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Sample records for aphonia

  1. Aphonia with unknown etiology: a case report

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    Porto, Celmo Celeno

    2010-06-01

    Full Text Available Introduction: The conversion aphonia is defined as the total loss of voice, is a rare disease that often affects women. The diagnosis is clinical, because there are no changes in the laryngeal structures. Objective: To describe a case of conversion aphonia, seen in a public hospital in the Midwest of Brazil. Case Report: Patient 32 years old female, complaining of hoarseness for two days without other apparent symptoms. The examinations revealed no changes in the laryngeal structures and / or extra laryngeal. Stages of care have been described since the initial consultation to the recovery of the patient. Final Comments: It is important to consider the psycho-emotional aspects involving patients with voice disorders since they may cause or modify the symptoms and affect the prognosis.

  2. [Cognitive-behavioral therapy of conversion aphonia].

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    Kuljić, Blagoje

    2004-01-01

    Although a common disease, conversion disorder still calls attention in the clinical practice. A case of conversion disorder, diagnosed as a psychogenic aphonia that persisted for a week, was reported in this paper. A 21-year-old woman developed symptoms after breaking off a long-lasting relationship with her boy-friend. History revealed that she was introvert with high neuroticism and communication problems. Cognitive-behavioral therapy was used. After the positive reinforcement in the therapy of her aphonia, assertion training for the development of communication skills was performed. In the end, cognitive restructuring was used to prevent relapse in regard to her actual life situation of being a refugee preparing for immigration to Australia.

  3. Cognitive-behavioral therapy of conversion aphonia

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    Kuljić Blagoje

    2004-01-01

    Full Text Available Although a common disease, conversion disorder still calls attention in the clinical practice. A case of conversion disorder, diagnosed as a psychogenic aphonia that persisted for a week, was reported in this paper. A 21-year-old woman developed symptoms after breaking off a long-lasting relationship with her boy-friend. History revealed that she was introvert with high neuroticism and communication problems. Cognitive-behavioral therapy was used. After the positive reinforcement in the therapy of her aphonia, assertion training for the development of communication skills was performed. In the end, cognitive restructuring was used to prevent relapse in regard to her actual life situation of being a refugee preparing for immigration to Australia.

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

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    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…

  5. Impact of syllable stress and phonetic vowel context on the distribution of intermittent aphonia

    DEFF Research Database (Denmark)

    Iwarsson, Jenny; Fredsø, Julie

    2014-01-01

    with intermittent aphonia are not totally randomly appearing, but related to syllable stress and phonetic context. Recordings of 31 dysphonic patients with intermittent aphonia reading a standard text were analyzed perceptually. All vowels of the text were labelled and categorized with regard to syllable stress...

  6. STEMKLACHTEN ALS BIJWERKING VAN GENEESMIDDELEN

    NARCIS (Netherlands)

    Van Puijenbroek, E.P.

    1996-01-01

    The occurrence of a voice disorder as a side effect of a drug can be very inconvenient for the patient concerned. A voice disorder can manifest itself as a change in pitch of the voice, hoarseness or aphonia. Early recognition is essential to prevent unnecessary diagnostics and treatment. In this

  7. Medical Department, United States Army. Surgery in World War II. Neurosurgery. Volume 1

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    1958-01-01

    nedrosurgeons. The arrangement described permitted experienced neurosurgeons to apply their skills in complicated cases and also to function as teachers and...phonation, 13; stammering, 3; aphonia, 2; stuttering , 2; aphasia and stuttering , stammering and stuttering , and multiple neuritis, 1 each. When this...subject treated functional disorders, such as stuttering , articulatory disorders due to poor habits, and speech defects due to foreign dialects. Darley

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

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    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.

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

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

    2014-01-01

    Psychogenic dysphonia is a functional disorder with variable clinical manifestations. To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n=17), teacher (n=4), salesclerk (n=4), nurse (n=1), retired (n=1), and psychologist (n=1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  10. Delayed onset neuropathy along with recurrent laryngeal nerve palsy due to organophosphate poisoning and the role of physiotherapy rehabilitation.

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    Shetye, Jaimala Vijay; Surkar, Swati M; Karnik, Niteen D; Mehta, Amita A

    2014-02-01

    Organophosphorus poisoning is a major global cause of health problems and the leading cause of mortality and morbidity in the developing countries. In this, the inhibition of acetyl-choline esterase and neurotoxic esterase along with nicotinic receptor involvement produces three well-identified and documented clinical phases: The initial cholinergic phase, which is a medical emergency often requiring management in an intensive care unit; the intermediate syndrome, during which prolonged ventilator care is necessary; and finally delayed neurotoxicity. Vocal cord paralysis is rare and leads to aphonia. Role of physiotherapy rehabilitation is substantial in all three stages and aims at early weaning off from mechanical ventilator until the functional independence and community integration of the patient.

  11. PVCM, PVCD, EPL, and irritable larynx syndrome: what are we talking about and how do we treat it?

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    Andrianopoulos, M V; Gallivan, G J; Gallivan, K H

    2000-12-01

    Paroxysmal vocal cord movement/motion (PVCM), paroxysmal vocal cord dysfunction (PVCD), episodic paroxysmal laryngospasm (EPL), and irritable larynx syndrome (ILS) are terms used to describe laryngeal dysfunction masquerading as asthma, upper airway obstruction, or functional and organic voice disorders. The differential diagnosis of PVCM, PVCD, EPL, and ILS is critical to successful medical and behavioral management of the patient. During the past 10 years, 27 subjects, ages 15-79 years, were identified to have paroxysms of inspiratory stridor, acute respiratory distress, associated aphonia and dysphonia, resulting in misdiagnosis and unnecessary emergency treatments, including endotracheal intubation, cardiopulmonary resuscitation, massive pharmacotherapy, or tracheostomy. A multifactorial management program is proposed utilizing principles of motor learning, neurolinguistic programming model, respiratory and phonatory synchronization, relaxation techniques, concurrent monitoring of behavioral adjustments, and formal psychological counseling.

  12. An Unusual Case of Neuralgic Amyotrophy Presenting with Bilateral Phrenic Nerve and Vocal Cord Paresis

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    F. Holtbernd

    2011-02-01

    Full Text Available Background: Neuralgic amyotrophy (brachial plexus neuropathy, brachial plexus neuritis, or Parsonage-Turner syndrome is an uncommon inflammatory condition typically characterized by acute and severe shoulder pain followed by paresis with muscle weakness and atrophy of the upper limb or shoulder girdle. We report an unusual clinical manifestation of neuralgic amyotrophy, namely bilateral phrenic nerve palsy with concomitant laryngeal paresis. Case Report: A 55-year-old male presented with orthopnea and aphonia after an episode of bilateral shoulder pain preceded by an upper respiratory tract infection. Spirometry, chest X-ray and videolaryngoscopy revealed bilateral and simultaneous paresis of the diaphragm and the vocal cords. Clinical examination at admission and at the 2-month follow-up did not show upper limb weakness or atrophy, except for a mild atrophy of the right supraspinatus muscle. An electromyography of the upper limb muscles and nerve conduction studies did not reveal signs of denervation. Analysis of the cerebrospinal fluid and an MRI of the neuraxis were unremarkable. After treatment with prednisolone, vocal cord function markedly improved within 8 weeks, whereas paresis of the diaphragm persisted. Conclusion: Shoulder pain followed by diaphragmatic paralysis with dyspnea and hoarseness may be a manifestation of neuralgic amyotrophy even if upper limb or shoulder girdle palsies are absent.

  13. External laryngeal injuries in children--comparison of diagnostic methods.

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    Zawadzka-Glos, L; Jakubowska, A; Frackiewicz, M; Brzewski, M

    2013-09-01

    The injuries of the larynx constitute around 1% of all injuries. The great majority of the injuries of the larynx happens during playing. The effects of these injuries may appear insignificant however, not always the direct clinical symptoms correlate with the degree of respiratory tract failure. The symptoms of laryngeal injuries depend on the extension and strength of the trauma and always relate to impair patency of respiratory tract. The aim of the study is to compare two diagnostic methods: laryngoscopy and ultrasonography in evaluation of laryngeal injuries in children. In the Department of Pediatric Otolaryngology, Medical University of Warsaw, in the period between 2004 and 2010 there were hospitalised 15 children with external injury of the larynx. From among 15 hospitalized children, 7 were qualified as not serious trauma and were treated preservatively and the other 8 as sever trauma. The mechanism of traumas was diverse. Dyspnea was a predominating symptom, the others included hoarsness, change in voice quality, even aphonia, pain while speaking and swallowing, cough and hemoptysis. Direct laryngoscopy is a standard in diagnostics of the injuries of the larynx. Ultrasonography of the larynx is recommended in every case of laryngeal injury as an additional non-invasive complementary diagnostic examination. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Phonatory symptoms and impact on quality of life in female patients with goiter.

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    Hamdan, Abdul-Latif; Dowli, Alexander; Jabbour, Jad; Sabri, Alain; Azar, Sami T

    2016-07-01

    Our objective is to report on the prevalence of phonatory symptoms and impact on quality of life in a group of female patients with goiter who had not been selected for surgery or who had not presented to the emergency room with respiratory distress. A total of 40 patients with goiter and 14 controls were enrolled in this study. Demographic data included age, sex, laryngopharyngeal reflux disease, allergy, smoking, duration of disease, presence or absence of compressive symptoms, presence or absence of thyroid gland nodules, vascular status, presence or absence of calcifications, and thyroid-stimulating hormone levels. Phonatory symptoms included hoarseness, vocal fatigue, vocal straining, lump sensation, and aphonia. The Voice Handicap Index 10 was used to assess the impact of phonatory symptoms on quality of life. The most common phonatory symptom in the patients with goiter was vocal fatigue followed by lump sensation. The only phonatory symptom that was significantly more present in patients with goiter was vocal straining. As for the impact of phonatory symptoms on quality of life, 15.8% of goiter patients had a Voice Handicap Index score >7 compared with 7.7% of controls. Phonatory symptoms are common in patients with goiter, with vocal straining occurring significantly more frequently than in controls. In 1 of 6 patients, the presence of phonatory symptoms had an impact on quality of life.

  15. Systematic Review of Adverse Effects: A Further Step towards Modernization of Acupuncture in China

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    Wu, Junyi; Hu, Yanmei; Zhu, Yin; Yin, Ping; Xu, Shifen

    2015-01-01

    As a further step towards the modernization of acupuncture, the objective of this review was to figure out the frequency and severity of adverse complications and events in acupuncture treatment reported from 1980 to 2013 in China. All first-hand case reports of acupuncture-related complications and adverse events that could be identified in the scientific literature were reviewed and classified according to the type of complication and adverse event, circumstance of the event, and long-term patient outcome. The selected case reports were published between 1980 and 2013 in 3 databases. Relevant papers were collected and analyzed by 2 reviewers. Over the 33 years, 182 incidents were identified in 133 relevant papers. Internal organ, tissue, or nerve injury is the main complications of acupuncture especially for pneumothorax and central nervous system injury. Adverse effects also included syncope, infections, hemorrhage, allergy, burn, aphonia, hysteria, cough, thirst, fever, somnolence, and broken needles. Qualifying training of acupuncturists should be systemized and the clinical acupuncture operations should be standardized in order to effectively prevent the occurrence of acupuncture accidents, enhance the influence of acupuncture, and further popularize acupuncture to the rest of the world. PMID:26339265

  16. Lessons Learned From 35 Cases of Laryngeal Foreign Bodies Undergoing Misdiagnosis in Pediatric Population.

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    Chen, Qingguo; Chu, Hanqi; Tao, Yanling; Huang, Hongyan; Peng, Liyan

    2017-02-01

    To present 35 cases of laryngeal foreign bodies (FBs) in pediatric population undergoing misdiagnosis so as to draw on our lessons to improve early diagnosis. A retrospective analysis over 15 years was conducted of 35 cases of laryngeal FBs undergoing misdiagnosis in children. Meanwhile, a control group, including 42 cases of laryngeal FBs without misdiagnosis in children, was set. These patients' clinical data were collected and analyzed to identify the risk factors for misdiagnosis. The results of chi-square test and univariate analysis both showed a significant difference in time elapsed between discomforts and admission, witnessed foreign body (FB) aspiration history, biphasic stridor, aphonia, roentgenologic findings, and type and size of FBs between the misdiagnosed group and control group. Multivariate analysis further identified delayed doctor visits, unwitnessed FB aspiration history, nonspecific symptoms, and negative roentgenologic manifestations as independent risk factors for misdiagnosis. Diagnosis of laryngeal FBs, especially small, thin, and radiolucent FBs, remains a challenge. We emphasized the importance of timely doctor visits, careful clinical history inquisition, and prompt performance of radiographic or endoscopic examinations for diagnosis.

  17. Systematic Review of Adverse Effects: A Further Step towards Modernization of Acupuncture in China

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    Junyi Wu

    2015-01-01

    Full Text Available As a further step towards the modernization of acupuncture, the objective of this review was to figure out the frequency and severity of adverse complications and events in acupuncture treatment reported from 1980 to 2013 in China. All first-hand case reports of acupuncture-related complications and adverse events that could be identified in the scientific literature were reviewed and classified according to the type of complication and adverse event, circumstance of the event, and long-term patient outcome. The selected case reports were published between 1980 and 2013 in 3 databases. Relevant papers were collected and analyzed by 2 reviewers. Over the 33 years, 182 incidents were identified in 133 relevant papers. Internal organ, tissue, or nerve injury is the main complications of acupuncture especially for pneumothorax and central nervous system injury. Adverse effects also included syncope, infections, hemorrhage, allergy, burn, aphonia, hysteria, cough, thirst, fever, somnolence, and broken needles. Qualifying training of acupuncturists should be systemized and the clinical acupuncture operations should be standardized in order to effectively prevent the occurrence of acupuncture accidents, enhance the influence of acupuncture, and further popularize acupuncture to the rest of the world.

  18. Effects of consensus training on the reliability of auditory perceptual ratings of voice quality.

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    Iwarsson, Jenny; Reinholt Petersen, Niels

    2012-05-01

    This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in memory common and more robust, which is of great importance to reduce the variability of auditory perceptual ratings. A prospective design with testing before and after training. Thirteen students of audiologopedics served as listening subjects. The ratings were made using a multidimensional protocol with four-point equal-appearing interval scales. The stimuli consisted of text reading by authentic dysphonic patients. The consensus training for each perceptual voice parameter included (1) definition, (2) underlying physiology, (3) presentation of carefully selected sound examples representing the parameter in three different grades followed by group discussions of perceived characteristics, and (4) practical exercises including imitation to make use of the listeners' proprioception. Intrarater reliability and agreement showed a marked improvement for intermittent aphonia but not for vocal fry. Interrater reliability was high for most parameters before training with a slight increase after training. Interrater agreement showed marked increases for most voice quality parameters as a result of the training. The results support the recommendation of specific consensus training, including use of a reference voice sample material, to calibrate, equalize, and stabilize the internal standards held in memory by the listeners. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  19. Muscle misuse voice disorders: description and classification.

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    Morrison, M D; Rammage, L A

    1993-05-01

    It is apparent that voice disorders frequently labelled "functional" are associated with laryngeal muscle misuse. This use of the word "functional" is, however, intrinsically ambiguous, and so we propose an alternative term based on descriptive features of dysfunction: "muscle misuse voice disorders". Persistent phonation with an abnormal laryngeal posture can lead to organic changes such as nodules or polyps, particularly in females with posterior glottic chink. We hypothesized that the chink was related to an overall increase in laryngeal muscle tension, and more directly due to inadequate relaxation of the posterior crico-arytenoid muscle during phonation. We employed the term "muscular tension dysphonia" (MTD) to note this condition, but it may be that the term "laryngeal isometric" is superior since there are other misuses of the larynx that obviously are manifestations of abnormalities of muscular tension. With this in mind we have evolved a new classification based on the laryngeal isometric, glottic and supraglottic lateral contraction states, antero-posterior contraction states, conversion aphonia, psychogenic bowing, and adolescent transitional dysphonia.

  20. [Conversion syndromes in neurology. A psychopathological and psychodynamic differentiation of conversion disorder, somatization disorder and factitious disorder].

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    Kapfhammer, H P; Dobmeier, P; Mayer, C; Rothenhäusler, H B

    1998-12-01

    Conversion syndromes are frequent among medically unexplained somatic symptoms in neurology. A careful differential diagnosis must be carried out in a psychiatric consultation service. In a prospective study lasting for over four years 169 patients with pseudoneurological signs of conversion were included. From a clinical point of view the following conversion syndromes were presented: astasia/abasia: 27.2%, paresis/plegia: 24.3%, aphonia: 1.8%, hyp-/anaesthesia: 21.9%, blindness: 5.3%, non-epileptic seizures: 19.5%. According to the diagnostic criteria of DSM-III-R three subgroups were differentiated: conversion disorder (n = 132), somatisation disorder (n = 28), factitious disorder (n = 9). Intermittent courses of illness were prevailing in conversion disorder, whereas chronic courses predominated in the other two subgroups. High rates of psychiatric comorbidity were typical signs of somatisation disorder. Frequent autodestructive motives (suicidality, deliberate and covert self-harm, chronic pain, high rate of operations) in illness behaviour had to be registered in somatisation and factitious disorder. Both subgroups were characterised by frequent traumatic events during early development. Important socio-economic aspects of illness behaviour above all in somatisation and factitious disorder were underlined. The results are discussed in terms of psychiatric differential diagnosis and psychiatric comorbidity, psychodynamic evaluation, illness behaviour and therapeutic options in a C/L-service.

  1. A non-recurrent inferior laryngeal nerve in a man undergoing thyroidectomy: a case report

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    Sousa Daniel

    2010-11-01

    Full Text Available Abstract Introduction A non-recurrent variant of the inferior laryngeal nerve has been seldom reported. These reports are mostly based on cadaveric dissection studies or large chart review studies in which the emphasis is placed on the determination of the frequency of the variation, and not on the clinical appearance of this variant. We graphically describe the intraoperative identification of a non-recurrent inferior laryngeal nerve. Case Presentation A 44-year old Caucasian man was referred to the Head and Neck Surgery Outpatient Clinic with the diagnosis of a nodular mass in his left thyroid lobe that had been growing for one year. A fine needle aspiration puncture was compatible with thyroid papillary cancer. It was decided that the patient should undergo total thyroidectomy. During surgery, a non-recurrent right inferior laryngeal nerve was noted. This nerve emanated from the right vagus nerve, entering the larynx 3 cm after its origin. The nerve did not show a recurrent course. The nerve on the left side had a normal configuration. The surgery and post-operative period were uneventful, and the patient had no change in his voice. Conclusion This paper allows those interested to become acquainted with the normal intraoperative appearance of a non-recurrent inferior laryngeal nerve. This will undoubtedly be of significance for all of those performing invasive diagnostic and surgical procedures in the neck and upper thoracic regions, in order to minimize the risk of iatrogenic injury to this nerve. This is of extreme importance, since a unilateral lesion of this nerve may result in permanent hoarseness, and a bilateral lesion may lead to aphonia and life-threatening dyspnea.

  2. Functional dysphonia: strategies to improve patient outcomes

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    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

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

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

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    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.

  4. Evaluación del adenoidismo en los niños: imagen endoscópica

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    Calogero Grillo

    2000-12-01

    Full Text Available El adenoidismo es un síndrome complejo cuya causa principal se identifica generalmente con la hiperplasia de las amígdalas y la nasofaringe, pero abarca también diversos aparatos y estructuras que aún cuando se encuentran lejos de la nasofaringe, se relacionan funcionalmente con ella. Las afecciones locales caracterizadas por obstrucción nasal y rinorrea a menudo purulentas, se asocian con enfermedades de los senos (sinusitis, con afecciones del oído (otalgia, otorrea serosa o serosa-purulenta o ambas cosas, así como hipoacusia, con enfermedades de la laringe (disfonía y afonía, con afecciones de las vías respiratorias inferiores (tos, bronquitis recurrente, con enfermedades de los huesos de la cara (paladar ojival, deficiencia de la oclusión dental, así como con afecciones sistémicas (apnea del sueño, OSAS. La endoscopia de fibra óptica es la prueba de selección para valorar la calidad y la extensión de la hipertrofia de las adenoidesAdenoidism is a complex syndrome whose main cause is generally identified with hyperplasia of the tonsils and nasopharynx, but it also involves diverse systems and structures that even when they are not close to the nasopharynx are functionally related to it. The local affections characterized by usually purulent nasal obstruction and rhinorrea are associated with diseases of the sinuses (sinusitis, with affections of the ear (otalgia, serous or serouspurulent otorrhoea or both, as well as hypoacusia, with larynx diseases (dysphonia and aphonia, with affections of the lower airways (cough, recurrent bronchitis, with face bone diseases (ogival palate, deficiency of dental oclussion, as well as systemic affections (sleep apnea, OSAS. The optic fibre endoscopy is the selection test to asses the quality and extension of adenoids hypertrophy

  5. Vocal problems of group fitness instructors: prevalence of self-reported sensory and auditory-perceptual voice symptoms and the need for preventative education and training.

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    Rumbach, Anna F

    2013-07-01

    To determine the prevalence and nature of both acute and chronic voice problems experienced by group fitness instructors (GFIs) and gather information about the level of education currently being received by fitness professionals, the source of their education, and their opinion on mandatory voice training to highlight potential training needs. Prospective self-completion questionnaire design. A total of 361 GFIs (81 males and 280 females), aged between 18 and 67 years currently active in the Australian fitness industry completed a self-report questionnaire distributed via SurveyMonkey. The prevalence of self-reported acute and chronic voice symptoms was high at 78.95% and 70.91%, respectively. Partial voice loss and hoarseness while instructing was experienced most often (57.62%), followed by partial voice loss and hoarseness immediately after instructing (46.81%). Aphonia after teaching was less frequently reported (9.97%). Over 25% of the total cohort reported chronic voice symptoms of increased hoarseness (39.61%), difficulty with high notes (31.58%), strained voice (32.13%), and limited singing range (27.7%). Only 30% of GFIs reported having received any voice education, with even fewer respondents (10%) receiving any practical voice training, despite 98.06% agreeing that formal voice education should be covered as a standard topic in all official GFI training. The results of this study confirm that voice problems represent a significant occupational hazard for GFIs. Speech-language pathologists and other voice professionals should consider taking a proactive stance in understanding the vocal demands of the profession and engage in training for instructors to prevent both acute and chronic voice problems. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  6. Sea urchin: toxinology, bioactive compounds and its treatment management

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    Gholamhossein Mohebbi

    2016-09-01

    Full Text Available Background: The sea urchins are classified in the echinoderms category because of their spiny skin. Saponins are the major responsible metabolites for Echinodermata biological activities . As mentioned before, about 80 species of sea urchins are venomous for human. Their spine, pedicellariae, and some other organs such as gonads and coelomic fluids contain different toxins and bioactive compounds. This review study have evaluated toxinology and bioactive compounds from the extracts, and treatment management of these venomous animals. Results: Contractin A, echinochrome A, echinometrin, major yolk protein (MYP, centrocins (I, II(, cathepsin B/X, strongylostatins (I,II, vitellogenin, UT841 toxin, spinochrome, and pedoxin as the prosthetic group of peditoxin are the most important compounds obtained from these animals. Some people show poisoning symptoms following the ingestion of sea urchin gonads, especially during the breeding season. Some of these symptoms included allergies symptoms, as the first symptoms, nausea, diarrhea, vomiting, epigastric distress, severe headache, swelling of the lips and mouth, salivation, abdominal pain and some systemic symptoms such as hypotension, numbness and weakness. The most injuries by sea urchin can cause by contact to spines, which can create the various complications such as granuloma, synovitis, arthritis, edema, hyperkeratosis and even neuroma. Injuries by pedicellaria may cause severe pain, local edema, bleeding, lethargy, weakness, tingling, joint pain, aphonia, dizziness, syncope, general muscle paralysis, respiratory distress, hypotension and, infrequently death. After the injury by sea urchin, removing the spines and pedicellariae should be done to minimize the contact with the venom source, and subsequently the management of wounds and poisoning symptoms, as quickly as possible. Conclusion: The venoms of some sea urchins have toxins and bioactive molecules that produce toxicity effects on their

  7. Czy smog ma wpływ na częstość występowania zaostrzeń przewlekłego zapalenia krtani? Analiza na przykładzie mieszkańców województwa małopolskiego.

    Science.gov (United States)

    Ziarno, Remigiusz; Suska, Anna; Kulinowski, Wojciech; Grudzień-Ziarno, Aleksandra; Kostrzon, Magdalena; Paciorek, Magdalena; Składzień, Jacek

    2017-06-30

    Due to dynamic industrialisation smog became a frequent phenomenon in most developing cities. According to the last WHO report from Global Urban Ambient Air Pollution Database, Krakow has been classified in the 11th place among the most polluted cities in Europe. It seems to be an urgent issue because of the influence of air pollution on the condition of upper respiratory tract. Materials & Methods: In December 2015 there were 141 patients aged 17-91 years with upper respiratory tract diseases admitted to the phoniatric outpatient clinic in the University Hospital in Cracow. They suffered from cough, hoarseness and periodic aphonia. On the basis of the results of videolaryngostroboscopy 60 patients with exacerbation of the chronic laryngitis were selected into two numerically equal groups: from Cracow and from other places at least 60 km away. The groups were equal to each other also in three categories: sex, age and voice usage. The patients were referred to the Pedagogical University in Cracow for laryngography to evaluate the movement of the vocal folds and to trace a voice profile. Finally, there were two possible types of treatment - conventional pharmacotherapy or subterraneotherapy in the underground Health Resort in the "Wieliczka" Salt Mine. Pearson correlation coefficient between the distance from the place of residence to Cracow and the scale of exacerbation of inflammation of upper respiratory tract presenting as vocal fold dysfunction was observed (r= 0,617; p<0,05). The place of residence (in or out of the industrial area) and exacerbations of chronic laryngitis are highly correlated. Air pollution seems to be the main factor influencing on the condition of upper respiratory tract. In our local conditions of Lesser Poland Voivodeship subterraneotherapy may be an interesting, non-invasive method preventing from exacerbations of upper respiratory tract diseases.

  8. [Food allergies in paediatrics: Current concepts].

    Science.gov (United States)

    Plaza-Martin, Ana María

    2016-07-01

    The concept of allergic reaction currently includes all those where an immunological reaction depends on a reaction mediated by IgE, as well as those that involve other immune mechanisms, such as T-cell regulators. There are many different clinical situations, like the classic immediate reactions (IgE mediated) such as urticaria, angioedema, immediate vomiting, abdominal pain, both upper respiratory (aphonia or rhinitis) and lower (wheezing or dyspnoea) symptom, and cardiovascular symptoms. The reactions that involve more than one organ, such as anaphylaxis, which could be an anaphylactic shock if there is cardiovascular involvement. The clinical signs and symptoms produced by non-IgE mediated reactions are usually more insidious in how they start, such as vomiting hours after the ingestion of food in enterocolitis, diarrhoea after days or weeks from starting food, dermatitis sometime after starting food. In these cases it is more difficult to associate these clinical symptoms directly with food. In this article, we attempt to clarify some concepts such as sensitisation/allergy, allergen/allergenic source, or the relationship of different clinical situations with food allergy, in order to help the paediatrician on the one hand, to prescribe strict diets in case of a suspicion based on the cause/effect relationship with the food, and on the other hand not to introduce unnecessary diets that very often have to last an excessively long time, and could lead to nutritional deficiencies in the children. Copyright © 2016 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  9. A study of the current situation regarding disabled children in China and its countermeasures.

    Science.gov (United States)

    Li, R

    1991-01-01

    The results of a national survey of disabled children in 1987 in China and the implications and recommendations for government and society to deal with recovery, education, and prevention are discussed. 41 questions were used to screen for children 14 years old with disabilities. Physicians followed up with positive identification of cases. The visually disabled were defined as those with corrected vision of 0.3. Hearing or speech disability meant hearing loss in both ears of 41 decibels, or aphasia, aphonia, or unclear speech. Mental disability referred to an IQ 50 or indicative behavior. Limb and trunk disabilities involved malformation or functional impediments of upper or lower arms or spine. Psychotic disabilities included mental or social functional disorders. Compound disabilities were also counted. 2.66% of the total children surveyed (1,579,316 in 369,448 households) were disabled and constituted 15.83% of all disabled (77,435). 65.96% children had mental, 14.2% had speech or hearing, 7.58% had physical, 9.87% had compound, 2.22% had visual, and .17% had psychotic disabilities. The error rate was set at 1.16%. Extrapolating to the national population, the 15.83% disabled translates to 8.17 million disabled children 14 years: 5.39 million intellectually disabled, 1.16 with speech or hearing disabilities, .806 with compound disabilities, .62 with physical disabilities, .181 with visual disabilities, and .014 with mental disabilities. 5 main features of the disabled are pointed out and discussed: 1) that males outnumber females, 2) that the qualitative rate increases with age, 3) that more disabled children are in villages than in cities, 4) that most have mental disabilities, and 5) that there are more minor disabilities than major disabilities. Several points are made concerning these figures. 1) Recovery is the remedy to many children's problems. 40-50% of all disabled needed hospital care or outpatient treatment including cataract extraction, orthopedic

  10. Isolated bilateral Tapia's syndrome after liver transplantation: A case report and review of the literature.

    Science.gov (United States)

    Bilbao, Itxarone; Dopazo, Cristina; Caralt, Mireia; Castells, Lluis; Pando, Elisabeth; Gantxegi, Amaia; Charco, Ramón

    2016-12-28

    To describe one case of bilateral Tapia's syndrome in a liver transplanted patient and to review the literature. We report a case of bilateral Tapia's syndrome in a 50-year-old man with a history of human immunodeficiency virus and hepatitis C virus child. A liver cirrhosis and a bi-nodular hepatocellular carcinoma, who underwent liver transplantation after general anesthesia under orotracheal intubation. Uneventful extubation was performed in the intensive care unit during the following hours. On postoperative day (POD) 3, he required urgent re-laparotomy due to perihepatic hematoma complicated with respiratory gram negative bacilli infection. On POD 13, patient was extubated, but required immediate re-intubation due to severe respiratory failure. At the following day a third weaning failure occurred, requiring the performance of a percutaneous tracheostomy. Five days later, the patient was taken off mechanical ventilation and severe dysphagia, sialorrea and aphonia revealed. A computerized tomography and a magnetic resonance imaging of the head and neck excluded central nervous injury. A stroboscopy showed bilateral paralysis of vocal cords and tongue and a diagnosis of bilateral Tapia's syndrome was performed. With conservative management, including a prompt establishment of a speech and swallowing rehabilitation program, the patient achieved full recovery within four months after liver transplantation. We carried out MEDLINE search for the term Tapia's syndrome. The inclusion criteria had no restriction by language or year but must provide sufficient available data to exclude duplicity. We described the clinical evolution of the patients, focusing on author, year of publication, age, sex, preceding problem, history of endotracheal intubation, unilateral or bilateral presentation, diagnostic procedures, type of treatment, follow-up, and outcome. Several authors mentioned the existence of around 70 cases, however only 54 fulfilled our inclusion criteria. We found

  11. Isolated bilateral Tapia’s syndrome after liver transplantation: A case report and review of the literature

    Science.gov (United States)

    Bilbao, Itxarone; Dopazo, Cristina; Caralt, Mireia; Castells, Lluis; Pando, Elisabeth; Gantxegi, Amaia; Charco, Ramón

    2016-01-01

    AIM To describe one case of bilateral Tapia’s syndrome in a liver transplanted patient and to review the literature. METHODS We report a case of bilateral Tapia’s syndrome in a 50-year-old man with a history of human immunodeficiency virus and hepatitis C virus child. A liver cirrhosis and a bi-nodular hepatocellular carcinoma, who underwent liver transplantation after general anesthesia under orotracheal intubation. Uneventful extubation was performed in the intensive care unit during the following hours. On postoperative day (POD) 3, he required urgent re-laparotomy due to perihepatic hematoma complicated with respiratory gram negative bacilli infection. On POD 13, patient was extubated, but required immediate re-intubation due to severe respiratory failure. At the following day a third weaning failure occurred, requiring the performance of a percutaneous tracheostomy. Five days later, the patient was taken off mechanical ventilation and severe dysphagia, sialorrea and aphonia revealed. A computerized tomography and a magnetic resonance imaging of the head and neck excluded central nervous injury. A stroboscopy showed bilateral paralysis of vocal cords and tongue and a diagnosis of bilateral Tapia’s syndrome was performed. With conservative management, including a prompt establishment of a speech and swallowing rehabilitation program, the patient achieved full recovery within four months after liver transplantation. We carried out MEDLINE search for the term Tapia’s syndrome. The inclusion criteria had no restriction by language or year but must provide sufficient available data to exclude duplicity. We described the clinical evolution of the patients, focusing on author, year of publication, age, sex, preceding problem, history of endotracheal intubation, unilateral or bilateral presentation, diagnostic procedures, type of treatment, follow-up, and outcome. RESULTS Several authors mentioned the existence of around 70 cases, however only 54 fulfilled our