Carlos Alberto da Silva Soares Moreno
Full Text Available ABSTRACT In this case report we highlight the uniqueness of aphonia as, to the best of our knowledge, cases of aphonia related to interscalene brachial plexus block (IBPB are not described in the literature. Although hoarseness is a common complication of IBPB, aphonia is not. Therefore, we think it is important to publicize the first case of aphonia after IBPB, which may have arisen only because of a recurrent laryngeal nerve chronic injury contralateral to the IBPB site.
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.
Murray, Sharon L.; And Others
Five cases of adolescents with functional aphonia (lack of speech despite normally appearing vocal chords) are presented. Therapeutic management is described which followed the symptomatic voice therapy approach. A consistent theme for four of the adolescents was stressful family environment, academic failure, and inadequate peer support.…
Iwarsson, Jenny; Fredsø, Julie
The occurrence of intermittent aphonia, perceived as sudden interruptions of voicing in connected speech, often reflects high stiffness of the vocal fold mucosa as part of a voice disorder. This retrospective study aimed to investigate the overarching hypothesis that the aphonic instances in voices...... 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...... in unstressed syllables as opposed to stressed, in vowels following an unvoiced phoneme as opposed to a voiced, and in vowels following two or more unvoiced phonemes as opposed to one unvoiced phoneme. No significant difference was found between vowels following aspirated stops [p], [t], [k] as opposed...
Van Puijenbroek, E.P.
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 ar
Abuelo, D N; Padre-Mendoza, T
A patient with mental retardation and mild facial dysmorphism had a karyotype which was considered to be normal before the availability of chromosomal banding techniques. She had a history of a cat-like cry and severe feeding problems during infancy. At the age of 9, she was still found to have initial aphonia on trying to initiate sounds. Repeat chromosome analysis with G banding showed an interstitial deletion of the long arm of chromosome 7.
Bożena Kosztyła-Hojna; Diana Moskal; Anna Kuryliszyn-Moskal; Ryszard Rutkowski
[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...
@@ Chronic pharyngitis is the diffuse inflammation of the pharyngeal mucus, submucosal and lymph tissues. Traditional Chinese medicine (TCM) considers it to be the category of "Meiheqi" (梅核气,globus hystericus), "Shiyin" (失音,aphonia) and "Houbi" (喉痹,inflammation of the throat). According to the theory of TCM, the author of the present paper adopted acupuncture plus Chinese herbal medicines to treat it from 1990 to 2002, and achieved a satisfactory result. It is reported as follows.
Iwarsson, Jenny; Petersen, Niels Reinholt
Objectives/Hypothesis: 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. Study Design: A prospective design with testing before and after training. Methods: Thirteen students of audiologopedics served as listening subjects. The ratings were made using...... 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. Results: Intrarater reliability and agreement showed a marked improvement for intermittent aphonia...
Buzhong Yiqi Decoction was used very extensively in clinic. In this paper, Buzhong Yiqi Decoction was used to treat different diseases, such as chronic: hepatitis B, pulmonary infection with urinary incontinence and left subtrochanteric fracture with aphonia. It embodied the Chinese traditional medicine thought of treating different diseases with the same therapeutic principle and dialectical treatment.%补中益气汤在临床上运用十分广泛.文章通过补中益气汤在慢性乙肝、肺部感染伴尿失禁、左股骨粗隆下骨折术后伴失声等不同疾病的灵活运用,体现中医异病同治、辨证施治的思想.
Kanski, A; Plocharska, E; Stanowski, E; Koziarski, T; Chmurzynska, A
A 45-year-old male, with symptoms of many years standing of gastro-oesophageal reflux disease, was subjected, under general anaesthesia, to laparoscopic fundoplication. Tracheal intubation yielded no problems but great difficulties were encountered during tube insertion into the oesophagus. After surgery, aphonia developed. Laryngological examination demonstrated paralysis of the left vocal cord. Voice strength returned to the pre-operative status after 3 months, and laryngological examination confirmed normal mobility of both cords. The possible cause of the complication was damage to the left recurrent laryngeal nerve which occurred during insertion of the tube into the oesophagus. Gastro-oesophageal reflux disease causing 'acid laryngitis' can create conditions favouring this type of complication.
Jaimala Vijay Shetye
Full Text Available 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.
Andrianopoulos, M V; Gallivan, G J; Gallivan, K H
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.
Faure, M A
Those three clinical cases involved aphonic female patients without any laryngeal disorders for their ENTs. 1) The first one had been out of work since 11/2 year because of her aphonia. She was still suffering from it in spite of a weekly speech therapy session and a monthly psychotherapy appointment. 2) The second patient had been aphonic for 3 weeks. Three different ENTs had renewed her prescription of work stoppage, even with normal laryngeal exam. 3) The third had lost her singing voicing ability during a performance in a national festival of songs and had to cancel the followings events. Even if all of them were waiting for a "miracle pill" they recorded their training session and left this single phoniatrician appointment with their restored voicing ability.
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.
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.
Iengo, M; Villari, P; Cavaliere, M; De Clemente, M; Merolla, F
The authors present a study of 37 patients affected by monolateral vocal cord paralysis in order to analyze etiology, degree of dysphonia and possible recovery of vocal function. The patients underwent the following tests: case history to determine the vocal characteristics prior to the lesion; video-laryngoscopy to define the position of the paralytic cord on the horizontal glottic plane and any compensation mechanisms; determination of the degree of dysphonia (light, moderate, severe, aphonia) on the basis of psycho-perceptive parameters; spectrography evaluated in classes (I, II, III and IV) according to Yanagihara. Analysis of the data obtained makes it possible to draw the following conclusions: the most frequent etiology encountered by the otorhinolaryngologist is surgical (particularly subsequent to thyroidectomy); the position taken by the paralytic vocal cord does not appear to determine the degree of dysphonia; during the period immediately after occurrence of the lesion (0-4 months) the vocal disorder is more intense and tends to be reduced thereafter, attenuated by a spontaneous compensation mechanism. In this regard, it must be pointed out, however, that such compensation can prove bad or even dangerous for good vocal function (falsetto voice); speech therapy makes it possible to nearly totally normalize vocal function in all patients presenting moderate dysphonia and in 60% of those with severe dysphonia. In the remaining 40% of those patients with severe dysphonia a partial improvement of vocal function was seen (from severe dysphonia to moderate dysphonia). This was determined by the fact that several negative prognostic factors came into play simultaneously in these patients (i.e. advanced age, longer time gap since the lesion occurred, position assumed by the paralytic cord) which prevented them from achieving better phonatory results.
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.
Experiências de doentes críticos com a ventilação mecânica invasiva Las experiencias de pacientes críticos con ventilación mecánica invasiva Experiences of critically ill patients with invasive mechanical ventilation
puntos importantes a considerarse para el cuidado de enfermería.The aim of this study was to identify the experiences of patients who used invasive mechanical ventilation in intensive care units of two hospitals in Southern Brazil. This research was conducted in a qualitative way, consisting of 10 interviewees, who emphasized their main difficulties and necessities during the period in which they used invasive mechanical ventilation. The results indicate that the difficulties reported were specially related to the presence of the artificial airway, such as: suffocation felling, nausea, injuries caused by the endotracheal tube, accumulation of secretions in the endotracheal tube and oral cavity and aphonia. In addition, the patients reported other problems such as: communication needs, thirst, and changes in their personal routine. Our findings elucidated the experience of critically ill patients through this invasive feature, bringing important issues to be considered for nursing care.