局灶性肌张力障碍,是一种疑难杂症.本病病因不明,药物及手术的临床疗效不甚理想,国内外尚无安全、有效的治疗方法.笔者灵活运用中医辨证论治理论,充分发挥传统中医优势,从病因、病证、病机等方面对痉挛性斜颈进行辨证分析,独创以开窍顺筋法为主、针刺"五心穴"治疗痉挛性斜颈的方法,临床收到满意疗效.

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

    Science.gov (United States)

    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. Irony in Tennyson's "Little Hamlet".

    Science.gov (United States)

    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)

  9. Art and dystonia.

    Science.gov (United States)

    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. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias

    Science.gov (United States)

    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

  11. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias.

    Directory of Open Access Journals (Sweden)

    Jeff L Waugh

    Full Text Available 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.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.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.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.

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

    LENUS (Irish Health Repository)

    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.

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

    OpenAIRE

    Erica Ortiz; Everardo A. de Costa; Ana Lúcia Spina; Agricio N. Crespo

    2004-01-01

    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,...

  14. Dystonia Overview - GeneReviews - NCBI Bookshelf [GeneReviews

    Lifescience Database Archive (English)

    Full Text Available uth (oromandibular dystonia, musician's cramp) Larynx (dystonic adductor dysphonia, whispering dysphonia) Ne...same extent throughout the day Action-specific (e.g., musician's dystonia, writer

  15. 38 CFR 4.73 - Schedule of ratings-muscle injuries.

    Science.gov (United States)

    2010-07-01

    ...) flexor digiti minimi brevis; (9) dorsal and plantar interossei. Other important plantar structures: Plantar aponeurosis, long plantar and calcaneonavicular ligament, tendons of posterior tibial, peroneus... muscles of the foot: Plantar: (1) Flexor digitorum brevis; (2) abductor hallucis; (3) abductor...

  16. 芍药甘草汤治疗痉挛疼痛性疾病举隅%Example of Treatment of Diseases with Spasmodic Pain with Shaoyao Gancao Tang

    Institute of Scientific and Technical Information of China (English)

    夏如宁; 许进秀

    2002-01-01

    @@芍药甘草汤源于《伤寒论》,本是用于治疗伤寒后阴津不足,筋脉失养所致的脚挛急、不得伸之症,后经历代医家临床发展,治疗范围日渐广泛,笔者多年来以此方原方或加味治疗以挛急、疼痛为主诉的病症,收到良好的效果。现将部分病例及心得体会整理如下。……

  17. 针刺治疗脑外伤后痉挛性瘫痪50例%Clinical observation to 50 cases with spasmodic paraplesia due to brain trauma treated with acupuncture

    Institute of Scientific and Technical Information of China (English)

    黄任秀

    2004-01-01

    随着人们生活节奏的加快,交通工具的大力使用,脑外伤的发生日趋增多,特别是一些重症颅脑损伤患者,虽经及时救治得以存活,但常留下痴呆,失语、肢体瘫痪、大小便失禁等后遗症,这些都是难治之症。在此,笔者仅以脑外伤后痉挛性瘫痪一症予以讨论,将自1997年7月-2003年12月治疗的该类患者情况作如下报告:

  18. Observation on the therapeutive effectiveness of treatment on adolescent spasmodic torticollis with moxibustion:A report of 30 cases%灸法治疗青少年痉挛性斜颈30例疗效观察

    Institute of Scientific and Technical Information of China (English)

    周立武

    2004-01-01

    痉孪性斜颈是以颈部肌肉不随意收缩为特点,患者不自主的一阵阵的斜着头的颈部颤动性疾病。笔者在临床工作中,应用灸法治疗本病,取得明显效果,现报道如下。

  19. Study of Mechanism and Efficacy of Prozac in Treatment of Spasmodic Torticollis%百忧解治疗痉挛性斜颈的效果和机理探讨

    Institute of Scientific and Technical Information of China (English)

    王桥根; 钱可久

    2001-01-01

    目的探讨百忧解治疗痉挛性斜颈的疗效和机理.方法分析6例痉挛性斜颈的治疗过程.结果6例病人应用百忧解治疗均有效果.结论百忧解治疗痉挛性斜颈是有效的,其发病可能与5-羟色胺浓度降低有关.

  20. Professor Li Ping's clinical experience of acupuncture treatment on spasmodic torecollis%李平教授针刺治疗痉挛性斜颈的临床体会

    Institute of Scientific and Technical Information of China (English)

    王宏业; 李晓霞; 李平

    2008-01-01

    本文介绍了李平教授治疗痉挛性斜颈的临床经验,李平教授针对痉挛性斜颈阴虚阳亢、风气内动、督脉瘀阻的基本病机,提出了"通督调神通络、祛风补虚"为主的"通督调神"针法,强调了督脉和调神在治疗中的重要作用.

  1. Cervical epidural block alleviated spasmodic torticollis: report of one case%颈段硬膜外阻滞缓解痉挛性斜颈1例报告

    Institute of Scientific and Technical Information of China (English)

    李杨敏; 张爱军; 钱游伷

    2013-01-01

    本文报道痉挛性斜颈患者1例行颈段硬膜外置管,泵注0.25%利多卡因100ml和地塞米松5 mg混合液,2d后行患侧副神经60%乙醇不全毁损.至此患者转颈困难症状基本缓解.

  2. Experience of Treating Spasmodical Neurological Disease with Xiaochaihutang and Acupuncture%小柴胡汤加减配合针灸治疗发作性神经系统疾病体会

    Institute of Scientific and Technical Information of China (English)

    庄子齐

    2005-01-01

    小柴胡汤为张仲景《伤寒论》代表方之一,针对邪犯少阳致胃虚(脾虚)胆郁、三焦失枢的病机而设,其药物组成为柴胡、黄芩、生姜、半夏、人参、大枣、甘草,集寒热、补泻于一方,既各奏其功,又相辅相成,构成一个有机整体。本方寒温并用,攻补兼施,达到疏利三焦、调达上下、宣通内外、和畅气机之目的,为“和法”代表方。

  3. 脑卒中所致痉挛型构音障碍的康复训练方法及疗效%Rehabilitation Training for Post-stroke Spasmodism Model Dysarthria and Its Efficacy

    Institute of Scientific and Technical Information of China (English)

    刘莉; 邵伟波

    2008-01-01

    目的 探讨脑卒中所致痉挛型构音障碍的临床康复训练方法及疗效.方法 对45例脑卒中所致痉挛型构音障碍患者给予针对性言语训练,采用改良Frenchay构音障碍评价法评定疗效.结果 45例患者的康复训练总有效率为93%,其中病程在1个月内的患者有效率100%,病程1~3个月的患者有效率96%,病程3个月以上的患者有效率85%.结论 针对性的言语训练可以恢复和改善脑卒中所致痉挛型构音障碍患者的言语功能,介入时间越早疗效越显著.

  4. Variação da intensidade vocal: estudo da vibração das pregas vocais em seres humanos com videoquimografia Vocal intensity variation: a study of vocal folds vibration in humans with videokymography

    Directory of Open Access Journals (Sweden)

    Henry U. Koishi

    2003-08-01

    functional disorders, like adductor spasmodic dysphonia and hyperfunctional dysphonia, even during soft phonation. AIM: To evaluate the vibratory pattern of the vocal folds in subjects with normal voice according to intensity variation, in order to establish standard values for the vibratory cycle phases. These values may improve the diagnosis and the follow up of those disorders. STUDY DESIGN: Clinical prospective. SUBJECTS AND METHODS: Fifty-eight adults were evaluated during habitual (soft and loud phonation. Vocal folds vibration patterns were analyzed with videokymography. Vocal intensity variation was studied with acoustic analysis software, comparing the intensity levels during habitual phonation and loud phonation. RESULTS: The results showed a spontaneous fundamental frequency (F0 rise as vocal intensity grew and a decrease of the open quotient at loud intensity phonation. CONCLUSION: Sound intensity levels were established at habitual (63,46 dB and loud phonation (72,55dB. Open quotient (OQ values were also established for those intensity phonation levels.

  5. Some Personality Variables in Functional Neurological Disorders

    Directory of Open Access Journals (Sweden)

    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.

  6. Observations of two special kinds of tremor at Galeras volcano, Colombia (1989-1991)

    Energy Technology Data Exchange (ETDEWEB)

    Gil Cruz, F. [Observatorio Vulcanologico y Sismologico, Manizales (Colombia)

    1999-06-01

    The paper analyzes two kinds of tremor produced by Galeras volcano in 1988: flute tremor and spasmodic tremor. Spectrum and peak of flute tremor are described. The paper also distinguishes two types of spasmodic tremor on the basis of their spectral characteristics and field observations.

  7. West Europe Report

    Science.gov (United States)

    2007-11-02

    Adelsohn was more familiar with municipal problems. I have to learn more about that." Spasmodic Impression We asked about Ingvar Carlsson’s... spasmodic impression with regard to foreign policy, but I am not sure I believe in the talk of a special environmental profile. Through the years he has

  8. Afecções laríngeas, tempos máximos de fonação e capacidade vital em mulheres com disfonia organofuncional Laryngeal disorders, maximum phonation times and vital capacity in women with organofunctional dysphonia

    Directory of Open Access Journals (Sweden)

    Carla Aparecida Cielo

    2012-06-01

    Full Text Available OBJETIVO: verificar e correlacionar os tempos máximos de fonação (TMF de vogais, a capacidade vital (CV e os tipos de afecções laríngeas (AL de mulheres com disfonia organofuncional (DOF. MÉTODO: pesquisa retrospectiva, transversal, exploratória, não experimental, quantitativa, com banco de dados de medidas de TMF [a, i, u], de CV e de AL de mulheres com DOF; e os testes estatísticos Qui- quadrado e exato de Fisher, para verificar as diferenças entre as variáveis e suas relações e o teste binomial, a fim de verificar a significância de proporção ou percentual da análise descritiva, com pPURPOSE: to determine and to correlate the maximum phonation times (MPT of vowels, vital capacity (VC and laryngeal disorders (LD for women with benign organic lesions resulting from vocal misuse or abuse (BOL. METHOD: retrospective, transverse, exploratory, non-experimental, quantitative study, with measurement database of MPT [a, i, u], VC and LD of women with BOL, and Chi-Square statistic and exact tests of Fisher in order to investigate the differences between the variables and their relationships and a binomial test in order to check the significance of proportion or percentage of descriptive analysis, with p<0.05. RESULTS: the majority (22; 75.86% showed MPT significantly reduced (p = 0.0053 and seven (24.14% normal MPT. The normal VC was statistically significant (p = 0.0001 (26; 89.66%, but three women (10.34% showed it to be reduced. There was significant dominance of vocal nodules (p = 0.0016 (22; 75.86%, followed by Reinke's edema (6, 20.69% and vocal polyp (1; 3.45%. Among the 22 woman (75.86% which showed reduced MPT, there was a predominance with normal VC (19; 86.36%, although no statistical significance (p = 0,558. All the individuals with normal MPT showed VC normal (7; 100%. The majority with BOL showed normal VC, although not statistically significant (p=0,199. There was a predominance of vocal nodules and reduced MPT (16; 72.73%, although not statistically significant (p=0.086. In the correlation of the three variables, most of the subjects presented vocal nodules associated with MPT reduced and normal VC (15; 68.18%, although not statistically significant. CONCLUSION: in women with BOL in this study, the reduced MPT, the normal VC and the presence of vocal nodules were significant and there was no relationship between the MPT, VC and LD.

  9. Disfonia organofuncional e queixas de distúrbios alérgicos e/ou digestivos Organic-functional dysphonia and complains off allergic and/or digestive disturbance

    OpenAIRE

    Carla Aparecida Cielo; Leila Susana Finger; Geise Roman-Niehues; Vanessa Panda Deuschle; Márcia do Amaral Siqueira

    2009-01-01

    OBJETIVO: verificar a ocorrência de queixas de distúrbios alérgicos e/ou digestivos em pacientes com disfonia organofuncional, atendidos no Setor de Voz de uma clínica-escola de Fonoaudiologia. MÉTODOS: este estudo caracteriza-se como estudo de série, retrospectivo e transversal. Realizou-se uma análise de 113 prontuários de pacientes com disfonia organofuncional que apresentavam queixas de distúrbios alérgicos e/ou digestivos, na faixa etária de cinco a 76 anos, sendo 41 do sexo masculino e ...

  10. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. 嗓音训练治疗声带小结的疗效观察%The Effects of Voice Training Therapy on Dysphonia in Patients with Vocal Nodules

    Institute of Scientific and Technical Information of China (English)

    李艳; 葛平江; 彭莉佳; 盛晓丽; 许咪咪; 任庆宜; 陈少华

    2015-01-01

    目的:探讨嗓音训练对声带小结患者发声障碍的治疗效果。方法对21例声带小结患者进行嗓音训练,包括嗓音教育和发声训练,根据“呼吸-发声-共鸣”平衡原理,采用喉部按摩、无声练习及发大开口咽音的训练方法,每周训练一次,每次1~2小时,共5次。训练前后对患者进行嗓音障碍指数量表(VHI)评估、GRBAS评估、动态喉镜检查、空气动力学检测、计算机嗓音声学分析,比较治疗前后评估结果。结果21例患者治疗后VHI评分总分(29.48±21.21分)明显低于治疗前(52.95±24.30分)(P<0.01);GRBAS评分中总嘶哑度G(0.67±0.76)明显低于训练前(1.88±1.05)(P<0.01),粗糙声R(0.52±0.58)明显低于训练前(1.36±0.55)(P<0.01);治疗后动态喉镜检查患者声带闭合、运动的对称性、粘膜波、振动规律性均改善(P<0.01);3例患者声带小结完全消失,13例患者声带小结缩小,5例与治疗前比较无明显变化;最长发声时间也由治疗前的8.87±3.75秒变为治疗后的12.54±3.68秒( P<0.01);治疗后嗓音的频率微扰、振幅微扰、噪谐比(分别为0.18%±0.08%、2.10%±0.98%、0.0034±0.0022 dB )均明显低于治疗前(分别为0.43%±0.31%、4.55%±1.80%、0.0184±0.028 dB )( P<0.01或0.05)。结论嗓音训练对声带小结患者发声障碍有良好的治疗效果。%Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

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

    Directory of Open Access Journals (Sweden)

    Marcela Guimarães Côrtes

    2010-01-01

    Full Text Available 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 harmônicos, presença de ruído, presença de harmônicos e de sub-harmônicos. Os dados obtidos foram submetidos a análise estatística, em que também se buscou observar a eventual diferença de padrões entre gêneros e diagnósticos. RESULTADOS: Não houve diferença estatisticamente significante entre a forma do traçado espectrográfico nas condições pré e pós-fonoterapia, porém a maioria dos pacientes (58% obteve melhora. O grau de escurecimento manteve-se estável nas condições pré e pós-fonoterapia (p=0,000. Houve significativa melhora espectrográfica, após a fonoterapia, para os parâmetros de estabilidade do traçado (p=0,006, presença de ruído (p=0,007, harmônicos (p=0,000 e sub-harmônicos (p=0,001. Não houve relação entre o gênero do paciente e o grau de melhora espectrográfica. Em relação ao diagnóstico, apenas o parâmetro forma do traçado apresentou diferenças significativas. CONCLUSÃO: Apesar de não terem sido encontradas mudanças significativas em todos os parâmetros avaliados, a espectrografia acústica demonstrou ser um instrumento eficaz para avaliar a evolução da voz do paciente no processo terapêutico, sendo complementar à avaliação perceptivo-auditiva e fazendo parte de um protocolo multidimensional.PURPOSE: To evaluate the effects of vocal therapy on voice disorders using different spectrographic parameters, before and after therapy. METHODS: This experimental retrospective study analyzed voice recordings of 67 dysphonic patients that had attended vocal therapy. Pre- and post-treatment spectrograms were analyzed by four speech-language pathologists. The following parameters were analyzed: spectrogram regularity, harmonic colors, spectrogram stability, presence of noise components, presence of harmonic and sub-harmonics. Data were submitted to statistical analysis, which aimed at identifying different patterns between genders and diagnoses. RESULTS: There was no difference between pre and post-therapy conditions for spectrogram regularity, however, most patients (58% showed improvement. Harmonic colors remained stable (p=0.000. Significant improvement was observed, after voice therapy, regarding spectrogram stability (p=0.006, and presence of noise (p=0.007, harmonics (p=0.000 and sub-harmonics components (p=0.001. No relation was found between patient's gender and spectrographic improvement. Regarding diagnoses, differences caused by therapy were only significant for spectrogram regularity. CONCLUSIONS: Not all evaluated parameters showed significant improvements with therapy, however, acoustic spectrography proved to be an efficient tool to evaluate patients' progresses during vocal rehabilitation, complementing auditory-perceptual evaluation and composing a multidimensional assessment protocol.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. [Potentialities of conservative therapy of vocal disorders in children].

    Science.gov (United States)

    Radtsig, E Yu; Bogomilsky, M R

    2007-01-01

    The article concerns problems of classification and treatment of various vocal problems in children, presents treatment outcomes in patients with functional and organic dysphonia using complex homeopathic drugs.

  15. The pectoral fin muscles of the coelacanth Latimeria chalumnae: Functional and evolutionary implications for the fin‐to‐limb transition and subsequent evolution of tetrapods

    National Research Council Canada - National Science Library

    Miyake, Tsutomu; Kumamoto, Minayori; Iwata, Masamitsu; Sato, Ryuichi; Okabe, Masataka; Koie, Hiroshi; Kumai, Nori; Fujii, Kenichi; Matsuzaki, Koji; Nakamura, Chiho; Yamauchi, Shinya; Yoshida, Kosuke; Yoshimura, Kohtaroh; Komoda, Akira; Uyeno, Teruya; Abe, Yoshitaka

    2016-01-01

    ... coelacanth, Latimeria chalumnae . We discovered nine antagonistic pairs of pronators and supinators that are anatomically and functionally distinct from the abductor and adductor superficiales and profundi...

  16. The effects of training abductors of hip on balance function and ambulation safety in hemiplegic patients%强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响

    Institute of Scientific and Technical Information of China (English)

    郭京伟; 谢欲晓; 黄学英; 孙启良

    2008-01-01

    目的:探讨强化髋外展肌群对脑卒中偏瘫患者平衡功能和步行安全性的影响.方法:将符合入选标准的脑卒中偏瘫患者随机分为观察组(20例)和对照组(20例),两组患者均采用以Bobath为主的现代康复技术进行平衡训练和步行训练,在此基础上,观察组加入强化髋外展肌群的训练方法,在治疗前和6周治疗结束后,分别用Berg平衡评分量表和Holden功能步行分类对两组患者进行平衡功能和步行能力的评定.随访并统计治疗结束后半年期间两组患者的跌倒发生率.结果:6周治疗后,两组的BBS和Holden功能步行分类的级别均较治疗前有明显提高(P<0.01).观察组的BBS和Holden功能步行分类的级别均优于对照组,差异具有显著性意义(P<0.05,P<0.01).通过随访,治疗结束半年内观察组的跌倒发生率比对照组低,差异有非常显著性意义(19<0.01).结论:在常规平衡训练的基础上,强化患侧髋外展肌群的训练.能更有效地提高脑卒中偏瘫患者的平衡功能,增加步行的安全性.

  17. Effect of general anesthesia on voice

    Directory of Open Access Journals (Sweden)

    Balegh Hamdy

    2016-07-01

    Conclusion: Traumatic manifestations of the laryngeal structures that occur during intubation are the most common causes of postoperative dysphonia, with a tendency toward a regressive course of the resulting dysphonia. As such, it is important to establish an early diagnosis and adopt preventive measures.

  18. Systemic Sclerosis: Diffuse and Limited

    Science.gov (United States)

    ... leading to spasmodic color changes (red, white, or blue) brought on by cold exposure. This is commonly ... heart involvement, including fluid around the heart, heart rhythm disturbances symptomatic enough to require treatment, and possibly ...

  19. Method of hydrodynamic studies of wells in beds

    Energy Technology Data Exchange (ETDEWEB)

    Fedin, L.M.; Bondarenko, Ye.S.; Fedin, K.L.; Lisin, N.I.; Reytenbakh, V.G.

    1982-01-01

    A method is proposed for hydrodynamic studies of wells in beds including the termination of the coefficient of piezoconductance by spasmodic change in pressure in the well. It is distinguished by the fact that in order to reduce the time for idling of the well, above the studied bed an output meter is installed and the output of the bed fluid is measured during the time from spasmodic change in pressure to establishment of the stationary output.

  20. Correlation analysis of transitional processes of chronorhythms

    Science.gov (United States)

    Strinadko, Marina M.; Timochko, Katerina B.; Strinadko, Olena M.; Abramov, Igor V.

    1999-11-01

    The biological system reaction on spasmodic change of a phase of sine wave revolting force is investigated. The model researches for the biosystem unit that is described by linear differential equation of the second order are carried out. Possibility of time asymmetry in adaptation and transitional processes of biological units, at spasmodic change of phase identical modulo and opposite on the sign is shown. The residual in time of adaptation depends on state of biosystem's unit at the moment of perturbation.

  1. Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports.

    Science.gov (United States)

    Baker, Janet

    2003-09-01

    Psychogenic dysphonia refers to loss of voice where there is insufficient structural or neurological pathology to account for the nature and severity of the dysphonia, and where loss of volitional control over phonation seems to be related to psychological processes such as anxiety, depression, conversion reaction, or personality disorder. Such dysphonias may often develop post-viral infection with laryngitis, and generally in close proximity to emotionally or psychologically taxing experiences, where "conflict over speaking out" is an issue. In more rare instances, severe and persistent psychogenic dysphonia may develop under innocuous or unrelated circumstances, but over time, it may be traced back to traumatic stress experiences that occurred many months or years prior to the onset of the voice disorder. In such cases, the qualitative nature of the traumatic experience may be reflected in the way the psychogenic voice disorder presents. The possible relationship between psychogenic dysphonia and earlier traumatic stress experience is discussed, and the reportedly low prevalence of conversion reaction (4% to 5%) as the basis for psychogenic dysphonia is challenged. Two cases are presented to illustrate the issues raised: the first, a young woman who was sexually assaulted and chose to "keep her secret," and the second, a 52-year-old woman who developed a psychogenic dysphonia following a second, modified thyroplasty for a unilateral vocal fold paresis.

  2. HOARSENESS AMONG SCHOOL-AGE CHILDREN

    Directory of Open Access Journals (Sweden)

    Robert Šifrer

    2004-02-01

    Full Text Available Background. The prevalence of dysphonia in schoolchildren has been reported to be from 7.1% to 23.3% and in adolescents from 0 to 80%. In Slovenia, the study on prevalence of dysphonia in schoolchildren has not been performed yet.Methods. The voice samples of 100 4th-graders and 102 8thgraders of elementary school were recorded. A lay judge and a professional assessed independently degree of hoarseness in the voice samples. One to three months after the recording, the dysphonic children were invited to an otorhinolaryngologic examination in order to find out the cause of dysphonia. All children and their parents answered the questionnaires on illnesses and vocal habits that might cause hoarseness. The prevalence of these unfavourable factors was compared between the group of children with long lasting hoarseness and the children without it.Results. At voice samples’ recording there were 34.2% dysphonic children. One to three months later, there were still 14.9% children with hoarse voice. The most frequent causes for acute dysphonia were acute respiratory infection and exacerbation of chronic laryngitis. The most frequent causes for persistent dysphonia were allergic catarrhal laryngitis, muscle tension dysphonia with or without vocal nodules and mutational voice disorder. The fast speaking rate appeared to be characteristic for children with long lasting dysphonia.Conclusions. Dysphonia in school-age children is the result of diseases of upper respiratory tract and/or functional voice disorders. Both causes of dysphonia could be successfully treated if they are detected early and the children are advised to see an otorhinolaryngologist. Adolescence is an ideal period for treatment of functional voice disorders. It is also the period when the children must decide for their future profession.

  3. Physiological and biochemical contributions to the problems of smoke damage research. III. The influence of strong spasmodic doses of SO/sub 2/ on the CO/sub 2/ absorption and on certain constituents of the needles of Picea abies and Pinus mugo under laboratory conditions

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, M.; Boertitz, S.; Polster, H.

    1964-01-01

    Potted young plants show assimilation depressions of various degrees before smoke damage becomes visible. Needles or parts of needles without any outward injuries can recover within a few weeks. Individual differences in outward appearance as well as in physiological behavior were found with the species investigated. Contrary to assimilation, the variations of pH-values as well as those of the sugar-, and amino-acid balances of saps pressed from needles are measurable within the lethal region only. 18 references, 9 figures.

  4. Therapeutical Effect on Rehabilitation Training Combined with Electrical Stimulation on Part of Phonetic Muscles on Exercise Spasmodic Dysarthria during Cerebrovascular Sequela by Treatment%康复训练结合部分发音肌电刺激治疗脑卒中后遗症期运动性痉挛型构音障碍的疗效观察

    Institute of Scientific and Technical Information of China (English)

    周洁信; 王凭; 张强

    2006-01-01

    目的:通过与康复训练治疗相比较,观察康复训练结合部分发音肌电刺激治疗脑卒中后遗症期运动性痉挛型构音障碍的疗效.方法:2001年5月~2004年6月共选取符合入选标准并完成临床观察病例共44例,其中康复训练组22例,康复训练结合部分发音肌电刺激组22例,病程1~3年.结果:康复训练结合部分发音肌电刺激治疗组与康复训练组治疗运动性痉挛型构音障碍疗效比较,治疗后构音障碍评分的变化有显著差异(P<0.01),结论:康复训练与部分发间肌电刺激治疗脑卒中后遗症期运动性痉挛型构音障碍的疗效优于康复训练组.

  5. Voice disorders in children, aged 5 to 7 years

    OpenAIRE

    Polutnik, Tjaša

    2013-01-01

    Dysphonia is a term for every unpleasant change which can be detected via hearing and the voice disorder is most frequently a consequence of recuperation after a respiratory infection and it can also occur due to an incorrect formation of sounds or throat disorders. The purpose of the research is to find out how often dysphonia occurs among children from the age of five to the age of seven and how illnesses or the individual way children talk influence the occurrence of dysphonia. The researc...

  6. 嗓音疾病自我评估特点及影响因素%Self-assessment characteristics of voice handicap index for voice disorders and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    李红艳; 徐文; 韩德民; 胡蓉; 胡慧英; 侯丽珍; 张丽; 叶京英; 王军

    2009-01-01

    in order among spasmodic dysphonia, vocal fold paralysis, functional dysphoina, sulcus vocalis, benign and malignant tumor of vocal fold, vocal fold cyst, Reinke' s edema, vocal fold polyp, vocal fold keratosis and chronic laryngitis, vocal nodule. The emotional scores were the highest in spasmodic dysphunia, and followed by functional dysphoina. In another group, the physical scores were higher than functional scores and emotional scores. Treatment resulted in statistical improvement in VHI scores (P<0.05). The total scores were different significantly between different educational background and age groups(F from 8.701 to 27. 371, P=0.000). The higher the educational degree, the higher the VHI scores. As to age groups, the juvenile group' s scores were the lowest, while the youth' s group the highest, then the scores declined when ages increased. Conclusion As a useful supplementary instrument to measure the voice disorder severity and the treatment' s effect, VHI can comprehensively assess the voice handicap' s affect to the life quality and the difference after the treatment, especially in physical, functional and emotional aspects, but it is somehow subject to the educational degree and age.

  7. INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY

    NARCIS (Netherlands)

    MAHIEU, HF; DIKKERS, FG

    Detailed preoperative laryngostroboscopic examination is a prerequisite for phonosurgical correction of organic dysphonia. Although suspension microlaryngoscopic surgery has proved its value in the past, it excludes functional control during the removal of vocal fold swellings. Using an indirect

  8. [Analysis of voice diseases in patients treated in the Podlaski region].

    Science.gov (United States)

    Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jerzy; Pepiński, Witold

    2004-05-01

    Analysis of professional dysphonia in 309 patients treated in Phoniatric Outpatient Clinic of the (chair and) Department of Otolaryngology AM in Bialystok was performed. The teachers of primary and lower secondary schools were the majority of the patients. The teachers were compared with the 65 patients of other occupations. Additional harmful factors were excluded in both groups. In all patients' otolaryngologic, phoniatric and videostroboscopic examinations were completed. The analysis paid attention to functional and organic dysphonias. In the group of voice workers there were found early functional laryngeal disorders, which were progressive with the period of work. In other patients organic disorders were more common and occurred earlier than functional ones. The degree of dysphonia depended on laryngeal pathology, especially in case of functional dysphonia.

  9. INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY

    NARCIS (Netherlands)

    MAHIEU, HF; DIKKERS, FG

    1992-01-01

    Detailed preoperative laryngostroboscopic examination is a prerequisite for phonosurgical correction of organic dysphonia. Although suspension microlaryngoscopic surgery has proved its value in the past, it excludes functional control during the removal of vocal fold swellings. Using an indirect mic

  10. Voice disorders without organic diseases of the larynx. A 10-year review of 62 patients.

    Science.gov (United States)

    Watanabe, Y; Miura, M; Shoji, H

    1983-01-01

    We reviewed the clinical records of 62 patients with voice disorders without organic diseases of the larynx who were examined in the Department of Otolaryngology, Kurume University Hospital during the 10 years from 1971 to 1980. There were 9 patients with psychogenic dysphonia, 24 with vocal abuse, 4 with spastic dysphonia, 9 with mutational voice disturbance, 8 with virilization of voice, 7 with dysphonia attributed to diseases of other organs than the larynx, and 1 with senile change of voice. The clinical service to the patients with these kinds of dysphonia has been poor in Japan for lack of trained voice pathologists. This has been also the case with our department. Recognition for the necessity of voice pathologists is strongly demanded.

  11. [Differential diagnosis of hoarseness].

    Science.gov (United States)

    Voigt-Zimmermann, S; Lampe, K; Arens, C

    2014-04-01

    Hoarseness can be the leading symptom of dysphonia. In combination with impaired vocal performance and subjective voice-related discomfort, it can represent an individually different handicap for patients and lead to limited participation in social and professional life. Since the reasons for dysphonia may be not only functional but also organic with a potentially poor prognosis, hoarseness must be clarified using differential diagnosis. In addition to the knowledge of possible diseases, pathogenesis, and treatment options for dysphonia, the differential diagnostic approach requires profound knowledge of the various diagnostic methods, and of the interpretation of the results in particular. The etiology of dysphonia is very diverse and rarely monocausal. Therefore, a team-based and interdisciplinary differential diagnostic approach is recommended.

  12. Stroboscopic findings in patients with benign laryngeal lesions: a brief report

    Directory of Open Access Journals (Sweden)

    S Azimian

    2012-11-01

    Full Text Available Background: Laryngeal videostroboscopy is an important noninvasive diagnostic tool in patients with dysphonia. More than 50% of patients with dysphonia have a benign laryngeal lesion on vocal fold examination. The aim of this study was to evaluate patients with benign laryngeal lesions by videostroboscopy.Methods: This cross-sectional study was done on 159 patients with dysphonia in Amiralam Hospital in Tehran, Iran during 2006-2007. All the patients underwent stroboscopic examination of the vocal folds, including their movement. We also evaluated the patients for mucosal status, mucosal wave and patterns of glottal closure.Results: Eighty-two patients participating in the study were female and 77 were male. Reflux laryngitis and muscle tension dysphonia were the most observed disorders in the patient population. Patients with sulcus vocalis and intracordal cysts had the worst mucosal wave patterns.Conclusion: Laryngeal videostroboscopy is a useful tool for the diagnosis and treatment planning in patients with benign laryngeal lesions.

  13. [The smokers voice self assessment based on Voice Handicap Index (VHI)].

    Science.gov (United States)

    Wiskirska-Woźnica, Bozena; Wojnowski, Waldemar

    2009-01-01

    Complex voice assessment due to European Laryngeal Society proposals (2000) contains voice self estimation based on the Polish version of the Voice Handicap Index (VHI). This study focuses on the relation between voice handicap and smoking in dysphonic patients, who are using voice professionally. Thirty outpatient (25 female and 5 male, aged 40 to 55 years) voice department attendees suffering from professional dysphonia took part in this study. All patients after phoniatric examination completed the Polish version of the Voice Handicap Index (VHI). The questions concern functional, emotional and physical complains due to dysphonia. Most of smokers did not complain of dysphonia related problems comparing to non smokers. Even the scores of functional and emotional scales of VHI in smokers shown better results (less handicap) than in nonsmokers. Smoking does not affect patients handicap due to dysphonia measured in the Voice Handicap Index.

  14. Work-related voice disorder

    OpenAIRE

    Paulo Eduardo Przysiezny; Luciana Tironi Sanson Przysiezny

    2015-01-01

    INTRODUCTION: Dysphonia is the main symptom of the disorders of oral communication. However, voice disorders also present with other symptoms such as difficulty in maintaining the voice (asthenia), vocal fatigue, variation in habitual vocal fundamental frequency, hoarseness, lack of vocal volume and projection, loss of vocal efficiency, and weakness when speaking. There are several proposals for the etiologic classification of dysphonia: functional, organofunctional, organic, and work-related...

  15. MUTASYONEL DİSFONİYE YAKLAŞIM VE SONUÇLARIMIZ

    OpenAIRE

    Yavuzer, Atilla; ÖĞÜT, Fatih; KOLCULAR, Derya; APAYDIN, Fazıl; MİDİLLİ, Raşit

    2000-01-01

    Approach to voice and phonation disorders gains more importance within Otorhinolaryngology. Etiology of these diseases is multifactorial. Therefore they are seen in different clinical forms in practice. Mutational dysphonia vvhich is a functional and non-organic type of voice disorder has a privileged place among the other types of voice and phonation disorders because of its unique pathophysiology. Patients who suffer from mutational dysphonia generally admit to either Internists or Otor...

  16. [Anatomo-functional study of 37 patients with monolateral chord paralysis].

    Science.gov (United States)

    Iengo, M; Villari, P; Cavaliere, M; De Clemente, M; Merolla, F

    2000-02-01

    The authors present a study of 37 patients affected by monolateral vocal cord paralysis in order to analyze etiology, degree of dysphonia and possible recovery of vocal function. The patients underwent the following tests: case history to determine the vocal characteristics prior to the lesion; video-laryngoscopy to define the position of the paralytic cord on the horizontal glottic plane and any compensation mechanisms; determination of the degree of dysphonia (light, moderate, severe, aphonia) on the basis of psycho-perceptive parameters; spectrography evaluated in classes (I, II, III and IV) according to Yanagihara. Analysis of the data obtained makes it possible to draw the following conclusions: the most frequent etiology encountered by the otorhinolaryngologist is surgical (particularly subsequent to thyroidectomy); the position taken by the paralytic vocal cord does not appear to determine the degree of dysphonia; during the period immediately after occurrence of the lesion (0-4 months) the vocal disorder is more intense and tends to be reduced thereafter, attenuated by a spontaneous compensation mechanism. In this regard, it must be pointed out, however, that such compensation can prove bad or even dangerous for good vocal function (falsetto voice); speech therapy makes it possible to nearly totally normalize vocal function in all patients presenting moderate dysphonia and in 60% of those with severe dysphonia. In the remaining 40% of those patients with severe dysphonia a partial improvement of vocal function was seen (from severe dysphonia to moderate dysphonia). This was determined by the fact that several negative prognostic factors came into play simultaneously in these patients (i.e. advanced age, longer time gap since the lesion occurred, position assumed by the paralytic cord) which prevented them from achieving better phonatory results.

  17. Observations of two special kinds of tremor at Galeras volcano, Colombia(1989-1991

    Directory of Open Access Journals (Sweden)

    F. Gil-Cruz

    1999-06-01

    Full Text Available Since the reactivation of Galeras volcano in 1988 its seismic activity has been dominated by a variety of LP waveforms and tremor events. Some of these signals occurred as a response to volcanic activity. Among them, two kinds of tremor deserve special attention, Flute tremor and Spasmodic tremor. Flute tremor has a spectrum of equally spaced peaks and is associated with a quasi-steady degassing process at the top of the lava dome. It is accompanied by a flute-like sound. Its spectral features and the correlation with field observations are consistent with a model generation indicating that a crack or set of cracks are excited to resonance by the release and flow of gas through the lava dome. Spasmodic tremor is composed of several distinct LP-like events joined together by a continuous signal with lower amplitudes. Two types of spasmodic tremor may be distinguished on the basis of their spectral characteristics and field observations. Spasmodic tremor type I is apparently dominated by a mix of P, SH and Rayleigh waves as determined from preliminary polarization analysis. The source appears to be located, in a region west of the active crater. As a first approximation, Spasmodic tremor type I could be associated with magmatic intrusion process occurred in 1989-1991.

  18. Novel speech signal processing algorithms for high-accuracy classification of Parkinson's disease.

    Science.gov (United States)

    Tsanas, Athanasios; Little, Max A; McSharry, Patrick E; Spielman, Jennifer; Ramig, Lorraine O

    2012-05-01

    There has been considerable recent research into the connection between Parkinson's disease (PD) and speech impairment. Recently, a wide range of speech signal processing algorithms (dysphonia measures) aiming to predict PD symptom severity using speech signals have been introduced. In this paper, we test how accurately these novel algorithms can be used to discriminate PD subjects from healthy controls. In total, we compute 132 dysphonia measures from sustained vowels. Then, we select four parsimonious subsets of these dysphonia measures using four feature selection algorithms, and map these feature subsets to a binary classification response using two statistical classifiers: random forests and support vector machines. We use an existing database consisting of 263 samples from 43 subjects, and demonstrate that these new dysphonia measures can outperform state-of-the-art results, reaching almost 99% overall classification accuracy using only ten dysphonia features. We find that some of the recently proposed dysphonia measures complement existing algorithms in maximizing the ability of the classifiers to discriminate healthy controls from PD subjects. We see these results as an important step toward noninvasive diagnostic decision support in PD.

  19. Effects of augmented trunk stabilization with external compression support on shoulder and scapular muscle activity and maximum strength during isometric shoulder abduction.

    Science.gov (United States)

    Jang, Hyun-jeong; Kim, Suhn-yeop; Oh, Duck-won

    2015-04-01

    The aim of the present study was to investigate the effects of augmented trunk stabilization with external compression support (ECS) on the electromyography (EMG) activity of shoulder and scapular muscles and shoulder abductor strength during isometric shoulder abduction. Twenty-six women volunteered for the study. Surface EMG was used to monitor the activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and middle deltoid (MD), and shoulder abductor strength was measured using a dynamometer during three experimental conditions: (1) no external support (condition-1), (2) pelvic support (condition-2), and (3) pelvic and thoracic supports (condition-3) in an active therapeutic movement device. EMG activities were significantly lower for UT and higher for MD during condition 3 than during condition 1 (p Shoulder abductor strength was significantly higher during condition 3 than during condition 1 (p muscle effort of the UT during isometric shoulder abduction and increasing shoulder abductor strength. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Anomalous Course of the Extensor Pollicis Longus With Multiple Absences of Thumb Muscles

    OpenAIRE

    Hong, Jayoung; Kim, Don-Kyu; Kang, Si Hyun; Seo, Kyung-Mook

    2013-01-01

    We report a rare case of a 10-year-old girl with anomalous course of extensor pollicis longus (EPL) muscle, which exists with absence of thenar muscles and muscles in the 1st extensor compartment. Her chief complaint was severe atrophy on the right thenar eminence. On physical examination, there was no obvious functional abnormality on her right thumb. On magnetic resonance imaging, we found that the abductor pollicis brevis, opponens pollicis, abductor pollicis longus, and extensor pollicis ...

  1. Assessing lateral stability of the hip and pelvis.

    Science.gov (United States)

    Grimaldi, Alison

    2011-02-01

    Adequate function of the hip abductor mechanism has been shown to be integral to ideal lower limb function and musculoskeletal health. Clinical assessment of hip abductor muscle function may include observational assessment of postural habits, muscle bulk, and of the ability to control optimal frontal plane femoropelvic alignment during a variety of single leg tasks. Strength testing using a hand held dynamometer is perhaps our most robust clinical assessment tool but should not be considered a 'gold standard' in the assessment of abductor muscle function. Evidence from magnetic resonance imaging (MRI), and electromyography (EMG) studies provides a deeper understanding of specific deficits that occur within the abductor synergy. The assessment of abductor function should not be based on a single test, but a battery of tests. The findings should be interpreted together rather than independently, and in the context of a thorough understanding of function of the lateral stability mechanism. Manner and comprehensiveness of abductor assessment will have important implications for management and particularly therapeutic exercise.

  2. Analysis of friction self-oscillations of a drilling string with the exponential law of resistance

    Energy Technology Data Exchange (ETDEWEB)

    Belokobylskiy, S.V.; Prokopov, V.K.

    1982-01-01

    An analysis of the friction self-oscillations in the drilling string based on the exponential law of resistance with. A spasmodic law of resistance was obtained from it as a particular case. It is indicated that for definite parameters, the amplitude of self-oscillations with expoential law of resistance exceeds the scope of oscillations with spasmodic law. Dependences were constructed for the period of self-oscillations and time for motion from these parameters. Dangerous modes of friction self-oscillations were defined.

  3. Conversion “V” Profiles in Torticollis

    Directory of Open Access Journals (Sweden)

    M. Jahanshahi

    1989-01-01

    Full Text Available The assumption that spasmodic torticollis represents a conversion reaction was examined by evaluating profiles of 61 patients on the hypochondriasis, depression, and hysteria scales of the Minnesota Multiphasic Personality Inventory. Thirty-six per cent of the sample had normal profiles. A conversion “V” profile with scores above 70 was found in a minority (9% of the patients. The profile of the majority of the group was characterized by the presence of mild depression. It was concluded that a personality profile suggestive of conversion reaction is not typical of patients with spasmodic torticollis.

  4. Effect of L-glutamine and isoniazid on torticollis and segmental dystonia.

    Science.gov (United States)

    Korein, J; Lieberman, A; Kupersmith, M; Levidow, L

    1981-09-01

    Fourteen patients with spasmodic torticollis and other segmental dystonic syndromes, who were refractory to previous forms of therapy, were selected for treatment with drugs intended to elevate brain gamma-aminobutyric acid (GABA) levels. These patients were simultaneously given diazepam, isoniazid, pyridoxine, and large doses of L-glutamine. Involuntary spasmodic activity improved to varying degrees in 7 patients; in 2 the dyskinesia became worse. Transient alteration of renal or hepatic function occurred in 6 patients and mild euphoria unrelated to neurological improvement in 8. Two patients are still being treated. Deficiency of GABA may be a factor in some patients with these disorders.

  5. A randomized double-blind crossover trial comparing subthalamic and pallidal deep brain stimulation for dystonia

    DEFF Research Database (Denmark)

    Schjerling, Lisbeth; Hjermind, Lena E; Jespersen, Bo;

    2013-01-01

    ratings were assessed by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and video recordings. Quality of life was evaluated by using questionnaires (36-item Short Form Health Survey). Supplemental Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were assessed for patients...

  6. GELASTIC SEIZURES IN TUBEROUS SCLEROSIS

    Directory of Open Access Journals (Sweden)

    M. B. Mironov

    2014-01-01

    Full Text Available The authors consider the historical description, nosological entity, clinical and electroencephalographic manifestations of gelastic seizures, a rare type of epileptic seizures manifesting as sudden attacks of spasmodic laughter. They describe their case of gelastic seizures in a child with tuberous sclerosis.

  7. Calcaneo-Scaphoid Coalition.

    Science.gov (United States)

    Seddon, H J

    1933-02-01

    Calcaneo-scaphoid coalition occurs in a number of forms, having one feature in common, namely, a skeletal abnormality of the calcaneo-scaphoid gap. The condition is congenital, but nothing is known of its causation. Ranking at first as merely an anatomical curiosity, it was later recognized to be frequently associated with spasmodic flat-foot. Probably 25% of all cases of spasmodic flat-foot show this skeletal anomaly in some form or other.Clinically, this variety of spasmodic flat-foot is indistinguishable from the better-known condition in which the bones are apparently normal. Diagnosis made radiographically; essential that an oblique lateral view of the foot should be taken.Causal relation of the condition to peroneal spasm.All the usual forms of treatment employed for the relief of spasmodic flat-foot fail when a calcaneo-scaphoid coalition is present. Resection of the offending bar is of no proven value, but may be worth further trial. If symptoms persist, subastragaloid arthrodesis is necessary.

  8. Muscle selection for treatment of cervical dystonia with botulinum toxin : A systematic review

    NARCIS (Netherlands)

    Nijmeijer, S. W. R.; Koelman, J. H. T. M.; Kamphuis, D. J.; Tijssen, M. A. J.

    2012-01-01

    Rationale: Cervical dystonia, also called spasmodic torticollis, is the most common form of (primary) dystonia. Intramuscular injections with botulinum toxin are the first line of treatment for cervical dystonia. To optimise the treatment response to botulinum toxin correct muscles should be selecte

  9. Common Acupoints in the Upper Limb

    Institute of Scientific and Technical Information of China (English)

    Journal of Acupuncture and Tuina Science editor; CUI Xue-jun

    2003-01-01

    @@ Chize (LU 5) Location: On the cubital crease, near the radial border of the tendon of m.biceps brachii (Fig. 1). Indications: Cough, asthma, hemoptysis, tidal fever,fullness in the chest, sore throat, infantile convulsion,vomiting, diarrhea, spasmodic pain of the elbow and arm.

  10. [Voice-related quality of life: structure, validity and factors of the German questionnaire].

    Science.gov (United States)

    Schwanfelder, Carla; Eysholdt, Ulrich; Rosanowski, Frank; Graessel, Elmar

    2008-01-01

    In this study, structure and validity of the German version of the Voice-Related Quality of Life (V-RQOL) questionnaire and its correlation to age, gender, and type of dysphonia (organic vs. functional) were assessed. Correlations of the V-RQOL result on the one hand and emotional and physical complaints on the other hand were investigated. Data were collected in 62 adult patients with dysphonia of benign origin and the following results were found: the German version of the V-RQOL questionnaire describes voice-related quality of life in one single value. Age, gender and type of dysphonia do not influence its result. Dysphonic patients present with an increased number of emotional and physical complaints when compared with normative values derived from the literature. However, not all of these complaints correlate with voice-related quality of life at a significant level.

  11. Vocim analysis of laryngeal images: is breathiness related to the glottic area?

    Science.gov (United States)

    Jeannon, J P; Carding, P N; Wilson, J A

    1998-08-01

    The aim of this study was to determine the relationship between glottic space and breathy voice. Using a new computerized method of analysing the glottic area of video images with the Vocim computer system, 16 patients with a vocal cord palsy and 31 with non-organic dysphonia were examined. The quality of the breathy voice was assessed and correlated with the size of the glottic space during phonation. There was a positive (r = 0.70) correlation between glottic area and breathy voice in vocal cord palsy. There was no correlation (r = 0.002) in non-organic dysphonia. Therefore in this study population, for vocal cord palsy, glottic area is the dominant feature in determining voice quality. This relationship is not maintained in non-organic dysphonia.

  12. [Strength of muscles surrounding the hip joint and gait in patients following implantation of a cementless hip endoprosthesis].

    Science.gov (United States)

    Horstmann, T; Martini, F; Mayer, F; Sell, S; Knak, J; Zacher, J

    1995-01-01

    There are only a few studies which could support conclusions concerning the strength of the muscles surrounding the hip joint and especially concerning the strength relationships following implantation of endoprotheses. The aim of this study was to examine the pre- and postoperative course of strength deficits in this musculature compared to clinical parameters and the uninvolved side. Fifty-eight patients between 30 and 67 years of age, in whom individual total hip protheses were implanted were clinically examined prior, 9 weeks and 6 months after surgery. Moreover, the maximum isometric strength of abductors, flexors, and rotator muscles as well as maximum isokinetic strength of the extensors and flexor musculature at 60% and 120%/s were measured. The flexor and extensor musculature already showed a clear increase in maximum strength after 9 weeks and 6 months (90-124%). By contrast, the isometric strengths of the rotators increased only slightly, the abductor strength decreased after 6 weeks to below the preoperative baseline level and attained this level again only after 6 months. The clinical parameters Trendelenburg sign, limping and walking capacity were clearly improved after 6 months, but no correlation to the abductor strength could be demonstrated. It is concluded that limp-free gait can be attained even without maximum strength increase in the abductors, which are important for fluid gait, at least for short distances. The importance of regular training of the rotator and abductor musculature in coxarthrosis is emphasized to delay limitation of movement and decreased strength in the sense of capsule pattern.

  13. Isokinetic force-velocity curves in patients following implantation of an individual total hip prosthesis.

    Science.gov (United States)

    Horstmann, T; Martini, F; Knak, J; Mayer, F; Sell, S; Zacher, J; Küsswetter, W

    1994-01-01

    There are only a few studies which could support conclusions concerning the strength of the muscles surrounding the hip joint and especially concerning the strength relationships following implantation of endoprostheses. The aim of this study was to examine the post-operative course of strength deficits in this musculature compared to clinical parameters. Fifty-eight patients between 30 and 67 years of age, in whom individual total hip prostheses were implanted, were clinically examined prior, 9 weeks and 6 months after surgery. Moreover, the maximum isometric strengths of abductors, flexors, and rotator muscles as well as maximum isokinetic strengths of the extensors and flexor musculature at 60 degrees/s and 120 degrees/s were measured. The flexor and extensor musculature already showed a clear increase in maximum strength after 9 weeks and 6 months. By contrast, the isometric strengths of the rotators increased only slightly, the abductor strength decreased after 9 weeks to below the preoperative baseline level and attained this level again only after 6 months. The clinical parameters Trendelenburg sign, limping, and walking capacity were clearly improved after 6 months, but no correlation to the abductor strength could be demonstrated. It is concluded that limp-free gait can be attained even without maximum strength increase in the abductors, which are important for fluid gait, at least for short distances. The importance of regular training of the rotator and abductor musculature in coxarthrosis is emphasized to delay limitation of movement and decreased strength in the sense of a capsule pattern.

  14. Comparison of evoked electromyography in three muscles of the hand during recovery from non-depolarising neuromuscular blockade.

    Science.gov (United States)

    Phillips, S; Stewart, P A; Freelander, N; Heller, G

    2012-07-01

    The evoked electromyographic responses to supramaximal train of four stimulation of three muscles, all innervated by the ulnar nerve, were compared during recovery from non-depolarising neuromuscular blockade. The abductor digiti minimi was the most resistant to neuromuscular blockade (P <0.001) and the most repeatable (repeatability coefficient 4.4%) when compared with the adductor pollicis (5.9%) and the first dorsal interosseous (5.8%). The abductor digiti minimi had a bias of 0.1 compared to the adductor pollicis and first dorsal interosseous and its limits of agreement were more acceptable (-0.10 to 0.30) at a train of four ratio of 0.9. The electromyography train of four of the adductor pollicis and first dorsal interosseous at 0.8 is equivalent to an electromyography train of four of 0.9 at abductor digiti minimi.

  15. Does anterior knee pain severity and function relate to the frontal plane projection angle and trunk and hip strength in women with patellofemoral pain?

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; Carvalho E Silva, Ana Paula de Moura Campos; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2015-07-01

    The aim of the present study was to determine the relationship between knee pain severity and function with the frontal plane projection angle (FPPA) and trunk and hip peak torque (PT) in women with patellofemoral pain (PFPS). Twenty-two women with PFPS were assessed. Knee pain severity (KPS) was assessed with an 11-point visual analog scale and function with an Anterior Knee Pain Scale. The FPPA was recorded with a digital camera. PT of extensors, abductors, and the lateral rotators of hip and lateral core stability were measured with a handheld dynamometer. FPPA was the only predictor for the KPS. Regarding predictors of function, PT of lateral core stability and the extensor and abductor of the hip explained 41.4% of the function. Increase in FPPA was associated with greater KPS, and the lowest PT of lateral core stability, hip abductors, and extensors was associated with lower function in women with PFPS.

  16. Anomalous course of the extensor pollicis longus with multiple absences of thumb muscles.

    Science.gov (United States)

    Hong, Jayoung; Kim, Don-Kyu; Kang, Si Hyun; Seo, Kyung-Mook

    2013-02-01

    We report a rare case of a 10-year-old girl with anomalous course of extensor pollicis longus (EPL) muscle, which exists with absence of thenar muscles and muscles in the 1st extensor compartment. Her chief complaint was severe atrophy on the right thenar eminence. On physical examination, there was no obvious functional abnormality on her right thumb. On magnetic resonance imaging, we found that the abductor pollicis brevis, opponens pollicis, abductor pollicis longus, and extensor pollicis brevis muscles were absent. The tendon of the EPL muscle was found, but it had abnormal insertion on the radial side of the proximal phalanx, not on the distal phalanx. This variation was thought to have played a major role in compensating for impaired abduction of the thumb, which is usually accompanied by agenesis of major abductors of the thumb.

  17. Quantitative analysis of the Trendelenburg test and invention of a modified method.

    Science.gov (United States)

    Fujita, Kenji; Kabata, Tamon; Kajino, Yoshitomo; Iwai, Shintaro; Kuroda, Kazunari; Hasegawa, Kazuhiro; Fujiwara, Katsuo; Tsuchiya, Hiroyuki

    2017-01-01

    While the Trendelenburg test has been used for 120 years to detect hip abductor muscle weakness, the methodology has not been standardised. This study undertook to quantitatively analyze the relation between abductor muscle activity and pelvic tilt angle in the Trendelenburg one-leg stance, examine the pitfalls associated with performing the T-test, and develop a modified method that will produce reliable results. A convenience sample of 15 healthy males was asked to assume a one-leg stance in ten different postures, five with mild flexion on the unsupported side, and five with severe flexion. Trunk sway angle, pelvic tilt angle, and the pelvic on femur (POF) angle were measured for each posture. Statistical analysis was used to assess differences in hip abductor activity and public tilt angle between the control posture and the test postures. With minimum trunk sway, hip abductor muscle activity increases when the pelvis is elevated and decreases when it is dropped. With trunk sway toward the test side, abductor muscle activity decreased when the pelvis was elevated; with trunk sway toward the non-test side, muscle activity stayed approximately constant when the pelvis was dropped. Based on the results we developed a modified T-test methodology that would improve reliability. This test should be performed with minimum trunk sway and severe flexion on the non-test side. The assessment of muscle weakness is based on whether the patient can keep the single-leg standing posture when forced to elevate the pelvis, not simply on the pelvic drop. In future research, we will perform the modified T-test on patients with a suspected hip abductor deficiency, and assess the usefulness of the modified test. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  18. Repercusión de la variabilidad anatómica del primer compartimento extensor de la mano en la enfermedad de De Quervain The impact of anatomical variability of the first extensor compartment of the hand in the De Quervain's disease

    OpenAIRE

    F.J. López Mendoza; C.X. Barón Ramos; Gargollo Orvañanos

    2011-01-01

    En la enfermedad de De Quervain, la cirugía es la indicación estándar como procedimiento terapéutico y consiste en la liberación de los tendones abductor pollicis longus (APL) y extensor pollicis brevis (EPB) del primer compartimento de la mano. Está documentada la presencia de un septum dentro del compartimento entre los tendones del extensor corto y del abductor largo del pulgar. La importancia que tiene describir y hallar este subcompartimento radica en que la falta de conocimiento del mis...

  19. Efficacy and safety of abobotulinumtoxinA liquid formulation in cervical dystonia: A randomized-controlled trial.

    Science.gov (United States)

    Poewe, Werner; Burbaud, Pierre; Castelnovo, Giovanni; Jost, Wolfgang H; Ceballos-Baumann, Andres O; Banach, Marta; Potulska-Chromik, Anna; Ferreira, Joaquim J; Bihari, Katalin; Ehler, Edvard; Bares, Martin; Dzyak, Lyudmyla A; Belova, Anna N; Pham, Emmanuel; Liu, Wenzhong Jerry; Picaut, Philippe

    2016-11-01

    Approved botulinum toxin A products require reconstitution. AbobotulinumtoxinA solution for injection is a ready-to-use liquid formulation of abobotulinumtoxinA. The objective of this study was to demonstrate the superior efficacy of abobotulinumtoxinA solution for injection to placebo and to test the noninferior efficacy of abobotulinumtoxinA solution for injection versus abobotulinumtoxinA (dry formulation) in cervical dystonia. This was a phase-3, multicenter, prospective, double-blind, randomized, active, and placebo-controlled study (N = 369). Patients with cervical dystonia were randomized (3:3:1) to abobotulinumtoxinA solution for injection 500 U, abobotulinumtoxinA 500 U, or placebo. Following the double-blind phase, patients received abobotulinumtoxinA solution for injection, open-label, for up to 4 cycles. The primary outcome was change from baseline at week 4 of the Toronto Western Spasmodic Torticollis Rating Scale total score. Secondary measures included change from baseline or cycle baseline in Toronto Western Spasmodic Torticollis Rating Scale scores. At week 4, both products were superior to placebo (Toronto Western Spasmodic Torticollis Rating Scale total score least square mean decrease from baseline, abobotulinumtoxinA solution for injection 500 U -12.5, abobotulinumtoxinA 500 U -14.0, placebo -3.9; P < .0001 vs placebo). The noninferiority limit of 3 points in the Toronto Western Spasmodic Torticollis Rating Scale total score at week 4 was not met for abobotulinumtoxinA solution for injection versus abobotulinumtoxinA. Toronto Western Spasmodic Torticollis Rating Scale total score reductions were maintained for up to 4 cycles of abobotulinumtoxinA solution for injection open-label follow-up treatment. Safety profiles of abobotulinumtoxinA solution for injection and abobotulinumtoxinA were similar, with dysphagia and injection-site pain the most frequent drug-related adverse events. Although the predefined noninferiority criterion was not

  20. Vocal Function in Introverts and Extraverts during a Psychological Stress Reactivity Protocol

    Science.gov (United States)

    Dietrich, Maria; Verdolini Abbott, Katherine

    2012-01-01

    Purpose: To examine the proposal that introversion predictably influences extralaryngeal and vocal behavior in vocally healthy individuals compared with individuals with extraversion and whether differences are of a nature that may support a risk hypothesis for primary muscle tension dysphonia. Method: Fifty-four vocally healthy female adults…

  1. SUSPENSION MICROLARYNGOSCOPIC SURGERY AND INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY FOR BENIGN LESIONS OF THE VOCAL FOLDS

    NARCIS (Netherlands)

    DIKKERS, FG; SULTER, AM

    1994-01-01

    A prospective study was designed to compare the effects on voice capacities after either suspension microlaryngoscopic surgery or indirect microlaryngostroboscopic surgery. Patients where the clinical diagnosis 'dysphonia due to a benign lesion of the vocal fold' was made, and who could be operated

  2. Treatment and partial recovery of ischemic stroke hemiplegy through acupuncture

    Directory of Open Access Journals (Sweden)

    David Gonçalves Nordon

    2011-06-01

    Full Text Available ABSTRACT We present the case of a patient with hemiplegy and dysphonia due to an ischemic stroke in the pons who was treated through classical systemic and scalpean acupuncture and electroacupuncture, presenting considerable improvement in speaking, walking and moving her right arm after three months of treatment.

  3. Use of Spectral/Cepstral Analyses for Differentiating Normal from Hypofunctional Voices in Sustained Vowel and Continuous Speech Contexts

    Science.gov (United States)

    Watts, Christopher R.; Awan, Shaheen N.

    2011-01-01

    Purpose: In this study, the authors evaluated the diagnostic value of spectral/cepstral measures to differentiate dysphonic from nondysphonic voices using sustained vowels and continuous speech samples. Methodology: Thirty-two age- and gender-matched individuals (16 participants with dysphonia and 16 controls) were recorded reading a standard…

  4. Esophageal, pharyngeal and hemorrhagic complications occurring in anterior cervical surgery: Three illustrative cases

    Directory of Open Access Journals (Sweden)

    Víctor Rodrigo Paradells

    2014-01-01

    Conclusions: Anterior cervical spine surgery is a safe approach and is associated with few major esophageal/pharyngeal complications, which most commonly include transient dysphagia and dysphonia. If symptoms persist, patients should be assessed for esophageal/pharyngeal defects utilizing appropriate imaging studies. Notably, even if the major complications listed above are adequately treated, optimal results are in no way guaranteed.

  5. Maximum Phonation Time: Variability and Reliability

    NARCIS (Netherlands)

    R. Speyer; H.C.A. Bogaardt; V.L. Passos; N.P.H.D. Roodenburg; A. Zumach; M.A.M. Heijnen; L.W.J. Baijens; S.J.H.M. Fleskens; J.W. Brunings

    2010-01-01

    The objective of the study was to determine maximum phonation time reliability as a function of the number of trials, days, and raters in dysphonic and control subjects. Two groups of adult subjects participated in this reliability study: a group of outpatients with functional or organic dysphonia v

  6. Ortner's syndrome: a case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Dutra, Bruno Landim; Campos, Lenilton da Costa; Marques, Helder de Castro; Vilela, Vagner Moyses, E-mail: brunolandim@yahoo.com.br [Universidade Federal de Juiz de Fora (HU/UFJF), MG (Brazil). Hospital Universitario. Unidade de Radiologia e Diagnostico por Imagem; Carvalho, Rodolfo Elias Diniz da Silva [Centro de Diagnostico Medico (CRM), Sao Mateus, ES (Brazil); Duque, Andre Geraldo da Silva [Axial Medicina Diagnostica, Belo Horizonte, MG (Brazil)

    2015-07-15

    The authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner's syndrome. (author)

  7. Genetic and Environmental Effects on Vocal Symptoms and Their Intercorrelations

    Science.gov (United States)

    Nybacka, Ida; Simberg, Susanna; Santtila, Pekka; Sala, Eeva; Sandnabba, N. Kenneth

    2012-01-01

    Purpose: Recently, Simberg et al. (2009) found genetic effects on a composite variable consisting of 6 vocal symptom items measuring dysphonia. The purpose of the present study was to determine genetic and environmental effects on the individual vocal symptoms in a population-based sample of Finnish twins. Method: The sample comprised 1,728 twins…

  8. Work-related voice disorder

    Directory of Open Access Journals (Sweden)

    Paulo Eduardo Przysiezny

    2015-04-01

    Full Text Available INTRODUCTION: Dysphonia is the main symptom of the disorders of oral communication. However, voice disorders also present with other symptoms such as difficulty in maintaining the voice (asthenia, vocal fatigue, variation in habitual vocal fundamental frequency, hoarseness, lack of vocal volume and projection, loss of vocal efficiency, and weakness when speaking. There are several proposals for the etiologic classification of dysphonia: functional, organofunctional, organic, and work-related voice disorder (WRVD.OBJECTIVE: To conduct a literature review on WRVD and on the current Brazilian labor legislation.METHODS: This was a review article with bibliographical research conducted on the PubMed and Bireme databases, using the terms "work-related voice disorder", "occupational dysphonia", "dysphonia and labor legislation", and a review of labor and social security relevant laws.CONCLUSION: WRVD is a situation that frequently is listed as a reason for work absenteeism, functional rehabilitation, or for prolonged absence from work. Currently, forensic physicians have no comparative parameters to help with the analysis of vocal disorders. In certain situations WRVD may cause, work disability. This disorder may be labor-related, or be an adjuvant factor to work-related diseases.

  9. Ortner’s syndrome: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Bruno Landim Dutra

    2015-08-01

    Full Text Available AbstractThe authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner’s syndrome.

  10. Development and validation of the inhaled corticosteroid questionnaire : a model for the measurement of patient-perceived side effects by self-report

    NARCIS (Netherlands)

    Foster, Juliet Michelle

    2007-01-01

    Inhaled corticosteroids are effective treatments in asthma and in some cases of chronic obstructive pulmonary disease. Unfortunately these medications are associated with commonly occurring side effects such as dysphonia (problems with the voice) or skin bruising. Some patients will stop taking inha

  11. ‘ SILENT’ LARYNGEAL FOREIGN BODY

    Directory of Open Access Journals (Sweden)

    Chandrasekhar

    2015-06-01

    Full Text Available Laryngeal foreign bodies in adults are rare. The foreign bodies accidentally entering the larynx are symptomatic in the form of choking , stridor or even death. We are presenting a rare case of foreign body in the larynx in a 42 year old male who was symptom free except for dysphonia. The foreign body was removed successfully under local anesthesia.

  12. Laryngeal

    Directory of Open Access Journals (Sweden)

    Brahim Bouaity

    2014-11-01

    Conclusion: Laryngeal amyloidosis is essentially a local clinical form whose main symptom is dysphonia. The treatment is usually based on local endoscopic procedures but may require a laryngectomy in advanced forms, associated with colchicine. The prognosis is much better than systemic forms.

  13. Psychosocial impact of the teacher's voice throughout the career.

    NARCIS (Netherlands)

    Kooijman, P.G.C.; Thomas, G.; Graamans, K.; Jong, F.I.C.R.S. de

    2007-01-01

    It is generally accepted that vocal performance decreases with age. This decrease can be expected to be more pronounced in voice loading professions, which may lead to occupational dysphonia. The aim of this study was to investigate the course of voice complaints, experienced handicap, and absenteei

  14. Is the sagittal postural alignment different in normal and dysphonic adult speakers?

    Science.gov (United States)

    Franco, Débora; Martins, Fernando; Andrea, Mário; Fragoso, Isabel; Carrão, Luís; Teles, Júlia

    2014-07-01

    Clinical research in the field of voice disorders, in particular functional dysphonia, has suggested abnormal laryngeal posture due to muscle adaptive changes, although specific evidence regarding body posture has been lacking. The aim of our study was to verify if there were significant differences in sagittal spine alignment between normal (41 subjects) and dysphonic speakers (33 subjects). Cross-sectional study. Seventy-four adults, 35 males and 39 females, were submitted to sagittal plane photographs so that spine alignment could be analyzed through the Digimizer-MedCalc Software Ltd program. Perceptual and acoustic evaluation and nasoendoscopy were used for dysphonic judgments: normal and dysphonic speakers. For thoracic length curvature (TL) and for the kyphosis index (KI), a significant effect of dysphonia was observed with mean TL and KI significantly higher for the dysphonic speakers than for the normal speakers. Concerning the TL variable, a significant effect of sex was found, in which the mean of the TL was higher for males than females. The interaction between dysphonia and sex did not have a significant effect on TL and KI variables. For the lumbar length curvature variable, a significant main effect of sex was demonstrated; there was no significant main effect of dysphonia or significant sex×dysphonia interaction. Findings indicated significant differences in some sagittal spine posture measures between normal and dysphonic speakers. Postural measures can add useful information to voice assessment protocols and should be taken into account when considering particular treatment strategies. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  15. Tremor and its duration-amplitude distribution at Popocatépetl volcano, Mexico

    Science.gov (United States)

    Arámbula-Mendoza, R.; Valdés-González, C.; Varley, N.; Reyes-Pimentel, T. A.; Juárez-García, B.

    2016-09-01

    The duration-amplitude distribution was calculated for the tremor observed at Popocatépetl volcano during episodes of activity in 2000 and 2012-2014. An exponential function was used to obtain a good fit for the duration-amplitude distribution, and the source of volcanic tremor is probably generated by the transportation of magmatic fluids and its coupling with the host rock within the volcanic conduit. In particular, harmonic tremor has shown large amplitudes, durations, and mean values of amplitude, more than spasmodic or pulsating tremor. This is due to different generation mechanisms: in the case of harmonic tremor, it is produced during magma ascent and lava dome growth, while spasmodic and pulsating tremors are associated with fragmentation of the lava dome and gas emissions. This paper presents the duration-amplitude distribution as a method to estimate the intensity of the tremor at Popocatépetl, a volcano with the major risk in all Mexico.

  16. Two Forms of Palilalia: A Clinicoanatomical Study

    Directory of Open Access Journals (Sweden)

    M. Ikeda

    1992-01-01

    Full Text Available The clinical and neuroradiological findings of three patients with marked palilalia due to different neurological disorders are reported. These cases and others in the literature suggest the possibility of different variations. “Spasmodic, heterophonic palilalia” is typically observed in Parkinson's syndrome and pseudobulbar palsy: the content of palilalia is characteristically changed by interruption. “Atonic, homophonic, autoecholalic palilalia” is mainly seen in Pick's disease, and is not affected by external interruption.

  17. 100 years of power plant technology - 100 years of material technology

    Energy Technology Data Exchange (ETDEWEB)

    Schoch, W.

    1983-07-01

    The introduction of the steam turbine required a spasmodic further development of steam boiler technology for the development of new boilers. The difficulties which occurred in this process due to the lack of suitable steels are indicated in this paper. Design and manufacture have nevertheless still not been resolved satisfactorily. With the founding of the VGB the operators endeavoured to find solutions. Further developments up to the technical maturity of our present conventional and nuclear power plant technology are described.

  18. 针刺结合葛根汤加减治疗痉挛性斜颈1例

    Institute of Scientific and Technical Information of China (English)

    曹国元; 杨青宇

    2010-01-01

    @@ 痉挛性斜颈(spasmodic tortiollis)是指颈部肌肉呈阵发性不自主收缩,使头、颈部多动并呈各种倾斜或旋转姿势.据Nutt等的文献报道,美国痉挛性斜颈的发病率大约是十万分之九.

  19. Triad of torticollis, photophobia and epiphora in a child with a posterior fossa tumor

    Directory of Open Access Journals (Sweden)

    Buijsrogge, Michiel

    2014-11-01

    Full Text Available [english] A 7-month-old Caucasian girl presented with an acquired, spasmodic torticollis to the right side with the head tilted downwards, photophobia and epiphora. Diagnostic work-out revealed a posterior fossa pilocytic astrocytoma. The symptoms improved after surgical resection. There is evidence of internuclear connections between cranial nerves II, V and VII acting as important mechanisms in this triad (Okamoto et al. 2010.

  20. Two Cases of Hiccups due to Gastroesophageal Reflux Disease

    OpenAIRE

    KOÇKAR, Cem; İşler, Mehmet; CÜRE, Erkan; Şenol, Altuğ; Bastürk, Abdulkadir

    2015-01-01

    Hiccup is a spasmodic, involuntary contraction of the inspiratory muscles, associated with delayed, abrupt glottic closure, causing a peculiar sound. There are numerous causes of hiccup, including diseases of the gastrointestinal tract. Hiccup is reported to represent an atypical manifestation of the gastroesophageal reflux disease (GERD).We report two cases with hiccup due to GERD. Endoscopic examinations showed esophagitis, Los Angeles class grade A and B, in two cases whose hiccups were im...

  1. Richard Eberhart: A Quest for Identity

    Directory of Open Access Journals (Sweden)

    Dr. J. Karthikeyan

    2014-09-01

    Full Text Available A short history of the life of Richard Eberhart becomes essential for us to understand the magnetic personality of a poet who believed in his younger generation. The secret of his continued popularity rests on his unique strong individuality, romantic mould, spasmodic vigour, his social commitment, simplicity of expression and a deep concern for mankind. The present study is a modest attempt in this direction and proposes to examine the predominant features of Richard Eberhart’s poetry.

  2. Vocal cord dysfunction in amyotrophic lateral sclerosis : four cases and a review of the literature

    NARCIS (Netherlands)

    van der Graaff, Maaike M; Grolman, Wilko; Westermann, Erik J; Boogaardt, Hans C; Koelman, Hans; van der Kooi, Anneke J; Tijssen, Marina A; de Visser, Marianne

    2009-01-01

    We describe 4 patients with amyotrophic lateral sclerosis (ALS) and glottic narrowing due to vocal cord dysfunction, and review the literature found using the following search terms: amyotrophic lateral sclerosis, motor neuron disease, stridor, laryngospasm, vocal cord abductor paresis, and hoarsene

  3. Anesthetic management in a child with Arnold-Chiari malformation and bilateral vocal cord paralysis.

    NARCIS (Netherlands)

    Setz, A.C.W.; Boer, H.D. de; Driessen, J.J.; Scheffer, G.J.

    2005-01-01

    We report a case of a child who was scheduled for an emergency ventriculoperitoneal shunt procedure. The patient had a type II Arnold-Chiari malformation (ACM) and associated hydrocephalus and presented with near complete respiratory obstruction from bilateral abductor vocal cord palsy. Early diagno

  4. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    Science.gov (United States)

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  5. The Effect of Visual and Auditory Enhancements on Excitability of the Primary Motor Cortex during Motor Imagery: A Pilot Study

    Science.gov (United States)

    Ikeda, Kohei; Higashi, Toshio; Sugawara, Kenichi; Tomori, Kounosuke; Kinoshita, Hiroshi; Kasai, Tatsuya

    2012-01-01

    The effect of visual and auditory enhancements of finger movement on corticospinal excitability during motor imagery (MI) was investigated using the transcranial magnetic stimulation technique. Motor-evoked potentials were elicited from the abductor digit minimi muscle during MI with auditory, visual and, auditory and visual information, and no…

  6. Anatomic localization of motor points for the neuromuscular blockade of hand intrinsic muscles involved in thumb-in-palm.

    Science.gov (United States)

    Im, Sun; Han, Seung Ho; Choi, Jin Hwan; Lee, Je Hoon; Ko, Young Jin; Lee, Jong In; Kim, Hye Won

    2008-09-01

    To determine the location of the motor points and intramuscular branches for the muscles involved in thumb-in-palm and the abductor pollicis brevis muscle, the latter of which, because of its anatomic proximity, may be inadvertently blocked. Hand intrinsic muscles from 20 fresh cadavers were dissected. The point of nerve entry to the muscle belly and the points where the intramuscular endings were located most proximally and distally were defined in relation to a reference line connecting the hook of hamate and the head of the first metacarpal bone. We were able to define a region, located from 66.08% +/- 8.67% to 70.28% +/- 10.62% of the reference line, with the hook of hamate as starting point, where intramuscular endings for the thumb-in-palm muscles were dense and farther from the intramuscular endings for the abductor pollicis brevis. The region around 40% of the reference line was the point where the intramuscular endings were most dense for the abductor pollicis brevis. The results may provide guidelines that could help in localizing the appropriate points for the neuromuscular blockade of thumb-in-palm muscles and, at the same time, help in minimizing the inadvertent block of the abductor pollicis brevis.

  7. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    Science.gov (United States)

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  8. Preoperative Predictors of Ambulation Ability at Different Time Points after Total Hip Arthroplasty in Patients with Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Akiko Kamimura

    2014-01-01

    Full Text Available The aims of this study were to identify the preoperative factors influencing ambulation ability at different postoperative time points after total hip arthroplasty (THA and to examine the cutoff values of predictive preoperative factors by receiver operating characteristic (ROC curves. Forty-eight women with unilateral THA were measured for hip extensor, hip abductor, and knee extensor muscle strength in both legs; hip pain (visual analog scale, VAS; and the Timed Up and Go (TUG test pre- and postoperatively. Multiple regression analysis indicated that preoperative knee extensor strength (β=-0.379,R2=0.409 at 3 weeks, hip abductor strength (β=-0.572,R2=0.570 at 4 months, and age (β=0.758,R2= 0.561 at 7 months were strongly associated with postoperative ambulation, measured using the TUG test. Optimal preoperative cutoff values for ambulation ability were 0.56 Nm/kg for knee extensor strength, 0.24 Nm/kg for hip abductor strength, and 73 years of age. Our results suggest that preoperative factors predicting ambulation ability vary by postoperative time point. Preoperative knee extensor strength, hip abductor strength, and age were useful predictors of ambulation ability at the early, middle, and late time points, respectively, after THA.

  9. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Rogéria Nobre Rodrigues

    2015-12-01

    Full Text Available Abstract Objective: To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods: Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV and those who had been operated on for nerve decompression were excluded. Results: A female prevalence (78.8% was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion: Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.

  10. Soft tissue injury related to choice of entry point in antegrade femoral nailing : piriform fossa or greater trochanter tip

    NARCIS (Netherlands)

    Moein, CMA; Verhofstad, MHJ; Bleys, RLAW; van der Werken, C

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  11. Soft tissue injury related to choice of entry point in antegrade femoral nailing: piriform fossa or greater trochanter tip

    NARCIS (Netherlands)

    Moein, C.M.A.; Verhofstad, M.H.J.; Bleys, R.L.A.W.; van der Werken, C.

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  12. Evaluation of Peer Training for Teaching Abduction Prevention Skills

    Science.gov (United States)

    Tarasenko, Melissa A.; Miltenberger, Raymond G.; Brower-Breitwieser, Carrie; Bosch, Amanda

    2010-01-01

    Child abduction is a serious problem, with approximately 100 children killed each year by nonfamily abductors. Training programs to teach children the correct skills to use if they ever come into contact with a stranger can be effective when they incorporate behavioral skills training (BST) and in-situ training (IST) into their protocol. However,…

  13. Abduction of Children by Their Parents: A Survey of the Problem.

    Science.gov (United States)

    Hegar, Rebecca L.; Greif, Geoffrey L.

    1991-01-01

    Findings from 371 parents who sought help from missing children's organizations provided profile of families in which children were abducted by 1 of parents. Abductors were described as less educated and less likely to be employed than searching parents. Three-fourths of abducted children were younger than seven years of age; most abductions…

  14. Bernese periacetabular osteotomy for hip dysplasia. A modification to original technique and South American perspective.

    Science.gov (United States)

    Lara, Joaquín; Tobar, Carlos; Besomi, Javier

    2014-12-01

    Bernese periacetabular osteotomy has become a secure and reproducible technique for treatment of hip dysplasia. It allows an adequate reorientation of the acetabulum and coverage of the femoral head improving biomechanical conditions of the hip joint. We present a review of literature and a modification of original technique that includes a smaller incision and preservation of the abductor muscles and rectus femoris tendon insertion.

  15. Positioning Techniques to Reduce the Occurrence of DeQuervain's Tendonitis in Nursing Mothers

    Science.gov (United States)

    Virzi, Alison

    2010-01-01

    DeQuervain's tendonitis is an inflammation of two tendons: the extensor pollicis brevis and the abductor pollicis longus as they cross in the first dorsal compartment of the wrist. Symptoms include pain, swelling along the radial aspect of the wrist, and a decrease in thumb motion. A positive Finkelstein's test at examination is seen. Frequently…

  16. Motor Unit Number Index (MUNIX): a novel neurophysiological marker for neuromuscular disorders; test-retest reliability in healthy volunteers.

    NARCIS (Netherlands)

    Neuwirth, C.; Nandedkar, S.; Stalberg, E.; Barkhaus, P.E.; Carvalho, M.; Furtula, J.; Dijk, J.P. van; Baldinger, R.; Castro, J.; Costa, J.; Otto, M.; Sandberg, A.; Weber, M.

    2011-01-01

    OBJECTIVE: To investigate the intra-rater and inter-rater test-retest reliability of the Motor Unit Number Index (MUNIX) in healthy subjects in a multicentre setting. METHODS: Six study centres applied the MUNIX technique in 66 healthy subjects. Five to six muscles (biceps brachii, BB; abductor digi

  17. Vocal cord dysfunction in amyotrophic lateral sclerosis : four cases and a review of the literature

    NARCIS (Netherlands)

    van der Graaff, Maaike M; Grolman, Wilko; Westermann, Erik J; Boogaardt, Hans C; Koelman, Hans; van der Kooi, Anneke J; Tijssen, Marina A; de Visser, Marianne

    2009-01-01

    We describe 4 patients with amyotrophic lateral sclerosis (ALS) and glottic narrowing due to vocal cord dysfunction, and review the literature found using the following search terms: amyotrophic lateral sclerosis, motor neuron disease, stridor, laryngospasm, vocal cord abductor paresis, and hoarsene

  18. Electrolytes,water,acid-base imbalance

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010296 Utility of clinical exercise test in diagnosis of hypokalaemic periodic paralysis. LIU Mingsheng(刘明生),et al. Dept Neurol,PUMC & CAMS,Beijing l00730. Chin J Neurol 2010;43(5):328-330. Objective To assess the utility of changes of muscle strength and compound muscle action potential (CMAP) of abductor digiti minimi (ADM) muscle after the exercise test

  19. Kashima's Posterior cordectomy using coablator our experience

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    Balasubramanian Thiagarajan

    2014-03-01

    Full Text Available Aim: To study the effectiveness of coblation technology in performing Kashima's procedure for bilateral abductor vocal fold paralysis. Methodology: Managing patients with bilateral vocal fold abductor paralysis is rather tricky one. It calls for delicate balance between airway and phonation. Various endolaryngeal techniques have been used to manage this problem. Here the authors describe their experience with posterior cordectomy using coablator. This study includes 10 patients who presented with stridor following bilateral abductor paralysis. All our patients were on tracheostomy tubes. They were very anxious with the tube and wanted decannulation done. All of these patients were operated by the same senior surgeon. These patients were managed with posterior cordotomy using coablation. Laryngeal wands were used in all these patients. These patients underwent spiggoting of their tracheostomy tube on the first post operative day. Decannulation was completed on the third post operative day. Early decannulation was made possible because there was negligible soft tissue oedema as these patients underwent coblation procedure. Observation: On discharge all of them had a good voice and adequate airway. These patients were able to climb two flights of stairs without discomfort.Although the causes of bilateral abductor paralysis of vocal cords are multifactorial post traumatic paralysis formed a large majority of our patients ( 8 who developed bilateral vocal fold paralysis following total thyroidectomy.

  20. Estimation of hip abduction moment based on body fixed sensors

    NARCIS (Netherlands)

    Zijlstra, W; Bisseling, R

    2004-01-01

    Background During standing and walking, abnormal trunk posture or movements may result from insufficient hip abductor force. Quantifying abduction moments requires inverse dynamics based on an appropriate model and measured data. Contrary to using a force plate and motion analysis system, body fixed

  1. Case Report of Lewis and Sumner Syndrome with Bilateral Vagus Nerves Paralysis for 16 Years.

    Science.gov (United States)

    Vasaghi, Attiyeh; Ashraf, Alireza; Shirzadi, Alireza; Petramfar, Peyman

    2016-12-01

    This report describes a patient with dysphonia for 16 years in combination with asymmetric and progressive decrease in sense and power of both upper and lower extremities for the past 3 years. Electrophysiological study revealed asymmetric conduction block and abnormal sensory action potential in 4 limbs. The vagus nerves palsy and abnormal electrodiagnosis of the limbs led us to diagnose the disease as Lewis and Sumner syndrome, also called multifocal acquired demyelinating sensory and motor neuropathy diagnosis, which improved by corticosteroid consumption to some extent. This case is uncommon by its long time presentation and progression. To the best of the authors' knowledge, this is the first report of simultaneous bilateral vagus nerve palsy in combination with upper and lower limbs' demyelinating neuropathy. In conclusion, persistent dysphonia can be a part of the presentation of demyelinating neuropathy.

  2. Sulcus vocalis: a rational analytical approach to diagnosis and management.

    Science.gov (United States)

    Ford, C N; Inagi, K; Khidr, A; Bless, D M; Gilchrist, K W

    1996-03-01

    The term sulcus vocalis has been applied to a spectrum of disorders ranging from minor vocal fold indentations to destructive lesions causing severe dysphonia. To clarify the pathophysiology and to develop a more rational approach to treatment, we report a series of sulcus patients including 20 surgical cases. Clinical and histopathologic analysis produced a clinically useful classification: type 1 is a physiologic variant accentuated by atrophy but with intact lamina propria; types 2 (sulcus vergeture) and 3 (sulcus vocalis) are characterized by severe dysphonia, loss of vibratory activity, and destruction of the functional superficial lamina propria. These latter cases respond favorably to microsurgery designed to remove destroyed tissue, release scar contracture, and promote mucosal redraping by regional undermining. Further study of the extracellular matrix of the superficial lamina propria (Reinke's space) might indicate a common pathway in the pathogenesis of sulcus deformities and other related benign vocal fold lesions.

  3. Addenda to Allied Medical Publication 8, NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) to Consider the Impact of Medical Treatment on Casualty Estimation

    Science.gov (United States)

    2013-05-01

    Botulism Survivor Injury Profile Stage 1 Stage 2 Stage 3 Signs and Symptoms (S/S) Fatigue; dry mouth; ptosis; diplopia (blurred or double vision...reflex; diplopia ; dysarthria; dysphonia; fatigue. Gradual reversal of muscle paralysis. The title of Table C-50 should be changed to read...signs and symptoms provided in Table C-50 should be changed to read: Fatigue; dry mouth; ptosis; diplopia (blurred or double vision); photophobia

  4. [Severe laryngitis associated to gastroesophageal reflux].

    Science.gov (United States)

    Botto, Hugo; Antonioli, Cintia; Nieto, Mary; Cocciaglia, Alejandro; Cuestas, Giselle; Roques Revol, Magdalena; López Marti, Jessica; Rodríguez, Hugo

    2014-02-01

    There is a strong association between gastroesophageal reflux and pharyngolaryngeal reflux as factors leading to respiratory disease, manifested as dysphonia, wheezing, coughing, recurrent laryngitis, bronchial obstruction, laryngospasm and apparent life-threatening events (ALTEs). These manifestations can be mild or severe and may sometimes put the patient's life at risk. We present two cases of patients with severe laryngitis who required endotracheal intubation, one of which underwent tracheostomy. The diagnostic methods and their limitations and the patients outcomes are described.

  5. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    OpenAIRE

    Budhram Singh; Santosh K Uddesh

    2014-01-01

    A sixty five years male presented with stridor and dysphonia in emergency clinic of Govt. CIMS medical college, Bilaspur. Indirect laryngoscopic examination revealed a polypoidal lesion in glottic chink. CT scan evaluation confirmed the findings of clinical examination. Patient was relived of symptoms after emergency tracheostomy followed by surgical removal of polypoidal lesion from right vocal cord by microlaryngeal surgery. Histopathological examination revealed myxoma. Clinical examinatio...

  6. Nonsurgical treatment of stylohyoid (Eagle) syndrome: a case report.

    Science.gov (United States)

    Taheri, Arman; Firouzi-Marani, Shahram; Khoshbin, Masoud

    2014-10-01

    Eagle syndrome is a rare condition caused by elongation of the styloid process or calcification of the stylohyoid ligament. Patients with Eagle syndrome typically present with dysphagia, dysphonia, cough, voice changes, otalgia, sore throat, facial pain, foreign body sensation, headache, vertigo, and neck pain. Here we report a case in which the patient initially presented with sore throat, left-sided facial pain, and cough. This case report provides a brief review of the diagnosis and nonsurgical management of this rare syndrome.

  7. United States Air Force Summer Faculty Research Program (1984). Program Management Report. Volume 2.

    Science.gov (United States)

    1984-12-01

    Approximation Theory and Old Dominion University Numerical Analysis Mathematics Department Assigned: AL Norfolk, VA 23508 (804) 440-3911 xxi ","’-’" i...Squires High- and Low-Fit Men to Head- - - Down Rest Followed by Ortho- stasis and Exercise 135 Recomnmendations on Combustion Dr. Arthur M. Sterling...behavioral functions can be dramatic (dysarthria, dysphonia, dysphagia , dysdipsia, and, possibly, convulsions terminating in coma). These outcomes suggested

  8. FOREIGN BODY ASPIRATION IN CHILDREN: A HIDDEN DANGER

    OpenAIRE

    Marlene Rodrigues; Joana Teixeira; Patrícia Nascimento; Susana Carvalho; Augusta Gonçalves; José Almeida; Cristiana Ribeiro

    2016-01-01

    Introduction: Foreign body aspiration (FBA) is a common pediatric emergency and an important cause of accidental death in children. The majority of cases occur with small organic or inorganic objects in preschool age. FBA may be associated with a broad spectrum manifestations and its diagnosis represents a challenge. Case report: We report a case of a two-year-old child admitted in the emergency department with cough, dysphonia and dysphagia. On physical examination she had persistent coug...

  9. Acute Motor Axonal Neuropathy (Aman) With Motor Conduction Blocks In Childhood; Case Report

    OpenAIRE

    Yildirim, Serhan; Adviye, Rahşan; Gül, Hakan Levent; Türk Börü, Ülkü

    2016-01-01

    Objective Acute motor axonal neuropathy (AMAN), characterized with decreased compound muscle action potentials (CMAP) and absence of demyelinating findings in electrophysiological studies, is a subtype of Guillain-Barre Syndrome (GBS). A 4 yr-old male patient presented with ascending weakness, dysarthria and dysphagia to İstanbul Dr. Lütfi Kırdar Kartal Training and Research Hospital Neurology outpatient for three days to in 2012. Dysphonia, restricted eye movements, flaccid tetraplegia and a...

  10. LINGUAL THYROID IN CHILDREN

    OpenAIRE

    Mujumdar; Sanjeev; Siddaling; Ahmed Abdu

    2012-01-01

    Lingual thyroid is a rare embryological anomaly, th e incidence being 1/100000 population, that originates from failure of the thyroid gland to descend from the foramen caecum to its normal prelaryngeal site. The ectopic gland, located at the base of the tongue is often asymptomatic, but may cause local sy mptoms such as dysphagia, dysphonia, stomatologia, upper airway obstruction and haemorrh age, often with hypothyroidism. This infrequent congenital anomaly is ...

  11. UNUSUAL PRESENTATION OF BRAINSTEM GLIOMA AS PROGRESSIVE BULBAR PALSY

    Directory of Open Access Journals (Sweden)

    Suma

    2015-04-01

    Full Text Available Brain stem gliomas/astrocytomas are slowly growing tumors affecting children and young adults. They usually present with unilateral cranial nerve palsies followed by long tract signs. Here we present a case report of a 42 year old male patient, who initially presented with thyrotoxicosis and slowly progressing dysphagia, dysarthria and dysphonia with no other long tract signs, and was later found to have brain stem glioma.

  12. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

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    Rodrigo Ramos-Zúñiga

    2015-01-01

    Full Text Available Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma; and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

  13. Comparison of surgical techniques in the treatment of laryngeal polypoid degeneration.

    Science.gov (United States)

    Lumpkin, S M; Bishop, S G; Bennett, S

    1987-01-01

    Surgical excision has been the accepted treatment of laryngeal polypoid degeneration, or chronic polypoid corditis. We report on 29 women with polypoid degeneration who received one of three surgical treatments: vocal fold stripping, carbon dioxide laser obliteration, or the Hirano technique. The duration of postoperative dysphonia was longest with the laser removal and shortest with the Hirano technique. A combination of vocal hygiene management and the Hirano technique of removal provided the most efficacious treatment.

  14. Cricoarytenoid joint involvement in rheumatoid arthritis: radiologic evaluation.

    Science.gov (United States)

    Greco, Antonio; Fusconi, Massimo; Macri, Gian Franco; Marinelli, Caterina; Polettini, Elisabetta; Benincasa, Anna Teresa; de Vincentiis, Marco

    2012-01-01

    Rheumatoid arthritis rarely involves the cricoarytenoid joint. The possible consequent symptom includes hoarseness, dysphagia, odynophagia, dysfunctional dysphonia, and acute dyspnea. Etiologic diagnosis is possible with high-resolution computed tomography, which can show spacing of the articular cartilage, density and volume alterations, and subluxation of the cartilage. However, these radiologic signs are not pathognomonic for rheumatoid arthritis, and they should be combined with anamnestic data.

  15. The Role of Occupational Voice Demand and Patient-Rated Impairment in Predicting Voice Therapy Adherence.

    Science.gov (United States)

    Ebersole, Barbara; Soni, Resha S; Moran, Kathleen; Lango, Miriam; Devarajan, Karthik; Jamal, Nausheen

    2017-07-11

    Examine the relationship among the severity of patient-perceived voice impairment, perceptual dysphonia severity, occupational voice demand, and voice therapy adherence. Identify clinical predictors of increased risk for therapy nonadherence. A retrospective cohort study of patients presenting with a chief complaint of persistent dysphonia at an interdisciplinary voice center was done. The Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (V-RQOL) survey scores, clinician rating of dysphonia severity using the Grade score from the Grade, Roughness Breathiness, Asthenia, and Strain scale, occupational voice demand, and patient demographics were tested for associations with therapy adherence, defined as completion of the treatment plan. Classification and Regression Tree (CART) analysis was performed to establish thresholds for nonadherence risk. Of 166 patients evaluated, 111 were recommended for voice therapy. The therapy nonadherence rate was 56%. Occupational voice demand category, VHI-10, and V-RQOL scores were the only factors significantly correlated with therapy adherence (P occupational voice demand are significantly more likely to be nonadherent with therapy than those with high occupational voice demand (P 40 is a significant cutoff point for predicting therapy nonadherence (P Occupational voice demand and patient perception of impairment are significantly and independently correlated with therapy adherence. A VHI-10 score of ≤9 or a V-RQOL score of >40 is a significant cutoff point for predicting nonadherence risk. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Isolated laryngeal myasthenia gravis for 26 years.

    Science.gov (United States)

    Renard, Dimitri; Hedayat, Amir; Gagnard, Corinne

    2015-02-01

    Laryngeal myasthenia gravis is a relatively rare variant of myasthenia gravis. A vast portion of patients with initial laryngeal myasthenia gravis develop involvement of ocular and/or extra-ocular muscles during the years after symptom onset although a minority of laryngeal myasthenia gravis patients continues to have isolated laryngeal muscle involvement for several years. We present a 58-year-old woman with recurrent episodic isolated dysphonia (associated with diffuse bilateral vocal cord paresis on laryngoscopy) since the age of 32. Dysphonia became permanent since 6 months. A diagnosis of laryngeal myasthenia gravis was made based on abnormal single-fiber electromyography and spectacular response to pyridostigmine treatment. Repetitive nerve stimulation was normal and anti-acetylcholine receptor and anti-muscle specific tyrosine kinase antibodies were absent. This case shows that laryngeal myasthenia gravis can be isolated during 26 years of follow-up. We propose that even when myasthenia gravis seems unlikely as underlying mechanism of isolated dysphonia (because of lack of antibodies, normal repetitive nerve stimulation, and absence of extra-laryngeal involvement after years of follow-up), single-fiber electromyography should be performed and myasthenia gravis treatment should be tried.

  17. Effect of Performance Time of the Semi-Occluded Vocal Tract Exercises in Dysphonic Children.

    Science.gov (United States)

    Ramos, Lorena de Almeida; Gama, Ana Cristina Côrtes

    2017-05-01

    This study aimed to verify the effects of execution time on auditory-perceptual and acoustic responses in children with dysphonia completing straw phonation exercises. A randomized, prospective, comparative intra-subject study design was used. Twenty-seven children, ranging from 5 to 10 years of age, diagnosed with vocal cord nodules or cysts, were enrolled in the study. All subjects included in the Experimental Group were also included in the Control Group which involved complete voice rest. Sustained vowels (/a/e/ε/e/) counting from 1 to 10 were recorded before the exercises (m0) and then again after the first (m1), third (m3), fifth (m5), and seventh (m7) minutes of straw phonation exercises. The recordings were randomized and presented to five speech therapists, who evaluated vocal quality based on the Grade Roughness Breathiness Asthenia/Strain Instability scale. For acoustic analysis, fundamental frequency, jitter, shimmer, glottal to noise excitation ratio, and noise parameters were analyzed. Reduced roughness, breathiness, and noise measurements as well as increased glottal to noise excitation ratio were observed in the Experimental Group after 3 minutes of exercise. Reduced grade of dysphonia and breathiness were noted after 5 minutes. The ideal duration of straw phonation in children with dysphonia is from 3 to 5 minutes. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Complications of the anterior approach to the cervical spine

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    Marcelo Lemos Vieira da Cunha

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels and, the type of procedure performed: discectomy and placement of cage and plate (D+C+P, discectomy with placement of a cage (D+C or corpectomy with placement of cage and plate (C+C+P. All complications related to surgical approach were reported. RESULTS: We studied 34 patients, 70% male. The average age was 50 years and mean follow-up was 8 months. Eighteen percent of patients had complications, distributed as follows: dysphasia (33% and dysphonic (67%. Among patients who developed complications, most underwent to D+C+P (83% and no complications were found in patients where no cervical plate was used. Regarding levels, both complications were identified in patients operated to one or two levels. However, in patients operated on three levels, only dysphonia was identified. CONCLUSION: The most frequent complication was dysphonia. Patients who presented more complications were those undergoing discectomy and fusion with cage and anterior cervical plate. All cases of dysphonia were in this group. The number of accessible levels does not seem to have affected the incidence of complications.

  19. Gait training assist system of a lower limb prosthetic visualizing muscle activation pattern using a color-depth sensor.

    Science.gov (United States)

    Ogata, Kunihiro; Mita, Tomoki; Tsuji, Toshiaki; Matsumoto, Yoshio

    2017-07-01

    Some unilateral lower-limb amputees load the intact limb more than the prosthetic limb. This can cause chronic pains, fatigue, lumbago, and joint diseases, including knee osteoarthritis. To avoid and counteract these symptoms it is necessary to improve their asymmetric gait. Increasing the function of the hip abductor muscle is important to maintaining symmetrical weight distribution. Therefore, the purpose of this study is to develop a training assist system, which estimates and visualizes an abductor muscle by using a color-depth sensor. To estimate the muscle activation, first, the floor reaction force is calculated using a simple dynamic model. Then, the hip torque is calculated using joint angles. The floor reaction force and, the muscle length are calculated based on a human musculoskeletal model. Muscle activity is estimated by these parameters. Evaluation experiments of this proposed method were performed on healthy persons and unilateral trans femoral amputees, and the effectiveness of this proposed algorithm has been confirmed.

  20. Quantitative ultrasound of denervated hand muscles.

    Science.gov (United States)

    Simon, Neil G; Ralph, Jeffrey W; Lomen-Hoerth, Catherine; Poncelet, Ann N; Vucic, Steve; Kiernan, Matthew C; Kliot, Michel

    2015-08-01

    Presentations to the neuromuscular clinic commonly involve hand muscle denervation, but few studies have evaluated hand muscle ultrasound. Ultrasound studies of abductor pollicis brevis, first dorsal interosseous, and abductor digit minimi were prospectively performed in a cohort of 34 patients (77 muscles) with electromyography (EMG)-confirmed denervation, compared with 58 healthy control subjects. In control subjects, muscle thickness was highly reproducible [intraclass correlation coefficient (ICC) = 0.88-0.98], and echogenicity was moderately reproducible (ICC = 0.542-0.686). Age, gender, and body mass index influenced muscle thickness and echogenicity. Ultrasound changes in denervated muscles correlated with the severity of EMG abnormalities. A z-score cutoff of 0 identified denervated muscles with a sensitivity of 100% and 89% for echogenicity and muscle thickness, respectively. Hand muscle ultrasound provides a noninvasive method to quantify muscle denervation and may be useful as a screening tool before EMG studies. © 2014 Wiley Periodicals, Inc.