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Sample records for abductor spasmodic dysphonia

  1. Spasmodic dysphonia.

    Science.gov (United States)

    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.

  2. 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.

  3. 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…

  4. 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…

  5. 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.

  6. 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

    2013-01-01

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

  7. 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.

  8. 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.

  9. 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…

  10. 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.

  11. 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.

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

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    Sanajeet Kumar

    2016-03-01

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

  13. 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. PMID:27143711

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  16. 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…

  17. 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.

  18. 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

    2015-01-01

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

  19. 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

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

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

    1994-06-01

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

  1. 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.

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

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    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…

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

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    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.

  4. Spasmodic Dysphonia

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

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

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

    2015-09-01

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

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

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    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.

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

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    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.

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

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    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…

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

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    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

  10. 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

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    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

  11. 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

  12. 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.

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

    Institute of Scientific and Technical Information of China (English)

    刘波; 屈季宁; 李再香; 袁琨

    2001-01-01

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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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

  19. Social phobia in spasmodic torticollis

    OpenAIRE

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

    2001-01-01

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

  20. 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. PMID:22916671

  1. [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.

  2. 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.

  3. [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.

  4. 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.

  5. 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.

  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. 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.

  8. 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…

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

    OpenAIRE

    Cannito, Michael

    2008-01-01

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

  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. Tendon variations of extensor digitorum and abductor pollicis longus muscles

    Directory of Open Access Journals (Sweden)

    Kocabiyik N

    2009-05-01

    Full Text Available Tendon variations of extensor digitorum and abductor pollicis longus muscles were observed in a 65-year-old male formalin fixed cadaver, during the dissections for second year medical students at the Gulhane Military Medical Academy Anatomy Dissection Laboratory. In the right forearm, the extensor digitorum muscle had a tripled tendon for the 3rd finger and a doubled tendon for the ring finger. The extensor digiti minimi muscle also had a doubled tendon. There was also a communicating tendon between the ring finger’s tendon of the extensor digitorum muscle and the extensor digiti minimi muscle’s tendon. The intertendinous connections between the tendons of extensor digitorum muscle were in normal locations. In left forearm, the abductor pollicis longus muscle had a tripled tendon. A thin additional tendon slip from the abductor pollicis longus was inserting into the abductor pollicis brevis. The extensor pollicis longus and brevis muscles were in their normal anatomical locations.

  13. Dysphonia after Bevacizumab Rechallenge: A Case Report

    Directory of Open Access Journals (Sweden)

    Corey A. Carter

    2015-10-01

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

  14. 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.)

  15. 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. PMID:27191884

  16. Etiological factors for muscle tension dysphonia

    OpenAIRE

    Kušar, Rozalija

    2012-01-01

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

  17. 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.

  18. Proton MR spectroscopy in idiopathic spasmodic torticollis

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    王丽萍; 张玉富; 张澍; 杨式麟

    2001-01-01

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

  20. 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...

  1. Cervical spondylodiscitis presenting with dysphagia and dysphonia

    Directory of Open Access Journals (Sweden)

    Siddharth M Shetty

    2014-01-01

    Full Text Available Infections of the deep spaces of the neck, like the prevertebral abscess, can present with catastrophic consequences due to compromise of air and food passages. The most common causes of the prevertebral abscess in orthopedic practice are tuberculosis of spine, retropharyngeal abscess, infections secondary to foreign body impalement and injury. Early recognition of these conditions is necessary to avert fatal complications. We report a case of a 50-year-old gentleman who presented with symptoms of dysphagia and dysphonia with altered sensorium of 4 days duration. He was diagnosed with septicemia, diabetic ketoacidosis, and an upper motor neuron type of quadriparesis. There was diffuse swelling over the anterior aspect of the neck with magnetic resonance imaging study suggesting a prevertebral abscess with septic discitis of cervical 5 and 6 vertebras. The case is presented along with the literature review discussed as an unusual cause of septic discitis due to Klebsiella manifesting as dysphonia and dysphagia.

  2. Functional dysphonia: strategies to improve patient outcomes

    OpenAIRE

    Behlau M; Madazio G; Oliveira G

    2015-01-01

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

  3. 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.

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

    OpenAIRE

    M. Jahanshahi; Marsden, C D

    1990-01-01

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

  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. Radiographic and ultrasonographic diagnosis of stenosing tenosynovitis of the abductor pollicis longus muscle in dogs.

    Science.gov (United States)

    Hittmair, Katharina M; Groessl, Veronika; Mayrhofer, Elisabeth

    2012-01-01

    Stenosing tenosynovitis of the abductor pollicis longus muscle causes chronic front limb lameness in dogs. The lesion, similar to de Quervain's tenosynovitis in people, is caused by repetitive movements of the carpus. Thirty dogs with front limb lameness, painful carpal flexion, and a firm soft tissue swelling medial to the carpus were examined prospectively. Seven dogs had bilateral abductor pollicis longus tenosynovitis. Radiographs of the carpus were characterized by a deeper radiolucent medial radial sulcus and bony proliferations medial and slightly cranial to the distal radius, resulting in stenosis of the tendon sheath and subsequent tendinitis. Ultrasonographic examination of the firm soft tissue swelling medial to the carpus was characterized by an irregular hypoechoic abductor pollicis longus tendon or tendinitis in 22 of 37 dogs. Nineteen of 37 abductor pollicis longus tendon sheaths were fluid-filled and all tendon sheaths were thickened, more hyperechoic, with small hyperechoic mineralizations embedded in the connective tissue of the abductor pollicis longus tendon sheath in 25 dogs. Enthesopathy of the abductor pollicis longus tendon was identified in seven dogs. While radiographs of stenosing tenosynovitis of the abductor pollicis longus are helpful in visualizing the deep radial sulcus and osteophytes medial to the distal radius, ultrasonography is useful to distinguish between lesions of the tendon or tendon sheath and to determine thickness and fluid content of the abductor pollicis longus tendon sheath. PMID:22118578

  7. 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.

  8. Factors Associated with Dysphonia in High School Cheerleaders.

    Science.gov (United States)

    Campbell, Shari L.; And Others

    1988-01-01

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

  9. 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 ...

  10. 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.

  11. Functional dysphonia: strategies to improve patient outcomes

    Directory of Open Access Journals (Sweden)

    Behlau M

    2015-12-01

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

  12. 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.

  13. [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.

  14. [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.

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

    Science.gov (United States)

    Beery, Quinter C.

    1991-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Comprehensive Management of Psychogenic Dysphonia: A Case Illustration

    Science.gov (United States)

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

    2009-01-01

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

  18. Dysphonia Detected by Pattern Recognition of Spectral Composition.

    Science.gov (United States)

    Leinonen, Lea; And Others

    1992-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  20. 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

  1. 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.

  2. 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. PMID:19598322

  3. 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.

  4. 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.

  5. 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

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

    OpenAIRE

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

    2007-01-01

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

  7. [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.

  8. 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...

  9. 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...

  10. 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.

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

    雷培香; 屈季宁; 周涛; 曹永茂

    2003-01-01

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

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

    Science.gov (United States)

    Eadie, Tanya L.; Kapsner-Smith, Mara

    2011-01-01

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

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

    Science.gov (United States)

    Awan, Shaheen N.; Roy, Nelson

    2006-01-01

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

  15. Dystonias

    Science.gov (United States)

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

  16. Taking Care of Your Voice

    Science.gov (United States)

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

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

    OpenAIRE

    Jayanta Nath

    2015-01-01

    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,...

  18. Effects of Early Muscle Strengthening of Hip Abductor and Adductor Muscles after Surgery for Pelvic Fracture

    OpenAIRE

    久保田, 雅史; 小久保, 安朗; 佐々木, 伸一; 嶋田, 誠一郎; 北出, 一平; 松村, 真裕美; 亀井, 健太; 北野, 真弓; 野々山, 忠芳; 鯉江, 祐介; 松尾, 英明; 成瀬, 廣亮; 小林, 茂; 馬場, 久敏; KUBOTA, Masafumi

    2009-01-01

    [Purpose] The purpose of this study was to clarify the effects of muscle strengthening of hip abductor and adductor muscles just after surgery on gait at discharge. [Subjects and Methods] Subjects were twelve patients who had open reduction and internal fixation (ORIF) for unstable unilateral fractures of the pelvis. Six patients started muscle strengthening exercises at two weeks after surgery (regular rehabilitation group, RR), and another six patients started muscle strengthening of hip ab...

  19. 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.

  20. [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.

  1. 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.

  2. Effects of ankle extensor muscle afferent inputs on hip abductor and adductor activity in the decerebrate walking cat.

    Science.gov (United States)

    Bolton, D A E; Misiaszek, J E

    2012-12-01

    Electrical stimulation of the lateral gastrocnemius-soleus (LGS) nerve at group I afferent strength leads to adaptations in the amplitude and timing of extensor muscle activity during walking in the decerebrate cat. Such afferent feedback in the stance leg might result from a delay in stance onset of the opposite leg. Concomitant adaptations in hip abductor and adductor activity would then be expected to maintain lateral stability and balance until the opposite leg is able to support the body. As many hip abductors and adductors are also hip extensors, we hypothesized that stimulation of the LGS nerve at group I afferent strength would produce increased activation and prolonged burst duration in hip abductor and adductor muscles in the premammillary decerebrate walking cat. LGS nerve stimulation during the extensor phase of the locomotor cycle consistently increased burst amplitude of the gluteus medius and adductor femoris muscles, but not pectineus or gracilis. In addition, LGS stimulation prolonged the burst duration of both gluteus medius and adductor femoris. Unexpectedly, long-duration LGS stimulus trains resulted in two distinct outcomes on the hip abductor and adductor bursting pattern: 1) a change of burst duration and timing similar to medial gastrocnemius; or 2) to continue rhythmically bursting uninterrupted. These results indicate that activation of muscle afferents from ankle extensors contributes to the regulation of activity of some hip abductor and adductor muscles, but not all. These results have implications for understanding the neural control of stability during locomotion, as well as the organization of spinal locomotor networks. PMID:22972967

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

    OpenAIRE

    Kandogan, Tolga; Aksoy, Gökce; Dalgic, Abdullah

    2012-01-01

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

  4. 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.

  5. 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

  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. [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.

  8. 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.

  9. 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.

  10. ABERRANT ABDUCTOR DIGITI MINIMI MUSCLE FOUND DURING OPEN SURGICAL DECOMPRESSION OF THE CARPAL TUNNEL: CASE REPORT. MÚSCULO ABDUCTOR DIGITI MINIMI ABERRANTE HALLADO DURANTE UNA CIRUGÍA ABIERTA DESCOMPRESIVA DEL TUNEL CARPIANO: REPORTE DE CASO

    OpenAIRE

    Svetoslav A. Slavchev; Georgiev, Georgi P.

    2013-01-01

    Herein, we present an interesting case of an aberrant hypothenar muscle found during carpal tunnel decompression. The variant muscle arised from the voloradial antebrachial fascia and coursed over the ulnar artery and nerve in the Guyon canal, and inserted into the ulnar aspect of the hypothenar. Tension on the muscle belly provided slight abduction of the fifth metacarpophalangeal joint, which confirmed it to be an aberrant abductor digiti minimi muscle. We also discuss different variations ...

  11. The Effect of an Inclined Ankle on the Activation of the Abductor Hallucis Muscle during Short Foot Exercise

    OpenAIRE

    Heo, Hyo-Jin; An, Duk-hyun

    2014-01-01

    [Purpose] The purpose of this study was to identify the effects of an inclined ankle on the activation of the abductor hallucis muscle during short foot exercises. [Subjects] We recruited 14 healthy volunteers who were free of pain, and did not suffer from arthritis or osteomuscular problems related to the foot or ankle. [Methods] The subjects performed short foot exercises and short inclined foot exercises with 30° passive ankle dorsiflexion. [Results] The exercise with an inclined foot show...

  12. 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. .

  13. 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 adductor torque ratios were significantly higher on the affected side (p = .008). The adductor 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. PMID:27017973

  14. 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

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

    Science.gov (United States)

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

    2009-01-01

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

  16. 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…

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

    Science.gov (United States)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

    Aronson, Arnold E.

    1971-01-01

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

  1. 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…

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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...

  7. 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.      

  8. 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...

  9. 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.

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

    OpenAIRE

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

    2013-01-01

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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  19. [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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. 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

  4. The effect of abductor muscle and anterior-posterior hip contact load simulation on the in-vitro primary stability of a cementless hip stem

    Directory of Open Access Journals (Sweden)

    Frei Hanspeter

    2010-06-01

    Full Text Available Abstract Background In-vitro mechanical tests are commonly performed to assess pre-clinically the effect of implant design on the stability of hip endoprostheses. There is no standard protocol for these tests, and the forces applied vary between studies. This study examines the effect of the abductor force with and without application of the anterior-posterior hip contact force in the in-vitro assessment of cementless hip implant stability. Methods Cementless stems (VerSys Fiber Metal were implanted in twelve composite femurs which were divided into two groups: group 1 (N = 6 was loaded with the hip contact force only, whereas group 2 (N = 6 was additionally subjected to an abductor force. Both groups were subjected to the same cranial-caudal hip contact force component, 2.3 times body weight (BW and each specimen was subjected to three levels of anterior-posterior hip contact load: 0, -0.1 to 0.3 BW (walking, and -0.1 to 0.6 BW (stair climbing. The implant migration and micromotion relative to the femur was measured using a custom-built system comprised of 6 LVDT sensors. Results Substantially higher implant motion was observed when the anterior-posterior force was 0.6BW compared to the lower anterior-posterior load levels, particularly distally and in retroversion. The abductor load had little effect on implant motion when simulating walking, but resulted in significantly less motion than the hip contact force alone when simulating stair climbing. Conclusions The anterior-posterior component of the hip contact load has a significant effect on the axial motion of the stem relative to the bone. Inclusion of the abductor force had a stabilizing effect on the implant motion when simulating stair climbing.

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

    Matteson, Sam; Lu, Fang-Ling

    2008-10-01

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

  7. 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.

  8. 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.)

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

    Institute of Scientific and Technical Information of China (English)

    张帅; 谢常宁; 刘勇; 吴平; 郭莹; 唐瑶云

    2012-01-01

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

  10. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus

    OpenAIRE

    Kim, Moon-Hwan; Yi, Chung-hwi; Weon, Jong-hyuck; Cynn, Heon-Seock; Jung, Do-Young; Kwon, Oh-yun

    2015-01-01

    [Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exerci...

  11. 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.

  12. 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.

  13. 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.

  14. [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.

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

    Science.gov (United States)

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

    2010-01-01

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

  16. 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

  17. National Spasmodic Torticollis Association

    Science.gov (United States)

    ... affected individuals and families. Finding Your Road to Happiness! Remember… You are not Alone! You can have ... of those living with dystonia. The DAN continuously works to adopt and advance a legislative agenda which ...

  18. 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

  19. [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.).

  20. 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.

  1. Botulinum toxin injection - larynx

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Corinne Fredouille

    2009-01-01

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

  3. 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.

  4. [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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Shivaji Patil

    2016-01-01

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

  7. 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

  8. 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.

  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. "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.

  11. 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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    宋维杰; 杜建群

    2015-01-01

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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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,…

  20. 痉挛性斜颈术前多层螺旋CT的诊断价值%Diagnostic value of multi-slice CT in the spasmodic torticollis before operation

    Institute of Scientific and Technical Information of China (English)

    李良才; 唐秉航; 陈信康; 何亚奇; 黄德成; 吴任国

    2009-01-01

    Objective To explore the method and its clinical value of Multi-slice CT (MSCT) in spasmodic torticollis (ST). Methods Thirty-three cases of spasmodic torticollis, including rotational type (18 cases, 55%), laterocollis(10 cases, 30%), bilateral retrocollis(5 cases, 15%), and the other 42 cases of normal persons as controls were studied using MSCT. The thickness of each paired cervical muscles in images were measured and compared. If hypertrophied muscles were found in different types of ST, the incrassated values on CT images and amplitude with EMG examination were measured and analyzed using Pearson's correlation test. Results (1) CT features of all 33 cases of ST correlated with its clinical types. The hypertrophied muscles in rotational type were distributed in the 1/4 postero-lateral region of rotational side and the 1/4 antero-lateral region of opposite side. The hypertrophied muscles in laterocollis were mainly distributed in the postero-lateral and antero-lateral region of same side. And the hypertrophied musles in laterocollis were distributed in the 1/4 postero-lateral region of both sides. (2) The thickness of cervical muscles could be measured correctly on axial CT images. The means of thickness of each paired cervical muscles in rotanional type and laterocollis showed significant differences(t = 2. 482~6. 540, P < 0. 05)The means of thickness of obliquns inferior, splenius capitis and semispinalis capitis in bilateral retrocollis showed significant differences with that of the normal group(F =4. 947~15.713, P <0.01)The increasing values of thickness of hypertrophied muscles on CT images and its amplitude with EMG examination showed positive correlation (r=0.713~0.963, P<0.01) (3) The results of MSCT and EMG examination could provide a basis of strategy for surgical treatment and improve the curative effect. Conclusions MSCT can clearly and definitely show the morphological change of cervical muscles in ST, and show the hypertrophied muscles

  1. 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

    Institute of Scientific and Technical Information of China (English)

    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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. [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.

  8. 足内侧跨供区(姆)展肌肌皮瓣重建大鱼际缺损的临床研究%Reconstruction of thenar eminence defects using modified medial pedis flap combined with abductor hallucis muscle transfer

    Institute of Scientific and Technical Information of China (English)

    李涛; 郑怀远; 陈振兵; 丛晓斌; 洪光祥

    2013-01-01

    Objective To explore the surgical technique of functional myocutaneous flap transfer for reconstruction of the appearance of the thenar eminence and thumb opposition,and to improve the design and harvest of medial pedis myocutaneous flap.Methods From November 2010 to January 2012,6 cases with skin and muscle defects of the thenar eminence were treated by modified medial pedis flap combined with abductor hallucis muscle transfer using microsurgical techniques.Functional exercises and physical therapy were initiated 3 weeks postoperatively.Electromyogram (EMG) of the thenar muscles was performed at 6 and 12 months after the transfer.Grip strength,pinch strength,British Medical Research Council (BMRC) muscle strength and sensory recovery grading were performed during the follow-up periods.Results Flaps in all cases survived well.The appearance of the flaps was similar to the normal skin of the hand.All cases had more than 12 months' followup.In all cases,voluntary abduction of the thumb by the transferred abductor hallucis was achieved and confirmed by EMG.EMG of the thenar muscles at 6 months showed a mixed pattern upon maximum voluntary contraction and an interference pattern at 12 months.Pain and touch perception returned at 6 months,while twopoint discrimination was 7.5 to 11.2 mm (mean,7.9 mm) at 12 months.BMRC sensory grading was S3+,while muscle power recovery was M3 to M4.Conclusion As a new myocutaneous flap,the modified medial pedis flap combined with abductor hallucis muscle transfer is effective for repairing thenar eminence defects.The flap had not only good appearance and sensory reinnervation,but also the transplanted hallucis abductor muscle results in satisfactory opposition function of the thumb once it is innervated.%目的 探索肌皮瓣动力重建大鱼际缺损的手术方式,改进足底内侧肌皮瓣的设计和切取方法,更好地重建大鱼际缺损区的逼真外形和对掌功能.方法 自2010年11月至2012年1月,游离移植足

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. [Movement disorders in David Copperfield].

    Science.gov (United States)

    Garćia Ruiz, P J; Gulliksen, L L

    1999-01-01

    Charles Dickens' novels are a source of vivid neurological descriptions. Besides Pickwickian syndrome, many other neurological descriptions can be found in Dickens' novels. David Copperfield contains several characters with movement disorders including generalized dystonia (Mr. Uriah Heep), restless legs syndrome (the waiter), cervical dystonia (Mr. Sharp) and spasmodic dysphonia (Mr. Creakle). These neurological descriptions an probably based on the observation of actual patients. PMID:10570623

  14. 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.

  15. 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.

  16. 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.

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

    Institute of Scientific and Technical Information of China (English)

    黄纯臣; 王钦; 马昱; 毛悦时; 刘骏桢; 张宇浩

    2012-01-01

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

  18. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Roy N; 王刚

    2010-01-01

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

  20. 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

  1. 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.

  2. 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.

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

    Institute of Scientific and Technical Information of China (English)

    赵鸣; 杨亦鸣; 王梅; 刘红; 方环海; 方环非

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    高晓葳; 黄永望; 刘丽燕; 李超; 牛俊涛; 傅德慧; 欧阳杰

    2015-01-01

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

  5. 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

  6. 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.

  7. 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.

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

    Institute of Scientific and Technical Information of China (English)

    李燕; 郑宏良

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴红敏; 王伟; 郑宏良; 李玎; 李孟

    2011-01-01

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

  10. 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.

  11. 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.

  12. Reliability and Applicability of Aerodynamic Measures in Dysphonia Assessment

    Science.gov (United States)

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

    2004-01-01

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

  13. Role of Laryngological Consultation in the Intervention of Dysphonia

    Science.gov (United States)

    Stone, Ed.; And Others

    1978-01-01

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

  14. 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

  15. 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.

  16. 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...

  17. 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.

    was further purified over sephadex LH-20 using acetone as eluent, yielding subfractions 1-9-1 to 1-9-4. Bioassay of these fractions located the activity in fraction 1-9-3. Final purification of the above fraction was carried out on a silica gel column using... 1: NMR assignment of peridininol (400 MHz, CDC13) Carbon No C-1' C-2' C-3' C-4' C-5' C-6' C-7' C-8' C-9' C-10' C-11' C-12' C-13' C-14' C-15' C-16' C-17' C-18' C-19' C-20' C-l C-2 C-3 C-4 C-5 C-6 C-7 C-8 C-9 C-10 C-11 C-14 C-15 C-16 C-17 C-18 C-19 13...

  18. [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.

  19. 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...

  20. 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.

  1. 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.

  2. 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.

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

    Science.gov (United States)

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

    1997-07-01

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

  4. 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.

  5. 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.

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

    Science.gov (United States)

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

    2014-05-01

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

  7. 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.

  8. 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

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Science.gov (United States)

    Awan, Shaheen N.; Roy, Nelson

    2009-01-01

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

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

    NARCIS (Netherlands)

    Y. Maryn; D. Weenink

    2015-01-01

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

  12. 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

  13. [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.

  14. 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.

  15. 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.

  16. 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...

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

    Directory of Open Access Journals (Sweden)

    Mohsen Rajati

    2014-07-01

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

  18. “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...

  19. 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。

  20. 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.

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

    Science.gov (United States)

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

    2011-01-01

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

  2. 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)

  3. 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.

  4. Clinical use of non-A botulinum toxins: botulinum toxin type B.

    Science.gov (United States)

    Dressler, D; Eleopra, R

    2006-04-01

    Botulinum neurotoxin type B (BT, BT-B) has been used as NeuroBloc/MyoBloc since 1999 for treatment of cervical dystonia, hyperhidrosis, spastic conditions, cerebral palsy, hemifacial spasm, bladder dysfunction, spasmodic dysphonia, sialorrhoea, anal fissures, piriformis syndrome, various pain conditions and cosmetic applications. Generally, its therapeutic effects are comparable to BT type A (BT-A). The adverse effect profiles of BT-B and BT-A, however, differ considerably. BT-B has been found to produce more regional as well as systemic anticholinergic adverse effects, such as dryness of mouth, accommodation difficulties, conjunctival irritation, reduced sweating, dysphagia, heartburn, constipation, bladder voiding difficulties and dryness of nasal mucosa. In BT-B the relationship between autonomic and motor effects known from BT-A is substantially shifted towards autonomic effects. BT-B, therefore, should be used carefully in patients with autonomic disorders and in patients with concomitant anticholinergic therapy. If NeuroBloc/MyoBloc is used to treat cervical dystonia patients with antibody-induced failure of BT-A therapy, 86% of those will develop complete secondary therapy failure after five applications. If NeuroBloc/MyoBloc used to treat cervical dystonia patients without prior exposure to BT, 44% of those will develop complete secondary therapy failure after nine applications. NeuroBloc/MyoBloc, therefore, is associated with substantial antigenicity problems originating from a particular low specific biological potency. Systemic anticholinergic adverse effects and high antigenicity limits the clinical use of NeuroBloc/MyoBloc considerably. PMID:16785108

  5. 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.

  6. 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. PMID:26139341

  7. Inter-rater reliability of isometric hip abductor strength, 1RM leg press, hamstrings flexibility and the Star Excursion Balance Test in elite female football- and handball players: A methodological stud

    OpenAIRE

    Harøy, Joar

    2013-01-01

    Strength-, flexibility- and balance measures are tools used to examine risk factors for injuries in a clinical setting. In an on-going prospective cohort study at the Oslo Sports Trauma Research Center aimed at investigating risk factors for ACL injuries in elite female football- and handball players several of these tests are used. The different tests have shown high inter-rater reliability, but the studies are rarely conducted on elite female football- or handball players. Th...

  8. Myxoma Virus Leukemia-Associated Protein Is Responsible for Major Histocompatibility Complex Class I and Fas-CD95 Down-Regulation and Defines Scrapins, a New Group of Surface Cellular Receptor Abductor Proteins

    OpenAIRE

    Guerin, Jean-Luc; Gelfi, Jacqueline; Boullier, Severine; Delverdier, Maxence; Bellanger, Frederique-Anne; Bertagnoli, Stephane; Drexler, Ingo; Sutter, Gerd; Messud-Petit, Frederique

    2002-01-01

    Down-modulation of major histocompatibility class I (MHC-I) molecules is a viral strategy for survival in the host. Myxoma virus, a member of the Poxviridae family responsible for rabbit myxomatosis, can down-modulate the expression of MHC-I molecules, but the viral factor(s) has not been described. We cloned and characterized a gene coding for an endoplasmic reticulum (ER)-resident protein containing an atypical zinc finger and two transmembrane domains, which we called myxoma virus leukemia...

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

    Institute of Scientific and Technical Information of China (English)

    唐惠兰

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    邓荣瑛; 李巧玉

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    于萍; 王国建; 韩冰; 杨伟炎; 韩东一

    2004-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    彭策; 熊屹; 陈文西; 万柏坤

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    于萍; 黄冬雁; Revis Joana; Giovanni Antoine

    2004-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

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

  15. 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,...

  16. 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.

  17. 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.

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

    Institute of Scientific and Technical Information of China (English)

    郑巧; 段辉菊; 吴洁

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙文海; 刘华敏; 梁大鹏; 万秀明; 丛志强; 王海萍

    2006-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张武宁; 吴铖林; 李永湘; 钟晖; 毛海燕

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    柴维敏

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    黄卫; 徐洁洁; 陈曦; 陆美萍

    2003-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    于萍; Giovanni Antoine

    2003-01-01

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

  4. 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.

  5. 药物结合发声训练治疗功能性发音障碍的临床研究%Clinic research on voice training in the treatment of functional dysphonia

    Institute of Scientific and Technical Information of China (English)

    王飞; 肖永涛; 黄昭明

    2010-01-01

    目的 探讨发声训练在功能性发音障碍治疗中的疗效及意义.方法 运用药物结合发声训练的方法 对66例功能性发音障碍患者进行嗓音治疗,并与69例单纯药物治疗者进行对照.比较分析其治疗前后基频微扰、振幅微扰、标准化噪声能量三个参数的变化和症状改善情况.结果 试验组患者治疗后的基频微扰、振幅微扰和标准化噪声能量与治疗前相比差异均有显著统计学意义(均P<0.01),基频微扰、振幅微扰在治疗后达到正常值范围:与对照组相比较,试验组患者的基频微扰、振幅微扰和标准化噪声能量治疗后差异也有显著统计学意义(均P<0.01).结论 在功能性发音障碍治疗中,发声训练是一种有效治疗手段;应将药物治疗与发声训练相结合.

  6. Research of Functional Dysphonia by Laryngoscopy Acoustic Analysis and Aero-dynamic Measurement%功能性发声障碍的喉镜观察及声学、空气动力学研究

    Institute of Scientific and Technical Information of China (English)

    黄卫; 徐洁洁; 陈曦; 陆美萍

    2005-01-01

    目的观察功能性发声障碍患者的喉镜图像、嗓音声学特征及空气动力学变化,探讨其在功能性发声障碍诊断、分类中的价值.方法对78例功能性发声障碍患者和50例正常成人进行喉镜检查,并对嗓音元音信号/a:/进行声学和空气动力学测试,观察喉部图像特征,分析声学和空气动力学参数特点并行统计学分析.结果根据颈部及喉镜检查结果将功能性发声障碍分为高功能性发声障碍及低功能性发声障碍两组.高功能性发声障碍患者基频升高,平均气流率降低.低功能性发声障碍患者基频降低,平均气流率增加.所有功能性发声障碍患者频率微扰(jitter)、振幅微扰(shimmer)、标准化噪声能量(NNE)较正常增高,最大发声时间(MPT)均缩短.91.03%的功能性发声障碍患者嗓音信号中出现正常声学特征.声谱图均表现为谐波及共振峰不规则、断裂甚至消失,噪声成分增加等.结论采用喉镜、声学和空气动力学检测方法有助于功能性发声障碍的分类、诊断及鉴别诊断.

  7. 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 .

  8. The Clinical Significance of Calculating the Coefficients of Lyapunov in the Objective Assessment of Dysphonia%Lyapunov系数在嗓音障碍评估中的意义

    Institute of Scientific and Technical Information of China (English)

    于萍; Ouaknine Maurice; Giovanni Antoine

    2006-01-01

    目的探讨Lyapunov系数在嗓音障碍客观分析中的意义,完善嗓音障碍的客观测试方法.方法声音样本采自132例嗓音障碍患者和47例嗓音正常者.采用法国开发的"EVA"嗓音工作站,选择2秒平稳段长元音/α:/声信号作为分析样本,测试基频微扰(jitter)和计算Lyapunov系数.主观听感知评估采用日本言语音声学会制定的嗓音障碍评估系统GRBAS中的总嘶哑度(grade, G),4级评估标准.结果Lyapunov系数在不同的嗓音障碍分级组间均有统计学差异,jitter只在中度和重度嗓音障碍组间有统计学差异;Lyapunov系数与听感知评估结果的一致性达到46%,jitter的一致性为36%.回归分析结果显示,Lyapunov系数和jitter之间既有相关性,但又有不同(r2=0.582,P<0.001).结论Lyapunov系数对嗓音障碍的测试优于jitter;非线性动态系统(相位图)的引入,为嗓音的客观分析开辟了新的研究领域.

  9. Laryngoscopic evaluation the hyper functional dysphonia with the polyps of vocal cord%高功能型发声障碍继发声带息肉的视频下活动状态分析

    Institute of Scientific and Technical Information of China (English)

    路承; 李革临; 张道行

    2013-01-01

    Objective Research of the incidence of hyper functional dysphonic among the patients with polyps or nodules in vocal cord by analyzing the pictures and videos of laryngoscopy, and initially try to find out the necessity of vocal rehabilitation training for the patients after operations and also provide quantitative reference value for voice correction after vocal cord polyp surgery. Methods Choose 302 cases from almost 2000 patients with polyps or nodules in vocal cords, evaluate their laryngoscopic videos and concluding data. Results Hyper functional dysphonic was divided into four types by Koufman criterion according to the laryngoscopy results based on morphological, which was made by, type 1 41 cases(13.57%), type 2 23 cases(7.61%), type 3 38 cases(12.58%), type 4 19 cases(6.29%). Therefore, the ratios of hyper functional dysphonic was 121/302(40.6%).Conclusion Laryngoscopy is very helpful for evaluating and analysing hyper funtional dysphonic of the patients with polyps or nodules in vocal cord.%目的 ①通过电子喉镜检查声带息肉患者术前术后的喉镜视频及图像,归纳分析,探讨声带息肉患者中有高功能性发声障碍者的发生概率.初步分析嗓音发声训练对于声带息肉术后嗓音治疗的必要性.②为声带息肉手术后进行嗓音矫治提供量化参考数值.方法 对2006年10月~2010年1月期间,302例年龄在20~68岁声带息肉患者进行喉镜检查,观察喉部视频及图像特征,评价并做分析.结果 对喉镜检查结果根据形态特点以KOUFMAN标准将高功能性发声障碍分为四种类型其中Ⅰ型41例占13.57%,Ⅱ型23例占7.61%,Ⅲ型38例占12.58%,Ⅴ型19例占6.29%(共121例).高功能性发声障碍比例为121/302,占40.06%.结论 采用喉镜检查有助于对声带息肉患者进行嗓音评价,以决定是否术后进行嗓音矫治.

  10. Application of acoustic analysis by computer in diagnosis and voice therapy of functional dysphonia%计算机声学测试在功能性发音障碍诊断和治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    陆美萍; 徐洁洁; 陈曦; 王娟

    2008-01-01

    目的:观察功能性发音障碍嗓音声学参数及声谱图特征并进行视听反馈性发声训练,探讨计算机声学测试技术在功能性发音障碍诊断和治疗中的应用价值.方法:采用计算机嗓音声学测试系统对68例功能性发音障碍患者及50例正常成人嗓音元音信号"α"进行测试,观察分析声学参数jitter、shimmer、NNE及声谱图特征,同时利用同一软件对功能性发音障碍患者进行视听反馈性发声训练,并观察治疗前后声学特征的改变.结果:功能性发音障碍噪音shimmer、NNE值较正常升高并有统计学意义;声谱图主要表现中、高频区谐波及共振峰病理改变.75%(51/68)患者能在某次元音信号的一段或几段声样中找到正常声学特征.通过视听反馈矫治86%(59/68)患者首次门诊就诊时即能掌握正确的发声方法,声学测试可显示一次元音信号的全程声样出现正常或明显改善的声学参数及声谱图.结论:计算机声学测试可通过观察嗓音的声学特征与器质性发音障碍相鉴别,视听反馈性发声训练简单、直观、有效.

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

    OpenAIRE

    Marcela Guimarães Côrtes; Ana Cristina Côrtes Gama

    2010-01-01

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

  12. 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.

  13. 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 ...

  14. 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.

  15. 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.

  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. 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.

  19. 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.

  20. Speech and Communication Disorders

    Science.gov (United States)

    ... or understand speech. Causes include Hearing disorders and deafness Voice problems, such as dysphonia or those caused by cleft lip or palate Speech problems like stuttering Developmental disabilities Learning disorders Autism spectrum disorder Brain injury Stroke Some speech and ...

  1. [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.

  2. 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

  3. 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.

  4. [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.

  5. 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.

  6. 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...

  7. 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...

  8. Hip Revision

    Medline Plus

    Full Text Available ... the abductor fibers -- kind of a more vertical fashion so you kind of create a recess for ... Thank you, Todd. Have a good night. [Exit music] Thank you for watching this OR Live webcast ...

  9. The effects of hip muscle strengthening on knee load, pain, and function in people with knee osteoarthritis: a protocol for a randomised, single-blind controlled trial

    OpenAIRE

    Hunter David J; Wrigley Tim V; Hunt Michael A; Bennell Kim L; Hinman Rana S

    2007-01-01

    Abstract Background Lower limb strengthening exercises are an important component of the treatment for knee osteoarthritis (OA). Strengthening the hip abductor and adductor muscles may influence joint loading and/or OA-related symptoms, but no study has evaluated these hypotheses directly. The aim of this randomised, single-blind controlled trial is to determine whether hip abductor and adductor muscle strengthening can reduce knee load and improve pain and physical function in people with me...

  10. 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

  11. 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.

  12. Laughter as Immanent Life-Affirmation: Reconsidering the Educational Value of Laughter through a Bakhtinian Lens

    Science.gov (United States)

    Vlieghe, Joris

    2014-01-01

    In this article I try to conceive a new approach towards laughter in the context of formal schooling. I focus on laughter in so far as it is a bodily response during which we are entirely delivered to uncontrollable, spasmodic reactions. To see the educational relevance of this particular kind of laughter, as well as to understand why laughter is…

  13. [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.

  14. 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.

  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. Perceived loading and muscle activity during hip strengthening exercises

    DEFF Research Database (Denmark)

    Brandt, Mikkel; Jakobsen, Markus Due; Thorborg, Kristian;

    2013-01-01

    category rating 10 scale (Borg CR10 scale) can be a useful tool for estimating the intensity of exercise. The aims of this study were 1) to investigate the feasibility of the use of the Borg CR10 scale for rating strength training intensity of the hip abductor and hip adductor muscles, and 2) to compare...... resistance training of the hip adductor and hip abductor muscles. Although elastic resistance and exercise machine seem equally effective for recruiting muscle activity of the hip adductors, the elastic resistance condition was able to demonstrate greater muscle recruitment than the exercise machine during...

  17. Differences in Dysfunction of Thenar and Hypothenar Motoneurons in Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Fang, Jia; Cui, Liying; Liu, Mingsheng; Guan, Yuzhou; Li, Xiaoguang; Li, Dawei; Cui, Bo; Shen, Dongchao; Ding, Qingyun

    2016-01-01

    This study aimed to determine differences in spinal motoneuron dysfunction between the abductor pollicis brevis (APB) and the abductor digiti minimi (ADM) in amyotrophic lateral sclerosis (ALS) patients based on studying F-waves. Forty ALS patients and 20 normal controls (NCs) underwent motor nerve conduction studies on both median and ulnar nerves, including F-waves elicited by 100 electrical stimuli. The F-wave persistence (P CMAP) amplitude ratio. Thus, F-waves may reveal subclinical alterations in anterior horn cells, and may potentially help to distinguish ALS from mimic disorders. PMID:27014030

  18. Behavioral and Environmental Analysis of Self-Reported Dysphonic and Non-Dysphonic High School Music Teachers

    Science.gov (United States)

    Brown, Emily Pence

    2016-01-01

    Vocal fatigue and dysphonia are considered to be common hazards associated with occupational voice users. Teachers, due to the consistent communication demands of the profession, represent the highest percentage of clinical voice disorder patients (Verdolini & Ramig, 2001). Voice related injuries in teachers could result in lost wages due to…

  19. 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

  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. Laryngeal neurinoma. Differential diagnosis of submucosal laryngeal tumors; Neurinoma laringeo. Diagnostico diferencial de tumoraciones submucosas laringeas

    Energy Technology Data Exchange (ETDEWEB)

    Higuera, A.; Palomo, V.; Munoz, R.; Sanchez, F.

    2002-07-01

    Laryngeal neurinoma is a rare benign tumor that appears as a submucosal mass, generally in the supraglottic region. We report the case of a patient with dysphonia of long evolution caused by a neurinoma. We discuss the radiological findings of the tumor and the value of computed tomography (CT) in the diagnosis of this and other submucosal laryngeal lesions. (Author) 16 refs.

  2. 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…

  3. ‘ 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.

  4. The Acoustic Voice Quality Index: Toward Improved Treatment Outcomes Assessment in Voice Disorders

    Science.gov (United States)

    Maryn, Youri; De Bodt, Marc; Roy, Nelson

    2010-01-01

    Voice practitioners require an objective index of dysphonia severity as a means to reliably track treatment outcomes. To ensure ecological validity however, such a measure should survey both sustained vowels and continuous speech. In an earlier study, a multivariate acoustic model referred to as the Acoustic Voice Quality Index (AVQI), consisting…

  5. 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.

  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. 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

  8. 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…

  9. 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.

  10. 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.

  11. 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.

  12. MEDICINAL USES AND PHYTOCONSTITUENTS OF PAEONIA OFFICINALIS

    OpenAIRE

    Ahmad F; Tabassum N; Rasool S

    2012-01-01

    Paeonia officinalis (European peony, Common peony) has been cultivated in Europe for years. The root has been used medicinally for over 2,000 years mainly in the treatment for epilepsy and to promote menstruation. Root is also antispasmodic, diuretic, sedative and tonic and has been successfully employed in the treatment of convulsions and spasmodic nervous affections such as epilepsy. It has also been used in the treatment of whooping cough whilst suppositories are sometimes made of the root...

  13. Allergie affections of the larynx in children-a clinico pathological study

    OpenAIRE

    Sahoo, Gobind Chandra

    1999-01-01

    Laryngeal manifestation of allergy though less common than, Rhinosinusitis, tubotympanitis and bronchopulmanary allergy but it is not that uncommon which is usually misdiagnosed and mistreated in children. Hence the importance of larynx as the allergic shock organ in children with spasmodic croup and laryngotracheo bronchits. In the present study in children bellow five years, presenting with stridor and/or hoarsness were evaluated regarding the history of allergy, direct laryngoscopic findin...

  14. A clinico-pathological study of the role of allergy on larynx in children

    OpenAIRE

    Sahoo, Govind Chandra

    1999-01-01

    Laryngeal manifestation of allergy though less common than rhinosinusitis, tubotympanitis and bronchopulmonary allergy is not that uncommon and is usually misdiagnosed and mistreated in children. Hence, the importance of larynx as the allergic shock organ in children with spasmodic croup and laryngotracheo hronchits. In the present study, children below five years, presenting with Stridor and/or hoarseness were evaluated regarding the history of allergy, direct laryngoscopic finding, measurem...

  15. Two Cases of Baclofen-Induced Encephalopathy in Hemodialysis and Peritoneal Dialysis Patients

    OpenAIRE

    Lee, Junseop; Shin, Ho Sik; Jung, Yeon Soon; Rim, Hark

    2012-01-01

    Hiccups are a spasmodic contraction of the diaphragm and usually transient phenomenon that affects nearly everyone. When hiccups develop, the patients are administrated antispastic agent, such as balcofen. Baclofen is widely used for the treatment of this spastic movement disorders. Also, baclofen is a gamma-aminobutyric acid (GABA) derivative that induces presynaptic motor neuron inhibition and produces a central antispastic response. Baclofen toxicity is rare and has been reported with intr...

  16. Synthesis and anticonvulsant activity of certain chalcone based pyrazoline compounds

    OpenAIRE

    Sudhakara Rao Gerapati; Kalaichelvan V K; Ganguri Sudhakara Rao

    2015-01-01

    Convulsions are involuntary, violent, spasmodic and prolonged contractions of skeletal muscles. That means a patient may have epilepsy without convulsions and vice versa. Epilepsy is a common neurological abnormality affecting about 1% of the world population. The primary objectives of these synthesized compounds are to suppress seizures and provide neuroprotection by minimizing the effects from seizure attacks. Here some of the chalcones and chalcone based various pyrazolines were evaluated ...

  17. Cardiovascular effects of monoterpenes: a review

    OpenAIRE

    Márcio R. V. Santos; Flávia V. Moreira; Byanka P. Fraga; Damião P. de Souza; Leonardo R. Bonjardim; Lucindo J. Quintans-Junior

    2011-01-01

    The monoterpenes are secondary metabolites of plants. They have various pharmacological properties including antifungal, antibacterial, antioxidant, anticancer, anti-spasmodic, hypotensive, and vasorelaxant. The purpose of this research was to review the cardiovascular effects of monoterpenes. The data in this resarch were collected using the Internet portals Pubmed, Scopus, and ISI Web of Knowledge between the years 1987 and 2010. In the study 33 monoterpenes were included, which were relate...

  18. THE ROLE OF THE SCO IN FORMING THE CENTRAL ASIAN SECURITY ENVIRONMENT: GEOPOLITICAL ASPECTS

    OpenAIRE

    Shaimergenov, Timur; Tusupbaeva, Gulnar

    2006-01-01

    Of course it would be too declamatory to maintain that the Central Asian countries are acquiring a special significance in the international relations system, but we cannot deny the increased attention the global actors are focusing on them, mainly due to the geostrategic and economic potential of the region. The situation is complicated by the spasmodic development of certain processes in some of the region’s countries, the roots of which can be found in political and economic problems, as w...

  19. Reversal of functional disorders by aspiration, expiration, and cough reflexes and their voluntary counterparts

    OpenAIRE

    ZoltanTomori

    2012-01-01

    Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation (VF), but it fails to revive infants with sudden infant death syndrome (SIDS). Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are two distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations (SIs) can be elicited by nasopharyngeal stimulation, strongly activating the brains...

  20. Walking on high heels changes muscle activity and the dynamics of human walking significantly

    DEFF Research Database (Denmark)

    Simonsen, Erik Bruun; Svendsen, Morten B; Nørreslet, Andreas;

    2012-01-01

    phase was doubled when walking on high heels. The knee joint angle showed that high-heeled walking caused the subjects to flex the knee joint significantly more in the first half of the stance phase. In the frontal plane a significant increase was observed in the knee joint abductor moment and the hip...

  1. Isokinetic imbalance of hip muscles in soccer players with osteitis pubis.

    Science.gov (United States)

    Mohammad, Walaa Sayed; Abdelraouf, Osama Ragaa; Elhafez, Salam Mohamed; Abdel-Aziem, Amr Almaz; Nassif, Nagui Sobhi

    2014-01-01

    In this study, we compared the isokinetic torques of hip flexors/extensors and abductors/adductors in soccer players suffering from osteitis pubis (OP), with normal soccer players. Twenty soccer male athletes with OP and 20 normal soccer athletes were included in this study. Peak torque/body weight (PT/BW) was recorded from hip flexor/extensor and abductor/adductor muscles during isokinetic concentric contraction modes at angular velocity of 2.1 rad · s(-1), for both groups. The results showed a significant difference between the normal and OP groups for hip flexors (P adductor and abductor muscles (P > 0.05). Regarding the hip adductor/abductor PT ratio, there was no significant difference between the normal and OP groups of athletes (P > 0.05). The OP group displayed increase in hip flexor strength that disturbed the hip flexor/extensor torque ratio of OP. Therefore, increasing the hip extensor strength should be part of rehabilitation programmes of patients with OP. PMID:24499182

  2. Antifouling activity of Indian marine invertebrate against the green mussel Perna viridis L.

    Digital Repository Service at National Institute of Oceanography (India)

    PrabhaDevi; Jayasree, V.; Naik, C.G.; Parameswaran, P.S.; Raveendran, T.V.; Kamat, S.Y.

    . The shells of P. viridis were opened by cutting the posterior abductor muscles. The mussels were allowed to rest in FSW. A known concentration (100 ppm) of test solution was allowed to drip on the foot gently without stimulating the foot Correspondence to...

  3. Normative values of eccentric hip abduction strength in novice runners

    DEFF Research Database (Denmark)

    Jørgensen, Daniel Ramskov; Pedersen, Mette Broen; Kastrup, Kristrian;

    2014-01-01

    PURPOSE: Low eccentric strength of the hip abductors, might increase the risk of patellofemoral pain syndrome and iliotibial band syndrome in runners. No normative values for maximal eccentric hip abduction strength have been established. Therefore the purpose of this study was to establish...

  4. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging*

    Science.gov (United States)

    Rodrigues, Rogéria Nobre; Lopes, Alexia Abuhid; Torres, Jardélio Mendes; Mundim, Marina Franco; Silva, Lênio Lúcio Gavio; Silva, Breno Rabelo de Carvalho e

    2015-01-01

    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. PMID:26811554

  5. 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

  6. 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…

  7. 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

  8. Kashima's Posterior cordectomy using coablator our experience

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

  10. 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.

  11. Hip Revision

    Medline Plus

    Full Text Available ... your cable pass kind of scrape along the femur. Yeah, and same thing here then. I'm just going to make a little nick kind of in line. I'm always amazed -- the abductors up here are really kind of coming in at this angle. So you're saying you're going to ...

  12. 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

  13. 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

  14. On Risk Forecast and Risk Reduction of Tectonic Rock Bursts and Earthquakes

    Science.gov (United States)

    Tazhibaev, Kushbakali

    2015-04-01

    Avershin, Shrepp, Kvochkin, Bojarkin and others observed that before strong rock bursts, considered as weak earthquakes, for several hours, sometimes for 2-5 days, there occurred spasmodic and sign-variable changes in deformations of rock massif adjacent areas. The works of seismologists Rikitaki, Asada, Isibasi, Matsuda, Saverensky, etc. describe a number of cases of an earthquake before which spasmodic and sign-variable deformations of earth's crust have been observed. The results of our own experimental research conducted during last decades show that abnormal spasmodic and sign-variable deformations are observed only in rocks having residual stresses. As a rule, these rocks at test after such abnormal deformations collapse dynamically, like explosions, and as a rule, such rocks represent dangerous rock bursts in deposits, located in seismically active areas (Tazhibaev K. Conditions of dynamic destruction of rocks and causes of rock bursts, Frunze 1989). It is necessary to notice that these spasmodic deformations are accompanied by formation and movement of internal discontinuities: dislocations, micro-cracks, and, hence, by redistribution of electric charges in a crystal lattice, and also in the rock as a whole. Redistribution and change in position of electric charges lead to the change of the natural electric potential and intensity of the magnetic field in the rocks massif. Before tectonic rock bursts and earthquakes together with abnormal changes of deformation, the same spasmodic and sign-variable changes of the natural electric and magnetic fields intensity occur. Based on the above-stated experimental findings, for solution of the problem of tectonic earthquakes forecast, we suggest placing the deformation measuring tool, the magnetic field intensity measuring tool and the device for measurement of natural electric potential along with seismic measurement into the seismic stations. Using abnormal, simultaneous changes of indications of all above listed

  15. Remarkable difference in paralytic shellfish poisoning toxin distribution in tissues of pen shell atrina pectinata exposed to toxic red tide bloom

    International Nuclear Information System (INIS)

    Pen shell atrina pectinata is one of the commercially important bivalves in Western Pacific region. In the Philippines, it is marketed as a whole meat or processed by shellfish harvesters to separate the abductor muscle as an export commodity. During blooms of toxic dinoflagellate pyrodinium bahamense var. compressum (Pbc), A. pectinata accumulates paralytic shellfish poisoning (PSP) toxins sometimes exceeding Philippine regulatory limit of 60μgSTXeq/100g tissue and international regulatory limit of 80μgSTXeq/100g tissue for safe human consumption, based on whole tissue analysis. Toxic blooms directly affect the shellfish industry which includes A. pectinata, and this causes not only significant economical losses on shellfish gatherers but also serious public health concerns. In this study, samples of A. pectinata exposed to toxic bloom of Pbc were collected in Sorsogon Bay, Philippines. Bioaccumulation and distribution of PSP toxins were determined in different tissues namely, abductor muscle, mantle, gills, gonads, siphon, stomach and intestine using High Performance Liquid Chromatography post column derivatization method with fluorescence detection. Likewise, green mussels Perna viridis being the sentinel species for PSP monitoring in the Philippines were also collected in the same area and served as control. Interestingly, results showed that the abductor muscle accumulates minimal level of PSP toxins and is several folds lower than the Philippine and international regulatory limits in contrast with the results obtained from P. viridis. Mantle parts showed toxicity values exceeding local regulatory limit and near to go beyond the international regulatory limit. Conversely, the remaining parts showed high toxicity values surpassing both regulation limits. Standard mouse bioassay regulatory used in PSP monitoring in the Philippines was also performed and revealed that the abductor muscle had non-detectable level of toxins. Also, toxicity values from different

  16. Vocal therapy with larynx compression after partial laryngectomy

    Directory of Open Access Journals (Sweden)

    Mumović Gordana M.

    2011-01-01

    Full Text Available The aim of the study was to establish the effects of the vocal therapy by manual compression of the larynx on dysphonia due to a partial laryngectomy and compare them with the effects of the standard vocal therapy. The prospective study included 66 patients submitted to any partial laryngectomy type. The patients were randomly classified into two groups: Group I (33 receiving the standard vocal therapy, and Group II (33 submitted to larynx compression vocal therapy. The 6-week vocal treatment was performed. The treatment effects were evaluated by subjective and objective voice analysis methods. The subjective and objective acoustic voice analysis revealed a significant influence (p<0.05 of either of the two vocal therapy modes on initial dysphonia. The larynx compression vocal therapy had better effects on the acoustic parameters: habitual fundamental frequency, mean fundamental frequency, standard deviation of fundamental frequency, maximal fundamental frequency, harmonics-to-noise ratio, and signal-to-noise ratio.

  17. A lifetime of professional singing: Voice parameters and age in the Netherlands Radio Choir.

    Science.gov (United States)

    Berghs, Geert; Creylman, Nena; Avaux, Marianne; Decoster, Wivine; de Jong, Felix

    2013-07-01

    In professional choirs one would like to identify the incidence and severity of vocal problems due to ageing, and know how to influence them. The aim of the current study was to investigate to what extent easily obtainable voice parameters were age-related. From 47 singers of the Netherlands Radio Choir the Voice Range Profile parameters and the vibrato characteristics were measured. Dysphonia Severity Index (DSI) was calculated. We found that the age of male and female singers correlated negatively to the highest fundamental frequency and the Dysphonia Severity Index. No signs of slower and wider vibrato were found. These findings can lead to identifying adequate parameters e.g. for the ageing voice, useful in larger groups of professional singers. PMID:23116370

  18. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

    Directory of Open Access Journals (Sweden)

    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.

  19. Benign Lesions of The Vocal Fold

    Directory of Open Access Journals (Sweden)

    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  20. Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx

    OpenAIRE

    Ido Filho, Jorge Massaaki; Carvalho, Bettina; Mizoguchi, Flavio Massao; Catani, Guilherme Simas do Amaral; Macedo Filho, Evaldo Dacheux de; Malafaia, Osvaldo; Stahlke Jr., Henrique Jorge

    2014-01-01

    Summary Introduction: Dysphonia is the main symptom of lesions that affect the vocal tract. Many of those lesions may require surgical treatment. Polyps are one of the most common forms of vocal cord lesions and the most prevalent indication for laryngeal microsurgery. There are different types of polyps, and their different characteristics can indicate different prognosis and treatments. Aim: To conduct a comparative study of polypoid lesions (angiomatous and gelatinous) in patients undergoi...

  1. [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.

  2. Acoustic measurement of overall voice quality in sustained vowels and continuous speech

    OpenAIRE

    Maryn, Youri

    2010-01-01

    Measurement of dysphonia severity involves auditory-perceptual evaluations and acoustic analyses of sound waves. Meta-analysis of proportional associations between these two methods showed that many popular perturbation metrics and noise-to-harmonics and others ratios do not yield reasonable results. However, this meta-analysis demonstrated that the validity of specific autocorrelation- and cepstrum-based measures was much more convincing, and appointed ‘smoothed cepstral peak prominence’ as ...

  3. An undiagnosed myasthenia gravis presenting as isolated recurrent acute respiratory failure

    OpenAIRE

    Shri Ram Sharma; Nalini Sharma; Yeolekar, M E

    2012-01-01

    Acute respiratory failure is an uncommon initial presentation of myasthenia gravis (MG). In our case a 22-year-old woman of unrecognized MG presented to the emergency department with isolated respiratory failure as the first presenting symptom. Initially she presented with dysphonia and was managed by speech therapist and ENT surgeons for 3 months. Subsequently, she presented with signs and symptoms of sepsis and went into acute respiratory failure. This case highlights the need to consider M...

  4. Occupational voice demands and their impact on the call-centre industry

    OpenAIRE

    Duffy OM; Hazlett, DE; Moorhead SA

    2009-01-01

    Abstract Background Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a...

  5. Comparison of Morphometric Aspects of Light and Electron Microscopy of the Hypoglossal Nerve between Young and Aged Male Wistar Rats

    OpenAIRE

    Mohsen Pourghasem; Yasser Asghari Vostacolaee; Nabiollah Soltanpour

    2012-01-01

    Objective: Age-related changes occur in many different systems of the body. Many elderly people show dysphagia and dysphonia. This research was conducted to evaluate quantitatively the morphometrical changes of the hypoglossal nerve resulting from the aging process in young and aged rats. Materials and Methods: Through an experimental study ten male wistar rats (4 months: 5 rats, 24 months: 5 rats) were selected randomly from a colony of wistars in the UWC. After a fixation process and prepar...

  6. A database and digital signal processing framework for the perceptual analysis of voice quality

    OpenAIRE

    Bermúdez de Alvear, Rosa M.; Corral, Jesús; Tardón, Lorenzo J.; Barbancho, Ana M.; Fernández-Contreras, Elena; Rando-Márquez, Sara; Martínez-Arquero, A. Ginés; Barbancho, Isabel

    2015-01-01

    Introduction. Clinical assessment of dysphonia relies on perceptual as much as instrumental methods of analysis [1]. The perceptual auditory analysis is potentially subject to several internal and external sources of bias [2]. Furthermore acoustic analyses which have been used to objectively characterize pathological voices are likely to be affected by confusion variables such as the signal processing or the hardware and software specifications [3]. For these reasons the poor correlation betw...

  7. An unusual presentation of an infected vallecular cyst presenting as supraglottitis

    OpenAIRE

    Pattni, Vijay; Porter, Graham; Omakobia, Eugene

    2013-01-01

    A 50-year-old gentleman presented to the emergency department with a 24 h history of stridor, dysphonia, dysphagia and vomiting. On examination, the patient had fever and tachycardic. There was no palpable cervical lymphadenopathy. Flexible nasendoscopy and lateral neck x-ray revealed soft tissue swelling around the epiglottis. The swelling subsided with conservative management of intravenous antibiotics and steroids, only to later reveal a vallecular cyst, which was confirmed on microlaryngo...

  8. A RARE CASE OF IMPACTED VEGETATIVE FOREIGN BODY IN LARYNX: XANTHIUM STRUMARIUM (CHHOTA GOKHRU)

    OpenAIRE

    Richa,; Surendra Singh

    2013-01-01

    ABSTRACT: - BACKGROUND : Impaction of foreign bodies in the larynx constit utes a medical emergency and requires immediate intervention. We report a rare case of a Xanthium Strumarium (Chhota Gokhru) impacted in larynx in a 10 year old female who pre sented with complaint of respiratory distress & dysphonia in ENT department, S.S. Medical college and associated hospital, Rewa (M.P.). Direct laryngoscopy was performed for its removal. The case report thus...

  9. Relationships between CSID and vocal fold vibratory function

    Science.gov (United States)

    Cooke, Melissa L.

    High correlations have been reported between the acoustic-based Cepstral/Spectral Index of Dysphonia (CSID) and perceptual judgments of dysphonia. This study explores whether CSID provides additional insight and explains more of the variance in HSV-based properties of vocal fold vibratory function than has been reported for other acoustic measures. Using the Analysis of Dysphonia in Speech and Voice (ADSV) program, CSID and its component variables were correlated with HSV-based measures of glottal cycle aperiodicity and glottal area for 20 subjects who underwent phonomicrosurgery. Results indicate CSID is only marginally correlated with glottal cycle aperiodicity in pre- and post-surgical conditions and does not correlate as highly as the cepstral peak prominence alone. Additionally, results reveal higher correlations when examining within-subject change from pre-surgical to post-surgical assessments rather than correlating measures across subjects. Future directions are discussed that aim at improving our understanding of the relationships between acoustic parameters and underlying phonatory function.

  10. Complications of the anterior approach to the cervical spine

    Directory of Open Access Journals (Sweden)

    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.

  11. The role of head position and prior contraction in manual aiming.

    Science.gov (United States)

    Sidaway, Ben; Bonenfant, Derek; Jandreau, Jesse; Longley, Andrew; Osborne, Kayla; Anderson, David

    2015-01-01

    We sought to determine if the asymmetrical tonic neck reflex influences the accuracy of self-selected arm positioning without vision and to ascertain if such accuracy is influenced by a pre-contraction of the prime movers. Participants reproduced an arm position using their abductors with the head in midline, rotated towards and away from the arm. Arm movements were made with and without a pre-contraction of the abductors. Twenty participants performed eight trials in each of the six different conditions. Compared to the midline position, participants undershot the reference position with the head turned away and overshot the position with the head rotated towards the arm. A pre-contraction caused undershooting regardless of head position. Results suggest that head position and pre-contraction may have significant and independent effects on arm positioning.

  12. An ergonomics study of thumb movements on smartphone touch screen.

    Science.gov (United States)

    Xiong, Jinghong; Muraki, Satoshi

    2014-01-01

    This study investigated the relationships between thumb muscle activity and thumb operating tasks on a smartphone touch screen with one-hand posture. Six muscles in the right thumb and forearm were targeted in this study, namely adductor pollicis, flexor pollicis brevis, abductor pollicis brevis (APB), abductor pollicis longus, first dorsal interosseous (FDI) and extensor digitorum. The performance measures showed that the thumb developed fatigue rapidly when tapping on smaller buttons (diameter: 9 mm compared with 3 mm), and moved more slowly in flexion-extension than in adduction-abduction orientation. Meanwhile, the electromyography and perceived exertion values of FDI significantly increased in small button and flexion-extension tasks, while those of APB were greater in the adduction-abduction task. This study reveals that muscle effort among thumb muscles on a touch screen smartphone varies according to the task, and suggests that the use of small touch buttons should be minimised for better thumb performance.

  13. EMG analysis of the lower extremities during pitching in high-school baseball.

    Science.gov (United States)

    Yamanouchi, T

    1998-01-01

    I evaluated the contractions of the muscles of the lower extremities during baseball pitching using video imaging and simultaneous surface EMG. The subjects were 10 members of a high school baseball club and, for contrast, 10 students without any baseball club experience. I divided their pitching movements into two phases determined with respect to the landing of the non-pivot leg. The EMG signal intensities over the 2 seconds prior to landing, and over the 2 seconds after landing, were then integrated to give an EMG value to each phase. I then computed this value as the % MMT. The abductor and adductor of the hip muscles of both lower extremities in the players were strongly contracted, especially the adductor. This finding was consistent with the observation that pitching tends to lead to adductor muscle disorders. Strengthening the adductor and its antagonist abductor can therefore directly influence the capability for pitching, and can reduce the risk for the adductor disorders. PMID:9658746

  14. Abduction of children by their parents: a survey of the problem.

    Science.gov (United States)

    Hegar, R L; Greif, G L

    1991-09-01

    On the basis of a survey of a non-representative national sample of 371 parents who sought help from missing children's organizations, this article provides a profile of families in which children were abducted by one of the parents. Abductors were described as less educated and less likely to be employed than searching parents. In this survey, three-fourths of abducted children were younger than seven years of age; most abductions involved a single child. Although the abducting parents tended to be male (55 percent, n = 205), the proportion of female abductors was higher than in previous research. Mothers whose children were kidnapped by the father described more violence in their marriages, more fault-related reasons for divorce, and more force used in the abduction than did fathers whose children were kidnapped by the mother. The different family and social experiences of these men and women are discussed, and implications for social work practice are explored.

  15. Absence of split hand in the flail arm variant of ALS.

    Science.gov (United States)

    Sun, Xian; Zhang, Zhecheng; Liu, Na

    2016-04-01

    Flail arm syndrome (FAS), a variant of amyotrophic lateral sclerosis (ALS), has many similarities with upper limb onset ALS (UL-ALS). This study analyzed the compound muscle action potentials (CMAPs) recorded from abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles in patients presenting these two types of ALS variants, compared to normal controls. The APB/ADM CMAP amplitude ratio was lower in the UL-ALS group (mean±SEM: 0.56±0.37), consistent with a split hand, compared to the FAS (1.05±0.29) or control (1.11±0.30) groups. An abnormally reduced APB/ADM CMAP amplitude ratio (CMAP in the APB or extremely low APB/ADM CMAP amplitude ratio (<0.25) were observed only in UL-ALS patients (27%) and could be used as diagnostic criteria to differentiate UL-ALS from FAS variant. PMID:27157380

  16. Hand weakness in Charcot-Marie-Tooth disease 1X.

    LENUS (Irish Health Repository)

    Arthur-Farraj, P J

    2012-07-01

    There have been suggestions from previous studies that patients with Charcot-Marie-Tooth disease (CMT) have weaker dominant hand muscles. Since all studies to date have included a heterogeneous group of CMT patients we decided to analyse hand strength in 43 patients with CMT1X. We recorded handedness and the MRC scores for the first dorsal interosseous and abductor pollicis brevis muscles, median and ulnar nerve compound motor action potentials and conduction velocities in dominant and non-dominant hands. Twenty-two CMT1X patients (51%) had a weaker dominant hand; none had a stronger dominant hand. Mean MRC scores were significantly higher for first dorsal interosseous and abductor pollicis brevis in non-dominant hands compared to dominant hands. Median nerve compound motor action potentials were significantly reduced in dominant compared to non-dominant hands. We conclude that the dominant hand is weaker than the non-dominant hand in patients with CMT1X.

  17. Reversal of functional disorders by aspiration, expiration and cough reflexes and their voluntary counterparts

    Directory of Open Access Journals (Sweden)

    Zoltan eTomori

    2012-12-01

    Full Text Available Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation, but it fails to revive infants with sudden infant death syndrome. Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are 2 distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations can be elicited by nasopharyngeal stimulation, strongly activating the brainstem generator for inspiration, which is also involved in the control of gasping. This aspiration reflex (AspR is characterized by spasmodic inspiration without subsequent active expiration and can be elicited during agonal gasping, caused by brainstem trans-sections in cats. Stimulation of the larynx can activate the generator for expiration to evoke the expiration reflex, manifesting with prompt expiration without preceding inspiration. Stimulation of the oro-pharynx and lower airways provokes the cough reflex which results from activating of both generators. The powerful potential of the AspR resembling auto-resuscitation by gasping can influence the control mechanisms of vital functions, mediating reversal of various functional disorders.The AspR in cats interrupted hypoxic apnea, laryngo- and bronchospasm, apneusis and even transient asphyxic coma, and can normalize various hypo- and hyper-functional disorders. Introduction of a nasogastric catheter evoked similar spasmodic inspirations in premature infants and interrupted hiccough attacks in adults. Coughing on demand can prevent anaphylactic shock and resuscitate the pertinent subject. Sniff representing nasal inspiratory pressure and maximal inspiratory and expiratory pressures are voluntary counterparts of airway reflexes, and are useful for diagnosis and therapy of various cardio-respiratory and neuromuscular disorders.

  18. Normative values of eccentric hip abduction strength in novice runners

    DEFF Research Database (Denmark)

    Ramskov, D; Pedersen, M B; Kastrup, K;

    2014-01-01

    PURPOSE: Low eccentric strength of the hip abductors, might increase the risk of patellofemoral pain syndrome and iliotibial band syndrome in runners. No normative values for maximal eccentric hip abduction strength have been established. Therefore the purpose of this study was to establish norma...... abduction strength in novice runners, and these variables should be taken into account when evaluating eccentric hip abduction strength in this group of athletes. LEVEL OF EVIDENCE: 2A....

  19. Changes in Hip and Knee Muscle Strength in Patients Following Total Hip Arthroplasty

    OpenAIRE

    Fukumoto, Yoshihiro; Ohata, Koji; Tsukagoshi, Rui; Kawanabe, Keiich; Akiyama, Haruhiko; Mata, Toshihiro; Kimura, Misaka; Ichihashi, Noriaki

    2013-01-01

    Objective: To investigate changes in hip and knee muscle strength in patients before and after total hip arthroplasty (THA) in comparison with that in healthy adults. Methods: The study included 21 women who underwent unilateral THA (THA group) and 21 age-matched healthy women (healthy group). Maximal isometric strengths of hip flexors, extensors, and abductors, and knee extensors and flexors were measured before surgery and at 4 weeks and 6 months after surgery. Results: Before surgery, musc...

  20. Associations between iliotibial band injury status and running biomechanics in women.

    Science.gov (United States)

    Foch, Eric; Reinbolt, Jeffrey A; Zhang, Songning; Fitzhugh, Eugene C; Milner, Clare E

    2015-02-01

    Iliotibial band syndrome (ITBS) is a common overuse knee injury that is twice as likely to afflict women compared to men. Lower extremity and trunk biomechanics during running, as well as hip abductor strength and iliotibial band flexibility, are factors believed to be associated with ITBS. The purpose of this cross-sectional study was to determine if differences in lower extremity and trunk biomechanics during running exist among runners with current ITBS, previous ITBS, and controls. Additionally, we sought to determine if isometric hip abductor strength and iliotibial band flexibility were different among groups. Twenty-seven female runners participated in the study. Participants were divided into three equal groups: current ITBS, previous ITBS, and controls. Overground running trials, isometric hip abductor strength, and iliotibial band flexibility were recorded for all participants. Discrete joint and segment biomechanics, as well as hip strength and flexibility measures were analyzed using a one-way analysis of variance. Runners with current ITBS exhibited 1.8 (1.5)° greater trunk ipsilateral flexion and 7 (6)° less iliotibial band flexibility compared to runners with previous ITBS and controls. Runners with previous ITBS exhibited 2.2 (2.9) ° less hip adduction compared to runners with current ITBS and controls. Hip abductor strength 3.3 (2.6) %BM×h was less in runners with previous ITBS but not current ITBS compared to controls. Runners with current ITBS may lean their trunk more towards the stance limb which may be associated with decreased iliotibial band flexibility.

  1. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    Science.gov (United States)

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  2. Associations between iliotibial band injury status and running biomechanics in women.

    Science.gov (United States)

    Foch, Eric; Reinbolt, Jeffrey A; Zhang, Songning; Fitzhugh, Eugene C; Milner, Clare E

    2015-02-01

    Iliotibial band syndrome (ITBS) is a common overuse knee injury that is twice as likely to afflict women compared to men. Lower extremity and trunk biomechanics during running, as well as hip abductor strength and iliotibial band flexibility, are factors believed to be associated with ITBS. The purpose of this cross-sectional study was to determine if differences in lower extremity and trunk biomechanics during running exist among runners with current ITBS, previous ITBS, and controls. Additionally, we sought to determine if isometric hip abductor strength and iliotibial band flexibility were different among groups. Twenty-seven female runners participated in the study. Participants were divided into three equal groups: current ITBS, previous ITBS, and controls. Overground running trials, isometric hip abductor strength, and iliotibial band flexibility were recorded for all participants. Discrete joint and segment biomechanics, as well as hip strength and flexibility measures were analyzed using a one-way analysis of variance. Runners with current ITBS exhibited 1.8 (1.5)° greater trunk ipsilateral flexion and 7 (6)° less iliotibial band flexibility compared to runners with previous ITBS and controls. Runners with previous ITBS exhibited 2.2 (2.9) ° less hip adduction compared to runners with current ITBS and controls. Hip abductor strength 3.3 (2.6) %BM×h was less in runners with previous ITBS but not current ITBS compared to controls. Runners with current ITBS may lean their trunk more towards the stance limb which may be associated with decreased iliotibial band flexibility. PMID:25701012

  3. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note.

    Science.gov (United States)

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants. PMID:27298870

  4. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note

    OpenAIRE

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T.

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants.

  5. Function-Orientated Structural Analysis of the Proximal Human Femur

    OpenAIRE

    Skuban, Tobias P.; Vogel, Tobias; Baur-Melnyk, Andrea; Jansson, Volkmar; Heimkes, Bernhard

    2009-01-01

    In his model of the biomechanics of the proximal human femur, Friedrich Pauwels assumes a resultant force acting on the femoral head that is created by the partial body weight and the force of the abductor muscles inserting at the greater trochanter. This model suggests a tensile force in the region of the greater trochanter. An exact examination of the muscle insertions at the greater trochanter resulted in a contrasting hypothesis assuming a local compression stress in the region of the gre...

  6. Bilateral Simultaneous Heterotopic Ossification of the Reflected Head of Rectus Femoris Muscle: A Case Report and Review of the Literature

    OpenAIRE

    Murat Tonbul; Seyma Ozen; Ayse Tuba Tonbul

    2014-01-01

    Lamellar bone formation in an abnormal location is defined as heterotopic ossification. It commonly occurs around the hip joint and most often involves the abductor muscles. It is a benign condition; however, its etiology remains largely unknown. Most previously reported cases have been due to trauma or intramuscular hemorrhage. In this paper, we present a case of bilateral heterotopic ossification of the reflected head of rectus femoris muscle without antecedent trauma or any other known cau...

  7. Changes in corticospinal drive to spinal motoneurones following tablet-based practice of manual dexterity

    DEFF Research Database (Denmark)

    Larsen, Lisbeth Højkjær; Jensen, Thor; Christensen, Mark Schram;

    2016-01-01

    The use of touch screens, which require a high level of manual dexterity, has exploded since the development of smartphone and tablet technology. Manual dexterity relies on effective corticospinal control of finger muscles, and we therefore hypothesized that corticospinal drive to finger muscles...... movements included electroencephalographic (EEG) activity from primary motor cortex and electromyographic (EMG) activity from first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles. Changes in the corticospinal drive were evaluated from coupling in the frequency domain (coherence...

  8. [The importance of soft tissue stabilization in trans-femoral amputation].

    Science.gov (United States)

    Gottschalk, F

    2015-06-01

    Transfemoral amputations with more proximal amputation levels have the problem of secondary development into flexion and abduction contractures. This is induced by muscle imbalance, especially the loss of adductor muscle insertions when abductor muscle insertions are preserved. This causes considerable problems when fitting prosthetics. Myodesis with insertion of the distally detached adductor magnus muscle to the lateral femoral cortex, introduced here, results in a stronger stump with good muscle balance, and prosthetics fitting is significantly improved.

  9. The importance of soft tissue stabilization in trans-femoral amputation : English version.

    Science.gov (United States)

    Gottschalk, F

    2016-03-01

    Transfemoral amputations with more proximal amputation levels have the problem of secondary development into flexion and abduction contractures. This is induced by muscle imbalance, especially the loss of adductor muscle insertions when abductor muscle insertions are preserved. This causes considerable problems when fitting prosthetics. Myodesis with insertion of the distally detached adductor magnus muscle to the lateral femoral cortex, introduced here, results in a stronger stump with good muscle balance, and prosthetics fitting is significantly improved.

  10. Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

    OpenAIRE

    Petis, Stephen; Howard, James L.; Lanting, Brent L.; Vasarhelyi, Edward M.

    2015-01-01

    Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of...

  11. [The importance of soft tissue stabilization in trans-femoral amputation].

    Science.gov (United States)

    Gottschalk, F

    2015-06-01

    Transfemoral amputations with more proximal amputation levels have the problem of secondary development into flexion and abduction contractures. This is induced by muscle imbalance, especially the loss of adductor muscle insertions when abductor muscle insertions are preserved. This causes considerable problems when fitting prosthetics. Myodesis with insertion of the distally detached adductor magnus muscle to the lateral femoral cortex, introduced here, results in a stronger stump with good muscle balance, and prosthetics fitting is significantly improved. PMID:25971242

  12. The importance of soft tissue stabilization in trans-femoral amputation : English version.

    Science.gov (United States)

    Gottschalk, F

    2016-03-01

    Transfemoral amputations with more proximal amputation levels have the problem of secondary development into flexion and abduction contractures. This is induced by muscle imbalance, especially the loss of adductor muscle insertions when abductor muscle insertions are preserved. This causes considerable problems when fitting prosthetics. Myodesis with insertion of the distally detached adductor magnus muscle to the lateral femoral cortex, introduced here, results in a stronger stump with good muscle balance, and prosthetics fitting is significantly improved. PMID:25875228

  13. [Seizure].

    Science.gov (United States)

    Saito, Ayumi; Terayama, Yasuo

    2013-06-01

    Seizure is defined as "a strong shrinkage state of the skeletal muscle which is involuntary, and occurs spasmodically" and it is often accompanied by disturbance of consciousness. The typical disease which causes seizure is epilepsy. But there is many conditions causing seizure. Therefore, diagnosis of epilepsy should be careful. Seizure among eldery increases in an era of an aging population in Japan. The risk of recurrence of seizure or epilepsy in elderly is higher than that in youth. In considering of the treatment of seizure among elderly, differential diagnosis from various condition must be done. PMID:23855204

  14. Variations in the usage and composition of a radial cocktail during radial access coronary angiography procedures.

    LENUS (Irish Health Repository)

    Pate, G

    2011-10-01

    A survey was conducted of medication administered during radial artery cannulation for coronary angiography in 2009 in Ireland; responses were obtained for 15 of 20 centres, in 5 of which no radial access procedures were undertaken. All 10 (100%) centres which provided data used heparin and one or more anti-spasmodics; verapamil in 9 (90%), nitrate in 1 (10%), both in 2 (20%). There were significant variations in the doses used. Further work needs to be done to determine the optimum cocktail to prevent radial artery injury following coronary angiography.

  15. Spray drying of Tinospora cordifolia leaf and stem extract and evaluation of antioxidant activity

    OpenAIRE

    Sarala, M.; Velu, V.; Anandharamakrishnan, C.; Singh, R. P.

    2011-01-01

    Tinospora cordifolia (Guduchi) is widely used in folk medicine/ ayurvedic system of medicine, also in ayurvedic ‘Rasayanas’ to improve the immune system and used as general tonic, anti-periodic, anti-spasmodic, anti-inflammatory, anti-arthritic and anti-diabetic agent. Numerous studies have been reported on the health benefits of individual parts or whole Guduchi plant. However, most of the work has focused on the extracts of T. cordifolia. In this study, T. cordifolia leaf and stem extract p...

  16. Acute anuric renal failure following jering bean ingestion.

    Science.gov (United States)

    Wong, Jin Shyan; Ong, Teng-Aik; Chua, Hock-Hin; Tan, Clare

    2007-01-01

    Djenkol beans or jering (Pithecellobium jeringa) is a traditional delicacy consumed by the local population in Malaysia. Jering poisoning or djenkolism is characterized by spasmodic pain, urinary obstruction and acute renal failure. The underlying pathology is an obstructive nephropathy, which is usually responsive to aggressive hydration and diuretic therapy. We present a case of djenkolism following ingestion of jering. The patient required urgent bilateral ureteric stenting following the failure of conservative therapy. Healthcare providers need to recognize djenkolism as a cause of acute renal failure and the public educated on this potential health hazard.

  17. An Integrated Musculoskeletal Countermeasure Battery for Long-Duration Lunar Missions

    Science.gov (United States)

    Lang, T. F.; Streeper, T. S.; Cavanagh, P. R.; Saeed, I. H.; Carpenter, R. D.; Frassetto, L. A.; Lee, S. M. C.; Grodsinsky, C. M.; Funk, J.; Hanson, A. M.; Bloomberg, J. J.; Mulavara, A. P.; Sibonga, J. D.

    2011-01-01

    During extended periods of skeletal unloading, losses in strength and density of the proximal femur will occur. In long-duration spaceflight, resistive exercise is used to replace the normal loads exerted on the spine and hip. At the present time, there is no conclusive evidence that hip bone loss has been prevented in this scenario. Our group has recently developed and clinically evaluated a multifunctional exercise system, the Combined Countermeasure Device (CCD). The CCD comprises a low-footprint Stuart Platform for lower-body resistance exercise and balance training, and a cardiovascular exercise bicycle. A consideration for resistance exercise was targeting of the hip abductor and adductor muscles, which attach directly at the hip and which should subject it to the largest loads. In our training study, we found that CCD exercise increased hip adductor and abductor strength, and modeling results suggest that this exercise exerts forces on the hip of approx. 4-6 body weights at 1g, compared to forces of approx.2.5 body weight y squatting exercise. In our current study, we hypothesize that abductor and adductor exercise will increase the density and strength of the proximal femur.

  18. Correlation of the Y-Balance Test with Lower-limb Strength of Adult Women.

    Science.gov (United States)

    Lee, Dong-Kyu; Kim, Gyoung-Mo; Ha, Sung-Min; Oh, Jae-Seop

    2014-05-01

    [Purpose] The purpose of this study was to elucidate the relationship between Y-balance test (YBT) distance and the lower-limb strength of adult women. [Subjects] Forty women aged 45 to 80 years volunteered for this study. [Methods] The participants were tested for maximal muscle strength of the lower limbs (hip extensors, hip flexors, hip abductors, knee extensors, knee flexors, and ankle dorsiflexors) and YBT distances in the anterior, posteromedial, and posterolateral directions. Pearson's correlation coefficient was used to quantify the linear relationships between YBT distances and lower-limb strength. [Results] Hip extensor and knee flexor strength were positively correlated with YBT anterior distance. Hip extensor, hip abductor, and knee flexor strength were positively correlated with the YBT posteromedial distance. Hip extensor and knee flexor strength were positively correlated with YBT posterolateral distance. [Conclusion] There was a weak correlation between lower-limb strength (hip extensors, hip abductors, and knee flexors) and dynamic postural control as measured by the YBT.

  19. Heel pain--operative results.

    Science.gov (United States)

    Baxter, D E; Thigpen, C M

    1984-01-01

    In 6 years through 1982, the authors performed 34 operative cases in 26 patients with recalcitrant heel pain. The operative procedure involves an isolated neurolysis of the mixed nerve supplying the abductor digiti quinti muscle as it passes beneath the abductor hallucis muscle and beneath the medial ridge of the calcaneus. The deep fascia of the abductor hallucis muscle is released routinely, and an impinging heel spur or tight plantar fascia is partially removed or released if it is causing entrapment of the nerve. The biomechanical pathogenesis of heel pain in relation to pes planus and pes cavus predisposing to an entrapment neuropathy is described, and the anatomy of the heel in relation to the nerve distribution is clarified and well illustrated. Of the 34 operated heels, 32 had good results and two had poor results. Heel pain can cause total disability in the working population and may jeopardize one's employment or professional athletic career. The authors believe operative treatment has a place in the care of recalcitrant heel pain and that an entrapment neuropathy is an etiological factor in heel pain.

  20. Incapacidad vocal en docentes de la provincia de Huelva Voice handicap in Huelva's teachers

    Directory of Open Access Journals (Sweden)

    Francisco Javier Barbero-Díaz

    2010-03-01

    Full Text Available Introducción: La prevalencia de trastornos de la voz en docentes en nuestro entorno se sitúa entre el 34% y 57%. Desde el año 2006 la patología por nódulos de las cuerdas vocales se considera enfermedad profesional. El Índice de Incapacidad Vocal es una herramienta validada para valorar el menoscabo asociado a la disfonía que percibe la persona. Objetivos: Valorar el impacto de la disfonía y las posibles diferencias en la incapacidad vocal entre factores relacionados con la disfonía. Material y Métodos: Durante el examen de salud voluntario los docentes son interrogados sobre síntomas de disfonía y cumplimentan el Índice de Incapacidad Vocal. Resultados: Los docentes con incapacidad moderada y severa representan el 16,6% y 1,2% respectivamente. Un 50,9% han presentado síntomas de disfonía en algún momento de su vida laboral. Se encuentran diferencias significativas en la incapacidad vocal según el diagnostico de nódulos de cuerdas vocales, la presencia de síntomas y el número de síntomas. Conclusiones: la disfonía supone un importante impacto en la población estudiada. El diagnostico de nódulos de cuerdas vocales, la presencia de síntomas y el número de síntomas de disfonía conllevan diferencias al valorar el menoscabo. No es posible realizar la extrapolación.Introduction: The prevalence of voice disorders in teachers in our environment is between 34% and 57%. Since 2006, the pathology of vocal cord nodules is considered an occupational disease. Vocal Handicap Index is a validated tool to assess the impairment associated with the perceived dysphonia. Objectives: To assess the impact of dysphonia and the possible differences in the vocal disability in function of dysphonia-related factors in teachers. Methods: During the exam of health, volunteer teachers are interviewed about symptoms of dysphonia and complete the Vocal Handicap Index. Results: Teachers with moderate and severe disability represent 16.6% and 1

  1. Spasmolytic effect of traditional herbal formulation on guinea pig ileum

    Directory of Open Access Journals (Sweden)

    Dushyant Kumar

    2015-01-01

    Full Text Available Background: The herbal formulation consisting of Andrographis paniculata Nees., Cassia fistula L., Foeniculum vulgare Mill. and Cuminum cyminum L. is widely used by the local traditional practitioners in rural Northern Karnataka for spasmodic abdominal pain. Objective: The present study was undertaken to evaluate safety and spasmolytic effect of poly-herbal formulation. Materials and Methods: Acute toxicity studies were carried out in Swiss mice, as per the Organization for Economic Co-operation and Development (OECD guidelines. The spasmolytic activity of the formulation was studied in isolated guinea pig ileum model using histamine and acetylcholine as agonists. The data were analyzed by one-way ANOVA, followed by Dunnetts post-hoc test and P ≤ 0.05 was considered as significant. Results: The formulation did not show any adverse toxic effects and found to be safe. It also showed significant (P < 0.05 relaxation in different agonist like histamine and acetylcholine-induced contractions in guinea pig ileum. Conclusions: Antispasmodic activity of the herbal formulation can be attributed to its atropine-like activity. The present findings, therefore, support its utility in spasmodic abdominal pain.

  2. Dynamic and ultrastructural study of sphincter of Oddi in early-stage cholelithiasis in rabbits with hypercholesterolemia

    Institute of Scientific and Technical Information of China (English)

    Jing Guo Wei; Yao Cheng Wang; Fan Du; Hou Jun Yu

    2000-01-01

    AIM To study the relationship between preformation of gallstone and the kinetics and ultrastructure of sphincter of Oddi.METHODS Adult female rabbits were used and divided into 3 groups, and fed with either normal or high cholesterol diet for four or eight weeks.Each group contained eight rabbits. The manometry of sphincter of Oddi, biliary cineradiography, gallbladder volume measurement and ultrastructure observation under electron microscope were performed.RESULTS In groups Ⅰ and Ⅱ, the basal pressure in low-pressure ampulla or high pressure zone of sphincter of Oddi was elevated, the amplitude of phasic contraction was decreased and the volume of gallbladder were increased, with a significant difference (P<0.01) from those of control. Gallstones were found in group Ⅱ rabbits (7/8). Under cineradiography, low-pressure ampulla showed a spasmodic status without apparent peristaltic contraction. Under electron microscope, inside the muscular cells of sphincter of Oddi,loosening of microfilament and swelling of plasmosomes which congregated at the top were observed. The amount showed no obvious change under nitric oxide synthase (NOS) stain.CONCLUSION Twisting of the microfilament and disarrangement of kink macula densa inside the muscular cells suggested that the sphincter of Oddi was under spasmodic status. The impaired diastolic function caused and aggravated the stasis of cystic bile. The swelling plasmosome could be one of the important factors in elevating the tonic pressure of sphincter of Oddi.

  3. Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis

    Science.gov (United States)

    Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria

    2016-01-01

    Introduction Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. Objective To identify factors associated with clinical and topographical features of LTB. Method a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Results Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Conclusions Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement. PMID:27077734

  4. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Science.gov (United States)

    Joffily, Lucia; Vincent, Maurice Borges

    2013-01-01

    Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA), is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP) represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP. PMID:24288639

  5. Vocal Polyps in Tourette Syndrome

    Directory of Open Access Journals (Sweden)

    Michael P Chu

    2011-10-01

    Full Text Available Hoarseness and dysphonia are often a result of vocal cord polyps which in turn, are linked to vocal trauma. We report the case of vocal polyps in the setting of a 27-year old male with a history only remarkable for Tourette syndrome. We review the literature regarding etiology and pathophysiology of vocal cord lesions and propose vocal tics in Tourette syndrome as an under-recognized etiology. In this way, we also review therapies that may aid in treating not only the vocal cord lesions but also particularly in the setting of vocal tics.

  6. A case of mixed type laryngocele presented with deep neck infection and review of the literature

    Directory of Open Access Journals (Sweden)

    Salih Bakır

    2012-09-01

    Full Text Available Laryngocele is an abnormal dilatation of the laryngeal ventricular saccule that may extend into the subcutaneous tissues of the neck through the thyrohyoid membrane or confined to the endolarynx. The etiology is still unclear. Many laryngoceles are asymptomatic. An asymptomatic laryngocele appears and produces symptoms only as it enlarges or when it becomes infected. In this report, we present a 40-year-old female patient, which had an asymptomatic neck swelling for 20 years, referred for deep neck infection, dysphonia and dyspnea. J Clin Exp Invest 2012; 3 (3: 415-419Key words: Larynx, laryngocele, laryngopyocele, neck mass

  7. A Case of Persistent Hiccup after Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Elisa Grifoni

    2013-01-01

    Full Text Available A 79-year-old man, with history of recent laparoscopic cholecystectomy, came to our attention for persistent hiccup, dysphonia, and dysphagia. Noninvasive imaging studies showed a nodular lesion in the right hepatic lobe with transdiaphragmatic infiltration and increased tracer uptake on positron emission tomography. Suspecting a malignant lesion and given the difficulty of performing a percutaneous transthoracic biopsy, the patient underwent surgery. Histological analysis of surgical specimen showed biliary gallstones surrounded by exudative inflammation, resulting from gallbladder rupture and gallstones spillage as a complication of the previous surgical intervention. This case highlights the importance of considering such rare complication after laparoscopic cholecystectomy.

  8. Pharyngeal Aspiration of Complete Upper Denture in 90-Year-Old Man; a Case Report

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    Mehrdad Haghighi

    2015-07-01

    Full Text Available Foreign body aspiration is unusual in adults, except those who are debilitated or have neuropsychiatric disorders. It can be a life-threatening situation and it often requires a high index of suspicion, because the diagnosis can be obscure. Prompt diagnosis and intervention through foreign body retrieval are critical to prevent significant morbidity and mortality. We present a case of denture aspiration by a debilitated 90 years old man. He had aspirated his complete upper denture to pharynx causing incomplete obstruction with pleasure whistling respiratory sound, dyspnea, dysphagia and dysphonia. He underwent successful retrieval of the dental plate manually by fingers with complete resolution of symptoms. 

  9. CO2激光治疗室带性发声紊乱

    Institute of Scientific and Technical Information of China (English)

    葛平江; 张思毅; 苏小妹

    2010-01-01

    @@ 室带性发声紊乱(ventricular dysphonia, VD)是由于假声带(室带)而非真声带振动导致的发声紊乱,大多数情况同喉肌的异常使用相关,有时是室带振动对声带振动的不合适的补偿行为导致的发声紊乱.其主要症状是发声响度降低和嘶哑,有时候会伴有破音和双音.

  10. [Acute pseudo-membranous laryngitis in epidermolysis bullosa acquisita].

    Science.gov (United States)

    Lecomte, H; Folia, M; Muller, G; Gilbert, D; Tron, F; Besancenot, J-F; Romanet, P

    2010-05-01

    Epidermolysis bullosa acquisita is a rare entity belonging to the auto-immune cutaneous blistering disorders of the dermo-epidermal junction. Clinical manifestations are generally cutaneous including the development of sub-epidermal blisters. Mucosal manifestations should be systematically looking for, but laryngeal involvement remains uncommon. We report an 81-year-old woman who presented with dysphagia, dyspnea and dysphonia as the presenting features of laryngeal involvement of an epidermolysis bullosa acquisita. This is the tenth reported case in the literature. We describe our diagnostic approach and the therapeutic management, comparing them with the literature.

  11. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Pinto

    2013-01-01

    Full Text Available Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA, is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP.

  12. Hybrid treatment of penetrating aortic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

    2015-05-15

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  13. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Budhram Singh

    2014-04-01

    Full Text Available 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 examination after eight months showed significant improvement in hoarseness of voice with no evidence of recurrence of lesion. [Natl J Med Res 2014; 4(2.000: 175-177

  14. Spontaneous retropharynegeal hematoma: A case report and literature overview

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Ji Hwa [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-02-15

    A spontaneous retropharyngeal hematoma is a rare condition with a difficult diagnostic. This disease may rapidly progress to an airway obstruction. The author reports about a case of a 56-year-old man with an acute onset of sore throat, dysphonia and dyspnea. A retropharyngeal high attenuated soft tissue density could be seen on the neck CT. A rapid improvement of the retropharyngeal abnormality was seen on the 3 days follow-up MR imaging. Signal changes caused by blood products which were visible on the MRI images suggested the diagnosis of retropharyngeal hematoma. The patient was conservatively managed.

  15. Treatment of a complicated penetrating ulcer of the descending thoracic aorta using a scalloped stent graft.

    Science.gov (United States)

    Esteban, Carlos; Pérez, Paulina; Muchart, Jordi; Sampere, Jaume; Martorell, Alberto; Llagostera, Secundino

    2014-01-01

    We show the use of a proximal scalloped stent graft for an pseudoaneurysm of the descending thoracic aorta to avoid occlusion of the left subclavian artery. A 63-year-old man with sudden onset dysphonia was diagnosed with left vocal fold paralysis and the presence of a lung mass. A computed tomography scan revealed saccular dilatation of the aortic arch (proximal neck: prosthesis with proximal scallop provides a good alternative to a carotid-subclavian bypass because it is less aggressive and can be used in nonurgent cases. PMID:24189003

  16. Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis

    Directory of Open Access Journals (Sweden)

    Kerem Kökoğlu

    2014-01-01

    Full Text Available Laryngeal chondrosarcoma (CS is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature.

  17. Status of larynx in children with congenital cleft of upper lip and palate

    Directory of Open Access Journals (Sweden)

    Nigora Makhkamova

    2010-09-01

    Full Text Available Study of 215 children with congenital cleft of upper lip and palate in the age of 1.5 to 15 years has established the organic dysphonia in 27.4% of patients. Of the organic diseases of larynx there were edema, hypertrophy, nodules of vocal folds and chronic laryngitis whose frequency is directly dependent on duration and severity of the defect, age of patient and the timing of recovery of velopharyngeal ring. Pathology of the larynx gradually disappears with the growth of the patient after plastic reconstruction of oronasal defect.

  18. A RARE CASE OF IMPACTED VEGETATIVE FOREIGN BODY IN LARYNX: XANTHIUM STRUMARIUM (CHHOTA GOKHRU

    Directory of Open Access Journals (Sweden)

    Richa

    2013-05-01

    Full Text Available ABSTRACT: - BACKGROUND : Impaction of foreign bodies in the larynx constit utes a medical emergency and requires immediate intervention. We report a rare case of a Xanthium Strumarium (Chhota Gokhru impacted in larynx in a 10 year old female who pre sented with complaint of respiratory distress & dysphonia in ENT department, S.S. Medical college and associated hospital, Rewa (M.P.. Direct laryngoscopy was performed for its removal. The case report thus emphasizes that early detection by meticulous history, clinica l findings, imaging modality & prompt management remains basis for favourable outcome.

  19. Recurrent vocal fold paralysis and parsonage-turner syndrome.

    Science.gov (United States)

    Pinto, Marcus Vinicius; Joffily, Lucia; Vincent, Maurice Borges

    2013-01-01

    Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA), is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP) represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP. PMID:24288639

  20. Advances in molecular genetic studies of primary dystonia

    Directory of Open Access Journals (Sweden)

    MA Ling-yan

    2013-07-01

    Full Text Available Dystonias are heterogeneous hyperkinetic movement disorders characterized by involuntary muscle contractions which result in twisting, repetitive movements and abnormal postures. In recent years, there was a great advance in molecular genetic studies of primary dystonia. This paper will review the clinical characteristics and molecular genetic studies of primary dystonia, including early-onset generalized torsion dystonia (DYT1, whispering dysphonia (DYT4, dopa-responsive dystonia (DYT5, mixed-type dystonia (DYT6, paroxysmal kinesigenic dyskinesia (DYT10, myoclonus-dystonia syndrome (DYT11, rapid-onset dystonia parkinsonism (DYT12, adult-onset cervical dystonia (DYT23, craniocervical dystonia (DYT24 and primary torsion dystonia (DYT25.

  1. Quality Control of Motor Unit Number Index (MUNIX Measurements in 6 Muscles in a Single-Subject "Round-Robin" Setup.

    Directory of Open Access Journals (Sweden)

    Christoph Neuwirth

    Full Text Available Motor Unit Number Index (MUNIX is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS has been established, but inter-rater variability between multiple raters in one single subject has not been investigated.To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced and to determine variables associated with variability of measurements.Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB, abductor digiti minimi (ADM, biceps brachii (BB, tibialis anterior (TA, extensor dig. brevis (EDB, abductor hallucis (AH twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV between different raters and their levels of experience with MUNIX were compared.Mean intra-rater COV of MUNIX was 14.0% (±6.4 ranging from 5.8 (APB to 30.3% (EDB. Mean inter-rater COV was 18.1 (±5.4 ranging from 8.0 (BB to 31.7 (AH. No significant differences of variability between experienced and less experienced raters were detected.We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method.

  2. Quality Control of Motor Unit Number Index (MUNIX) Measurements in 6 Muscles in a Single-Subject “Round-Robin” Setup

    Science.gov (United States)

    Neuwirth, Christoph; Burkhardt, Christian; Alix, James; Castro, José; de Carvalho, Mamede; Gawel, Malgorzata; Goedee, Stephan; Grosskreutz, Julian; Lenglet, Timothée; Moglia, Cristina; Omer, Taha; Schrooten, Maarten; Weber, Markus

    2016-01-01

    Background Motor Unit Number Index (MUNIX) is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS) has been established, but inter-rater variability between multiple raters in one single subject has not been investigated. Objective To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced) and to determine variables associated with variability of measurements. Methods Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibialis anterior (TA), extensor dig. brevis (EDB), abductor hallucis (AH)) twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV) between different raters and their levels of experience with MUNIX were compared. Results Mean intra-rater COV of MUNIX was 14.0% (±6.4) ranging from 5.8 (APB) to 30.3% (EDB). Mean inter-rater COV was 18.1 (±5.4) ranging from 8.0 (BB) to 31.7 (AH). No significant differences of variability between experienced and less experienced raters were detected. Conclusion We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method. PMID:27135747

  3. The effects of hip muscle strengthening on knee load, pain, and function in people with knee osteoarthritis: a protocol for a randomised, single-blind controlled trial

    Directory of Open Access Journals (Sweden)

    Hunter David J

    2007-12-01

    Full Text Available Abstract Background Lower limb strengthening exercises are an important component of the treatment for knee osteoarthritis (OA. Strengthening the hip abductor and adductor muscles may influence joint loading and/or OA-related symptoms, but no study has evaluated these hypotheses directly. The aim of this randomised, single-blind controlled trial is to determine whether hip abductor and adductor muscle strengthening can reduce knee load and improve pain and physical function in people with medial compartment knee OA. Methods/Design 88 participants with painful, radiographically confirmed medial compartment knee OA and varus alignment will be recruited from the community and randomly allocated to a hip strengthening or control group using concealed allocation stratified by disease severity. The hip strengthening group will perform 6 exercises to strengthen the hip abductor and adductor muscles at home 5 times per week for 12 weeks. They will consult with a physiotherapist on 7 occasions to be taught the exercises and progress exercise resistance. The control group will be requested to continue with their usual care. Blinded follow up assessment will be conducted at 12 weeks after randomisation. The primary outcome measure is the change in the peak external knee adduction moment measured during walking. Questionnaires will assess changes in pain and physical function as well as overall perceived rating of change. An intention-to-treat analysis will be performed using linear regression modelling and adjusting for baseline outcome values and other demographic characteristics. Discussion Results from this trial will contribute to the evidence regarding the effect of hip strengthening on knee loads and symptoms in people with medial compartment knee OA. If shown to reduce the knee adduction moment, hip strengthening has the potential to slow disease progression. Trial Registration Australia New Zealand Clinical Trials Registry ACTR12607000001493

  4. Correlation of MRI findings with clinical findings of trochanteric pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Blankenbaker, Donna G.; Ullrick, Steven R.; Davis, Kirkland W.; De Smet, Arthur A. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Haaland, Ben; Fine, Jason P. [University of Wisconsin School of Medicine and Public Health, Departments of Biostatistics and Medical Informatics and Statistics, Madison, WI (United States)

    2008-10-15

    Greater trochanter pain syndrome due to tendinopathy or bursitis is a common cause of hip pain. The previously reported magnetic resonance (MR) findings of trochanteric tendinopathy and bursitis are peritrochanteric fluid and abductor tendon abnormality. We have often noted peritrochanteric high T2 signal in patients without trochanteric symptoms. The purpose of this study was to determine whether the MR findings of peritrochanteric fluid or hip abductor tendon pathology correlate with trochanteric pain. We retrospectively reviewed 131 consecutive MR examinations of the pelvis (256 hips) for T2 peritrochanteric signal and abductor tendon abnormalities without knowledge of the clinical symptoms. Any T2 peritrochanteric abnormality was characterized by size as tiny, small, medium, or large; by morphology as feathery, crescentic, or round; and by location as bursal or intratendinous. The clinical symptoms of hip pain and trochanteric pain were compared to the MR findings on coronal, sagittal, and axial T2 sequences using chi-square or Fisher's exact test with significance assigned as p<0.05. Clinical symptoms of trochanteric pain syndrome were present in only 16 of the 256 hips. All 16 hips with trochanteric pain and 212 (88%) of 240 without trochanteric pain had peritrochanteric abnormalities (p=0.15). Eighty-eight percent of hips with trochanteric symptoms had gluteus tendinopathy while 50% of those without symptoms had such findings (p=0.004). Other than tendinopathy, there was no statistically significant difference between hips with or without trochanteric symptoms and the presence of peritrochanteric T2 abnormality, its size or shape, and the presence of gluteus medius or minimus partial thickness tears. Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities

  5. Greater Trochanteric Pain Syndrome.

    Science.gov (United States)

    Redmond, John M; Chen, Austin W; Domb, Benjamin G

    2016-04-01

    Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically. Greater trochanteric pain syndrome encompasses trochanteric bursitis, external coxa saltans (ie, snapping hip), and abductor tendinopathy. A thorough understanding of the anatomy, examination findings, and imaging characteristics aids the clinician in treating these patients. Open and endoscopic treatment options are available for use when nonsurgical treatment is unsuccessful. PMID:26990713

  6. Damage to the superior gluteal nerve after the Hardinge approach to the hip.

    LENUS (Irish Health Repository)

    Ramesh, M

    2012-02-03

    We studied prospectively 81 consecutive patients undergoing hip surgery using the Hardinge (1982) approach. The abductor muscles of the hip in these patients were assessed electrophysiologically and clinically by the modified Trendelenburg test. Power was measured using a force plate. We performed assessment at two weeks, and at three and nine months after operation. At two weeks we found that 19 patients (23%) showed evidence of damage to the superior gluteal nerve. By three months, five of these had recovered. The nine patients with complete denervation at three months showed no signs of recovery when reassessed at nine months. Persistent damage to the nerve was associated with a positive Trendelenburg test.

  7. Isometric hip muscle strength in posttraumatic below-knee amputees

    Directory of Open Access Journals (Sweden)

    Jandrić Slavica

    2007-01-01

    Full Text Available Background/Aim. Traumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-knee amputation on the hip isometric muscle strength and effect of rehabilitation on improvement of hip muscle strength in below-knee amputees, secondary to war wounding. Methods. Forty below-knee amputees (after war wounding, average age 35.6±10.6 years, that were included in primary rehabilitation program with prosthetics, were examined. Objective parameters were used to evaluate therapeutical effects. Isometric muscle strength of hip flexors, extensors, abductors and adductors was measured by dynamometer and expressed in Newton (N at admission, control and discharge for each patient. Average length of the treatment was 51 ± 34.1 days. Results. For isometric hip flexors (t = - 1.99346, p < 0.05, extensors (t = -4.629073, p < 0.001, abductors (t = -4.9408, p < 0.001 and adductors (t = -2.00228, p < 0.05, muscle strength was significantly less on the amputated than on nonamputated side. The highest differences in muscle strength between amputated and nonamputated limbs were noted for hip abductors (26.6% and extensors (23.3%. There was significant improvement of mean values of strength for all examined hip muscles after rehabilitation and prosthetics for both legs in comparison to beginning of the therapy. The hip abductor on the amputated side was for 19.4% weaker after rehabilitation in comparison to the nonamputated limb. Conclusion. Decreases of isometric muscle strength in all examined hip muscles were observed, more in the amputated limb. Rehabilitation

  8. Plantar calcaneal enthesophytes: new observations regarding sites of origin based on radiographic, MR imaging, anatomic, and paleopathologic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, M.R.; Chung, C.B.; Mendes, L.; Mohana-Borges, A.; Trudell, D.; Resnick, D. [Department of Radiology, Musculoskeletal Section, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161 (United States)

    2003-01-01

    To determine the relationship between sites of calcaneal plantar enthesophytes and surrounding fascial and soft tissue structures using routine radiography, MR imaging, and data derived from cadaveric and paleopathologic specimens.Design and patients. Two observers analyzed the MR imaging studies of 40 ankles in 38 patients (35 males, 3 females; mean age 48.3 years) with plantar calcaneal enthesophytes that were selected from all the ankle MR examinations performed during the past year. Data derived from these MR examinations were the following: the size of the enthesophyte; its location in relation to the plantar fascia (PF) and flexor muscles; and the thickness and signal of the PF. The corresponding radiographs of the ankles were evaluated at a different time by the same observers for the presence or absence of plantar enthesophytes and, when present, their measurements. A third observer reviewed all the discordant observations of MR imaging and radiographic examinations. Two observers analyzed 22 calcaneal specimens with plantar enthesophytes at an anthropology museum to determine the orientation of each plantar enthesophyte. MR imaging of a cadaveric foot with a plantar enthesophyte with subsequent sagittal sectioning was performed to provide further anatomic understanding.Results. With regard to MR imaging, the mean size of the plantar enthesophytes was 4.41 mm (SD 2.4). Twenty (50%) enthesophytes were located above the PF, 16 (40%) between the fascia and abductor digiti minimi, flexor digitorum brevis and abductor hallucis muscles, and only one (3%) was located within the PF. In three (8%) cases the location was not determined. The size of enthesophytes seen with MR imaging and radiographs was highly correlated (P<0.01). The interobserver agreement for all measurements was good (Pearson >0.8, kappa >0.9). Eleven of the 22 bone specimens had plantar enthesophytes oriented in the direction of the abductor digiti minimi and 11 oriented in the direction of the

  9. Tendon Transfers for the Hypoplastic Thumb.

    Science.gov (United States)

    Wall, Lindley B; Goldfarb, Charles A

    2016-08-01

    Thumb hypoplasia is a component of radial longitudinal deficiency. The severity of hypoplasia can range from a slightly smaller thumb to a complete absence. Types II and IIIA hypoplastic thumbs are candidates for reconstruction to improve function, stability, and strength. There are 2 commonly used tendon transfers that can augment thumb opposition strength: the Huber abductor digiti minimi muscle transfer and the flexor digitorum superficialis opposition transfer. Both transfers use ulnar-sided structures to augment the thenar musculature. The Huber opposition transfer increases thenar bulk, but does not provide additional tissue for metacarpophalangeal stability. PMID:27387085

  10. Low Median Nerve Transfers (Opponensplasty).

    Science.gov (United States)

    Chadderdon, Robert Christopher; Gaston, R Glenn

    2016-08-01

    Opposition is the placement of the thumb opposite the fingers into a position from which it can work. This motion requires thumb palmar abduction, flexion, and pronation, which are provided by the abductor pollicis brevis, flexor pollicis brevis (FPB), and opponens pollicis. In the setting of a median nerve palsy, this function is typically lost, although anatomic variations and the dual innervation of the FPB may prevent complete loss at times. There are multiple well described and accepted tendon transfers to restore opposition, none of which have been proven to be superior to the others. PMID:27387078

  11. Uso de programas de bipedestación como parte del tratamiento de la displasia de cadera en la parálisis cerebral infantil (PCI). Revisión bibliográfica

    OpenAIRE

    Salgado Caballero, Unai

    2016-01-01

    Introducción: en el momento del nacimiento, las caderas de un/a niño/a con problemas neuromotores no se diferencian de las de otros niños/as. La displasia de cadera se desarrolla debido al retraso en los hitos motores y a un desequilibrio entre el tono muscular de los músculos flexores y aductores y los extensores y abductores. También hay que tener en cuenta el componente de espasticidad ya que es el que va a provocar la excursión de la cabeza femoral y el característico patrón en tijera si ...

  12. Acupuncture in De Quervain's disease: a treatment proposal.

    Science.gov (United States)

    da Silva, João Bosco Guerreiro; Batigália, Fernando

    2014-02-01

    De Quervain's disease is a painful stenosing tenosynovitis of the first dorsal compartment of the hand affecting the tendons of the abductor pollicis longus and extensor pollicis brevis, caused mainly by overuse. Conventional treatments include rest, immobilisation, oral anti-inflammatory drugs, corticosteroid injection and even surgery, but none of these is established as clearly effective. Acupuncture is rarely mentioned and the points suggested are rather general-regional, tender and ah shi points. Tendinopathy is almost always associated with problems in the relevant muscles and this paper calls attention to the correct identification and needling of the affected muscles, in order to increase the specificity of acupuncture treatment. PMID:24323632

  13. The Gluteus Medius Vs. Thigh Muscles Strength Ratio and Their Relation to Electromyography Amplitude During a Farmer’s Walk Exercise

    OpenAIRE

    Stastny Petr; Lehnert Michal; Zaatar Amr; Svoboda Zdenek; Xaverova Zuzana; Pietraszewski Przemysław

    2015-01-01

    The strength ratio between hamstrings and quadriceps (H/Q) is associated with knee injuries as well as hip abductor muscle (HAB) weakness. Sixteen resistance trained men (age, 32.5 ± 4.2 years) performed 5 s maximal isometric contractions at 75° of knee flexion/extension and 15° of hip abduction on a dynamometer. After this isometric test they performed a Farmer’s walk exercise to find out if the muscle strength ratio predicted the electromyography amplitude expressed as a percentage of maxim...

  14. Surgical hip dislocation: techniques for success.

    Science.gov (United States)

    Ricciardi, Benjamin F; Sink, Ernest L

    2014-01-01

    Surgical hip dislocation (SHD) is a versatile approach used to address both intra-articular and extra-articular pathology around the hip joint in both pediatric and adult patients. It allows anterior dislocation of the femoral head for direct visualization of the hip joint while preserving femoral head vascularity and minimizing trauma to the abductor musculature. Previously described indications for SHD include femoroacetabular impingement, deformity resulting from Legg-Calve-Perthes disease, slipped capital femoral epiphysis, periarticular trauma, benign lesions of the hip joint, and osteochondral lesions. In this review, we will describe current surgical techniques, indications, and clinical outcomes for SHD. PMID:25207733

  15. A Comparison of Classification Methods for Telediagnosis of Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Haydar Ozkan

    2016-03-01

    Full Text Available Parkinson’s disease (PD is a progressive and chronic nervous system disease that impairs the ability of speech, gait, and complex muscle-and-nerve actions. Early diagnosis of PD is quite important for alleviating the symptoms. Cost effective and convenient telemedicine technology helps to distinguish the patients with PD from healthy people using variations of dysphonia, gait or motor skills. In this study, a novel telemedicine technology was developed to detect PD remotely using dysphonia features. Feature transformation and several machine learning (ML methods with 2-, 5- and 10-fold cross-validations were implemented on the vocal features. It was observed that the combination of principal component analysis (PCA as a feature transformation (FT and k-nearest neighbor (k-NN as a classifier with 10-fold cross-validation has the best accuracy as 99.1%. All ML processes were applied to the prerecorded PD dataset using a newly created program named ParkDet 2.0. Additionally, the blind test interface was created on the ParkDet so that users could detect new patients with PD in future. Clinicians or medical technicians, without any knowledge of ML, will be able to use the blind test interface to detect PD at a clinic or remote location utilizing internet as a telemedicine application.

  16. Videostroboscopic and morphological aspects of voice disturbances in patients with larynx atrophy and coexisting hypopharynx cancer

    Directory of Open Access Journals (Sweden)

    Dawid Falkowski

    2012-01-01

    Full Text Available Vocal folds play a crucial role in voice production. The physiological vibrations of vocal folds depend on the unchanged multilayered structure of the vocal folds mucosa. Morphological changes of mucosa are the cause of voice quality disorders — dysphonia. The aim of this study was to determine the morphological base of dysphonia in patients with vocal folds atrophy. A group of 24 patients with larynx atrophy confirmed by endoscopic (VLS and stroboscopic (VLSS examination of the larynx was included in the study. The morphological assessment of the larynx mucosa was carried out with the use of the transmission electron microscopy (TEM. Ultramorphological examinations revealed changes in the epithelium, basal membrane and lamina propria of the vocal folds mucosa. An increased number of collagenous fibers, fibroblasts with signs of vacuolar degeneration inflammatory cells and a decreased number of blood vessels and pericytes were observed. Morphological changes found in the epithelium, basal membrane and lamina propria of the vocal folds mucosa were the cause of disorders of vocal folds vibrations registered in the stroboscopic examination of the larynx (VLSS. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 4, pp. 659–663

  17. Acoustic analysis assessment in speech pathology detection

    Directory of Open Access Journals (Sweden)

    Panek Daria

    2015-09-01

    Full Text Available Automatic detection of voice pathologies enables non-invasive, low cost and objective assessments of the presence of disorders, as well as accelerating and improving the process of diagnosis and clinical treatment given to patients. In this work, a vector made up of 28 acoustic parameters is evaluated using principal component analysis (PCA, kernel principal component analysis (kPCA and an auto-associative neural network (NLPCA in four kinds of pathology detection (hyperfunctional dysphonia, functional dysphonia, laryngitis, vocal cord paralysis using the a, i and u vowels, spoken at a high, low and normal pitch. The results indicate that the kPCA and NLPCA methods can be considered a step towards pathology detection of the vocal folds. The results show that such an approach provides acceptable results for this purpose, with the best efficiency levels of around 100%. The study brings the most commonly used approaches to speech signal processing together and leads to a comparison of the machine learning methods determining the health status of the patient

  18. Successful Treatment of Hemifacial Myokymia and Dystonia Associated to Linear Scleroderma “En Coup de Sabre” with Repeated Botox Injections

    Directory of Open Access Journals (Sweden)

    Carlos A. Cañas

    2012-01-01

    Full Text Available Linear scleroderma “en coup de sabre” (LSCS is a form of localized scleroderma presents as band-like sclerotic lesions of the frontoparietal area. It has been reported in association with diverse neurological manifestations like seizures, migraine, neuromyotonia, dystonia and abnormalities in MRI and CT studies as cerebral atrophy, white matter lesions, intraparenchymal calcification, meningeocortical alterations, and skull atrophy. We describe a patient with LSCS associated with two abnormal movements: permanent myokimia of right masseter muscle and recurrent spasmodic retraction of right cigomatic and depressor labii inferioris muscles. He was initially treated with methotrexate and steroids without response, so later on he underwent repeated Botox injections with remarkable improvement.

  19. Lemon grass oil for improvement of oral health

    Directory of Open Access Journals (Sweden)

    Ruckmani Rajesvari

    2013-01-01

    Full Text Available Lemon grass essential oil has been used for decades to treat respiratory infections, sinusitis, bladder infections, high cholesterol, digestive problem, varicose veins and also for regeneration of connective tissue. It has anti spasmodic, anti-pyretic, anti-fungal, anti-bacterial, anti-inflammatory, anti-septic, insect repellent, sedative, vasodilator and flavoring properties. In china, it has been used traditionally as a remedy for stomach and liver diseases and also to treat rheumatism. Since lemon grass oil possess various pharmacological actions, it is also quite useful in dentistry. Hence, the objective of this article is to highlight various uses of lemon grass oil in the dental field and in the medical field in order to aid the professionals for future research.

  20. MEDICINAL USES AND PHYTOCONSTITUENTS OF PAEONIA OFFICINALIS

    Directory of Open Access Journals (Sweden)

    Ahmad F

    2012-04-01

    Full Text Available Paeonia officinalis (European peony, Common peony has been cultivated in Europe for years. The root has been used medicinally for over 2,000 years mainly in the treatment for epilepsy and to promote menstruation. Root is also antispasmodic, diuretic, sedative and tonic and has been successfully employed in the treatment of convulsions and spasmodic nervous affections such as epilepsy. It has also been used in the treatment of whooping cough whilst suppositories are sometimes made of the root to relieve anal and intestinal spasms, hemorrhoids and varicose veins. Experimentally it has been proved to have antihypertensive, abortifacient action and anti-ulcer activity. The roots of this plant are of great medicinal significance in unani system and homeopathy. The roots contain asparagin, benzoic acid, flavonoids, paeoniflorin, paeonin, paeonol, protoanemonin, tannic acid, triterpenoids, and volatile oil. This review covers botany, traditional uses and the phytoconstituents of the roots of Paeonia officinalis.

  1. Ultrasound and Electromyography Guidance for Injection of the Longus Colli With Botulinum Toxin for the Treatment of Cervical Dystonia.

    Science.gov (United States)

    Allison, Stephen K; Odderson, Ib R

    2016-09-01

    Cervical dystonia, also called spasmodic torticollis, is a painful condition in which neck muscles contract involuntarily, and may cause abnormal head position or movements. The primary (or first line of) treatment of cervical dystonia is chemodenervation with injection of botulinum toxin into the affected muscles. We report a case of a young man with idiopathic cervical dystonia who developed anterocollis (forward flexion of the neck) not responsive to prior scalene and sternocleidomastoid muscle injections. To safely access the deeper cervical musculature, ultrasound (US) was used in conjunction with electromyography, to inject the longus colli muscles bilaterally. The patient responded well and had no complications. The longus colli has been reported to be injected using electromyography, fluoroscopy, computed tomography, and, less frequently, US. We propose that US guidance is an excellent technique for botulinum toxin injection, especially for deep cervical muscles such as the longus colli. PMID:26886108

  2. A REVIEW ON THERAPEUTIC USES OF PEDALIUM MUREX LINN

    Directory of Open Access Journals (Sweden)

    A. Elumalai

    2011-06-01

    Full Text Available Traditional system of medicinal consists of large number of plants with various medicinal and pharmacological importances and hence represents a priceless tank of new bioactive molecules. Pedalium murex is a small herb distributed in tropical Africa, Ceylon, India and Mexico. It is commonly found in Deccan and some parts of Ceylon and Gujarat and in its costal areas of Southern India. It is commonly called Gokhru (Yaanai Nerinji a member of family Pedaliaceae. The plant is sweet, cooling, mucilaginous, diuretic and inflammatory and used to treat digestive, carminative, tonic, spasmodic affections, amenorrhoea, and vitiated conditions of pita, inflammation and general debility. This review will be helpful to create interest towards Pedalium murex and may be useful in developing new formulations with more therapeutic and economical value.

  3. Rectal cancer in pregnancy: A diagnostic and therapeutic challenge

    International Nuclear Information System (INIS)

    Introduction: The occurrence of colorectal cancer during pregnancy is rare and is associated with diagnostic and therapeutic challenges. Herein, we report such a case of rectal cancer in pregnancy and review the literature. Case report: A 31-year-old multiparous, pregnant woman, in the 20th week of gestation, presented with rectal bleeding progressing to spasmodic abdominal pain and right flank vague pain. A flexible recto sigmoidoscopy showed a large ulcerative mass located in the recto sigmoid junction, 15 cm away from anal verge. Imaging studies and biopsy proved it to be rectal adenocarcinoma with single liver metastasis. The patient’s pregnancy was terminated and neoadjuvant therapy followed by curative surgery was performed. She is currently receiving adjuvant systemic therapy to eradicate potential micro metastatic disease. Conclusion: This case suggests that colorectal cancer can mimic the signs and the symptoms of pregnancy and tends to present at an advanced stage in pregnant women.

  4. Elements of a nuclear criticality safety program

    International Nuclear Information System (INIS)

    Nuclear criticality safety programs throughout the United States are quite successful, as compared with other safety disciplines, at protecting life and property, especially when regarded as a developing safety function with no historical perspective for the cause and effect of process nuclear criticality accidents before 1943. The programs evolved through self-imposed and regulatory-imposed incentives. They are the products of conscientious individuals, supportive corporations, obliged regulators, and intervenors (political, public, and private). The maturing of nuclear criticality safety programs throughout the United States has been spasmodic, with stability provided by the volunteer standards efforts within the American Nuclear Society. This presentation provides the status, relative to current needs, for nuclear criticality safety program elements that address organization of and assignments for nuclear criticality safety program responsibilities; personnel qualifications; and analytical capabilities for the technical definition of critical, subcritical, safety and operating limits, and program quality assurance

  5. Máscara laríngea y tubo endotraqueal: incidencia de odinogagia y disfonía por su uso en anestesia general en el Hospital Universitario San Vicente de Paúl, Medellín, 2000 Laryngeal mask airway and endotracheal tube: odynophagia and dysfhonia incidence under general anesthesia at the University Hospital San Vicente de Paúl, Medellín, 2000

    Directory of Open Access Journals (Sweden)

    Mónica del Rosario Guzmán Carazo

    2001-03-01

    Full Text Available Se describe la incidencia de odinofagia y disfonía después del uso de la máscara laríngea (ML o del tubo endotraqueal (TET en pacientes adultos sometidos a cirugía electiva, bajo anestesia general, en el Hospital Universitario San Vicente de Paúl, de Medellín, entre febrero y marzo de 2000. Se hizo un estudio descriptivo, prospectivo, de corte transversal, en 63 pacientes, en los cuales se encontró una incidencia global de odinofagia del 15.9% y de disfonía del 12.5%. Hubo una mayor incidencia de odinofagia con el uso del TET, 37.5%, que con la ML, 2.6%. La incidencia de disfonía también fue mayor con el uso del TET (25% que con la ML (5.1%. La incidencia de odinofagia fue mayor en las mujeres (19.1% que en los hombres (6.2%. La disfonía también fue más frecuente en mujeres (14.8% que en hombres (6.2%. De acuerdo con los resultados obtenidos en nuestro estudio se puede concluir que la incidencia de odinofagia y disfonía es menor en pacientes de sexo masculino, cuando el tiempo de anestesia es de dos horas o menos y cuando se utiliza como técnica de aseguramiento de la vía aérea la ML. Son necesarios más estudios que incluyan un análisis comparativo de las complicaciones con el uso de la ML y el TET, con el fin de brindar al paciente técnicas más seguras y eficaces para el aseguramiento de la vía aérea. We describe the odynophagia and dysphonia incidence after the use of either laryngeal mask (LM or endotracheal tube (ETT in adult patients submitted to elective surgery, under general anesthesia, at the University Hospital San Vicente of Paul, Medellín, Colombia, between February 14 and March 16 of 2000. A descriptive and prospective study was carried out in 63 patients, in which the global incidence of odynophagia was 15.9% and that of dysphonia 12.5%; there was a higher odynophagia incidence with the use of ETT, 37.5%, than with LM, 2.6%. The dysphonia incidence was also higher with the use of the TET (25% than with LM

  6. The 2004–2008 dome-building eruption at Mount St. Helens, Washington: Epilogue

    Science.gov (United States)

    Dzurisin, Daniel; Moran, Seth C.; Lisowski, Michael; Schilling, Steve P.; Anderson, Kyle R.; Werner, Cynthia A.

    2015-01-01

    The 2004–2008 dome-building eruption at Mount St. Helens ended during winter 2007–2008 at a time when field observations were hampered by persistent bad weather. As a result, recognizing the end of the eruption was challenging—but important for scientists trying to understand how and why long-lived eruptions end and for public officials and land managers responsible for hazards mitigation and access restrictions. In hindsight, the end of the eruption was presaged by a slight increase in seismicity in December 2007 that culminated on January 12–13, 2008, with a burst of more than 500 events, most of which occurred in association with several tremor-like signals and a spasmodic burst of long-period earthquakes. At about the same time, a series of regular, localized, small-amplitude tilt events—thousands of which had been recorded during earlier phases of the eruption—came to an end. Thereafter, seismicity declined to 10–20 events per day until January 27–28, when a spasmodic burst of about 50 volcano-tectonic earthquakes occurred over a span of 3 h. This was followed by a brief return of repetitive “drumbeat” earthquakes that characterized much of the eruption. By January 31, however, seismicity had declined to 1–2 earthquakes per day, a rate similar to pre-eruption levels. We attribute the tilt and seismic observations to convulsive stagnation of a semisolid magma plug in the upper part of the conduit. The upward movement of the plug ceased when the excess driving pressure, which had gradually decreased throughout the eruption as a result of reservoir deflation and increasing overburden from the growing dome, was overcome by increasing friction as a result of cooling and crystallization of the plug.

  7. Why does a little mean a lot when you have nothing? A brief review of cell therapy strategies for spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Dajue Wang

    2015-01-01

    Without an understanding of functional musculoskeletal system recovery, the translation of knowledge concerning neurological recovery from laboratory discoveries to bedside applications will be incomplete. Because improvements in neurological function after cell transplantation are minor and can be easily ignored, this article draws attention to the minimal improvements required to allow a spinal cord injury patient or person to live a relatively independent life. These minimal improvements include (1) the key muscle power required for trunk stability; (2) the key muscle power required to allow a paraplegic to walk;and (3) the key muscle power required for hand usefulness or functionality. The system of muscle power grading promoted by the British Medical Research Council (MRC) is more sensitive and delicate than the ASIA Standards, as the latter only accept the full range of movement of a joint. The MRC system seems to be preferable to the ASIA Standards in clinical trials of cell transplantation, wherein minute improvements in function might result in large differences in the quality of life. The threshold of function is a grade 3 power level. Even if all relevant muscles fail to achieve a power higher than grade 3, the patient can be minimally functional and hence relatively independent. These relevant muscles include the latissimus dorsi, hip flexors, hip abductors, shoulder abductors and flexors, elbow flexors and extensors, and wrist extensors. These muscles are innervated by the C5–7 spinal cord segments except the latissimus dorsi, for which innervation extends to C8.

  8. How human gait responds to muscle impairment in total knee arthroplasty patients: Muscular compensations and articular perturbations.

    Science.gov (United States)

    Ardestani, Marzieh M; Moazen, Mehran

    2016-06-14

    Post-surgical muscle weakness is prevalent among patients who undergo total knee arthroplasty (TKA). We conducted a probabilistic multi-body dynamics (MBD) to determine whether and to what extent habitual gait patterns of TKA patients may accommodate strength deficits in lower extremity muscles. We analyzed muscular and articular compensations in response to various muscle impairments, and the minimum muscle strength requirements needed to preserve TKA gait patterns in its habitual status. Muscle weakness was simulated by reducing the strength parameter of muscle models in MBD analysis. Using impaired models, muscle and joint forces were calculated and compared versus those from baseline gait i.e. TKA habitual gait before simulating muscle weakness. Comparisons were conducted using a relatively new statistical approach for the evaluation of gait waveforms, i.e. Spatial Parameter Mapping (SPM). Principal component analysis was then conducted on the MBD results to quantify the sensitivity of every joint force component to individual muscle impairment. The results of this study contain clinically important, although preliminary, suggestions. Our findings suggested that: (1) hip flexor and ankle plantar flexor muscles compensated for hip extensor weakness; (2) hip extensor, hip adductor and ankle plantar flexor muscles compensated for hip flexor weakness; (3) hip and knee flexor muscles responded to hip abductor weakness; (4) knee flexor and hip abductor balanced hip adductor impairment; and (5) knee extensor and knee flexor weakness were compensated by hip extensor and hip flexor muscles. Future clinical studies are required to validate the results of this computational study. PMID:27063251

  9. Postoperative gait analysis and hip muscle strength in patients with pelvic ring fracture.

    Science.gov (United States)

    Kubota, Masafumi; Uchida, Kenzo; Kokubo, Yasuo; Shimada, Seiichiro; Matsuo, Hideaki; Yayama, Takafumi; Miyazaki, Tsuyoshi; Sugita, Daisuke; Watanabe, Shuji; Baba, Hisatoshi

    2013-07-01

    The aims of present study were (1) to determine changes in kinematic and kinetic variables at 3 and 12 months after open reduction and internal fixation (ORIF) of pelvic ring fracture and (2) to determine the factor(s) associated with gait disorders that correlate with gait parameters measured at 12 months after surgery. Nineteen patients with pelvic ring fractures underwent ORIF and examined at 3 and 12 months postoperatively. The study also included a similar number of age-matched control subjects. Peak hip abduction angle, peak hip extension moment in the stance, peak hip abduction moment, and peak ankle plantarflexion moment at 3 months after ORIF were significantly lower than the respective control values. At 12 months, complete recovery was noted in peak hip abduction moment and peak ankle plantarflexion moment, whereas the recovery in peak hip abduction angle and peak hip extension moment in the stance was partial. The existence of neurological lesions and strength asymmetry of hip abductor and adductor at 3 months post-ORIF correlated with decreased peak hip abduction moment after ORIF. Our results highlighted characteristic gait patterns up to 12 months after ORIF for pelvic fracture, and these patterns correlated with neurological lesion and weakness of hip abductor and adductor muscles. PMID:23333355

  10. Evaluation and management of greater trochanter pain syndrome.

    Science.gov (United States)

    Mulligan, Edward P; Middleton, Emily F; Brunette, Meredith

    2015-08-01

    Greater trochanteric pain syndrome is an enigmatic but common cause of lateral hip symptoms in middle-aged active women. The most common manifestation of this syndrome is a degenerative tendinopathy of the hip abductors similar to the intrinsic changes seen with rotator cuff pathology in the shoulder. There are no definitive tests to isolate the underlying pathology and palpation is a non-specific means by which to differentiate the source of the pain generator. The physical examination must comprehensively evaluate for a cluster of potential impairments and contributing factors that will need to be addressed to effectively manage the likely functional limitations and activity challenges the syndrome presents to the patient. Compressive forces through increased tension in the iliotibial band should be avoided. Intervention strategies should include education regarding postural avoidance, activity modifications, improvement of lumbopelvic control, and a patient approach to resolving hip joint restrictions and restoring the tensile capabilities of the deep rotators and abductors of the hip. A number of reliable and validated hip-specific self-report outcome tools are available to baseline a patient's status and monitor their progress. Further investigations to identify the epidemiological risk factors, establish effective treatment strategies, and predict prognosis are warranted.

  11. Practical management of iliotibial band friction syndrome in runners.

    Science.gov (United States)

    Fredericson, Michael; Weir, Adam

    2006-05-01

    This article outlines the practical management of iliotibial band friction syndrome (ITBFS) in running athletes. ITBFS is the most common cause of lateral knee pain in runners and is related to repetitive friction of the iliotibial band sliding over the lateral femoral epicondyle. Runners predisposed to this injury are typically in a phase of over training and often have underlying weakness of the hip abductor muscles. The diagnosis of ITBFS is clinical and is based on a thorough patient history and physical exam. In the acute phase, treatment includes activity modification, ice, nonsteroidal anti-inflammatory medication, and corticosteroid injection in cases of severe pain or swelling. During the subacute phase emphasis is on stretching of the iliotibial band and soft tissue therapy for any myofascial restrictions. The recovery phase focuses on a series of exercises to improve hip abductor strength and integrated movement patterns. The final return to running phase is begun with an every other day program, starting with easy sprints and avoidance of hill training with a gradual increase in frequency and intensity. In rare refractory cases that do not respond to conservative treatment, surgery can be considered.

  12. Comparison of functional outcome of total hip arthroplasties involving four surgical approaches.

    Science.gov (United States)

    Mostardi, R A; Askew, M J; Gradisar, I A; Hoyt, W A; Snyder, R; Bailey, B

    1988-01-01

    One hundred thirty-seven total hip arthroplasty patients had a follow-up evaluation consisting of an orthopaedic physical evaluation, isokinetic strength testing, and collection of demographic and surgical information from medical records. The intraoperative variables of surgical time and blood loss and the functional outcome status of the subjects, as demonstrated by D'Aubigne--Postel ratings and isokinetic strength tests, were compared for various trochanteric management techniques: no osteotomy; complete Charnley-type osteotomy; sharp abductor release; and a wafer technique, in which a wafer of bone was osteotomized from the trochanter to release the abductors. A comparison of the mean values for the variables indicated that the wafer and sharp techniques were superior to the complete and no osteotomy techniques. The wafer technique resulted in statistically significant superior isokinetic strength measured in adduction, flexion, and extension. Surgical time was significantly greater in the complete osteotomy cases and blood loss was least in the wafer cases, although these differences were not significant. PMID:3183682

  13. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial

    DEFF Research Database (Denmark)

    Jensen, Carsten; Aagaard, Per; Overgaard, S

    2011-01-01

    in maximal lower limb muscle strength (in 2/6 muscle groups) compared to S-THA. Notably, the attenuated strength recovery following R-THA was most markedly manifested in the late phase (1 yr) of post-surgical recovery, and appeared to be due to the detachment of the lower half of the gluteus maximus muscle...... randomised into (A) standard total hip arthroplasty (S-THA) and (B) resurfacing total hip arthroplasty (R-THA). Pre-surgery assessment and follow-up were conducted (8, 26 and 52 wks). Maximal isometric muscle strength (Nm) and between-limb asymmetry for the knee extensors/flexors, hip adductors....../abductors, hip extensors/flexors were analysed. RESULTS: Maximal knee extensor and hip abductor strength were higher in S-THA than R-THA at 52 wks post-surgery (P ≤ 0.05) and hip extensors tended to be higher in S-THA at 52 wks (P = 0.06). All muscle groups showed substantial between-limb strength asymmetry (7...

  14. Representing tools as hand movements: early and somatotopic visuomotor transformations.

    Science.gov (United States)

    Bartoli, Eleonora; Maffongelli, Laura; Jacono, Marco; D'Ausilio, Alessandro

    2014-08-01

    The term affordance defines a property of objects, which relates to the possible interactions that an agent can carry out on that object. In monkeys, canonical neurons encode both the visual and the motor properties of objects with high specificity. However, it is not clear if in humans exists a similarly fine-grained description of these visuomotor transformations. In particular, it has not yet been proven that the processing of visual features related to specific affordances induces both specific and early visuomotor transformations, given that complete specificity has been reported to emerge quite late (300-450ms). In this study, we applied an adaptation-stimulation paradigm to investigate early cortico-spinal facilitation and hand movements׳ synergies evoked by the observation of tools. We adapted, through passive observation of finger movements, neuronal populations coding either for precision or power grip actions. We then presented the picture of one tool affording one of the two grasps types and applied single-pulse Transcranial Magnetic Stimulation (TMS) to the hand primary motor cortex, 150ms after image onset. Cortico-spinal excitability of the Abductor Digiti Minimi and Abductor Pollicis Brevis showed a detailed pattern of modulations, matching tools׳ affordances. Similarly, TMS-induced hand movements showed a pattern of grip-specific whole hand synergies. These results offer a direct proof of the emergence of an early visuomotor transformation when tools are observed, that maintains the same amount of synergistic motor details as the actions we can perform on them.

  15. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence.

    Science.gov (United States)

    Houdayer, Elise; Cursi, Marco; Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits.

  16. Surgical treatment of thumb adduction contracture in children with infantile cerebral palsy

    Directory of Open Access Journals (Sweden)

    Владимир Александрович Новиков

    2015-06-01

    Full Text Available The purpose of the work is to evaluate the effectiveness of different methods of surgical treatment of thumb adduction contracture in children with infantile cerebral palsy.Materials and methods.The present study is based on diagnostic results of children with infantile cerebral palsy with affected upper limb. The main criterion for selection of patients was the presence of thumb adduction contracture, the absence of significant positive outcome in a patient after conservative treatment, the impossibility of active thumb abduction more than 30° and the instability of the first metacarpophalangeal joint. Total we examined and treated 9 patients with spastic types of cerebral palsy.Results and conclusions.We evaluated the results of the following types of surgical treatment: release of adductor pollisis muscle, release of adductor pollisis muscle and tendon shortening of m.abductor pollicis longus, release of adductor pollisis muscle and tendon transfer of m.extensor indicis in the tendon m. abductor pollicis longus, the fixation of the first metacarpophalangeal joint with extramedullary plate. Based on these data, we were able to confirm the effectiveness of surgical treatment of thumb adduction contracture.

  17. Evaluation and management of greater trochanter pain syndrome.

    Science.gov (United States)

    Mulligan, Edward P; Middleton, Emily F; Brunette, Meredith

    2015-08-01

    Greater trochanteric pain syndrome is an enigmatic but common cause of lateral hip symptoms in middle-aged active women. The most common manifestation of this syndrome is a degenerative tendinopathy of the hip abductors similar to the intrinsic changes seen with rotator cuff pathology in the shoulder. There are no definitive tests to isolate the underlying pathology and palpation is a non-specific means by which to differentiate the source of the pain generator. The physical examination must comprehensively evaluate for a cluster of potential impairments and contributing factors that will need to be addressed to effectively manage the likely functional limitations and activity challenges the syndrome presents to the patient. Compressive forces through increased tension in the iliotibial band should be avoided. Intervention strategies should include education regarding postural avoidance, activity modifications, improvement of lumbopelvic control, and a patient approach to resolving hip joint restrictions and restoring the tensile capabilities of the deep rotators and abductors of the hip. A number of reliable and validated hip-specific self-report outcome tools are available to baseline a patient's status and monitor their progress. Further investigations to identify the epidemiological risk factors, establish effective treatment strategies, and predict prognosis are warranted. PMID:25497431

  18. Correlation of crossed cerebellar diaschisis with motor impairment of the hemiplegic upper extremity in stroke patients

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    Song, Ho Chun; Choi, In Sung; Heo, Young Jun; Min, Jeong Jun; Lee, Sam Gyu; Bom, Hee Seung [School of Medicine, Chonnam National University, Gwangju (Korea, Republic of)

    2004-07-01

    The aim of this study was to investigate the correlation between crossed cerebellar diaschisis (CCD) and motor evoked potentials (MEPs) and to study the relationship between CCD and the severity and prognosis of stroke. Twenty-eight patients with first-ever unilateral stroke underwent brain perfusion SPECT with Tc-99m ECD. The existence of CCD was evaluated by visual inspection on SPECT images. The central motor conduction times were obtained from Abductor pollicis brevis and Abductor hallucis by recording MEPs. The National Institutes of Health stroke scale, the motricity Index (MI), and the functional outcome scales were measured. Fifteen of 28 patients (53.6%) had CCD. The presence of CCD was significantly correlated with 'not evoked' MEPs in the upper extremity (p<0.01). The existence of CCD was not associated with locations (p>0.05) and volume of brain lesion (p>0.05). There was a significant correlation between the presence of CCD and lower MI score of upper extremity (p<0.05). The presence of CCD would indicate the damage on the descending motor pathways and be associated with the severe motor impairment of the upper extremity in stroke patients.

  19. Anomalous composition of musculature of the first dorsal fibro-osseous compartment of the wrist.

    Science.gov (United States)

    Dhuria, Ruchi; Mehta, Vandana; Suri, Rajesh Kumar; Rath, Gayatri

    2012-06-01

    The anomalous orientation of musculature of the first dorsal fibro-osseous compartment of the wrist is clinically relevant to De Quervian's stenosing tenosynovitis and reconstructive surgeries. Split insertion of the abductor pollicis longus (APL) is commonly found in chimpanzees, gorillas and gibbons. A comparable identical pattern of anomalous slips in humans is of anthropological and phylogenetic importance and could be a result of atavism. This case report describes an unusual fused muscle belly of the APL and extensor pollicis brevis (EPB), which split into three slips--medial, intermediate and lateral. Further, the medial slip was seen to divide into two tendons, inserting on the base of the first metacarpal along with the intermediate slip. The lateral slip divided into three tendons, inserting into the base of the proximal phalanx, base of the first metacarpal and abductor pollicis brevis muscle. The fusion and unusual insertion pattern of the APL and EPB merits documentation for reconstructive procedures such as tendon transfer and interposition arthroplasty. PMID:22711053

  20. Modulation of motor cortical outputs to the reading hand of braille readers.

    Science.gov (United States)

    Pascual-Leone, A; Cammarota, A; Wassermann, E M; Brasil-Neto, J P; Cohen, L G; Hallett, M

    1993-07-01

    We used focal transcranial magnetic stimulation to map the motor cortical areas targeting the first dorsal interosseous and the abductor digiti minimi muscles bilaterally in 10 proficient braille readers and 10 blind controls who were matched for age (mean, 50.6 yr) and age at time of blindness (mean, 7.5 yr). The proficient braille readers had learned braille at age 8 to 14 years and used it daily for 5 to 10 hours. Controls had not learned braille until age 17 to 21 years and used it daily for braille readers, the representation of the first dorsal interosseous muscle in the reading hand was significantly larger than that in the nonreading hand or in either hand of the controls. Conversely, the representation of the abductor digiti minimi muscle in the reading hand was significantly smaller than that in the nonreading hand or in either hand of the controls. These differences were not due to differences in motor thresholds. Our results suggest that the cortical representation of the reading finger in proficient braille readers is enlarged at the expense of the representation of other fingers.

  1. The architecture and contraction time of intrinsic foot muscles.

    Science.gov (United States)

    Tosovic, Danijel; Ghebremedhin, Estifanos; Glen, Christopher; Gorelick, Mark; Mark Brown, J

    2012-12-01

    Although critical for effective human locomotion and posture, little data exists regarding the segmentation, architecture and contraction time of the human intrinsic foot muscles. To address this issue, the Abductor Hallucis (AH), Abductor Digiti Minimi (ADM), Flexor Digitorum Brevis (FDB) and Extensor Digitorum Brevis (EDB) were investigated utilizing a cadaveric dissection and a non-invasive whole muscle mechanomyographic (wMMG) technique. The segmental structure and architecture of formaldehyde-fixed foot specimens were determined in nine cadavers aged 60-80 years. The wMMG technique was used to determine the contraction time (Tc) of individual muscle segments, within each intrinsic foot muscle, in 12 volunteers of both genders aged between 19 and 24 years. While the pattern of segmentation and segmental -architecture (e.g. fibre length) and -Tc of individual muscle segments within the same muscle were similar, they varied between muscles. Also, the average whole muscle Tc of FDB was significantly (p muscles investigated (ADM Tc = 72 ms, EDB Tc = 72 ms and ABH Tc = 69 ms). The results suggest that the architecture and contraction time of the FDB reflect its unique direct contribution, through toe flexion, to postural stability and the rapid development of ground reaction forces during forceful activities such as running and jumping.

  2. The split hand syndrome in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Eisen, Andrew; Kuwabara, Satoshi

    2012-04-01

    In amyotrophic lateral sclerosis (ALS), hand muscle wasting preferentially affects the 'thenar (lateral) hand', including the abductor pollicis brevis (APB) and first dorsal interosseous (FDI) muscles, with relative sparing of the hypothenar muscles (the abductor digiti minimi (ADM)). This peculiar pattern of dissociated atrophy of the intrinsic hand muscles is termed the 'split hand' and is rarely seen in diseases other than ALS. The muscles involved in the split hand are innervated through the same spinal segments (C8 and T1), and FDI and ADM, which are differentially affected, are both ulnar nerve innervated. The physiological mechanisms underlying the split hand in ALS are incompletely understood but both cortical and spinal/peripheral mechanisms are probably involved. Motor potentials evoked by magnetic stimulation are significantly smaller when recorded from the thenar complex, compared with the hypothenar muscles, supporting a cortical mechanism. But peripheral axonal excitability studies have suggested that APB/FDI motor axons have more prominent persistent sodium currents than ADM axons, leading to higher axonal excitability and thereby more ready degeneration. Pincer or precision grip is vital to human hand function, and frequent use of thenar complex muscles may lead to greater oxidative stress and metabolic demands at both upper and lower motoneurons innervating the APB and FDI. The split hand is a useful diagnostic sign in early ALS, and recent objective studies indicate that the sign has a high degree of specificity.

  3. An investigation of the association between grip strength and hip and knee joint moments in older adults.

    Science.gov (United States)

    Samuel, Dinesh; Rowe, Philip

    2012-01-01

    Grip strength is a predictor of health outcomes but with differing rates of age-related decline in muscle strength, it is unclear whether handgrip is a reliable indicator of lower limb moments. This study investigated the relationship between grip strength and lower extremity moments in community-dwelling older adults. Eighty-two healthy volunteers aged 60-82 years (mean age 73.2 years) performed maximal voluntary contractions of knee and hip extensors and flexors at three positions and at neutral position for hip abductors and adductors using a custom-built dynamometer. Grip strength was measured using an electronic Jamar dynamometer. The relative reduction in muscle strength of 80s age category compared to 60-year-olds ranged from 14% for grip strength to 27% for hip abductors. Peak torque of flexors and extensors of the knee and hip joints were significantly correlated with grip strength and Pearson's correlation coefficients ranged from 0.56 to 0.78 with the highest correlations observed between knee moments and grip strength. "Good" correlation was found but only 31-60% of the variation in grip strength could be related to changes in joint torques. Hence the assumption that grip strength is an indicator of strength in the lower limb would seem unjustified in the healthy older adult.

  4. A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia.

    Science.gov (United States)

    Huang, Ziqiang; Zhou, Yonggang; Chai, Wei; Ji, Weiping; Cui, Guopeng; Ma, Miaoqun; Zhu, Yin

    2016-07-01

    [Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I-III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I-III). PMID:27512242

  5. Characteristics of corticospinal projections to the intrinsic hand muscles in skilled harpists.

    Science.gov (United States)

    Buick, Alison R; Kennedy, Niamh C; Carson, Richard G

    2016-01-26

    The process of learning to play a musical instrument necessarily alters the functional organisation of the cortical motor areas that are involved in generating the required movements. In the case of the harp, the demands placed on the motor system are quite specific. During performance, all digits with the sole exception of the little finger are used to pluck the strings. With a view to elucidating the impact of having acquired this highly specialised musical skill on the characteristics of corticospinal projections to the intrinsic hand muscles, focal transcranial magnetic stimulation (TMS) was used to elicit motor evoked potentials (MEPs) in three muscles (of the left hand): abductor pollicis brevis (APB); first dorsal interosseous (FDI); and abductor digiti minimi (ADM) in seven harpists. Seven non-musicians served as controls. With respect to the FDI muscle-which moves the index finger, the harpists exhibited reliably larger MEP amplitudes than those in the control group. In contrast, MEPs evoked in the ADM muscle-which activates the little finger, were smaller in the harpists than in the non-musicians. The locations on the scalp over which magnetic stimulation elicited discriminable responses in ADM also differed between the harpists and the non-musicians. This specific pattern of variation in the excitability of corticospinal projections to these intrinsic hand muscles exhibited by harpists is in accordance with the idiosyncratic functional demands that are imposed in playing this instrument. PMID:26673887

  6. [Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].

    Science.gov (United States)

    Martín-Oliva, X; Elgueta-Grillo, J; Veliz-Ayta, P; Orosco-Villaseñor, S; Elgueta-Grillo, M; Viladot-Perice, R

    2013-01-01

    The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. To describe the anatomical variants of the posterior tibial nerve and its terminal branches. To describe the steps for tarsal tunnel release. To describe Baxter nerve release. The anatomical variants of the posterior tibial nerve and its terminal branches within the tarsal tunnel were studied. Then the Lam technique was performed; it consists of: 1) opening of the laciniate ligament, 2) opening of the fascia over the abductor hallucis muscle, 3) exoneurolysis of the posterior tibial nerve and its terminal branches, identifying the emergence and pathway of the medial calcaneal branch, the lateral plantar nerve and its Baxter nerve branch and the medial plantar nerve. Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel. PMID:24701749

  7. Retrowalking as an adjunct to conventional treatment versus conventional treatment alone on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Gauri Arun Gondhalekar

    2013-01-01

    Full Text Available Background: Increased external knee adduction moment during walking alters the joint biomechanics; which causes symptoms in chronic knee osteoarthritis patients. Aims: To assess additional effects of Retro-walking over conventional treatment on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis. Materials and Methods: Thirty chronic knee osteoarthritis patients were randomly assigned into 2 groups. Group ′A′ (7 men, 8 women received conventional treatment. Group ′B′ (8 men, 7 women received conventional treatment and Retro-walking. Pain, assessed through visual analogue scale (VAS, and Western Ontario and McMaster Universities Arthritis Index (WOMAC were the primary outcomes and knee range of motion (ROM, hip abductor and extensor strength were secondary outcomes; measured pre-intervention, after 1 week and after 3 weeks of intervention. Results: Two factors analysis of variance for repeated measures was used for all outcomes. At the end of 3 weeks; WOMAC score showed highly significant difference within ( P < 0.0001 and significant difference between groups ( P = 0.040 also by Time × group interaction ( P = 0.024, VAS showed highly significant difference within groups ( P < 0.0001. Knee ROM showed significant difference within groups. Hip abductor and extensor strength showed significant difference by Time × group interaction ( P < 0.05. Conclusion: Retrowalking is an effective adjunct to conventional treatment in decreasing disability in patients with knee osteoarthritis.

  8. Preliminary observation of the relationship between intraoperative electrophysiologic testing and surgical outcome of carpal tunnel release%腕管综合征术中神经电生理检测与手术疗效评价的初步探讨

    Institute of Scientific and Technical Information of China (English)

    陈劼; 徐雷; 徐建光; 田东; 朱艺; 韩栋; 顾玉东

    2010-01-01

    Objective To explore a reliable predicator of surgical outcomes of carpal tunnel release(CTR)by exploring the changes of pre-and intraoperative median nerve-abductor pollicis brevis compound muscle action potential(CMAP).Methods Fifteen patients with carpal tunnel syndrome were involved in the study.Electrophysiologic examination was carried out to record CMAP of abductor pollicis brevis muscle at following moments:before CTR right after brachial plexus block,immediate after CTR and tourniquet release,1minute,3 minutes,5 minutes and 7 minutes after tourniquet release.Statistics analysis was done to compare these parameters with preoperative values.Results There were statistically significant changes in both amplitude and latency of the CMAP within 5 minutes after toumiquet release(P0.05).正中神经-拇短展肌CMAP的潜伏期比术前缩短,差异有统计学意义(P<0.05),但波幅与术前相比差异有明显统计学意义(P<0.01).方论 对腕管综合征行神经松解术后,拇短展肌CMAP的波幅比其潜伏期更能体现神经松解的疗效,而在松止血带5 min后进行神经电生理检测来评价手术效果更为可靠.

  9. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins

    Directory of Open Access Journals (Sweden)

    Hyun-Mi Oh

    2015-12-01

    Full Text Available MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH and abductor digiti quinti (ADQ muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect.

  10. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins.

    Science.gov (United States)

    Oh, Hyun-Mi; Park, Joo Hyun; Song, Dae Heon; Chung, Myung Eun

    2016-01-01

    MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB) muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX) was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH) and abductor digiti quinti (ADQ) muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP) amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA) differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect. PMID:26712786

  11. 神经电生理检查在22例腕管综合征患者中的应用%Electrophysiological analysis in carpal tunnel syndrome in 22 cases

    Institute of Scientific and Technical Information of China (English)

    万泉

    2011-01-01

    目的:对比分析腕管综合征(carpal tunnel syndrome,CTS) 患者的神经电生理特征.方法:对临床症状、体征符合CTS的22例患者进行正中神经和尺神经的运动与感觉传导速度测定,以及大鱼际肌、小鱼际肌的肌电图检测.结果:在22例患者中,双侧上肢均有病变者7例,单侧上肢病变者15例,共有29侧上肢病变.22例CTS患者中29条正中神经感觉传导潜伏期均延长,29条正中神经感觉传导速度均减慢,21条正中神经感觉诱发波幅降低,28条正中神经运动远端潜伏期延长,28条正中神经的复合肌肉动作电位波幅降低,1条正中神经运动远端潜伏期和诱发波幅正常.19块正中神经支配的大鱼际肌呈神经原性损害.结论:神经电生理检查在CTS的诊断与鉴别诊断中具有重要价值.%Objective:To find out the neural electrophysiological features in patients with carpal tunnel syndrome (CTS). Methods: We performed the measurement of motor nerve conduction velocity and sensory nerve conduction velocity on median nerve and ulnar nerve as well as electromyogram of abductor polleis brevis and abductor digiti minimi in 22 cases of CTS patients. Results: Of the 22 patients, bilateral lesions were found in 7 and unilateral in 15, and totally there were 29 lesions. The latency of 29 median nerves sensory conduction became delayed and the sensory conduction velocity were decreased. Reduced evoked amplitude was seen in 21 median nerves sensory nerves and delayed distal motor latency (DML) in 28 median nerves. In addition, 28 median nerves compound muscle action potential (CMAP) were found decreased. The DML and the evoked amplitude remained normal in only 1 median nerve. The neurogenic injury was seen in 19 abductor pollicis brevis controlled by the median nerve. Conclusion: Neural electrophysiological examination has great value in the diagnosis and differential diagnosis of CTS.

  12. Inter-device reliability of DSI measurement.

    Science.gov (United States)

    Aichinger, Philipp; Feichter, Felicitas; Aichstill, Birgitta; Bigenzahn, Wolfgang; Schneider-Stickler, Berit

    2012-12-01

    The Dysphonia Severity Index (DSI) is a measure that quantifies the overall vocal quality. The aim of the study is to evaluate the reliability of DSI measurements. The DSIs of 30 subjects were therefore measured using LingWAVES (WEVOSYS) and DiVAS (XION). To evaluate the inter-device reliability of DSI measurement, the devices' results were compared for each subject. The DSI values of both devices showed great differences. The calculated DSI differences of 95% of the subjects were within the limits of +2.39 and -2.82, which makes a clinical interpretation of severity of voice disorder using different devices questionable. The technical and procedural aspects of measurement divergences are discussed, and the need to define hardware and software standards is shown. PMID:22702894

  13. VIDEOLARYNGOSCOPIC SURGEY IN BENIGN LARYNGEAL LESIONS-OUR EXPERIENCE

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    Satheesh

    2015-11-01

    Full Text Available : Benign laryngeal lesions are commonly encountered causes of dysphonia and are often surgically correctable. A prospective study on 62 cases selected for videolaryngoscopic surgery was undertaken in a single unit in the department of ENT, Medical College Hospital, Thiruvananthapuram. The male: female ratio was 1.8:1 and the most common affected age group was 35-45 yrs. The most common benign lesion was vocal polyp. Preoperative voice assessment and 70 degree endoscopy was done. Follow up visits were done at 1 week, 3 weeks and 6 weeks and voice assessment and laryngoscopic appearances were noted. 98% reported excellent improvement of voice. The varieties of benign lesions which cause hoarseness are sources of concern and worry as it can affect the self esteem of a person. Thus videolaryngoscopic surgery (VLS coupled with voice therapy offers cost effective and safe management in benign laryngeal lesions

  14. Automatic Assessment of Pathological Voice Quality Using Higher-Order Statistics in the LPC Residual Domain

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    JiYeoun Lee

    2009-01-01

    Full Text Available A preprocessing scheme based on linear prediction coefficient (LPC residual is applied to higher-order statistics (HOSs for automatic assessment of an overall pathological voice quality. The normalized skewness and kurtosis are estimated from the LPC residual and show statistically meaningful distributions to characterize the pathological voice quality. 83 voice samples of the sustained vowel /a/ phonation are used in this study and are independently assessed by a speech and language therapist (SALT according to the grade of the severity of dysphonia of GRBAS scale. These are used to train and test classification and regression tree (CART. The best result is obtained using an optima l decision tree implemented by a combination of the normalized skewness and kurtosis, with an accuracy of 92.9%. It is concluded that the method can be used as an assessment tool, providing a valuable aid to the SALT during clinical evaluation of an overall pathological voice quality.

  15. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

    Science.gov (United States)

    Roberts, Rachel Margaret; Mukherjee, Jayanta; Phillips, David

    2016-01-01

    We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection. PMID:27329097

  16. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Junor, E.J.; Paul, J.; Reed, N.S. (Beatson Oncology Centre, Glasgow (United Kingdom))

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author).

  17. A Rare Early Complication of Tracheostomy

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    Manjeet Singh Pawar

    2011-01-01

    Full Text Available A polytrauma patient on ventilator was admitted to ICU with open tracheostomy, GCS 8/15 and unequal pupils. After 10 days, he was weaned from the ventilator. The patient had respiratory problems i.e. expiratory stridor, shortness of breath, dysphonia and dyspnea on closing tracheostomy. It was diagnosed as a case of asthma, and the patient responded to salbutamol nebulization and intravenous steroid therapy. However, after some time, he desaturated and a plan for rapid sequence intubation was made. Endotracheal tube could not be negotiated beyond vocal cords, so an unprepared tracheostomy without proper equipment had to be immediately done by an anesthetist to save the patient’s life. CT scan revealed tracheal stenosis. This case demonstrates that patients with a short 15-days history of previous tracheostomy may have tracheal stenosis.

  18. Synchronous metastatic skull base chordoma to the breast: case report and literature review

    Science.gov (United States)

    Shakir, S.I.; Pelmus, M.; Florea, A.; Boileau, J.F.; Guiot, M.C.; Di Maio, S.; Muanza, T.M.

    2016-01-01

    Clinical Scenario During routine staging work-up for a left breast mass, a 68-year-old woman complained of dysphagia and dysphonia. During further investigations, a left-sided lesion at the foramen magnum was observed on brain imaging. Both lesions were biopsied and showed a classical chordoma. Management The skull-base lesion and the breast lesion were surgically resected, and adjuvant radiotherapy was given. Summary Chordoma is a rare primary central nervous system tumour that seldom metastasizes. The lung is the most common site of metastasis. Synchronous breast metastasis from a skull-base chordoma is very rare, and a safe management option includes a maximum resection followed by adjuvant radiotherapy. PMID:27122985

  19. Proton radiation therapy for clivus chordoma; Case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoshii, Yoshihiko; Tsunoda, Takashi; Hyodo, Akio; Nose, Tadao (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine); Tsujii, Hirohiko; Tsuji, Hiroshi; Inada, Tetsuo; Maruhashi, Akira; Hayakawa, Yoshinori

    1993-03-01

    A 57-year-old male with clival chordoma developed severe hoarseness, dysphagia, and dysphonia 1 month after a second removal of the tumor. Magnetic resonance imaging demonstrated a mass 10 cm in diameter in the region of the middle clivus enhanced inhomogeneously by gadolinium-diethylenetriaminepenta-acetic acid, and a defect in the skull base. There was evidence of compression of the anterior surface of the pons. He received proton irradiation employing a pair of parallel opposed lateral proton beams. The dose aimed at the tumor mass was 75.5 Gy, to the pharyngeal wall less than 38 Gy, and to the anterior portion of the pons less than 30 Gy. Time dose and fractionation factor was calculated at 148. Thirty-one months following treatment, he was free of clinical neurological sequelae. Proton therapy should be considered in treatment planning following initial surgical removal or for inoperable clivus chordoma. (author).

  20. An Improved Time Domain Pitch Detection Algorithm for Pathological Voice

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    Mohd R. Jamaludin

    2012-01-01

    Full Text Available Problem statement: The present study proposes a new pitch detection algorithm which could potentially be used to detect pitch for disordered or pathological voices. One of the parameters required for dysphonia diagnosis is pitch and this prompted the development of a new and reliable pitch detection algorithm capable of accurately detect pitch in disordered voices. Approach: The proposed method applies a technique where the frame size of the half wave rectified autocorrelation is adjusted to a smaller frame after two potential pitch candidates are identified within the preliminary frame. Results: The method is compared to PRAATs standard autocorrelation and the result shows a significant improvement in detecting pitch for pathological voices. Conclusion: The proposed method is more reliable way to detect pitch, either in low or high pitched voice without adjusting the window size, fixing the pitch candidate search range and predefining threshold like most of the standard autocorrelation do.

  1. Diagnosing the tight building syndrome.

    Science.gov (United States)

    Rogers, S A

    1987-12-01

    Formaldehyde is but one of many chemicals capable of causing the tight building syndrome or environmentally induced illness (EI). The spectrum of symptoms it may induce includes attacks of headache, flushing, laryngitis, dizziness, nausea, extreme weakness, arthralgia, unwarranted depression, dysphonia, exhaustion, inability to think clearly, arrhythmia or muscle spasms. The nonspecificity of such symptoms can baffle physicians from many specialties. Presented herein is a simple office method for demonstrating that formaldehyde is among the etiologic agents triggering these symptoms. The very symptoms that patients complain of can be provoked within minutes, and subsequently abolished, with an intradermal injection of the appropriate strength of formaldehyde. This injection aids in convincing the patient of the cause of the symptoms so he can initiate measures to bring his disease under control.

  2. Harmonic scalpel tonsillectomy versus monopolar diathermy tonsillectomy: a prospective study.

    Science.gov (United States)

    Roth, Jason A; Pincock, Tobias; Sacks, Raymond; Forer, Martin; Boustred, Neil; Johnston, William; Bailey, Michael

    2008-06-01

    For tonsillectomy, the ultrasonic harmonic scalpel has been purported to cause less tissue injury and postoperative morbidity while providing adequate levels of hemostasis. We undertook a prospective study to compare outcomes in 162 patients who had undergone harmonic scalpel tonsillectomy and 40 patients who had undergone monopolar diathermy tonsillectomy over a 33-month period. We found that patients in the harmonic scalpel group experienced significantly less intraoperative bleeding (5.0 vs. 16.5 ml; p < 0.0001). There was no clinically significant difference between the groups with respect to (1) the amount of operating time, (2) the incidence of postoperative nausea and vomiting, dysphonia, and primary or secondary bleeding, and (3) the amount of time patients needed to resume normal diet and activities. PMID:18561118

  3. Conservative Management for Lingual Thyroid Ectopic

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    Eder Alberto Sigua-Rodriguez

    2015-01-01

    Full Text Available Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with Tc99m and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years.

  4. Conservative management for lingual thyroid ectopic.

    Science.gov (United States)

    Sigua-Rodriguez, Eder Alberto; Rangel Goulart, Douglas; Asprino, Luciana; de Moraes Manzano, Afonso Celso

    2015-01-01

    Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with Tc(99m) and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years.

  5. Outcomes of Autologous Fat Injection Laryngoplasty in Unilateral Vocal Cord Paralysis

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    Ehsan Khadivi

    2016-05-01

    Full Text Available Introduction: Unilateral vocal cord paralysis (UVCP is not an uncommon finding. Several procedures are available to manage glottal insufficiency. We conducted a clinical trial to evaluate the outcome of fat injection laryngoplasty.   Materials and Methods: Liposuctioned lower abdomen fat was injected for augmentation of paralyzed vocal cord in 20 patients with UVCP. Autologous fat was harvested with an 18G needle and a 20-ml disposable syringe using a liposuction technique. Clinical follow-up after the injection was carried out from 1 to 6–21 months   Results: Voice and glottal protective function were significantly improved after the surgery. Vocal elements were immediately improved after the surgery, and after 1 year of follow-up. Conclusion:  Fat injection laryngoplasty by liposuction is simple, safe, effective and has a low cost for patients with UVCP with aspiration and breathy voice dysphonia.

  6. Management of respiratory failure in severe neuroparalytic snake envenomation.

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    Agrawal P

    2001-01-01

    Full Text Available Fourteen patients with severe neuroparalytic snake envenomation, resulting in acute type II respiratory failure, admitted to respiratory critical care unit for mechanical ventilation during one year period, were studied. Ventilatory requirements, amount of anti snake venom (ASV infused, period of neurological recovery and hospital survival were evaluated. All patients had severe manifestations such as ptosis, extraocular muscle paresis and limb weakness along with dyspnoea. Seven patients (50% had additional complaints of dysphagia and dysphonia. ASV was administered to all, with a median requirement of 900 ml. Mechanical ventilation was required for a median duration of 17 hours and all except one patient, who had suffered irreversible hypoxic cerebral injury prior to resuscitation, survived with complete neurological recovery. We conclude, that the timely institution of ventilatory support and anti-venom therapy in such patients, is associated with an excellent outcome.

  7. 嗓音障碍性疾病患者应用VHI评估与嗓音声学分析的比较%CORRELATION BETWEEN VHI AND VOICE ACOUSTIC ANALYSIS IN DYSPHONIC PATIENTS

    Institute of Scientific and Technical Information of China (English)

    董金辉; 单春光; 郝芳

    2012-01-01

    Objective To analyse the relationship between voice acoustic analysis ( VAA ) and voice handicap index ( VHI ) in dysphonic patients, and to investigate the characteristic of the VHI. Methods One hundred and fourteen dysphonic patients( dysphonia group ) and 40 subjects with normal voice( control group ) were tested by multi dimensional voice program( MDVP )and underwent VHI. Fundamental frequency, pitch perturbation, amplitude perturbation( shimmer ) and noise to harmonic ratio ( NHR)as objective items of the voice acoustic analysis were evaluated. Voice handicap index( VHI ) concluded function( F )、 physiology ( P ) and emotion ( E ), and the the total scores of the VHI were recorded. Results The parameters such as jitter, shimmer, NHR in dysphonia patients were much higher and Fo was lower than those in the normal voice group. The average score of VHI had obvious significant difference between the two groups. There were well correlations between P and E ( r = 0. 863 ), Fand TVH ( r= 0. 818 ), P and TVH ( r = 0. 929 ), E and TVH ( r = 0. 910 )( P < 0. 01 ). There was no correlation between VHI and VAA ( P > 0. 05 ). Conclusion VAA can not be used as a standard to speculate the subjective evaluation of dysphonia, while VHI can reflect the level of dysphonia in dysphonic patients.%目的 探讨嗓音障碍指数(voice handicap index,VHI)用于嗓音障碍性疾病患者自我评估的临床意义及与声学参数间的相关性.方法 对嗓音障碍性患者114例(患者组) 及嗓音正常者40例(对照组)采用多维嗓音软件(multi dimensional voice program,MDVP)进行嗓音声学分析和VHI调查,嗓音声学分析指标包括基频、基频微扰、振幅微扰、噪声/谐和比(noise to harmonic ratio,NHR),VHI 调查包括功能(function,F) 、生理(physiology,P) 、情感(emotion,E) 3个范畴,记录3方面得分及总分(total scores of the VHI,TVH ) 分值.结果 患者组的基频微扰、振幅微扰、NHR 均高于正常

  8. Nebulized lidocaine in the treatment of intractable cough.

    Science.gov (United States)

    Truesdale, Kelly; Jurdi, Adham

    2013-09-01

    Cough is one of the most common symptoms prompting patients to be seen by health care providers in the United States. Persistent cough can disrupt daily activities such as conversation, eating, breathing, and sleeping, and it can become extremely debilitating both physically and mentally. Pharmacological treatments include dextramethorphan, opioid cough suppressants, benzonatate, inhaled ipratropium, and guaifenesin. Successful cough suppression has also been demonstrated in several studies with the use of nebulized lidocaine. Nebulized lidocaine also appears to be well tolerated by patients with minimal side effects including dysphonia, oropharyngeal numbness, and bitter taste. Studies conducted thus far have been small, so larger randomized control trials comparing nebulized lidocaine to placebo need to be conducted in the future. PMID:22964341

  9. Effect of continuous cuff pressure regulator in general anaesthesia with laryngeal mask airway.

    Science.gov (United States)

    Jeon, Y-S; Choi, J-W; Jung, H-S; Kim, Y-S; Kim, D-W; Kim, J-H; Lee, J-A

    2011-01-01

    Postoperative pharyngolaryngeal complications (PPLC) occur during anaesthesia due to increased cuff pressure following the insertion of laryngeal mask airways. The use of a pressure regulator to prevent PPLC was evaluated in a prospective, randomized study. Sixty patients scheduled to receive general anaesthesia were randomly assigned to two equal groups of 30, either with or without the regulator. The 'just seal' cuff pressure (JSCP), cuff pressure at 5-min intervals during anaesthesia, incidence of pharyngeal sore throat (PST), dysphagia, dysphonia and other complications were evaluated at 1 and 24 h postoperatively. The combined mean ± SD JSCP of both groups was 20.3 ± 3.2 mmHg. In the group with the regulator, cuff pressure was maintained at a constant level during anaesthesia. This study demonstrated that the regulator is a simple, functional device that can reduce the incidence of PST significantly at 1 h postoperatively, following general anaesthesia. PMID:22117992

  10. Reactional Plasmacytosis In Plasma Cell Orificial mucositis In A Patient Of Pulmonary Tuberculosis

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    Bose Sumit Kumar

    1997-01-01

    Full Text Available Skin biopsy of a 50 year old Moroccan male patient with labial and oro-pharyngeal plasmocytosis showed hyperplastic, with papillomatous eroded epithelium. Dense infiltrates of plasma cells were seen in the dermis, with perivascular prominence. Hypopharynx, epiglottis, adenoids, and tonsils showed the same type of infiltration. Immunofluorescence (IF and peroxidase antiperoxidase (PAP techniques demonstrated the presence of mostly and infiltrate of plasma cells showing IgA (30 â€" 40%, IgM (20-30%, IgG(10-20% after staining with polyclonal antibodies along with T4 & T8 Iymphocytes with monoclonal staining. Electron microscopy showed absence of atypical plasma cells with abundant endoplasmic reticulum. Patient’s symptoms of stomtitis, dysphonia and pharyngitis were temporarily relieved by systemic corticosteroids of plasma cells suggesting a reactive type of benign plasmocytosis.

  11. Solitary Polypoid Laryngeal Xanthoma

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    Francisco Vera-Sempere

    2013-01-01

    Full Text Available We report the case of a 51-year-old male smoker with diabetes mellitus and hyperlipidaemia and a long history of human immunodeficiency virus (HIV/hepatitis C virus (HCV infection treated with various antiretroviral regimes, who was referred to the otolaryngology department with progressive dysphonia. Fibre-optic laryngoscopy showed a solitary, yellowish-white pedunculated polyp on the anterior third of the left cord, with no other abnormality. Pathological analysis revealed a polypoid laryngeal xanthoma that was immunoreactive against CD68, perilipin, and adipophilin. This unusual laryngeal lesion in the clinical context of our patient suggests a possible role of antiretroviral treatment in the pathogenesis of these xanthomas.

  12. Diagnosing the tight building syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, S.A.

    1987-12-01

    Formaldehyde is but one of many chemicals capable of causing the tight building syndrome or environmentally induced illness (EI). The spectrum of symptoms it may induce includes attacks of headache, flushing, laryngitis, dizziness, nausea, extreme weakness, arthralgia, unwarranted depression, dysphonia, exhaustion, inability to think clearly, arrhythmia or muscle spasms. The nonspecificity of such symptoms can baffle physicians from many specialties. Presented herein is a simple office method for demonstrating that formaldehyde is among the etiologic agents triggering these symptoms. The very symptoms that patients complain of can be provoked within minutes, and subsequently abolished, with an intradermal injection of the appropriate strength of formaldehyde. This injection aids in convincing the patient of the cause of the symptoms so he can initiate measure to bring his disease under control.

  13. Voz e posição de prega vocal em homens com paralisia unilateral de prega vocal Voice and vocal fold position in men with unilateral vocal fold paralysis

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    Karine Schwarz

    2011-12-01

    Full Text Available O posicionamento da prega vocal paralisada e o grau de disfonia são fatores importantes para decidir as opções de tratamento na paralisia de prega vocal unilateral (PPVU. OBJETIVO: Verificar as características perceptivo-auditivas da voz e a posição da prega vocal paralisada, em homens, com PPVU. MATERIAIS E MÉTODOS: Estudo retrospectivo, coorte histórica, com corte transversal, com dados de 24 homens com PPVU, com média de 60,7 anos, submetidos à avaliação vocal perceptivo-auditiva da voz, por três juízas fonoaudiólogas e perceptivo-visual das imagens laríngeas, com a classificação da posição da prega vocal paralisada, por três juízes otorrinolaringologistas. RESULTADOS: A prega vocal paralisada em posição paramediana ocorreu em 45,83% dos casos; a intermediária, em 25%; a lateral, em 20,83%, e a mediana, em 4,16%; a disfonia resultante da PPVU foi caracterizada pela rouquidão, aspereza e tensão, de grau moderado; soprosidade (maior frequência do grau grave; astenia e instabilidade (maior frequência do grau leve; a posição da prega vocal paralisada influenciou significativamente o grau geral de desvio vocal. CONCLUSÃO: O grau geral de disfonia está relacionado com a posição da prega vocal paralisada; a disfonia é caracterizada pela presença de rouquidão, soprosidade, aspereza e tensão de grau moderado a grave.The paralyzed vocal fold positioning and the degree of dysphonia are important inputs when one is deciding upon treatment options for unilateral vocal fold paralysis (UVFP. OBJECTIVE: To check voice characteristics and paralyzed vocal fold position in men with UVFP. MATERIALS AND METHODS: This is a retrospective historical cross-sectional cohort study, with data from 24 men with UVFP with mean age of 60.7 years, submitted to voice assessment by three speech therapists and three ENT physicians used laryngeal images to classify the position of the paralyzed vocal fold. RESULTS: The paralyzed vocal fold

  14. Correlação da qualidade de vida e voz com atividade profissional Correlation between voice and life quality and occupation

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    Ana Lúcia Spina

    2009-04-01

    Full Text Available As disfonias podem comprometer a qualidade da comunicação e, por conseqüência, a relação social do indivíduo e assim afetar sua qualidade de vida. Existe hoje necessidade de protocolos objetivos para avaliação da qualidade vocal que mensurem suas implicações na qualidade de vida do paciente. OBJETIVOS: Relacionar qualidade de vida e voz com o grau de disfonia e o uso profissional da voz em um grupo de pacientes disfônicos. MATERIAL E MÉTODO: Realizou-se estudo clínico prospectivo aplicando-se protocolo internacional para avaliar a qualidade de vida e voz em um grupo de pacientes disfônicos. Realizou-se tratamento estatístico dos resultados considerando-se não-distinção entre profissionais da voz e não-profissionais da voz e, em seguida, considerando-se esta distinção profissional. RESULTADOS: A disfonia afetou a qualidade de vida em todos os indivíduos. Não houve diferença estatística entre os grupos, profissionais da voz e não-profissionais da voz, quanto ao grau de disfonia. Houve correlação entre qualidade de vida e grau de disfonia, no entanto, considerando-se os grupos separadamente, esta correlação foi significativa apenas no grupo de sujeitos não-profissionais da voz. CONCLUSÃO: A disfonia afetou a qualidade de vida em todos os sujeitos independente do uso profissional da voz.Dysphonia may impair the quality of communication and social relations of people, thereby directly affecting quality of life. It is common knowledge amongst professionals involved with the treatment of voice disorders the need for objective protocols to evaluate voice quality and measure its impact on the individual's quality of life. AIM: To associate life quality with the degree of dysphonia and professional voice use in a group of dysphonic patients. MATERIALS AND METHODS: A prospective clinical study was undertaken with a group of dysphonic patients using an internationally validated voice-related quality-of-life protocol. A

  15. The application of short-term efficiency analysis in diagnosing occupational voice disorders

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    Ewa Niebudek-Bogusz

    2015-06-01

    Full Text Available Background: An objective determination of the range of vocal efficiency is rather difficult. The aim of the study was to assess the possibility of application of short-term acoustic efficiency analysis in diagnosing occupational voice disorders. Material and Methods: The study covered 98 people (87 women and 11 men diagnosed with occupational dysphonia through videostroboscopic examination. The control group comprised 100 people (81 women and 19 men with normal voices. The short-term acoustic analysis was carried out by means of DiagnoScope software, including classical parameters (Jitter group, Shimmer group and the assessment of noise degree NHR, as well as new short-term efficiency parameters determined in a short time period during sustained phonation of the vowel “a.” The results were then compared. Results: The values of all the examined classical parameters were considerably higher in the study group of pathological voices than in the control group of normal voices (p = 0.00. The aerodynamic parameter, maximum phonation time, was significantly shorter by over 0.5 s in the study group than in the control group. The majority of the acoustic efficiency parameters were also considerably worse in the study group of subjects with occupational dysphonia than in the control group (p = 0.00. Moreover, the correlation between the efficiency parameters and most of the classical acoustic parameters in the study group implies that for the voices with occupational pathology the decreased efficiency of the vocal apparatus is reflected in the acoustic voice structure. Conclusions: Efficiency parameters determined during short-term acoustic analysis can be an objective indicator of the decreased phonatory function of the larynx, useful in diagnosing occupational vocal pathology. Med Pr 2015;66(2:225–234

  16. Efficacy and Safety of Axitinib Versus Sorafenib in Metastatic Renal Cell Carcinoma: Subgroup Analysis of Japanese Patients from the Global Randomized Phase 3 AXIS Trial

    Science.gov (United States)

    Ueda, Takeshi; Uemura, Hirotsugu; Tomita, Yoshihiko; Tsukamoto, Taiji; Kanayama, Hiroomi; Shinohara, Nobuo; Tarazi, Jamal; Chen, Connie; Kim, Sinil; Ozono, Seiichiro; Naito, Seiji; Akaza, Hideyuki

    2013-01-01

    Objective Axitinib is a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors 1, 2 and 3. The efficacy and safety of axitinib in Japanese patients with metastatic renal cell carcinoma were evaluated. Methods A subgroup analysis was conducted in Japanese patients enrolled in the randomized Phase III trial of axitinib versus sorafenib after failure of one prior systemic therapy for metastatic renal cell carcinoma. Results Twenty-five (of 361) and 29 (of 362) patients randomized to the axitinib and sorafenib arms, respectively, were Japanese and included in this analysis. Median progression-free survival in Japanese patients was 12.1 months (95% confidence interval 8.6 to not estimable) for axitinib and 4.9 months (95% confidence interval 2.8–6.6) for sorafenib (hazard ratio 0.390; 95% confidence interval 0.130–1.173; stratified one-sided P = 0.0401). The objective response rate was 52.0% for axitinib and 3.4% for sorafenib (P = 0.0001). The common all-causality adverse events (all grades) in Japanese patients were dysphonia (68%), hypertension (64%), hand–foot syndrome (64%) and diarrhea (56%) for axitinib, and hand–foot syndrome (86%), hypertension (62%) and diarrhea (52%) for sorafenib. The safety profiles of axitinib and sorafenib in Japanese patients were generally similar to those observed in the overall population, with the exceptions of higher incidences of hypertension, dysphonia, hand–foot syndrome, hypothyroidism and stomatitis. Conclusions Axitinib is efficacious and well tolerated in Japanese patients with previously treated metastatic renal cell carcinoma, consistent with the results in the overall population, providing a new targeted therapy for these Japanese patients. PMID:23630366

  17. A case of laryngeal neurofibroma associated with neurofibromatosis type 2

    International Nuclear Information System (INIS)

    Purpose: Laryngeal neurofibromas have been reported in 16 patients with NF1, and schwannomas, in two patient with NF1 and 2 patients with NF2. To the best our knowledge our case is the first to document a laryngeal neurofibroma in a patient with NF2. Another unique feature of our case is the coexistence of multiple intramedullary tumors, which has not previously been reported in a patient with a laryngeal neurofibroma. Material and methods: A 32-year-old woman presented with a history of cataract, hoarseness and dysphonia since childhood, which had recently become worse. The patient also had hearing disability for low frequencies. Results: Laryngoscopy revealed a 2x2x3.5 cm smooth-surfaced submucosal supraglottic mass. On CT of the neck, the lesion was seen as a round and well-defined hypopharyngeal mass extended through and obliterating the left supraglottic space. It was hypodense on unenhanced CT images and slightly enhanced with IV contrast administration. On MR imaging, the mass was heterogeneously hypointense on T1-weighted images and hyperintense on T2-weighted images, with moderate homogenous enhancement after gadolinium administration. Bilateral vestibular schwannomas and multiple intramedullary masses (presumed to be ependymoma or astrocytoma) were delineated on these MR images The patient was diagnosed as having NF-2 and the laryngeal mass was totally resected. On histopathological examination, the mass were consistent with neurofibroma. Conclusion: Dysphonia and hoarseness may be the only presenting symptoms suggesting the possibility of a laryngeal nerve sheath tumor, and neurofibroma should be included in differential diagnosis of laryngeal masses in patients with NF2. (authors)

  18. Study of the pathology valued at Phoniatrics Unit Complex Care of Zamora in the first quarter of 2012

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    Bajo-Santos C

    2012-06-01

    Full Text Available SummaryIntroduction: We present this study about the activity of the first term of Phoniatrics consulting belongs to the Virgen de la Concha Hospital in ZamoraMaterial and Methods: A statistical study was developedResults: Total number of patients evaluated: 244, with 137 (56.15% who came as first time (new cases and 107 (43.85% who were previously evaluated. Of these, 139 (56, 97% had vocal pathology and 105 (43.3% speech pathology. 38 patients (15, 57% were referred from the phoniatrics unit to speech therapy at the hospital for treatment. Vocal pathology occupies 86.84% (from the 38 submitted, being 32 the number of dysphonia, 19 (59.37% organic (of which 10.52% were professional voice users, 9 were laryngeal microsurgery (28, 13% and 4 functional dysphonia (12.5%. From all the language pathologies analyzed by Phoniatrics unit, only 4.76% is referred to Speech therapy. The remaining 95.24% are sent to the school centers, with specialist teachers in LA whose are responsible for its rehabilitation (in order of SEN 1992. Conclusions: 1. - The number of patients evaluated for first time in the medical consultation is higher than phoniatric revisions. 2. - The percentage of vocal pathology evaluated predominates but the difference versus language pathology is narrowing as pediatricians have medical knowledge of this activity. 3. - The number of patients included in speech rehabilitation is significantly lower than those who have been studied in the consultation. 4 - The Vocal therapy predominates at hospital level and Language therapy in the schools.

  19. Voice amplification for primary school teachers with voice disorders: A randomized clinical trial

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    Roberto Bovo

    2013-06-01

    Full Text Available Objectives: Several studies have demonstrated a high prevalence of voice disorders in teachers, together with the personal, professional and economical consequences of the problem. Good primary prevention should be based on 3 aspects: 1 amelioration of classroom acoustics, 2 voice care programs for future professional voice users, including teachers and 3 classroom or portable amplification systems. The aim of the study was to assess the benefit obtained from the use of portable amplification systems by female primary school teachers in their occupational setting. Materials and Methods: Forty female primary school teachers attended a course about professional voice care, which comprised two theoretical lectures, each 60 min long. Thereafter, they were randomized into 2 groups: the teachers of the first group were asked to use a portable vocal amplifier for 3 months, till the end of school-year. The other 20 teachers were part of the control group, matched for age and years of employment. All subjects had a grade 1 of dysphonia with no significant organic lesion of the vocal folds. Results: Most teachers of the experimental group used the amplifier consistently for the whole duration of the experiment and found it very useful in reducing the symptoms of vocal fatigue. In fact, after 3 months, Voice Handicap Index (VHI scores in "course + amplifier" group demonstrated a significant amelioration (p = 0.003. The perceptual grade of dysphonia also improved significantly (p = 0.0005. The same parameters changed favourably also in the "course only" group, but the results were not statistically significant (p = 0.4 for VHI and p = 0.03 for perceptual grade. Conclusions: In teachers, and particularly in those with a constitutional weak voice and/or those who are prone to vocal fold pathology, vocal amplifiers may be an effective and low-cost intervention to decrease potentially damaging vocal loads and may represent a necessary form of prevention.

  20. Voice therapy and assistive techniques in voice disorders caused by unilateral vocal cord pareses

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    Kašterović Bojana

    2014-01-01

    Full Text Available Introduction. Dysphonias due to primary neurogenic disorders are a group of voice disorders that can be caused by both central and peripheral disorders of the larynx innervation. There are numerous causes leading to paralysis of superior and/or inferior laryngeal nerves, particularly of the inferior laryngeal or recurrent nerve. Voice Therapy in Unilateral Vocal Cord Paresis. Vocal therapy is an integral part of the conservative treatment. Specific methods are applied to individual vocal problems, while the non-specific ones are applied to a number of dysphonias. Non-specific methods are further divided into integrated and focused vocal methods. Integrated methods treat the voice and speech disorders as a unified entity of all quality and segments of voice and speech. Focused non-specific methods treat the segments and the quality of voice and speech individually. Assistive Techniques in Voice Disorders Caused by Unilateral Vocal Cord Paresis. Digital compression of the larynx by Seeman includes the treatment of voice with compression of the thyroid cartilage, thus moving the paralyzed and healthy vocal cord medially and upwards, and medially and downwards, respectively. This leads to the proper occlusion of vocal cords because in these conditions the paralyzed vocal cord is lower than the healthy one. According to the theoretical assumption, when the head anc neck are rotated to one or the other side, the anatomic relations in the neck are change and thus the vocal cords are brought into contact with the resulting reduction of the gap between them and the reduced air flow. Conclusion. Studies assessing the efficiency of different methods of vocal therapy are scarce bearing in mind the importance of vocal therapy and the fact that many patients refuse surgical treatment. Research on the efficiency of assistive techniques in phoniatric rehabilitation of patients with unilateral vocal cord paresis yields conflicting results. However, assistive

  1. Voice disorders in mucosal leishmaniasis.

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    Ana Cristina Nunes Ruas

    Full Text Available INTRODUCTION: Leishmaniasis is considered as one of the six most important infectious diseases because of its high detection coefficient and ability to produce deformities. In most cases, mucosal leishmaniasis (ML occurs as a consequence of cutaneous leishmaniasis. If left untreated, mucosal lesions can leave sequelae, interfering in the swallowing, breathing, voice and speech processes and requiring rehabilitation. OBJECTIVE: To describe the anatomical characteristics and voice quality of ML patients. MATERIALS AND METHODS: A descriptive transversal study was conducted in a cohort of ML patients treated at the Laboratory for Leishmaniasis Surveillance of the Evandro Chagas National Institute of Infectious Diseases-Fiocruz, between 2010 and 2013. The patients were submitted to otorhinolaryngologic clinical examination by endoscopy of the upper airways and digestive tract and to speech-language assessment through directed anamnesis, auditory perception, phonation times and vocal acoustic analysis. The variables of interest were epidemiologic (sex and age and clinic (lesion location, associated symptoms and voice quality. RESULTS: 26 patients under ML treatment and monitored by speech therapists were studied. 21 (81% were male and five (19% female, with ages ranging from 15 to 78 years (54.5+15.0 years. The lesions were distributed in the following structures 88.5% nasal, 38.5% oral, 34.6% pharyngeal and 19.2% laryngeal, with some patients presenting lesions in more than one anatomic site. The main complaint was nasal obstruction (73.1%, followed by dysphonia (38.5%, odynophagia (30.8% and dysphagia (26.9%. 23 patients (84.6% presented voice quality perturbations. Dysphonia was significantly associated to lesions in the larynx, pharynx and oral cavity. CONCLUSION: We observed that vocal quality perturbations are frequent in patients with mucosal leishmaniasis, even without laryngeal lesions; they are probably associated to disorders of some

  2. Experimental study of different nickel-titanium memory tracheal stents in dogs

    International Nuclear Information System (INIS)

    Objective: Since membrane -covered metal tracheal stent was applied successfully to treat the airway stenosis, it has been widely used and obtained satisfactory result during the past years. The purpose of our study was provide theoretical rational for treatment with membrane-covered tracheal stent by using animal experiment. Methods: The nickel- titanium memory stents of 22 mm in diameter and 6 cm in length were deployed in 18 dogs. The dogs were grouped into full- length membrane-covered group (n=6), partial-length membrane-covered group (membrane was covered for 4 cm in the medial part of the stent, n=6), and naked stent group (n=6). After the stent placement dysphagia or dysphonia was monitored daily. Twenty-four weeks later, the dogs were executed. Speiments were taken from the cephalic, medial, and caudal trachea under the stent. HE stain and proliferating cell nuclear antigen (PCNA) were evaluated. Results: After the stent placement, no dyspnea, dysphagia or dysphonia but cough was present in each dog. There was no significant difference in symptom between the three groups. Inflammation reaction, metaplasia from low columnar epithelium to spuamous epithelium, and mild granulation tissue hyperplasia in the underlying mucosa were present in each group. However, fibrosis and tracheal straitness were present only in the non-membrane-covered area, but not in the membrane-covered area. More PCNA expression was observed in the non-membrane -covered area than in the membrane-covered area. Conclusion: Both membrane-covered and non-membrane-covered stents can cause similar symptoms. However, the membrane -covered tracheal stent has good biological compatibility and would not induce tracheal straitness. The non-membrane -covered tracheal stent could induce a severe pathologic reaction and tracheal straitness. (authors)

  3. The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis-A Cross-Sectional Study

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren;

    2016-01-01

    BACKGROUND: The Gait Deviation Index summarizes overall gait 'quality', based on kinematic data from a 3-dimensional gait analysis. However, it is unknown which clinical outcomes may affect the Gait Deviation Index in patients with primary hip osteoarthritis. The aim of this study......) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...... was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2...

  4. Bringing transcranial mapping into shape: Sulcus-aligned mapping captures motor somatotopy in human primary motor hand area

    DEFF Research Database (Denmark)

    Raffin, Estelle; Pellegrino, Giovanni; Di Lazzaro, Vincenzo;

    2015-01-01

    of the central sulcus to obtain mediolateral corticomotor excitability profiles of the abductor digiti minimi (ADM) and first dorsal interosseus (FDI) muscles. In thirteen young volunteers, we used stereotactic neuronavigation to stimulate the right M1HAND with a small eight-shaped coil at 120% of FDI resting...... motor threshold. We pseudorandomly stimulated six targets located on a straight mediolateral line corresponding to the overall orientation of the central sulcus with a fixed coil orientation of 45° to the mid-sagittal line (STRAIGHT-450 FIX) or seven targets in the posterior part of the crown...... of the central sulcus following the bending of the central sulcus (CURVED). CURVED mapping employed a fixed (CURVED-450 FIX) or flexible coil orientation producing always a current perpendicular to the sulcal wall (CURVED-900 FLEX). During relaxation, CURVED but not STRAIGHT mapping revealed distinct...

  5. Disorders of the Peritrochanteric and Deep Gluteal Space: New Frontiers for Arthroscopy.

    Science.gov (United States)

    Byrd, John W Thomas

    2015-12-01

    Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band). Deep gluteal disorders include piriformis syndrome, and other variations of deep gluteal syndrome, and ischiofemoral impingement. Each of these evolving areas is highlighted in this chapter. PMID:26524558

  6. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    Science.gov (United States)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  7. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    Science.gov (United States)

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts. PMID:25457317

  8. Anticipatory and Reactive Response to Falls: Muscle Synergy Activation of Forearm Muscles.

    Science.gov (United States)

    Couzens, Greg; Kerr, Graham

    2015-10-01

    We investigated the surface electromyogram response of six forearm muscles to falls onto the outstretched hand. The extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, abductor pollicis longus, flexor carpi radialis and flexor carpi ulnaris muscles were sampled from eight volunteers who underwent ten self-initiated falls. All muscles initiated prior to impact. Co-contraction is the most obvious surface electromyogram feature. The predominant response is in the radial deviators. The surface electromyogram timing we recorded would appear to be a complex anticipatory response to falling modified by the effect on the forearm muscles following impact. The mitigation of the force of impact is probably more importantly through shoulder abduction and extension and elbow flexion rather than action of the forearm muscles.

  9. Role of muscles in the stabilization of ligament-deficient wrists.

    Science.gov (United States)

    Esplugas, Mireia; Garcia-Elias, Marc; Lluch, Alex; Llusá Pérez, Manuel

    2016-01-01

    This article reviews the results of a series of cadaver investigations aimed at clarifying the role of muscles in the stabilization of ligament-deficient wrists. According to these studies, isometric contraction of some forearm muscles induces midcarpal (MC) supination (ie, the abductor pollicis longus, extensor carpi radialis longus, and flexor carpi ulnaris), whereas other muscles induce MC pronation (ie, the extensor carpi ulnaris). Because MC supination implies tightening of the volar scaphoid-distal row ligaments, the MC supination muscles are likely to prevent scaphoid collapse of wrists with scapholunate ligament insufficiency. MC pronator muscles, by contrast, would be beneficial in stabilizing wrists with ulnar-sided ligament deficiencies owing to their ability to tighten the triquetrum-distal row ligaments. Should these laboratory findings be validated by additional clinical research, proprioceptive reeducation of selected muscles could become an important tool for the treatment of dynamic carpal instabilities. PMID:27264901

  10. Histochemical study of posterior cricoarytenoid muscle reinnervation by a nerve-muscle pedicle in the cat.

    Science.gov (United States)

    Fata, J J; Malmgren, L T; Gacek, R R; Dum, R; Woo, P

    1987-01-01

    Reinnervation of the posterior cricoarytenoid (PCA) muscle with a nerve-muscle pedicle (NMP) has been proposed for patients with bilateral abductor vocal cord paralysis. Since its success has been controversial, a glycogen depletion histochemical technique was used to examine reinnervation. An ansa cervicalis NMP was implanted into the denervated PCA in nine cats. Eight months later, vocal cord activity was evaluated. The NMP nerve was stimulated extensively in seven cats (experimental group). Optical densities of NMP-supplied PCA muscle fibers from experimental and control groups were compared to detect differences in glycogen content. The results demonstrated quantitative evidence of reinnervation in two experimental animals. Electrical stimulation of the NMP produced abduction in one of these two animals, but was never observed during spontaneous respiration or airway occlusion. These observations indicate that reinnervation can occur but abduction requires electrical stimulation. The NMP technique may be more successful with an electrical pacer. PMID:3674642

  11. Increase in H-reflex gain following 1 week of immobilization

    DEFF Research Database (Denmark)

    Jensen, Jesper Lundbye; Sørensen, Mie; Nielsen, Jens Bo

    any changes in the flexion torque elicited by supramaximal stimulation of the median nerve. Both at rest and during tonic contraction the H-reflex increased significantly following immobilization without significant changes in Mmax. MEP amplitudes did not change significantly following immobilization...... the effect of 1 week of immobilization on transmission in the corticospinal pathway and the central part of the monosynaptic stretch reflex. In ten healthy volunteers the nondominant forearm, hand and fingers were immobilized by a cast for one week. EMG was obtained from m. Flexor Carpi Radialis (FCR......) and m. Abductor Pollicis Brevis (APB). Motor evoked potentials (MEPS) elicited by transcranial magnetic stimulation and H-reflexes were obtained at rest and during tonic contraction (10% of MVC) in both muscles. Maximal voluntary flexion torque decreased significantly following immobilization without...

  12. Repeater F waves: a comparison of sensitivity with sensory antidromic wrist-to-palm latency and distal motor latency in the diagnosis of carpal tunnel syndrome.

    Science.gov (United States)

    Macleod, W N

    1987-05-01

    Thirty-five thousand six hundred supramaximal shocks were applied to 209 healthy and 147 entrapped median nerves (carpal tunnel syndrome--CTS) to characterize the backfiring behavior of the alpha motor neuron pool of abductor pollicis brevis in health and the modifying effect of a compressive neuropathy. A contraction of the normal subpopulation of active F-wave generators was found in CTS, while active neurons backfired at higher than normal frequencies (p less than 0.001). These modifications in spinal behavior are reflected in the % Repeater F-wave value, whose sensitivity in the detection of CTS approaches that of sensory wrist-to-palm latency estimation. This technique offers an alternative to latency measurement in the diagnosis of CTS. An economical strategy for the electrodiagnosis of CTS is proposed.

  13. SOME CLASSICAL HYPOTEXTS IN MARGARET DOODY’S ARISTOTLE AND POETIC JUSTICE

    Directory of Open Access Journals (Sweden)

    F. Pauw

    2012-03-01

    Full Text Available

    The philosopher Aristotle appears in seven detective novels by the academic Margaret Doody in which he makes use of hisinvestigative powers to solve murder mysteries. In Aristotle andpoetic justice Stephanos, a friend of Aristotle, narrates how Anthia, the heiress of a silver merchant, has been abducted. While Stephanosand Aristotle pursue the abductor and the heiress on the road to Delphi, two murders complicate their challenge.

    Doody’s novel provides a convenient framework for opening awindow onto the Greek world of 330 BC. In the body of the article,hypertextual allusions introduced by Doody are examined andevaluated, using a modified version of Genette’s scheme ashermeneutic paradigm.

  14. De quervain tenosynovitis of the wrist.

    Science.gov (United States)

    Ilyas, Asif M; Ilyas, Asif; Ast, Michael; Schaffer, Alyssa A; Thoder, Joseph

    2007-12-01

    De quervain disease, or stenosing tenosynovitis of the first dorsal compartment of the wrist, is a common wrist pathology. Pain results from resisted gliding of the abductor pollicis longus and the extensor pollicis brevis tendons in the fibro-osseus canal. de Quervain tenosynovitis of the wrist is more common in women than men. Diagnosis may be made on physical examination. Radiographs are helpful in ruling out offending bony pathology. Nonsurgical management, consisting of corticosteroid injections and supportive thumb spica splinting, is usually successful. In resistant cases, surgical release of the first dorsal compartment is done, taking care to protect the radial sensory nerve and identify all accessory compartments. Repair of the extensor retinaculum by step-cut lengthening or other techniques is rarely required. PMID:18063716

  15. The role of reading activity on the modulation of motor cortical outputs to the reading hand in Braille readers.

    Science.gov (United States)

    Pascual-Leone, A; Wassermann, E M; Sadato, N; Hallett, M

    1995-12-01

    We studied the cortical motor output maps of the first dorsal interosseous (FDI) of both hands and the abductor digiti minimi of the reading hand in 6 blind proficient Braille readers. The maps were generated using transcranial magnetic stimulation. We compared the maps obtained on a day in which they worked as Braille proofreaders (reading Braille for approximately 6 hours) with the maps obtained on a day they took off from work. On the work day, the maps for the FDI of the reading hand were significantly larger after the working shift than in the morning after having been off work for 2 days. These changes were not seen for the same muscle on the day off work or on any of the 2 days in the other two muscles studied. These results illustrate the rapid modulation in motor cortical outputs in relation to preceding activity and emphasize the importance of precise timing in studies of the neurophysiological correlates of skill acquisition.

  16. Bilateral Simultaneous Heterotopic Ossification of the Reflected Head of Rectus Femoris Muscle: A Case Report and Review of the Literature

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    Murat Tonbul

    2014-01-01

    Full Text Available Lamellar bone formation in an abnormal location is defined as heterotopic ossification. It commonly occurs around the hip joint and most often involves the abductor muscles. It is a benign condition; however, its etiology remains largely unknown. Most previously reported cases have been due to trauma or intramuscular hemorrhage. In this paper, we present a case of bilateral heterotopic ossification of the reflected head of rectus femoris muscle without antecedent trauma or any other known cause, as the first and unique case in the literature. She was treated by excision of the right symptomatic bony mass via a modified Smith-Petersen approach. Postoperatively, she received 75 mg indomethacin daily for six weeks. She was pain-free and obtained full range of motion 3 weeks after the first intervention.

  17. Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review.

    Science.gov (United States)

    Alba-Martín, Pablo; Gallego-Izquierdo, T; Plaza-Manzano, Gustavo; Romero-Franco, Natalia; Núñez-Nagy, Susana; Pecos-Martín, Daniel

    2015-07-01

    [Purpose] The aim of this study was to analyze the effectiveness of conservative treatment of patellofemoral pain syndrome with physical exercise. [Subjects and Methods] A computer-based review conducted of four databases (PubMed, the Cochrane Library, PEDro, and the University Library) was completed based on the inclusion criteria of patellofemoral pain syndrome patients treated with physical exercise methods and examination with self-reported pain and/or functional questionnaires. [Results] The findings of ten clinical trials of moderate to high quality were evaluated to determine the effectiveness of physical exercise as conservative management for patellofemoral pain syndrome. [Conclusion] The intervention programs that were most effective in relieving pain and improving function in patellofemoral pain syndrome included proprioceptive neuromuscular facilitation stretching and strengthening exercises for the hip external rotator and abductor muscles and knee extensor muscles. PMID:26311988

  18. MRI features in de Quervain`s tenosynovitis of the wrist

    Energy Technology Data Exchange (ETDEWEB)

    Glajchen, N. [Mount Sinai Hospital, New York, NY (United States). Dept. of Radiology; Schweitzer, M. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology

    1996-01-01

    De Quervain`s stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain`s synovitis was suggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain`s disease. De Quervain`s tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings. (orig.)

  19. Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

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    Liu RuiYu

    2012-06-01

    Full Text Available Abstract Background The gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction. Methods 19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA, radiological density (RD and the length of gluteus medius using computed tomograhpy(CT (scanned before THA. Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs. Results Both CSA and RD of gluteus medius muscle were significantly reduced (p  Conclusions The gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.

  20. A study of transcranial magnetic stimulation in older (>3 years patients of malnutrition.

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    Karak B

    1999-07-01

    Full Text Available Transcranial magnetic stimulation was performed in 40 subjects. Twenty patients in the age group of 3 to 8 years and having different grades of malnutrition were included in the ′study group′ whereas 20 normal children having no complaints comprised the ′control group′. The coil of the magnetic stimulator was applied tangentially over the vertex to stimulate the cortex. The motor evoked potential (MEP was obtained using root stimulation by applying the coil at the cervical and lumbosacral spines. Recordings were made from the abductor pollicis brevis (APB and extensor digitorum brevis (EDB muscles of both sides. Cortical threshold, latency and amplitude of motor evoked potential and central conduction time were recorded. Malnourished children showed significantly increased cortical threshold, prolonged cortical latency and central conduction time and reduction in amplitude of MEP. Observed delay in central motor conduction in malnourished children suggests asymptomatic involvement of corticospinal pathways.