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Sample records for intrinsic laryngeal muscles

  1. Muscle Bioenergetic Considerations for Intrinsic Laryngeal Skeletal Muscle Physiology

    Science.gov (United States)

    Sandage, Mary J.; Smith, Audrey G.

    2017-01-01

    Purpose: Intrinsic laryngeal skeletal muscle bioenergetics, the means by which muscles produce fuel for muscle metabolism, is an understudied aspect of laryngeal physiology with direct implications for voice habilitation and rehabilitation. The purpose of this review is to describe bioenergetic pathways identified in limb skeletal muscle and…

  2. Effect of Dystrophin Deficiency on Selected Intrinsic Laryngeal Muscles of the "mdx" Mouse

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    Fry, Lisa T.; Stemple, Joseph C.; Andreatta, Richard D.; Harrison, Anne L.; Andrade, Francisco H.

    2010-01-01

    Background: Intrinsic laryngeal muscles (ILM) show biological differences from the broader class of skeletal muscles. Yet most research regarding ILM specialization has been completed on a few muscles, most notably the thyroarytenoid and posterior cricoarytenoid. Little information exists regarding the biology of other ILM. Early evidence suggests…

  3. Functional electrical stimulation of intrinsic laryngeal muscles under varying loads in exercising horses.

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    Jon Cheetham

    Full Text Available Bilateral vocal fold paralysis (BVCP is a life threatening condition and appears to be a good candidate for therapy using functional electrical stimulation (FES. Developing a working FES system has been technically difficult due to the inaccessible location and small size of the sole arytenoid abductor, the posterior cricoarytenoid (PCA muscle. A naturally-occurring disease in horses shares many functional and etiological features with BVCP. In this study, the feasibility of FES for equine vocal fold paralysis was explored by testing arytenoid abduction evoked by electrical stimulation of the PCA muscle. Rheobase and chronaxie were determined for innervated PCA muscle. We then tested the hypothesis that direct muscle stimulation can maintain airway patency during strenuous exercise in horses with induced transient conduction block of the laryngeal motor nerve. Six adult horses were instrumented with a single bipolar intra-muscular electrode in the left PCA muscle. Rheobase and chronaxie were within the normal range for innervated muscle at 0.55±0.38 v and 0.38±0.19 ms respectively. Intramuscular stimulation of the PCA muscle significantly improved arytenoid abduction at all levels of exercise intensity and there was no significant difference between the level of abduction achieved with stimulation and control values under moderate loads. The equine larynx may provide a useful model for the study of bilateral fold paralysis.

  4. Laryngeal Muscles Are Spared in the Dystrophin Deficient "mdx" Mouse

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    Thomas, Lisa B.; Joseph, Gayle L.; Adkins, Tracey D.; Andrade, Francisco H.; Stemple, Joseph C.

    2008-01-01

    Purpose: "Duchenne muscular dystrophy (DMD)" is caused by the loss of the cytoskeletal protein, dystrophin. The disease leads to severe and progressive skeletal muscle wasting. Interestingly, the disease spares some muscles. The purpose of the study was to determine the effects of dystrophin deficiency on 2 intrinsic laryngeal muscles, the…

  5. Changes in calsequestrin, TNF-α, TGF-β and MyoD levels during the progression of skeletal muscle dystrophy in mdx mice: a comparative analysis of the quadriceps, diaphragm and intrinsic laryngeal muscles.

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    Barros Maranhão, Juliana; de Oliveira Moreira, Drielen; Maurício, Adriana Fogagnolo; de Carvalho, Samara Camaçari; Ferretti, Renato; Pereira, Juliano Alves; Santo Neto, Humberto; Marques, Maria Julia

    2015-10-01

    In Duchenne muscular dystrophy (DMD), the search for new biomarkers to follow the evolution of the disease is of fundamental importance in the light of the evolving gene and pharmacological therapies. In addition to the lack of dystrophin, secondary events including changes in calcium levels, inflammation and fibrosis greatly contribute to DMD progression and the molecules involved in these events may represent potential biomarkers. In this study, we performed a comparative evaluation of the progression of dystrophy within muscles that are differently affected by dystrophy (diaphragm; DIA and quadriceps; QDR) or spared (intrinsic laryngeal muscles) using the mdx mice model of DMD. We assessed muscle levels of calsequestrin (calcium-related protein), tumour necrosis factor (TNF-α; pro-inflammatory cytokine), tumour growth factor (TGF-β; pro-fibrotic factor) and MyoD (muscle proliferation) vs. histopathology at early (1 and 4 months of age) and late (9 months of age) stages of dystrophy. Fibrosis was the primary feature in the DIA of mdx mice (9 months: 32% fibrosis), which was greater than in the QDR (9 months: 0.6% fibrosis). Muscle regeneration was the primary feature in the QDR (9 months: 90% of centrally nucleated fibres areas vs. 33% in the DIA). The QDR expressed higher levels of calsequestrin than the DIA. Laryngeal muscles showed normal levels of TNF-α, TGF-β and MyoD. A positive correlation between histopathology and cytokine levels was observed only in the diaphragm, suggesting that TNF-α and TGF-β serve as markers of dystrophy primarily for the diaphragm. © 2015 The Authors. International Journal of Experimental Pathology © 2015 International Journal of Experimental Pathology.

  6. Transoesophageal ultrasound and computer tomographic assessment of the equine cricoarytenoid dorsalis muscle: Relationship between muscle geometry and exercising laryngeal function.

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    Kenny, M; Cercone, M; Rawlinson, J J; Ducharme, N G; Bookbinder, L; Thompson, M; Cheetham, J

    2017-05-01

    Early detection of recurrent laryngeal neuropathy (RLN) is of considerable interest to the equine industry. To describe two imaging modalities, transoesophageal ultrasound (TEU) and computed tomography (CT) with multiplanar reconstruction to assess laryngeal muscle geometry, and determine the relationship between cricoarytenoid dorsalis (CAD) geometry and function. Two-phase study evaluating CAD geometry in experimental horses and horses with naturally occurring RLN. Equine CAD muscle volume was determined from CT scan sets using volumetric reconstruction with LiveWire. The midbody and caudal dorsal-ventral thickness of the CAD muscle was determined using a TEU in the same horses; and in horses with a range of severity of RLN (n = 112). Transoesophageal ultrasound was able to readily image the CAD muscles and lower left:right CAD thickness ratios were observed with increasing disease severity. Computed tomography based muscle volume correlated very closely with ex vivo muscle volume (R 2 = 0.77). Computed tomography reconstruction can accurately determine intrinsic laryngeal muscle geometry. A relationship between TEU measurements of CAD geometry and laryngeal function was established. These imaging techniques could be used to track the response of the CAD muscle to restorative surgical treatments such as nerve muscle pedicle graft, nerve anastomosis and functional electrical stimulation. © 2016 EVJ Ltd.

  7. Quantitative PCR Analysis of Laryngeal Muscle Fiber Types

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    Van Daele, Douglas J.

    2010-01-01

    Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses…

  8. Reversing Age Related Changes of the Laryngeal Muscles by Chronic Electrostimulation of the Recurrent Laryngeal Nerve.

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    Michael Karbiener

    Full Text Available Age related atrophy of the laryngeal muscles -mainly the thyroarytenoid muscle (TAM- leads to a glottal gap and consequently to a hoarse and dysphonic voice that significantly affects quality of life. The aim of our study was to reverse this atrophy by inducing muscular hypertrophy by unilateral functional electrical stimulation (FES of the recurrent laryngeal nerve (RLN in a large animal model using aged sheep (n = 5. Suitable stimulation parameters were determined by fatiguing experiments of the thyroarytenoid muscle in an acute trial. For the chronic trial an electrode was placed around the right RLN and stimulation was delivered once daily for 29 days. We chose a very conservative stimulation pattern, total stimulation time was two minutes per day, or 0.14% of total time. Overall, the mean muscle fiber diameter of the stimulated right TAM was significantly larger than the non-stimulated left TAM (30μm±1.1μm vs. 28μm±1.1 μm, p<0.001. There was no significant shift in fiber type distribution as judged by immunohistochemistry. The changes of fiber diameter could not be observed in the posterior cricoarytenoid muscle (PCAM. FES is a possible new treatment option for reversing the effects of age related laryngeal muscle atrophy.

  9. Metastasis of Laryngeal Squamous Cell Carcinoma to Bilateral Thigh Muscles

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    Zarah Lucas

    2014-01-01

    Full Text Available Importance. Laryngeal cancer infrequently results in distant metastases, but metastasis to skeletal muscle is extremely uncommon. Observations. A 55-year-old male presenting with progressive dyspnea and hoarseness was found to have Stage IVA T4aN2cM0 laryngeal cancer and eventually underwent total laryngectomy. Before the patient could be started on adjuvant chemoradiation, the patient developed masses on both thighs. Biopsy revealed metastatic squamous cell carcinoma consistent with the primary laryngeal cancer. He was offered palliative chemotherapy; however, he developed new soft tissue masses to the left of his stoma and in the prevertebral area one week later. He also had new cervical and supraclavicular nodes and a pathological compression fracture of L3. Patient died within 4 months of diagnosis. Conclusions. Distant metastasis such as skeletal metastasis portends a poor prognosis. Further studies are required to determine the best course of treatment in these patients.

  10. Laryngeal movements during inspiratory muscle training in healthy subjects.

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    Sandnes, Astrid; Andersen, Tiina; Hilland, Magnus; Ellingsen, Thor Andre; Halvorsen, Thomas; Heimdal, John-Helge; Røksund, Ola Drange

    2013-07-01

    Inspiratory muscle training (IMT) has been used to treat patients with exercise-induced vocal cord dysfunction (VCD); the theoretical basis being the close relationship between the diaphragm and the posterior cricoarytenoid muscle, which is the main abductor of the larynx. Before launching a treatment protocol in patients with VCD, we aimed to substantiate this theory by performing laryngoscopy in healthy subjects during standardized IMT programs. Twenty healthy volunteers at mean age 24 years were examined with video-recorded continuous transnasal flexible laryngoscopy while performing standardized training programs using a resistive loading IMT device (Respifit S). All subjects were exposed to two modes of training, that is, the resistance set to generate mouth pressures ≥80% of the maximal attainable inspiratory mouth pressure (PImax) and 60-80% of PImax. Laryngeal movements were scored in retrospect from the video recordings by a senior laryngologist. At pressure settings of ≥80% of PImax, laryngeal movements could not be assessed in one subject. Abduction was observed in 10 (53%) subjects, six to a maximal extent and four to a moderate extent. At pressure settings of 60-80% of PImax, abduction was observed in 18 (90%) subjects, seven to a maximal extent and 11 to a moderate extent. IMT can produce laryngeal abduction in healthy subjects, and training programs may conceivably contribute positively in patients suffering from laryngeal adduction during exercise. Individual response patterns varied between subjects and individualized programs seem crucial for effect. Use of high resistances seemed to be counterproductive. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  11. Potential of laryngeal muscle regeneration using induced pluripotent stem cell-derived skeletal muscle cells.

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    Dirja, Bayu Tirta; Yoshie, Susumu; Ikeda, Masakazu; Imaizumi, Mitsuyoshi; Nakamura, Ryosuke; Otsuki, Koshi; Nomoto, Yukio; Wada, Ikuo; Hazama, Akihiro; Omori, Koichi

    2016-01-01

    Conclusion Induced pluripotent stem (iPS) cells may be a new potential cell source for laryngeal muscle regeneration in the treatment of vocal fold atrophy after recurrent laryngeal nerve paralysis. Objectives Unilateral vocal fold paralysis can lead to degeneration, atrophy, and loss of force of the thyroarytenoid muscle. At present, there are some treatments such as thyroplasty, arytenoid adduction, and vocal fold injection. However, such treatments cannot restore reduced mass of the thyroarytenoid muscle. iPS cells have been recognized as supplying a potential resource for cell transplantation. The aim of this study was to assess the effectiveness of the use of iPS cells for the regeneration of laryngeal muscle through the evaluation of both in vitro and in vivo experiments. Methods Skeletal muscle cells were generated from tdTomato-labeled iPS cells using embryoid body formation. Differentiation into skeletal muscle cells was analyzed by gene expression and immunocytochemistry. The tdTomato-labeled iPS cell-derived skeletal muscle cells were transplanted into the left atrophied thyroarytenoid muscle. To evaluate the engraftment of these cells after transplantation, immunohistochemistry was performed. Results The tdTomato-labeled iPS cells were successfully differentiated into skeletal muscle cells through an in vitro experiment. These cells survived in the atrophied thyroarytenoid muscle after transplantation.

  12. Laryngitis

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    ... Symptom Checker Cough Laryngitis Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

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

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

    2013-01-01

    The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD. PMID:24319372

  14. Importance and challenges of measuring intrinsic foot muscle strength

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    2012-01-01

    Background Intrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders. However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure intrinsic foot muscle strength. Method Literature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro and CINAHL up to June 2012. Results There is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force. Conclusions There are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative contribution of intrinsic and extrinsic muscles

  15. Congenital hypertrophy of multiple intrinsic muscles of the foot.

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    Shiraishi, Tomohiro; Park, Susam; Niu, Atushi; Hasegawa, Hiromi

    2014-12-01

    Congenital hypertrophy of a single intrinsic muscle of the foot is rare, and as far as we know, only six cases have been reported. We describe a case of congenital anomaly that showed hypertrophy of multiple intrinsic muscles of the foot; the affected muscles were all the intrinsic muscles of the foot except the extensor digitorum brevis or extensor hallucis. Other tissues such as adipose tissue, nervous tissue, or osseous tissue showed no abnormalities. To reduce the volume of the foot we removed parts of the enlarged muscles.

  16. Acoustic Correlates of Fatigue in Laryngeal Muscles: Findings for a Criterion-Based Prevention of Acquired Voice Pathologies

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    Boucher, Victor J.

    2008-01-01

    Purpose: The objective was to identify acoustic correlates of laryngeal muscle fatigue in conditions of vocal effort. Method: In a previous study, a technique of electromyography (EMG) served to define physiological signs of "voice fatigue" in laryngeal muscles involved in voicing. These signs correspond to spectral changes in contraction…

  17. Laryngeal paralysis associated with a muscle pseudotumour in a young dog

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    Francesca Rizzo

    2017-08-01

    Full Text Available An 18-month-old male entire Bloodhound dog was presented with a six-week history of progressive inspiratory dyspnoea, stridor, dysphonia and exercise intolerance. CT scan performed elsewhere had revealed the presence of an unencapsulated nodular mass (3x1x5 cm dorsal to the larynx and first tracheal rings. Laryngoscopy demonstrated the presence of bilateral laryngeal paralysis and distorted laryngeal architecture suggestive of extraluminal compression. Histopathology results of incisional biopsies from the mass were suggestive of a benign non-neoplastic muscular lesion. Surgery was performed to manage laryngeal paralysis and attempt mass excision. A second histopathology examination confirmed an inflammatory and dysplastic lesion suggestive of a pseudotumour. All clinical signs resolved after surgery and at the 13 months follow-up the dog remains asymptomatic. To the authors’ knowledge, this is the first report of a case of laryngeal paralysis caused by a muscle pseudotumour in a young dog.

  18. Modified frontolateral partial laryngectomy operation: combined muscle-pedicle hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction

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    Ouyang, Dian; Liu, Tian-Run; Chen, Yan-Feng; Wang, Jian

    2013-01-01

    Objective Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohy...

  19. Review on Laryngeal Palpation Methods in Muscle Tension Dysphonia: Validity and Reliability Issues.

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    Khoddami, Seyyedeh Maryam; Ansari, Noureddin Nakhostin; Jalaie, Shohreh

    2015-07-01

    Laryngeal palpation is a common clinical method for the assessment of neck and laryngeal muscles in muscle tension dysphonia (MTD). To review the available laryngeal palpation methods used in patients with MTD for the assessment, diagnosis, or document of treatment outcomes. A systematic review of the literature concerning palpatory methods in MTD was conducted using the databases MEDLINE (PubMed), ScienceDirect, Scopus, Web of science, Web of knowledge and Cochrane Library between July and October 2013. Relevant studies were identified by one reviewer based on screened titles/abstracts and full texts. Manual searching was also used to track the source literature. There were five main as well as miscellaneous palpation methods that were different according to target anatomical structures, judgment or grading system, and using tasks. There were only a few scales available, and the majority of the palpatory methods were qualitative. Most of the palpatory methods evaluate the tension at both static and dynamic tasks. There was little information about the validity and reliability of the available methods. The literature on the scientific evidence of muscle tension indicators perceived by laryngeal palpation in MTD is scarce. Future studies should be conducted to investigate the validity and reliability of palpation methods. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Intrinsic properties of the knee extensor muscles after subacute stroke

    NARCIS (Netherlands)

    Horstman, A.M.H.; Gerrits, K.H.L.; Beltman, M.J.; Koppe, P.A.; Janssen, T.W.J.; de Haan, A.

    2010-01-01

    Horstman AM, Gerrits KH, Beltman MJ, Koppe PA, Janssen, TW, de Haan A. Intrinsic properties of the knee extensor muscles after subacute stroke. Objective: To characterize muscle properties of paretic lower-limb (PL) and nonparetic lower-limb (NL) knee extensors in patients with subacute stroke.

  1. Revision laryngeal framework surgery performed by directly pulling the lateral cricoarytenoid muscle.

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    Kanazawa, T; Komazawa, D; Watanabe, Y; Ichimura, K

    2014-10-01

    Revision laryngeal framework surgery is usually performed for medialisation laryngoplasty failure, rather than for failure after arytenoid adduction. We describe a new method for revision arytenoid adduction surgery, performed by directly pulling the lateral cricoarytenoid muscle ('lateral cricoarytenoid muscle pull surgery'). We describe a case of revision laryngeal framework surgery, present a literature review and describe the advantages of lateral cricoarytenoid muscle pull surgery over the original method of arytenoid adduction using a posterior approach. Medialisation laryngoplasty combined with arytenoid adduction was performed following unilateral vocal fold paralysis from mediastinal surgery, resulting in severe glottic insufficiency. The patient's voice improved after the initial surgery, but had deteriorated 18 months later. Revision surgery was performed using lateral cricoarytenoid muscle pull surgery, and her voice recovered normally in terms of perceptual impression. The post-operative course was uneventful for 10 months following revision surgery. To our knowledge, this is the first case of revision arytenoid adduction performed using a lateral cricoarytenoid muscle pull approach. Lateral cricoarytenoid muscle pull surgery should therefore be considered as a new fenestration approach for arytenoid adduction.

  2. Modified frontolateral partial laryngectomy operation: combined muscle-pedicle hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction

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    Ouyang, Dian; Liu, Tian-Run; Chen, Yan-Feng; Wang, Jian

    2013-01-01

    Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy

  3. Effect on laryngeal adductor function of vincristine block of posterior cricoarytenoid muscle 3 to 5 months after recurrent laryngeal nerve injury.

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    Paniello, Randal C; Park, Andrea

    2015-06-01

    It has been shown in a canine model that a single injection of vincristine into the posterior cricoarytenoid (PCA) muscle at the time of recurrent laryngeal nerve (RLN) injury effectively blocks its reinnervation and results in improved adductor strength. But clinically, such injuries are usually diagnosed weeks or months after onset. Vincristine injection does not affect a muscle that is already innervated; thus, there is a limited time frame following RLN injury during which a vincristine injection could effectively improve ultimate laryngeal adductor functional recovery. A series of delayed injections was performed in a canine model and results assessed. Animal (canine) experiment. The RLN was transected and repaired, and vincristine (0.4 mg) was injected into the PCA muscle at the time of injury (n=12) or 3, 4, and 5 months later (n=8 each study group). Six months after RLN injury, laryngeal adductor function was measured. Results of vincristine injection without RLN injury (n=6) and longer-term (12 months) follow-up for time zero injections (n=4) are also reported. The animals injected at time zero had better adductor function than non-injected controls, as reported previously, and this result was further increased at 12 months. The 3-month delay gave results similar to the time zero group. The 5-month delay group showed no vincristine benefit, and the 4-month delay group gave an intermediate result. Vincristine to the PCA had no effect on adductor function when the RLN was left intact. Plasma levels showed 19% of injected vincristine reached systemic circulation, which was cleared within 69 hours. Vincristine injection of the PCA muscle after RLN injury, which blocks this antagonist muscle from synkinetic reinnervation, leads to improved laryngeal adductor functional recovery. The window of opportunity to apply this treatment closes by 4 months after RLN injury in the canine model. Human RLN recovery follows a similar time course and can reasonably be

  4. Regenerative Effects of Basic Fibroblast Growth Factor on Restoration of Thyroarytenoid Muscle Atrophy Caused by Recurrent Laryngeal Nerve Transection.

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    Kaneko, Mami; Tsuji, Takuya; Kishimoto, Yo; Sugiyama, Yoichiro; Nakamura, Tatsuo; Hirano, Shigeru

    2017-10-27

    Vocal fold atrophy following unilateral vocal fold paralysis is caused by atrophy of the thyroarytenoid (TA) muscle and remains a challenge. Medialization procedures are popular treatment options; however, hoarseness often remains due to the reduction in mass or tension of the TA muscle. Therefore, in addition to medialization procedures, TA muscle reinnervation is desirable. In vivo studies have shown the potential for basic fibroblast growth factor (bFGF) to affect muscular and nerve regeneration. The present study aimed to examine the regenerative effects of bFGF on restoration of TA muscle atrophy caused by recurrent laryngeal nerve transection. Prospective animal experiments with controls. TA muscle atrophy was induced by unilateral transection of the recurrent laryngeal nerve. One month after transection, different doses (200 ng, 100 ng, 10 ng) of bFGF in 50 µL were repeatedly injected into the TA muscle four times with an interval of 1 week between injections. Saline only was injected in the sham group. Larynges were harvested for histologic and immunohistochemical examination 4 weeks after the final injection. The cross-sectional TA muscle area was significantly larger in the bFGF-treated groups compared with the sham-treated groups. Immunohistochemistry indicated that bFGF significantly increases the number of neuromuscular junctions and satellite cells in the TA muscle. These results suggest that local application of bFGF to the TA muscle may improve TA muscle atrophy caused by recurrent laryngeal nerve paralysis. Furthermore, bFGF may have regenerative effects on both nerves and muscles. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. Surface electromyography assessment of back muscle intrinsic properties.

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    Larivière, Christian; Arsenault, A Bertrand; Gravel, Denis; Gagnon, Denis; Loisel, Patrick

    2003-08-01

    The purpose of this study was to assess (1) the reliability and (2) the sensitivity to low back pain status and gender of different EMG indices developed for the assessment of back muscle weakness, muscle fiber composition and fatigability. Healthy subjects (men and women) and chronic low back pain patients (men only) performed, in a static dynamometer, maximal and submaximal static trunk extension tasks (short and long duration) to assess weakness, fiber composition and fatigue. Surface EMG signals were recorded from four (bilateral) pairs of back muscles and three pairs of abdominal muscles. To assess reliability of the different EMG parameters, 40 male volunteers (20 controls and 20 chronic low back pain patients) were assessed on three occasions. Reliable EMG indices were achieved for both healthy and chronic low back pain subjects when specific measurement strategies were applied. The EMG parameters used to quantify weakness and fiber composition were insensitive to low back status and gender. The EMG fatigue parameters did not detect differences between genders but unexpectedly, healthy men showed higher fatigability than back pain patients. This result was attributed to the smaller absolute load that was attributed to the patients, a load that was defined relative to their maximal strength, a problematic measure with this population. An attempt was made to predict maximal back strength from anthropometric measurements but this prediction was prone to errors. The main difficulties and some potential solutions related to the assessment of back muscle intrinsic properties were discussed.

  6. Surgical Treatment Guidelines for Digital Deformity Associated With Intrinsic Muscle Spasticity (Intrinsic Plus Foot) in Adults With Cerebral Palsy.

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    Boffeli, Troy J; Collier, Rachel C

    2015-01-01

    Intrinsic plus foot deformity has primarily been associated with cerebral palsy and involves spastic contracture of the intrinsic musculature with resultant toe deformities. Digital deformity is caused by a dynamic imbalance between the intrinsic muscles in the foot and extrinsic muscles in the lower leg. Spastic contracture of the toes frequently involves curling under of the lesser digits or contracture of the hallux into valgus or plantarflexion deformity. Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. Four different patterns of intrinsic plus foot deformity have been observed by the authors that likely relate to the different patterns of muscle involvement. Case examples are provided of the 4 patterns of intrinsic plus foot deformity observed, including global intrinsic plus lesser toe deformity, isolated intrinsic plus lesser toe deformity, intrinsic plus hallux valgus deformity, and intrinsic plus hallux flexus deformity. These case examples are presented to demonstrate each type of deformity and our approach for surgical management according to the contracture pattern. The surgical approach has typically involved tenotomy, capsulotomy, or isolated joint fusion. The main goals of surgical treatment are to relieve pain and reduce pressure points through digital realignment in an effort to decrease the risk of pressure sores and allow more effective bracing to ultimately improve the patient's mobility. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Intrinsic muscle atrophy and toe deformity in the diabetic neuropathic foot: a magnetic resonance imaging study

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    Bus, Sicco A.; Yang, Qing X.; Wang, Jinghua H.; Smith, Michael B.; Wunderlich, Roshna; Cavanagh, Peter R.

    2002-01-01

    OBJECTIVE: The objectives of this study were to compare intrinsic foot muscle cross-sectional area (CSA) in patients with diabetic polyneuropathy and nondiabetic control subjects and to examine the association between intrinsic muscle CSA and clawing/hammering of the toes in neuropathic feet.

  8. Electromyographic Study of Differential Sensitivity to Succinylcholine of the Diaphragm, Laryngeal and Somatic Muscles: A Swine Model

    Directory of Open Access Journals (Sweden)

    I-Cheng Lu

    2010-12-01

    Full Text Available Neuromuscular blocking agents (NMBAs might diminish the electromyography signal of the vocalis muscles during intraoperative neuromonitoring of the recurrent laryngeal nerve. The aim of this study was to compare differential sensitivity of different muscles to succinylcholine in a swine model, and to realize the influence of NMBAs on neuromonitoring. Six male Duroc-Landrace piglets were anesthetized with thiamylal and underwent tracheal intubation without the use of an NMBA. The left recurrent laryngeal nerve, the spinal accessory nerve, the right phrenic nerve and the brachial plexus were stimulated. Evoked potentials (electromyography signal of four muscle groups were elicited from needle electrodes before and after intravenous succinylcholine bolus (1.0 mg/kg. Recorded muscles included the vocalis muscles, trapezius muscle, diaphragm and triceps brachii muscles. The onset time and 80% recovery of control response were recorded and analyzed. The testing was repeated after 30 minutes. The onset time of neuromuscular blocking for the vocalis muscles, trapezius muscle, diaphragm and triceps brachii muscle was 36.3 ± 6.3 seconds, 38.8 ± 14.9 seconds, 52.5 ± 9.7 seconds and 45.0 ± 8.2 seconds during the first test; and 49.3 ± 10.8 seconds, 40.0 ± 12.2 seconds, 47.5 ± 11.9 seconds and 41.3 ± 10.1 seconds during the second test. The 80% recovery of the control response for each muscle was 18.3 ± 2.7 minutes, 16.5±6.9 minutes, 8.1±2.5 minutes and 14.8±2.9 minutes during the first test; and 21.5±3.8 minutes, 12.5 ± 4.3 minutes, 10.5 ± 3.1 minutes and 16.4 ± 4.2 minutes during the second test. The sensitivity of the muscles to succinylcholine, ranked in order, was: the vocalis muscles, the triceps brachii muscle, the trapezius muscle and the diaphragm. We demonstrated a useful and reliable animal model to investigate the effects of NMBAs on intraoperative neuromonitoring. Extrapolation of these data to humans should be done with caution.

  9. Speed, accuracy, and stability of laryngeal movement in singing

    Science.gov (United States)

    Titze, Ingo R.

    2004-05-01

    Motor performance is often quantified in terms of speed, strength, accuracy, and stability of a target gesture, or maintaining a given posture. In the vocal system, this involves primarily the intrinsic laryngeal muscles and the respiratory muscles. Agonist-antagonist pairs of muscles are used to position the vocal folds for phonation (vocal onset), for pitch change, and for registration (as in yodeling). Maximum speed and accuracy are discussed for vocal embellishments such as trills, trillo, scales, arpeggios, yodel, and glissando. This speed and accuracy are interpreted in terms of muscle twitch and tetanic responses obtained in vitro on animal muscles, from electromyographic recordings on humans, and from muscles not easily tested on humans. The laryngeal reflex system is also described, particularly with regard to its ability to stabilize (or destabilize) neurologic tremor originating from the central nervous system.

  10. Ultrasonographic quantification of intrinsic hand muscle cross-sectional area; Reliability and validity for predicting muscle strength

    NARCIS (Netherlands)

    Mohseny, Behnam; Nijhuis, Tim H.; Hundepool, Caroline A.; Janssen, Wim G.; Selles, Ruud W.; Coert, J. Henk

    2015-01-01

    Objective To investigate whether ultrasonographic measurement of the cross-sectional area (CSA) of the intrinsic hand muscles can be used to predict muscle strength in a valid and reliable manner, and to determine if this method can be used for follow-up of patients with peripheral nerve injury

  11. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume.

    Science.gov (United States)

    Chen, Tony Lin-Wei; Sze, Louis K Y; Davis, Irene S; Cheung, Roy T H

    2016-07-01

    Minimalist shoes have gained popularity recently because it is speculated to strengthen the foot muscles and foot arches, which may help to resist injuries. However, previous studies provided limited evidence supporting the link between changes in muscle size and footwear transition. Therefore, this study sought to examine the effects of minimalist shoes on the intrinsic and extrinsic foot muscle volume in habitual shod runners. The relationship between participants' compliance with the minimalist shoes and changes in muscle õvolume was also evaluated. Twenty habitual shod runners underwent a 6-month self-monitoring training program designed for minimalist shoe transition. Another 18 characteristics-matched shod runners were also introduced with the same program but they maintained running practice with standard shoes. Runners were monitored using an online surveillance platform during the program. We measured overall intrinsic and extrinsic foot muscle volume before and after the program using MRI scans. Runners in the experimental group exhibited significantly larger leg (P=0.01, Cohen's d=0.62) and foot (Pshoes and changes in leg muscle volume (r=0.51; P=0.02). Habitual shod runners who transitioned to minimalist shoes demonstrated significant increase in leg and foot muscle volume. Additionally, the increase in leg muscle volume was significantly correlated associated with the compliance of minimalist shoe use. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. The effect of minimal shoes on arch structure and intrinsic foot muscle strength

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    Elizabeth E. Miller

    2014-06-01

    Conclusion: These results suggest that endurance running in minimal support footwear with 4 mm offset or less makes greater use of the spring-like function of the longitudinal arch, thus leading to greater demands on the intrinsic muscles that support the arch, thereby strengthening the foot.

  13. Muscle insulin sensitivity and glucose metabolism are controlled by the intrinsic muscle clock

    DEFF Research Database (Denmark)

    Dyar, Kenneth A.; Ciciliot, Stefano; Wright, Lauren E.

    2014-01-01

    Circadian rhythms control metabolism and energy homeostasis, but the role of the skeletal muscle clock has never been explored. We generated conditional and inducible mouse lines with muscle-specific ablation of the core clock gene Bmal1. Skeletal muscles from these mice showed impaired insulin-s...

  14. Rat diaphragm mitochondria have lower intrinsic respiratory rates than mitochondria in limb muscles.

    Science.gov (United States)

    Garcia-Cazarin, Mary L; Gamboa, Jorge L; Andrade, Francisco H

    2011-06-01

    The mitochondrial content of skeletal muscles is proportional to activity level, with the assumption that intrinsic mitochondrial function is the same in all muscles. This may not hold true for all muscles. For example, the diaphragm is a constantly active muscle; it is possible that its mitochondria are intrinsically different compared with other muscles. This study tested the hypothesis that mitochondrial respiration rates are greater in the diaphragm compared with triceps surae (TS, a limb muscle). We isolated mitochondria from diaphragm and TS of adult male Sprague Dawley rats. Mitochondrial respiration was measured by polarography. The contents of respiratory complexes, uncoupling proteins 1, 2, and 3 (UCP1, UCP2, and UCP3), and voltage-dependent anion channel 1 (VDAC1) were determined by immunoblotting. Complex IV activity was measured by spectrophotometry. Mitochondrial respiration states 3 (substrate and ADP driven) and 5 (uncoupled) were 27 ± 8% and 24 ± 10%, respectively, lower in diaphragm than in TS (P respire at lower rates, despite a higher content of respiratory complexes. The results invalidate our initial hypothesis and indicate that mitochondrial content is not the only determinant of aerobic capacity in the diaphragm. We propose that UCP1 and VDAC1 play a role in regulating diaphragm aerobic capacity.

  15. The CT features of recurrent laryngeal nerve paralysis

    International Nuclear Information System (INIS)

    Wu Bin; Peng Weijun; Gu Yajia; Yang Tianxi; Wang Hongshi

    2006-01-01

    Objective: To describe the CT appearance of recurrent laryngeal nerve paralysis, discuss the anatomic and pathologic basis of this paralysis, and evaluate CT diagnosis. Methods: 32 cases of recurrent laryngeal nerve paralysis clinical confirmed were analyzed retrospectively. All of these patients had the CT scans from the level of hyoid bone to the upper thorax, the slice and interval are 5 mm. Results: CT findings of recurrent laryngeal nerve paralysis included: oblique of aryepiglottic fold, dislocation of arytenoid cartilage and cricoarytenoid joint, dilation and relaxation of piriform sinus for 27 cases (84.4%); wide and asymmetrical ventricle of larynx for 16 cases (50.0%); asymmetrical and fix of vocal fold for 11 cases (34.4%) et al. Conclusion: The recurrent laryngeal nerve innervate all the intrinsic muscles of the larynx except cricothyroid muscle, paralysis of the nerve leads to atrophy of related muscles. CT scan demonstrate the larynx morphologic changes of recurrent nerve paralysis and is helpful to identify the etiology. (authors)

  16. Increased intrinsic mitochondrial respiratory capacity in skeletal muscle from rats with streptozotocin-induced hyperglycemia

    DEFF Research Database (Denmark)

    Larsen, Steen; Scheede-Bergdahl, Celena; Whitesell, Thomas

    2015-01-01

    expression and integrated mitochondrial respiratory function. Mitochondrial capacity for oxidative phosphorylation (OXPHOS) was found to be higher in the slow (more oxidative) soleus muscle from STZ rats when evaluating lipid and complex I linked OXPHOS capacity, whereas no difference was detected between...... the groups when evaluating the more physiol. complex I and II linked OXPHOS capacity. These findings indicate that chronic hyperglycemia results in an elevated intrinsic mitochondrial respiratory capacity in both soleus and, at varying degree, plantaris muscle, findings that are consistent with human T1DM...

  17. Long-term outcome of muscle strength in ulnar and median nerve injury: Comparing manual muscle strength testing, grip and pinch strength dynamometers and a new intrinsic muscle strength dynamometer

    NARCIS (Netherlands)

    A.R. Schreuders (Ton); M.E. Roebroeck (Marij); J.B. Jaquet (Jean); S.E.R. Hovius (Steven); H.J. Stam (Henk)

    2004-01-01

    textabstractObjective: To compare the outcome of muscle strength with manual muscle strength testing grip and pinch strength measurements and a dynamometer which allows for measurements of the intrinsic muscles of the hand in isolation (the Rotterdam Intrinsic Hand Myometer, RIHM). Methods:

  18. Terminal Branch of Recurrent Human Laryngeal Nerve

    Directory of Open Access Journals (Sweden)

    Andréa Aparecida Ferreira Pascoal

    2014-01-01

    Full Text Available The importance of the recurrent laryngeal nerve in surgery on the anterior region of the neck has motivated many published papers on critical points of its pathway, relationship with the inferior thyroid artery, penetration in the larynx, division outside the larynx, and branches communicating with the internal branch of the superior laryngeal nerve. We analyze the terminal branches of the recurrent laryngeal nerve and their distribution through the laryngeal muscles. 44 laryngeal nerves had been dissected. Most frequently, the recurrent laryngeal nerve presents a division below or at the level of the lower margin of the cricoid cartilage (outside the larynx. One of these branches forms the communication with the internal branch of the superior laryngeal nerve, and the other penetrates the laryngeal space. Above the lower margin of the cricoid cartilage, the inferior laryngeal nerve issues a variable number of branches to muscles (3 to 7: to the posterior cricoarytenoid muscle; to the oblique and transversal arytenoid muscles; and to the lateral cricoarytenoid muscle and the thyroarytenoid muscle.

  19. Spasmodic Dysphonia: a Laryngeal Control Disorder Specific to Speech

    Science.gov (United States)

    Ludlow, Christy L.

    2016-01-01

    Spasmodic dysphonia (SD) is a rare neurological disorder that emerges in middle age, is usually sporadic, and affects intrinsic laryngeal muscle control only during speech. Spasmodic bursts in particular laryngeal muscles disrupt voluntary control during vowel sounds in adductor SD and interfere with voice onset after voiceless consonants in abductor SD. Little is known about its origins; it is classified as a focal dystonia secondary to an unknown neurobiological mechanism that produces a chronic abnormality of laryngeal motor neuron regulation during speech. It develops primarily in females and does not interfere with breathing, crying, laughter, and shouting. Recent postmortem studies have implicated the accumulation of clusters in the parenchyma and perivascular regions with inflammatory changes in the brainstem in one to two cases. A few cases with single mutations in THAP1, a gene involved in transcription regulation, suggest that a weak genetic predisposition may contribute to mechanisms causing a nonprogressive abnormality in laryngeal motor neuron control for speech but not for vocal emotional expression. Research is needed to address the basic cellular and proteomic mechanisms that produce this disorder to provide intervention that could target the pathogenesis of the disorder rather than only providing temporary symptom relief. PMID:21248101

  20. Vestibular-Evoked Responses Indicate a Functional Role for Intrinsic Foot Muscles During Standing Balance.

    Science.gov (United States)

    Wallace, Jonathan W; Rasman, Brandon G; Dalton, Brian H

    2018-05-01

    Maintaining standing balance involves multisensory processing and integration to produce dynamic motor responses. Electrical vestibular stimulation (EVS) delivered over the mastoid processes can be used to explore the vestibular control of balance. The purpose of this study was to determine whether intrinsic foot muscles exhibit vestibular-evoked balance responses and to characterize the traits associated with these responses. Electromyography (EMG) of the abductor hallucis (AH), abductor digiti minimi (ADM) and medial gastrocnemius (MG) and anterior-posterior (AP) forces were sampled while quietly standing participants were subjected to a random continuous EVS signal (peak-to-peak amplitude = ±3 mA). The relationship between EVS input and motor output was characterized in both the frequency (coherence) and time (cumulant density) domains. When head orientation was rotated in yaw from left to right, the biphasic cumulant density function was inverted for all muscle (EVS-EMG) and whole-body (EVS-AP forces) balance responses. When vision was occluded, the EVS-EMG and EVS-AP forces coherence function amplitude increased at low frequencies (<2 Hz) and was accompanied by a heightened medium-latency peak amplitude for all muscles as well as the whole-body balance response (AP forces) compared to when static visual cues were present. The enhanced coherence amplitudes at lower frequencies may highlight a mechanism for the increase in postural sway from vision to occluded vision. The current findings indicate that the vestibular control of standing balance can be represented by the intrinsic foot muscles and implicate a postural role for these muscles in modulating quiet standing. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  1. Altered Myokine Secretion Is an Intrinsic Property of Skeletal Muscle in Type 2 Diabetes.

    Directory of Open Access Journals (Sweden)

    Theodore P Ciaraldi

    Full Text Available Skeletal muscle secretes factors, termed myokines. We employed differentiated human skeletal muscle cells (hSMC cultured from Type 2 diabetic (T2D and non-diabetic (ND subjects to investigate the impact of T2D on myokine secretion. Following 24 hours of culture concentrations of selected myokines were determined to range over 4 orders of magnitude. T2D hSMC released increased amounts of IL6, IL8, IL15, TNFa, Growth Related Oncogene (GROa, monocyte chemotactic protein (MCP-1, and follistatin compared to ND myotubes. T2D and ND hSMC secreted similar levels of IL1ß and vascular endothelial growth factor (VEGF. Treatment with the inflammatory agents lipopolysaccharide (LPS or palmitate augmented the secretion of many myokines including: GROa, IL6, IL8, IL15, and TNFa, but did not consistently alter the protein content and/or phosphorylation of IkBa, p44/42 MAPK, p38 MAPK, c-Jun N-terminal kinase (JNK and NF-kB, nor lead to consistent changes in basal and insulin-stimulated glucose uptake or free fatty acid oxidation. Conversely, treatment with pioglitazone or oleate resulted in modest reductions in the secretion of several myokines. Our results demonstrate that altered secretion of a number of myokines is an intrinsic property of skeletal muscle in T2D, suggesting a putative role of myokines in the response of skeletal muscle to T2D.

  2. Absence of inspiratory laryngeal constrictor muscle activity during nasal neurally adjusted ventilatory assist in newborn lambs.

    Science.gov (United States)

    Hadj-Ahmed, Mohamed Amine; Samson, Nathalie; Bussières, Marie; Beck, Jennifer; Praud, Jean-Paul

    2012-07-01

    In nonsedated newborn lambs, nasal pressure support ventilation (nPSV) can lead to an active glottal closure in early inspiration, which can limit lung ventilation and divert air into the digestive system, with potentially deleterious consequences. During volume control ventilation (nVC), glottal closure is delayed to the end of inspiration, suggesting that it is reflexly linked to the maximum value of inspiratory pressure. Accordingly, the aim of the present study was to test whether inspiratory glottal closure develops at the end of inspiration during nasal neurally adjusted ventilatory assist (nNAVA), an increasingly used ventilatory mode where maximal pressure is also reached at the end of inspiration. Polysomnographic recordings were performed in eight nonsedated, chronically instrumented lambs, which were ventilated with progressively increasing levels of nPSV and nNAVA in random order. States of alertness, diaphragm, and glottal muscle electrical activity, tracheal pressure, Spo(2), tracheal Pet(CO(2)), and respiratory inductive plethysmography were continuously recorded. Although phasic inspiratory glottal constrictor electrical activity appeared during nPSV in 5 of 8 lambs, it was never observed at any nNAVA level in any lamb, even at maximal achievable nNAVA levels. In addition, a decrease in Pco(2) was neither necessary nor sufficient for the development of inspiratory glottal constrictor activity. In conclusion, nNAVA does not induce active inspiratory glottal closure, in contrast to nPSV and nVC. We hypothesize that this absence of inspiratory activity is related to the more physiological airway pressurization during nNAVA, which tightly follows diaphragm electrical activity throughout inspiration.

  3. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus

    Science.gov (United States)

    Lobo, César Calvo; Marín, Alejandro Garrido; Sanz, David Rodríguez; López, Daniel López; López, Patricia Palomo; Morales, Carlos Romero; Corbalán, Irene Sanz

    2016-01-01

    Abstract A cross-sectional area (CSA) and thickness reduction of the abductor hallucis (AbH) is shown in subjects with hallux valgus (HV). To date, other soft-tissue structures have not been researched in relation with HV. The aim of this study was to compare the CSA and thickness of the intrinsic plantar muscles and fascia (PF) between feet with and without HV. Therefore, a cross-sectional and case-control study was performed using B-mode with an iU22 Philips ultrasound system and a 5 to 17-MHz transducer. The CSA and thickness were measured for the AbH, flexor digitorum brevis (FDB) and flexor hallucis brevis (FHB), and also the thickness for the anterior, middle, and posterior PF portions. A convenience sample of 40 feet, 20 with HV and 20 without HV, was recruited from a clinical and research center. A multivariate regression analysis using linear regression was performed to evaluate the ultrasound imaging measurements (α = 0.05). Consequently, statistically significant differences were observed between the groups (P fascia thickness increase in favor of the HV group. On the contrary, the FDB thickness and CSA did not show statistically significant differences (P ≥ 0.05). In conclusion, the CSA and thickness of the AbH and FHB intrinsic plantar muscles are reduced, whereas the thickness of the anterior, middle, and posterior PF portions are increased, in subjects with HV compared with those without HV. PMID:27828846

  4. Surface electromyography can quantify temporal and spatial patterns of activation of intrinsic human foot muscles.

    Science.gov (United States)

    Ferrari, E; Cooper, G; Reeves, N D; Hodson-Tole, E F

    2018-04-01

    Intrinsic foot muscles (IFM) are a crucial component within the human foot. Investigating their functioning can help understand healthy and pathological behaviour of foot and ankle, fundamental for everyday activities. Recording muscle activation from IFM has been attempted with invasive techniques, mainly investigating single muscles. Here we present a novel methodology, to investigate the feasibility of recording physiological surface EMG (sEMG) non-invasively and quantify patterns of activation across the whole plantar region of the foot. sEMG were recorded with a 13 × 5 array from the sole of the foot (n = 25) during two-foot stance, two-foot tiptoe and anterior/posterior sways. Physiological features of sEMG were analysed. During anterior/posterior epochs within the sway task, sEMG patterns were analysed in terms of signal amplitude (intensity) and structure (Sample Entropy) distribution, by evaluating the centre of gravity (CoG) of each topographical map. Results suggest signals are physiological and not affected by loading. Both amplitude and sample entropy CoG coordinates were grouped in one region and overlapped, suggesting that the region with highest amplitude corresponds with the most predictable signal. Therefore, both spatial and temporal features of IFM activation may be recorded non-invasively, providing opportunity for more detailed investigation of IFM function in healthy and patient populations. Copyright © 2018. Published by Elsevier Ltd.

  5. Intrinsic muscle strength and voluntary activation of both lower limbs and functional performance after stroke.

    Science.gov (United States)

    Horstman, Astrid M; Beltman, Marijke J; Gerrits, Karin H; Koppe, Peter; Janssen, Thomas W; Elich, Peter; de Haan, Arnold

    2008-07-01

    The objective of this study was to assess the nature of muscle weakness in both legs after stroke compared with able-bodied control individuals and to examine whether there is a relationship between the degree of muscle weakness and coactivation of knee extensors and flexors as well as voluntary activation capacity of knee extensors of both paretic and non-paretic legs and indices of functional performance. Maximal voluntary isometric torques of knee extensors (MVCe) and flexors (MVCf) were determined in 14 patients (bilaterally) and 12 able-bodied controls. Simultaneous measurements were made of torque and surface EMG from agonist and antagonist muscles. Coactivation was calculated. Supramaximal triplets were evoked with electrical stimulation to estimate maximal torque capacity and degree of voluntary activation of knee extensors. MVCs, activation and coactivation parameters were correlated to scores of seven functional performance tests. MVCe, MVCf and voluntary activation were lower in paretic lower limb (PL) compared with both non-paretic lower limb (NL) and control. Besides, all these parameters of NL were also lower than control. Electrically evoked torque capacity of knee extensors of PL was about 60% of both NL and control, which were not significantly different from each other. Strong significant correlations between strength, as well as voluntary activation, and functional performance were found. Coactivation did not correlate well with functional performance. Thus, whereas for NL activation failure can explain weakness, for PL both activation failure and reduced intrinsic torque capacity are responsible for the severe weakness. Activation capacity and muscle strength correlated strongly to functional performance, while coactivation did not.

  6. A robot-assisted study of intrinsic muscle regulation on proximal interphalangeal joint stiffness by varying metacarpophalangeal joint position.

    Science.gov (United States)

    Li, Zong-Ming; Davis, Gregg; Gustafson, Norm P; Goitz, Robert J

    2006-03-01

    The tightness of intrinsic hand muscles is a common cause of finger joint stiffness. The purposes of this study were to develop a robot-assisted methodology to obtain torque-angle data of a finger joint, and to investigate the regulation of the intrinsic muscles on finger joint stiffness. Our robot system features the integration of a low payload robot arm, a controller, and a force/torque transducer. The system provided highly reproducible torque-angle curves. Torque-angle data of the proximal interphalangeal joint with the metacarpophalangeal joint at 0 and 60 degrees were obtained from eight asymptomatic hands. The torque-angle curve shifted with the position of the metacarpophalangeal joint. As the metacarpophalangeal joint flexion angle changed from 60 to 0 degrees, the equilibrium of the proximal interphalangeal joint increased more than 20 degrees, and joint stiffness increased more than 50%. The dependence of the stiffness of the proximal interphalangeal joint on metacarpophalangeal joint position supports the regulatory role of the intrinsic muscles on finger joint mechanics. This regulatory mechanics is likely amplified in hands with intrinsic muscle tightness, justifying the commonly used Bunnell Intrinsic Tightness Test. Copyright 2005 Orthopaedic Research Society.

  7. Laryngeal Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Moraes, Bruno Teixeira de

    2012-01-01

    Full Text Available Introduction: Leishmaniasis is classified into three clinical presentations: visceral, coetaneous and mucocutaneous. The latter is usually secondary to hematogenous spread after months or years of skin infection and can manifest as infiltrative lesions, ulcerated or vegetating in nose, pharynx, larynx and mouth, associated or not with ganglionics infarction. Laryngeal involvement is part of the differential diagnosis of lesions in this topography as nonspecific chronic laryngitis, granulomatosis and even tumors of the upper aerodigestive tract presenting atypical evolution. Sometimes it is difficult for the correct diagnosis of Leishmaniasis, with description of cases in the literature were conducted improperly. Objective: The objective of this study is to report a case of laryngeal Leishmaniasis addressing the difficulty of diagnosis, complications and treatment applied. Case Report: A patient with pain throat, dysphagia, odynophagia, dysphonia and weight loss, with no improvement with symptomatic medication. At telelaringoscopy, infiltrative lesion showed nodular supraglottis. He underwent a tracheotomy for airway obstruction and biopsy with immunohistochemical study for a definitive diagnosis of laryngeal Leishmaniasis. The patient was referred to the infectious diseases that initiated treatment with N-methylglucamine antimoniate with satisfactory response to therapy. Final Comments: Faced with a clinical suspicion of granulomatous diseases, it is essential to follow protocol laboratory evaluation associated with histological injury, to get a precise definition etiological without prolonging the time of diagnosis. Medical treatment for mucosal Leishmaniasis, recommended by the World Health Organization, was adequate in the case of laryngeal disorders, with complete resolution of symptoms.

  8. Effect of vanadate on glucose transporter (GLUT4) intrinsic activity in skeletal muscle plasma membrane giant vesicles

    DEFF Research Database (Denmark)

    Kristiansen, S; Youn, J; Richter, Erik

    1996-01-01

    Maximally effective concentrations of vanadate (a phosphotyrosine phosphatase inhibitor) increase glucose transport in muscle less than maximal insulin stimulation. This might be due to vanadate-induced decreased intrinsic activity of GLUT4 accompanying GLUT4 translocation. Thus, the effect of va...

  9. EFFECTIVENESS OF INTRINSIC MUSCLE STRENGTHENING WITH ORTHOSIS OVER CONVENTIONAL PHYSIOTHERAPY WITH ORTHOSIS FOR NAVICULAR DROP IN PROLONG STANDING WORKERS

    Directory of Open Access Journals (Sweden)

    Pooja Saikia

    2015-08-01

    Full Text Available Background: Foot pronation is a series of movements which is intended to absorb shock by decelerating and cushioning the foot as it comes in contact with surface. When this motion is exaggerated, the ankle rolls too far inward and the arch is flattened causing overpronation. It is seen that with an abnormal pronation, navicular drop occurs. Navicular drop causes pain in ankle and knee, fatigue, difficulty in walking. The purpose of the study was to determine the effect of intrinsic muscle strengthening with orthosis over conventional physiotherapy exercises with orthosis for correction of navicular drop and Pain Disability in prolong standing workers. Method: An Experimental study design, seventy industrial workers were tested for navicular drop test out of which fifty tested positive. The subjects were divided into two groups Group A (N=25 and Group B (N=25. Group-A subjects received intrinsic muscle strengthening exercises with orthosis and Group-B received conventional physiotherapy exercises with orthosis. The duration of treatment continued was given for 8 weeks and outcome measurements were measured at 0 day, 4th week and 8th week using the Navicular drop (ND test and Pain Disability Questionnaire (PDQ. Results: Comparative analysis using Independent t-test was carried out separately for ND and PDQ. For ND, t =-5.01 which is highly significant (p=0.00. It has been inferred that ND decreases more when intrinsic muscle strengthening with orthosis was applied. To see the difference of means of PDQ, t = -1.97 which is significant (p = 0.049 implying that PDQ decrease more when intrinsic muscle strengthening was applied as compared to conventional physiotherapy with orthosis. Conclusion: It is concluded that 8 weeks of intrinsic muscle strengthening exercise with orthosis is more effective than conventional physiotherapy exercises with orthosis in reducing navicular drop and improving Pain Disability in prolong standing workers.

  10. Chronic intrinsic transient tracheal occlusion elicits diaphragmatic muscle fiber remodeling in conscious rodents.

    Directory of Open Access Journals (Sweden)

    Barbara K Smith

    Full Text Available BACKGROUND: Although the prevalence of inspiratory muscle strength training has increased in clinical medicine, its effect on diaphragm fiber remodeling is not well-understood and no relevant animal respiratory muscle strength training-rehabilitation experimental models exist. We tested the postulate that intrinsic transient tracheal occlusion (ITTO conditioning in conscious animals would provide a novel experimental model of respiratory muscle strength training, and used significant increases in diaphragmatic fiber cross-sectional area (CSA as the primary outcome measure. We hypothesized that ITTO would increase costal diaphragm fiber CSA and further hypothesized a greater duration and magnitude of occlusions would amplify remodeling. METHODOLOGY/PRINCIPAL FINDINGS: Sprague-Dawley rats underwent surgical placement of a tracheal cuff and were randomly assigned to receive daily either 10-minute sessions of ITTO, extended-duration, 20-minute ITTO (ITTO-20, partial obstruction with 50% of cuff inflation pressure (ITTO-PAR or observation (SHAM over two weeks. After the interventions, fiber morphology, myosin heavy chain composition and CSA were examined in the crural and ventral, medial, and dorsal costal regions. In the medial costal diaphragm, with ITTO, type IIx/b fibers were 26% larger in the medial costal diaphragm (p<0.01 and 24% larger in the crural diaphragm (p<0.05. No significant changes in fiber composition or morphology were detected. ITTO-20 sessions also yielded significant increases in medial costal fiber cross-sectional area, but the effects were not greater than those elicited by 10-minute sessions. On the other hand, ITTO-PAR resulted in partial airway obstruction and did not generate fiber hypertrophy. CONCLUSIONS/SIGNIFICANCE: The results suggest that the magnitude of the load was more influential in altering fiber cross-sectional area than extended-duration conditioning sessions. The results also indicated that ITTO was

  11. The effect of additional activation of the plantar intrinsic foot muscles on foot dynamics during gait.

    Science.gov (United States)

    Okamura, Kazunori; Kanai, Shusaku; Hasegawa, Masaki; Otsuka, Akira; Oki, Sadaaki

    2017-08-18

    The plantar intrinsic foot muscles (PIFMs) contribute to support the medial longitudinal arch. But the functional role of the PIFMs during dynamic activities is not clear. The purpose of this study was to examine the change in the foot dynamics during gait accompanied with the change in the PIFMs activity to determine the functional role of the PIFMs during gait. Twenty healthy male subjects were randomly assigned to the electrical stimulation group (ESG) or control group (CG). In the ESG, the electrical stimulation to the PIFMs was provided from mid-stance to pre-swing using surface electrodes to simulate reinforcement of the PIFMs. The foot dynamics during the stance phase of gait was measured using a 3D motion analysis, and the amount of change from baseline (electrical stimulation was not provided) was compared between groups using an independent sample t-test. In the ESG, the timing for the navicular height to reach the minimum value was significantly later, and the vertical ground reaction force (2nd peak) significantly decreased more. There were no group differences in the amount of change from baseline on gait velocity, stance phase duration, minimum navicular height and ground reaction force in other directions. Results from this study showed that the functions of the PIFMs most likely include shock absorption and facilitation of efficient foot ground force transmission during the stance phase of gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Rapid Alleviation of Parkinson’s Disease Symptoms via Electrostimulation of Intrinsic Auricular Muscle Zones

    Directory of Open Access Journals (Sweden)

    Yusuf O. Cakmak

    2017-06-01

    Full Text Available Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS and the pedunculopontine nucleus (PPN significantly improve cardinal motor symptoms and postural instability and gait difficulty, respectively, in Parkinson’s disease (PD.Objective and Hypothesis: Intrinsic auricular muscle zones (IAMZs allow the potential to simultaneously stimulate the C2 spinal nerve, the trigeminal nerve, the facial nerve, and sympathetic and parasympathetic nerves in addition to providing muscle feedback and control areas including the STN, the PPN and mesencephalic locomotor regions. Our aim was to observe the clinical responses to IAMZ stimulation in PD patients.Method: Unilateral stimulation of an IAMZ, which includes muscle fibers for proprioception, the facial nerve, and C2, trigeminal and autonomic nerve fibers, at 130 Hz was performed in a placebo- and sham-controlled, double-blinded, within design, two-armed study of 24 PD patients.Results: The results of the first arm (10 patients of the present study demonstrated a substantial improvement in Unified Parkinson’s Disease Ratings Scale (UPDRS motor scores due to 10 min of IAMZ electrostimulation (p = 0.0003, power: 0.99 compared to the placebo control (p = 0.130. A moderate to large clinical difference in the improvement in UPDRS motor scores was observed in the IAMZ electrostimulation group. The results of the second arm (14 patients demonstrated significant improvements with dry needling (p = 0.011 and electrostimulation of the IAMZ (p < 0.001 but not with sham electrostimulation (p = 0.748. In addition, there was a significantly greater improvement in UPDRS motor scores in the IAMZ electrostimulation group compared to the IAMZ dry needling group (p < 0.001 and the sham electrostimulation (p < 0.001 groups. The improvement in UPDRS motor scores of the IAMZ electrostimulation group (ΔUPDRS = 5.29 reached moderate to high clinical significance, which was not the case for the dry needling

  13. Muscle misuse voice disorders: description and classification.

    Science.gov (United States)

    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.

  14. Laryngeal (Voice Box) Cancer

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Voice Box (Laryngeal) Cancer Voice Box (Laryngeal) Cancer Patient Health Information News media ... laryngeal cancer can be severe with respect to voice, breathing, or swallowing. It is fundamentally a preventable ...

  15. Isolated laryngeal myasthenia gravis for 26 years.

    Science.gov (United States)

    Renard, Dimitri; Hedayat, Amir; Gagnard, Corinne

    2015-02-01

    Laryngeal myasthenia gravis is a relatively rare variant of myasthenia gravis. A vast portion of patients with initial laryngeal myasthenia gravis develop involvement of ocular and/or extra-ocular muscles during the years after symptom onset although a minority of laryngeal myasthenia gravis patients continues to have isolated laryngeal muscle involvement for several years. We present a 58-year-old woman with recurrent episodic isolated dysphonia (associated with diffuse bilateral vocal cord paresis on laryngoscopy) since the age of 32. Dysphonia became permanent since 6 months. A diagnosis of laryngeal myasthenia gravis was made based on abnormal single-fiber electromyography and spectacular response to pyridostigmine treatment. Repetitive nerve stimulation was normal and anti-acetylcholine receptor and anti-muscle specific tyrosine kinase antibodies were absent. This case shows that laryngeal myasthenia gravis can be isolated during 26 years of follow-up. We propose that even when myasthenia gravis seems unlikely as underlying mechanism of isolated dysphonia (because of lack of antibodies, normal repetitive nerve stimulation, and absence of extra-laryngeal involvement after years of follow-up), single-fiber electromyography should be performed and myasthenia gravis treatment should be tried. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Primary bovine skeletal muscle cells enters apoptosis rapidly via the intrinsic pathway when available oxygen is removed.

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    Sissel Beate Rønning

    Full Text Available Muscle cells undergo changes post-mortem during the process of converting muscle into meat, and this complex process is far from revealed. Recent reports have suggested programmed cell death (apoptosis to be important in the very early period of converting muscle into meat. The dynamic balance that occurs between anti-apoptotic members, such as Bcl-2, and pro-apoptotic members (Bid, Bim helps determine whether the cell initiates apoptosis. In this study, we used primary bovine skeletal muscle cells, cultured in monolayers in vitro, to investigate if apoptosis is induced when oxygen is removed from the growth medium. Primary bovine muscle cells were differentiated to form myotubes, and anoxia was induced for 6h. The anoxic conditions significantly increased (P<0.05 the relative gene expression of anti- and pro-apoptotic markers (Aif, Bcl-2, Bid and Bim, and the PARK7 (P<0.05 and Grp75 (Hsp70 protein expressions were transiently increased. The anoxic conditions also led to a loss of mitochondrial membrane potential, which is an early apoptotic event, as well as cytochrome c release from the mitochondria. Finally, reorganization and degradation of cytoskeletal filaments occurred. These results suggest that muscle cells enters apoptosis via the intrinsic pathway rapidly when available oxygen in the muscle diminishes post-mortem.

  17. Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study.

    Science.gov (United States)

    Rogić Vidaković, Maja; Jerković, Ana; Jurić, Tomislav; Vujović, Igor; Šoda, Joško; Erceg, Nikola; Bubić, Andreja; Zmajević Schönwald, Marina; Lioumis, Pantelis; Gabelica, Dragan; Đogaš, Zoran

    2016-11-01

    Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.

  18. Laryngeal histoplasmosis.

    Science.gov (United States)

    Ansari, Hina A; Saeed, Noora; Khan, Nazoora; Hasan, Naba

    2016-08-17

    Histoplasmosis is a fungal infection, having interesting synonyms such as Cave disease, Darling's disease, Ohio Valley disease, reticuloendotheliosis, Spelunker's lung and Caver's disease. The aetiological agent is a dimorphic fungus, Histoplasma capsulatum, causing chronic granulomatous disease. The route of transmission is by inhalation of dust particles from soil contaminated by excrement of birds or bats, harbouring the small spores or microconidia, which is considered the infectious form of fungus. The spectrum of illness ranges from subclinical infection of the lung to progressive disseminated disease. The major bulk of histoplasmosis infections are asymptomatic or present with mild influenza like illness and involve immunocompetent individuals. However, the immunocompromised or immunodeficient cases have disseminated/haematogenous infections with multiple organs involved and are usually fatal unless treated immediately. Laryngeal involvement is associated with the disseminated form of the disease. Histoplasmosis of larynx is a rare entity and poses diagnostic difficulty to otolaryngologists because clinically it may be mistaken for malignancy. We report an unusual case of laryngeal histoplasmosis in a man aged 60 years who presented with provisional diagnosis of tuberculosis/malignancy. 2016 BMJ Publishing Group Ltd.

  19. Aerodynamic and Nonlinear Dynamic Acoustic Analysis of Tension Asymmetry in Excised Canine Larynges

    Science.gov (United States)

    Devine, Erin E.; Bulleit, Erin E.; Hoffman, Matthew R.; McCulloch, Timothy M.; Jiang, Jack J.

    2012-01-01

    Purpose: To model tension asymmetry caused by superior laryngeal nerve paralysis (SLNP) in excised larynges and apply perturbation, nonlinear dynamic, and aerodynamic analyses. Method: SLNP was modeled in 8 excised larynges using sutures and weights to mimic cricothyroid (CT) muscle function. Weights were removed from one side to create tension…

  20. THE MUSCLES TREASURY SURVEY. II. INTRINSIC LY α AND EXTREME ULTRAVIOLET SPECTRA OF K AND M DWARFS WITH EXOPLANETS

    Energy Technology Data Exchange (ETDEWEB)

    Youngblood, Allison; France, Kevin; Loyd, R. O. Parke [Laboratory for Atmospheric and Space Physics, University of Colorado, 600 UCB, Boulder, CO 80309 (United States); Linsky, Jeffrey L. [JILA, University of Colorado and NIST, 440 UCB, Boulder, CO 80309 (United States); Redfield, Seth [Astronomy Department and Van Vleck Observatory, Wesleyan University, Middletown, CT 06459-0123 (United States); Schneider, P. Christian [European Space Research and Technology Centre (ESA/ESTEC), Keplerlaan 1, 2201 AZ Noordwijk (Netherlands); Wood, Brian E. [Naval Research Laboratory, Space Science Division, Washington, DC 20375 (United States); Brown, Alexander [Center for Astrophysics and Space Astronomy, University of Colorado, 389 UCB, Boulder, CO 80309 (United States); Froning, Cynthia [Dept. of Astronomy C1400, University of Texas, Austin, TX 78712 (United States); Miguel, Yamila [Laboratoire Lagrange, Universite de Nice-Sophia Antipolis, Observatoire de la Cote d’Azur, CNRS, Blvd de l’Observatoire, CS 34229, F-06304 Nice cedex 4 (France); Rugheimer, Sarah [Department of Earth and Environmental Sciences, Irvine Building, University of St. Andrews, St. Andrews KY16 9AL (United Kingdom); Walkowicz, Lucianne, E-mail: allison.youngblood@colorado.edu [The Adler Planetarium, 1300 S Lakeshore Dr, Chicago, IL 60605 (United States)

    2016-06-20

    The ultraviolet (UV) spectral energy distributions (SEDs) of low-mass (K- and M-type) stars play a critical role in the heating and chemistry of exoplanet atmospheres, but are not observationally well-constrained. Direct observations of the intrinsic flux of the Ly α line (the dominant source of UV photons from low-mass stars) are challenging, as interstellar H i absorbs the entire line core for even the closest stars. To address the existing gap in empirical constraints on the UV flux of K and M dwarfs, the MUSCLES Hubble Space Telescope Treasury Survey has obtained UV observations of 11 nearby M and K dwarfs hosting exoplanets. This paper presents the Ly α and extreme-UV spectral reconstructions for the MUSCLES targets. Most targets are optically inactive, but all exhibit significant UV activity. We use a Markov Chain Monte Carlo technique to correct the observed Ly α profiles for interstellar absorption, and we employ empirical relations to compute the extreme-UV SED from the intrinsic Ly α flux in ∼100 Å bins from 100–1170 Å. The reconstructed Ly α profiles have 300 km s{sup −1} broad cores, while >1% of the total intrinsic Ly α flux is measured in extended wings between 300 and 1200 km s{sup −1}. The Ly α surface flux positively correlates with the Mg ii surface flux and negatively correlates with the stellar rotation period. Stars with larger Ly α surface flux also tend to have larger surface flux in ions formed at higher temperatures, but these correlations remain statistically insignificant in our sample of 11 stars. We also present H i column density measurements for 10 new sightlines through the local interstellar medium.

  1. Strain sonoelastographic evaluation of biceps muscle intrinsic stiffness after botulinum toxin-A injection.

    Science.gov (United States)

    Aşkın, Ayhan; Kalaycı, Özlem Tuğçe; Bayram, Korhan Barış; Tosun, Aliye; Demirdal, Ümit Seçil; Atar, Emel; İnci, Mehmet Fatih

    2017-01-01

    The most commonly used clinical tools for measuring spasticity are modified Ashworth scale (MAS) and Tardieu scale but both yield subjective rather than objective results. Ultrasound elastography (EUS) provides information on tissue stiffness and allows the qualitative or quantitative measurements of the mechanical properties of tissues. To assess the stiffness of biceps brachialis muscles in stroke patients by strain EUS and to investigate the sonoelastographic changes and its correlations with clinical evaluation parameters after botulinum toxin-A (BTA) injections. This is a prospective study. A total of 48 chronic stroke patients requiring BTA injections to biceps brachialis muscles were included in the study. All patients received injections with BTA to biceps brachialis muscles under ultrasound guidance. MAS, goniometric measurements, and strain EUS assessments were performed at preintervention and at 4-week postintervention. Strain index values of biceps muscle on the affected side were significantly increased compared with those on the unaffected side (p < 0.01). At 4 weeks after BTA injection, significant improvements were observed in MAS grades and goniometric measurements (p < 0.05). Statistically significant differences were also found between the MAS grades and strain index values in both pre-/postintervention period (p < 0.01). No significant correlations were observed between clinical parameters and strain EUS findings. Strain EUS is a promising diagnostic tool for assessing stiffness in spastic muscles, in establishing the treatment plan and monitoring the effectiveness of the therapeutic modality.

  2. Laryngeal biomechanics of the singing voice.

    Science.gov (United States)

    Koufman, J A; Radomski, T A; Joharji, G M; Russell, G B; Pillsbury, D C

    1996-12-01

    By transnasal fiberoptic laryngoscopy, patients with functional voice often demonstrate abnormal laryngeal biomechanics, commonly supraglottic contraction. Appropriately, such conditions are sometimes termed muscle tension dysphonias. Singers working at the limits of their voice may also transiently demonstrate comparable tension patterns. However, the biomechanics of normal singing, particularly for different singing styles, have not been previously well characterized. We used transnasal fiberoptic laryngoscopy to study 100 healthy singers to assess patterns of laryngeal tension during normal singing and to determine whether factors such as sex, occupation, and style of singing influence laryngeal muscle tension. Thirty-nine male and 61 female singers were studied; 48 were professional singers, and 52 were amateurs. Examinations of study subjects performing standardized and nonstandardized singing tasks were recorded on a laser disk and subsequently analyzed in a frame-by-frame fashion by a blinded otolaryngologist. Each vocal task was graded for muscle tension by previously established criteria, and objective muscle tension scores were computed. The muscle tension score was expressed as a percentage of frames for each task with one of the laryngeal muscle tension patterns shown. The lowest muscle tension scores were seen in female professional singers, and the highest muscle tension scores were seen in amateur female singers. Male singers (professional and amateur) had intermediate muscle tension scores. Classical singers had lower muscle tension scores than nonclassical singers, with the lowest muscle tension scores being seen in those singing choral music (41%), art song (47%), and opera (57%), and the highest being seen in those singing jazz/pop (65%), musical theater (74%), bluegrass/country and western (86%), and rock/gospel (94%). Analyzed also were the influences of vocal nodules, prior vocal training, number of performance and practice hours per week

  3. The posterior cricoarytenoid muscle is spared from MuRF1-mediated muscle atrophy in mice with acute lung injury.

    Directory of Open Access Journals (Sweden)

    D Clark Files

    Full Text Available Skeletal muscle wasting in acute lung injury (ALI patients increases the morbidity and mortality associated with this critical illness. The contribution of laryngeal muscle wasting to these outcomes is unknown, though voice impairments and aspiration are common in intensive care unit (ICU survivors. We evaluated the intrinsic laryngeal abductor (PCA, posterior cricoarytenoid, adductor (CT, cricothyroid and limb (EDL, extensor digitorum longus muscles in a mouse model of ALI.Escherichia coli lipopolysaccharides were instilled into the lungs of adult male C57Bl6J mice (ALI mice. Limb and intrinsic laryngeal muscles were analyzed for fiber size, type, protein expression and myosin heavy chain (MyHC composition by SDS-PAGE and mass spectroscopy.Marked muscle atrophy occurred in the CT and EDL muscles, while the PCA was spared. The E3 ubiquitin ligase muscle ring finger-1 protein (MuRF1, a known mediator of limb muscle atrophy in this model, was upregulated in the CT and EDL, but not in the PCA. Genetic inhibition of MuRF1 protected the CT and EDL from ALI-induced muscle atrophy. MyHC-Extraocular (MyHC-EO comprised 27% of the total MyHC in the PCA, distributed as hybrid fibers throughout 72% of PCA muscle fibers.The vocal cord abductor (PCA contains a large proportion of fibers expressing MyHC-EO and is spared from muscle atrophy in ALI mice. The lack of MuRF1 expression in the PCA suggests a previously unrecognized mechanism whereby this muscle is spared from atrophy. Atrophy of the vocal cord adductor (CT may contribute to the impaired voice and increased aspiration observed in ICU survivors. Further evaluation of the sparing of muscles involved in systemic wasting diseases may lead to potential therapeutic targets for these illnesses.

  4. Clonal characterization of rat muscle satellite cells: proliferation, metabolism and differentiation define an intrinsic heterogeneity.

    Directory of Open Access Journals (Sweden)

    Carlo A Rossi

    2010-01-01

    Full Text Available Satellite cells (SCs represent a distinct lineage of myogenic progenitors responsible for the postnatal growth, repair and maintenance of skeletal muscle. Distinguished on the basis of their unique position in mature skeletal muscle, SCs were considered unipotent stem cells with the ability of generating a unique specialized phenotype. Subsequently, it was demonstrated in mice that opposite differentiation towards osteogenic and adipogenic pathways was also possible. Even though the pool of SCs is accepted as the major, and possibly the only, source of myonuclei in postnatal muscle, it is likely that SCs are not all multipotent stem cells and evidences for diversities within the myogenic compartment have been described both in vitro and in vivo. Here, by isolating single fibers from rat flexor digitorum brevis (FDB muscle we were able to identify and clonally characterize two main subpopulations of SCs: the low proliferative clones (LPC present in major proportion (approximately 75% and the high proliferative clones (HPC, present instead in minor amount (approximately 25%. LPC spontaneously generate myotubes whilst HPC differentiate into adipocytes even though they may skip the adipogenic program if co-cultured with LPC. LPC and HPC differ also for mitochondrial membrane potential (DeltaPsi(m, ATP balance and Reactive Oxygen Species (ROS generation underlying diversities in metabolism that precede differentiation. Notably, SCs heterogeneity is retained in vivo. SCs may therefore be comprised of two distinct, though not irreversibly committed, populations of cells distinguishable for prominent differences in basal biological features such as proliferation, metabolism and differentiation. By these means, novel insights on SCs heterogeneity are provided and evidences for biological readouts potentially relevant for diagnostic purposes described.

  5. Intrinsic contractures of the hand.

    Science.gov (United States)

    Paksima, Nader; Besh, Basil R

    2012-02-01

    Contractures of the intrinsic muscles of the fingers disrupt the delicate and complex balance of intrinsic and extrinsic muscles, which allows the hand to be so versatile and functional. The loss of muscle function primarily affects the interphalangeal joints but also may affect etacarpophalangeal joints. The resulting clinical picture is often termed, intrinsic contracture or intrinsic-plus hand. Disruption of the balance between intrinsic and extrinsic muscles has many causes and may be secondary to changes within the intrinsic musculature or the tendon unit. This article reviews diagnosis, etiology, and treatment algorithms in the management of intrinsic contractures of the fingers. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Recurrent laryngeal nerve regeneration using an oriented collagen scaffold containing Schwann cells.

    Science.gov (United States)

    Chitose, Shun-Ichi; Sato, Kiminori; Fukahori, Mioko; Sueyoshi, Shintaro; Kurita, Takashi; Umeno, Hirohito

    2017-07-01

    Regeneration of the recurrent laryngeal nerve (RLN), which innervates the intrinsic laryngeal muscles such that they can perform complex functions, is particularly difficult to achieve. Synkinesis after RLN neogenesis leads to uncoordinated movement of laryngeal muscles. Recently, some basic research studies have used cultured Schwann cells (SCs) to repair peripheral nerve injuries. This study aimed to regenerate the RLN using an oriented collagen scaffold containing cultured SCs. Preliminary animal experiment. A 10-mm-long autologous canine cervical ansa was harvested. The nerve tissue was scattered and subcultured on oriented collagen sheets in reduced serum medium. After verifying that the smaller cultivated cells with high nucleus-cytoplasm ratios were SCs, collagen sheets with longitudinally oriented cells were rolled and inserted into a 20-mm collagen conduit. The fabricated scaffolds containing SCs were autotransplanted to a 20-mm deficient RLN, and vocal fold movements and histological characteristics were observed. Scaffolds containing cultured SCs were successfully fabricated. Immunocytochemical examination revealed that these isolated and cultured cells, identified as SCs, expressed S-100 protein and GFAP but not vimentin. The orientation of SCs matched that of the oriented collagen sheet. Two months after successful transplantation, laryngeal endoscopy revealed coordinated movement of the bilateral vocal folds by external stimulation under light general anesthesia. Hematoxylin and eosin staining showed that the regenerated RLN lacked epineurium surrounding the nerve fibers and was interspersed with collagen fibers. Myelin protein zero was expressed around many axons. Partial regeneration of RLN was achieved through the use of oriented collagen scaffolding. NA Laryngoscope, 127:1622-1627, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

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

    Science.gov (United States)

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

    2017-04-01

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

  8. Neurological complications in thyroid surgery: a surgical point of view on laryngeal nerves.

    Directory of Open Access Journals (Sweden)

    EMANUELA eVARALDO

    2014-07-01

    Full Text Available The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified,the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a

  9. [Morphological and functional interface between palmar plates of metacarpophalangeal joints and intrinsic muscles of the hand].

    Science.gov (United States)

    Gratzer, J; Vökt, C A; Brenner, P

    2001-09-01

    Summary. After a ten-year period of intensively dealing with the hand as a Medical Artist, it became quite obvious that the palmar section of MP joints is described in the literature partly different from what we found in our cadaver studies. This especially applies to the proximal continuation and fixation of palmar plates and the deep transverse metacarpal ligament. Thus we tried to understand and explain the complex character of interaction between locomotion apparatus and structures of the hand's "connective-tissue body". Cadaveric operation microscope-assisted dissection of the palmar ligament (plate), deep transverse metacarpal ligament, interosseous muscles as well as mechanically stable sections of the "connective tissue body" and fascia allowed a clear view of morphology, interaction, and character of these structures during passive finger motion. 1. Proximally, the palmar ligament (plate) of a metacarpophalangeal joint ranges to the tendinous sheets of origin of the interosseous muscles and in extension of these it is attached to the palmar carpal ligaments. In the following, these tendinous structures will be referred to as "deep longitudinal metacarpal fibres". This highly sophisticated proximal attachment is formed bilaterally from each palmar plate in several cascades. Thus, a widely ranging distribution of forces implied by MP-extension is guaranteed. The deep transverse metacarpal ligament executes the function of a "force dissipating center": Extension strain is passed on from the fingers via the "lateral digital sheet" and the "spiral ligament" to the palmar fascia and further on into a proximal and "deep" direction by the vertical sheets (Legueu and Juvara 1892/1974). On the next central level, a similar flow of forces reaches the palmar carpal ligaments from the osseous phalangeal base via the phalangoglenoidal ligaments and the palmar plate. Junction of these forces is the "soft tissue confluence" (Zancolli 1992), whereas the described "deep

  10. Laryngitis (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... for Educators Search English Español Laryngitis KidsHealth / For Kids / Laryngitis What's in this article? How Your Voice ...

  11. In vivo and in vitro evidence that in oldest-old humans intrinsic upper- and lower-limb skeletal muscle function is unaffected by ageing and disuse

    Science.gov (United States)

    Venturelli, M.; Saggin, P.; Muti, E.; Naro, F.; Cancellara, L.; Toniolo, L.; Tarperi, C.; Calabria, E.; Richardson, R.S.; Reggiani, C.; Schena, F.

    2015-01-01

    Aim To parse out the impact of advanced ageing and disuse on skeletal muscle function, we utilized both in vivo and in vitro techniques to comprehensively assess upper- and lower-limb muscle contractile properties in 8 young (YG; 25±6yrs) and 8 oldest-old mobile (OM; 87±5yrs) and 8 immobile (OI; 88±4yrs) women. Methods In vivo, maximal voluntary contraction (MVC), electrically evoked resting twitch force (RT), and physiological cross sectional area (PCSA) of the quadriceps and elbow flexors was assessed. Muscle biopsies of the vastus lateralis and biceps brachii facilitated the in vitro assessment of single fibre specific tension (Po). Results In vivo, compared to the young, both the OM and OI exhibited a more pronounced loss of MVC in the lower-limb (OM (−60%) and OI (−75%)) than the upper-limb (OM=−51%; OI=−47%). Taking into account the reduction in muscle PCSA (OM=−10%; OI=−18%), only evident in the lower-limb, by calculating voluntary muscle specific force, the lower-limb of the OI (−40%) was more compromised than the OM (−13%). However, in vivo, RT in both upper- and lower-limbs (~9.8 N·m·cm−2) and Po (~123 mN·mm−2), assessed in vitro, implies preserved intrinsic contractile function in all muscles of the oldest-old and were well correlated (r=0.81). Conclusion These findings suggest that in the oldest-old neither advanced ageing nor disuse, per se, impact intrinsic skeletal muscle function, as assessed in vitro. However, in vivo, muscle function is attenuated by age and exacerbated by disuse, implicating factors other than skeletal muscle, such as neuromuscular control, in this diminution of function. PMID:25965867

  12. In vivo and in vitro evidence that intrinsic upper- and lower-limb skeletal muscle function is unaffected by ageing and disuse in oldest-old humans.

    Science.gov (United States)

    Venturelli, M; Saggin, P; Muti, E; Naro, F; Cancellara, L; Toniolo, L; Tarperi, C; Calabria, E; Richardson, R S; Reggiani, C; Schena, F

    2015-09-01

    To parse out the impact of advanced ageing and disuse on skeletal muscle function, we utilized both in vivo and in vitro techniques to comprehensively assess upper- and lower-limb muscle contractile properties in 8 young (YG; 25 ± 6 years) and 8 oldest-old mobile (OM; 87 ± 5 years) and 8 immobile (OI; 88 ± 4 years) women. In vivo, maximal voluntary contraction (MVC), electrically evoked resting twitch force (RT), and physiological cross-sectional area (PCSA) of the quadriceps and elbow flexors were assessed. Muscle biopsies of the vastus lateralis and biceps brachii facilitated the in vitro assessment of single fibre-specific tension (Po). In vivo, compared to the young, both the OM and OI exhibited a more pronounced loss of MVC in the lower limb [OM (-60%) and OI (-75%)] than the upper limb (OM = -51%; OI = -47%). Taking into account the reduction in muscle PCSA (OM = -10%; OI = -18%), only evident in the lower limb, by calculating voluntary muscle-specific force, the lower limb of the OI (-40%) was more compromised than the OM (-13%). However, in vivo, RT in both upper and lower limbs (approx. 9.8 N m cm(-2) ) and Po (approx. 123 mN mm(-2) ), assessed in vitro, implies preserved intrinsic contractile function in all muscles of the oldest-old and were well correlated (r = 0.81). These findings suggest that in the oldest-old, neither advanced ageing nor disuse, per se, impacts intrinsic skeletal muscle function, as assessed in vitro. However, in vivo, muscle function is attenuated by age and exacerbated by disuse, implicating factors other than skeletal muscle, such as neuromuscular control, in this diminution of function. © 2015 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  13. Assessment of laryngeal muscle and testicular cell types in Xenopus laevis (Anura Pipidae) inhabiting maize and non-maize growing areas of South Africa

    Science.gov (United States)

    Smith, E.E.; Du Preez, L.H.; Gentles, A.; Solomon, K.R.; Tandler, B.; Carr, J.A.; Van Der Kraak, G. L.; Kendall, R.J.; Giesy, J.P.; Gross, T.S.

    2005-01-01

    We tested the hypothesis that adult African clawed frogs (Xenopus laevis) inhabiting water bodies in maize-growing areas (MGA) of South Africa would exhibit differences in testicular structure compared to frogs from water bodies in non-maize-growing areas (NMGA) in the same locale. Adults of both sexes were collected during the autumn of 2002 in South Africa, and stereological analytical techniques were used to quantify the distribution of testicular cell types. In addition, total laryngeal mass was used as a gauge of secondary sex differences in animals from MGA and NMGA study sites. Evaluation of the total laryngeal mass revealed that there were no statistically significant differences between X. laevis of the same sex from the NMGA and MGA sites. Mean percent fractional-volume values for seminiferous tubule distribution of testicular cell types of mature X. laevis, ranged from 3-4% for spermatogonia, 26-28% for spermatocytes, 54-57% for spermatozoa, and 14-15% for other cells types. The mean percent volume for blood vessels ranged from 0.3-0.4%. These values did not differ significantly between frogs from NMGA and MGA areas. Collectively, these data demonstrated no differences in gonadal and laryngeal development in X. laevis collected in South Africa from MGA and NMGA areas and that there is little evidence for an effect of agricultural chemicals used in maize production functioning as endocrine disrupters in this species. Screening of X. laevis testes revealed a small incidence of Stage 1 testicular oocytes in adult male frogs collected from the NMGA (3%) and MGA (2%).

  14. A case of laryngeal angioleiomyoma and review of literature

    OpenAIRE

    Zhao, Xue; Yu, Dan; Zhao, Yin; Liu, Yan; Qi, Xinmeng; Jin, Chunshun

    2015-01-01

    Angioleiomyoma is a rare benign vascular smooth muscle tumor that arise from the tunica media of veins and arteries. Here a case of laryngeal angioleiomyoma in a 57-year-old Chinese man is reported. The patient presented with dysphagia for one and half-month and dyspnea during the previous one week, was hospitalized for treatment with a tracheotomy and laryngofissure with the unblock mass excision. Final pathological evaluation of the neoplasm confirmed a diagnosis of laryngeal angioleiomyoma...

  15. Current evidence for the existence of laryngeal macrotremor and microtremor.

    Science.gov (United States)

    Shipp, T; Izdebski, K

    1981-07-01

    To test for the existence of laryngeal "microtremors" two experiments were conducted on humans. The first analyzed the acoustic characteristics of observable tremors (macrotremors) in the voice of singers using vocal vibrato and in pathologic subjects producing vocal tremor. In both of these groups acoustic oscillations between 4 and 8 Hz were found. The second study, using a normal subject, sampled electromyographic (EMG) activity from laryngeal and arm muscles during isometric contraction to determine if a periodic component (microtremor) was present in either muscle's contraction pattern. A 9-Hz signal was detected in limb muscle contraction, whereas no periodicity was found in signals from laryngeal muscles. The application of these findings to the theory behind voice "stress" analyzers is discussed

  16. Simulation model for transcervical laryngeal injection providing real-time feedback.

    Science.gov (United States)

    Ainsworth, Tiffiny A; Kobler, James B; Loan, Gregory J; Burns, James A

    2014-12-01

    This study aimed to develop and evaluate a model for teaching transcervical laryngeal injections. A 3-dimensional printer was used to create a laryngotracheal framework based on de-identified computed tomography images of a human larynx. The arytenoid cartilages and intrinsic laryngeal musculature were created in silicone from clay casts and thermoplastic molds. The thyroarytenoid (TA) muscle was created with electrically conductive silicone using metallic filaments embedded in silicone. Wires connected TA muscles to an electrical circuit incorporating a cell phone and speaker. A needle electrode completed the circuit when inserted in the TA during simulated injection, providing real-time feedback of successful needle placement by producing an audible sound. Face validation by the senior author confirmed appropriate tactile feedback and anatomical realism. Otolaryngologists pilot tested the model and completed presimulation and postsimulation questionnaires. The high-fidelity simulation model provided tactile and audio feedback during needle placement, simulating transcervical vocal fold injections. Otolaryngology residents demonstrated higher comfort levels with transcervical thyroarytenoid injection on postsimulation questionnaires. This is the first study to describe a simulator for developing transcervical vocal fold injection skills. The model provides real-time tactile and auditory feedback that aids in skill acquisition. Otolaryngologists reported increased confidence with transcervical injection after using the simulator. © The Author(s) 2014.

  17. Laryngeal nerve damage

    Science.gov (United States)

    Symptoms include: Difficulty speaking Difficulty swallowing Hoarseness Injury to the left and right laryngeal nerves at the same time can cause a breathing problem. This can be an urgent medical problem.

  18. Congenital laryngeal anomalies,

    OpenAIRE

    Rutter, Michael J.

    2014-01-01

    Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the ma...

  19. Imaging of laryngeal trauma.

    Science.gov (United States)

    Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  20. Imaging of laryngeal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Minerva, E-mail: Minerva.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Leuchter, Igor, E-mail: Igor.Leuchter@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Platon, Alexandra, E-mail: Alexandra.Platon@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Becker, Christoph D., E-mail: Christoph.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Dulguerov, Pavel, E-mail: Pavel.Dulguerov@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Varoquaux, Arthur, E-mail: Arthur.Varoquaux@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland)

    2014-01-15

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed.

  1. Intrinsic Deregulation of Vascular Smooth Muscle and Myofibroblast Differentiation in Mesenchymal Stromal Cells from Patients with Systemic Sclerosis.

    Directory of Open Access Journals (Sweden)

    Björn Hegner

    Full Text Available Obliterative vasculopathy and fibrosis are hallmarks of systemic sclerosis (SSc, a severe systemic autoimmune disease. Bone marrow-derived mesenchymal stromal cells (MSCs from SSc patients may harbor disease-specific abnormalities. We hypothesized disturbed vascular smooth muscle cell (VSMC differentiation with increased propensity towards myofibroblast differentiation in response to SSc-microenvironment defining growth factors and determined responsible mechanisms.We studied responses of multipotent MSCs from SSc-patients (SSc-MSCs and healthy controls (H-MSCs to long-term exposure to CTGF, b-FGF, PDGF-BB or TGF-β1. Differentiation towards VSMC and myofibroblast lineages was analyzed on phenotypic, biochemical, and functional levels. Intracellular signaling studies included analysis of TGF-β receptor regulation, SMAD, AKT, ERK1/2 and autocrine loops.VSMC differentiation towards both, contractile and synthetic VSMC phenotypes in response to CTGF and b-FGF was disturbed in SSc-MSCs. H-MSCs and SSc-MSCs responded equally to PDGF-BB with prototypic fibroblastic differentiation. TGF-β1 initiated myofibroblast differentiation in both cell types, yet with striking phenotypic and functional differences: In relation to H-MSC-derived myofibroblasts induced by TGF-β1, those obtained from SSc-MSCs expressed more contractile proteins, migrated towards TGF-β1, had low proliferative capacity, and secreted higher amounts of collagen paralleled by reduced MMP expression. Higher levels of TGF-β receptor 1 and enhanced canonical and noncanonical TGF-β signaling in SSc-MSCs accompanied aberrant differentiation response of SSc-MSCs in comparison to H-MSCs.Deregulated VSMC differentiation with a shift towards myofibroblast differentiation expands the concept of disturbed endogenous regenerative capacity of MSCs from SSc patients. Disease related intrinsic hyperresponsiveness to TGF-β1 with increased collagen production may represent one responsible mechanism

  2. Botulinum toxin injection in laryngeal dyspnea.

    Science.gov (United States)

    Woisard, Virginie; Liu, Xuelai; Bes, Marie Christine Arné; Simonetta-Moreau, Marion

    2017-02-01

    Data, regarding the use of botulinum toxin (BT-A) in laryngeal dyspnea, are scarce, coming from some cases reports in the literature, including Vocal fold paralysis, laryngeal dystonia, vocal cord dysfunction also called paradoxical motion of the vocal fold (PMVF), and post-neuroleptic laryngeal dyskinesia. There is no consensus regarding the muscles and the doses to inject. The aim of this study is to present a retrospective review of patients treated in our ENT Department by BT-A injection in this indication. This study is a retrospective study describing patients who underwent an injection of botulinum toxin for laryngeal dyspnea in the ENT Department from 2005 to 2015 years. The inclusion criteria were a dyspnea associated with a laryngeal dysfunction, confirmed by flexible fiberoptic nasopharyngolaryngoscopy. Information concerning the causes of the dyspnea, the botulinum toxin BT-A injections procedure, post-injection follow-up, and respiratory outcome were collected for all patients included. In the group of 13 patients included, the main cause identified as principal factor linked with the short breath was: a bilateral VF paralysis (Patel et al., Otolaryngol Head Neck Surg 130:686-689, 7), laryngeal dystonia (Balkissoon and Kenn, Semin Respir Crit Care Med 33:595-605, 2), Anxiety syndrome associated with unilateral vocal fold paralysis or asthma (Marcinow et al., Laryngoscope 124:1425-1430, 3), and an isolated asthma (Zwirner et al., Eur Arch Otorhinolaryngol 254:242-245, 1). Nine out of the thirteen patients were improved by the injections. A BT-A-induced stable benefit for four patients led them to stop the injections in the follow-up. Good outcome was observed in five other patients (main cause: bilateral VP paralysis), allowing a progressive lengthening of the delay between BT-A injections. Four patients did not report a positive risk/benefit ratio after BT-A injections; two of them (with bilateral VF paralysis), because of respiratory side effects and

  3. Laryngeal carcinoma presenting as polymyositis: A paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Ritesh Sahu

    2016-01-01

    Full Text Available Laryngeal carcinoma is rarely associated with paraneoplastic syndrome. Inflammatory myopathy presenting as paraneoplastic event is commonly associated with carcinomas of ovary, lung, pancreas, stomach, colorectal, and non-Hodgkin′s lymphoma. We report a case of elderly male, who presented with proximal muscle weakness and found to be associated with laryngeal carcinoma. Diagnosis of polymyositis (PM was confirmed based on clinical features, laboratory test, and muscle biopsy. Exclusion of other commonly associated malignancies was done. This patient improved gradually after 6 months of immunosuppressive therapy and management of underlying cancer.

  4. Inducible laryngeal obstruction

    DEFF Research Database (Denmark)

    Halvorsen, Thomas; Walsted, Emil Schwarz; Bucca, Caterina

    2017-01-01

    Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenc...

  5. TREATMENT OF LARYNGEAL DYSTONIA WITH BOTULINUM TOXIN: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Irena Hočevar-Boltežar

    2002-07-01

    Full Text Available Background. Laryngeal dystonia (LD is a form of focal dystonia, involving laryngeal muscles and causing disturbed phonation. Adductor, abductor and mixed forms of LD are described.Methods. Largely unsuccessful treatments include voice therapy, psychotherapy, biofeedback, section of the laryngeal recurrent nerve, laryngeal framework surgery and the use of centrally acting drugs. Botulinum toxin proved to be the most efficient treatment of LD; it acts by chemically denervating hyperactive laryngeal muscles.Case report. Authors report on the first use of botulinum toxin in a patient with LD in Slovenia. A female patient with a degenerative disease of extrapyramidal, cerebellar and autonomous system (probable multiple system atrophy and severe adductor form of LD is presented. By gradually increasing dose, the optimal dosage of botulinum has been established that greatly improves the patient’s speech for four months and causes transient mild adverse effects (dysphagia. Botulinum is injected percutaneously under endoscopic control, using the method, which has been described in literature for the first time.Conclusions. Treatment of LD with botulinum toxin demonstrated good results. It improves patient’s communication with others and the quality of his/her life.

  6. CT findings of laryngeal tuberculosis : comparison with laryngeal carcinoma

    International Nuclear Information System (INIS)

    Kim, Man Deuk; Kim, Dong Ik; Lee, Byung Hee; Sung, Ki Joon; Jung, Tae Sub; Cho, Jae Min; Yune, Heun Yune; Kim, Sun Yong

    1996-01-01

    To determine the value of CT(Computerized Tomography) in the diagnosis of laryngeal tuberculosis and to assess to what extent its characteristic findings different from those of laryngeal carcinoma. CT scans of twelve patients with laryngeal tuberculosis were reviewed and compared with those of fifteen patients with laryngeal cancer, retrospectively. Clinical symptoms, laryngoscopic examinations and the presence of pulmonary tuberculosis chest radiographs were also reviewed. In laryngeal tuberculosis, bilateral symmetric or asymmetric involvement was noted in nine(75%) patients, while unilateral involvement was seen in three(25%). This was significantly different from laryngeal cancer in which unilateral involvement was noted in twelve patients(80%). Diffuse thickening of the free margin of the epiglottis was a characteristic and frequent finding in tuberculosis(n=6, 50%). No deep submucosal infiltration of preepiglottic and paralaryngeal fat spaces is seen in tuberculosis in spite of large areas of involvement of laryngeal mucosa, while twelve patients(80%) with laryngeal cancer showed thickened deep infiltration which resulted in a submucosal mass. CT was useful in the diagnosis of laryngeal tuberculosis and its CT findings were characterized by bilateral involvement, thickening of the free margin of the epiglottis and good preservation of preepiglottic and paralaryngeal fat spaces in spite of large areas of involvement

  7. Laryngeal paralysis in dogs.

    Science.gov (United States)

    Millard, Ralph P; Tobias, Karen M

    2009-05-01

    Laryngeal paralysis is a common cause of upper airway obstruction in older, large-breed dogs and is likely associated with a generalized polyneuropathy in most animals. Surgical therapy is frequently indicated, and UAL is currently the recommended treatment. Respiratory signs significantly improve in most patients after surgery; however, postoperative complication rates can be high, and patients have a lifelong risk of developing respiratory tract disease.

  8. Laryngeal sarcoidosis: literature review

    OpenAIRE

    Moraes, Bruno Teixeira de; Neves, Luciano Rodrigues; Brasil, Osíris de Oliveira Camponês do; Pedroso, José Eduardo de Sá; Melo Junior, Jose Elson Santiago de

    2011-01-01

    INTRODUCTION: Laryngeal sarcoidosis is a granulomatous disease representing a challenge as regards diagnosis and treatment. METHOD: In this review, all aspects of the disease are involved, including etiology, clinical manifestations in adults and children, diagnosis, and treatment, by searching through Medline, Lilacs and Scielo databases, as well as English and Portuguese articles published from 1973 to 2008. FINAL COMMENTS: Despite the breakthroughs in its diagnosis and treatment, sarcoidos...

  9. Reduced rate of knee extensor torque development in older adults with knee osteoarthritis is associated with intrinsic muscle contractile deficits.

    Science.gov (United States)

    Callahan, Damien M; Tourville, Timothy W; Slauterbeck, James R; Ades, Philip A; Stevens-Lapsley, Jennifer; Beynnon, Bruce D; Toth, Michael J

    2015-12-01

    We examined the effect of knee osteoarthritis on the rate of torque development (RTD) of the knee extensors in older adults with advanced-stage knee osteoarthritis (OA; n=15) and recreationally-active controls (n=15) of similar age, sex and health status, as well as the relationship between RTD and the size and contractility of single muscle fibers. OA participants had lower RTD when expressed in absolute terms (Nm/ms). There were sex differences in peak RTD (Pmuscle, and was mitigated when RTD was normalized to peak torque (PT). In knee OA volunteers, we found strong correlations between the RTD expressed relative to PT and the velocity of contraction of single myosin heavy chain (MHC) I and IIA/X muscle fibers (r=0.652 and 0.862; both Pmuscle contractile kinetics in patients with advanced-stage knee osteoarthritis and healthy older adults is related, in part, to the size and function of single muscle fibers. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Wide-pulse electrical stimulation to an intrinsic foot muscle induces acute functional changes in forefoot-rearfoot coupling behaviour during walking.

    Science.gov (United States)

    James, D C; Chesters, T; Sumners, D P; Cook, D P; Green, D A; Mileva, K N

    2013-05-01

    Interventions for strengthening intrinsic foot muscles may be beneficial for rehabilitation from overuse injuries. In this study the acute effects of high-frequency, low-intensity wide-pulse electrical stimulation (WPS) over an intrinsic muscle on subsequent foot function during walking was assessed in healthy participants. WPS was delivered to the m. abductor hallucis (m.AH) of the non-dominant foot during relaxed standing. 3-dimensional forefoot (FF)--rearfoot (RF) coordination was quantified with a vector coding technique within separate periods of the stance phase to study WPS functional effects on foot motion. 4 types of coordinative strategies between the FF and RF were interpreted and compared PRE-to-POST-WPS for both the experimental and control feet. Bilateral electromyography (EMG) from m.AH was analysed during the intervention period for evidence of acute neuromuscular adaptation. The results showed that WPS significantly modulated FF-RF coordination during mid-stance, indicative of a more stable foot. Specifically, a statistically significant increase in FF eversion with concomitant RF inversion in the frontal plane and RF-dominated adduction in the transverse plane was observed. Subject-specific increases in post-stimulus m.AH EMG activation were observed but this was not reflected in an overall group effect. It is concluded that the structural integrity of the foot during walking is enhanced following an acute session of WPS and that this mechanical effect is most likely due to stimulation induced post-tetanic potentiation of synaptic transmission. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Laryngeal neurinoma. Differential diagnosis of submucosal laryngeal tumors

    International Nuclear Information System (INIS)

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

    2002-01-01

    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

  12. Constitutively active signaling by the G protein βγ-subunit mediates intrinsically increased phosphodiesterase-4 activity in human asthmatic airway smooth muscle cells.

    Directory of Open Access Journals (Sweden)

    Aihua Hu

    Full Text Available Signaling by the Gβγ subunit of Gi protein, leading to downstream c-Src-induced activation of the Ras/c-Raf1/MEK-ERK1/2 signaling pathway and its upregulation of phosphodiesterase-4 (PDE4 activity, was recently shown to mediate the heightened contractility in proasthmatic sensitized isolated airway smooth muscle (ASM, as well as allergen-induced airway hyperresponsiveness and inflammation in an in vivo animal model of allergic asthma. This study investigated whether cultured human ASM (HASM cells derived from asthmatic donor lungs exhibit constitutively increased PDE activity that is attributed to intrinsically upregulated Gβγ signaling coupled to c-Src activation of the Ras/MEK/ERK1/2 cascade. We show that, relative to normal cells, asthmatic HASM cells constitutively exhibit markedly increased intrinsic PDE4 activity coupled to heightened Gβγ-regulated phosphorylation of c-Src and ERK1/2, and direct co-localization of the latter with the PDE4D isoform. These signaling events and their induction of heightened PDE activity are acutely suppressed by treating asthmatic HASM cells with a Gβγ inhibitor. Importantly, along with increased Gβγ activation, asthmatic HASM cells also exhibit constitutively increased direct binding of the small Rap1 GTPase-activating protein, Rap1GAP, to the α-subunit of Gi protein, which serves to cooperatively facilitate Ras activation and, thereby, enable enhanced Gβγ-regulated ERK1/2-stimulated PDE activity. Collectively, these data are the first to identify that intrinsically increased signaling via the Gβγ subunit, facilitated by Rap1GAP recruitment to the α-subunit, mediates the constitutively increased PDE4 activity detected in asthmatic HASM cells. These new findings support the notion that interventions targeted at suppressing Gβγ signaling may lead to novel approaches to treat asthma.

  13. Laryngeal Manifestations of Neurofibromatosis.

    Science.gov (United States)

    Naunheim, Matthew R; Plotkin, Scott R; Franco, Ramon A; Song, Phillip C

    2016-03-01

    To describe the range of findings in patients with neurofibromatosis (NF) presenting to a laryngology clinic and to analyze the etiologic factors of vocal fold dysfunction in this cohort. Case series with chart review. Tertiary laryngology practice. All cases of NF presenting to an academic laryngology practice were retrospectively reviewed (August 2005 to May 2014), with a total of 34 cases. Demographic data, symptoms, and endoscopic examination findings were reviewed. Etiologic factors of laryngeal complaints were analyzed with reference to NF-associated pathologies and surgical history. Thirty-four patients with NF-1 or NF-2 were evaluated, and 28 of these patients (6 NF-1 and 22 NF-2) had laryngeal pathology. The most common presenting symptoms were vocal weakness (n = 21), dysphagia (n = 5), and globus (n = 4). Three patients had NF-related vocal fold masses on examination, including 2 neurofibromas and 1 schwannoma. Unilateral vocal cord paralysis was seen in 17 patients; bilateral paralysis was observed in 5 patients. Of patients with unilateral or bilateral paralysis, 20 had intracranial masses (vestibular schwannoma, meningioma, or skull base tumors), and 16 had previously undergone surgery for these lesions. Of the patients with NF-associated intracranial tumors, 87.0% presented with vocal cord paralysis, whereas only 40.0% of those without intracranial masses had paralysis (P = .0560). Seven patients underwent medialization procedures. Neurofibromatosis patients may present to laryngology clinic with primary laryngeal tumors or, more commonly, unilateral or bilateral paralysis. Otolaryngologists should be keenly aware of vocal fold paralysis caused by the NF-associated tumors, with particular attention to bilateral paralysis in NF-2. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Primary laryngeal tuberculosis mimicking laryngeal carcinoma: CT scan features

    International Nuclear Information System (INIS)

    El Kettani, N Ech-Cherif; El Hassani, MR; Chakir, N; Jiddane, M

    2010-01-01

    Laryngeal tuberculosis is a rare disease. It is almost always associated with pulmonary tuberculosis. It occurs generally in adults without BCG vaccination or in cases of the acquired immune deficiency syndrome. On laryngoscopy and imaging, it often simulates laryngeal carcinoma, and confirmation is always histological. We report the case of a 36-year-old man who presented to our hospital with dysphonia and dysphagia. Laryngoscopy revealed a lesion of the left vocal cord and the ventricular strip. CT scan found focal, regular thickening of the left vocal cord, associated with irregular thickening of the posterior laryngeal wall. A biopsy confirmed the diagnosis of tuberculosis

  15. Immediate effect of laryngeal surface electrical stimulation on swallowing performance.

    Science.gov (United States)

    Takahashi, Keizo; Hori, Kazuhiro; Hayashi, Hirokazu; Fujiu-Kurachi, Masako; Ono, Takahiro; Tsujimura, Takanori; Magara, Jin; Inoue, Makoto

    2018-01-01

    Surface electrical stimulation of the laryngeal region is used to improve swallowing in dysphagic patients. However, little is known about how electrical stimulation affects tongue movements and related functions. We investigated the effect of electrical stimulation on tongue pressure and hyoid movement, as well as suprahyoid and infrahyoid muscle activity, in 18 healthy young participants. Electrical stimulation (0.2-ms duration, 80 Hz, 80% of each participant's maximal tolerance) of the laryngeal region was applied. Each subject swallowed 5 ml of barium sulfate liquid 36 times at 10-s intervals. During the middle 2 min, electrical stimulation was delivered. Tongue pressure, electromyographic activity of the suprahyoid and infrahyoid muscles, and videofluorographic images were simultaneously recorded. Tongue pressure during stimulation was significantly lower than before or after stimulation and was significantly greater after stimulation than at baseline. Suprahyoid activity after stimulation was larger than at baseline, while infrahyoid muscle activity did not change. During stimulation, the position of the hyoid at rest was descended, the highest hyoid position was significantly inferior, and the vertical movement was greater than before or after stimulation. After stimulation, the positions of the hyoid at rest and at the maximum elevation were more superior than before stimulation. The deviation of the highest positions of the hyoid before and after stimulation corresponded to the differences in tongue pressures at those times. These results suggest that surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. NEW & NOTEWORTHY Surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. Tongue muscles may contribute to overshot recovery

  16. Elementary School Teachers' Vocal Dose: Muscle Bioenergetics and Training Implications.

    Science.gov (United States)

    Smith, Audrey G; Sandage, Mary J; Pascoe, David D; Plexico, Laura W; Lima, Italo R; Cao, Guanqun

    2017-07-12

    Translating exercise-science methodology for determination of muscle bioenergetics, we hypothesized that the temporal voice-use patterns for classroom and music teachers would indicate a reliance on the immediate energy system for laryngeal skeletal-muscle metabolism. It was hypothesized that the music-teacher group would produce longer voiced segments than the classroom teachers. Using a between- and within-group multivariate analysis-of-variance design (5 classroom teachers; 7 music teachers), we analyzed fundamental-frequency data-collected via an ambulatory phonation monitor-for length (seconds) of voiced and nonvoiced intervals. Data were collected for 7.5 hr during the workday, over the course of several workdays for each teacher. Descriptive analyses of voiced and nonvoiced intervals indicated that over 99% of voiced segments for both groups were no longer than 3.15 s, supporting the hypothesis of reliance on the immediate energy system for muscle bioenergetics. Significant differences were identified between and within the classroom- and music-teacher groups, with the music-teacher group producing longer voiced segments overall. Knowledge of probable intrinsic laryngeal skeletal-muscle bioenergetics requirements could inform new interdisciplinary considerations for voice habilitation and rehabilitation.

  17. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  18. Section four: laryngitis and dysphonia.

    Science.gov (United States)

    Hueston, William J; Kaur, Dipinpreet

    2013-12-01

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

  19. Laryngeal Aerodynamics in Children with Hearing Impairment versus Age and Height Matched Normal Hearing Peers.

    Science.gov (United States)

    Das, Barshapriya; Chatterjee, Indranil; Kumar, Suman

    2013-01-01

    Lack of proper auditory feedback in hearing-impaired subjects results in functional voice disorder. It is directly related to discoordination of intrinsic and extrinsic laryngeal muscles and disturbed contraction and relaxation of antagonistic muscles. A total of twenty children in the age range of 5-10 years were considered for the study. They were divided into two groups: normal hearing children and hearing aid user children. Results showed a significant difference in the vital capacity, maximum sustained phonation, and fast adduction abduction rate having equal variance for normal and hearing aid user children, respectively, but no significant difference was found in the peak flow value with being statistically significant. A reduced vital capacity in hearing aid user children suggests a limited use of the lung volume for speech production. It may be inferred from the study that the hearing aid user children have poor vocal proficiency which is reflected in their voice. The use of voicing component in hearing impaired subjects is seen due to improper auditory feedback. It was found that there was a significant difference in the vital capacity, maximum sustained phonation (MSP), and fast adduction abduction rate and no significant difference in the peak flow.

  20. Laryngeal disease in dogs and cats.

    Science.gov (United States)

    Macphail, Catriona

    2014-01-01

    The most common disease process involving the larynx is laryngeal paralysis, which occurs much more frequently in dogs than in cats. Diagnosis of laryngeal paralysis requires close attention to anesthetic plane and coordination of respiratory effort with laryngeal motion. Surgical arytenoid lateralization improves respiration and quality of life in dogs with laryngeal paralysis; however, aspiration pneumonia is a recognized complication, and generalized neuropathy can progress. Laryngeal collapse can result from any cause of chronic upper airway obstruction, but is most often associated with unaddressed brachycephalic airway syndrome. Laryngeal neoplasia, while generally uncommon, occurs more frequently in cats than in dogs. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Laryngeal dysfunction and oral hygiene: Any relation?

    Science.gov (United States)

    Eryaman, Esra; Ilhan, Banu Oter

    2012-06-01

    The purpose of this study is to establish a relation between poor oral hygiene and laryngeal dysfunction. 43 adult patients were divided into two groups according to caries activity and oral hygiene. 18 patients with oral hygiene index score (OHI-S) 0-1 were grouped as the control group (good oral hygiene). 25 patients with OHI-S 2-3 were grouped as the study group (poor oral hygiene). Larygostroboscopic examination, aerodynamic measures by defining maximum phonation time (MPT) and s/z ratio and the pitch level measurements were done. Patients with gastroesophageal reflux disease (GERD), laryngopharyngeal reflux (LPR), previously confirmed laryngeal diseases or pathologies, systemic other diseases, or smokers were excluded from this study. The average MPT values of the study group were found to be statistically very significantly lower than those of the control group (ppoor oral hygiene group correlate with LPR findings such as muscle tension dysphonia. Poor oral hygiene may aggravate potential LPR in people. Copyright © 2011. Published by Elsevier Ireland Ltd.

  2. Intrinsic Motivation.

    Science.gov (United States)

    the activity. There has been very little research and theorizing which considers the topic of intrinsic motivation , yet there is a substantial amount...reported within the framework of intrinsic motivation , yet the paper reinterprets the work within that framework. It considers several approaches of

  3. Laryngeal Involvement of Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Ariel B. Grobman

    2012-01-01

    Full Text Available The objectives of this paper are to discuss a rare cause of laryngeal multiple myeloma, to review unique pathologic findings associated with plasma cell neoplasms, to discuss epidemiology, differential diagnosis, and treatment options for plasma cell neoplasms of the larynx. Laryngeal multiple myeloma, also noted in the literature as “metastatic” multiple myeloma, presenting as a de novo laryngeal mass is extremely rare with few reported cases. Laryngeal involvement of extramedullary tumors is reported to be between 6% and 18% with the epiglottis, glottis, false vocal folds, aryepiglottic folds, and subglottis involved in decreasing the order of frequency. We present the case of a 58-year-old male with a history of IgA smoldering myeloma who presented to a tertiary care laryngological practice with a two-month history of dysphonia, which was found to be laryngeal involvement of multiple myeloma. We review the classification of and differentiation between different plasma cell neoplasms, disease workups, pathologic findings, and treatment options.

  4. RECCURENT LARYNGEAL PAPILLOMA

    Directory of Open Access Journals (Sweden)

    Nyilo Purnami

    2012-01-01

    Full Text Available A case of respiratory papillomatosis was reported. The patient suffered from the disease since eight months old with chief complaint progressive hoarseness and dyspnea. It was diagnosed with respiratory papillomatosis and scheduled for performing tracheotomy and continued with the first microlaryngeal surgery (MLS. Decanulation was taken after 2nd surgery of removing papillomas. Finally was reported she got serial of surgery for 22 times during 18 years of age. It was costly and deteriorating quality of life. The problem remains persisted because of frequent recurrences and need for repetitive surgeries. Specimen biopsy for histologic examination was shown the signs of HPV infection, papilomatic coated squamous epithel with mild dysplasia and coilocytosis. The threatening of upper airway obstruction is the main important reason for patient's coming. The patency of airway assessed by Direct Laryngoscopy then the next treatment was decided with schedule of Micro Laryngeal Surgery (MLS. Finally the MLS treatment is just only for temporarily recovery. A further research to define the proper treatment in the future is required, especially for prevention of the diseases related to the viral causes of infection.

  5. Septal graft in laryngeal reconstruction

    International Nuclear Information System (INIS)

    Bahannan, Abdulrahman; Slavicek, A.; Taudy, M.; Chovanec, M.

    2006-01-01

    A 62-year-old woman presented with symptoms of dyspnea. Ultrasonography and computed tomography examinations revealed mass extending from the cricoid cartilage to the left lobe of thyroid gland and thyroid cartilage. Cytology revealed possibility of cartilaginous origin, which was proven to be chondrosarcoma (Grade 1) from the biopsy specimen obtained during panendosopy. She underwent one stage radical resection and immediate reconstruction of laryngeal skeleton defect by mucocartilaginous graft from the nasal septum. Her postoperative course was optimal with preservation of the laryngeal functions. Twenty-eight months postoperatively, she had to undergo total laryngectomy as a salvage procedure for the advanced local recurrence. We report on the relatively easy technique for functional reconstruction of the large laryngeal defect with the employment cartilage graft from the nasal septum. (author)

  6. Unilateral Laryngeal Pacing System and Its Functional Evaluation

    Directory of Open Access Journals (Sweden)

    Taiping Zeng

    2017-01-01

    Full Text Available Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG signals from cricothyroid (CT muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.

  7. Value of Laryngeal Electromyography in Spasmodic Dysphonia Diagnosis and Therapy.

    Science.gov (United States)

    Yang, Qingwen; Xu, Wen; Li, Yun; Cheng, Liyu

    2015-07-01

    To investigate the role of laryngeal electromyography (LEMG) in the diagnosis and treatment of spasmodic dysphonia (SD). The clinical manifestations, characteristics of motor unit potentials (MUPs), recruitment potentials, and laryngeal nerve evoked potentials (EPs) in LEMG, as well as the changes after botulinum toxin (BTX) treatment, were analyzed in 39 patients with adductor SD. The main clinical manifestations were a strained voice and phonation interruptions; in addition, the patients displayed hyper-adducted vocal folds during phonation. LEMG revealed significantly increased amplitudes of the thyroarytenoid muscle MUPs. The recruitment potentials were in a dense bunch, discharging full interference patterns with significantly increased amplitudes; the mean and maximum amplitude of recruitment potentials were 3090 μV and 5000 μV, respectively. The amplitude of EPs of thyroarytenoid muscle increased significantly; the mean and maximum amplitudes were 10.3 mV and 26.3 mV, respectively. After BTX was injected, the LEMG revealed denervation changes, and the EPs weakened or disappeared in the injected muscle. SD could be diagnosed, and the therapeutic efficacy of SD treatments could be evaluated based on clinical characteristics combined with LEMG characteristics. The increased amplitudes of the recruitment potentials and EPs of the thyroarytenoid muscle were the characteristic indexes. After BTX was injected, denervated potential characteristics appeared in the muscles. © The Author(s) 2015.

  8. Laryngeal metastasis from lung cancer

    Science.gov (United States)

    Kalai, Umasankar; Madan, Karan; Jain, Deepali; Mohan, Anant; Guleria, Randeep

    2015-01-01

    Metastatic tumors of the larynx are rare. The most common tumors metastasizing to the larynx are melanoma and renal cell carcinoma. Bronchogenic carcinoma metastasizing to the larynx has been rarely described. Herein, we report the case of a 49-year-old, chronic smoker, who incidentally had a laryngeal growth detected during flexible bronchoscopy examination for evaluation of suspected lung cancer. Histopathological examination of the laryngeal nodule and the biopsy obtained from the main bronchus growth confirmed the diagnosis of metastatic squamous cell carcinoma to the larynx from primary lung cancer. PMID:25983415

  9. Laryngeal metastasis from lung cancer

    Directory of Open Access Journals (Sweden)

    Umasankar Kalai

    2015-01-01

    Full Text Available Metastatic tumors of the larynx are rare. The most common tumors metastasizing to the larynx are melanoma and renal cell carcinoma. Bronchogenic carcinoma metastasizing to the larynx has been rarely described. Herein, we report the case of a 49-year-old, chronic smoker, who incidentally had a laryngeal growth detected during flexible bronchoscopy examination for evaluation of suspected lung cancer. Histopathological examination of the laryngeal nodule and the biopsy obtained from the main bronchus growth confirmed the diagnosis of metastatic squamous cell carcinoma to the larynx from primary lung cancer.

  10. Pediatric mumps with laryngeal edema.

    Science.gov (United States)

    Hattori, Yujiro; Oi, Yasufumi; Matsuoka, Ryo; Daimon, Yumi; Ito, Asami; Kubota, Wataru; Konishi, Kyoko; Onguchi, Toshimi; Sato, Akihiro; Yamashita, Yukio; Ishihara, Jun

    2013-10-01

    Mumps virus infection primarily affects the salivary glands and may incur various complications. Laryngeal edema is such a rare complication that few adult cases have been reported. We report the first known pediatric patient with mumps with laryngeal edema. An 8-year-old boy developed dyspnea after a rapidly progressive swelling of his face and neck. Laryngoscopy revealed edematous changes in the supraglottic and subglottic regions, and computed tomography confirmed significant laryngeal edema in addition to swelling of the cervical soft tissue and the salivary glands. Laboratory findings revealed a high serum amylase level and confirmed the diagnosis of mumps. Intravenous steroid administration alleviated the dyspnea, although the patient required temporary tracheal intubation to maintain airway patency. He did not need tracheotomy and did not experience any other complications. Laryngeal edema must be regarded as a rare, potentially life-threatening complication of mumps. When mumps is diagnosed with significant swelling of the neck, an emergency airway should be established to prevent airway obstruction.

  11. SWALLOWING IN PATIENTS WITH LARYNGITIS.

    Science.gov (United States)

    Moda, Isabela; Ricz, Hilton Marcos Alves; Aguiar-Ricz, Lilian Neto; Dantas, Roberto Oliveira

    2018-01-01

    Dysphagia is described as a complaint in 32% of patients with laryngitis. The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

  12. Laryngeal assessment by videolaryngostroboscopy in patients with rheumatoid arthritis.

    Science.gov (United States)

    Gómez-Puerta, José A; Cisternas, Ariel; Hernández, M Victoria; Ruiz-Esquide, Virginia; Vilaseca, Isabel; Sanmartí, Raimon

    2014-01-01

    To evaluate the larynx involvement in patients with rheumatoid arthritis (RA) in a clinical setting and correlate with the different clinical features related to more aggressive disease. Cross-sectional study including 36 consecutive patients with RA. Reflux symptoms were evaluated by the Reflux Symptom Index (RSI) and vocal cord impairment by the Voice Handicap Index-10 (VHI-10). Laryngeal involvement was done by videolaryngostroboscopy (VLS). The mean age was 56,3 ± 14 years with a mean disease duration of 2,6 ± 3,1 years (range 0-16 years). Voice use was considered as professional users in 33%. Twenty-four (67%) out of 36 patients had abnormal findings of VLS. One patient had larynx nodules (bamboo nodules). Eleven patients (31%) were diagnosed with muscle tension dysphonia, and there were symptoms and signs of pharyngeal-laryngeal reflux in 23 (64%) patients. No signs of cricoarytenoid joint impairment was found. Organic larynx involvement was uncommon in patients with RA. However symptoms and signs of pharyngeal-laryngeal reflux were seen in around 60% of patients. There was no correlation between the clinical phenotype, severity of disease, immunological profile or treatment with VLS findings. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  13. [Laryngeal tuberculosis: study of 11 cases].

    Science.gov (United States)

    Montejo, M; Alonso, M; Aguirrebengoa, K; Moreno, G; Goicoetxea, J; Petreñas, E; Bañuelos, S; Vergez, A

    2001-01-01

    We report 11 patients with laryngeal tuberculosis seen in our hospital, January 1990 to July 2000. Eight were men and all cases presented with dysphonia and/or disphagia. In 8 pulmonary tuberculosis was associated. Mycobacterium tuberculosis was isolated from the sputum in 7 patients. Granulomatous laryngitis was demonstrated in the eight patients with laryngeal biopsy. The evolution with medical treatment was favourable in all patients.

  14. Allergic laryngitis: unraveling the myths.

    Science.gov (United States)

    Stachler, Robert J; Dworkin-Valenti, James P

    2017-06-01

    This article provides a thorough review of the literature highlighting the articles that have advanced our knowledge about the sensitivity of the larynx to allergens in the air or ones consumed. This area of inquiry requires continued interest and investigation. As the field of clinical laryngology changes, and more information is discovered about the possible causal association between allergy and vocal pathologies, practicing otolaryngologists, allergists, and other medical professionals may discover more comprehensive methods to evaluate and treat their allergic patients, particularly those who present with complaints of dysphonia, dysphagia, laryngopharyngeal reflux (LPR), and/or dyspnea. There continues to be epidemiological studies designed to describe the relationship of allergy to vocal symptoms and signs. Both population and smaller studies have recently attempted to link these two conditions. Unfortunately, the patient with chronic laryngeal complaints is often tagged by default with the diagnosis of LPR and treated with proton pump inhibitors, which are not always beneficial. The endoscopic assessment may not be as reliable to make the diagnosis of LPR as the examination is subjective and the inter-rater reliability is low. It has been demonstrated by direct laryngeal provocation studies that sticky-viscous endo-laryngeal mucous is the only reliable finding consistently associated with allergy potential allergic tissue reactivity. The interrelationship of allergic sensitivity and chronic laryngitis in certain individuals is becoming clearer because our knowledge of inquiry has increased and the available routine technology to diagnose these conditions has remarkably improved. Notwithstanding these advancements, much more research is needed on this subject to reduce the frequency of mis-diagnoses and mis-management of allergic patients.

  15. Branched-chain amino acids increase arterial blood ammonia in spite of enhanced intrinsic muscle ammonia metabolism in patients with cirrhosis and healthy subjects

    DEFF Research Database (Denmark)

    Dam, Gitte; Keiding, Susanne; Munk, Ole Lajord

    2011-01-01

    Branched-chain amino acids (BCAA) are used in attempts to reduce blood ammonia in patients with cirrhosis and intermittent hepatic encephalopathy based on the hypothesis that BCAA stimulate muscle ammonia detoxification. We studied the effects of an oral dose of BCAA on the skeletal muscle...... the metabolism of blood-supplied ammonia and the A-V measurements were used to measure the total ammonia metabolism across the thigh muscle. After intake of BCAA, blood ammonia increased more than 30% in both groups of subjects (both P supplied ammonia (PET) was unaffected (P.......05). BCAA intake led to a massive glutamine release from the muscle (cirrhotic patients, P supplied ammonia in both the patients with cirrhosis and in the healthy...

  16. The epidemiology of laryngeal cancer in Brazil

    Directory of Open Access Journals (Sweden)

    Victor Wünsch

    Full Text Available The city of São Paulo exhibits one of the highest incidences of laryngeal cancer in world and Brazil presents remarkable occurrence, compared with other Latin American countries. Around 8,000 new cases and 3,000 deaths by laryngeal cancer occur annually in the Brazilian population. In the city of São Paulo, incidence rates for laryngeal cancer among males have been decreasing since the late 1980s while, among females, the rates have shown a stable trend. This phenomenon is probably the expression of changes in gender behavior related to tobacco smoking. Several risk factors are involved in the genesis of laryngeal cancer. The most important are tobacco smoking and alcohol intake, but occupational hazards have also been associated with the disease, such as asbestos, strong inorganic acids, cement dust and free crystalline silica. Additionally, salted meat and total fat intake have been linked to elevated risk of laryngeal cancer. Conversely, several studies have confirmed that fruits, raw leaf vegetables and legumes protect against this cancer. Some researchers have postulated a possible association between laryngeal squamous cell carcinoma and human papilloma virus (HPV, but this is not universally accepted. Gastroesophageal reflux disease is weakly, but consistently correlated with laryngeal cancer. Familial cancer clusters, particularly of head and neck tumors, seem to increase the risk of laryngeal cancer. Some genetic polymorphisms, such as of genes that code for xenobiotic-metabolizing enzymes, have shown elevated risk for laryngeal cancer according to recent studies. Public health policies regarding the control of tobacco smoking and alcohol consumption, and also surveillance of carcinogen exposure in occupational settings, could have an impact on laryngeal cancer. No proposals for screening have been recommended for laryngeal cancer, but one diagnostic goal should be to avoid treatment delay when suspected symptoms have been observed.

  17. Clinical manifestation of Laryngeal Tuberculosis | Abdalla | Sudan ...

    African Journals Online (AJOL)

    All tuberculous patients with laryngeal symptoms and those diagnosed histologically to have laryngeal tuberculosis were included. Results: Eight patients were studied; they were five males and three females, with age range between 12-70 years (mean 41years). Strider, dysphonia and dysphagia were the main complaints.

  18. Contemporary management of advanced laryngeal cancer.

    Science.gov (United States)

    Britt, Christopher J; Gourin, Christine G

    2017-10-01

    The treatment of advanced laryngeal cancer has undergone a paradigm shift in recent years, with an increase in chemoradiation for organ preservation and a decrease in primary surgery. This review will summarize the contemporary management of advanced laryngeal cancer and discuss treatment-related toxicity and strategies to improve outcomes. NA.

  19. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

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    Mohammad Javad Saeedi Borujeni

    2017-01-01

    Full Text Available Introduction:Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Case Report:In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy.  Conclusion:In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child.

  20. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  1. Histopathological confirmation of polyneuropathy in 11 dogs with laryngeal paralysis.

    Science.gov (United States)

    Thieman, Kelley M; Krahwinkel, D J; Sims, Michael H; Shelton, G Diane

    2010-01-01

    Acquired laryngeal paralysis (LP) is an important cause of upper airway obstruction in dogs. We hypothesize that LP may be part of a generalized polyneuropathy complex. Electro-diagnostic studies were performed in six dogs, and histopathological studies of muscle and nerve biopsies were obtained from 11 dogs diagnosed with acquired LP. Abnormalities in electrodiagnostic procedures were consistent with a generalized polyneuropathy. Loss of large-caliber nerve fibers and axonal degeneration were identified in nerve biopsies, and neurogenic atrophy was observed in muscle specimens. Abnormalities in electrodiagnostic studies and histopathology provide evidence that LP may be part of a generalized polyneuropathy. Establishing a diagnosis of a more involved disease process is relevant for long-term prognosis.

  2. Lateral Cricoarytenoid Release: Development of a Novel Surgical Treatment Option for Adductor Spasmodic Dysphonia in a Canine Laryngeal Model.

    Science.gov (United States)

    Park, Andrea M; Paniello, Randal C

    2016-09-01

    To investigate the efficacy of a novel adductor muscle-releasing technique designed to decrease the force of vocal fold adduction, as a potential surgical therapy for patients with adductor spasmodic dysphonia (ADSD). Experimental animal study. A canine laryngeal model was used to assess the acute and sustained efficacy of a lateral cricoarytenoid (LCA) muscle release. A total of 34 canine hemilaryngeal preparations were divided among 7 experimental groups. The LCA muscle was separated from its cricoid cartilage origin via an open, anterior, submucosal approach. The laryngeal adductory pressures (LAP) were assessed pre- and post-muscle release via direct recurrent laryngeal nerve stimulation. Measurements were repeated at 1.5, 3, or 6 months postoperatively. Another study evaluated release of the thyroarytenoid (TA) muscle from its thyroid cartilage origin. Releasing the LCA muscle demonstrated a significant decrease in LAP acutely and was maintained at all 3 time points with the aid of a barrier (P < .05). Without the barrier, the LCA muscle reattached to the cricoid. Acute release of the TA muscle did not significantly decrease the LAP. The proposed LCA release procedure may provide patients with a permanent treatment option for ADSD. However, longer-term studies and human trials are needed. © The Author(s) 2016.

  3. Laryngeal Sensation Before and After Clearing Behaviors

    Science.gov (United States)

    Bonilha, Heather Shaw; Gerlach, Terri Treman; Sutton, Lori Ellen; Dawson, Amy Elizabeth; Nietert, Paul J

    2013-01-01

    Purpose People frequently present to voice clinics with complaints of irritating laryngeal sensations. Clinicians attempt to reduce the irritating sensations and their common sequela, coughing and throat clearing, by advocating for techniques that remove the irritation with less harm to the vocal fold tissue. Despite the prevalence of patients with these complaints, it is not known if the less harmful techniques recommended by clinicians are effective at clearing irritating laryngeal sensations or that irritating laryngeal sensations are, in fact, more frequent in people with voice disorders than people without voice disorders. Method Assessments of participant reported laryngeal sensation, pre- and post- clearing task, were obtained from 22 people with and 24 people without a voice disorder. Six clearing tasks were used to preliminarily evaluate the differing effects of tasks believed to be deleterious and ameliorative. Results People with and without voice disorders reported pre-clear laryngeal sensation at a similar rate. Post-clear sensation was less likely to be completely or partially removed in people with voice disorders than in the non-voice disordered group. Hard throat clear and swallow with water were the most effective techniques at removing laryngeal sensation. Conclusions The findings provide initial evidence for some of the clinical practices common to treating patients with voice disorders and chronic clearing such as advocating for swallowing a sip of water as a replacement behavior instead of coughing or throat clearing. However, the findings raise questions about other practices such as associating irritating laryngeal sensation with a voice disorder. PMID:22717491

  4. Maturation of the Coordination Between Respiration and Deglutition with and Without Recurrent Laryngeal Nerve Lesion in an Animal Model.

    Science.gov (United States)

    Ballester, Ashley; Gould, François; Bond, Laura; Stricklen, Bethany; Ohlemacher, Jocelyn; Gross, Andrew; DeLozier, Katherine; Buddington, Randall; Buddington, Karyl; Danos, Nicole; German, Rebecca

    2018-02-24

    The timing of the occurrence of a swallow in a respiratory cycle is critical for safe swallowing, and changes with infant development. Infants with damage to the recurrent laryngeal nerve, which receives sensory information from the larynx and supplies the intrinsic muscles of the larynx, experience a significant incidence of dysphagia. Using our validated infant pig model, we determined the interaction between this nerve damage and the coordination between respiration and swallowing during postnatal development. We recorded 23 infant pigs at two ages (neonatal and older, pre-weaning) feeding on milk with barium using simultaneous high-speed videofluoroscopy and measurements of thoracic movement. With a complete linear model, we tested for changes with maturation, and whether these changes are the same in control and lesioned individuals. We found (1) the timing of swallowing and respiration coordination changes with maturation; (2) no overall effect of RLN lesion on the timing of coordination, but (3) a greater magnitude of maturational change occurs with RLN injury. We also determined that animals with no surgical intervention did not differ from animals that had surgery for marker placement and a sham procedure for nerve lesion. The coordination between respiration and swallowing changes in normal, intact individuals to provide increased airway protection prior to weaning. Further, in animals with an RLN lesion, the maturation process has a larger effect. Finally, these results suggest a high level of brainstem sensorimotor interactions with respect to these two functions.

  5. Near Total Laryngectomy: A Versatile Approach for Voice Restoration in Advanced T3 and T4 Laryngeal Cancer: Functional Results and Survival

    International Nuclear Information System (INIS)

    Maamoun, S.I.; Amira, A.; Younis, A.

    2004-01-01

    Creation of a tunneled mucosal shunt between the trachea and pharynx that is controlled by remaining intrinsic laryngeal musculature with its nerve supply is an acceptable voice restoration procedure for advanced T3 and T4 laryngeal cancer. Such a tunnel will allow unilateral direction of air from lung to pharynx during phonation and will prevent aspiration since deglutition is a vagal mediated response which will induce contraction of tubed laryngeal musculature preventing aspiration. We previously reported our preliminary experience with the technique and we adopted the voice restoration approach based on the concept of the near total laryngectomy thereafter. Methods: Forty five patients with histologically proven squamous cell carcinoma of the larynx were included in this study (between January 1998 and February 2001). They were 42 males and 3 females with a mean age of 52.6 years. Criteria for selection were a normal vocal process and arytenoid cartilage on the opposite side of the lesion as evidenced by endoscopy and CT scan with no major sub glottic extension. In two patients supraglottic laryngectomy was carried out and in four other patients, complete tumor extirpation necessitated total laryngectomy. Accordingly, near total laryngectomy was carried out in the remaining 39 patients. Following a near total laryngectomy, where all laryngeal mucosa and cartilages are resected sparing the contralateral arytenoid cartilage with the overlying mucosa and surrounding musculature, the shunt was created by tubing the remaining mucosa with augmentation by pyroform sinus mucosa if necessary. The resulting tube was fashioned over 14 FG catheter for diameter control only and the remaining muscles were sutured over the tube. A permanent tracheostomy was established. Voice training was started postoperatively following resumption of oral feeding. Results: Only one patient died in the immediate postoperative period due to massive myocardial infarction. One patient developed

  6. An Unusual Laryngeal Foreign Body in Adult

    Directory of Open Access Journals (Sweden)

    Cire Ndiaye

    2016-01-01

    Full Text Available The accidental aspiration of a foreign body is a frequent domestic accident among children but a rare occurrence in adults. The laryngeal impaction of a coin is an unusual accident; only a few cases have been reported in the literature. Diagnosis is mostly achieved by clinicoradiological examinations. The authors report an uncommon case of laryngeal impaction of a coin in a 21-year-old patient, presenting with dysphonia without dyspnea or stridor. The extraction was performed by endoscopy.

  7. An Unusual Laryngeal Foreign Body in Adult.

    Science.gov (United States)

    Ndiaye, Cire; Regonne, Eric Joel; Ahmed, Houra; Diom, Evelyne Siga; Deguenonvo, Richard Edouard Alain; Mbaye, Aminata; Zemene, Yilkal; Ndiaye, Issa Cheikh

    2016-01-01

    The accidental aspiration of a foreign body is a frequent domestic accident among children but a rare occurrence in adults. The laryngeal impaction of a coin is an unusual accident; only a few cases have been reported in the literature. Diagnosis is mostly achieved by clinicoradiological examinations. The authors report an uncommon case of laryngeal impaction of a coin in a 21-year-old patient, presenting with dysphonia without dyspnea or stridor. The extraction was performed by endoscopy.

  8. An Unusual Laryngeal Foreign Body in Adult

    OpenAIRE

    Ndiaye, Cire; Regonne, Eric Joel; Ahmed, Houra; Diom, Evelyne Siga; Deguenonvo, Richard Edouard Alain; Mbaye, Aminata; Zemene, Yilkal; Ndiaye, Issa Cheikh

    2016-01-01

    The accidental aspiration of a foreign body is a frequent domestic accident among children but a rare occurrence in adults. The laryngeal impaction of a coin is an unusual accident; only a few cases have been reported in the literature. Diagnosis is mostly achieved by clinicoradiological examinations. The authors report an uncommon case of laryngeal impaction of a coin in a 21-year-old patient, presenting with dysphonia without dyspnea or stridor. The extraction was performed by endoscopy.

  9. Laryngeal Chondritis in Sheep in Iceland.

    Science.gov (United States)

    Sigurðardóttir, Ó G; Jörundsson, E; Friðriksdóttir, V

    2016-11-01

    Laryngeal chondritis is a chronic disease in sheep with low morbidity, high mortality and unresolved pathogenesis. The disease has been recognized recently in Iceland and affects both ewes and rams. Animals of different ages are affected, but lambs and yearlings predominate. The disease is seen in housed animals and most cases occur during the late winter months. We report the gross and microscopical findings in 45 cases of laryngeal chondritis in Icelandic sheep. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Laryngeal sarkoidose hos 13-årig

    DEFF Research Database (Denmark)

    Herlow, Louise Buchreitz; Rasmussen, Niels

    2010-01-01

    Sarcoidosis is a chronic granulomatous disease of unknown pathogenesis. It can affect numerous organs but most commonly involves the respiratory tract. On rare occasions it only involves the larynx. We describe a case of isolated laryngeal sarcoidosis in a teenage girl with symptoms of hoarseness......, snoring and dyspnoea. The diagnosis was supported by detection of granulomatous inflammation in a laryngeal biopsy. She was successfully treated by surgical excision of the granulomatous swellings of the arytenoids and epiglottis combined with inhaled corticosteroids....

  11. Laryngitis

    Science.gov (United States)

    ... include: Bacterial or fungal infections Infections with certain parasites Other causes of chronic hoarseness include: Cancer Vocal ... reflux disease (GERD). Include whole grains, fruits and vegetables in your diet. These foods contain vitamins A, ...

  12. Use of a laryngeal mask airway in a brachycephalic dog with masticatory myositis and trismus

    Science.gov (United States)

    Reed, Frances; Iff, Isabelle

    2012-01-01

    An 8-month old, male, neutered bulldog was presented for investigation of a 2-day history of trismus. Endotracheal intubation was impossible as the dog was only able to open his mouth approximately 2 cm. A laryngeal mask airway was blindly inserted after induction of general anesthesia to maintain the patient on inhalational anesthesia and improve respiration for computed tomography and muscle biopsy. The dog recovered from anesthesia uneventfully. PMID:22942446

  13. 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.

  14. Laryngeal granuloma: a complication of prolonged endotracheal intubation.

    OpenAIRE

    Keiser, G. J.; Bozentka, N. E.; Gold, B. D.

    1991-01-01

    Laryngeal granuloma is an uncommon complication arising from irritation of the laryngeal structures. We present a case where bilateral laryngeal granulomas became clinically evident 3 mo after orthognathic surgery. The patient, a 19-yr-old female, developed acute dyspnea after experiencing gradual voice loss. Excision of the lesions under endotracheal general anesthesia led to an uneventful outcome. The causes, predisposing factors, diagnostic features, and treatment of laryngeal granuloma ar...

  15. Laryngeal Neuropathy in Adult Goats With Copper Deficiency.

    Science.gov (United States)

    Sousa, R F A; Almeida, V M; Neto, J E; Nascimento, C W A; Medeiros, G X; Medeiros, R M T; Riet-Correa, F; Mendonça, F S

    2017-07-01

    The aim of this study was to elucidate the cause of a neurological syndrome characterized by stridor in adult goats with clinical signs of copper deficiency. The main clinical signs consisted of apathy, emaciation, pale mucous membranes, mucous nasal discharge, dyspnea, severe achromotrichia, diffuse alopecia, torpor, ataxia, and stridor. When the goats were forced to move, the stridor increased. In a herd of 194 Toggenburg goats, 10 adult goats with clinical signs of copper deficiency were removed from the herd and divided into 2 groups: group 1, which consisted of 4 nannies and 1 buck with stridor, and group 2, which consisted of 4 nannies and 1 buck without stridor. Group 3, used as a control, consisted of 5 adult goats from another flock without any clinical signs of disease. The mean serum copper concentrations were 1.3 ± 0.3 μmol/L in group 1, 8.1 ± 1.1 μmol/L in group 2, and 11.3 ± 2.2 μmol/L in group 3. The mean serum iron concentrations were 42.3 ± 14.2 μmol/L in group 1, 39.1 ± 8.2 μmol/L in group 2, and 20.6 ± 6.1 μmol/L in group 3. The main histological lesions in goats from group 1 were axonal degeneration of the recurrent laryngeal nerves and atrophy of the muscles of vocal folds and of the dorsal cricoarytenoid and right and left cricothyroid muscles. Goats with ataxia had neuronal degeneration and necrosis of cerebellar Purkinje cells and of the cranial cervical ganglion. We concluded that the stridor was caused by axonal degeneration of the recurrent laryngeal nerves due to the severe copper deficiency.

  16. 21 CFR 874.3730 - Laryngeal prosthesis (Taub design).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngeal prosthesis (Taub design). 874.3730... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3730 Laryngeal prosthesis (Taub design). (a) Identification. A laryngeal prosthesis (Taub design) is a device intended to direct...

  17. Laryngeal lesions in Ibadan, Nigeria | Ogunleye | Nigerian Journal ...

    African Journals Online (AJOL)

    In the adult population in this study, the major findings at direct laryngoscopy were laryngeal tumours 43(53.1%), laryngeal stenosis 9(11.1%), and vocal cord nodules 7(8.6%). The laryngeal tumours were confirmed histologically to be carcinomas in 36(44.4%), dysplasias 3 (3.7%), papillomas 2 (2.5%) and sarcomas in 2 ...

  18. Arytenoid lateralization for management of combined laryngeal paralysis and laryngeal collapse in small dogs.

    Science.gov (United States)

    Nelissen, Pieter; White, Richard A S

    2012-02-01

    To identify combined laryngeal paralysis and collapse in small dogs and describe postoperative outcome after arytenoid lateralization. Case series. Small nonbrachycephalic breed dogs with laryngeal paralysis and collapse (n = 6). Medical records of small breed dogs with airway problems and undergoing laryngeal surgery (January-December 2008) were reviewed. Dogs with combined laryngeal paralysis and laryngeal collapse (LPLC) had arytenoid lateralization. The immediate, 4 week and 6 month postoperative outcomes were described. Direct visual laryngeal exam under a light plane of anesthesia revealed bilateral failure of arytenoid and vocal fold movement and concurrent bilateral medial folding with contact of the cuneiform processes in all dogs. None of the dogs had intra- or immediate postoperative complications after arytenoid lateralization. Two dogs required a 2nd contralateral procedure. Follow-up after 6 months revealed marked improvement in clinical signs related to upper airway obstruction, but all dogs continued to have mild respiratory noise. Concurrent laryngeal paralysis and collapse should be considered as part of the differential diagnosis for small, nonbrachycephalic dogs with upper airway disease. Arytenoid lateralization resulted in improvement of clinical signs related to obstructive airway disease. © Copyright 2011 by The American College of Veterinary Surgeons.

  19. Comparison of Medical and Voice Therapy for reflux Laryngitis Based on Acoustic and Laryngeal Characteristics

    Directory of Open Access Journals (Sweden)

    Abbas Dehestani Ardakani

    2011-12-01

    Full Text Available Background and Aim: Reflux laryngitis is extremely common among patients with voice disorder. Medical therapy approaches are not efficient enough. The main goal of this study is to assess the acoustic and laryngeal characteristics of patients with dysphonia before and after medical or voice therapy, and to evaluate the effectiveness of each.Methods: In this retrospective study, 16 reflux laryngitis patients were assessed. Five received complete voice therapy, tow ceased voice therapy and nine received medication. Perceptual voice evaluation was performed by a speech-language pathologist, the severity of voice problem was calculated, based on the affected acoustic and laryngeal characteristics pre- and post-treatment.Results: Post-treatment evaluation in patients who received complete voice therapy indicates 80 percent improvement in the severity of disorder and 100 percent improvement in the perceptual voice evaluation. After medical therapy, we observed that voice disorder and perceptual voice evaluation are improved 44 and 66 percent respectively. The improvement was statistically significant in both treatment approaches: complete voice therapy (P=0.039 and medical therapy (p=0.017.Conclusion: In patients with reflux laryngitis, most acoustic and laryngeal characteristics were normal and satisfying after the treatment. It can be concluded that the proficiency of voice therapy in improving the acoustic and laryngeal characteristics is comparable to medical therapy

  20. Upper airway obstruction in canine laryngeal paralysis.

    Science.gov (United States)

    Amis, T C; Smith, M M; Gaber, C E; Kurpershoek, C

    1986-05-01

    The type and the severity of airway obstruction in 30 dogs with bilateral laryngeal paralysis was assessed, using tidal breathing flow-volume loop (TBFVL) analysis. The dogs had clinical evidence of mild-to-severe upper airway obstruction (ie, respiratory distress, exercise intolerance, stridor). Seventeen dogs had TBFVL consistent with a nonfixed (inspiratory) obstruction, 10 had TBFVL indicative of a fixed (inspiratory/expiratory) obstruction, and 3 had normal TBFVL. Analysis of TBFVL confirmed that dogs with laryngeal paralysis have upper airway obstruction that differs in type and severity. Use of TBFVL provided a quantitative evaluation of airway obstruction and demonstrated the effects of bilateral laryngeal paralysis on the breathing patterns of dogs.

  1. [Acute laryngitis and epiglottitis in children].

    Science.gov (United States)

    Mimouni, Olivia; Nicollas, Richard; Roman, Stéphane; Triglia, Jean-Michel

    2007-10-31

    The anatomical characteristic of the pediatric larynx allows physicians to better understand the incidence of symptomatic and severe presentations of acute laryngitis, which are frequent pediatric emergencies. Subglottis laryngitis and epiglottitis must be distinguished from each other. These two diseases are absolutely different: the first one is essentially viral and usually moderate, even though acute respiratory distress can occur. The other (epiglottitis) is bacterial, essentially caused by Haemophilus influenza B (Hi-B), and can be life threatening. The anti Hi-B vaccine leads to a decrease of frequency but does not make them disappear. Moreover, even if a child has a history of the Hi-B vaccine, diagnosis of epiglottitis can not to be ruled out. Lastly, in case of acute laryngeal dyspnea in a child, one must think about a foreign body.

  2. Undifferentiated Laryngeal Carcinoma with Pagetoid Spread.

    Science.gov (United States)

    Sarioglu, Sulen; Dogan, Ersoy; Sahin, Yasemin; Uzun, Evren; Bekis, Recep; Ada, Emel; Sagol, Ozgul; Akman, Fadime

    2016-06-01

    Pagetoid spread, is used to define intraepithelial spread of cancer cells, when a massive carcinoma is identified beneath the basal membrane. There are only few reports of pagetoid spread at the head and neck region. Herein a 74 year old male patient with bilateral transglottic laryngeal high grade malignant epithelial tumor with pagetoid spread is presented. The tumor was located at the submucosa and there was spread of the CK7 and CK19 positive tumor cells into the non neoplastic mucosa, which was CK5/6 positive, sparing the basement membrane, creating a typical pagetoid pattern. Radiographic and positron emission tomography scan examination of the patient was unremarkable at presentation other than the laryngeal and neck lesions; but extensive systemic metastasis developed at 6 months following operation. To the best of our knowledge no epithelial malignancy with pagetoid spread was described at the larynx. Pagetoid spread may be a hallmark of very aggressive behavior in laryngeal carcinoma.

  3. 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.

  4. [Laryngeal neuroendocrine carcinoma: a case report].

    Science.gov (United States)

    Hallaoui, Y; El Kohen, A; Sefiani, S; Benchekroun, L; Jazouli, N; Kzadri, M

    2004-01-01

    Laryngeal neuroendocrine carcinomas are uncommon and not well known tumors. Three histological subtypes, each of them with a different prognosis and treatment, can be identified. We report a case of a large cell laryngeal neuroendocrine carcinoma in 32 old-year boy who presented a right glotto-subglottic tumoral process. The patient was treated by total laryngectomy associated with bilateral functional neck dissection but without postoperative chemotherapy. A disease recurrence occured three months after surgery consisting on a massive involvment of laterocervical and sus clavicular lymph nodes. The authors discussed the clinical features, the histological and immunohistochemical characteristics, the treatment and the prognosis of laryngeal neuroendocrine carcinoma, according to literature. (full article translated in English available on www.ent-review.com).

  5. Effect of laryngeal anesthesia on pulmonary function testing in normal subjects.

    Science.gov (United States)

    Kuna, S T; Woodson, G E; Sant'Ambrogio, G

    1988-03-01

    Pulmonary function tests (PFT) were performed on 11 normal subjects before and after topical anesthesia of the larynx. The PFT consisted of flow volume loops and body box determinations of functional residual capacity and airway resistance, each performed in triplicate. After the first set of tests, cotton pledgets soaked in 4% lidocaine were held in the pyriform sinuses for 2 min to block the superior laryngeal nerves. In addition, 1.5 ml of 10% cocaine was dropped on the vocal cords via indirect laryngoscopy. PFT were repeated 5 min after anesthesia. Besides routine analysis of the flow volume loops, areas under the inspiratory (Area I) and expiratory (Area E) portions of the loops were calculated by planimetry. Area I, peak inspiratory flow (PIF), as well as forced inspiratory flow at 25, 50, and 75% forced vital capacity (FVC), decreased after anesthesia. Peak expiratory flow decreased after anesthesia, but Area E and forced expiratory flow at 25, 50, and 75% FVC were unchanged. This protocol also was performed in 12 normal subjects with isotonic saline being substituted for the lidocaine and cocaine. In this group, no significant differences were observed when flow volume loop parameters were compared before and after topical application of saline. In 5 spontaneously breathing anesthetized dogs, posterior cricoarytenoid muscle and afferent superior laryngeal nerve activity were recorded before and after laryngeal anesthesia performed with the same procedure used in the human subjects. Laryngeal anesthesia resulted in a substantial decrease or a complete disappearance of afferent SLN activity recorded during unobstructed and obstructed respiration. The data suggest that laryngeal receptors help modulate upper airway patency in man.

  6. Laryngeal plexiform neurofibroma in a child.

    Science.gov (United States)

    Kasapoglu, Fikret; Ozdemircan, Talip; Erisen, Levent

    2013-06-01

    Neurofibromatosis (NF) is a genetically inherited, autosomal dominant disease, characterized by multiple cafe au lait spots, cutaneous neurofibromas and "Lisch nodules." Neurofibromatosis can develop from a neural source at any age. However, neurofibroma of the larynx is extremely rare and is usually manifested by obstructive airway symptoms. We encountered a 5-year-old child presenting with stridor and dyspnea, who had a diagnosis of laryngeal plexiform neurofibroma. The purpose of our report is the consideration of laryngeal NF in the differential diagnosis of dyspnea in infants and children.

  7. Laryngeal Chondroma: An Unusual Complication Endotracheal Entubation.

    Science.gov (United States)

    Gökdoğan, Ozan; Koybasioglu, Ahmet; Ileri, Fikret

    2016-06-01

    Laryngeal cartilaginous framework tumors are very rare. Chondroma and chondrosarcoma are the most common types of these tumors. A 27-year-old man with a history of intubation presented with exercise-induced dyspnea. A computed tomography scan of larynx showed a rounded and circumscribed mass without infiltration of the adjacent structures which obstructs 75% of airway. Histopathological investigation of the mass revealed the chondroma of the larynx. The patients' history of intubation trauma with the subsequent progressive onset of clinical symptoms demonstrates the relationship between these 2 entities. Clinicians should consider laryngeal chondroma in the differential diagnosis of dyspnea after endotracheal intubation.

  8. Bronchial or Laryngeal Obstruction Induced by Exercise?

    Directory of Open Access Journals (Sweden)

    Ayoub Bey

    2017-06-01

    Full Text Available A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

  9. Paediatric laryngeal malignant nerve sheath tumour.

    Science.gov (United States)

    Lucioni, Marco; Marioni, Gino; Della Libera, Duilio; Rizzotto, Giuseppe

    2007-12-01

    Malignant nerve sheath tumours (MNSTs) are more frequently diagnosed in the extremities, the chest wall and the abdominal wall. Laryngeal MNST is an extremely rare occurrence, particularly in children. We treated a laryngeal recurrence of MNST in a 13-year-old boy with chemotherapy followed by horizontal supraglottic laryngectomy extended to left arytenoid and ipsilateral vocal fold and bilateral neck dissection. Four years later, hemithyroidectomy was performed for thyroid MNST recurrence. At present, 6 years after last intervention, the patient shows no evidence of recurrent disease.

  10. The Role of Immediate Recurrent Laryngeal Nerve Reconstruction for Thyroid Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Tetsuji Sanuki

    2010-01-01

    Full Text Available Unilateral vocal fold paralysis (UVFP is one of the most serious problems in conducting surgery for thyroid cancer. Different treatments are available for the management of UVFP including intracordal injection, type I thyroplasty, arytenoid adduction, and laryngeal reinnervations. The effects of immediate recurrent laryngeal nerve (RLN reconstruction during thyroid cancer surgery with or without UVFP before the surgery were evaluated with videostroboscopic, aerodynamic, and perceptual analyses. All subjects experienced postoperative improvements in voice quality. Particularly, aerodynamic analysis showed that the values for all patients entered normal ranges in both patients with and without UVFP before surgery. Immediate RLN reconstruction has the potential to restore a normal or near-normal voice by returning thyroarytenoid muscle tone and bulk seen with vocal fold denervation. Immediate RLN reconstruction is an efficient and effective approach to the management of RLN resection during surgery for thyroid cancer.

  11. Comparison of different techniques of laryngeal mask placement in children.

    Science.gov (United States)

    Ghai, Babita; Wig, Jyotsna

    2009-06-01

    The insertion of laryngeal mask airway is not always easy in children, and many techniques are described to improve success rate of placement. It is very important to determine the optimal insertion technique as unsuccessful prolonged insertion and multiple attempts are associated with adverse respiratory events and trauma in children. This article will review different techniques studied recently for the placement of classical laryngeal mask airway in children as well as recent findings of cuff pressure and depth of anesthesia for laryngeal mask airway placement. Laryngeal mask airway in children has undergone many modifications such as ProSeal laryngeal mask airway to improve its functioning. This article will also review different insertion techniques for ProSeal laryngeal mask airway. Rotational technique with partially inflated cuff is reported to have the highest success rate of insertion and lowest incidence of complications for classical laryngeal mask airway in children. Clinical endpoints for cuff inflation are associated with significant hyperinflation and increased leakage around the laryngeal mask airway cuff. The inferences regarding the dosage of intravenous anesthetic agents and end-tidal concentration of volatile anesthetics in children to achieve adequate depth for laryngeal mask airway placement are very difficult to draw. ProSeal laryngeal mask airway is associated with a very high first attempt success and overall success of insertion in children. Rotational technique may be considered as the first technique of choice for classical laryngeal mask airway insertion in children. The routine use of cuff pressure monitoring is mandatory during the use of laryngeal mask airway in children. Modification of laryngeal mask airway in children, that is ProSeal laryngeal mask airway, is promising and improves the success rate of insertion.

  12. Laryngeal mask airway and bougie intubation failures: the Combitube as a secondary rescue device for in-hospital emergency airway management.

    Science.gov (United States)

    Mort, Thomas C

    2006-11-01

    When conventional intubation methods fail, an accessory rescue airway device must be immediately available and rapidly deployed to assist the clinician in managing the airway. I reviewed an emergency intubation database to determine what airway devices were used as a backup to rescue the primary rescue device failures. The bougie and the laryngeal mask airway each have an intrinsic failure rate. The Combitube(R), commonly used in the emergency prehospital setting, appeared to be a useful secondary rescue device in the hospital setting when the bougie and laryngeal mask airway failed.

  13. Consequences of tumor planning target volume reduction in treatment of T2-T4 laryngeal cancer.

    Science.gov (United States)

    Vugts, Cornelia A J M; Terhaard, Chris H J; Philippens, Marielle E P; Pameijer, Frank A; Kasperts, Nicolien; Raaijmakers, Cornelis P J

    2014-09-04

    Since lymph nodes volumes are generally four times the volume of the primary PTV, the advantage of using tight margins around the primary PTV is not clear. Therefore treatment margins of T2-T4 laryngeal carcinoma for IMRT are generally chosen in such a way that the PTV is comparable to that in conventional radiotherapy. The aim of this study is to quantify the effect of volume reduction of the primary PTV of T2-T4 laryngeal carcinoma with regard to late toxicity despite elective irradiation of lymph node levels II to IV. Two treatment plans based on conservative (GTV-PTV = 15 mm and 20 mm cranial), and on evidence-based tight margins (GTV-PTV = 8 mm) were calculated for 16 patients. Toxicity effects were estimated based on the dose distributions. Compared to conservative margins, using tight margins resulted in: 1) significant reduction of the normal tissue complication probability (NTCP) for swallowing muscles and submandibular glands, 2) significant reduction of the mean dose in all organs at risk (OAR), 3) a mean dose smaller than 60 Gy for all OARs except for the laryngeal cartilages. When the lymph node levels II to IV were prescribed with an elective dose, an NTCP reduction of 53% for the swallowing muscles and of 23% for the submandibular glands was found by using tight instead of conservative margins. When positive nodes were present, NTCP reduction amounted to 29% and 15%, respectively. There is a potential benefit in realizing evidence-based tight margins for laryngeal cancer patients despite elective irradiation of lymph node levels II to IV.

  14. Effects of laryngeal manual therapy (LMT) and transcutaneous electrical nerve stimulation (TENS) in vocal folds diadochokinesis of dysphonic women: a randomized clinical trial.

    Science.gov (United States)

    Siqueira, Larissa Thaís Donalonso; Silverio, Kelly Cristina Alves; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Carneiro, Christiano Giácomo; Behlau, Mara

    2017-05-15

    To verify and compare the effect of transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) on laryngeal diadochokinesis (DDK) of dysphonic women. Twenty women with bilateral vocal nodules participated and were equally divided into: LMT Group - LMT application; TENS Group - TENS application; both groups received 12 sessions of treatment, twice a week, with a duration of 20 minutes each, applied by the same therapist. The women were evaluated as to laryngeal DDK at three moments: diagnostic, pre-treatment, and post-treatment, which produced three groups of measurements. The DDK recording was performed with intersected repetition of vowels /a/ and / i/. The analysis of vowels was performed by the program Motor Speech Profile Advanced (MSP)-KayPentax. The DDK parameters of the three evaluations were compared by means of the paired t-test (p≤0.05). The measurements of laryngeal DDK parameters were similar in the phase without treatment, indicating no individual variability over time. There was no change with respect to the speed of DDK after intervention, but after LMT, DDK of the vowel /i/ was more stable in terms of the duration of the emissions and intensity of emissions repeated. These results show improved coordination of vocal folds movement during phonation. There were no changes in the DDK parameters following TENS. LMT provides greater regularity of movement during laryngeal diadochokinesis in dysphonic women, which extends knowledge on the effect of rebalancing the larynx muscles during phonation, although TENS does not impact laryngeal diadochokinesis.

  15. Disseminated cutaneous histoplasmosis with laryngeal involvement ...

    African Journals Online (AJOL)

    Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome. ... Grocott-Gomori methenamine silver and Periodic acid–Schiff (PAS) stains revealed a relative paucity of intracellular, narrow-neck budding fungal organisms. Culture findings confirmed the ...

  16. [Multispiral computed tomographic semiotics of laryngeal cancer].

    Science.gov (United States)

    Vasil'ev, P V; Iudin, A L; Sdvizhkov, A M; Kozhanov, L G

    2007-01-01

    Multispiral computed tomography (MSCT) with intravenous bolus contrasting is a currently available method for radiodiagnosis of laryngeal cancer. MSCT is of much higher informative value in estimating the extent of a tumorous lesion than the traditional radiodiagnostic techniques: linear tomography, lateral X-ray study, roentgenoscopy and roentgenography of the laryngopharynx and esophagus with barium meal.

  17. Dysphagia Caused by Chronic Laryngeal Edema.

    Science.gov (United States)

    Delides, Alexander; Sakagiannis, George; Maragoudakis, Pavlos; Gouloumi, Αlina-Roxani; Katsimbri, Pelagia; Giotakis, Ioannis; Panayiotides, John G

    2015-10-01

    A rare case of a young female with chronic diffuse laryngeal edema causing severe swallowing difficulty is presented. The patient was previously treated with antibiotics and steroids with no improvement. Diagnosis was made with biopsy of the epiglottis under local anesthesia in the office.

  18. Laryngeal spindle cell liporna: case report

    African Journals Online (AJOL)

    University Hospital "Queen Ioanna", Sofia Bulgaria. Key words: Larynx , spindle cell, lipoma. This is a case report of a 24-year-old female patient who presented with a history of hoarseness of the voice, dysphagia and difficulty in breathing. A mass located on the laryngeal surface of the epiglottis was found and removed.

  19. Progressive Dysphagia Post Laryngeal Mask Airway Intubation ...

    African Journals Online (AJOL)

    The laryngeal mask airway (LMA) is an important addition to the anaesthetic equipments; however its use may involve some important complications. We report an unusual and potentially serious complication arising from the use of this equipment. A 58 year old man underwent cataract surgery under general anaesthesia ...

  20. Epidemiological review of laryngeal cancer: An Indian perspective

    Science.gov (United States)

    Bobdey, Saurabh; Jain, Aanchal; Balasubramanium, Ganesh

    2015-01-01

    Background: Laryngeal cancer is one of the 10 leading causes of cancer in Indian men. The association of laryngeal cancer and tobacco smoking is well-established, but the peculiarities such as wide variation of disease distribution and survival, role of tobacco chewing, indoor air pollution, and dietary factors in laryngeal cancer causation needs to be understood. In this study, we review the descriptive and observational epidemiology of laryngeal cancer in India. Materials and Methods: MEDLINE and Web of science electronic database was searched from January 1995 to December 2013, using the using keywords “laryngeal cancer, laryngeal cancer outcome, epidemiology, etiological factor and their corresponding Mesh terms were used in combination like OR, AND.” Two authors independently selected studies published in English and conducted in India. A total of 15 studies were found to be relevant and eligible for this review. Results: In India, laryngeal cancer contributes to approximately 3-6% of all cancers in men. The age-adjusted incidence rate of cancer larynx in males varies widely among registries, highest is 8.18 per 100,000 in Kamprup Urban District and the lowest is 1.26 per 100,000 in Nagaland. The 5-year survival for laryngeal cancer in India is approximately 28%. Indian studies show tobacco, alcohol, long-term exposure to indoor air pollution, spicy food, and nonvegetarian diet as risk factors for laryngeal cancer. Conclusion: There is wide regional variation in the incidence of laryngeal cancer in India. Survival rates of laryngeal carcinoma are much lower as compared to other Asian countries. Studies conducted in India to identify important risk factors of laryngeal cancer are very limited, especially on diet and indoor air pollution. Hence, more research is required for identifying the etiological factors and development of scientifically sound laryngeal cancer prevention programs. PMID:26855523

  1. Laryngeal involvement in pemphigus vulgaris: a proposed classification.

    Science.gov (United States)

    Mahmoud, A; Miziara, I D; Costa, K C; Santi, C G; Maruta, C W; Aoki, V

    2012-10-01

    (1) To investigate the incidence of laryngeal involvement in a large series of patients with pemphigus vulgaris, using endoscopic examination, (2) to describe the lesions, and (3) to establish a classification of laryngeal involvement in pemphigus vulgaris based on the location of the lesions. Prospective study. A total of 40 sequentially treated pemphigus vulgaris patients, diagnosed using clinical, histological and immunofluorescence criteria, were evaluated for laryngeal manifestations using endoscopic examination. The results were used to establish a graded classification of laryngeal involvement according to the location of the lesions. Active laryngeal lesions (ulcers or blisters) were found in 16 patients (40 per cent). Of these, 37.5 per cent were classified as grade I, 20 per cent as grade II, 20 per cent as grade III and 17.5 per cent as grade IV. Laryngeal involvement is common in pemphigus vulgaris and must be considered at the point of diagnosis. Grade I lesions are the most frequent.

  2. Laryngeal Chondrosarcoma: A rare cause of critical upper airway obstruction.

    LENUS (Irish Health Repository)

    Tuite, K

    2018-01-01

    Laryngeal cancers are rare, encompassing around one percent of all cancers. Suspicion should be raised if a patient presents with classical signs and symptoms; i.e. dysphonia, inspiratory stridor, dysphagia, odynophagia, neck mass, or persistent cough. Laryngeal chondrosarcoma is a rare form of laryngeal cancer, the diagnosis of which can be difficult. The case in question describes an unusual presentation of one such case, and its subsequent investigation, management and outcome.

  3. Increased intrinsic mitochondrial function in humans with mitochondrial haplogroup H

    DEFF Research Database (Denmark)

    Larsen, Steen; Díez-Sánchez, Carmen; Rabøl, Rasmus

    2014-01-01

    and determined their mitochondrial haplogroup, mitochondrial oxidative phosphorylation capacity (OXPHOS), mitochondrial content (citrate synthase (CS)) and VO2max. Intrinsic mitochondrial function is calculated as mitochondrial OXPHOS capacity divided by mitochondrial content (CS). Haplogroup H showed a 30......% higher intrinsic mitochondrial function compared with the other haplo group U. There was no relationship between haplogroups and VO2max. In skeletal muscle from men with mitochondrial haplogroup H, an increased intrinsic mitochondrial function is present....

  4. Laryngeal paralysis associated with a muscle pseudotumour in a ...

    African Journals Online (AJOL)

    An 18-month-old male entire Bloodhound dog was presented with a six-week history of progressive inspiratory dyspnoea, stridor, dysphonia and exercise intolerance. CT scan performed elsewhere had revealed the presence of an unencapsulated nodular mass (3x1x5 cm) dorsal to the larynx and first tracheal rings.

  5. Radical radiotherapy for T3 laryngeal cancers

    International Nuclear Information System (INIS)

    Uno, T.; Itami, J.; Kotaka, K.; Toriyama, M.

    1996-01-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [de

  6. Primary laryngeal leishmaniasis: A rare case report

    Directory of Open Access Journals (Sweden)

    Kumar Bipin

    2009-01-01

    Full Text Available Laryngeal leishmaniasis is extremely rare. We report a case of primary laryngeal leishmaniasis in a 70-year-old male who was admitted with complaints of gradual progressive hoarseness of the voice, dyspnea, cough for the past 3 months and noisy breathing for the past 5 days. An X-ray of the soft tissue of the neck showed a prevertebral soft tissue mass causing narrowing of the airway at the C6-C7 vertebral level. A computerized tomography (CT scan showed a soft tissue mass in the subglottic region causing significant narrowing of the airway. A direct laryngoscopy showed a pinkish-white, friable mass involving the subglottic region and the anterior half of the vocal cords. With the clinical suspicion of malignancy, an endoscopic biopsy was done. A histopathological examination showed diffuse mixed inflammatory cell infiltrate in subepithelium with numerous Leishmania donovani bodies in the cytoplasm of histiocytes.

  7. Laryngeal manual therapy as a treatment for impaired production of tahrir vibrato in traditional Iranian singers.

    Science.gov (United States)

    Salehi, Abolfazl; Barkmeier-Kraemer, Julie

    2014-01-01

    Iranian vibrato (tahrir) is a common feature of traditional Iranian singing. A unique feature of tahrir is a modulated voice quality perceived as a rhythmic falsetto voice break associated with upward pitch inflections. Laryngeal discomfort and impaired voice quality can occur in singers when they perform Iranian tahrir using an improper technique. A case series research design was used to explore voice treatment outcomes using laryngeal manual therapy (LMT) for treating voice problems associated with tahrir singing. Four professional Iranian singers of the traditional style (3 men and 1 woman) were studied. All subjects reported difficulty executing tahrir during performances. They were assessed by a speech-language pathologist (SLP) specializing in the administration of LMT for voice disorders. Multidimensional assessments were made of the participants' vocal function using acoustic and auditory-perceptual evaluation, self-reports of the singers, and LMT assessments by the SLP before and after treatment. The therapeutic program implemented LMT techniques to release laryngeal joints and reduce muscular tension. Pretreatment examination of the larynx and anterior neck musculature using palpation showed that the difficulties in producing tahrir vibrato were associated with a decreased thyrohyoid space and tension in the submental complex and sternocleidomastoid. Posttreatment examination showed an increased thyrohyoid space and reduced tension in the submental complex and sternocleidomastoid, associated with the singers' perception of reduced effort producing tahrir vibrato during singing. Tahrir vibrato requires specific training to prevent excessive tension in laryngeal and neck muscles. In the absence of such training, or in the context of excessive singing associated with fatigue, LMT may facilitate more efficient vocal production in tahrir singers. © 2015 S. Karger AG, Basel.

  8. Structural Organization of the Laryngeal Motor Cortical Network and Its Implication for Evolution of Speech Production.

    Science.gov (United States)

    Kumar, Veena; Croxson, Paula L; Simonyan, Kristina

    2016-04-13

    The laryngeal motor cortex (LMC) is essential for the production of learned vocal behaviors because bilateral damage to this area renders humans unable to speak but has no apparent effect on innate vocalizations such as human laughing and crying or monkey calls. Several hypotheses have been put forward attempting to explain the evolutionary changes from monkeys to humans that potentially led to enhanced LMC functionality for finer motor control of speech production. These views, however, remain limited to the position of the larynx area within the motor cortex, as well as its connections with the phonatory brainstem regions responsible for the direct control of laryngeal muscles. Using probabilistic diffusion tractography in healthy humans and rhesus monkeys, we show that, whereas the LMC structural network is largely comparable in both species, the LMC establishes nearly 7-fold stronger connectivity with the somatosensory and inferior parietal cortices in humans than in macaques. These findings suggest that important "hard-wired" components of the human LMC network controlling the laryngeal component of speech motor output evolved from an already existing, similar network in nonhuman primates. However, the evolution of enhanced LMC-parietal connections likely allowed for more complex synchrony of higher-order sensorimotor coordination, proprioceptive and tactile feedback, and modulation of learned voice for speech production. The role of the primary motor cortex in the formation of a comprehensive network controlling speech and language has been long underestimated and poorly studied. Here, we provide comparative and quantitative evidence for the significance of this region in the control of a highly learned and uniquely human behavior: speech production. From the viewpoint of structural network organization, we discuss potential evolutionary advances of enhanced temporoparietal cortical connections with the laryngeal motor cortex in humans compared with nonhuman

  9. A randomised trial comparing the laryngeal mask airway Supreme™ with the laryngeal mask airway Unique™ in children.

    Science.gov (United States)

    Jagannathan, N; Sohn, L E; Sawardekar, A; Chang, E; Langen, K E; Anderson, K

    2012-02-01

    We conducted a randomised controlled trial comparing the laryngeal mask airway Supreme(™) with the laryngeal mask airway Unique(™) in children. Fifty children presenting for elective surgery were randomly assigned to receive either the laryngeal mask airway Supreme or laryngeal mask airway Unique. The outcomes measured were airway leak pressure, ease and time for insertion, insertion success rate, fibreoptic examination, incidence of gastric insufflation, ease of gastric tube placement through the laryngeal mask airway Supreme, quality of airway during anaesthetic maintenance and complications. Median (IQR [range]) time to successful device placement was shorter with the laryngeal mask airway Unique, 14.5 [13.5-16.3 (10.0-23.6)] s than with the laryngeal mask airway Supreme, 17.4 [14.8-19.8 (11.5-29.2)] s; p = 0.007. Median (IQR [range]) airway leak pressures for the laryngeal mask airway Supreme and laryngeal mask airway Unique were 20 [16-21 (12-22)] cmH(2)O and 15 [14-18 (10-24)] cmH(2)O, respectively (p = 0.001). The incidence of gastric insufflation was lower with the laryngeal mask airway Supreme (zero vs six patients), p = 0.01. In conclusion, the laryngeal mask airway Supreme performed as well as the laryngeal mask airway Unique and is a useful alternative for airway maintenance, particularly in children who require evacuation of gastric contents during anaesthesia. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  10. Laryngeal chondrosarcoma - Ten years of experience

    Directory of Open Access Journals (Sweden)

    José Fernando dos Santos Oliveira

    2014-07-01

    Full Text Available INTRODUCTION: Laryngeal involvement by cartilaginous tumors is rare. However, although accounting for only 1% of laryngeal tumor pathology, they are the most frequently occurring non-epithelial neoplasms. The most probable location is the endolaryngeal surface of the cricoid cartilage. Their symptoms are variable, depending on the size and location, and may include hoarseness, stridor, and dyspnea. Treatment is based on surgical excision. Some centers take into account the degree of differentiation and whether it is a case of relapse when deciding to perform a radical resection. AIM: To evaluate this disease in a sample of the Portuguese population. METHODS: A review of the medical records from 2002 to 2012 by assessment of clinical processes was performed. Data on demographics, clinical treatments, and outcomes were collected. RESULTS: Six patients were included in the study. Five of them underwent total laryngectomy, and in one case, partial excision of the thyroid cartilage was performed. None of the patients had either metastases or tumor-related death. CONCLUSION: Laryngeal chondrosarcomas remain a rare disease of unknown etiology, with slow and insidious symptoms. The treatment is surgical, with favorable prognosis, and metastases rarely occur. The main concern regards their propensity to relapse.

  11. Laryngeal adenoid cystic carcinoma: case report

    Directory of Open Access Journals (Sweden)

    André Del Negro

    Full Text Available CONTEXT: Adenoid cystic carcinomas are malignant tumors that occur in both the major and the minor salivary glands. A laryngeal location is rare because of the paucity of accessory salivary glands in this area. Adenoid cystic carcinomas account for less than 1% of all malignant tumors in the larynx, and only about 120 cases have been reported in the literature. These tumors have a slight female predisposition, and their peak incidence is in the fifth and sixth decades of life. In this article, we describe a case of laryngeal adenoid cystic carcinoma and discuss its clinical characteristics and treatment. CASE REPORT: We report on a case of laryngeal adenoid cystic carcinoma in a 55 year-old female patient who presented with dyspnea and hoarseness. Features of the diagnostic and therapeutic evaluation are described and the clinical management of such cases is outlined. The clinical course, definitive treatment strategy and surgical procedure, and also adjuvant treatment with irradiation are discussed. Although the tumor is radiosensitive, it is not radiocurable.

  12. Saccharomyces cerevisiae Laryngitis and Oral Lesions in a Patient with Laryngeal Carcinoma

    Directory of Open Access Journals (Sweden)

    Jumanah N. Algazaq

    2017-01-01

    Full Text Available Saccharomyces cerevisiae is increasingly being promoted as a nutritional supplement by health food enthusiasts and is also recommended as prophylaxis against antibiotic-associated diarrhea. However, severe opportunistic infections due to S. cerevisiae have been reported in patients with chronic disease, cancer, and immunosuppression. Fungemia, endocarditis, pneumonia, peritonitis, urinary tract infections, skin infections, and esophagitis have been described. It is important to consider infections due to S. cerevisiae in appropriate clinical settings. Here, we describe the first case of S. cerevisiae laryngitis in a patient with a history of laryngeal carcinoma who also had oral lesions.

  13. [Evaluation and treatment of children's laryngeal clefts].

    Science.gov (United States)

    Chen, C; Tan, L T; Xu, Z M

    2018-01-07

    Objectives: To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC). Methods: A retrospective case study was conducted at an academic children's hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow. Results: Of 30 cases, 18 were male and 12 were female, ranging in age from birth to 8 years. Two cases were diagnosed as type 0 LC, and they were offered thickened liquid without medication. Throughout follow-up, they remained asymptomatic and showed no respiratory complications. Nineteen children were diagnosed as type Ⅰ LC. Six of them were significantly improved by anti-reflux therapy and feeding instructions. Four children were concomitant with swallowing dysfunction and/or neuromuscular disorders, and they were given a tracheotomy and routine management. Another 4 children were submitted surgical repair when routine treatment failed, and their symptoms were relieved. Five children were concomitant with larygomalacia, and their symptoms were totally ameliorated by supraglottoplasty. Three children were diagnosed as type Ⅱ LC. Two of them received surgical repair and clinically improved, and the rest one was treated by anti-reflux therapy and still under follow-up. Three children were diagnosed as type Ⅲ LC. One of them was underwent surgical repair and clinically improved. Two children were tracheotomized and treated by anti-reflux therapy. Three cases were diagnosed as type Ⅳ LC at birth and no one survived. Conclusions: Laryngeal cleft is a rare congenital anomaly manifesting with a variety of symptoms, including swallowing disorder, aspirations, dyspnea, stridor and hoarseness. Diagnosis and treatment of laryngeal

  14. Laryngeal sarcoidosis: a case report presenting transglottic involvement

    NARCIS (Netherlands)

    Broek, E.M.J.M. van den; Heijnen, B.J.; Verbist, B.M.; Sjögren, E.V.

    2013-01-01

    Isolated laryngeal sarcoidosis is a very rare disease. In most cases, it will present as a supraglottic pale edematous swelling. In our case, the patient presented with hoarseness and dyspnea during exertion. Laryngeal examination did show not only supraglottic edema but also prominent subglottic

  15. Laryngeal dysfunction after thyroid surgery: diagnostic and treatments

    OpenAIRE

    FINCK, Camille

    2006-01-01

    Vocal fold hypomobility after thyroidectomy is a frequent complication of thyroidectomy. Laryngeal nerve paresis or paralysis may present with various symptoms like dysphagia, aspiration, voice alteration or dyspnea. Are described: the normal anatomophysiology of the larynx, the symptoms of nerve trauma following thyroidectomy, techniques of thoroughfull laryngeal and voice examination, some clinical entities( unilateral recurrent nerve paralysis, bilateral recurrent nerve paralysis, superior...

  16. The Recurrent Laryngeal Nerve and Thyroid Surgery; Who to Scope ...

    African Journals Online (AJOL)

    Thyroid surgery is a common general and specialist surgical procedure. Recurrent laryngeal nerve injury during thyroid surgery, though rare, is the most feared surgical complication. Various steps and perioperative assessments can minimize recurrent laryngeal nerve injury. In this opinion article, two clinical vignettes.

  17. The Recurrent Laryngeal Nerve and Thyroid Surgery; Who to Scope ...

    African Journals Online (AJOL)

    Thyroid surgery is a common general and specialist surgical procedure. Recurrent laryngeal nerve injury during thyroid surgery, though rare, is the most feared surgical complication. Various steps and perioperative assessments can minimize recurrent laryngeal nerve injury. In this opinion article, two clinical vignettes are ...

  18. Congenital Laryngeal Cyst: A Rare Cause of Polyhydramnios

    OpenAIRE

    Hatice Tatar Aksoy; Nilda Süslü; Gamze Demirel; İstemihan Çelik; Fuat Emre Canpolat; Ömer Erdeve; Umut Akyol; Ugur Dilmen

    2013-01-01

    Congenital laryngeal cyst is a rare cause of airway obstruction that may require urgent diagnosis and treatment. We report a case of a neonate having history of polyhydramnios and severe respiratory distress at birth. A laryngeal cyst detected during intubation. The outcome of laryngoscopic treatment of the cyst was favorable.

  19. Congenital Laryngeal Cyst: A Rare Cause of Polyhydramnios

    Science.gov (United States)

    Süslü, Nilda; Demirel, Gamze; Çelik, İstemihan; Canpolat, Fuat Emre; Erdeve, Ömer; Akyol, Umut; Dilmen, Ugur

    2013-01-01

    Congenital laryngeal cyst is a rare cause of airway obstruction that may require urgent diagnosis and treatment. We report a case of a neonate having history of polyhydramnios and severe respiratory distress at birth. A laryngeal cyst detected during intubation. The outcome of laryngoscopic treatment of the cyst was favorable. PMID:24040590

  20. External laryngeal manipulation done by the laryngoscopist makes the best laryngeal view for intubation.

    Science.gov (United States)

    Ali, Mohamed Shaaban; Bakri, Mohamed Hassan; Mohamed, Hesham Ali; Shehab, Hany; Al Taher, Waleed

    2014-07-01

    External laryngeal manipulation (ELM) is used to get better laryngeal view during direct laryngoscopy. This study was designed to test the hypothesis that ELM done by the intubating anesthetist (laryngoscopist) offers the best laryngeal view for tracheal intubation. A total of 160 patients underwent different surgical procedures were included in this study. Percentage of glottic opening (POGO) score and Cormack and Lehane scale were used as outcome measures for comparison between different laryngoscopic views. Four views were described; basic laryngoscopic view and then views after ELM done by the assistant, by the laryngoscopist and finally by the assistant after the guidance from the laryngoscopist respectively. The last three views compared with the basic laryngoscopic view. ELM done by the laryngoscopist or by the assistant after guidance from the laryngoscopist showed significant improvement of Cormack grades and POGO scores compared with basic laryngoscopic view. Number of patients with Cormack grade1 increased from 39 after direct laryngoscopy to 97 and 96 patients (P < 0.001 by Fisher's exact test), after ELM done by the laryngoscopist and that done by the assistant after guidance from the anesthetist respectively. Furthermore, the number of patients with POGO scores of 100% increased from 39 after direct laryngoscopy to 78 and 61 (P < 0.01) patients after ELM done by the laryngoscopist and that done by the assistant after guidance from the anesthetist respectively. It appeared from this study that ELM done by the anesthetist makes the best laryngeal view for tracheal intubation.

  1. Evaluation of Autologous Fascia Implantation With Controlled Release of Fibroblast Growth Factor for Recurrent Laryngeal Nerve Paralysis Due to Long-term Denervation.

    Science.gov (United States)

    Nagai, Hiromi; Nishiyama, Koichiro; Seino, Yutomo; Tabata, Yasuhiko; Okamoto, Makito

    2016-06-01

    Paralyzed tissue due to long-term denervation is resistant to many treatments because it induces irreversible histological changes and disorders of deglutition or phonation. We sought to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on long-term unilateral vocal fold paralysis (UVFP). Unilateral recurrent laryngeal nerve (RLN) section was performed on 20 rats. Five rats were implanted with autologous fascia only (fascia group), and 10 rats were implanted with autologous fascia and a gelatin hydrogel sheet with 1 μg (1 μg bFGF + fascia group) or 0.1 μg (0.1 μg bFGF + fascia group) of bFGF 4 months after RLN section. We evaluated the normalized glottal gap and laryngeal volume and histological changes 3 months after implantation. The normalized glottal gap was significantly reduced in the 3 fascia implantation groups. Normalized laryngeal volume, fat volume, and lateral thyroarytenoid muscle volume were significantly increased in the 2 fascia implantation with bFGF groups. The ATFV with controlled release of bFGF repaired the glottal gap and laryngeal volume after RLN section and may reduce the occurrence of aspiration and hoarseness. We speculate that this treatment improves laryngeal function in long-term RLN denervation. © The Author(s) 2016.

  2. Aggressive laryngeal fibromatosis: A case report and brief review

    Directory of Open Access Journals (Sweden)

    Enam Murshed Khan

    2018-01-01

    Full Text Available We describe a rare case of aggressive fibromatosis of the larynx occurring in a 72-year-old man. The lesion manifested with complaints of dyspnea and stridor. A computerized tomographic scan of the neck revealed irregular polypoidal growth invading right vocal cord, crossing midline. A malignant tumor was suspected. Although several laryngoscopy-driven biopsies were negative for malignancy, total laryngectomy was done since the lesion was not deemed amenable to conservative therapy. Tissue sections featured a moderately cellular lesion composed of spindle cells with bland, elongated nuclei, enmeshed in a variably collagenized ground substance. The spindle cells were immunopositive for vimentin and negative for cytokeratins, PGP-9.5, smooth muscle antigen, CD68, desmin, and S-100 protein and Ki-67 of 4%. No further therapy was administered. Based on the available literature, our data confirm that aggressive laryngeal fibromatosis in adult patients is a locally infiltrating disease. Total laryngectomy with clear margins is needed as to avoid the high risk of local recurrence.

  3. Laryngeal Preservation in Managing Advanced Tracheal Adenoid Cystic Carcinoma

    Directory of Open Access Journals (Sweden)

    Thavakumar Subramaniam

    2015-01-01

    Full Text Available A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally.

  4. Laryngeal paralysis in dogs: An update on recent knowledge

    Directory of Open Access Journals (Sweden)

    Adriaan M. Kitshoff

    2013-04-01

    Full Text Available Laryngeal paralysis is the effect of an inability to abduct the arytenoid cartilages during inspiration, resulting in respiratory signs consistent with partial airway obstruction. The aetiology of the disease can be congenital (hereditary laryngeal paralysis or congenital polyneuropathy, or acquired (trauma, neoplasia, polyneuropathy, endocrinopathy. The most common form of acquired laryngeal paralysis (LP is typically seen in old, large breed dogs and is a clinical manifestation of a generalised peripheral polyneuropathy recently referred to as geriatric onset laryngeal paralysis polyneuropathy. Diagnosing LP based on clinical signs, breed and history has a very high sensitivity (90% and can be confirmed by laryngeal inspection. Prognosis after surgical correction depends on the aetiology: traumatic cases have a good prognosis, whereas tumour-induced or polyneuropathy-induced LP has a guarded prognosis. Acquired idiopathic LP is a slow progressive disease, with dogs reaching median survival times of 3–5 years after surgical correction.

  5. Cardiac, Skeletal, and smooth muscle mitochondrial respiration

    DEFF Research Database (Denmark)

    Park, Song-Young; Gifford, Jayson R; Andtbacka, Robert H I

    2014-01-01

    in cardiac, skeletal, and smooth muscle suggest all mitochondria are created equal, the contrasting RCR and non-phosphorylating respiration highlight the existence of intrinsic functional differences between these muscle mitochondria. This likely influences the efficiency of oxidative phosphorylation...

  6. [Recurrent laryngeal papillomatosis complicated by decompensated respiratory failure in two children].

    Science.gov (United States)

    Aurégan, C; Thierry, B; Blanchard, M; Chéron, G

    2015-11-01

    Laryngeal papillomatosis is a rare, potentially severe cause of recurrent laryngeal dyspnea. It should be known as a cause of laryngeal dyspnea resistant to the usual treatments. We report on two pediatric cases of severe laryngeal papillomatosis with respiratory distress and failure. These observations illustrate the importance of early adequate treatment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. [Comparison of sevoflurane concentration for insertion of proseal laryngeal mask airway and tracheal intubation in children (correlation with BIS)].

    Science.gov (United States)

    Mudakanagoudar, Mahantesh S; Santhosh, M C B

    2016-01-01

    Sevoflurane is an inhalational agent of choice in paediatric anaesthesia. For management of airways in children a suitable alternative to ETT is a paediatric proseal laryngeal mask airway (benchmark second generation SAD). Various studies have shown that less sevoflurane concentration is required for LMA insertion in comparison to TI. BIS is a useful monitor of depth of anaesthesia. To compare concentration of sevoflurane (end tidal and MAC value) required for proseal laryngeal mask airway insertion and tracheal intubation in correlation with BIS index. The prospective randomised single blind study was done in children between 2 and 9 years of ASA I and II and they were randomly allocated to Group P (proseal laryngeal mask airway insertion) and Group TI (tracheal intubation). No sedative premedication was given. Induction was done with 8% sevoflurane and then predetermined concentration was maintained for 10min. Airway was secured either by proseal laryngeal mask airway or endotracheal tube without using muscle relaxant. End tidal sevoflurane concentration, MAC, BIS, and other vital parameters were monitored every minute till insertion of an airway device. Insertion conditions were observed. Statistical analysis was done by Anova and Student's t test. Difference between ETLMI (2.49±0.44) and ETTI (2.81±0.65) as well as MACLMI (1.67±0.13) and MACTI (1.77±0.43) was statistically very significant, while BISLMI (49.05±10.76) and BISTI (41.25±3.25) was significant. Insertion conditions were comparable in both the groups. We can conclude that in children airway can be secured safely with proseal laryngeal mask airway using less sevoflurane concentration in comparison to tracheal intubation and this was supported by BIS index. Copyright © 2014. Publicado por Elsevier Editora Ltda.

  8. Comparison of sevoflurane concentration for insertion of proseal laryngeal mask airway and tracheal intubation in children (correlation with BIS

    Directory of Open Access Journals (Sweden)

    Mahantesh S. Mudakanagoudar

    2016-02-01

    Full Text Available BACKGROUND: Sevoflurane is an inhalational agent of choice in paediatric anaesthesia. For management of airways in children a suitable alternative to ETT is a paediatric proseal laryngeal mask airway (benchmark second generation SAD. Various studies have shown that less sevoflurane concentration is required for LMA insertion in comparison to TI. BIS is a useful monitor of depth of anaesthesia. AIMS: To compare concentration of sevoflurane (end tidal and MAC value required for proseal laryngeal mask airway insertion and tracheal intubation in correlation with BIS index. METHOD: The prospective randomised single blind study was done in children between 2 and 9 years of ASA I and II and they were randomly allocated to Group P (proseal laryngeal mask airway insertion and Group TI (tracheal intubation. No sedative premedication was given. Induction was done with 8% sevoflurane and then predetermined concentration was maintained for 10 min. Airway was secured either by proseal laryngeal mask airway or endotracheal tube without using muscle relaxant. End tidal sevoflurane concentration, MAC, BIS, and other vital parameters were monitored every minute till insertion of an airway device. Insertion conditions were observed. Statistical analysis was done by ANOVA and Students t test. RESULTS: Difference between ETLMI (2.49 ± 0.44 and ETTI (2.81 ± 0.65 as well as MACLMI (1.67 ± 0.13 and MACTI (1.77 ± 0.43 was statistically very significant, while BISLMI (49.05 ± 10.76 and BISTI (41.25 ± 3.25 was significant. Insertion conditions were comparable in both the groups. CONCLUSION: We can conclude that in children airway can be secured safely with proseal laryngeal mask airway using less sevoflurane concentration in comparison to tracheal intubation and this was supported by BIS index.

  9. Comparison of sevoflurane concentration for insertion of proseal laryngeal mask airway and tracheal intubation in children (correlation with BIS).

    Science.gov (United States)

    Mudakanagoudar, Mahantesh S; Santhosh, M C B

    2016-01-01

    Sevoflurane is an inhalational agent of choice in paediatric anaesthesia. For management of airways in children a suitable alternative to ETT is a paediatric proseal laryngeal mask airway (benchmark second generation SAD). Various studies have shown that less sevoflurane concentration is required for LMA insertion in comparison to TI. BIS is a useful monitor of depth of anaesthesia. To compare concentration of sevoflurane (end tidal and MAC value) required for proseal laryngeal mask airway insertion and tracheal intubation in correlation with BIS index. The prospective randomised single blind study was done in children between 2 and 9 years of ASA I and II and they were randomly allocated to Group P (proseal laryngeal mask airway insertion) and Group TI (tracheal intubation). No sedative premedication was given. Induction was done with 8% sevoflurane and then predetermined concentration was maintained for 10 min. Airway was secured either by proseal laryngeal mask airway or endotracheal tube without using muscle relaxant. End tidal sevoflurane concentration, MAC, BIS, and other vital parameters were monitored every minute till insertion of an airway device. Insertion conditions were observed. Statistical analysis was done by ANOVA and Students t test. Difference between ETLMI (2.49 ± 0.44) and ETTI (2.81 ± 0.65) as well as MACLMI (1.67 ± 0.13) and MACTI (1.77 ± 0.43) was statistically very significant, while BISLMI (49.05 ± 10.76) and BISTI (41.25 ± 3.25) was significant. Insertion conditions were comparable in both the groups. We can conclude that in children airway can be secured safely with proseal laryngeal mask airway using less sevoflurane concentration in comparison to tracheal intubation and this was supported by BIS index. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  10. Laryngeal sarcoidosis: a case-control study.

    Science.gov (United States)

    Duchemann, Boris; Lavolé, Armelle; Naccache, Jean-Marc; Nunes, Hilario; Benzakin, Sylvain; Lefevre, Marine; Kambouchner, Marianne; Périé, Sophie; Valeyre, Dominique; Cadranel, Jacques

    2014-10-20

    We undertook a study on a series of laryngeal sarcoidosis (LS), a very rare and often threatening localization to better specify laryngeal manifestations, sarcoidosis clinical expression and long-term follow-up. This was a retrospective case-control study. All LS patients from two French centers were included and compared to sarcoidosis patients without laryngeal localization with two controls for one patient. Twelve consecutive LS patients were recruited between 1993 and 2011. LS revealed sarcoidosis in eight cases (67%). The most common symptoms were hoarseness (77%), inspiratory dyspnea (38%) and dysphagia (38%). Epidemiological characterisics were not different. Extrapulmonary localizations were significantly more common in LS patients than in controls (92% vs. 54%, p=0.02), particularly lupus pernio (25% vs. 0%, p=0.03) and nasosinusal involvement (83% vs. 4%, p<0.01) while thoracic involvement was less frequent (58% vs 100%, p < 0.01). Treatment rates were higher in the LS group (92% vs. 58%, p=0.04), and treatment duration was longer (median: 81 vs. 13 months, p=0.04), with frequent long-term treatment (67%, N=8/12). Two patients underwent surgery. One patient needed temporary tracheostomy during the course of the disease; Remission rates were lower in LS patients (9% vs. 58% at 2 years p<0.01). Eventually, there was no death nor definitive tracheotomy. LS is a rare condition that is often associated to other loco-regional localizations. LS are often difficult to manage. Survival is good but may require a medico-surgical approach.

  11. Exchanging digital video of laryngeal examinations.

    Science.gov (United States)

    Crump, John M; Deutsch, Thomas

    2004-03-01

    Laryngeal examinations, especially stroboscopic examinations, are increasingly recorded using digital video formats on computer media, rather than using analog formats on videotape. It would be useful to share these examinations with other medical professionals in formats that would facilitate reliable and high-quality playback on a personal computer by the recipients. Unfortunately, a personal computer is not well designed for reliable presentation of artifact-free video. It is particularly important that laryngeal video play without artifacts of motion or color because these are often the characteristics of greatest clinical interest. With proper tools and procedures, and with reasonable compromises in image resolution and the duration of the examination, digital video of laryngeal examinations can be reliably exchanged. However, the tools, procedures, and formats for recording, converting to another digital format ("transcoding"), communicating, copying, and playing digital video with a personal computer are not familiar to most medical professionals. Some understanding of digital video and the tools available is required of those wanting to exchange digital video. Best results are achieved by recording to a digital format best suited for recording (such as MJPEG or DV),judiciously selecting a segment of the recording for sharing, and converting to a format suited to distribution (such as MPEG1 or MPEG2) using a medium suited to the situation (such as e-mail attachment, CD-ROM, a "clip" within a Microsoft PowerPoint presentation, or DVD-Video). If digital video is sent to a colleague, some guidance on playing files and using a PC media player is helpful.

  12. [Laryngeal tube II : alternative airway for children?].

    Science.gov (United States)

    Schalk, R; Scheller, B; Peter, N; Rosskopf, W; Byhahn, C; Zacharowski, K; Meininger, D

    2011-06-01

    Difficult airway situations both expected and unexpected, present major challenges to every anesthesiologist, especially in pediatric anesthesia. However, the integration of extraglottic airway devices, such as the laryngeal mask, into the algorithm of difficult airways has improved the handling of difficult airway situations. A device for establishing a supraglottic airway, the laryngeal tube (LT), was introduced in 1999. The LT is an extraglottic airway designed to secure a patent airway during either spontaneous breathing or controlled ventilation. The design of the device has been revised several times and a further development is the LTS II/LTS-D, which provides an additional channel for the insertion of a gastric drain tube. This article reports on the successful use of the LTS II in 12 children aged from 2 days to 6 years when endotracheal intubation, alternative mask or laryngeal mask ventilation failed. Use of the LTS II was associated with a high level of success, securing the airway when other techniques had failed. The potential advantage of the LTS II over the standard LT is an additional suction port, which allows gastric tube placement and can be used as an indirect indicator of correct placement. With a modified insertion technique using an Esmarch manoeuvre, placement was simple and fast to perform. In emergency situations when direct laryngoscopy fails or is too time-consuming the LTS II tube is recommended as an alternative device to secure the airway. As with all extraglottic airway devices, familiarity and clinical experience with the respective device and the corresponding insertion technique are essential for safe and successful use, especially in emergency situations.

  13. Esophageal stenosis after radiation for laryngeal carcinoma

    International Nuclear Information System (INIS)

    Takeuchi, Kazuhiko; Majima, Yuichi; Nomoto, Yoshito; Okamoto, Yasunori; Sakakura, Yasuo

    1995-01-01

    A 57-year-old female received radiation with 60 Gy, delivered by Cobalt 60 unit for laryngeal carcinoma in 1989. Several months later she complained of dyspnea, and fiberscopic observation revealed fixation of bilateral vocal cords and a swelling of bilateral arytenoid portions. In 1990, she developed difficulty swallowing. Further examinations showed that the cervical esophagus was extremely narrowed but no malignancy was found either in the larynx or in the esophagus. We suspected that the esophageal stenosis was caused by post-radiation fibrosis. (author)

  14. Esophageal stenosis after radiation for laryngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Kazuhiko; Majima, Yuichi; Nomoto, Yoshito; Okamoto, Yasunori; Sakakura, Yasuo [Mie Univ., Tsu (Japan). School of Medicine

    1995-10-01

    A 57-year-old female received radiation with 60 Gy, delivered by Cobalt 60 unit for laryngeal carcinoma in 1989. Several months later she complained of dyspnea, and fiberscopic observation revealed fixation of bilateral vocal cords and a swelling of bilateral arytenoid portions. In 1990, she developed difficulty swallowing. Further examinations showed that the cervical esophagus was extremely narrowed but no malignancy was found either in the larynx or in the esophagus. We suspected that the esophageal stenosis was caused by post-radiation fibrosis. (author).

  15. Two rare cases of laryngeal intralymphatic histiocytosis

    DEFF Research Database (Denmark)

    Reznitsky, Martin; Daugaard, Søren; Charabi, Birgitte Wittenborg

    2016-01-01

    We report two rare cases of intralymphatic histiocytosis causing, respectively, recurrent and persistent episodes of upper airway swelling and breathing difficulties. Case 1 was a 39-year-old man who was referred with recurrent upper airway swelling causing difficulty in breathing. A direct....... Extensive investigations were performed but discovered no abnormal findings. He received CO2 laser treatment twice and the swelling decreased. Intralymphatic histiocytosis is extremely rare in upper airway pathology. It is an important differential diagnosis in patients with recurrent and chronic laryngeal...

  16. [The effect of PSK on laryngeal cancer].

    Science.gov (United States)

    Saito, H; Hozawa, J; Kamata, S; Hakamada, M; Kasahara, M; Takagi, A

    1982-07-01

    In order to examine effects of PSK (polysaccharide Kureha) on laryngeal cancer, clinical results of 28 patients treated by PSK were compared with those of 31 of the historical control group. Three months after treatments, the PSK group showed a higher cumulative survival rate and better results in immunological parameters such as counts of peripheral lymphocyte, PPD and PHA skin reaction. However, these differences between the PSK group and the control group were not significant statistically, except peripheral leucocyte counts. The side effect was found in one patient who complained of stomach discomfort after applicating PSK.

  17. Remifentanil halves the EC50 of propofol for successful insertion of the laryngeal mask airway and laryngeal tube in pediatric patients.

    Science.gov (United States)

    Park, Hye-Jin; Lee, Jeong-Rim; Kim, Chong Sung; Kim, Seong Deok; Kim, Hee-Soo

    2007-07-01

    Propofol and remifentanil are the drugs of choice for insertion of the supraglottic airway without muscle relaxants for short duration surgery. In this study, we compared propofol concentrations required for insertion of laryngeal mask way (LMA) or laryngeal tube (LT) with and without remifentanil. We included children scheduled for surgeries lasting airway device placement was determined using Dixon's up-and-down method. The concentration of propofol for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.2 microg/mL. In patients receiving remifentanil, propofol EC50 for insertion of a LMA was 2.57 +/- 0.22 microg/mL and that of LT was 2.59 +/- 0.20 microg/mL (n.s.). In patients receiving saline, the corresponding values were 5.45 +/- 0.21 microg/mL and 5.58 +/- 0.23 microg/mL (n.s.). Conditions were excellent in 64% (9 of 14) and 79% (11 of 14) of patients receiving remifentanil, but in patients receiving saline, the values were 18% (2 of 11) for the LMA and 40.0% (4 of 10) for the LT. Remifentanil 7.5 ng/mL reduced the propofol concentration required for airway insertion by half, and improved conditions for insertion. Propofol concentrations for insertion of the LMA and LT were similar.

  18. Correction: Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-11-30

    ABSTRACT: Following the publication of our article [Inferior alveolar nerve injury with laryngeal mask airway: a case report. Journal of Medical Case Reports 2011, 5:122] it was brought to our attention that we inadvertently used the registered trademark of the Laryngeal Mask Company Limited (LMA) as the abbreviation for laryngeal mask airway. A Portex(R) Soft Seal(R) Laryngeal Mask was used and not a device manufactured by the Laryngeal Mask Company.

  19. Laryngeal adenocystic carcinoma treated by proton therapy

    International Nuclear Information System (INIS)

    Sugiyama, Tomonori; Araki, Mamika; Fukukita, Kouhei; Yamada, Hiroyuki

    2013-01-01

    Adenocystic carcinoma most commonly develops in the major salivary glands, on the other hand it is rare for adenocystic carcinoma to develop in the larynx. We report a case of adenocystic carcinoma in the larynx. A 54-year-old male was hospitalized with symptoms of hoarseness and dyspnea on exertion. He presented a tumor that developed at the base of the right arytenoid, and covered over the glottis. It was confirmed to be adenocystic carcinoma (solid type) by biopsy. Positron emission tomography (PET)-CT also revealed a left cervical lymph node metastasis and multiple pulmonary metastases (T1N2cM1). He was treated with proton therapy to the larynx to prevent airway obstruction by growth of the tumor and to preserve the larynx because he had uncontrollable pulmonary metastasis. Although the tumor vanished after the treatment, one month later he had halitosis, dyspnea and bilateral vocal cord palsy. Despite administration of an antibacterial drug and steroid, there was no improvement to the narrowness of the glottis. A tracheotomy was therefore performed three months after the proton therapy. PET-CT, which was performed after the tracheotomy, suggested growth of the residual tumor or laryngeal radionecrosis. This study confirmed that proton therapy is effective for adenocystic carcinoma in the larynx. However, proton therapy also was found to cause laryngeal radionecrosis. These results indicate the importance of evaluating the side effects of radiation therapy and providing that information to the patient. (author)

  20. Laryngeal cancer in acquired immunodeficiency syndrome.

    Science.gov (United States)

    Shushan, S; Cinamon, U; Levy, D; Sokolov, M; Roth, Y

    2009-08-01

    With improved survival, more AIDS patients, especially heavy smokers and alcohol abusers, may be confronted with laryngeal squamous cell carcinoma. Since curative treatment may require aggressive combined therapy, these patients, often suffering from immunosupression and poor general condition, present unique therapeutic challenges. The objective of the study was to describe treatment dilemmas. This case report presents a detailed description of an AIDS patient with carcinoma of the larynx. A patient with T3N0M0 laryngeal carcinoma and AIDS underwent tracheotomy and biopsy, followed by severe neck and pulmonary infection. After convalescence, radiotherapy was administered, with no evidence of a disease during a 3.5-year follow-up. During his remaining life, the patient developed severe psychoaffective disorder, his immune state deteriorated until he demised from sepsis. In conclusion, patients with HIV infection, especially having a history of tobacco or alcohol abuse, should be carefully examined for head and neck carcinoma that is likely to be more aggressive. Following surgery, AIDS patients may have worse wound healing and a greater tendency to contract infections. Radiotherapy and especially chemotherapy may cause life-threatening complications. Although early detection may increase survival, curative treatment should involve many disciplines and extra caution.

  1. Laryngeal complications by orotracheal intubation: Literature review

    Directory of Open Access Journals (Sweden)

    Mota, Luiz Alberto Alves

    2012-01-01

    Full Text Available Introduction: The injuries caused for the orotracheal intubation are common in our way and widely told by literature. Generally the pipe rank of or consequence of its permanence in the aerial ways of the patient is caused by accidents in. It has diverse types of larynx injuries, caused for multiple mechanisms. Objective: To verify, in literature, the main causes of laryngeal complications after- orotracheal intubation and its mechanisms of injury. Revision of Literature: The searched databases had been LILACS, BIREME and SCIELO. Were updated, books and theses had been used, delimiting itself the period enters 1953 the 2009. The keywords used for the search of articles had been: complications, injuries, larynx, intubation, endotracheal, orotracheal, granulomas, stenosis. 59 references had been selected. The used criteria of inclusion for the choice of articles had been the ones that had shown to the diverse types of injuries caused for the orotracheal intubation and its pathophysiology. Final Considerations: This revision of literature was motivated by the comment in the practical clinic of a great number of laryngeal sequels in patients submitted to the orotracheal intubation. Of that is ahead important the knowledge, for the professionals of the area of health, the types of complications and its causes, with intention to prevent them, adopting measured of prevention of these injuries.

  2. Phonation threshold flow in elongated excised larynges.

    Science.gov (United States)

    Jiang, Jack J; Regner, Michael F; Tao, Chao; Pauls, Steven

    2008-07-01

    This study proposes the use of a new parameter of vocal aerodynamics, phonation threshold flow (PTF). The sensitivities of the PTF and the phonation threshold pressure (PTP) were quantitatively compared to the percent of vocal fold elongation from physiologic length. Ten excised canine larynges were mounted on a bench apparatus capable of controlling vocal fold elongation. Subglottal airflow was gradually increased until the onset of phonation. Elongation of the vocal folds was varied from +0% (physiologic length) to +15%, and the PTF and PTP were measured. The mean PTFs at physiologic vocal fold length ranged from 101 to 217 mL/s. No statistically significant relationship was found to exist between the size of the larynx and the measured PTF values (p = .404). The average percent change of PTF compared to the magnitude of elongation was found to be statistically significant (p < .001). The data indicated that the PTF was proportional to the percent of vocal fold elongation. The PTF was positively correlated with vocal fold elongation and the PTP for small magnitudes of elongation. The results suggest that the PTF may be indicative of the biomechanical properties of the vocal folds, thus providing a possibly valuable tool in the clinical evaluation of laryngeal function.

  3. Endoscopic laryngeal web formation for pitch elevation.

    Science.gov (United States)

    Anderson, Jennifer

    2007-02-01

    Endoscopic laryngeal web formation has been used to elevate the speaking voice, primarily in male to female transsexuals as part of gender reassignment intervention. The goal of this article is to review the literature regarding surgical treatment for pitch elevation and to describe a novel method of laryngeal web formation. The results of this technique are also reported in a series of six patients. All patients were assessed and treated at the St. Michael's Hospital Voice Disorders Clinic, a tertiary referral centre for voice disorders. Pre- and postoperative voice recordings, acoustic analysis, and videostroboscopic examinations were performed in this series. The acoustic data collected included isolated vowel samples, a reading task, and a modified voice range profile. The patients all underwent successful endoscopic web formation with a Gelfoam augmentation technique. The voice results collected at least 6 months after vocal fold web formation demonstrate a dramatic increase in the habitual speaking fundamental frequency. This new modification for endoscopic web formation has been shown to be a successful procedure for permanent elevation of pitch with little or no morbidity.

  4. Expression of Podoplanin in Laryngeal Squamous Cell Carcinoma and Dysplasia.

    Science.gov (United States)

    Ibrahim, Badawia Bayoumy; Salem, Mostafa Mohamed; Khairy, Rasha Ahmed; Al Gunaid, Reema Abdul Rahman

    2017-05-01

    In human cancers, podoplanin expression and its correlation with tumour invasive potential raise its possible role as a diagnostic and prognostic marker for cancer. To investigate the immunohistochemical expression of podoplanin in laryngeal Squamous Cell Carcinoma (SCC) and dysplasia. This study included a total of 60 archived, formalin fixed, paraffin embedded tissue blocks of 40 cases of laryngeal SCC and 20 cases of dysplastic lesions. The samples were immunohistochemically analysed for podoplanin expression. Podoplanin expression was significantly higher in laryngeal SCC (90%) than laryngeal dysplastic lesions (55%) (p-value=0.002). The expression of podoplanin was significantly increased with the higher grades of dysplasia (p-value=0.016). A significant positive correlation was detected between podoplanin expression in laryngeal SCC and depth of tumour invasion (p-value=0.035), and stage (p-value=0.026). The high expression of podoplanin in laryngeal SCC and its significant correlation with poor prognostic parameters recommends podoplanin as a prognostic marker in laryngeal SCC. In addition, increased podoplanin expression with higher grades of dysplasia, supports its role in malignant transformation and allows us to recommend its evaluation in premalignant lesions.

  5. Laryngeal Cysts in Adults: Simplifying Classification and Management.

    Science.gov (United States)

    Heyes, Richard; Lott, David G

    2017-12-01

    Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Data Sources PubMed/Medline. Review Methods A primary literature search of the entire Medline database was performed for all titles of publications pertaining to laryngeal cysts and reviewed for relevance. Full manuscripts were reviewed per the relevance of their titles and abstracts, and selection into this review was according to their clinical and scientific relevance. Conclusion Laryngeal cysts have been associated with rapid-onset epiglottitis, dyspnea, stridor, and death; therefore, they should not be considered of little significance. Symptoms are varied and nonspecific. Laryngoscopy is the primary initial diagnostic tool. Cross-sectional imaging may be required, and future use of endolaryngeal ultrasound and optical coherence tomography may revolutionize practice. Where possible, cysts should be completely excised, and there is growing evidence that a transoral approach is superior to transcervical excision for nearly all cysts. Histology provides definitive diagnosis, and oncocytic cysts require close follow-up. Implications for Practice A new classification system is proposed that increases clarity in terminology, with the aim of better preparing surgeons and authors for future advances in the understanding and management of laryngeal cysts.

  6. Association Between Laryngeal Cancer and Asbestos Exposure: A Systematic Review.

    Science.gov (United States)

    Ferster, Ashley P O'Connell; Schubart, Jane; Kim, Yesul; Goldenberg, David

    2017-04-01

    It has been debated whether a link exists between laryngeal cancer and asbestos exposure. Prior systematic reviews have been conducted on this topic, but no updates have been performed on the most recent literature since 2000. To provide an updated systematic review of the association between laryngeal cancer and asbestos exposure. A search of electronic databases, including PubMed and the Cochrane Library, was performed for articles published between January 1, 2000, and April 30, 2016. Search terms, including laryngeal cancer and asbestos, were used to identify publications reviewing the risk of laryngeal cancer in association with asbestos exposure. Studies analyzing this association that were published in any language and translated reliably were included. Two independent reviewers assessed articles based on predetermined eligibility criteria. Each study was reviewed for quality using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence and assessed for their findings of support for or against a correlation between asbestos exposure and laryngeal cancer. A total of 160 studies were retrieved from all databases, and 2 additional articles were identified by cross-references. Of the 162 articles screened, 15 articles comprising 438 376 study participants were included in this review. Of these 15 studies, 10 showed no correlation between asbestos exposure and laryngeal cancer. The remaining 5 studies claimed a correlation between asbestos exposure and incidence of laryngeal cancer, although only 1 accounted for smoking or alcohol exposure while 3 others did not, and 1 study included only 2 patients. Although asbestos is considered hazardous and carcinogenic, current evidence is lacking to support a correlation between asbestos exposure and laryngeal cancer. Few studies have been able to definitively conclude a causal association between asbestos exposure and laryngeal cancer, and those that found an association often did not account for the

  7. Laryngeal sarcoidosis: a case report presenting transglottic involvement.

    Science.gov (United States)

    van den Broek, Emke M J M; Heijnen, Bas J; Verbist, Berit M; Sjögren, Elisabeth V

    2013-09-01

    Isolated laryngeal sarcoidosis is a very rare disease. In most cases, it will present as a supraglottic pale edematous swelling. In our case, the patient presented with hoarseness and dyspnea during exertion. Laryngeal examination did show not only supraglottic edema but also prominent subglottic swelling and edematous true vocal folds. Histology showed noncaseating granulomas. After excluding other causes and localizations, the patient was diagnosed with laryngeal sarcoidosis and treated with systemic corticosteroid with good result. We describe our case of isolated transglottic sarcoidosis and discuss the disease, its presentation, diagnosis, and therapeutic options. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  8. [A case of laryngeal papilloma with sudden dyspnea].

    Science.gov (United States)

    Pabiszczak, Maciej; Wierzbicka, Małgorzata; Borucki, Lukasz; Iwanik, Katarzyna

    2005-01-01

    Laryngeal papilloma is one of the most common non-malignant tumors of the larynx. In adult they are included to pre-cancerous diseases. In morphological examination, it is a solid tumor. Often it is possible to cure them during one surgical procedure. The disease is mostly localized on the anterior commissurae region, vocal fold, ventricules, and on the laryngeal surface of the epiglottis. If the malignant transformation is suspected, a large excision with margin has to be performed, completed by a histological evaluation. A case of a huge laryngeal papilloma with dyspnea is presented.

  9. [Simultaneous pulmonar, laryngeal and lingual affectation by Mycobacterium tuberculosis].

    Science.gov (United States)

    Díaz Manzano, J A; Castillo Romero, J L; Padilla Romero, M J; Sánchez Laínez, J J; Castillo Aguilar, C; Cegarra Navarro, M F

    2007-01-01

    The incidence of tuberculosis has lately increased in developed countries. The most frequent affectation is the pulmonar one and in the ORL area the laryngeal. The lingual affectation is exceptional. We present a case of a man 39 years old, with bilateral pulmonar, left vocal cord and mobile tongue affectation, negative Mantoux, positive spit culture and presence of acido-alcohol resistent bacillus in lingual and laryngeal biopsies. After antituberculosis treatment during 6 months the laryngeal and lingual lesions disappeared. We have only found two cases published of simultaneous tuberculosis in these three localisations in the last 30 years.

  10. 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.

  11. Laryngeal necrosis after combined chemotherapy and radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Miyaguchi, Mamoru; Kubo, Takeshi [Osaka Univ., Suita (Japan). School of Medicine; Takashima, Hitoshi [Kagawa Medical School (Japan)

    1997-08-01

    Post-radiation necrosis of the larynx is a major complication after irradiation and has become rare. Recently, combined chemotherapy and radiation therapy has been introduced for head and neck tumours. The authors report a case of laryngeal necrosis after combination therapy for a patient with cervical lymph node metastases of nasopharyngeal carcinoma and review the literature on late laryngeal necrosis. Although radiation-induced laryngeal necrosis has become a rare complication, the combination of chemotherapy and radiation therapy may increase its incidence. (author).

  12. Neurophysiology and Clinical Implications of the Laryngeal Adductor Reflex.

    Science.gov (United States)

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

    2013-09-01

    The laryngeal adductor reflex (LAR) is an involuntary protective response to stimuli in the larynx. The superior laryngeal nerve (SLN) acts as the afferent limb and the recurrent laryngeal nerve (RLN) as the efferent limb of this reflex, which is modulated by the central nervous system. Perhaps the most clinically significant application of the LAR is its use in laryngopharyngeal (LP) sensory discrimination testing. Importantly, aberrations in the LAR may predict dysphagia or portend clinical phenotypes of chronic cough, vocal cord dysfunction or pediatric apneas. LP sensation is a potential target for interventions addressing the aforementioned conditions though currently remains an area of active investigation.

  13. [Comparison of efficacy for laryngeal mask airway-Supreme(TM) versus common laryngeal mask airway in children].

    Science.gov (United States)

    Shangguan, Wang-ning; You, Shan; He, Wei; DI, Mei-qin; Xu, Jian; Li, Jun; Lian, Qing-quan

    2013-11-19

    To compare the efficacy of laryngeal mask airway-Supreme(TM) versus common laryngeal mask airway in children with general anesthesia. With local research ethics committee's approval and written informed parental consent, 100 children were randomly divided into groups L (size 2.0 common laryngeal mask airway) and S (size 2.0 laryngeal mask airway-Supreme(TM)) according to random number (n = 50 each). After anesthesia induction, a common laryngeal mask airway or laryngeal mask airway-Supreme(TM) was inserted and mechanically ventilated. Time and ease for insertion, insertion success rate, airway leak pressure, success rate and ease of disposal sputum collecting tube insertion in group S, quality of airway during anesthetic maintenance, abdominal circumference changes and complications within 24 h post-operation were measured. Compared with group L, abdominal circumference increased less in group S (0.90 ± 0.35 vs 0.43 ± 0.18 cm, n = 46, P children with mechanical ventilation, laryngeal mask airway-Supreme(TM) can be effectively applied to maintain a good airway. And the incidence of gastric insufflation is lower. It is particularly useful for those requiring evacuation of gastric contents during general anesthesia.

  14. hemangiomes larynges de l'adulte a propos de 9 cas adult laryngeal ...

    African Journals Online (AJOL)

    16 juin 2006 ... pique, avec hémostase locale. Deux récidives ont été notées, pour lesquels une seconde exérèse instrumentale par voie endoscopique a été réalisée avec une évolution favorable. Le recul moyen était de 9 ans. SUMMARY. The adult laryngeal hemangioma is extremely rare and presents histological and ...

  15. External laryngeal manipulation done by the laryngoscopist makes the best laryngeal view for intubation

    Directory of Open Access Journals (Sweden)

    Mohamed Shaaban Ali

    2014-01-01

    Full Text Available Purpose: External laryngeal manipulation (ELM is used to get better laryngeal view during direct laryngoscopy. This study was designed to test the hypothesis that ELM done by the intubating anesthetist (laryngoscopist offers the best laryngeal view for tracheal intubation. Materials and method: A total of 160 patients underwent different surgical procedures were included in this study. Percentage of glottic opening (POGO score and Cormack and Lehane scale were used as outcome measures for comparison between different laryngoscopic views. Four views were described; basic laryngoscopic view and then views after ELM done by the assistant, by the laryngoscopist and finally by the assistant after the guidance from the laryngoscopist respectively. The last three views compared with the basic laryngoscopic view. Results: ELM done by the laryngoscopist or by the assistant after guidance from the laryngoscopist showed significant improvement of Cormack grades and POGO scores compared with basic laryngoscopic view. Number of patients with Cormack grade1 increased from 39 after direct laryngoscopy to 97 and 96 patients (P < 0.001 by Fisher′s exact test, after ELM done by the laryngoscopist and that done by the assistant after guidance from the anesthetist respectively. Furthermore, the number of patients with POGO scores of 100% increased from 39 after direct laryngoscopy to 78 and 61 (P < 0.01 patients after ELM done by the laryngoscopist and that done by the assistant after guidance from the anesthetist respectively. Conclusion: It appeared from this study that ELM done by the anesthetist makes the best laryngeal view for tracheal intubation.

  16. Inducible Laryngeal Obstruction: Excessive Dynamic Airway Collapse vs. Inducible Laryngeal Obstruction

    Science.gov (United States)

    2017-10-20

    closure with inspiratory wheezing • Can be exercise induced and believed to occur in up to 10% of incorrectly diagnosed cases of asthma Case Past...observed in COPD, bronchiectasis and asthma • Inducible laryngeal obstruction (ILO), previously called ’vocal cord dysfunction,’ describes vocal cord...Iraq • Non-reactive methacboline challenge with 9".4 reduced FEVI • Exercise laryngoscopy found ILONCD by ENf • \\bcal cord relaxation training

  17. Elementary School Teachers' Vocal Dose: Muscle Bioenergetics and Training Implications

    Science.gov (United States)

    Smith, Audrey G.; Sandage, Mary J.; Pascoe, David D.; Plexico, Laura W.; Lima, Italo R.; Cao, Guanqun

    2017-01-01

    Purpose: Translating exercise-science methodology for determination of muscle bioenergetics, we hypothesized that the temporal voice-use patterns for classroom and music teachers would indicate a reliance on the immediate energy system for laryngeal skeletal-muscle metabolism. It was hypothesized that the music-teacher group would produce longer…

  18. Laryngeal spasm after general anaesthesia due to Ascaris Lumbricoides

    OpenAIRE

    Finsnes, K D

    2013-01-01

    Postoperative upper airway obstruction during recovery from general anaesthesia may have several causes. This is a report of a young girl who developed laryngeal spasm as a result of an ectopic roundworm Ascaris lumbricoides.

  19. Risk factors for recurrent laryngeal nerve neuropraxia postthyroidectomy.

    LENUS (Irish Health Repository)

    Sheahan, Patrick

    2012-06-01

    Despite preservation of the recurrent laryngeal nerve (RLN), transient vocal cord paralysis (VCP) occurs after 1.2% to 10.9% of thyroidectomies. The objective of this study was to study risk factors for transient VCP after thyroidectomy.

  20. Undiagnosed Maternal HPV Infection Causing Postnatal Recurrent Laryngeal Papillomatosis

    Directory of Open Access Journals (Sweden)

    Mehmet Coşkun Salman

    2008-08-01

    Here, a woman with undiagnosed genital HPV infection who transmitted infection to her infant is reported. Infection of infant caused recurrent laryngeal papillomatosis which necessitated repeated surgical procedures.

  1. Expression of TGF-β1 and CTGF Is Associated with Fibrosis of Denervated Sternocleidomastoid Muscles in Mice.

    Science.gov (United States)

    Liu, Fei; Tang, Weifang; Chen, Donghui; Li, Meng; Gao, Yinna; Zheng, Hongliang; Chen, Shicai

    2016-01-01

    Injury to the recurrent laryngeal nerve often leads to permanent vocal cord paralysis, which has a significant negative impact on the quality of life. Long-term denervation can induce laryngeal muscle fibrosis, which obstructs the muscle recovery after laryngeal reinnervation. However, the mechanisms of fibrosis remain unclear. In this study, we aimed to analyze the changes in the expression of fibrosis-related factors, including transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), and α-smooth muscle actin (α-SMA) in denervated skeletal muscles using a mouse model of accessory nerve transection. Because of the small size, we used sternocleidomastoid muscles instead of laryngeal muscles for denervation experiments. Masson's trichrome staining showed that the grade of atrophy and fibrosis of muscles became more severe with time, but showed a plateau at 4 weeks after denervation, followed by a slow decrease. Quantitative assessment and immunohistochemistry showed that TGF-β1 expression peaked at 1 week after denervation (p muscle cells were detected at 1 week after denervation, peaked at 2 weeks (p muscle fibrosis. They may induce the differentiation of myoblasts into myofibroblasts, as characterized by the activation of α-SMA. These findings may provide insights on key pathological processes in denervated skeletal muscle fibrosis and develop novel therapeutic strategies.

  2. Radical radiotherapy for T3 laryngeal cancers

    Energy Technology Data Exchange (ETDEWEB)

    Uno, T. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Itami, J. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Kotaka, K. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Toriyama, M. [International Medical Center of Japan, Tokyo (Japan). Dept. of Otolaryngology

    1996-08-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [Deutsch] Von 1974 bis 1992 wurden 37 zuvor nicht behandelte Patienten mit T3-Larynxkarzinomen (15 supraglottisch, 22 glottisch) primaer kurativ bestrahlt und, wenn erforderlich, einer Salvage-Operation unterzogen. Die Zwei-Jahres-Kontrollrate bei alleiniger Strahlentherapie, die Rate der Stimmerhaltung sowie die unter Einschluss der Operation erreichbare lokale Kontrollrate bei supraglottischen T3-Larynxkarzinomen betrugen 33%, 33% und 60%. Bei glottischen T3-Karzinomen wurden jeweils 32%, 23% und 77% erreicht. Die Fuenf-Jahres-Ueberlebensrate betrug 47% bei supraglottischen T3-Karzinomen und 77% bei den glottischen Karzinomen. Im Fall von supraglottischen Karzinomen erreichte keiner der vier Patienten mit subglottischer Tumorausdehnung eine lokale Kontrolle durch alleinige Strahlentherapie. Die lokoregionale rezidivfreie Zeit war bei den Patienten mit subglottischer Tumorausdehnung oder Tracheostomie vor Einleitung der

  3. Laryngeal Adenoid Cystic Carcinoma: A Systematic Review.

    Science.gov (United States)

    Marchiano, Emily; Chin, Oliver Y; Fang, Christina H; Park, Richard Chan; Baredes, Soly; Eloy, Jean Anderson

    2016-03-01

    Adenoid cystic carcinoma is a malignant minor salivary gland tumor that represents laryngeal tumors. The submucosal location of laryngeal adenoid cystic carcinoma (LACC) results in delayed presentation. Here, we present the first systematic review of reported cases of LACC to determine trends in presentation, diagnostic and treatment modalities, and patient outcome. PubMed, Web of Science, MEDLINE, and EMBASE databases. A search of the above databases was done to identify articles reporting cases of LACC. The variables included in the analysis were patient demographics, presenting symptoms, tumor location, imaging, treatment, follow-up time, recurrence, and outcome. A total of 50 articles and 120 cases were included in the review. The most common presenting symptom was dyspnea (48.8%), followed by hoarseness (43.9%). LACC arose most frequently from the subglottis (56.7%). At presentation, 14.6% (13 of 89) of patients had regional disease. The average follow-up time was 54.0 months. At follow-up, distant metastasis was reported in 30 cases (33.3%). Surgery alone (43.3%) and surgery with radiotherapy (43.3%) were used most frequently and resulted in 57.1% and 55.3% of patients alive with no evidence disease at follow-up, respectively. LACC was most often located in the subglottis. Patients commonly presented with dyspnea and hoarseness. In this systematic review, surgery with radiotherapy and surgery alone were the most commonly employed treatment modalities, and both resulted in slightly more than 50% of patients alive with no evidence of disease at follow-up. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  4. Electroconvulsive Therapy Under General Anesthesia With Cisatracurium, Laryngeal Mask Airways, and Bispectral Index.

    Science.gov (United States)

    Liu, Cai-Cai; Qian, Xiao-Yan; An, Jian-Xiong; Yu, Zeng-Lei; Wu, Jian-Ping; Wen, Hui; Cao, Zong-Xin; Wang, Yong; Fang, Qi-Wu; Williams, John P

    2016-03-01

    Electroconvulsive therapy (ECT) has dramatically reduced musculoskeletal complications when carried out with muscle relaxants under general anesthesia. However, seizure quality can be affected by the depth of anesthesia and choice of anesthetic agent. The purpose of this study was to describe a general anesthetic technique for ECT by using laryngeal mask, bispectral index (BIS), and muscle relaxant monitoring. Twenty-one patients, between ages 18 and 70 years (American Society of Anesthesiologists physical status I-III), who underwent a total of 89 sessions of ECT were examined in a retrospective study. Anesthesia was induced by use of propofol (1.0 mg/kg) followed by cisatracurium (0.2 mg/kg). The BIS, train-of-four, and end-tidal carbon dioxide were all monitored continuously. A laryngeal mask airway was used to maintain and protect the airway during the procedure. Electroconvulsive therapy stimuli were applied bilaterally when the train-of-four was assessed as being zero and BIS scores were 70. All patients then received 5 μg sufentanil and 2 mg midazolam, while titrated to maintain the BIS value at 40 to 50, before the muscle relaxation exhibited complete recovery. The mean duration of treatment process takes approximately 82.5 minutes. Mean (SD) seizure length was 58.8 (28.3) seconds, with 4.5% incidence of restimulation per treatment. Incidence of awareness was 0%. No patients exhibited delirium, nausea, vomiting, or myalgia in the postseizure phase. Bispectral index monitoring of the depth of anesthesia may have improved seizure quality, and awareness did not occur.

  5. Predicting Intrinsic Motivation

    Science.gov (United States)

    Martens, Rob; Kirschner, Paul A.

    2004-01-01

    Intrinsic motivation can be predicted from participants' perceptions of the social environment and the task environment (Ryan & Deci, 2000)in terms of control, relatedness and competence. To determine the degree of independence of these factors 251 students in higher vocational education (physiotherapy and hotel management) indicated the…

  6. Laryngeal Dysfunction: Assessment and Management for the Clinician.

    Science.gov (United States)

    Hull, James H; Backer, Vibeke; Gibson, Peter G; Fowler, Stephen J

    2016-11-01

    The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation. In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute to the development of symptoms that appear "refractory" to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g., inducible laryngeal obstruction), voice disturbance, and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward, however, and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some time. This review provides an overview of the current state of knowledge in the field of laryngeal dysfunction, with a focus on pragmatic clinical assessment and management.

  7. 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.

  8. Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy.

    Science.gov (United States)

    Maruo, Takashi; Fujimoto, Yasushi; Ozawa, Kikuko; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Nakashima, Tsutomu

    2014-08-01

    The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained.

  9. [Usefulness and limitation of crico-pharyngeal myotomy and laryngeal suspension after wide resection of the tongue or oropharynx].

    Science.gov (United States)

    Fujimoto, Y; Hasegawa, Y; Nakayama, B; Matsuura, H

    1998-03-01

    To prevent post-surgical dysphagia in oral or oropharyngeal cancer patients, crico-pharyngeal myotomy and laryngeal suspension are recommended; however, its indication has been controversial. When it was though that patients would lose the mechanisms of laryngeal elevation or mechanisms to produce oropharyngeal pressure we opted for crico-pharyngeal myotomy and laryngeal suspension: total or subtotal glossectomy with bilateral resection of suprahyoid muscles, and wide resection of the oropharynx including the tongue base. In this paper, we report the usefulness and limitation of crico-pharyngeal myotomy and laryngeal suspension after wide resection of the tongue or oropharynx. From April 1992 to January 1996, 19 patients received circo-pharyngeal myotomys and laryngeal suspensions along with their initial operation for oral or oropharyngeal cancer. Their ages ranged from 28 to 69 years. Fourteen had tongue cancer and 5 had oropharyngeal cancer. We examined the relationship between the ability to have an oral diet and the extent of mobile tongue resection, extent of tongue base resection, and extent of resection of the lateral wall of the oropharynx, reconstruction method, and age. Fifteen of the 19 patients (68%) could have an oral diet when they were discharged. The extent of tongue base resection (more than 50%) and age (> or = 60) significantly affected post-surgical aspiration. Two patients who had total glossectomy with total tongue base resection could have an oral diet. They were 41 and 51 years old. One 35-year-old patient who had total glossectomy with wide tongue base resection (80%) was able to have the same diet as his family. On the other hand, 4 elderly patients (> or = 60) who had wide resection of the tongue base (> or = 50%) could not have an oral diet at all. A crico-pharyngeal myotomy and a laryngeal suspension can contribute to the prevention of post-surgical dysphagia. However, if an elderly patient (> or = 60) has had wide tongue base

  10. Parathyroid, Thyroid and Recurrent Laryngeal Nerve Anatomy in an Indian Rhinoceros (Rhinoceros unicornis).

    Science.gov (United States)

    Udelsman, R; Citino, S B; Prasad, M; Donovan, P I; Fredholm, D V

    2018-02-01

    The parathyroid gland was first identified in the Indian rhinoceros in 1849 by Sir Richard Owen. We performed a necropsy in an Indian rhinoceros, recapitulating Owen's dissection and display what appear to be the initial identification of the recurrent laryngeal nerve in situ and the anatomy and histology of the largest rhinoceros parathyroid glands yet identified. Patrick T. Rhino, a 41-year-old Indian rhinoceros was born in 1974. His early years were unremarkable. In 2006, he was donated to White Oak Conservation in Yulee, Florida, where he bred and sustained minor injuries. In his geriatric years, he developed a cataract and degenerative joint disease (DJD). At age 41, he developed progressive ataxia and lameness and was euthanized to minimize suffering when he was unable to stand. ROS, FH, SH and medication history were unremarkable. Physical exam was age and species appropriate. Pre-mortem serum demonstrated: creat 1.8 mg/dL (0.8-2.1), calcium 10.6 mg/dL (9.7-13.1), phos 3.8 mg/dL (2.5-6.7), alk phos 69 U/L (26-158) and intact PTH 44.1 pg/mL (rhinoceros reference range: unknown). Necropsy revealed intervertebral DJD with thoracic spondylosis, which combined with osteoporosis, resulted in thoracic myelopathy and ataxia. The neck block was sent in formalin to the Yale University School of Medicine. Detailed dissection was performed under loupe magnification. Presumed structures were photographed in situ and biopsied. The thyroid was identified deep to the strap muscles, received its blood supply from the inferior and superior thyroid arteries and was blue in color. The right recurrent laryngeal nerve, identified and photographed in situ for the first time in the rhinoceros, was deep to the inferior thyroid artery and was traced throughout its cervical course. Single parathyroid glands identified on the lateral thyroid lobes received their blood supply from the inferior thyroid arteries and were confirmed histologically. They appear to be the largest

  11. Eletromiografia laríngea e análise vocal em pacientes com Mal de Parkinson: estudo comparativo Laryngeal electromyography and acoustic voice analysis in Parkinson's disease: a comparative study

    Directory of Open Access Journals (Sweden)

    Ana Paula Zarzur

    2010-02-01

    . RESULTS: The main electromyographic pattern observed in the PD group was rest hypertonicity meaning that patients with PD presented with spontaneous intrinsic laryngeal muscle activity during voice rest, which occurred in 73% of the individuals. Not a case of laryngeal tremor was detected by electromyography, although vocal tremor was detected by VOXMETRIA in 69.5% of the individuals and in 61% of them by perceptive-auditive analysis. CONCLUSION: Vocal tremor was the main acoustic change in the PD group, with no correlation to LEMG findings.

  12. Intrinsic and Extrinsic Motivation

    OpenAIRE

    Roland Bénabou; Jean Tirole

    2003-01-01

    A central tenet of economics is that individuals respond to incentives. For psychologists and sociologists, in contrast, rewards and punishments are often counterproductive, because they undermine "intrinsic motivation". We reconcile these two views, showing how performance incentives offered by an informed principal (manager, teacher, parent) can adversely impact an agent's (worker, child) perception of the task, or of his own abilities. Incentives are then only weak reinforcers in the short...

  13. Evaluating Post-Radiotherapy Laryngeal Function with Laryngeal Videostroboscopy in Early Stage Glottic Cancer

    Directory of Open Access Journals (Sweden)

    Ariel E. Marciscano

    2017-06-01

    Full Text Available ObjectiveDysphonia is common among patients with early stage glottic cancer. Laryngeal videostroboscopy (LVS has not been routinely used to assess post-radiotherapy (RT voice changes. We hypothesized that LVS would demonstrate improvement in laryngeal function after definitive RT for early-stage glottic cancer.Study designBlinded retrospective review of perceptual voice and stroboscopic parameters for patients with early glottic cancer and controls.SettingHigh-volume, single-institution academic medical center.Subjects and methodsFifteen patients underwent RT for Tis-T2N0M0 glottic cancer and were evaluated with serial LVS exams pre- and post-RT. Stroboscopic assessment included six parameters: vocal fold (VF vibration, VF mobility, erythema/edema, supraglottic compression, glottic closure, and secretions. Grade, roughness, breathiness, asthenia, strain (GRBAS voice perceptual scale was graded in tandem with LVS score. Assessments were grouped by time interval from RT: pre-RT, 0–4, 4–12, and >12 months post-RT.Results60 LVS exams and corresponding GRBAS assessments were reviewed. There were significant improvements in ipsilateral VF motion (P = 0.03 and vibration (P = 0.001 and significant worsening in contralateral VF motion (P < 0.001 and vibration (P = 0.008 at >12 months post-RT. Glottic closure significantly worsened, most prominent >12 months post-RT (P = 0.01. Composite GRBAS scores were significantly improved across all post-RT intervals.ConclusionLVS proved to be a robust tool for assessing pre- and post-RT laryngeal function. We observed post-RT improvement in ipsilateral VF function, a decline in contralateral VF function, and decreased glottic closure. These results demonstrate that LVS can detect meaningful changes in VF and glottic function and support its use for post-RT evaluation of glottic cancer patients.

  14. Long-term follow-up after surgery in localized laryngeal amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Aldert J. C.; Hazenberg, Bouke P. C.; Dikkers, Frederik G.

    2016-01-01

    To study effectiveness of surgery and watchful waiting in localized laryngeal amyloidosis, retrospective case series. This retrospective study comprises all consecutive patients with localized laryngeal amyloidosis surgically treated in a tertiary hospital between 1994 and February 2016. Recurrence

  15. Long-term follow-up after surgery in localized laryngeal amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Aldert J. C.; Hazenberg, Bouke P. C.; Dikkers, Frederik G.

    To study effectiveness of surgery and watchful waiting in localized laryngeal amyloidosis, retrospective case series. This retrospective study comprises all consecutive patients with localized laryngeal amyloidosis surgically treated in a tertiary hospital between 1994 and February 2016. Recurrence

  16. Pulmonary and laryngeal tuberculosis in a 25-weeks' gestation parturient, diagnosed after failed tracheal intubation.

    Science.gov (United States)

    Geier, J; Orlando, B

    2018-02-01

    A pregnant woman at 25weeks of gestation was diagnosed with laryngeal tuberculosis following a failed intubation for upper gastrointestinal endoscopy. Laryngeal tuberculosis represents approximately 1% of all cases of tuberculosis in the United States and presents a unique diagnostic challenge, because accompanying laryngeal changes are both varied and nonspecific. This report highlights both the challenges of the pregnant airway and the diagnosis and treatment of laryngeal tuberculosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Intrinsic and extrinsic mortality reunited

    DEFF Research Database (Denmark)

    Koopman, Jacob J E; Wensink, Maarten J; Rozing, Maarten P

    2015-01-01

    Intrinsic and extrinsic mortality are often separated in order to understand and measure aging. Intrinsic mortality is assumed to be a result of aging and to increase over age, whereas extrinsic mortality is assumed to be a result of environmental hazards and be constant over age. However......, allegedly intrinsic and extrinsic mortality have an exponentially increasing age pattern in common. Theories of aging assert that a combination of intrinsic and extrinsic stressors underlies the increasing risk of death. Epidemiological and biological data support that the control of intrinsic as well...... as extrinsic stressors can alleviate the aging process. We argue that aging and death can be better explained by the interaction of intrinsic and extrinsic stressors than by classifying mortality itself as being either intrinsic or extrinsic. Recognition of the tight interaction between intrinsic and extrinsic...

  18. Comparison of the laryngeal mask (LMA) and laryngeal tube (LT) with the perilaryngeal airway (cobraPLA) in brief paediatric surgical procedures.

    Science.gov (United States)

    Kaya, G; Koyuncu, O; Turan, N; Turan, A

    2008-05-01

    We compared the laryngeal mask airway (LMA) and the laryngeal tube (LT) with the perilaryngeal airway (CobraPLA, PLA) in anaesthetised, paralysed children having brief surgical procedures. After obtaining informed consent, 90 paediatric ASA Status 1 and 2 patients awaiting short surgical procedures were randomised to have their airways managed with an LMA, LT or PLA. Anaesthesia was induced with sevoflurane (2.5 to 4%) and muscle paralysis with mivacurium (0.2 mg/kg intravenously). The number of insertion attempts, time taken to insert the device, haemodynamic responses to insertion (mean arterial blood pressure, heart rate, pulse oximetry and end-tidal CO2), clinical performance and occurrence of postoperative sore throat were recorded. When the airway device was removed, it was examined for visible blood. Patients and parents were asked about the occurrence of sore throat, dysphonia and dysphagia 24 hours postoperatively. Heart rate, mean arterial blood pressure, pulse oximetry and end tidal CO2 did not differ among the groups. Insertion times for the devices were similar (LMA: 19+/-11 seconds, LT 21+/-12 seconds, PLA: 18+/-12 seconds), as were the rates of successful insertion at first attempt (LMA 66.7%; LT 70.0%; PLA 73.3%). The number and type of airway interventions to achieve an effective airway were comparable. When the airways were removed, positive blood traces were noted on 20% of the LMAs, 20% of the PLAs and 10% of the LTs. Haemodynamic, ventilation and oxygenation variables throughout the surgery were similar with LMA, LT and PLA and there were no significant differences in insertion time or signs or symptoms of mucosal trauma when these devices were used in paralysed children.

  19. Laryngeal Electromyography for Prognosis of Vocal Fold Paralysis.

    Science.gov (United States)

    Pardo-Maza, Adriana; García-Lopez, Isabel; Santiago-Pérez, Susana; Gavilán, Javier

    2017-01-01

    This study aimed to determine the value of laryngeal electromyography in the prognosis of vocal fold paralysis. This is a retrospective descriptive study. This study included 80 patients diagnosed with unilateral or bilateral vocal fold paralysis on flexible laryngoscopy between 2002 and 2014 in a tertiary medical center. Laryngeal electromyography using a standardized protocol was performed; the outcome measures were classified and analyzed into two groups according to the degree of injury. Group 1 included patients with mild to moderate injury, and group 2 included patients with severe to complete injury. Prognosis was correlated with vocal fold motion recovery status with a minimum of 6 months of follow-up since the symptoms onset using positive and negative predictive values. Sixty patients showed acute or chronic recurrent laryngeal neuropathy in laryngeal electromyography. Twelve of 41 patients included in group 1 recovered motion, and 30 of 35 patients included in group 2 did not recover, resulting in 88.2% of positive predictive value and 35.7% of negative predictive value. Our data confirm that laryngeal electromyography is a useful clinical tool in predicting poor recovery in patients with vocal fold paralysis. It allows identification of candidates for early intervention. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. [Laryngeal foreign bodies: management in children in Senegal].

    Science.gov (United States)

    Diop, E M; Tall, A; Diouf, R; Ndiaye, I C

    2000-01-01

    Inhalation of foreign bodies is a frequent accident in children. It remains severe in the case of laryngeal foreign bodies. Retrospectively, for a 16-year period, 65 laryngeal foreign bodies have been treated (44.8%), among 145 cases of airway foreign bodies, in the ENT department of Dakar University hospital. Etiological, clinical and therapeutic aspects were reviewed. Average age was 36 months, with a sex-ratio of 2.42 in favour of males. The time lag (time between the accident and admission to the department) was particularly long; 73.33% of the children were admitted more than 24 hours after the event. Eighty-three percent of the patients presented greater or lesser laryngeal dyspnea. Tracheostomy was performed in 55.4% of the patients. Average duration for abiation of the canula was ten days. Three cases of death were recorded (4.16%). The frequency of 44.8% for laryngeal localization of foreign bodies appears to be the highest in the literature. If the appropriate treatment for foreign bodies in the respiratory tract is endoscopic removal, the tracheostomy nevertheless occupies a central place in the management of the disease. This procedure may be recommended to all ENT specialists working in similar conditions. In spite of its inherent complications, tracheostomy allows reduction of mortality in relation to laryngeal foreign bodies. Improvement of prognosis requires prevention based on widespread public information and improving technical infrastructures.

  1. Evaluation of laryngeal cartilage calcification in computed tomography

    International Nuclear Information System (INIS)

    Laskowska, K.; Serafin, Z.; Lasek, W.; Maciejewski, M.; Wieczor, W.; Wisniewski, S.

    2008-01-01

    Computed tomography (CT) is one of the basic methods used for laryngeal carcinoma diagnostics. Osteosclerotic and osteolytic changes of the cartilages are considered as a common radiologic symptom of laryngeal neoplasms. The aim of this paper was to evaluate the prevalence of both osteosclerotic changes and focal calcification defects, which may be suggestive of osteolysis. Calcification was assessed in the thyroid, the cricoid and the arytenoids cartilages on CT images of the neck. We have retrospectively analyzed neck CT examinations of 50 patients without any laryngeal pathology in anamnesis. The grade and symmetry of calcifications was assessed in the thyroid, the cricoid and the arytenoids cartilages. Calcification of the laryngeal cartilages was present in 83% of the patients. Osteosclerotic lesions of the thyroid cartilage were seen in 70% of the patients (asymmetric in 60% of them), of the cricoid catrilage in 50% (asymmetric in 60%), and of the arytenoid cartilages in 24% (asymmetric in 67%). Focal calcification defects were present in the thyroid cartilage in 56% of the patients (asymmetric in 67% of them), in the cricoid catrilage in 8% (asymmetric in all cases), and in the arytenoid cartilages in 20% (asymmetric in 90%). Osteosclerotic changes and focal calcification defects, which may suggest osteolysis, were found in most of the patients. Therefore, they cannot be used as crucial radiological criteria of neoplastic invasion of laryngeal cartilages. (authors)

  2. Laryngeal cancer at the Korle Bu Teaching Hospital Accra Ghana

    International Nuclear Information System (INIS)

    Kitcher, E.D.; Cheyuo, C.; Yarney, J.; Gyasi, R. K.

    2006-01-01

    Laryngeal cancer is the commonest head and neck cancer seen at the Ear Nose and Throat (ENT) Unit Korle Bu Teaching Hospital. The aim of this study was to determine the number of cases of laryngeal cancer seen at the Korle Bu Teaching Hospital, establish epidemiological parameters of the disease and to outline preventive measures. One hundred and fifteen (115) patients who were managed for laryngeal cancer from 1st January 1998 to 31st December 2003 were studied retrospectively with respect to age, sex, duration of symptoms at presentation, risk factors, symptoms complex, histopathology, stage of tumor, details of treatment offered and follow up. The age range was 17-85 years with a mean of 55.5 years (SD10.7). Majority of the patients (90.4%) were above 40 years. The commonest symptom at presentation was dysphonia. A significant proportion of cases (37.3%) presented with locally advanced disease. The commonest histological type of laryngeal tumour seen was squamous cell carcinoma. The treatment offered consisted of radiotherapy for 83 (79.8%) patients and total laryngectomy with neck dissection when necessary for 17 (16.3%) patients who also had postoperative radiotherapy. Only 58 (69.9%) patients completed radiotherapy treatment and in all 32 (24.3 %) patients did not report for any treatment. Majority of patients failed to report for post treatment follow-up. We conclude that significant number of patients with laryngeal cancer presented with locally advanced disease and dysphonia was the commonest symptom. (au)

  3. Laryngeal Sarcoidosis in a Child: Case Report.

    Science.gov (United States)

    Vega-Cornejo, Gabriel; Ayala-Buenrostro, Priscila

    2017-11-01

    Sarcoidosis is a chronic, multisystemic, granulomatous disorder. Our patient was a 2-year-old girl with multiple airway conditions and a partial response to inhaled and systemic steroids. She was positive for acute phase reactants and negative for antibodies. Polymerase chain reaction revealed atypical Mycobacteria and she was negative for Mycobacterium tuberculosis. Laryngeal sarcoidosis was diagnosed by histopathology in a biopsy of larynx that revealed a chronic granulomatous inflammatory process with Langhans giant cells and acute and ulcerated areas with changes compatible with tuberculosis. Treatment consisted of monthly gammaglobulin for 6 months at doses of 2g/kg body weight, accompanied by Valmetrol™ and methotrexate. Immunomodulation with gammaglobulin was prescribed, with subsequent use of methotrexate-based immunosuppression. Currently, bronchoscopy shows no evidence of granulomas and she is negative for acute-phase reactants. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  4. Conservation laryngeal surgery in the elderly patient.

    Science.gov (United States)

    Tucker, H M

    1977-12-01

    In the 100 years since Bilroth first undertook a total laryngectomy, general improvements in the prevention and management of childhood and adult disease have led to continuing increase in life expectancy to the point that, in many developed countries, 25% or more of the population is over the age of 65. Although many of these individuals are in otherwise reasonable health, major head and neck procedures are often not performed in favor of radiation therapy for cure, even for lesions that would otherwise be considered amenable to surgery in younger patients, on the grounds that the patient is too old to tolerate the necessary procedure. The same argument has been employed in favoring total laryngectomy over subtotal procedures in the older patient. Review of the author's experience (27 cases) with conservation laryngeal surgery in patients over the age of 65 at the time treatment was undertaken reveals that such procedures are well tolerated in this age group. There were no mortalities and an overall complication rate of 11.1% resulted. These findings compare favorably with complication rates reported for similar patients and surgery in the under 65 age group and strongly suggest that chronologic age alone need not be a contraindication to such surgery.

  5. Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

    The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.

  6. Immunology Guides Skeletal Muscle Regeneration

    OpenAIRE

    F. Andrea Sass; Michael Fuchs; Matthias Pumberger; Sven Geissler; Georg N. Duda; Carsten Perka; Katharina Schmidt-Bleek

    2018-01-01

    Soft tissue trauma of skeletal muscle is one of the most common side effects in surgery. Muscle injuries are not only caused by accident-related injuries but can also be of an iatrogenic nature as they occur during surgical interventions when the anatomical region of interest is exposed. If the extent of trauma surpasses the intrinsic regenerative capacities, signs of fatty degeneration and formation of fibrotic scar tissue can occur, and, consequentially, muscle function deteriorates or is d...

  7. Nasal, pharyngeal, and laryngeal pemphigus vulgaris successfully treated with rituximab.

    Science.gov (United States)

    Sami, Naveed

    2017-01-01

    Pemphigus vulgaris is a potentially fatal autoimmune blistering disease that can involve the nasopharyngeal and laryngeal tissues. The disease can be recalcitrant to conventional oral treatments, and treatment alternatives are limited. This retrospective study evaluated the efficacy of rituximab as a rescue agent in 5 patients with recalcitrant pemphigus vulgaris involving nasopharyngeal and laryngeal mucosa. All 5 patients were unresponsive to systemic steroids and at least one conventional oral immunosuppressive agent. The patients received rituximab infusions as a rescue agent because of recalcitrant disease. All 5 patients had a complete clinical response to rituximab and could discontinue systemic steroids and reduce the dosage of their initial immunosuppressive agent. No major adverse reactions were observed or reported with rituximab. Rituximab can be used as an effective rescue agent in the treatment of severe pemphigus vulgaris with nasopharyngeal and laryngeal involvement.

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

    Directory of Open Access Journals (Sweden)

    João Gustavo Corrêa Reis

    Full Text Available 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.To identify factors associated with clinical and topographical features of LTB.a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis.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.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.

  9. ['Laryngeal neuropathy' and 'irritable larynx syndrome': synonyms or distinct entities?].

    Science.gov (United States)

    Meyer, S; Ptok, M

    2012-10-01

    The term 'laryngeal neuropathy' (LN) has first been used in veterinary medicine to describe an idiopathic and typically exercise induced inspiratory noise in horses.Nowadays, the term is often used in relation with intermittent vocal cord pareses in humans. Some authors use the term 'irritable larynx syndrome' (ILS) in a similar context. This article reviews the state of knowledge regarding LN and ILS and discusses the somewhat confusing terminology.For this systematic review a selective literature research in PubMed has been carried out.35 articles were found, which report on LN in animals and 17 articles reported on humans. 4 of these articles used the term 'irritable larynx syndrome'.Laryngeal neuropathy in horses usually affects the left recurrent laryngeal nerve and results in decreased vocal cord abduction and an inspiratory roaring or whistling noise, particularly during exercise. In dogs LN has been reported to also occur bilaterally. In association with humans LN has not been defined clearly in the literature. The term ILS on the other hand has only been used in relation to humans. The term describes a hypersensitivity of the laryngeal structures towards external stimuli, which causes symptoms such as dyspnea or cough among others. Sufficient knowledge does not exist for either of the 2 diseases, ILS or LN. As of yet, the term LN should not be used in human medicine to describe according symptoms of unknown aetiology. The term 'laryngeal movement disorder' seems a lot more appropriate. The symptom oriented term irritable larynx syndrome also seems suitable to describe laryngeal hypersensitivity appropriately. © Georg Thieme Verlag KG Stuttgart · New York.

  10. 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

    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. To identify factors associated with clinical and topographical features of LTB. a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. 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. 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.

  11. Nuclear medicine imaging of locally advanced laryngeal and hypopharyngeal cancer

    Science.gov (United States)

    Medvedeva, A.; Chernov, V.; Zeltchan, R.; Sinilkin, I.; Bragina, O.; Chijevskaya, S.; Choynzonov, E.; Goldberg, A.

    2017-09-01

    The diagnostic capabilities of nuclear medicine imaging in the detection and assessment of the spread of laryngeal/hypopharyngeal cancer were studied. A total of 40 patients with histologically verified laryngeal and hypopharyngeal cancer and 20 patients with benign laryngeal lesions were included into the study. Submucosal injections of 99mTc-MIBI and 99mTc-Alotech were made around the tumor. Single photon emission computed tomography (SPECT) was performed 20 minutes after the injection of 99mTc-MIBI. Sentinel lymph nodes (SLNs) were detected in 26 patients. In 18 hours after the injection of 99mTc-Alotech, SPECT was performed. In 24 hours after the injection of 99mTc-Alotech, intraoperative SLN detection was performed using Gamma Finder II. SPECT with 99mTc-MIBI revealed laryngeal and hypopharyngeal tumors in 38 of the 40 patients. The 99mTc-MIBI uptake in metastatic lymph nodes was visualized in 2 (17%) of the 12 patients. Twenty eight SLNs were detected by SPECT and 31 SLNs were identified using the intraoperative gamma probe. The percentage of 99mTc-Alotech in the SLN was 5-10% of the radioactivity in the injection site by SPECT and 18-33% by intraoperative gamma probe detection. Thus, SPECT with 99mTc-MIBI is an effective tool for the diagnosis of laryngeal/hypopharyngeal cancer. The sensitivity, specificity and accuracy of this technique were 95%, 80% and 92%, respectively. The use of 99mTc-Alotech for the detection of SLNs in patients with laryngeal/hypopharyngeal cancer is characterized by 92.8% sensitivity.

  12. Recurrent Laryngeal Nerve Injury In Total Versus Subtotal Thyroidectomy.

    Science.gov (United States)

    Sajid, Tahira; Qamar Naqvi, Syeda Rifaat; Qamar Naqvi, Syeda Saima; Shukr, Irfan; Ghani, Rehman

    2016-01-01

    Both Total and Subtotal Thyroidectomy are correct treatment options for symptomatic Euthyroid Multinodular Goitre. The choice depends upon surgeon's preference due to consideration of disadvantages like permanent hypothyroidism in Total Thyroidectomy and high chances of recurrence in Subtotal Thyroidectomy. Many surgeons believe that there is a higher incidence of Recurrent Laryngeal nerve injury in Total Thyroidectomy which affects their choice of surgery. This study aimed to compare the incidence of recurrent laryngeal nerve injury in total versus subtotal thyroidectomy. This non randomized controlled trial was carried out at Department of Surgery and ENT of Ayub Teaching Hospital Abbottabad, and Combined Military Hospital Rawalpindi from 1st September 2013 to 30th August 2014. During the period of study, patients presenting in surgical outpatient department with euthyroid multinodular goitre having pressure symptoms requiring thyroidectomy were divided into two groups by convenience sampling with 87 patients in group 1 and 90 patients in group 2. Group-1 was subjected to total thyroidectomy and Group -2 underwent subtotal thyroidectomy. All the patients had preoperative Indirect Laryngoscopy examination and it was repeated postoperatively to check for injury to the recurrent laryngeal nerve. A total of 177 patients were included in the study. Out of these, 87 patients underwent total thyroidectomy (Group-1). Two of these patients developed recurrent laryngeal nerve injury (2.3%). In group-2 subjected to subtotal thyroidectomy, three of the patients developed recurrent laryngeal nerve injury (3.3%). The p-value was 0.678. The overall risk of injury to this nerve in both surgeries combined was 2.8%. There is no significant difference in the risk of recurrent laryngeal nerve damage in patients undergoing total versus subtotal thyroidectomy.

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

    International Nuclear Information System (INIS)

    Cihangiroglu, M.; Yilmaz, S.; Yildirim, H.; Ozdemir, H.; Altinsoy, B.; Ogur, E.

    2002-01-01

    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)

  14. Laryngeal Amyloidosis Mimicking Glottic Cancer: A Case Report

    International Nuclear Information System (INIS)

    Lee, Sun Jin; Kim, Jee Young; Ahn, Kook Jin; Kim, Bum Soo; Park, Young Hak

    2010-01-01

    Amyloidosis is a slowly progressive, benign disease that is characterized by the extracellular deposition of fibrillar proteins in many different tissues and organs throughout the body. Primary amyloidosis can be subdivided into the systemic and localized forms. The localized form is less common than the systemic form and the larynx is the most frequently affected site. The importance of laryngeal amyloidosis lies in its possible confusion with glottic cancer because of the clinical feature. We report here on a case of laryngeal amyloidosis in a 47-year-old man who suffered from progressive dyspnea

  15. Laryngeal Amyloidosis Mimicking Glottic Cancer: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Jin; Kim, Jee Young; Ahn, Kook Jin; Kim, Bum Soo [The Catholic University of Korea, Seoul (Korea, Republic of); Park, Young Hak [St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2010-08-15

    Amyloidosis is a slowly progressive, benign disease that is characterized by the extracellular deposition of fibrillar proteins in many different tissues and organs throughout the body. Primary amyloidosis can be subdivided into the systemic and localized forms. The localized form is less common than the systemic form and the larynx is the most frequently affected site. The importance of laryngeal amyloidosis lies in its possible confusion with glottic cancer because of the clinical feature. We report here on a case of laryngeal amyloidosis in a 47-year-old man who suffered from progressive dyspnea.

  16. Respiratory distress of the newborn: congenital laryngeal atresia.

    Science.gov (United States)

    Ambrosio, Art; Magit, Anthony

    2012-11-01

    Congenital laryngeal atresia is a rare cause of respiratory distress of the newborn. The defect may be isolated or occur in association with other congenital abnormalities, notably the presence of a tracheoesophageal fistula, esophageal atresia, encephalocele, or Congenital High Airway Obstructive Syndrome (CHAOS). We present the case of a newborn with no identified intrapartum abnormalities with respiratory distress at birth secondary to near-complete laryngeal atresia. Management included tracheostomy, repeated endoscopic incisions, and serial balloon dilatations employing the topical use of Mitomycin C. Seven year follow-up was significant for mobilization of the true vocal cords bilaterally, as well as successful decannulation. Published by Elsevier Ireland Ltd.

  17. Speech-Language Pathology as a Primary Treatment for Exercise-Induced Laryngeal Obstruction.

    Science.gov (United States)

    Shaffer, Monica; Litts, Juliana K; Nauman, Emily; Haines, Jemma

    2018-05-01

    Exercise-induced laryngeal obstruction is a condition that restricts respiration during exercise via inappropriate glottic or supraglottic obstruction. The literature supports behavioral treatment provided by a speech-language pathologist as an effective means of treating exercise-induced laryngeal obstruction. Treatment includes educating the patient, training on relaxation, instruction on paced exercise, and use of various breathing techniques to optimize laryngeal aperture. Intervention for patients with exercise-induced laryngeal obstruction may be delivered by a speech-language pathologist, given their clinical skill of facilitating long-term behavioral change and expertise in the laryngeal mechanism. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Immunological responses against human papilloma virus and human papilloma virus induced laryngeal cancer.

    Science.gov (United States)

    Chitose, Shun-ichi; Sakazaki, T; Ono, T; Kurita, T; Mihashi, H; Nakashima, T

    2010-06-01

    This study aimed to clarify the local immune status in the larynx in the presence of infection or carcinogenesis associated with human papilloma virus. Cytological samples (for human papilloma virus detection) and laryngeal secretions (for immunoglobulin assessment) were obtained from 31 patients with laryngeal disease, during microscopic laryngeal surgery. On histological examination, 12 patients had squamous cell carcinoma, four had laryngeal papilloma and 15 had other benign laryngeal disease. Cytological samples were tested for human papilloma virus DNA using the Hybrid Capture 2 assay. High risk human papilloma virus DNA was detected in 25 per cent of patients (three of 12) with laryngeal cancer. Low risk human papilloma virus DNA was detected only in three laryngeal papilloma patients. The mean laryngeal secretion concentrations of immunoglobulins M, G and A and secretory immunoglobulin A in human papilloma virus DNA positive patients were more than twice those in human papilloma virus DNA negative patients. A statistically significant difference was observed between the secretory immunoglobulin A concentrations in the two groups. Patients with laryngeal cancer had higher laryngeal secretion concentrations of each immunoglobulin type, compared with patients with benign laryngeal disease. The study assessed the mean laryngeal secretion concentrations of each immunoglobulin type in the 12 laryngeal cancer patients, comparing human papilloma virus DNA positive patients (n = 3) and human papilloma virus DNA negative patients (n = 9); the mean concentrations of immunoglobulins M, G and A and secretory immunoglobulin A tended to be greater in human papilloma virus DNA positive cancer patients, compared with human papilloma virus DNA negative cancer patients. These results suggest that the local laryngeal immune response is activated by infection or carcinogenesis due to human papilloma virus. The findings strongly suggest that secretory IgA has inhibitory activity

  19. MUSCLE TENSION DYSPHONIA

    Directory of Open Access Journals (Sweden)

    Irena Hočevar Boltežar

    2004-07-01

    Full Text Available Background. Muscle tension dysphonia (MTD is the cause of hoarseness in almost one half of the patients with voice disorders. The otorhinolaryngologic examination discovers no evident organic lesions in the larynx at least in the beginning of the voice problems. The reason for the hoarse voice is a disordered and maladjusted activity of the muscles taking part in phonation and/or articulation. In some patients, the irregular function of the larynx results in mucosal lesions on vocal folds. The factors participating in the development of MTD, directly or indirectly influence the quality of laryngeal mucosa, the activity of the phonatory muscles and/or increase of the vocal load. In the diagnostics and treatment of the MTD a phoniatrician, a speech and language therapist and a psychologist closely cooperate with the patient who must take an active role. The treatment is a long-lasting one but resulted in a high percentage of clinical success.Conclusions. Most likely, MTD is not a special disease but only a reflection of any disorder in the complicated system of regulation and realization of phonation. The prognosis of treatment is good when all unfavourable factors participating in development of MTD are eliminated and a proper professional voice- and psychotherapy started.

  20. Intrinsic Chevrolets at the SSC

    International Nuclear Information System (INIS)

    Brodsky, S.J.; Collins, J.C.; Ellis, S.D.; Gunion, J.F.; Mueller, A.H.

    1984-01-01

    The possibility of the production at high energy of heavy quarks, supersymmetric particles and other large mass colored systems via the intrinsic twist-six components in the proton wave function is discussed. While the existing data do not rule out the possible relevance of intrinsic charm production at present energies, the extrapolation of such intrinsic contributions to very high masses and energies suggests that they will not play an important role at the SSC

  1. Laryngeal tumours: clinical features and management challenges as ...

    African Journals Online (AJOL)

    Twenty (57.14%) of the patients had emergency tracheostomy. The predominant histological type was well differentiated squamous cell carcinoma [15(42.86%)]. Only three (8.57 %) patients had total laryngectomy. Conclusion: The prevalence of laryngeal tumours in our environment was found to be 1.52% and patients ...

  2. Radiographic assessment of laryngeal reflexes in ketamine-anesthetized cats

    International Nuclear Information System (INIS)

    Robinson, E.P.; Johnston, G.R.

    1986-01-01

    The competence of the laryngeal closure reflexes of cats anesthetized with ketamine was assessed. Radiographic evaluations of the respiratory and digestive tracts were made after colloidal barium suspension was instilled into the pharynges of conscious and ketamine-anesthetized cats. There was a significant ketamine dose-related response of spread of contrast medium into the supraglottic laryngeal area and into the stomach 2 minutes after contrast medium was instilled into the pharynx (P less than 0.05). Cats did not aspirate contrast medium into the lower respiratory tract. Three ketamine-anesthetized cats aspirated contrast medium into the subglottic area of the larynx, and 2 of these cats also aspirated the material into the cranial part of the trachea. This material was coughed up and swallowed within 5 minutes. Transit time of contrast medium into the stomach seemed to be increased in 11 of the 15 cats given the larger dosages of ketamine (24, 36, 48 mg/kg of body weight), compared with that in conscious cats and those given ketamine at 12 mg/kg. Competent laryngeal protective reflexes in cats can be maintained with ketamine anesthesia. Contrast radiography could be used as a diagnostic aid in ketamine-anesthetized cats suspected of laryngeal reflex abnormalities

  3. [A rare cause of recurrent laryngeal nerve palsy].

    Science.gov (United States)

    Zamiati, W; Kably, M I; Kadiri, R

    2005-09-01

    Aneurysm of the cervical carotid artery is rare and usually presents with ischemic symptoms as opposed to local mass effect. The authors report a case of recurrent laryngeal nerve palsy secondary to mass effect from a cervical internal carotid artery aneurysm.

  4. Laryngeal spasm after general anaesthesia due to Ascaris lumbricoides.

    Science.gov (United States)

    Finsnes, K D

    2013-08-01

    Postoperative upper airway obstruction during recovery from general anaesthesia may have several causes. This is a report of a young girl who developed laryngeal spasm as a result of an ectopic roundworm Ascaris lumbricoides. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Laryngeal obstruction caused by lymphoma in an adult dairy cow

    OpenAIRE

    Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Chénier, Sonia

    2014-01-01

    A Holstein cow was presented for inspiratory dyspnea. Endoscopic evaluation revealed swollen arytenoids and a presumptive diagnosis of bilateral arytenoidal chondritis was made. A partial arytenoidectomy was performed, the right arytenoid was submitted for histopathology, and a diagnosis of laryngeal lymphoma was made. Due to the poor prognosis, the cow was euthanized.

  6. Laryngeal manifestations of relapsing polychondritis and a novel treatment option.

    Science.gov (United States)

    Childs, Lesley F; Rickert, Scott; Wengerman, Oscar C; Lebovics, Robert; Blitzer, Andrew

    2012-09-01

    Laryngotracheal involvement in relapsing polychondritis (RP) is rare. However, it is one of the most common causes of death in this patient population. We present three patients who primarily presented with laryngeal manifestations of RP and a novel treatment option for bamboo nodules. Retrospective chart review and comprehensive review of the literature. Two patients first presented to an otolaryngologist because of hoarseness and chronic cough that eventually progressed to dyspnea upon exertion. Laryngeal examination revealed subglottic stenoses. Upon rheumatologic workup both were diagnosed with RP. After treatment with steroids and immunosuppressive drugs, one of the patient's laryngeal symptoms improved, whereas the other required dilation procedures. Neither patient had classic auricular or nasal symptoms upon initial presentation. The third patient was being treated for spasmodic dysphonia and was noted to have bamboo nodules with accompanying dysphonia. Rheumatologic workup revealed RP and systemic treatment ensued. Unfortunately, her symptoms of hoarseness persisted despite systemic treatment. A pulsed-potassium-titanyl-phosphate (KTP) laser was applied to the bilateral bamboo nodules, which eventually caused resolution of her vocal fold lesions and dysphonia. We present three patients with RP, all of whom sought health care by an otolaryngologist primarily. Awareness of this disease entity and the possibility for early laryngeal involvement is crucial for proper care of those with this life-threatening disease. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  7. Laryngeal Presentation of Systemic Apolipoprotein A-I-Derived Amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Aldert J. C.; Dikkers, Frederik G.; Hawkins, Philip N.; Bijzet, Johan; Rowczenio, Dorota; Gilbertson, Janet; Posthumus, Marcel D.; Leijsma, Martha K.; Hazenberg, Bouke P. C.

    Objective: To study the clinical and pathological characteristics of two patients with laryngeal apolipoprotein A-I (apoA-I)-derived (AApoAI) amyloidosis with the apolipoprotein A-I variants Leu174Ser and Leu178Pro, respectively. The latter variant has not been associated with amyloid before. Study

  8. Evaluation of the Intubating Laryngeal Mask Airway (ILMA) as an ...

    African Journals Online (AJOL)

    Evaluation of the Intubating Laryngeal Mask Airway (ILMA) as an intubation conduit in patients with a cervical collar simulating fixed cervical spine. The page number in the footer is not for bibliographic referencing .... their use in patients with suspected cervical spine injury.1. Removal of the front portion of the collar before ...

  9. The Icatibant Outcome Survey: treatment of laryngeal angioedema attacks

    Science.gov (United States)

    Aberer, Werner; Bouillet, Laurence; Caballero, Teresa; Maurer, Marcus; Fabien, Vincent; Zanichelli, Andrea

    2016-01-01

    Objective To characterize the management and outcomes of life-threatening laryngeal attacks of hereditary angioedema (HAE) treated with icatibant in the observational Icatibant Outcome Survey (NCT01034969) registry. Methods This retrospective analysis was based on data from patients with HAE type I/II who received healthcare professional-administered or self-administered icatibant to treat laryngeal attacks between September 2008 and May 2013. Results Twenty centers in seven countries contributed data. Overall, 42 patients with HAE experienced 67 icatibant-treated laryngeal attacks. Icatibant was self-administered for 62.3% of attacks (healthcare professional-administered, 37.7%). One icatibant injection was used for 87.9% of attacks, with rescue or concomitant medication used for 9.0%. The median time to treatment was 2.0 h (n=31 attacks) and the median time to resolution was 6.0 h (n=35 attacks). Conclusions This analysis describes successful use of icatibant for the treatment of laryngeal HAE attacks in a real-world setting. PMID:27116379

  10. A bony connection signals laryngeal echolocation in bats.

    Science.gov (United States)

    Veselka, Nina; McErlain, David D; Holdsworth, David W; Eger, Judith L; Chhem, Rethy K; Mason, Matthew J; Brain, Kirsty L; Faure, Paul A; Fenton, M Brock

    2010-02-18

    Echolocation is an active form of orientation in which animals emit sounds and then listen to reflected echoes of those sounds to form images of their surroundings in their brains. Although echolocation is usually associated with bats, it is not characteristic of all bats. Most echolocating bats produce signals in the larynx, but within one family of mainly non-echolocating species (Pteropodidae), a few species use echolocation sounds produced by tongue clicks. Here we demonstrate, using data obtained from micro-computed tomography scans of 26 species (n = 35 fluid-preserved bats), that proximal articulation of the stylohyal bone (part of the mammalian hyoid apparatus) with the tympanic bone always distinguishes laryngeally echolocating bats from all other bats (that is, non-echolocating pteropodids and those that echolocate with tongue clicks). In laryngeally echolocating bats, the proximal end of the stylohyal bone directly articulates with the tympanic bone and is often fused with it. Previous research on the morphology of the stylohyal bone in the oldest known fossil bat (Onychonycteris finneyi) suggested that it did not echolocate, but our findings suggest that O. finneyi may have used laryngeal echolocation because its stylohyal bones may have articulated with its tympanic bones. The present findings reopen basic questions about the timing and the origin of flight and echolocation in the early evolution of bats. Our data also provide an independent anatomical character by which to distinguish laryngeally echolocating bats from other bats.

  11. Laryngeal cancer at the Korle Bu Teaching Hospital, Accra, Ghana ...

    African Journals Online (AJOL)

    Majority of the patients (90.4%) were above 40 years. The commonest symptom at presentation was dysphonia. A significant proportion of cases (37.3%) presented with locally advanced disease. The commonest histological type of laryngeal tumour seen was squamous cell carcinoma. The treatment offered consisted of ...

  12. Prone surgery and laryngeal mask airways: an overview of recent ...

    African Journals Online (AJOL)

    2013-08-17

    Aug 17, 2013 ... patient trauma. • Effective laryngeal mask airway (LMA) placement in the prone position may suggest a rescue airway in the event of endotracheal .... Facet infiltrations. • Rhizotomy. • Spinal decompression. • Spinal fusion. • Pilonidal sinus. • Melanoma excision on the back. • Bone marrow aspiration.

  13. Heredity of supraglottic exercise-induced laryngeal obstruction

    DEFF Research Database (Denmark)

    Walsted, Emil Schwarz; Hvedstrup, Jeppe; Eiberg, Hans

    2017-01-01

    Respiratory symptoms on exertion, such as shortness of breath and wheezing, are commonly associated with asthma, but might also arise from the larynx [1–3]. In recent years, the emergence of exercise laryngoscopy [4] has led to a better understanding of laryngeal movement during exercise, and ins...

  14. The Laryngeal Mask Airway (LMA) as an alternative to airway ...

    African Journals Online (AJOL)

    Background: To evaluate the possibility of airway management using a laryngeal mask airway (LMA) during dental procedures on mentally retarded (MR) patients and patients with genetic diseases. Design: A prospective pilot study. Setting: University Hospital. Methods: A pilot study was designed to induce general ...

  15. The Laryngeal Mask Airway Supreme™: safety and efficacy during ...

    African Journals Online (AJOL)

    Background: Laryngeal Mask Airway Supreme™ (LMA Supreme™) is a new single-use polyvinyl chloride supraglottic device that offers gastric access. To date, studies that have tested the LMA Supreme™) for use in laparoscopic surgery have been reported. We present the largest evaluative study that describes the use of ...

  16. Endoscopic approach for a laryngeal neoplasm in a dog

    Directory of Open Access Journals (Sweden)

    Pedro Paulo Maia Teixeira

    2015-01-01

    Full Text Available Laryngeal and tracheal tumors are rare in pets; some piece of information on their disease behavior, therapy and evolution are limited. Neoplasms in this area are a diagnostic challenge. In many cases, they can be biopsied and excised using endoscopic instruments, but there is no report of this in canines. The goal of this study is to report a successful case of a laryngeal neoplasm removal through endoscopy. A head and neck radiogram revealed a mass in the laryngeal lumen protruding into the trachea. The patient then underwent an endoscopy to confirm the radiographic diagnosis and to surgically remove the tumor. The histopathological diagnosis was poorly differentiated carcinoma. The most appropriate treatment for laryngeal tumors is the resection of the submucosa or a partial laryngectomy however, partial and total laryngectomies are associated with many postoperative complications. In contrast, the endoscopic approach allows for highly magnified visualization of the lesion in situ, which facilitates the surgical removal of the mass through videosurgery. With little manipulation of the affected area, the chances of postoperative complications are reduced, leading to a more rapid recovery.

  17. Schwannoma of the Recurrent Laryngeal Nerve : A Rare Entity

    NARCIS (Netherlands)

    de Heer, Linda M; Teding van Berkhout, F; Priesterbach, Loudy; Buijsrogge, Marc P

    Neurogenic tumors are the most common posterior mediastinal tumors in adults. Schwannomas originating from the recurrent laryngeal nerve are rare. The present study describes a 46-year-old man with a tumor in the left superior mediastinum. Because of the narrow relationship with the aorta and the

  18. Cryptococcal laryngitis: An uncommon presentation of a common ...

    African Journals Online (AJOL)

    common infection is pulmonary, which is usually self-limiting. Central nervous system involvement results in high morbidity and mortality; mortality rates of up to 30% have been reported.[2] Laryngeal involvement is extremely uncommon and has only been reported in 12 other patients.[3] Features of these cases are outlined ...

  19. Laryngeal Aerodynamics Associated with Oral Contraceptive Use: Preliminary Findings

    Science.gov (United States)

    Gorham-Rowan, Mary; Fowler, Linda

    2009-01-01

    The purpose of this study was to examine possible differences in laryngeal aerodynamic measures during connected speech associated with oral contraceptive (OC) use. Eight women taking an OC, and eight others not taking an OC, participated in the study. Three trials of syllable /p[subscript alpha] /repetitions were obtained using a…

  20. Improving Voice Outcomes After Injury to the Recurrent Laryngeal Nerve

    Directory of Open Access Journals (Sweden)

    Lejla Junuzovic Zunic

    2017-11-01

    Discussion: Laryngeal symptoms are known to often accompany thyroidectomy procedures. In the present study, it was observed that administration of vocal therapy and teamwork between the doctors and speech therapist significantly affected the patient’s recovery and improvement in the quality of voice after thyroidectomy.

  1. The intubating laryngeal mask produces less heart rate response to ...

    African Journals Online (AJOL)

    Pc

    We compared heart rate and blood pressure changes to intubation produced by conventional laryngoscopic-guided intubation to those produced by blind intubation through the intubating laryngeal mask (ILM) in normotensive adults with normal airways. Forty paralysed, anaesthetised adults undergoing elective surgery ...

  2. Impacted Laryngeal Foreign Body in a Child: A Diagnostic and ...

    African Journals Online (AJOL)

    Impacted laryngeal foreign body could lead to catastrophic consequences if appropriate diagnostic and therapeutic procedures are not promptly instituted. A case of 4‑year‑old child who presented with a 4‑day history of probable ingestion or aspiration of a pen part and history of occasional noisy breathing on exertion and ...

  3. Prone surgery and laryngeal mask airways: an overview of recent ...

    African Journals Online (AJOL)

    Clinicians tend to avoid the use of a laryngeal mask airway (LMA) in the prone position, but several trials demonstrate its low rate of complication if patient selection is performed properly. Obesity is also demonstrated not to be a contraindication to this anaesthetic technique. Patients are more haemodynamically stable if ...

  4. Probiotics reduce psychological stress in patients before laryngeal cancer surgery.

    Science.gov (United States)

    Yang, Hui; Zhao, Xiaoyun; Tang, Shan; Huang, Hua; Zhao, Xiulan; Ning, Zhuohui; Fu, Xiurong; Zhang, Caihong

    2016-03-01

    Laryngeal cancer is a common malignancy; surgery is the preferred treatment. Psychosocial stress is one of the negative impacts on patient recovery. This study aimed to elucidate the effect of probiotics on ameliorating anxiety, and on serum corticotropin-releasing factor (CRF) in laryngeal cancer patients before surgery. A total 30 patients with laryngeal cancer and 20 healthy volunteers were recruited. During the 2 weeks before surgery, 20 patients were randomly allocated to receive probiotics or placebo twice a day. Heart rate was recorded daily. The degree of anxiety was assessed by the Hamilton Anxiety Scale (HAMA). Serum CRF levels in laryngeal cancer patients increased significantly in approaching surgery. After ingestion of probiotics, serum levels of CRF and heart rate did not increase before surgery. In addition, taking probiotics relieved the degree of anxiety of the patients from HAMA 19.8 to 10.2. Probiotics can ameliorate the clinical anxiety and biochemical features of stress in patients scheduled for laryngectomy. © 2014 Wiley Publishing Asia Pty Ltd.

  5. The intubating laryngeal mask produces less heart rate response to ...

    African Journals Online (AJOL)

    Blind intubation through the ILM using a straight silicone tracheal tube manufactured for specific use with the ILM; 2. Intubation with a size 3 macintosh laryngoscope ... such as in patients with ischaemic heart disease. Key Words: Equipment:intubating laryngeal mask airway; Airway,complications: haemodynamic response ...

  6. A randomized comparison of the laryngeal mask airway supreme™ and laryngeal mask airway unique™ in infants and children: does cuff pressure influence leak pressure?

    Science.gov (United States)

    Jagannathan, Narasimhan; Sohn, Lisa; Sommers, Katherine; Belvis, Dawn; Shah, Ravi D; Sawardekar, Amod; Eidem, Jami; Dagraca, Justin; Mukherji, Isabella

    2013-10-01

    The cuff pressure for optimal airway sealing with first-generation laryngeal mask airway has been shown to be 40 cm H(2)O in children. Currently, there are no data regarding the ideal intracuff pressure for the laryngeal mask airway Supreme (Supreme) in children. To compare the clinical performance of the laryngeal mask airway supreme with the laryngeal mask airway unique in infants and children. One hundred eighty children were assigned to receive either a Supreme or a laryngeal mask airway-U. We hypothesized higher airway leak pressure with the Supreme at both 40 cm H(2)O and 60 cm H(2)O, when compared with the laryngeal mask airway-U. Ease and time of insertion, insertion attempts, fiber optic examination, quality of airway, efficacy of mechanical ventilation, success of gastric tube placement (Supreme), incidence of gastric insufflation, and complications were also assessed. Airway leak pressure at an intracuff pressure of 60 cm H(2)O for the Supreme was 17.4 (5.2) vs laryngeal mask airway-U at 18.4 (6.6) cm H(2)O and did not differ when compared to an intracuff pressure of 40 cm H(2)O for both devices; Supreme at 17.2 (5) vs laryngeal mask airway-U at 17.7 (6) cm H(2)O. The laryngeal mask airway-U was associated with higher first-attempt success rates. The Supreme was associated with less gastric insufflation than the laryngeal mask airway-U. Intracuff pressures of 40 cm H(2)O may be sufficient for the Supreme in children, and there may be no added benefit of an intracuff pressure of 60 cm H(2)O, as leak pressures were similar. The Supreme may be preferred over the laryngeal mask airway-U for its lower rates of gastric insufflation and provision for gastric access when mechanical ventilation is utilized. © 2013 John Wiley & Sons Ltd.

  7. Intrinsically dynamic population models

    Directory of Open Access Journals (Sweden)

    Robert Schoen

    2005-03-01

    Full Text Available Intrinsically dynamic models (IDMs depict populations whose cumulative growth rate over a number of intervals equals the product of the long term growth rates (that is the dominant roots or dominant eigenvalues associated with each of those intervals. Here the focus is on the birth trajectory produced by a sequence of population projection (Leslie matrices. The elements of a Leslie matrix are represented as straightforward functions of the roots of the matrix, and new relationships are presented linking the roots of a matrix to its Net Reproduction Rate and stable mean age of childbearing. Incorporating mortality changes in the rates of reproduction yields an IDM when the subordinate roots are held constant over time. In IDMs, the birth trajectory generated by any specified sequence of Leslie matrices can be found analytically. In the Leslie model with 15 year age groups, the constant subordinate root assumption leads to reasonable changes in the age pattern of fertility, and equations (27 and (30 provide the population size and structure that result from changing levels of net reproduction. IDMs generalize the fixed rate stable population model. They can characterize any observed population, and can provide new insights into dynamic demographic behavior, including the momentum associated with gradual or irregular paths to zero growth.

  8. Laryngeal findings and acoustic changes in hubble-bubble smokers.

    Science.gov (United States)

    Hamdan, Abdul-latif; Sibai, Abla; Oubari, Dima; Ashkar, Jihad; Fuleihan, Nabil

    2010-10-01

    The purpose of our investigation was to evaluate the laryngeal findings and acoustic changes in hubble-bubble smokers. A total of 42 subjects with history of hubble-bubble smoking were recruited for this study. A corresponding group with a history of cigarette smoking and controls were matched. All subjects underwent laryngeal video-endostroboscopic evaluation and acoustic analysis. In the hubble-bubble smoking group, 61.9% were males. The average age was 30.02 +/- 9.48 years and the average number of years of smoking was 8.09 +/- 6.45 years. Three subjects had dysphonia at the time of examination. The incidence of benign lesions of the vocal folds in the hubble-bubble group was 21.5%, with edema being the most common at 16.7% followed by cyst at 4.8%. The incidence of laryngeal findings was significantly higher in the hubble-bubble group compared to controls. In the cigarette-smoking group, the most common finding was vocal fold cyst in 14.8% followed by polyps in 7.4%, and edema, sulcus vocalis and granuloma. These findings were not significantly different from the hubble-bubble group except for the thick mucus, which was significantly higher in the latter. There were no significant changes in any of the acoustic parameters between hubble-bubble smokers and controls except for the VTI and MPT, which were significantly lower in the hubble-bubble group. In comparison with the cigarette-smoking group, hubble-bubble smokers had significantly higher Fundamental frequency and habitual pitch (p value 0.042 and 0.008, respectively). The laryngeal findings in hubble-bubble smokers are comparable to cigarette smokers. These laryngeal findings are not translated acoustically, as all the acoustic parameters are within normal range compared to controls.

  9. Vocal Function Exercises for Muscle Tension Dysphonia: Auditory-Perceptual Evaluation and Self-Assessment Rating.

    Science.gov (United States)

    Jafari, Narges; Salehi, Abolfazl; Izadi, Farzad; Talebian Moghadam, Saeed; Ebadi, Abbas; Dabirmoghadam, Payman; Faham, Maryam; Shahbazi, Mehdi

    2017-07-01

    Muscle tension dysphonia (MTD) is a functional dysphonia, which appears with an excessive tension in the intrinsic and extrinsic laryngeal musculatures. MTD can affect voice quality and quality of life. The purpose of the present study was to assess the effectiveness of vocal function exercises (VFEs) on perceptual and self-assessment ratings in a group of 15 subjects with MTD. The study comprised 15 subjects with MTD (8 men and 7 women, mean age 39.8 years, standard deviation 10.6, age range 24-62 years). All participants were native Persian speakers who underwent a 6-week course of VFEs. The Voice Handicap Index (VHI) (the self-assessment scale) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale (perceptual rating of voice quality) were used to compare pre- and post-VFEs. GRBAS data of patients before and after VFEs were compared using Wilcoxon signed-rank test, and VHI data of patients pre- and post-VFEs were compared using Student paired t test. These perceptual parameters showed a statistically significant improvement in subjects with MTD after voice therapy (significant at P self-assessment ratings measurements (with the VHI). As a result, the data provide evidence regarding the efficacy of VFEs in the treatment of patients with MTD. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. A survey of practice patterns in the use of laryngeal mask by pediatric anesthesiologists.

    Science.gov (United States)

    Patel, Anuradha; Clark, Scott R; Schiffmiller, Moshe; Schoenberg, Catherine; Tewfik, George

    2015-11-01

    Laryngeal mask is frequently the airway device of choice in routine general anesthesia for many procedures in children. Several studies have described the use of laryngeal masks in unconventional situations. This survey was undertaken to assess how laryngeal masks are being used by pediatric anesthesiologists. The 40-question electronic survey using SurveyMonkey™ was sent to 2740 members of the Society for Pediatric Anesthesia (SPA). This survey assessed the age, work environment, types of practice, and training levels, as well as clinical situations in which the practitioners use laryngeal masks across different pediatric age groups. Seven hundred and forty-three (27.1%) responses were obtained. The use of laryngeal mask increased as the patient age increased in nearly every queried situation. The practitioners routinely utilize laryngeal masks in a variety of challenging scenarios, such as in patients with a recent upper respiratory infection, in the difficult airway, remote locations, and long-duration surgeries. A small percentage of pediatric anesthesiologists use laryngeal masks in laparoscopic surgery and prone position procedures. Pediatric anesthesiologists are using laryngeal masks in both routine and challenging/unconventional situations. Although many of the uses for laryngeal masks are not explicitly stated in the manufacturer guidelines, literature and current practice support the use of laryngeal masks in several of these scenarios. © 2015 John Wiley & Sons Ltd.

  11. Muscle Cramps

    Science.gov (United States)

    Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They often occur after ... It is a very common muscle problem. Muscle cramps can be caused by nerves that malfunction. Sometimes ...

  12. Adipose-derived mesenchymal stem cells accelerate nerve regeneration and functional recovery in a rat model of recurrent laryngeal nerve injury

    Directory of Open Access Journals (Sweden)

    Yun Li

    2017-01-01

    Full Text Available Medialization thyroplasty or injection laryngoplasty for unilateral vocal fold paralysis cannot restore mobility of the vocal fold. Recent studies have shown that transplantation of mesenchymal stem cells is effective in the repair of nerve injuries. This study investigated whether adipose-derived stem cell transplantation could repair recurrent laryngeal nerve injury. Rat models of recurrent laryngeal nerve injury were established by crushing with micro forceps. Adipose-derived mesenchymal stem cells (ADSCs; 8 × 105 or differentiated Schwann-like adipose-derived mesenchymal stem cells (dADSCs; 8 × 105 or extracellular matrix were injected at the site of injury. At 2, 4 and 6 weeks post-surgery, a higher density of myelinated nerve fiber, thicker myelin sheath, improved vocal fold movement, better recovery of nerve conduction capacity and reduced thyroarytenoid muscle atrophy were found in ADSCs and dADSCs groups compared with the extracellular matrix group. The effects were more pronounced in the ADSCs group than in the dADSCs group. These experimental results indicated that ADSCs transplantation could be an early interventional strategy to promote regeneration after recurrent laryngeal nerve injury.

  13. Adipose-derived mesenchymal stem cells accelerate nerve regeneration and functional recovery in a rat model of recurrent laryngeal nerve injury

    Science.gov (United States)

    Li, Yun; Xu, Wen; Cheng, Li-yu

    2017-01-01

    Medialization thyroplasty or injection laryngoplasty for unilateral vocal fold paralysis cannot restore mobility of the vocal fold. Recent studies have shown that transplantation of mesenchymal stem cells is effective in the repair of nerve injuries. This study investigated whether adipose-derived stem cell transplantation could repair recurrent laryngeal nerve injury. Rat models of recurrent laryngeal nerve injury were established by crushing with micro forceps. Adipose-derived mesenchymal stem cells (ADSCs; 8 × 105) or differentiated Schwann-like adipose-derived mesenchymal stem cells (dADSCs; 8 × 105) or extracellular matrix were injected at the site of injury. At 2, 4 and 6 weeks post-surgery, a higher density of myelinated nerve fiber, thicker myelin sheath, improved vocal fold movement, better recovery of nerve conduction capacity and reduced thyroarytenoid muscle atrophy were found in ADSCs and dADSCs groups compared with the extracellular matrix group. The effects were more pronounced in the ADSCs group than in the dADSCs group. These experimental results indicated that ADSCs transplantation could be an early interventional strategy to promote regeneration after recurrent laryngeal nerve injury. PMID:29090002

  14. Laryngeal Rosai-Dorfman Disease (Sinus Histiocytosis with Massive Lymphadenopathy): A Retrospective Study of 5 Cases

    OpenAIRE

    Yanyan Niu; Yongjin Li; Jian Wang; Xiaofeng Jin; Dahai Yang; Hong Huo; Wuyi Li

    2017-01-01

    This study was performed to investigate the clinical manifestations, treatment methods, and prognosis of Rosai-Dorfman disease (RDD) with laryngeal involvement. Five clinical cases of RDD with laryngeal involvement diagnosed between 1986 and 2015 were retrospectively analyzed. The laryngeal lesions of these 5 patients mostly involved the glottis and subglottis, with the main symptoms being a hoarse voice and airway obstruction. In addition, the patients mostly exhibited a unilateral or asymme...

  15. Self evaluation of communication experiences after laryngeal cancer – A longitudinal questionnaire study in patients with laryngeal cancer

    Directory of Open Access Journals (Sweden)

    Finizia Caterina

    2008-03-01

    Full Text Available Abstract Background Aim of this longitudinal study was to investigate the sensitivity to change of the Swedish Self Evaluation of Communication Experiences after Laryngeal Cancer questionnaire (the S-SECEL, addressing communication dysfunction in patients treated for laryngeal cancer. Previous studies have highlighted the need for more specific questionnaires for this purpose. Methods 100 patients with Tis-T4 laryngeal cancer were included prior to treatment onset. Patients answered four questionnaires at six occasions during one year; the S-SECEL, the European Organisation for Research and Treatment of Cancer (EORTC Core Quality of Life Core Questionnaire (QLQ-C30 supplemented by the Head and Neck cancer module (QLQ-H&N35 and the Hospital Anxiety and Depression (HAD scale. In addition, performance status was assessed. Differences within groups were tested with the Wilcoxon paired signed ranks test and between-group analyses were carried out using the Mann-Whitney U test. Magnitude of group differences was analyzed by means of effect sizes. Results The S-SECEL was well accepted with a response rate of 76%. Communication dysfunction increased at 1 month, followed by a continuous decrease throughout the year. Changes were statistically significant at most measurement, demonstrating the sensitivity of the S-SECEL to changes in communication over time. The S-SECEL and the EORTC QLQ-C30 with the QLQ-H&N35 demonstrated similar results; however the S-SECEL was more sensitive regarding communication dysfunction. The largest changes were found in the most diagnose specific items concerning voice and speech. Conclusion The S-SECEL was investigated in the largest Scandinavian longitudinal study concerning health-related quality of life (HRQL in laryngeal cancer patients. The questionnaire was responsive to change and showed convergent results when compared to established HRQL questionnaires. Our findings also indicate that the S-SECEL could be a more

  16. VIDEOLARYNGOSCOPIC SURGEY IN BENIGN LARYNGEAL LESIONS-OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    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

  17. Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO)

    DEFF Research Database (Denmark)

    Mehlum, Camilla Slot; Walsted, Emil Schwarz; Godballe, Christian

    2016-01-01

    Breathing difficulties during exertion may be caused by exercise-induced laryngeal obstruction (EILO). The diagnosis depends on visualization of the larynx during exercise, i.e. by continuous laryngoscopic exercise (CLE) test. In case of severe supraglottic collapse and pronounced symptoms during...... or on very few patients. This study is the second larger-scale study that documents the positive effect of supraglottoplasty as treatment of EILO in terms of reduced respiratory symptoms and decreased laryngeal obstruction assessed by post-operative CLE test. We suggest that surgery is a well...... strenuous exertion, surgical treatment (supraglottoplasty) has been suggested. The aims of this study were to evaluate outcome and patient satisfaction after supraglottoplasty for EILO and to compare our results with previously reported data. During the period December 2010 to October 2013, 17 patients...

  18. Diagnosis and management with botulinum toxin in 11 cases of laryngeal synkinesis.

    Science.gov (United States)

    Lekue, Asier; García-López, Isabel; Santiago, Susana; Del Palacio, Antonio; Gavilán, Javier

    2015-09-01

    Laryngeal synkinesis is a vocal fold movement disorder produced by a misdirected reinnervation after a recurrent laryngeal nerve injury. Its symptoms differ greatly between patients, requiring diverse therapeutical approaches. We aim to describe our experience in the diagnosis and treatment of different laryngeal synkinesis presentations. 11 patients diagnosed between 2011 and 2014 in a tertiary referral center with laryngeal synkinesis confirmed by laryngeal electromyography were included in our study. All medical records and laryngoscopic and electromyographic data were reviewed retrospectively. Four patients had previous unilateral vocal fold palsy and seven had a bilateral palsy with different degrees of clinical involvement. All of them showed paradoxical movements during inhalation in videofibrolaryngoscopic examination. Laryngeal electromyography confirmed the diagnosis of laryngeal synkinesis. Dyspnea was the main presentation symptom. Three patients with mild symptoms were not treated. Patients with unilateral vocal fold immobility were successfully treated with periodic botulinum toxin injections. Patients with bilateral immobility had a good initial response to botulinum toxin, although in some of them, a posterior cordectomy had to be finally performed. In conclusion, laryngeal synkinesis is a heterogeneous clinic entity that appears in patients with unilateral or bilateral vocal fold paralysis. Videofibrolaryngoscopy and laryngeal electromyography are essential to a correct diagnosis. Botulinum toxin injections are the main treatment for symptomatic cases, even if in bilateral palsy cases more aggressive treatments are often required.

  19. Detection of helicobacter pylori in benign laryngeal lesions by polymerase chain reaction: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Izadi Farzad

    2012-04-01

    Full Text Available Abstract Background Although Helicobacter Pylori (HP was detected in some cases of chronic laryngitis, the results were not confirmed by polymerase chain reaction (PCR. By this time, it has not been found in laryngeal lesions by in house PCR, the most sensitive method for detecting the genome tracks. Regarding the previous results and also few numbers of studies about the presence of HP in benign laryngeal lesions, specifically by PCR, we aimed to investigate the presence of HP in benign laryngeal lesions by in-house PCR. Methods The samples were taken from 55 patients with benign laryngeal lesions and frozen in −20°C. One milliliter (ml of lysis buffer was added to 100 mg (mg of each sample and the tube was placed in 56°C overnight. Then DNA extraction was carried out. Results To find HP DNA, in-house PCR was performed that revealed 5 positive results among 55 patients with benign laryngeal lesions. Of them, 3 were polyp, 1 was nodule and 1 was papilloma. Conclusion Although the number of positive results was not a lot in this study, it was in contrast with previous studies which could not find any HP tracks in benign laryngeal lesions by other methods. More studies about the prevalence of HP in benign laryngeal lesions improve judging about the effect of this infection on benign laryngeal lesions.

  20. Benign anatomical mistakes: the correct anatomical term for the recurrent laryngeal nerve.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2002-01-01

    The term recurrent laryngeal nerve has been adopted by Nomina Anatomica (1989) and Terminologia Anatomica (1998) to describe this vagus branch from its origin, its turn dorsally around the subclavian artery and the aortic arch, and its cranial pathway until it reaches its terminal organs in the neck. However, there is still much confusion, and either the terms inferior and recurrent laryngeal nerve are used interchangeably or inferior laryngeal nerve is considered the terminal branch of the recurrent laryngeal nerve. We hereby feel that it is necessary to reassess the term and we propose the term inferior laryngeal nerve for the entire nerve under consideration, from its origin from the vagus nerve to its destinations, including tracheal, esophageal, and pharyngeal branches. If the term superior laryngeal nerve is a given, standard and accepted term in the anatomical terminology, then logically the term inferior laryngeal nerve should also be accepted, as opposed to it. Of course the upward travel of the inferior laryngeal nerve is "recurrent". When nonrecurrence is encountered together with an arteria lusoria, a retroesophageal right subclavian artery or a right aortic arch, we consider that the term nonrecurrent inferior laryngeal nerve should be used to describe the deviation from the normal.

  1. Cuff leak test and laryngeal survey for predicting post-extubation stridor.

    Science.gov (United States)

    Patel, Anit B; Ani, Chizobam; Feeney, Colin

    2015-02-01

    Evidence for the predictive value of the cuff leak test (CLT) for post-extubation stridor (PES) is conflicting. We evaluated the association and accuracy of CLT alone or combined with other laryngeal parameters with PES. Fifty-one mechanically ventilated adult patients in a medical-surgical intensive care unit were tested prior to extubation using; CLT, laryngeal ultrasound and indirect laryngoscopy. Biometric, laryngeal and endotracheal tube (ETT) parameters were recorded. PES incidence was 4%. CLT demonstrated 'no leak' in 20% of patients. Laryngeal oedema was present in 10% of the patients on indirect laryngoscopy, and 71% of the patients had a Grades 1-3 indirect laryngoscopic view. Mean air column width on laryngeal ultrasound was 0.66 ± 0.15 cm (cuff deflated), mean ratio of ETT to laryngeal diameter was 0.48 ± 0.07, and the calculated CLT and laryngeal survey composite was 0.86 ± 1.25 (range 0-5). CLT and the CLT and Laryngeal survey composite measure were not associated with or predict PES. Age, sex, peri-extubation steroid use, intubation duration and body mass index were not associated with PES. Even including ultrasonographic and indirect laryngoscopic examination of the airway, no single aspect of the CLT or combination with laryngeal parameters accurately predicts PES.

  2. Intrinsically Passive Handling and Grasping

    NARCIS (Netherlands)

    Stramigioli, Stefano; Scherpen, Jacquelien M.A.; Khodabandehloo, Koorosh

    2000-01-01

    The paper presents a control philosophy called Intrinsically Passive Control, which has the feature to properly behave during interaction with any passive objects. The controlled robot will never become unstable due to the physical structure of the controller.

  3. Laryngeal sarcoidosis: presentation and management in the pediatric population.

    Science.gov (United States)

    Strychowsky, Julie E; Vargas, Sara O; Cohen, Ezra; Vielman, Rene; Son, Mary Beth; Rahbar, Reza

    2015-09-01

    Sarcoidosis is a disease characterized by systemic non-necrotizing granulomas of unknown etiology. Laryngeal sarcoidosis is extremely uncommon, especially among pediatric patients. The clinical presentation and management of this entity in the pediatric population are poorly understood. A comprehensive search in PubMed was conducted to identify all cases in the published literature. We also present a case of isolated pediatric laryngeal sarcoidosis and outline the multidisciplinary approach to evaluation and management. A previously healthy 13-year-old female presented with a five-month history of mild dysphonia, dyspnea on exertion, and diffuse supraglottic edema. Biopsy showed non-necrotizing granulomas. Treatment with methotrexate led to marked improvement. The literature search identified seven previously published cases of pediatric laryngeal sarcoidosis, four in which disease was isolated to the larynx. All patients presented with a symptomatic and diffusely edematous supraglottis. Diagnoses were based on supraglottic biopsies showing non-necrotizing granulomas; all other possible etiopathologies were excluded. Three patients responded to corticosteroid therapy alone, one patient to tumor necrosis factor (TNF) inhibitor and methotrexate, and the remainder to a combination of corticosteroid therapy and surgical debulking. Laryngeal sarcoidosis in the pediatric population is challenging to diagnose and manage. When epithelioid granulomas are encountered histologically, other causes of granulomatous inflammation must be ruled out before a diagnosis of sarcoidosis can be made. Corticosteroid therapy alone may be ineffective. Medical therapy with methotrexate alone or in combination with TNF inhibitors versus surgical debulking alone or as part of multimodality treatment should be considered. A multidisciplinary approach with involvement of an otolaryngologist, pathologist, and rheumatologist is suggested. Copyright © 2015 Elsevier Ireland Ltd. All rights

  4. Laryngeal lipoma associated with Madelung's disease: a case report.

    Science.gov (United States)

    Landínez-Cepeda, Guillermo Arturo; Alarcos-Tamayo, Emilio V; Millás-Gómez, Teresa; Morais-Pérez, Darío

    2012-01-01

    Multiple symmetric lipomatosis is an alteration in the neck, upper trunk and upper extremities fat deposits. It produces an aesthetic problem and sometimes upper airway obstruction when the larynx is infiltrated by the mass. We report the case of a male with Madelung's disease, which began with acute dyspnea caused by laryngeal fat deposits and obstructive lipoma. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  5. Radiation therapy of laryngeal cancer: a twenty year experience

    Energy Technology Data Exchange (ETDEWEB)

    Robson, N.L.K.; Oswal, V.H.; Flood, L.M.

    1990-09-01

    This paper reviews a 20 year experience of radiation treatment of 286 laryngeal cancers and presents results with a minimum five year follow-up. All cases presented had glottic or supraglottic squamous cell carcinomas with no clinical evidence of nodal metastasis. A policy of primary radiotherapy, with surgery for salvage of treatment failures, produced control of primary disease and prevention of metastases superior to most other regimes documented in the literature. (author).

  6. Laryngeal schwannoma: a case report with emphasis on sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Luis Ronan Marquez Ferreira de, E-mail: luisronan@gmail.com [Universidade Federal do Triangulo Mineiro (UFTM), Uberaba, MG (Brazil); De Nicola, Harley; Yamasaki, Rosiane; Pedroso, Jose Eduardo; Brasil, Osiris de Oliveira Campones do; Yamashita, Helio [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina

    2014-05-15

    Schwannomas are benign nerve sheath tumors composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral, cranial and autonomic nerves. Twenty-five to forty-five percent of all schwannomas occur in the head and neck region, but location of such tumors in the larynx is rarely observed. The present report is aimed at describing a clinical case of laryngeal schwannoma, with emphasis on sonographic findings. (author)

  7. Comparison of the Success Rate of Laryngeal Mask Air Way Insertion in Classic & Rotatory Methods in Pediatric Patients Undergoing General Anesthesia.

    Science.gov (United States)

    Aghdashi, Mir Mousa; Valizade Hasanloei, Mohammad Amin; Abbasivash, Rahman; Shokouhi, Shahram; Salehi Gharehvaran, Shahram

    2017-04-01

    Laryngeal mask airway (LMA) is frequently used as a replacement method for endotracheal intubation. Few studies have investigated placement of laryngeal mask airway in pediatric surgical patients. In the present study, we aimed at comparing the success rate of 2 techniques, classic versus rotational, in the correct placement of laryngeal mask airway in pediatric patients. After obtaining approval from the research committee of Faculty of Medicine, and receiving clearance from the ethics board of the University, this randomized controlled clinical trial (RCT) was administered on children of 2 months to 8 years with ASA class I & II undergoing lower abdominal surgical procedures in Motahari hospital in Urmia. General anesthesia using muscle relaxant was the preferred anesthesia technique for all the patients. Demographic data were recorded. Success rate, number of trials for correct placement, cuff leak pressure, and blood stain on the cuff of the laryngeal mask airway after its removal were all recorded. In the present study, 116 children were evaluated and placed into 2 groups. According to the results of the t test, no significant effect of age, weight, or average number of trials in mask placement was observed between the 2 groups (P > 0.05). According to the results of the Fisher's exact test, no significant difference was detected between the 2 groups in blood staining on the cuff (P > 0.05); no leak was recorded in any of the LMA placement methods (classic or rotational). Both insertion techniques work well in pediatric surgical patients. Success rate and complications were comparable between the 2 groups.

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

    Science.gov (United States)

    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.

  9. Deep neuromuscular block improves the surgical conditions for laryngeal microsurgery.

    Science.gov (United States)

    Kim, H J; Lee, K; Park, W K; Lee, B R; Joo, H M; Koh, Y W; Seo, Y W; Kim, W S; Yoo, Y C

    2015-12-01

    Adequate neuromuscular block is required throughout laryngeal microsurgery. We hypothesized that the surgical conditions would improve under a deeper level of rocuronium-induced neuromuscular block. Seventy-two patients undergoing laryngeal microsurgery were randomly allocated to either the 'post-tetanic counts 1-2' (PTC1-2) group or the 'train-of-four counts 1-2' (TOFcount1-2) group according to the level of neuromuscular block used. Two different doses of rocuronium (1.2 or 0.5 mg kg(-1)) were used after anaesthetic induction, and two respective targets of neuromuscular block (post-tetanic counts ≤2 or train-of-four count of 1 or 2) were used. Surgical conditions were assessed by the surgeon using a five-point rating scale (extremely poor/poor/acceptable/good/optimal), and clinically acceptable surgical conditions were defined as those which were rated acceptable, good, or optimal. The occurrence of vocal cord movement and postoperative adverse events was assessed. The surgical conditions were significantly different between the PTC1-2 and TOFcount1-2 groups (extremely poor/poor/acceptable/good/optimal: 0/2/1/7/26 and 3/10/2/14/7, respectively, Pneuromuscular block (post-tetanic count of 1-2) surgical conditions in patients undergoing laryngeal microsurgery improves. NCT01980069. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Intralesional cidofovir for recurrent laryngeal papillomas: preliminary report.

    Science.gov (United States)

    Wilson, W R; Hashemiyoon, R; Hawrych, A

    2000-04-01

    This is a preliminary report of an ongoing study to test the efficacy of intralesional injections of the antiviral drug cidofovir in adults with recurrent laryngeal papillomas in whom multiple other treatments have previously failed. This study has been designed to include 10 to 20 patients, a number sufficient to either prove or disprove the safety and efficacy of this agent. This report conveys information on the first three patients enrolled in the trial. Each patient received an overall dose of 5 to 10 ml of cidofovir, at a concentration of 4.17 mg/ml, intralesionally at 2- to 4-week intervals. The approximate volume injected into each wart was 0.2 to 0.5 ml. Biopsies of the lesion sites were obtained at the initiation and completion of therapy. No other treatment was given. Resolution of lesions was monitored by videolaryngoscopy and still photography 1 to 2 weeks after each treatment. In time, the lesions resolved in all three patients, although all three later experienced a minor recurrence. We conclude that intralesional cidofovir appears to be a promising new treatment for controlling--and perhaps at higher dosages curing--refractory laryngeal papillomas, while causing little or no injury to laryngeal structures.

  11. Comparison of performance and efficacy of air-Q intubating laryngeal airway and flexible laryngeal mask airway in anesthetized and paralyzed infants and children.

    Science.gov (United States)

    Darlong, Vanlal; Biyani, Ghansham; Pandey, Ravindra; Baidya, Dalim K; Punj, Chandralekha and Jyotsna

    2014-10-01

    Flexible laryngeal mask airway is a commonly used supraglotic airway device (SAD) during ophthalmic surgeries. Air-Q intubating laryngeal airway (ILA) is a newer SAD used as primary airway device and as a conduit for intubation as well. Available literature shows that air-Q performs equal or better than other SADs in children and adults. However, limited data is available using air-Q in infants and small children children’. Our hypothesis is that air-Q due to its improved cuff design will yield better airway seal pressures and improved laryngeal alignment as compared to flexible laryngeal mask airway. ASA I–II infants and children weighing insertion success rate, time to insert, and any other complications. There was no difference between the groups in demographic data, first insertion success rate, time to insert, and postoperative complications. Air-Q provided significantly more OLP [21.1 ± 6.4 cmH2O vs 17.4 ± 4.1 cmH2O, P = 0.02] and better FO view of glottis (good view 84% vs 48%, P = 0.0016) as compared to flexible laryngeal mask airway. We conclude that air-Q is superior to flexible laryngeal mask airway in providing higher airway sealing pressures and better FO grade of laryngeal view in infants and children.

  12. Solitary Laryngeal Metastasis from Transitional Cell Carcinoma of the Kidney: Clinical Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tarek Assi

    2015-01-01

    Full Text Available The urogenital tract is a rare origin of laryngeal metastasis; transitional cell carcinoma with laryngeal metastases had never been reported previously. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of the first reported case of a laryngeal metastasis of a TCC followed by a brief review of the literature.

  13. Muscle Deoxygenation Causes Muscle Fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  14. Use of laryngeal mask airway for prolonged ventilatory support in a preterm newborn.

    Science.gov (United States)

    Fernández-Jurado, Ma Isabel; Fernández-Baena, Mariano

    2002-05-01

    We present the case report of a preterm, low weight newborn with dysmorphic features and micrognathia in whom a laryngeal mask airway was inserted and maintained for 44 h for ventilatory support after several failed intubations. No complications associated with laryngeal mask airway use were apparent.

  15. F-18-FLT PET for visualization of laryngeal cancer : Comparison with F-18-FDG PET

    NARCIS (Netherlands)

    Cobben, DCP; van der Laan, BFAM; Maas, B; Vaalburg, W; Suurmeijer, AJH; Hoekstra, HJ; Jager, PL; Elsinga, PH

    The feasibility of F-18-3'-fluoro-3'-deoxy-L-thymidine PET (FLT PET) for detecting laryngeal cancer was investigated and compared with F-18-FDG PET. Methods: Eleven patients diagnosed with or strongly suspected of having recurrent laryngeal cancer and 10 patients with histologically proven primary

  16. Laryngeal Aerodynamics in Healthy Older Adults and Adults with Parkinson's Disease

    Science.gov (United States)

    Matheron, Deborah; Stathopoulos, Elaine T.; Huber, Jessica E.; Sussman, Joan E.

    2017-01-01

    Purpose: The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method: Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and…

  17. Prenatal development supports a single origin of laryngeal echolocation in bats.

    Science.gov (United States)

    Wang, Zhe; Zhu, Tengteng; Xue, Huiling; Fang, Na; Zhang, Junpeng; Zhang, Libiao; Pang, Jian; Teeling, Emma C; Zhang, Shuyi

    2017-01-09

    Bat laryngeal echolocation is considered as one of the most complex and diverse modes of auditory sensory perception in animals and its evolutionary history has been the cause of many scientific controversies in the past two decades. To date, the majority of scientific evidence supports that bats (Chiroptera) are divided into two subordinal groups: Yinpterochiroptera, containing the laryngeal echolocating superfamily Rhinolophidae as sister taxa to the non-laryngeal echolocating family Pteropodidae; and Yangochiroptera, containing all other laryngeal echolocating lineages. This topology has led to an unanswered question in mammalian biology: was laryngeal echolocation lost in the ancestral pteropodids or gained convergently in the echolocating bat lineages? To date, there is insufficient and conflicting evidence from fossil, genomic, morphological and phylogenomic data to resolve this question. We detail an ontogenetic study of fetal cochlear development from seven species of bats and five outgroup mammals and show that in early fetal development, all bats including the non-laryngeal echolocating pteropodids have a similarly large cochlea typically associated with laryngeal echolocation abilities. The subsequent cochlear growth rate in the pteropodids is the slowest of all mammals and leads to the pteropodids and the non-echolocating lineages eventually sharing a similar cochlear morphospace as adults. The results suggest that pteropodids maintain a vestigial developmental stage indicative of past echolocation capabilities and thus support a single origin of laryngeal echolocation in bats.

  18. Tea and coffee consumption and risk of laryngeal cancer: a systematic review meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jiangbo Chen

    Full Text Available BACKGROUND: Tea and coffee are the most commonly consumed beverages in the worldwide. The relationship between tea and coffee consumption on the risk of laryngeal cancer was still unclear. METHODS: Relevant studies were identified by searching electronic database (Medline and EMBASE and reviewing the reference lists of relevant articles until Oct. 2013. Observational studies that reported RRs and 95% CIs for the link of tea and coffee consumption on the risk of laryngeal cancer were eligible. A meta-analysis was obtained to combine study-specific RRs with a random-effects model. RESULTS: A total of 2,803 cases and 503,234 controls in 10 independent studies were identified. The overall analysis of all 10 studies, including the case-control and cohort studies, found that tea drinking was not associated with laryngeal carcinoma (RR = 1.03; 95% CI: 0.66-1.61. However, coffee consumption was significantly associated with the laryngeal carcinoma (RR = 1.47; 95% CI: 1.03-2.11. A dose-response relationship between coffee intake and laryngeal carcinoma was detected; however, no evidence of dose-response link between tea consumption and laryngeal carcinoma risk was detected. CONCLUSIONS: The results from this meta-analysis of observational studies demonstrate that coffee consumption would increase the laryngeal cancer risk, while tea intake was not associated with risk of laryngeal carcinoma.

  19. Adverse Events in Children Receiving General Anaesthesia with Laryngeal Mask Airway Insertion

    Directory of Open Access Journals (Sweden)

    Sindhu Khatiwada

    2015-06-01

    Conclusions: The commonest adverse event in children is related to respiratory system. Adverse events occur more frequently in the operating room, mostly immediately after removal of laryngeal mask airway. Respiratory events are more frequent in children below five years whereas cardiac events are more frequent in children above five years. Keywords: adverse events; children; laryngeal mask airway; laryngospasm; perioperative.

  20. Failed obstetric tracheal intubation and postoperative respiratory support with the ProSeal laryngeal mask airway

    NARCIS (Netherlands)

    Keller, Christian; Brimacombe, Joseph; Lirk, Philipp; Pühringer, Fritz

    2004-01-01

    The ProSeal laryngeal mask airway (ProSeal LMA) provides a better seal and probably better airway protection than the classic laryngeal mask airway (classic LMA). We report the use of the ProSeal LMA in a 26-yr-old female with HELLP syndrome for failed obstetric intubation and postoperative

  1. T(3) LARYNGEAL-CANCER, PRIMARY SURGERY VS PLANNED COMBINED RADIOTHERAPY AND SURGERY

    NARCIS (Netherlands)

    TJHOHESLINGA, RE; TERHAARD, CHJ; SCHOUWENBURG, P; HILGERS, FJM; DOLSMA, WV; CROLL, GA; HOOGENHOUT, J; KNEGT, PP; LEER, JWH; HORDIJK, GJ

    1993-01-01

    The Dutch Co-operative Head and Neck Oncology Group performed a retrospective, nationwide study of laryngeal cancer between 1975 and 1984. The results for T3 laryngeal cancer treated with primary laryngectomy (n = 137) with post-operative radiotherapy when indicated or planned combined

  2. Strain modulations as a mechanism to reduce stress relaxation in laryngeal tissues.

    Science.gov (United States)

    Hunter, Eric J; Siegmund, Thomas; Chan, Roger W

    2014-01-01

    Vocal fold tissues in animal and human species undergo deformation processes at several types of loading rates: a slow strain involved in vocal fold posturing (on the order of 1 Hz or so), cyclic and faster posturing often found in speech tasks or vocal embellishment (1-10 Hz), and shear strain associated with vocal fold vibration during phonation (100 Hz and higher). Relevant to these deformation patterns are the viscous properties of laryngeal tissues, which exhibit non-linear stress relaxation and recovery. In the current study, a large strain time-dependent constitutive model of human vocal fold tissue is used to investigate effects of phonatory posturing cyclic strain in the range of 1 Hz to 10 Hz. Tissue data for two subjects are considered and used to contrast the potential effects of age. Results suggest that modulation frequency and extent (amplitude), as well as the amount of vocal fold overall strain, all affect the change in stress relaxation with modulation added. Generally, the vocal fold cover reduces the rate of relaxation while the opposite is true for the vocal ligament. Further, higher modulation frequencies appear to reduce the rate of relaxation, primarily affecting the ligament. The potential benefits of cyclic strain, often found in vibrato (around 5 Hz modulation) and intonational inflection, are discussed in terms of vocal effort and vocal pitch maintenance. Additionally, elderly tissue appears to not exhibit these benefits to modulation. The exacerbating effect such modulations may have on certain voice disorders, such as muscle tension dysphonia, are explored.

  3. A prospective, randomized, Single-blinded, comparative study of Classic Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway in pediatric patients

    OpenAIRE

    Das, Bikramjit; Jamil, Shahin N; Mitra, Subhro; Varshney, Rohit K

    2012-01-01

    Context: ProSeal Laryngeal Mask Airway (PLMA) is extensively being used in pediatric anesthesia. Aims: To evaluate the efficacy of PLMA as compared to Classic Laryngeal Mask Airway (CLMA) for airway maintenance in pediatric patients. Settings and Design: A prospective, randomized, Single-blinded study was conducted in a tertiary care teaching hospital. Materials and Methods: Sixty ASA I and II children were included. Patients were randomized to either size 2 PLMA or size 2 CLMA gr...

  4. Exercise induced laryngeal obstruction: a review of diagnosis and management.

    Science.gov (United States)

    Liyanagedera, Savinda; McLeod, Robert; Elhassan, Hassan A

    2017-04-01

    Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used. Primary searching found 469 records, 308 were excluded following screening of titles and citation. 100 were duplicates, a further 47 studies were excluded after applying inclusion and exclusion criteria. Two studies were identified following cross-referencing. A total of 15 studies were included. The last search date was 6/06/15. Average prevalence in the general adolescent population and athletes was 7.1 and 35.2 %, respectively. Dyspnoea was reported in 96.5, 99 and 100 % of three EILO patient cohorts. Two studies (n = 107) reported continuous laryngoscopy during exercise (CLE) testing could differentiate between patients and controls. In two studies (n = 33) the visual analogue scale (VAS) showed a beneficial effect of endoscopic supraglottoplasty (ES). Thirty-eight out of 43 patients who received two or more laryngeal control therapy sessions (LCT) had improvement or resolution of EILO symptoms. Exercise induced dyspnoea is the most common EILO symptom. EILO has a high occurrence in adolescents and athletes. The CLE test is the current gold standard for EILO diagnostics. Management of EILO includes both surgical and non-surgical interventions.

  5. A STATISTICAL ANALYSIS OF LARYNGEAL MALIGNANCIES AT OUR INSTITUTION

    Directory of Open Access Journals (Sweden)

    Bharathi Mohan Mathan

    2017-03-01

    Full Text Available BACKGROUND Malignancies of larynx are an increasing global burden with a distribution of approximately 2-5% of all malignancies with an incidence of 3.6/1,00,000 for men and 1.3/1,00,000 for women with a male-to-female ratio of 4:1. Smoking and alcohol are major established risk factors. More than 90-95% of all malignancies are squamous cell type. Three main subsite of laryngeal malignancies are glottis, supraglottis and subglottis. Improved surgical techniques and advanced chemoradiotherapy has increased the overall 5 year survival rate. The above study is statistical analysis of laryngeal malignancies at our institution for a period of one year and analysis of pattern of distribution, aetiology, sites and subsites and causes for recurrence. MATERIALS AND METHODS Based on the statistical data available in the institution for the period of one year from January 2016-December 2016, all laryngeal malignancies were analysed with respect to demographic pattern, age, gender, site, subsite, aetiology, staging, treatment received and probable cause for failure of treatment. Patients were followed up for 12 months period during the study. RESULTS Total number of cases studied are 27 (twenty seven. Male cases are 23 and female cases are 4, male-to-female ratio is 5.7:1, most common age is above 60 years, most common site is supraglottis, most common type is moderately-differentiated squamous cell carcinoma, most common cause for relapse or recurrence is advanced stage of disease and poor differentiation. CONCLUSION The commonest age occurrence at the end of the study is above 60 years and male-to-female ratio is 5.7:1, which is slightly above the international standards. Most common site is supraglottis and not glottis. The relapse and recurrences are higher compared to the international standards.

  6. Computational Models of Laryngeal Aerodynamics: Potentials and Numerical Costs.

    Science.gov (United States)

    Sadeghi, Hossein; Kniesburges, Stefan; Kaltenbacher, Manfred; Schützenberger, Anne; Döllinger, Michael

    2018-02-07

    Human phonation is based on the interaction between tracheal airflow and laryngeal dynamics. This fluid-structure interaction is based on the energy exchange between airflow and vocal folds. Major challenges in analyzing the phonatory process in-vivo are the small dimensions and the poor accessibility of the region of interest. For improved analysis of the phonatory process, numerical simulations of the airflow and the vocal fold dynamics have been suggested. Even though most of the models reproduced the phonatory process fairly well, development of comprehensive larynx models is still a subject of research. In the context of clinical application, physiological accuracy and computational model efficiency are of great interest. In this study, a simple numerical larynx model is introduced that incorporates the laryngeal fluid flow. It is based on a synthetic experimental model with silicone vocal folds. The degree of realism was successively increased in separate computational models and each model was simulated for 10 oscillation cycles. Results show that relevant features of the laryngeal flow field, such as glottal jet deflection, develop even when applying rather simple static models with oscillating flow rates. Including further phonatory components such as vocal fold motion, mucosal wave propagation, and ventricular folds, the simulations show phonatory key features like intraglottal flow separation and increased flow rate in presence of ventricular folds. The simulation time on 100 CPU cores ranged between 25 and 290 hours, currently restricting clinical application of these models. Nevertheless, results show high potential of numerical simulations for better understanding of phonatory process. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Characterization of Partial Intrinsic Symmetries

    NARCIS (Netherlands)

    Shehu, Aurela; Brunton, Alan; Wuhrer, Stefanie; Wand, Michael

    2014-01-01

    We present a mathematical framework and algorithm for characterizing and extracting partial intrinsic symmetries of surfaces, which is a fundamental building block for many modern geometry processing algorithms. Our goal is to compute all “significant” symmetry information of the shape, which we

  8. Reading: Intrinsic versus Extrinsic Motivation.

    Science.gov (United States)

    Ediger, Marlow

    Much debate centers on motivating student in reading achievement. Should students feel motivated from within (intrinsic motivation), or is it better to have extrinsic motivation whereby external stimuli are used to help learners achieve optimally in reading? This paper aims to analyze the two points of view about motivating students in reading…

  9. Intrinsic volumes of symmetric cones

    OpenAIRE

    Amelunxen, Dennis; Bürgisser, Peter

    2012-01-01

    We compute the intrinsic volumes of the cone of positive semidefinite matrices over the real numbers, over the complex numbers, and over the quaternions, in terms of integrals related to Mehta's integral. Several applications for the probabilistic analysis of semidefinite programming are given.

  10. Acoustic resonance spectroscopy intrinsic seals

    International Nuclear Information System (INIS)

    Olinger, C.T.; Burr, T.; Vnuk, D.R.

    1994-01-01

    We have begun to quantify the ability of acoustic resonance spectroscopy (ARS) to detect the removal and replacement of the lid of a simulated special nuclear materials drum. Conceptually, the acoustic spectrum of a container establishcs a baseline fingerprint, which we refer to as an intrinsic seal, for the container. Simply removing and replacing the lid changes some of the resonant frequencies because it is impossible to exactly duplicate all of the stress patterns between the lid and container. Preliminary qualitative results suggested that the ARS intrinsic seal could discriminate between cases where a lid has or has not been removed. The present work is directed at quantifying the utility of the ARS intrinsic seal technique, including the technique's sensitivity to ''nuisance'' effects, such as temperature swings, movement of the container, and placement of the transducers. These early quantitative tests support the potential of the ARS intrinsic seal application, but also reveal a possible sensitivity to nuisance effects that could limit environments or conditions under which the technique is effective

  11. Intrinsic Motivation in Physical Education

    Science.gov (United States)

    Davies, Benjamin; Nambiar, Nathan; Hemphill, Caroline; Devietti, Elizabeth; Massengale, Alexandra; McCredie, Patrick

    2015-01-01

    This article describes ways in which educators can use Harter's perceived competence motivation theory, the achievement goal theory, and self-determination theory to develop students' intrinsic motivation to maintain physical fitness, as demonstrated by the Sound Body Sound Mind curriculum and proven effective by the 2013 University of…

  12. Study on the correlation between extracellular matrix protein-1 and the growth, metastasis and angiogenesis of laryngeal carcinoma.

    Science.gov (United States)

    Meng, Xin-Yu; Liu, Juan; Lv, Feng; Liu, Ming-Qiu; Wan, Jing-Ming

    2015-01-01

    To investigate the correlation between extracellular matrix protein-1 (ECM1) and the growth, metastasis and angiogenesis of laryngeal carcinoma. Forty-five samples with laryngeal benign and malignant tumors confirmed by pathology in Laiwu City People's Hospital from March 2006 to March 2011 were collected, in which there were 29 cases with laryngeal carcinoma and 16 with benign tumors. The expression of ECM1 and factor VIII-related antigens in patients with laryngeal carcinoma and those with benign tumors was respectively detected using immunohistochemical method, and the correlation between ECM1 staining grade and microvessel density (MVD) was analyzed. In laryngeal carcinoma tissue, ECM1 was mainly expressed in cytoplasm, less in cytomembrane or intercellular substance. With abundant expression in the tissue of laryngeal benign tumors (benign mesenchymoma and hemangioma), ECM1 was primarily expressed in the connective tissue, which was different from the expression in laryngeal carcinoma tissue. The proportion of positive ECM1 staining (++) in patients with laryngeal carcinoma was dramatically higher than those with benign tumors (pcorrelation analysis revealed that ECM1 staining grade in laryngeal carcinoma tissue had a significantly-positive correlation with MVD (r=0.866, p=0.000). ECM1 expression in laryngeal carcinoma is closely associated with tumor cell growth, metastasis and angiogenesis, which can be considered as an effective predictor in the occurrence and postoperative recurrence of laryngeal carcinoma.

  13. Muscle pain

    African Journals Online (AJOL)

    Key Summary Points. • Muscle pain, known as myalgia, can be in one targeted area or across many muscles, occurring with overexertion or overuse of these muscles. • Pain can be classified as acute or chronic pain and further categorized as nociceptive or neuropathic. • Causes of muscle pain include stress, physical ...

  14. Spontaneous pharyngo-laryngeal hematoma and anticoagulation. A case report

    Directory of Open Access Journals (Sweden)

    Marleny CASASOLA-GIRÓN

    2016-03-01

    Full Text Available Introduction and Objective: Spontaneous pharyngeal-laryngeal hematoma shows the importance of a complete ENT examination in the face of symptoms of banal appearance and a correct history that, in the case reported, unveiled the therapeutic use of anticoagulants. Case description: A 55 year old woman comes to emergency because of unexplained dysphagia. The inspection shows the presence of a hematoma in the pharyngeal-laryngeal region that, after the anticoagulant therapy was reversed, evolved favorably with conservative treatment. Discussion: In this case, apart from medical management performed by the hematology department, we focus our therapeutic approach in the protection of the airway and the prevention of a possible massive bleeding. Determining which patients require endotracheal intubation or tracheostomy and hemostatic surgery is the key to treatment. Conclusions: The anticoagulant therapy involves several complications that ENT specialists must consider in the face of clinical symptoms of dysphagia, dysphonia, dyspnea or signs of bleeding and they must know the possibilities of performance depending on the severity of each case.

  15. Type I-II laryngeal cleft: clinical course and outcome.

    Science.gov (United States)

    Slonimsky, Guy; Carmel, Eldar; Drendel, Michael; Lipschitz, Noga; Wolf, Michael

    2015-04-01

    Laryngeal cleft (LC) is a rare congenital anomaly manifesting in a variety of symptoms, including swallowing disorders and aspirations, dyspnea, stridor and hoarseness. The mild forms (types I-II) may be underdiagnosed, leading to protracted symptomatology and morbidity. To evaluate the diagnostic process, clinical course, management and outcome in children with type I-II laryngeal clefts. We conducted a retrospective case analysis for the years 2005-2012 in a tertiary referral center. Seven children were reviewed: five boys and two girls ranging in age from birth to 5 years. The most common presenting symptoms were cough, aspirations and pneumonia. Evaluation procedures included fiber-optic laryngoscopy (FOL), direct laryngoscopy (DL) and videofluoroscopy. Other pathologies were seen in three children. Six children underwent successful endoscopic surgery and one child was treated conservatively. The postoperative clinical course was uneventful in most of the cases. Types I-II LC should be considered in the differential diagnosis of children presenting with protracted cough and aspirations. DL is crucial for establishing the diagnosis. Endoscopic surgery is safe and should be applied promptly when conservative measures fail.

  16. Clinical experiences of NBI laryngoscope in diagnosis of laryngeal lesions

    Science.gov (United States)

    Qi, Xinmeng; Yu, Dan; Zhao, Xue; Jin, Chunshun; Sun, Changling; Liu, Xueshibojie; Cheng, Jinzhang; Zhang, Dejun

    2014-01-01

    Endoscopy is essential for the diagnosis and treatment of cancers derived from the larynx. However, a laryngoscope with conventional white light (CWL) has technical limitations in detecting small or superficial lesions on the mucosa. Narrow band imaging especially combined with magnifying endoscopy (ME) is useful for the detection of superficial squamous cell carcinoma (SCC) within the oropharynx, hypopharynx, and oral cavity. A total of 3675 patients who have come to the outpatient clinic and complained of inspiratory stridor, dyspnea, phonation problems or foreign body sensation, were enrolled in this study. We describe the glottic conditions of the patients. All 3675 patients underwent laryngoscopy equipped with conventional white light (CWL) and NBI system. 1149 patients received a biopsy process. And 1153 lesions were classified into different groups according to their histopathological results. Among all the 1149 patients, 346 patients (312 males, 34 females; mean age 62.2±10.5 years) were suspected of having a total of 347 precancerous or cancerous (T1 or T2 without lymphnode involvement) lesions of the larynx under the CWL. Thus, we expected to attain a complete vision of what laryngeal lesions look like under the NBI view of a laryngoscope. The aim was to develop a complete description list of each laryngeal conditions (e.g. polyps, papilloma, leukoplakia, etc.), which can serve as a criteria for further laryngoscopic examinations and diagnosis. PMID:25419362

  17. The accuracy of target delineation in laryngeal and hypopharyngeal cancer.

    Science.gov (United States)

    Caldas-Magalhaes, Joana; Kooij, Nina; Ligtenberg, Hans; Jager, Elise A; Schakel, Tim; Kasperts, Nicolien; Pameijer, Frank A; Terhaard, Chris H J; Janssen, Luuk M; van Diest, Paul J; Philippens, Marielle E P; Raaijmakers, Cornelis P J

    2015-01-01

    To determine the spatial correspondence between the gross tumor volume (GTV) delineated on computer tomography (CT) and the actual tumor on histopathology. Sixteen patients with T3 or T4 laryngeal or hypopharyngeal cancer underwent a CT scan before total laryngectomy. The GTV was delineated on CT by three independent observers and by consensus between the three observers. After surgery, whole-mount hematoxylin-eosin stained (H&E) sections were obtained. One pathologist delineated the tumor in the H&E sections (tumorH&E). The reconstructed specimen was registered to the CT scan in order to compare the GTV to the tumorH&E in three dimensions. The overlap between the GTV and the tumorH&E was calculated and the distance between the volumes was determined. Tumor tissue was delineated in 203 of 516 H&E sections. For 14 patients a detailed analysis could be performed. The GTV volume was on average 1.7 times larger than the volume of the tumorH&E. The mean coverage of the tumorH&E by the consensus GTV was 88%. tumorH&E tissue was found at 1.6 mm to 12.9 mm distance outside the GTV depending on observer and patient. GTVs delineated on CT for laryngeal and hypopharyngeal cancer were 1.7 times larger than the tumor. Complete coverage of the tumor by the GTV was, however, not obtained.

  18. Quality of life and utility in irradiated laryngeal cancer patients

    International Nuclear Information System (INIS)

    Ringash, Jolie; Redelmeier, Donald A.; O'Sullivan, Brian; Bezjak, Andrea

    2000-01-01

    Purpose: To determine quality of life (QOL) and health utility in irradiated laryngeal cancer survivors. Materials and Methods: Over 6 months, consecutive follow-up patients at a comprehensive cancer centre completed the QOL questionnaire FACT-H and N and the time trade-off (TTO) utility instrument. Results: Inclusion criteria were met by 339 patients, of whom 269 were eligible, 245 were approached, and 120 agreed to participate. Most participants were men (83%) who had received radiotherapy (97%) for Stage I disease (53%) of the glottis (75%); 7% had undergone total laryngectomy. Participants differed from nonparticipants only in being younger (mean age, 65 vs. 68 years, p = 0.0049) and having higher performance status (Karnofsky 88 vs. 84, p = 0.0012). The average scores for FACT-H and N and the TTO were 124/144 (SD, 14) and 0.90/1.0 (SD, 0.16) respectively. FACT-H and N score was more highly correlated with Karnofsky score (r = 0.43, p = 0.001) than with the TTO (r = 0.29, p = 0.002). Gender predicted QOL (means: M = 125, F 118), while natural speech, no relapses, and more time since initial treatment predicted higher utility. Conclusion: The QOL of irradiated laryngeal cancer survivors was reasonably high and independent of initial disease variables. The QOL questionnaire correlated more strongly with performance status than with utility, suggesting that QOL and utility measures may be perceived differently by patients

  19. [Clinic features of laryngeal carcinosarcoma and sarcomatoid carcinoma].

    Science.gov (United States)

    Li, Y J; Li, W Y; Wang, J; Gao, Z Q; Qi, F; Jiang, H

    2017-05-07

    Objective: To investigate the clinic feature, pathology, therapy and prognosis of the sarcomatoid caricinoma or carcinosarcoma of the larynx. Methods: We reviewed the clinical records of 7 patients with laryngeal carcinosarcoma /sarcomatoid caricinoma who were treated at our hospital between June 1996 and August 2016. All patients were men (mean age, 65.9 years; range, 52 to 94 years). Among 7 patients, 6 had a history of smoking; 2 underwent radiotherapy; and 5 patients who didn't undergo radiotherapy complained of hoarseness. The glottis was the most frequent site of involvement. Most tumors exhibited a polypold or pedunculated gross morphology. Among the 5 patients who didn't undergo a radiotherapy, 2 were in stage Ⅰ, 2 in stageⅡ, and 1 in stage Ⅲ. The other 2 cases underwent surgeries and radiotherapy were staged. Results: All 7 patients received surgeries, without lymph node metastasis. All the tumors were pathologically carcinosarcoma/sarcomatoid carcinoma. With immunohistochemistry examination, Vimetin was positive in all tumors, SMA positive in 3 tumors, S-100 positive in 1 tumors, but CD-68, HMB-45 or Myglobin was negative in all tumors. With follows-up from 3 months to 20 years, of 7 patients, 4 survived without recurrent, 1 dead, and 2 lost connection. Conclusions: Both of the carcinosarcoma and the sarcomatoid carcinoma of larynx contain pathologically carcinoma and sarcoma. Surgery is the best choice for laryngeal sarcomatoid carcinoma, and these patients without a undergoing radiotherapy before surgery or these with little sarcoma in tumors show better prognosis.

  20. Management of Oropharyngeal Dysphagia in Laryngeal and Hypopharyngeal Cancer

    Directory of Open Access Journals (Sweden)

    Jose Granell

    2012-01-01

    Full Text Available On considering a function-preserving treatment for laryngeal and hypopharyngeal cancer, swallowing is a capital issue. For most of the patients, achieving an effective and safe deglutition will mark the difference between a functional and a dysfunctional outcome. We present an overview of the management of dysphagia in head and neck cancer patients. A brief review on the normal physiology of swallowing is mandatory to analyze next the impact of head and neck cancer and its treatment on the anatomic and functional foundations of deglutition. The approach proposed underlines two leading principles: a transversal one, that is, the multidisciplinary approach, as clinical aspects to be managed in the oncologic patient with oropharyngeal dysphagia are diverse, and a longitudinal one; that is, the concern for preserving a functional swallow permeates the whole process of the diagnosis and treatment, with interventions required at multiple levels. We further discuss the clinical reports of two patients who underwent a supracricoid laryngectomy, a function-preserving surgical technique that particularly disturbs the laryngeal mechanics, and in which swallowing rehabilitation dramatically conditions the functional results.

  1. Radiation-induced mucositis pain in laryngeal cancer

    International Nuclear Information System (INIS)

    Takahashi, Atsuhito; Shoji, Kazuhiko; Iki, Takehiro; Mizuta, Masanobu; Matsubara, Mami

    2009-01-01

    Radiation therapy in those with head and neck malignancies often triggers painful mucositis poorly controlled by nonsteroidal antiinflammatory drugs (NSAIDs). To better understand how radiation-induced pain develops over time, we studied the numerical rating scale (NRS 0-5) pain scores from 32 persons undergoing radiation therapy of 60-72 Gy for newly diagnosed laryngeal cancer. The degree of mucositis was evaluated using Common Terminology Criteria for Adverse Events version3.0 (CTCAE v3.0). We divided the 32 into a conventional fractionation (CF) group of 14 and a hyperfractionation (HF) group of 18, and further divided laryngeal cancer into a small-field group of 23 and a large-field group of 9. The mucositis pain course was similar in CF and HF, but mucositis pain was severer in the HF group, which also required more NSAIDs. Those in the large-field group had severer pain and mucositis and required more NSAIDs than those in the small-field group. We therefore concluded that small/large-field radiation therapy, rather fractionation type, was related to the incidence of radiation-induced mucositis pain. (author)

  2. [Rare problem with the insertion of a Supreme™ laryngeal mask airway device. Case of the trimester].

    Science.gov (United States)

    2014-03-01

    A breast tumor was resected under general anesthesia. After induction, the airway was managed with a Supreme™ laryngeal mask airway device. The insertion of the laryngeal mask airway device, the insertion of the orogastric tube through the drain tube, as well as the mechanical ventilation, were very difficult from the beginning. On removing the laryngeal mask airway device to solve the problem, it was observed that the drain tube was broken, and the orogastric tube had passed into the anterior, laryngeal part of the device through the split. It was later found out that the laryngeal mask airway device, as well as the whole manufacturing batch, had suffered a design modification: the cuff was constructed with a softer material without reinforcement in the tip, and the drain tube had a heat-sealing defect that facilitated the break. The incident was reported to the local supplier and the manufacturer, and the defective batch of laryngeal mask airway devices was recalled. The incident was also reported to other hospitals via SENSAR, to warn other users of the potential dangers of the design modification in the Supreme™ laryngeal mask airway. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  3. Treatment of laryngeal radionecrosis with hyperbaric oxygen therapy. A case report

    International Nuclear Information System (INIS)

    Nishida, Akiko T.; Honda, Nobumitsu; Tsujimura, Mika; Adachi, Tsunemichi; Fujiki, Nobuya; Miyata, Kouji; Fukushima, Hideyuki; Kitani, Yoshiharu

    2007-01-01

    Laryngeal necrosis is a rare complication of radiotherapy for early-staged laryngeal or hypopharyngeal cancer. However, when it occurs, there is no definitive treatment and laryngectomy is frequently required. Here we present a case of advanced laryngeal necrosis (grade 4, Chandler classification) treated with hyperbaric oxygen (HBO) therapy. A 60-year-old woman received radiotherapy with 64.8 Gy for early-staged hypopharyngeal cancer in combination with three courses of cisplatin (40 mg/body/week). She developed pharyngeal pain and progressive dyspnea because of laryngeal edema 3 months after the completion of radiotherapy, and received an emergent tracheostomy. In order to differentiate radiation injury from cancer recurrence, biopsies were obtained under direct laryngoscopy and showed intense necrosis without malignancy. Since laryngeal radionecrosis was presumed, the patient received HBO therapy at 2 atmospheres absolute (ATA) with 100% O 2 for 2 hours per session. After 20 HBO treatments, laryngeal edema improved and her clinical symptoms including pharyngeal pain, swallowing pain and dysphagia, were ameliorated significantly. However, decannulation has not been achieved because of bilateral vocal cord fixation. We considered that HBO therapy was effective in the present case and that HBO therapy should be recommended as a therapeutic option whenever laryngeal necrosis occurs and there is a chance to save the larynx. (author)

  4. Laryngeal Rosai-Dorfman Disease (Sinus Histiocytosis with Massive Lymphadenopathy: A Retrospective Study of 5 Cases

    Directory of Open Access Journals (Sweden)

    Yanyan Niu

    2017-01-01

    Full Text Available This study was performed to investigate the clinical manifestations, treatment methods, and prognosis of Rosai-Dorfman disease (RDD with laryngeal involvement. Five clinical cases of RDD with laryngeal involvement diagnosed between 1986 and 2015 were retrospectively analyzed. The laryngeal lesions of these 5 patients mostly involved the glottis and subglottis, with the main symptoms being a hoarse voice and airway obstruction. In addition, the patients mostly exhibited a unilateral or asymmetric onset that was manifested by a laryngeal submucosal nodular mass. The patients were subjected to a regimen of hormone treatment combined with surgical resection. The median follow-up duration was 101 months (8–384 months. One case was lost, and the remaining 4 subjects are alive with disease. The follow-up examinations revealed that 4 subjects had stable laryngeal conditions, whereas one showed minor progression. RDD with laryngeal involvement is clinically rare and differs considerably from classical RDD in age of onset, gender composition, and extranodal involvement. The regimen of hormone treatment combined with surgical resection can stabilize the patient’s general condition and laryngeal lesion. Tracheotomies are recommended for patients with dyspnea. After their conditions stabilize, decannulation can be successfully performed in most cases. This therapeutic regimen generally delivers a good prognosis.

  5. Laryngeal Rosai-Dorfman Disease (Sinus Histiocytosis with Massive Lymphadenopathy): A Retrospective Study of 5 Cases.

    Science.gov (United States)

    Niu, Yanyan; Li, Yongjin; Wang, Jian; Jin, Xiaofeng; Yang, Dahai; Huo, Hong; Li, Wuyi

    2017-01-01

    This study was performed to investigate the clinical manifestations, treatment methods, and prognosis of Rosai-Dorfman disease (RDD) with laryngeal involvement. Five clinical cases of RDD with laryngeal involvement diagnosed between 1986 and 2015 were retrospectively analyzed. The laryngeal lesions of these 5 patients mostly involved the glottis and subglottis, with the main symptoms being a hoarse voice and airway obstruction. In addition, the patients mostly exhibited a unilateral or asymmetric onset that was manifested by a laryngeal submucosal nodular mass. The patients were subjected to a regimen of hormone treatment combined with surgical resection. The median follow-up duration was 101 months (8-384 months). One case was lost, and the remaining 4 subjects are alive with disease. The follow-up examinations revealed that 4 subjects had stable laryngeal conditions, whereas one showed minor progression. RDD with laryngeal involvement is clinically rare and differs considerably from classical RDD in age of onset, gender composition, and extranodal involvement. The regimen of hormone treatment combined with surgical resection can stabilize the patient's general condition and laryngeal lesion. Tracheotomies are recommended for patients with dyspnea. After their conditions stabilize, decannulation can be successfully performed in most cases. This therapeutic regimen generally delivers a good prognosis.

  6. [Fibre optic-assisted endotracheal intubation through the laryngeal mask in children].

    Science.gov (United States)

    Weiss, M; Mauch, J; Becke, K; Schmidt, J; Jöhr, M

    2009-07-01

    Fibre optic-assisted tracheal intubation through the laryngeal mask airway is a simple and safe procedure for securing the airway in the paediatric patient with unexpected and known difficult tracheal intubation. Therefore, fibre optic-assisted tracheal intubation through the laryngeal mask airway represents a standard airway technique and must be part of clinical education and also regular training. However, the removal of the laryngeal mask airway over the tracheal tube is impaired by the short length of the tracheal tube, easily resulting in tube dislocation from the trachea. Among several techniques to overcome this problem, the Cook airway exchange catheter offers a reliable method not only for safe removal of the laryngeal mask over the tracheal tube but also for insertion of an adequate tracheal tube, particularly in paediatric patients. This is particularly important for cuffed tubes as the pilot balloon of the cuffed tube is too large to pass through laryngeal mask airway tubes size 2.5 and smaller. This presentation demonstrates fibre optic-assisted tracheal intubation through the laryngeal mask airway in children step-by-step and discusses its clinical implications. A list with compatible sizes of laryngeal mask airways, tracheal tubes and airway exchange catheters is also provided.

  7. Podoplanin expression in the development and progression of laryngeal squamous cell carcinomas

    Science.gov (United States)

    2010-01-01

    Background Podoplanin expression is attracting interest as a marker for cancer diagnosis and prognosis. We therefore investigated the expression pattern and clinical significance of podoplanin during the development and progression of laryngeal carcinomas. Results Podoplanin expression was determined by immunohistochemistry in paraffin-embedded tissue specimens from 84 patients with laryngeal premalignancies and 53 patients with laryngeal squamous cell carcinomas. We found podoplanin expression extending from the basal to the suprabasal layer of the epithelium in 37 (44%) of 84 dysplastic lesions, whereas normal epithelium showed negligible expression. Patients carrying podoplanin-positive lesions had a higher laryngeal cancer incidence than those with negative expression reaching borderline statistical significance (51% versus 30%, P = 0.071). Podoplanin expression in laryngeal carcinomas exhibited two distinct patterns. 20 (38%) cases showed diffuse expression in most tumour cells and 33 (62%) focal expression at the proliferating periphery of tumour nests. High podoplanin expression was inversely correlated with T classification (P = 0.033), disease stage (P = 0.006), and pathological grade (P = 0.04). There was a trend, although not significant, towards reduced disease-specific survival for patients with low podoplanin levels (P = 0.31) and diffuse expression pattern (P = 0.08). Conclusions Podoplanin expression increases in the early stages of laryngeal tumourigenesis and it seems to be associated with a higher laryngeal cancer risk. Podoplanin expression in laryngeal squamous cell carcinomas, however, diminishes during tumour progression. Taken together, these data support a role for podoplanin expression in the initiation but not in the progression of laryngeal cancers. PMID:20196862

  8. Podoplanin expression in the development and progression of laryngeal squamous cell carcinomas

    Directory of Open Access Journals (Sweden)

    Fresno Manuel F

    2010-03-01

    Full Text Available Abstract Background Podoplanin expression is attracting interest as a marker for cancer diagnosis and prognosis. We therefore investigated the expression pattern and clinical significance of podoplanin during the development and progression of laryngeal carcinomas. Results Podoplanin expression was determined by immunohistochemistry in paraffin-embedded tissue specimens from 84 patients with laryngeal premalignancies and 53 patients with laryngeal squamous cell carcinomas. We found podoplanin expression extending from the basal to the suprabasal layer of the epithelium in 37 (44% of 84 dysplastic lesions, whereas normal epithelium showed negligible expression. Patients carrying podoplanin-positive lesions had a higher laryngeal cancer incidence than those with negative expression reaching borderline statistical significance (51% versus 30%, P = 0.071. Podoplanin expression in laryngeal carcinomas exhibited two distinct patterns. 20 (38% cases showed diffuse expression in most tumour cells and 33 (62% focal expression at the proliferating periphery of tumour nests. High podoplanin expression was inversely correlated with T classification (P = 0.033, disease stage (P = 0.006, and pathological grade (P = 0.04. There was a trend, although not significant, towards reduced disease-specific survival for patients with low podoplanin levels (P = 0.31 and diffuse expression pattern (P = 0.08. Conclusions Podoplanin expression increases in the early stages of laryngeal tumourigenesis and it seems to be associated with a higher laryngeal cancer risk. Podoplanin expression in laryngeal squamous cell carcinomas, however, diminishes during tumour progression. Taken together, these data support a role for podoplanin expression in the initiation but not in the progression of laryngeal cancers.

  9. Tracheal and laryngeal tumors in the dog and cat: literature review and 13 additional patients

    International Nuclear Information System (INIS)

    Carlisle, C.H.; Biery, D.N.; Thrall, D.E.

    1991-01-01

    Primary tumors of the larynx or trachea are uncommon in the dog and cat. In a review of the English language literature, description of 65 such patients were found. In a search of the Veterinary Teaching Hospitals of the University of Pennsylvania and North Carolina State University, an additional 13 previously unreported patients were identified, bringing the total to at least 78. Of these 78, there have been 16 canine tracheal, 7 feline tracheal, 34 canine laryngeal and 21 feline laryngeal tumors. In the canine and feline trachea, osteochondroma and epithelial malignancies, respectively, appear to be the most common. Epithelial malignancies appear to be the most common tumor of the canine larynx whereas lymphosarcoma appears to be the most common feline laryngeal tumor. In patients described herein, tumors produced clinical signs consistent with airway obstruction. Voice alteration was common in patients with laryngeal tumors. Patients were middle-aged to older, except for dogs with osteochondroma. This compares favorably to historical data. All tumors in this study were readily seen radiographically, with most laryngeal and tracheal tumors appearing as masses within the lumen of the airway. Mineralization was uncommon except for canine osteochondromas. Feline laryngeal tumors in this study appeared as generalized laryngeal thickening rather than as a distinct mass. Response of canine and feline tracheal and laryngeal thickening rather than as a distinct mass. Response of canine and feline tracheal and laryngeal tumors to treatment can not be adequately assessed from available data. Benign tumors of the larynx or trachea may be amenable to complete excision. Neoplastic lesions must be differentiated from polyps or abscesses within the upper airway as these may appear radiographically identical to primary tumors. This can be achieved by endoscopic evaluation and biopsy of airway masses before formulating a prognosis

  10. [Role of gastroesophageal reflux in acute recurrent laryngeal dyspnea in children].

    Science.gov (United States)

    Andrieu-Guitrancourt, J; Dehesdin, D; Le Luyer, B; Fouin, M; Peron, J M

    1984-01-01

    Recurrent laryngeal croup (RLC) in children is rarely discussed unless permanent laryngeal obstruction is involved or there is an allergic basis. An atypical case is described where gastro-esophageal reflux (GER) was not only associated with but was also directly related to the provocation of each period. A series of 15 patients with RLC were investigated for the presence of GER, and this was confirmed in 7 cases. These findings suggest that GER may be responsible for the onset of RLC, as is now admitted for numerous respiratory manifestations in children. Moreover, GER may be implicated in the course of various laryngeal obstructive lesions, particularly subglottic angioma.

  11. Does intrinsic motivation enhance motor cortex excitability?

    Science.gov (United States)

    Radel, Rémi; Pjevac, Dusan; Davranche, Karen; d'Arripe-Longueville, Fabienne; Colson, Serge S; Lapole, Thomas; Gruet, Mathieu

    2016-11-01

    Intrinsic motivation (IM) is often viewed as a spontaneous tendency for action. Recent behavioral and neuroimaging evidence indicate that IM, in comparison to extrinsic motivation (EM), solicits the motor system. Accordingly, we tested whether IM leads to greater excitability of the motor cortex than EM. To test this hypothesis, we used two different tasks to induce the motivational orientation using either words representing each motivational orientation or pictures previously linked to each motivational orientation through associative learning. Single-pulse transcranial magnetic stimulation over the motor cortex was applied when viewing the stimuli. Electromyographic activity was recorded on the contracted first dorsal interosseous muscle. Two indexes of corticospinal excitability (the amplitude of motor-evoked potential and the length of cortical silent period) were obtained through unbiased automatic detection and analyzed using a mixed model that provided both statistical power and a high level of control over all important individual, task, and stimuli characteristics. Across the two tasks and the two indices of corticospinal excitability, the exposure to IM-related stimuli did not lead to a greater corticospinal excitability than EM-related stimuli or than stimuli with no motivational valence (ps > .20). While these results tend to dismiss the advantage of IM at activating the motor cortex, we suggest alternative hypotheses to explain this lack of effect, which deserves further research. © 2016 Society for Psychophysiological Research.

  12. Turning scar into muscle.

    Science.gov (United States)

    de Carvalho, Antonio Carlos Campos; Carvalho, Adriana Bastos

    2012-09-26

    After the demonstration that somatic cells could be reprogrammed to a pluripotent state, exciting new prospects were opened for the cardiac regeneration field. It did not take long for the development of strategies to convert somatic cells directly into cardiomyocytes. Despite the intrinsic difficulties of cell reprogramming, such as low efficiency, the therapeutic possibilities created by the ability to turn scar into muscle are enormous. Here, we discuss some of the major advances and strategies used in direct cardiac reprogramming and examine discrepancies and concerns that still need to be resolved in the field.

  13. Cricothyroid muscle dysfunction impairs vocal fold vibration in unilateral vocal fold paralysis.

    Science.gov (United States)

    Pei, Yu-Cheng; Fang, Tuan-Jen; Li, Hsueh-Yu; Wong, Alice M K

    2014-01-01

    The relevance of the cricothyroid (CT) muscle in patients with unilateral vocal fold paralysis (UVFP) remains controversial. To clarify the functional significance of the CT muscle in patients with UVFP, the confounding effect of the severity of recurrent laryngeal nerve injury should be taken into consideration. In the present study, quantitative laryngeal electromyography (LEMG) was used to measure the severity of paralysis of the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex to allow the functional contribution of the CT muscle to be determined. Cross-sectional study performed in an otolaryngology outpatient clinic. Thirty-one patients with a main diagnosis of UVFP were recruited. The main outcome measures included LEMG examination, quantitative LEMG analysis of the TA-LCA muscle complex, UVFP-related quality-of-life questionnaire (Voice Outcome Survey [VOS]), voice acoustics analysis, videolaryngostroboscopy, and general quality-of-life questionnaire (Short Form-36 Health Survey [SF-36]) assessments. The vocal cord position did not differ between patients with and without CT muscle impairment. Patients with both TA-LCA and CT paralysis showed poorer vocal fold vibration (P = .048) and higher fundamental frequency (P = .02), and the VOS and SF-36 were both poorer compared with patients with only TA-LCA paralysis. Although the vocal cord position was not influenced by CT muscle function, coexisting CT muscle paralysis may damage the voice by impairing vocal fold vibration in UVFP patients. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Novel device for tissue cooling during endoscopic laryngeal laser surgery: thermal damage study in an ex vivo calf model.

    Science.gov (United States)

    Koo, Hae Jin; Burns, James A; Kobler, James B; Heaton, James T; Zeitels, Steven M

    2012-07-01

    Minimizing collateral thermal damage during endoscopic laryngeal laser surgery remains a priority, and tissue cooling is one way to achieve this goal. Cooling systems utilizing compressed air have been shown to reduce the extent of thermal trauma on the vocal folds, but these units are not ideal for endoscopic applications because cooling is inefficient at the low airflows needed. We examined whether a novel vortex cooling device that generates cooled air at low flow rates would provide a cooling benefit beyond that which could be obtained by using room-temperature air for cooling tissue or by using no cooling during simulated laryngeal laser surgery. A continuous-wave thulium laser was used to incise glottic tissue in 12 calf vocal folds. Cooling was achieved with a prototype vortex cooler (9 degrees C air output; flow rate, 3 L/min), and tissue temperature measurements were compared to those with room-air cooling and no cooling. Thermal damage was analyzed histologically by measuring the depth of lactate dehydrogenase inactivation surrounding the mucosal incision. The cooling conditions were tested during time-constant cuts (8 seconds) and depth-constant cuts (into the thyroarytenoid muscle). During time-constant cuts, comparison between vortex cooling and room-air cooling revealed that vortex cooling resulted in a thermal damage zone that was 14% smaller (519 versus 603 microm; p cooling created a thermal damage zone that was 32% smaller than that created with no cooling (p cooling (p cooling reduces thermal damage more effectively than room-air cooling or no cooling during both time-constant and depth-constant thulium laser cuts.

  15. Quality indicators of laryngeal cancer care in the elderly.

    Science.gov (United States)

    Gourin, Christine G; Frick, Kevin D; Blackford, Amanda L; Herbert, Robert J; Quon, Harry; Forastiere, Arlene A; Eisele, David W; Dy, Sydney M

    2014-09-01

    To examine associations between quality of care, survival, and costs in elderly patients treated for laryngeal squamous cell cancer (SCCA). Retrospective analysis of Surveillance, Epidemiology, and End Results Medicare data. We evaluated 2,370 patients diagnosed with laryngeal SCCA from 2004 to 2007 using multivariate regression and survival analysis. Using quality indicators derived from guidelines for recommended care, summary measures of quality were calculated for diagnosis, initial treatment, surveillance, treatment of recurrence, end-of-life care, performance, and an overall summary measure of quality. High-quality care was associated with significant differences in survival for diagnosis [HR = 0.80, 95% CI (0.66-0.97)], initial treatment [HR = 0.75 (0.63-0.88)], surveillance [HR = 0.54 (0.44-0.66)], treatment of recurrence [HR = 1.54 (1.26-1.89)], end-of-life care [HR = 0.69 (0.52-0.92)], performance [HR = 0.41 (0.33-0.52)], and an overall summary measure of quality [HR = 0.66 (0.54-0.80)], which was significantly associated with lower mean incremental costs [-$24,958 (-$35,873 - -$14,042)]. There was a significant survival advantage for initial treatment with surgery and postoperative radiation [HR = 0.66 (0.53-0.82)] and high-volume surgical care [HR = 0.64 (0.43-0.96)] after controlling for all other variables, including quality of care. High-quality larynx cancer care in elderly patients was associated with improved survival and reduced costs; however, high-quality care for treatment of recurrence was associated with poorer survival. These data suggest that survival outcomes in elderly patients with laryngeal cancer are not entirely explained by differences in the receipt of quality care using existing treatment and performance quality indicators and also suggest a need to develop sensitive and valid quality indicators of larynx cancer care in this population. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Detecting Nosocomial Intrinsic Infections through Relating Bacterial ...

    African Journals Online (AJOL)

    Sierra Leone Journal of Biomedical Research ... Surgical procedures often lead to both intrinsic and extrinsic infections. ... This study demonstrated surgical procedures as precursory to intrinsic infections and that bacterial pathogens found on wounds and endogenous indicators of surgery are links to intrinsic infection.

  17. Radiation therapy for life-threatening huge laryngeal hemangioma involving pharynx and parapharyngeal space.

    Science.gov (United States)

    Huang, Chun-Ming; Lee, Ka-Wo; Huang, Chih-Jen

    2013-04-01

    Adult hemangiomas are rare, slowly progressing vascular tumors. Potential complications include laryngeal involvement or massive tumor burden. A case of recurrent, bulky laryngeal hemangioma involving the parapharyngeal space is presented herein. The clinical course and treatment are described, and a series of MRI studies are compared to demonstrate the treatment response. A 35-year-old woman presented with progressive hoarseness, neck fullness, and intermittent dyspnea caused by a bulky laryngeal hemangioma. Steroid therapy had a limited response. Radiation therapy with a total dose of 40 Gray (Gy) in 20 fractions successfully relieved her symptoms. Image studies after therapy revealed moderate tumor regression. The patient showed no serious complications during the next 2 years of follow-up. Radiation therapy may be effective in intractable and function-threatening laryngeal hemangiomas. Copyright © 2012 Wiley Periodicals, Inc.

  18. A case of vogt-koyanagi-harada syndrome with persistent dyspnea secondary to laryngeal edema.

    Science.gov (United States)

    Mantopoulos, Dimosthenis; deSilva, Brad W; Cebulla, Colleen M

    2014-01-01

    We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH) syndrome. A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. The patient had persistent dyspnea, which was out of proportion to chest CT findings and which was exacerbated during a recurrence of VKH. Flexible fiberoptic laryngoscopy with stroboscopy revealed diffuse laryngeal edema. Symptoms were alleviated with breathing exercises. Several autoimmune diseases may cause diffuse laryngeal edema. In this case, VKH was associated with the patient's glottic edema and dyspnea. We recommend that laryngeal edema be considered in the differential diagnosis for patients with dyspnea and VKH.

  19. A Case of Vogt-Koyanagi-Harada Syndrome with Persistent Dyspnea Secondary to Laryngeal Edema

    Directory of Open Access Journals (Sweden)

    Dimosthenis Mantopoulos

    2014-11-01

    Full Text Available Purpose: We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH syndrome. Patient and Methods: A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. Results: The patient had persistent dyspnea, which was out of proportion to chest CT findings and which was exacerbated during a recurrence of VKH. Flexible fiberoptic laryngoscopy with stroboscopy revealed diffuse laryngeal edema. Symptoms were alleviated with breathing exercises. Conclusions: Several autoimmune diseases may cause diffuse laryngeal edema. In this case, VKH was associated with the patient's glottic edema and dyspnea. We recommend that laryngeal edema be considered in the differential diagnosis for patients with dyspnea and VKH.

  20. Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention (PDQ®)—Health Professional Version

    Science.gov (United States)

    Expert-reviewed information summary about factors that may influence the risk of developing oral cavity, pharyngeal, and laryngeal cancers and about approaches that may help in the prevention of these diseases.

  1. Arterial baroreflex and peripheral chemoreflex function after radiotherapy for laryngeal or pharyngeal cancer

    NARCIS (Netherlands)

    Timmers, Henri J. L. M.; Karemaker, John M.; Wieling, Wouter; Kaanders, Johannes H. A. M.; Folgering, Hans Th M.; Marres, Henri A. M.; Lenders, Jacques W. M.

    2002-01-01

    Purpose: Denervation of the carotid sinus causes baroreflex and chemoreflex failure, resulting in labile hypertension and loss of hypoxic responsiveness. We investigated whether radiation therapy for laryngeal or pharyngeal cancer affects baroreflex and chemoreflex function. Methods and Materials:

  2. A comparison of 2 methods of endoscopic laryngeal sensory testing: a preliminary study.

    Science.gov (United States)

    Kaneoka, Asako; Krisciunas, Gintas P; Walsh, Kayo; Raade, Adele S; Langmore, Susan E

    2015-03-01

    This study examined the association between laryngeal sensory deficits and penetration or aspiration. Two methods of testing laryngeal sensation were carried out to determine which was more highly correlated with Penetration-Aspiration Scale (PAS) scores. Healthy participants and patients with dysphagia received an endoscopic swallowing evaluation including 2 sequential laryngeal sensory tests-air pulse followed by touch method. Normal/impaired responses were correlated with PAS scores. Fourteen participants completed the endoscopic swallowing evaluation and both sensory tests. The air pulse method identified sensory impairment with greater frequency than the touch method (Ppenetration/aspiration. Significant laryngeal sensory loss revealed by the touch method is associated with compromised airway protection. © The Author(s) 2014.

  3. Acromegaly presented as a cause of laryngeal dyspnea.

    Science.gov (United States)

    Saussez, S; Mahillon, V; Chantrain, G; Thill, M P; Lequeux, T

    2007-12-01

    Acromegalic patients can develop obstructive sleep apnea syndrome or upper airflow obstruction. The development of dyspnea is unusual and the fixation of both vocal cords is exceptional. We report the case of a patient with bilateral vocal cord paralysis. Fiberoptic laryngoscopy and computed tomography (CT) of the neck showed a supra-glottic stenosis due to a swelling of the soft tissue. A tracheostomy was first performed. Thereafter, micro-laryngoscopy using laser vaporisation of the supra-glottic soft tissue was attempted but failed to remove the tracheostomy canula. Finally, blood tests and cerebral MRI revealed an acromegaly. The patient underwent a trans-sphenoidal resection of the pituitary adenoma. Fifteen months later, fiberoptic laryngoscopy showed bilateral restoration of vocal cord mobility and the tracheostomy canula was successfully removed after 18 months. Vocal cord fixation is probably due to hypopharyngeal and laryngeal soft tissue swelling and can be reversible after successful treatment of the adenoma.

  4. [ANCA-negative subglottic laryngeal stenosis in childhood].

    Science.gov (United States)

    Wittekindt, C; Lüers, J-C; Drebber, U; Guntinas-Lichius, O; Hüttenbrink, K-B

    2007-10-01

    A 15-year-old female, having developed recurrent infections of the upper airway, hoarseness, dyspnea, and nasal congestion, was referred to our department. There was no history of trauma or intubation. The subglottic space was circularly narrowed. The test for c-ANCA was negative. Chest X-ray and renal function were normal. A tracheotomy was performed; the histology showed infiltrating plasma cells, but no signs of vasculitis or granulomatous inflammation. One year later the patient developed acute renal failure. Biopsy of the kidney confirmed Wegener's disease. The laryngeal stenosis completely resolved after therapy with cyclophosphamide. Juvenile Wegener's granulomatosis is extremely rare; the larynx and trachea seem to be involved more frequently in children than in adults. The positive testing of c-ANCA can support the diagnosis; however, even when c-ANCA do not test positive, the disease can never be excluded. Surgical interventions within the larynx or trachea might only be considered after ineffective therapy with immunosuppressive drugs.

  5. [Laryngeal disease. Endoscopic characterization of 1493 procedures based on age].

    Science.gov (United States)

    Che-Morales, José Luis; Figueroa-Hurtado, Esperanza; Cortes-Télles, Arturo

    2018-01-01

    Based on international epidemiology, some laryngeal diseases could be more frequent at certain ages. The objective was to describe endoscopic findings in patients through distinct decades of age in a laryngoscopy facility. retrospective and descriptive study; clinical and endoscopic records were collected from 1493 procedures performed between 2009 and 2015, and organized in five groups of age for analysis. Differences among them were analyzed by chi squared and ANOVA. 70% of patients reported dysphonia as a main symptom; 24% of subjects were referred with cancer diagnosis and just 7% of them, showed findings related to malignancy; on the other hand, cancer suspicion increased in direct proportion with age (p age, particularly in patients of 70 years of age or older. Finally, subglottic stenosis was observed in patients younger than 50 years of age (p age. Carcinoma was more prevalent in adults of 70 years of age or older. Benign causes were secondary to inflammatory and functional conditions.

  6. Stabilisation of Laryngeal AL Amyloidosis with Long Term Curcumin Therapy

    Directory of Open Access Journals (Sweden)

    Terry Golombick

    2015-01-01

    Full Text Available Multiple myeloma (MM, smoldering myeloma (SMM, and monoclonal gammopathy of undetermined significance (MGUS represent a spectrum of plasma cell dyscrasias (PCDs. Immunoglobulin light chain amyloidosis (AL falls within the spectrum of these diseases and has a mortality rate of more than 80% within 2 years of diagnosis. Curcumin, derived from turmeric, has been shown to have a clinical benefit in some patients with PCDs. In addition to a clinical benefit in these patients, curcumin has been found to have a strong affinity for fibrillar amyloid proteins. We thus administered curcumin to a patient with laryngeal amyloidosis and smoldering myeloma and found that the patient has shown a lack of progression of his disease for a period of five years. This is in keeping with our previous findings of clinical benefits of curcumin in patients with plasma cell dyscrasias. We recommend further evaluation of curcumin in patients with primary AL amyloidosis.

  7. Biomechanical Properties of Recurrent Laryngeal Nerve in the Piglet

    Science.gov (United States)

    Alexander, Megan J.; Barkmeier-Kraemer, Julie M.; Vande Geest, Jonathan P.

    2016-01-01

    Unilateral vocal fold paralysis (UVP) results from damage to the recurrent laryngeal nerve (RLN). The most common causes of UVP are associated with compromised RLN tissue. The purpose of this research was to investigate the biomechanical properties of piglet RLN and identify differences in these properties along its length and in between the left and right side. Quasi-static uniaxial tensile testing and isotropic constitutive modeling was performed on seven piglet RLNs. Stiffness and other biomechanical parameters were derived from these tests and compared from conducting two different statistical analysis for the between and within nerve comparisons. Results showed higher stiffness values in the left RLN segment than for the right. Descriptive data demonstrated a higher stiffness in RLN segments surrounding the aortic arch, indicating a more protective role of the extracellular matrix in these nerves. This research offers insight regarding the protective function of the RLN connective tissues and structural compromise due to its environment. PMID:20369296

  8. Laryngeal mask airway (LMA) artefact resulting in MRI misdiagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Schieble, Thomas [University of Medicine and Dentistry of New Jersey, Department of Anesthesiology, New Jersey Medical School, Newark, NJ (United States); Maimonides Medical Center, Department of Anesthesiology, Brooklyn, NY (United States); Patel, Anuradha; Davidson, Melissa [University of Medicine and Dentistry of New Jersey, Department of Anesthesiology, New Jersey Medical School, Newark, NJ (United States)

    2008-03-15

    We report a 7-year-old child who underwent brain MRI for a known seizure disorder. The technique used for general anesthesia included inhalation induction followed by placement of a laryngeal mask airway (LMA) for airway maintenance. Because the reviewing radiologist was unfamiliar with the use of an LMA during anesthesia, and because the attending anesthesiologist did not communicate his technique to the radiologist, an MRI misdiagnosis was reported because of artefact created by the in situ LMA. As a result of this misdiagnosis the child was subjected to unnecessary subsequent testing to rule out a reported anatomic abnormality induced by the LMA. Our case illustrates the need for coordination of patient care among hospital services. (orig.)

  9. IMPLANTATION METASTASIS OF LARYNGEAL CANCER AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

    Directory of Open Access Journals (Sweden)

    A. O. Guz

    2017-01-01

    Full Text Available Squamous cell head and neck carcinoma is frequently associated with dysphagia. An adequate enteral nutrition is the key to successful treatment and rehabilitation of these patients. Percutaneous endoscopic gastrostomy is the preferred route of feeding and nutritional support in head and neck cancer patients with dysphagia. We report a rare case of implantation metastasis of laryngeal cancer following percutaneous endoscopic gastrostomy. Our experience in treating this complication has been described. Percutaneous endoscopic gastrostomy is a less-invasive procedure than open gastrostomy. Percutaneous endoscopic gastrostomy can be accompanied by severe complications such as implantation metastasis at gastrostomy site. Careful monitoring can provide early detection of this complication and early treatment. 

  10. High Prevalence of Exercise-Induced Laryngeal Obstruction in Athletes

    DEFF Research Database (Denmark)

    Walsted Nielsen, Emil; Hull, James H; Backer, Vibeke

    2013-01-01

    INTRODUCTION: Unexplained respiratory symptoms reported by athletes are often incorrectly considered secondary to exercise-induced asthma. We hypothesised that this may be related to exercise induced laryngeal obstruction (EILO). This study evaluates the prevalence of EILO in an unselected cohort...... of athletes. METHODS: We retrospectively reviewed the prevalence of EILO in a cohort of athletes (n=91) referred consecutively during a two-year period for asthma work-up including continuous laryngoscopy during exercise (CLE) testing. We compared clinical characteristics and bronchial hyper......-one percent of athletes with EILO and negative bronchoprovocation and bronchodilator reversibility tests used regular asthma medication at referral. CONCLUSION: In athletes with unexplained respiratory symptoms, EILO is an important differential diagnosis not discerned from other aetiologies by clinical...

  11. Acute laryngeal obstruction in children. A fifty-year review.

    Science.gov (United States)

    Davison, F W

    1978-01-01

    When dealing with acute laryngeal obstruction, the first important consideration is the differential diagnosis of the cause. The author considers the following six types: acute laryngotracheobronchitis, acute epiglottitis, diphtheria, supraglottic allergic edema (angioedema), subglottic allergic edema (spasmodic croup) and foreign body in the larynx or trachea. He traces the development of the treatments that have in 50 years lowered the mortality rate from 70% to practically zero. High humidity, best supplied by an ultrasonic nebulizer, antibiotics, and corticosteroids in very high dose have been the prime effective measures. There still is controversy about the choice between tracheostomy and nasotracheal intubation if medical therapy is delayed or ineffective. The primary physician must know when and where to send these children in order to prevent the fatalities so frequent in previous years.

  12. Automatic segmentation of equine larynx for diagnosis of laryngeal hemiplegia

    Science.gov (United States)

    Salehin, Md. Musfequs; Zheng, Lihong; Gao, Junbin

    2013-10-01

    This paper presents an automatic segmentation method for delineation of the clinically significant contours of the equine larynx from an endoscopic image. These contours are used to diagnose the most common disease of horse larynx laryngeal hemiplegia. In this study, hierarchal structured contour map is obtained by the state-of-the-art segmentation algorithm, gPb-OWT-UCM. The conic-shaped outer boundary of equine larynx is extracted based on Pascal's theorem. Lastly, Hough Transformation method is applied to detect lines related to the edges of vocal folds. The experimental results show that the proposed approach has better performance in extracting the targeted contours of equine larynx than the results of using only the gPb-OWT-UCM method.

  13. Intrinsic disorder in the BK channel and its interactome.

    Directory of Open Access Journals (Sweden)

    Zhenling Peng

    Full Text Available The large-conductance Ca2+-activated K+ (BK channel is broadly expressed in various mammalian cells and tissues such as neurons, skeletal and smooth muscles, exocrine cells, and sensory cells of the inner ear. Previous studies suggest that BK channels are promiscuous binders involved in a multitude of protein-protein interactions. To gain a better understanding of the potential mechanisms underlying BK interactions, we analyzed the abundance, distribution, and potential mechanisms of intrinsic disorder in 27 BK channel variants from mouse cochlea, 104 previously reported BK-associated proteins (BKAPS from cytoplasmic and membrane/cytoskeletal regions, plus BK β- and γ-subunits. Disorder was evaluated using the MFDp algorithm, which is a consensus-based predictor that provides a strong and competitive predictive quality and PONDR, which can determine long intrinsically disordered regions (IDRs. Disorder-based binding sites or molecular recognition features (MoRFs were found using MoRFpred and ANCHOR. BKAP functions were categorized based on Gene Ontology (GO terms. The analyses revealed that the BK variants contain a number of IDRs. Intrinsic disorder is also common in BKAPs, of which ∼ 5% are completely disordered. However, intrinsic disorder is very differently distributed within BK and its partners. Approximately 65% of the disordered segments in BK channels are long (IDRs (>50 residues, whereas >60% of the disordered segments in BKAPs are short IDRs that range in length from 4 to 30 residues. Both α and γ subunits showed various amounts of disorder as did hub proteins of the BK interactome. Our analyses suggest that intrinsic disorder is important for the function of BK and its BKAPs. Long IDRs in BK are engaged in protein-protein and protein-ligand interactions, contain multiple post-translational modification sites, and are subjected to alternative splicing. The disordered structure of BK and its BKAPs suggests one of the underlying

  14. Increased respiratory neural drive and work of breathing in exercise-induced laryngeal obstruction.

    Science.gov (United States)

    Walsted, Emil S; Faisal, Azmy; Jolley, Caroline J; Swanton, Laura L; Pavitt, Matthew J; Luo, Yuan-Ming; Backer, Vibeke; Polkey, Michael I; Hull, James H

    2018-02-01

    Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls). Subjects underwent baseline spirometry and a symptom-limited incremental exercise test with simultaneous and synchronized recording of endoscopic video and gastric, esophageal, and transdiaphragmatic pressures, diaphragm electromyography, and respiratory airflow. The EILO and control groups had similar peak work rates and minute ventilation (V̇e) (work rate: 227 ± 35 vs. 237 ± 35 W; V̇e: 103 ± 20 vs. 98 ± 23 l/min; P > 0.05). At submaximal work rates (140-240 W), subjects with EILO demonstrated increased work of breathing ( P laryngeal closure ( P laryngeal closure; there were however no differences in dyspnea intensity between groups. Using simultaneous measurements of respiratory mechanics and diaphragm electromyography with endoscopic video, we demonstrate, for the first time, increased work of breathing and respiratory neural drive in association with the development of EILO. Future detailed investigations are now needed to understand the role of upper airway closure in causing exertional dyspnea and exercise limitation. NEW & NOTEWORTHY Exercise-induced laryngeal obstruction is a prevalent cause of exertional dyspnea in young individuals; yet, how laryngeal closure affects breathing is unknown. In this study we synchronized endoscopic video with respiratory physiological measurements, thus providing the first detailed commensurate assessment of respiratory mechanics and neural drive in relation to laryngeal

  15. The Use of Cryotherapy for Papilloma and Early Laryngeal Cancers: Long-term Results.

    Science.gov (United States)

    Benninger, Michael S; Derakhshan, Adeeb; Milstein, Claudio F

    2015-07-01

    Retrospective chart review. To determine the efficacy of adjuvant cryotherapy in the treatment of early glottic cancer and laryngeal papillomatosis. The use of cryotherapy in conjunction with traditional modalities has recently been proposed to improve voice outcomes in patients with early laryngeal cancer as compared to pretreatment conditions. This study investigates its utility in improving oncological outcomes and decreasing recurrences of laryngeal papillomatosis. Patients with either early glottic cancer or laryngeal papillomatosis that received cryotherapy as part of their surgical regimen were investigated. All patients were seen at a large tertiary care center within a 10-year window. Demographic data were collected and all postoperative notes were reviewed. Recurrences of the laryngeal cancer were noted, as was the duration of time between successive papillomatosis operations. The charts of 54 glottic cancer and 29 papillomatosis patients that received cryotherapy were reviewed. One patient from the papillomatosis cohort was excluded from statistical analysis due to lack of follow-up. Overall, 16 (30%) of the laryngeal cancer patient experienced a malignant recurrence. The overall 5-year survival of these patients was 98% and the 5-year disease-free survival was 74%. The use of adjuvant cryotherapy in the treatment of laryngeal papillomatosis extended the duration of time between surgeries by an average of 79 days (P=.23). The use of adjuvant cryotherapy in the treatment of early glottic cancer does not improve the rate of carcinoma recurrences. Additionally, cryotherapy does not result in a statistically significant increase in the duration of disease-free period for laryngeal papillomatosis patients, although the observed increase may be clinically important. © The Author(s) 2015.

  16. Assessment of effect of nasal continuous positive pressure on laryngeal opening using fibre optic laryngoscopy

    OpenAIRE

    Gaon, P; Lee, S; Hannan, S; Ingram, D; Milner, A

    1999-01-01

    AIM—To assess the effect of nasal continuous positive airways pressure (CPAP) on the dimensions of the laryngeal opening.
METHODS—Nine preterm infants who had previously received ventilatory support for respiratory distress syndrome (RDS) were studied. All were receiving nasal CPAP. The laryngeal opening was visualised using a fibre optic video camera system. The ratio of width to length of the opening was measured on and off CPAP.
RESULTS—In eight of the infants the w...

  17. Osteoblastoma of the thyroid cartilage treated with voice preserving laryngeal framework resection.

    Science.gov (United States)

    Glazer, Tiffany A; Spector, Matthew E; McHugh, Jonathan; Hogikyan, Norman D

    2013-08-01

    Osteoblastoma is a slow-growing, locally destructive benign bone neoplasm, rarely occurring in the laryngeal cartilage. We present the case of a professional voice user diagnosed with laryngeal osteoblastoma after microdirect laryngoscopy and endoscopic biopsy. Her treatment required a unique operation, with elements of partial laryngectomy and maintenance of vital endolaryngeal soft tissues, in order to optimize vocal outcome. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  18. CREB promotes laryngeal cancer cell migration via MYCT1/NAT10 axis

    Directory of Open Access Journals (Sweden)

    Zhang ZX

    2018-03-01

    Full Text Available Zhao-Xiong Zhang,1 Wan-Ni Zhang,1 Yuan-Yuan Sun,1 Yun-Hui Li,2 Zhen-Ming Xu,3 Wei-Neng Fu1 1Department of Medical Genetics, China Medical University, Shenyang, People’s Republic of China; 2Department of Laboratory Medicine, No 202 Hospital of PLA, Shenyang, People’s Republic of China; 3Department of Otolaryngology, No 463 Hospital of PLA, Shenyang, People’s Republic of China Purpose: CREB, MYCY1 and NAT10 are involved in cancer cell migration. However, the relationship between these three proteins and their role in laryngeal cancer cell migration remains unknown. Methods: Transient gene transfection was performed in laryngeal cancer cells. Bioinformatics analysis was used to predict the binding of CREB to MYCT1 promoter. Binding of CREB to the promoter of MYCT1 was monitored by luciferase reporter assay and chromatin immunoprecipitation method in vitro and in vivo, respectively. Real-time RT-PCR and Western bolt were applied to detect gene transcription and translation levels, respectively. Laryngeal cancer cell migration was assayed by transwell cham­ber experiment. Results: CREB protein expression was significantly up-regulated in laryngeal cancer tissues and associated with cancer differentiation, tumor stage, and lymphatic metasta­sis. CREB inhibits MYCT1 expression by direct binding to its promoter. Meanwhile, MYCT1 has a negative impact on the NAT10 gene expression. Furthermore, CREB promotes NAT10 expression via down-regulating the MYCT1 gene expression. In addition, contrary to MYCT1, CREB and NAT10 enhanced laryngeal cancer cell migration. MYCT1 and NAT10 significantly rescued the effects of CREB and MYCT1 on Hep2 cell migration, respectively. Conclusion: CREB promotes laryngeal cancer cell migration via MYCT1/NAT10 axis, suggesting that CREB might be a potential prognostic marker in laryngeal cancer. Keywords: laryngeal cancer, CREB, MYCT1, NAT10, migration

  19. Molecular cloning and characterization of human papilloma virus DNA derived from a laryngeal papilloma.

    OpenAIRE

    Gissmann, L; Diehl, V; Schultz-Coulon, H J; zur Hausen, H

    1982-01-01

    Papilloma virus DNA from a laryngeal papilloma was cloned in phage lambda L 47 and characterized after cleavage with different restriction enzymes. Hybridization with the DNAs of human papilloma virus types 1, 2, 3, 4, 5, and 8 showed no homology under stringent hybridization conditions. Human papilloma virus type 6 DNA, however, was partially identical to laryngeal papilloma virus DNA; different restriction enzyme fragments hybridizing with the other DNA were identified on each genome. The d...

  20. Removal of Laryngeal Mask Airway: Awake or Deep Anesthesia?

    Directory of Open Access Journals (Sweden)

    SM Heidari

    2005-03-01

    Full Text Available Background: The aim of this study was to study the influence of depth of anesthesia (awake or deep anesthesia and choice of anesthetic drug (halothane or propofol on the incidence and severity of airway hyperreactivity associated with Laryngeal Mask Airway (LMA removal. Methods: A prospective, randomized, double blind study was done in 156 ASA physical status I and II patients, aged 18-65 years, who had under gone short time elective surgery (<1 hour. Patients were randomly assigned in one of the four subgroups: Hal-Aw (anesthesia maintenance with halothane and LMA removal in awaked state, Hal-Deep (anesthesia maintenance with halothane and LMA removal in deep anesthesia, Pro-Aw (anesthesia maintenance with propofol and LMA removal in awaked state, and Pro-Deep (anesthesia maintenance with propofol and LMA removal in deep anesthesia. The incidence of cough and straining, bronchospasm, laryngospasm, breathholding, vomiting, oxygen desaturation, and severity of airway hyperreactivity (mild, moderate, severe with LMA removal were evaluated. Results: There were no significant differences in bronchospasm, larynchospasm, oxygen desaturation among four subgroups. Significant differences were in cough and straining, breath holding, vomiting, and finally severity of airway hyperreactivity among four subgroups. Depth of anesthesia didn’t have any effect on incidence and severity of airway hyperreactivity but in those with propofol, they were lower than those with halothane. Conclusion: In short time surgery and with use of LMA, anesthesia with propofol is associated with lower incidence and severity of airway hyperreactivity than halothane. Keywords: propofol, halothane, airway hyperreactivity, Laryngeal Mask Airway (LMA.

  1. The role of the superior laryngeal nerve in esophageal reflexes

    Science.gov (United States)

    Medda, B. K.; Jadcherla, S.; Shaker, R.

    2012-01-01

    The aim of this study was to determine the role of the superior laryngeal nerve (SLN) in the following esophageal reflexes: esophago-upper esophageal sphincter (UES) contractile reflex (EUCR), esophago-lower esophageal sphincter (LES) relaxation reflex (ELIR), secondary peristalsis, pharyngeal swallowing, and belch. Cats (N = 43) were decerebrated and instrumented to record EMG of the cricopharyngeus, thyrohyoideus, geniohyoideus, and cricothyroideus; esophageal pressure; and motility of LES. Reflexes were activated by stimulation of the esophagus via slow balloon or rapid air distension at 1 to 16 cm distal to the UES. Slow balloon distension consistently activated EUCR and ELIR from all areas of the esophagus, but the distal esophagus was more sensitive than the proximal esophagus. Transection of SLN or proximal recurrent laryngeal nerves (RLN) blocked EUCR and ELIR generated from the cervical esophagus. Distal RLN transection blocked EUCR from the distal cervical esophagus. Slow distension of all areas of the esophagus except the most proximal few centimeters activated secondary peristalsis, and SLN transection had no effect on secondary peristalsis. Slow distension of all areas of the esophagus inconsistently activated pharyngeal swallows, and SLN transection blocked generation of pharyngeal swallows from all levels of the esophagus. Slow distension of the esophagus inconsistently activated belching, but rapid air distension consistently activated belching from all areas of the esophagus. SLN transection did not block initiation of belch but blocked one aspect of belch, i.e., inhibition of cricopharyngeus EMG. Vagotomy blocked all aspects of belch generated from all areas of esophagus and blocked all responses of all reflexes not blocked by SLN or RLN transection. In conclusion, the SLN mediates all aspects of the pharyngeal swallow, no portion of the secondary peristalsis, and the EUCR and ELIR generated from the proximal esophagus. Considering that SLN is not

  2. Aberrant laryngeal location of Onchocerca lupi in a dog.

    Science.gov (United States)

    Alho, Ana Margarida; Cruz, Luís; Coelho, Ana; Martinho, Filipe; Mansinho, Mário; Annoscia, Giada; Lia, Riccardo P; Giannelli, Alessio; Otranto, Domenico; de Carvalho, Luís Madeira

    2016-06-01

    Onchocerca lupi (Spirurida, Onchocercidae) is an emerging vector-borne helminth that causes nodular lesions associated with acute or chronic ocular disease in dogs and cats. Since its first description in dogs in 1991, this zoonotic filarioid has been increasingly reported in Europe and the United States. An 8-year-old outdoor mixed-breed female dog from the Algarve (southern Portugal) was presented with a history of severe dyspnoea. Cervical and thoracic radiographs revealed a slight reduction in the diameter of the cervical trachea and a moderate increase in radiopacity of the laryngeal soft tissue. An exploratory laryngoscopy was performed, revealing filiform worms associated with stenosis of the thyroid cartilage and a purulent necrotic tissue in the larynx lumen. A single sessile nodule, protruding from the dorsal wall of the laryngeal lumen caused a severe reduction of the glottis and tracheal diameter. Fragments of the worms were morphologically and molecularly identified as O. lupi. Histological examination of the nodule showed a granulomatous reaction with sections of coiled gravid female nematodes. Following laryngoscopy, a tracheostomy tube was inserted to relieve dyspnoea and ivermectin (300 μg/kg, once a week, for 8 weeks) combined with prednisolone was prescribed. The dog showed a complete recovery. Although O. lupi has been isolated in human patients from the spinal cord, this is the first report of an aberrant migration of O. lupi in a dog. The veterinary medical community should pay attention to aberrant location of O. lupi and consider onchocercosis as a differential diagnosis for airway obstruction in dogs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Exclusive radiation therapy for locally advanced laryngeal carcinoma

    International Nuclear Information System (INIS)

    Antognoni, P.; Bossi, A.; Molteni, M.; Richetti, A.; Tordiglione, M.

    1990-01-01

    The authors analyse a retrospective series of 90 consecutive patients (pts) affected with locally advanced laryngeal carcinoma (T3-4, N0-3 - TNM, UICC 1978) who were radically irradiated from November 1979 to December 1986 at the Radiotherapy Department of the General Hospital of Varese. All the patients were treated with 60 Co and two opposed parallel lateral fields and progressive shrinkage: 66 conventional fractionation (2 Gy once a day, 5 times a week), 24 with an accelerated hyperfractionated regimen (1.5 Gy twice a day, 5 times a week). The median total dose delivered to the tumor and clinically involved nodes was 64 Gy (1678 reu, CRE). Median follow-up was 21 months (range: 3-113). The 5-year overall survival (Kaplan-Meier) was 40.5%. The 5-year disease-free survival, for 47 patients in complete remission at the end of radiotherapy, was 51.9% after irradiation alone and 56.7% with salvage surgery. There were no statistically significant differences in survival according to local spread (T3 vs T4), nodal status (N0 vs N1-3) and dose fractionation regimen (conventional vs accelerated hyper-fractionated). Isoeffect (CRE) values above 1751 reu obtained a 3-year loco-regional control rate was 33.3%. Relevant late sequelae were not observed. Our findings suggest that primary radiotherapy with salvage surgery in reserve could be considered as an effective choice for locally advanced laryngeal carcinoma, at least in selected groups of patients

  4. Paralisia do músculo cricoaritenóideo lateral: relato de caso como contribuição ao estudo da anatomia funcional da laringe Paralysis of the lateral cricoarytenoid muscle: a case report as a contribution to the understanding of the functional anatomy of the larynx

    Directory of Open Access Journals (Sweden)

    Noemi De Biase

    2003-01-01

    Full Text Available A eletromiografia da laringe (EMG vem sendo útil nas avaliações das alterações de mobilidade das pregas vocais, sobretudo diferenciando as paralisias das fixações, e também fornecendo dados para o prognóstico e localização de lesões neuromusculares. Com base na EMG e na telelaringoscopia buscamos entender o papel dos músculos intrínsecos da laringe a partir de um caso de paralisia de músculo cricoaritenóideo lateral, confirmado por estudo eletromiográfico, em uma paciente com história de afonia e perda de mobilidade da prega vocal esquerda, fixa na posição lateral.In the last few years electromyography of the larynx (EMG has become helpful in the evaluation of vocal fold immobility, especially to differentiate paralysis from fixation, and providing data for diagnosis, site of lesion and prognosis. Based on a case of selective paralysis of lateral cricoarytenoid muscle in a woman who had paralyzed vocal fold at lateral position, confirmed by electromyography study, we conducted an analysis in order to understand the role of intrinsic laryngeal muscles.

  5. Longitudinal voice outcomes following laryngeal reinnervation via vagus-to-recurrent laryngeal nerve anastomosis after vagal nerve sacrifice: a case series.

    Science.gov (United States)

    Ward, Greg M; Sauder, Cara; Olson, Garth T; Nuara, Michael J

    2015-02-01

    This study aimed to describe longitudinal voice outcomes of vagus-to-recurrent laryngeal nerve anastomosis following operative vagal nerve sacrifice. Two patients who underwent anastomosis were assessed by a multidisciplinary voice team at 1, 4, 9, 12, and 18 months after vagal sacrifice. Long-term changes in voice function based on auditory perceptual measures of voice quality and visual perceptual changes in glottal closure were observed and maintained for 18 months after vagus-to-recurrent laryngeal nerve anastomosis in 2 patients with proximal vagal nerve sacrifice. Patients achieved acceptable voice outcomes and elected not to undergo further treatment, which was supported by Voice Handicap Index scores. Gradual restoration of voice following operative vagal sacrifice can be achieved over an 18-month period using vagus-to-recurrent laryngeal nerve anastomosis and warrants further investigation in appropriately selected patients. © The Author(s) 2014.

  6. Phenomenology, genetics, and CNS network abnormalities in laryngeal dystonia: A 30-year experience.

    Science.gov (United States)

    Blitzer, Andrew; Brin, Mitchell F; Simonyan, Kristina; Ozelius, Laurie J; Frucht, Steven J

    2018-01-01

    Laryngeal dystonia (LD) is a functionally specific disorder of the afferent-efferent motor coordination system producing action-induced muscle contraction with a varied phenomenology. This report of long-term studies aims to review and better define the phenomenology and central nervous system abnormalities of this disorder and improve diagnosis and treatment. Our studies categorized over 1,400 patients diagnosed with LD over the past 33 years, including demographic and medical history records and their phenomenological presentations. Patients were grouped on clinical phenotype (adductor or abductor) and genotype (sporadic and familial) and with DNA analysis and functional magnetic resonance imaging (fMRI) to investigate brain organization differences and characterize neural markers for genotype/phenotype categorization. A number of patients with alcohol-sensitive dystonia were also studied. A spectrum of LD phenomena evolved: adductor, abductor, mixed, singer's, dystonic tremor, and adductor respiratory dystonia. Patients were genetically screened for DYT (dystonia) 1, DYT4, DYT6, and DYT25 (GNAL)-and several were positive. The functional MRI studies showed distinct alterations within the sensorimotor network, and the LD patients with a family history had distinct cortical and cerebellar abnormalities. A linear discriminant analysis of fMRI findings showed a 71% accuracy in characterizing LD from normal and in characterizing adductor from abductor forms. Continuous studies of LD patients over 30 years has led to an improved understanding of the phenomenological characteristics of this neurological disorder. Genetic and fMRI studies have better characterized the disorder and raise the possibility of making objective rather than subjective diagnoses, potentially leading to new therapeutic approaches. Laryngoscope, 128:S1-S9, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Strain modulations as a mechanism to reduce stress relaxation in laryngeal tissues.

    Directory of Open Access Journals (Sweden)

    Eric J Hunter

    Full Text Available Vocal fold tissues in animal and human species undergo deformation processes at several types of loading rates: a slow strain involved in vocal fold posturing (on the order of 1 Hz or so, cyclic and faster posturing often found in speech tasks or vocal embellishment (1-10 Hz, and shear strain associated with vocal fold vibration during phonation (100 Hz and higher. Relevant to these deformation patterns are the viscous properties of laryngeal tissues, which exhibit non-linear stress relaxation and recovery. In the current study, a large strain time-dependent constitutive model of human vocal fold tissue is used to investigate effects of phonatory posturing cyclic strain in the range of 1 Hz to 10 Hz. Tissue data for two subjects are considered and used to contrast the potential effects of age. Results suggest that modulation frequency and extent (amplitude, as well as the amount of vocal fold overall strain, all affect the change in stress relaxation with modulation added. Generally, the vocal fold cover reduces the rate of relaxation while the opposite is true for the vocal ligament. Further, higher modulation frequencies appear to reduce the rate of relaxation, primarily affecting the ligament. The potential benefits of cyclic strain, often found in vibrato (around 5 Hz modulation and intonational inflection, are discussed in terms of vocal effort and vocal pitch maintenance. Additionally, elderly tissue appears to not exhibit these benefits to modulation. The exacerbating effect such modulations may have on certain voice disorders, such as muscle tension dysphonia, are explored.

  8. A case of adult congenital laryngeal cleft asymptomatic until hypopharynx cancer treatment.

    Science.gov (United States)

    Shimizu, Kotaro; Uno, Atsuhiko; Takemura, Kazuya; Ashida, Naoki; Oya, Ryohei; Kitamura, Takahiro; Takenaka, Yukinori; Yamamoto, Yoshifumi

    2018-06-01

    Laryngeal cleft is an anomaly of failed posterior closure of the larynx. Most cases are diagnosed and need treatment early in life due to respiratory and swallowing problems. We report an unusual case of a 66-year-old man with an asymptomatic laryngeal cleft until treatment for hypopharyngeal cancer. During concurrent chemoradiotherapy (CCRT), despite reduced tumor volume, he presented severe dysphagia and dyspnea, followed by severe pneumonia twice. Because CCRT had to be discontinued, a pharyngolaryngectomy was performed for the cancer treatment. The resected specimen showed total removal of the tumor and a total longitudinal cleft of the cricoid cartilage, classified as a type III laryngeal cleft by the Benjamin and Inglis' classification. A review of computed tomography images indicated that the redundant mucosa from bilateral edges closed the separation of the posterior cricoid cartilage and narrowed the laryngeal airway during CCRT. Adult presentations of laryngeal cleft are quite rare with only ten reported cases in English literature; the present case is of the oldest patient. Undiagnosed cases with laryngeal cleft may exist asymptomatically or without severe symptoms. The awareness of this condition may increase its diagnosis as a cause of diseases such as aspiration and recurrent pneumonia even in adult patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Neuromagnetic detection of the laryngeal area: Sensory-evoked fields to air-puff stimulation.

    Science.gov (United States)

    Miyaji, Hideaki; Hironaga, Naruhito; Umezaki, Toshiro; Hagiwara, Koichi; Shigeto, Hiroshi; Sawatsubashi, Motohiro; Tobimatsu, Shozo; Komune, Shizuo

    2014-03-01

    The sensory projections from the oral cavity, pharynx, and larynx are crucial in assuring safe deglutition, coughing, breathing, and voice production/speaking. Although several studies using neuroimaging techniques have demonstrated cortical activation related to pharyngeal and laryngeal functions, little is known regarding sensory projections from the laryngeal area to the somatosensory cortex. The purpose of this study was to establish the cortical activity evoked by somatic air-puff stimulation at the laryngeal mucosa using magnetoencephalography. Twelve healthy volunteers were trained to inhibit swallowing in response to air stimuli delivered to the larynx. Minimum norm estimates was performed on the laryngeal somatosensory evoked fields (LSEFs) to best differentiate the target activations from non-task-related activations. Evoked magnetic fields were recorded with acceptable reproducibility in the left hemisphere, with a peak latency of approximately 100ms in 10 subjects. Peak activation was estimated at the caudolateral region of the primary somatosensory area (S1). These results establish the ability to detect LSEFs with an acceptable reproducibility within a single subject and among subjects. These results also suggest the existence of laryngeal somatic afferent input to the caudolateral region of S1 in human. Our findings indicate that further investigation in this area is needed, and should focus on laryngeal lateralization, swallowing, and speech processing. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Asbestos, dental x-rays, tobacco, and alcohol in the epidemiology of laryngeal cancer

    International Nuclear Information System (INIS)

    Hinds, M.W.; Thomas, D.B.; O'Reilly, H.P.

    1979-01-01

    A case-control study of 47 laryngeal cancers in males of three counties of Washington State was conducted. Personal interview was used to obtain information on smoking, alcohol use, exposure to asbestos, and other substances, and x-rays of the head and neck area. Smoking and alcohol consumption were found to increase risk of laryngeal cancer independently, with a clear dose-response relationship. Neither asbestos exposure nor exposure to other substances was found to significantly increase the risk of laryngeal cancer, although the relative risk with asbestos exposure was 1.75. Lifetime history of exposure to dental x-rays on five or more occasions was associated with significantly increased risk of laryngeal cancer among heavy smokers but not among light smokers. The importance of tobacco and alcohol in the epidemiology of laryngeal cancer was re-affirmed, the importance of asbestos exposure was brought into question, and a possible relationship of laryngeal cancer with exposure to dental x-rays among heavy smokers was demonstrated

  11. Effect of human papilloma virus expression on clinical course of laryngeal papilloma.

    Science.gov (United States)

    Kim, Kwang Moon; Cho, Nam Hoon; Choi, Hong Shik; Kim, Young Ho; Byeon, Hyung Kwon; Min, Hyun Jin; Kim, Se-Heon

    2008-10-01

    Our observations suggest that human papilloma virus (HPV) 6/11 is the main causative agent of laryngeal papilloma and that detection of active HPV DNA expression may be helpful in identifying patients with aggressive recurrent laryngeal papilloma. HPV is assumed to be the main causative agent of this disease. We investigated the expression of the entire genotype of HPV in cases of laryngeal papilloma and correlated their expression with the clinical course of the disease. Seventy cases of laryngeal papilloma were evaluated for the presence of the HPV genome by in situ hybridization (ISH) using wide-spectrum HPV DNA probe. Specific types of HPV infection were determined by DNA ISH using type-specific HPV DNA probes (HPV 6, 11, 16, 18, 31, 33). Separate analyses were conducted comparing viral types, frequency of recurrences and duration of disease-free periods. We detected HPV DNA in 40 of the 70 laryngeal papilloma cases (57%). In particular, HPV DNA was detected in 75% of the juvenile types. There were significant associations between HPV and laryngeal papilloma (p<0.01). Among the HPV-positive cases, major specific types were HPV 6/11 (97%). Significant associations were also noted between viral expression and clinical course.

  12. Intrinsic cylindrical and spherical waves

    International Nuclear Information System (INIS)

    Ludlow, I K

    2008-01-01

    Intrinsic waveforms associated with cylindrical and spherical Bessel functions are obtained by eliminating the factors responsible for the inverse radius and inverse square radius laws of wave power per unit area of wavefront. The resulting expressions are Riccati-Bessel functions for both cases and these can be written in terms of amplitude and phase functions of order v and wave variable z. When z is real, it is shown that a spatial phase angle of the intrinsic wave can be defined and this, together with its amplitude function, is systematically investigated for a range of fixed orders and varying z. The derivatives of Riccati-Bessel functions are also examined. All the component functions exhibit different behaviour in the near field depending on the order being less than, equal to or greater than 1/2. Plots of the phase angle can be used to display the locations of the zeros of the general Riccati-Bessel functions and lead to new relations concerning the ordering of the real zeros of Bessel functions and the occurrence of multiple zeros when the argument of the Bessel function is fixed

  13. Comparison of Ambu® AuraGain™ laryngeal mask and air-Q™ intubating laryngeal airway for blind tracheal intubation in adults: A randomized controlled trial

    OpenAIRE

    Sameer Sethi; Souvik Maitra; Vikas Saini; Tanvir Samara

    2017-01-01

    Background: This study has been designed to compare the performance of Ambu® AuraGain™ laryngeal mask with the air-Q™ as a conduit for blind tracheal intubation in adult patients. Methods: In this prospective randomized controlled trial blind endotracheal intubation success rates were compared between Ambu® AuraGain™ and air-Q™ intubating laryngeal airway in 90 adult patients. Patients were randomized in two equal groups: Group Ambu® AuraGain™ (n = 45) and Group air-Q™ (n = 45). Results...

  14. Immunology Guides Skeletal Muscle Regeneration

    Directory of Open Access Journals (Sweden)

    F. Andrea Sass

    2018-03-01

    Full Text Available Soft tissue trauma of skeletal muscle is one of the most common side effects in surgery. Muscle injuries are not only caused by accident-related injuries but can also be of an iatrogenic nature as they occur during surgical interventions when the anatomical region of interest is exposed. If the extent of trauma surpasses the intrinsic regenerative capacities, signs of fatty degeneration and formation of fibrotic scar tissue can occur, and, consequentially, muscle function deteriorates or is diminished. Despite research efforts to investigate the physiological healing cascade following trauma, our understanding of the early onset of healing and how it potentially determines success or failure is still only fragmentary. This review focuses on the initial physiological pathways following skeletal muscle trauma in comparison to bone and tendon trauma and what conclusions can be drawn from new scientific insights for the development of novel therapeutic strategies. Strategies to support regeneration of muscle tissue after injury are scarce, even though muscle trauma has a high incidence. Based on tissue specific differences, possible clinical treatment options such as local immune-modulatory and cell therapeutic approaches are suggested that aim to support the endogenous regenerative potential of injured muscle tissues.

  15. Immunology Guides Skeletal Muscle Regeneration.

    Science.gov (United States)

    Sass, F Andrea; Fuchs, Michael; Pumberger, Matthias; Geissler, Sven; Duda, Georg N; Perka, Carsten; Schmidt-Bleek, Katharina

    2018-03-13

    Soft tissue trauma of skeletal muscle is one of the most common side effects in surgery. Muscle injuries are not only caused by accident-related injuries but can also be of an iatrogenic nature as they occur during surgical interventions when the anatomical region of interest is exposed. If the extent of trauma surpasses the intrinsic regenerative capacities, signs of fatty degeneration and formation of fibrotic scar tissue can occur, and, consequentially, muscle function deteriorates or is diminished. Despite research efforts to investigate the physiological healing cascade following trauma, our understanding of the early onset of healing and how it potentially determines success or failure is still only fragmentary. This review focuses on the initial physiological pathways following skeletal muscle trauma in comparison to bone and tendon trauma and what conclusions can be drawn from new scientific insights for the development of novel therapeutic strategies. Strategies to support regeneration of muscle tissue after injury are scarce, even though muscle trauma has a high incidence. Based on tissue specific differences, possible clinical treatment options such as local immune-modulatory and cell therapeutic approaches are suggested that aim to support the endogenous regenerative potential of injured muscle tissues.

  16. Are Instructions to Manipulate Specific Parameters of Laryngeal Function Associated with Auditory-Perceptual Ratings of Voice Quality in Nondisordered Speakers?

    Science.gov (United States)

    Madill, Catherine J; Sheard, Christine; Heard, Robert

    2017-07-01

    This preliminary study investigated whether auditory-perceptual judgments of voice quality by experienced speech language pathologists were associated with instructions given to speakers to manipulate specific laryngeal postures. Experimental, within-subject design. Nine speakers were instructed and trained to manipulate three vocal parameters implicated in functional voice disorders-false vocal fold constriction, vocal fold mass, and larynx height-while reading a standard passage. Experienced judges rated these standard passages in terms of the widely used perceptual voice qualities breathiness, roughness, vocal strain, glottal fry, tone onset, tone color, loudness, and pitch. Between-subject factorial analysis of variance, controlling for judge unreliability, revealed some evidence that perceptual judgments are strongly associated with underlying laryngeal muscle activity that can then serve clinical planning of goals for intervention. Eta 2 effect sizes were large for all dependent measures, ranging from 0.39 for pitch to 0.77 for strained. Although these results are encouraging, they were obtained under ideal conditions. Further research is warranted. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. Lack of CFTR in skeletal muscle predisposes to muscle wasting and diaphragm muscle pump failure in cystic fibrosis mice.

    Directory of Open Access Journals (Sweden)

    Maziar Divangahi

    2009-07-01

    Full Text Available Cystic fibrosis (CF patients often have reduced mass and strength of skeletal muscles, including the diaphragm, the primary muscle of respiration. Here we show that lack of the CF transmembrane conductance regulator (CFTR plays an intrinsic role in skeletal muscle atrophy and dysfunction. In normal murine and human skeletal muscle, CFTR is expressed and co-localized with sarcoplasmic reticulum-associated proteins. CFTR-deficient myotubes exhibit augmented levels of intracellular calcium after KCl-induced depolarization, and exposure to an inflammatory milieu induces excessive NF-kB translocation and cytokine/chemokine gene upregulation. To determine the effects of an inflammatory environment in vivo, sustained pulmonary infection with Pseudomonas aeruginosa was produced, and under these conditions diaphragmatic force-generating capacity is selectively reduced in Cftr(-/- mice. This is associated with exaggerated pro-inflammatory cytokine expression as well as upregulation of the E3 ubiquitin ligases (MuRF1 and atrogin-1 involved in muscle atrophy. We conclude that an intrinsic alteration of function is linked to the absence of CFTR from skeletal muscle, leading to dysregulated calcium homeostasis, augmented inflammatory/atrophic gene expression signatures, and increased diaphragmatic weakness during pulmonary infection. These findings reveal a previously unrecognized role for CFTR in skeletal muscle function that may have major implications for the pathogenesis of cachexia and respiratory muscle pump failure in CF patients.

  18. Inhibition of Intrinsic Thrombin Generation

    Directory of Open Access Journals (Sweden)

    Thomas W. Stief MD

    2006-01-01

    Full Text Available Background The contact phase of coagulation is of physiologic/pathophysiologic importance, whenever unphysiologic polynegative substances such as cell fragments (microparticles get in contact with blood. There are several clinically used inhibitors of intrinsic thrombin generation. Here the inhibitory concentrations 50% (IC50 of these anticoagulants are measured by the highly specific thrombin generation assay INCA. Methods Unfrozen pooled normal citrated plasma in polystyrole tubes was supplemented at 23°C in duplicate with 0–2 IU/ml low molecular weight heparin (dalteparin, 0–2 IU/ml unfractionated heparin, 0–500 KIU/ml aprotinin, or 0–40 mM arginine. 50 μl plasma or 1 IU/ml thrombin standard were pipetted into a polystyrole microtiter plate with flat bottom. 5 μl SiO 2 /CaCl 2 - reagent (INCA activator were added and after 0–30 min incubation at 37°C 100 μl 2.5 M arginine, pH 8.6, were added; arginine inhibits hemostasis activation and depolymerizes generated fibrin within 20 min at 23°C. The in the physiologic 37°C incubation phase generated thrombin was then chromogenically detected. The intra-assay CV values were < 5%. Results and Discussion The approximate IC50 were 0.01 IU/ml dalteparin, 0.02 IU/ml heparin, 25 KIU/ml aprotinin, and 12 mM arginine. The efficiency of any anticoagulant on intrinsic thrombin generation should be measured for each individual patient. Abbreviations IIa, thrombin; δA, increase in absorbance; APTT, activated partial thromboplastin time; CRT, coagulation reaction time (at 37°C in water-bath; F-wells, polystyrole microtiter plates with flat bottom; IC50, inhibitory concentration 50%; INCA, intrinsic coagulation activity assay; IU, international units; KIU, kallikrein inhibiting unis; LMWH, low molecular weight heparin; mA, milli-absorbance units; PSL, pathromtin SL®; RT, room temperature (23°C; U-wells, polystyrole microtiter plates with round bottom.

  19. Abnormality of Auricular Muscles in Congenital Auricular Deformities.

    Science.gov (United States)

    Yotsuyanagi, Takatoshi; Yamauchi, Makoto; Yamashita, Ken; Sugai, Asuka; Gonda, Ayako; Kitada, Ayaka; Saito, Tamotsu; Urushidate, Satoshi

    2015-07-01

    It has been suggested that there is a close association of abnormality in auricular muscles with various congenital auricular deformities. However, there has been no investigation to determine what muscles are involved and how they affect the deformity. The authors examined abnormalities of auricular muscles for patients with various auricular deformities. The authors examined 77 auricles of 62 patients with congenital auricular deformities, including cryptotia, Stahl's ear, prominent ear, lop ear, and others. The superior and posterior auricular muscles from the extrinsic auricular muscle group and the auricular oblique and transverse muscles from the auricular intrinsic muscle group were investigated. The authors found characteristic features of the abnormality of the muscle for each auricular deformity. In nearly all cases of cryptotia, abnormality was found in the superior auricular, auricular oblique, and auricular transverse muscles. Abnormal insertion was found mainly in the superior auricular muscle and was the main cause of cryptotia. In Stahl's ear, the major abnormality was abnormal insertion of the auricular transverse muscle, which creates an abnormal cartilaginous prominence in the scapha. The abnormality in cases of prominent ear was clearly limited mostly to the auricular transverse muscle and, in some cases, to the posterior auricular muscle. In lop ear, abnormality was mostly found in the auricular transverse muscle, with elongation, and in the superior auricular or auricular oblique muscle in some cases. There is a tendency for a specific muscle abnormality to be found in each deformity. It is important to identify the abnormal muscle and correct the abnormality during the operation.

  20. Changes in survival in locally advanced laryngeal carcinoma over past three decades

    International Nuclear Information System (INIS)

    EL-Zawahry, I.M.Sh.

    2013-01-01

    Laryngeal cancer is the commonest carcinoma of the head and neck region with Squamous-cell carcinomas (SCC) in 90 % of cases (Birchall Met al 2008) The incidence of laryngeal cancer was relatively about 160,000 new cases per year. The disease predominantly affects men; about 2.4% of all cancer cases and 2.1% of all cancer deaths worldwide ,also in United States in 2012 the Es)mated new cases is 12,360 and deaths from laryngeal cancer is 3,650. The majority of patients with SCC of larynx present with locally advanced (LA) disease.(American Cancer Society, 2012) The incidence of laryngeal cancer in the Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK), Faculty of Medicine, Cairo University from year 2005 - 2008 is 3.1%per year. Advanced laryngeal cancer is generally considered as the disease in stages III and IV based on the primary tumor extension and/or the presence of metastatic lymph node(s) in the neck and it accounts for roughly 40% to 50% of patients with laryngeal cancer (Chen AY, et al 2006). From the second half of the 20th century total laryngectomy combined with a neck dissection was considered a treatment of choice for advanced laryngeal cancer (Genden EM et al, 2007). In most institutions, postoperative radiotherapy as adjuvant treatment following ablative surgery with radiation doses up to 60-66 Gy has also become the standard approach for patients with stage III-IV laryngeal cancer (Corvo R , 2007). However, the treatment of advanced laryngeal cancer seams to be a permanent challenge, but the management of patients with advanced laryngeal cancer has become more complex as other modalities including induction chemotherapy followed by radiotherapy or concurrent chemo-radiotherapy have evolved with the goal of preserving the larynx and reserved total laryngectomy as a salvage procedure for cases with less than 50% response to induction chemotherapy or in those who have persistent disease following concurrent chemo

  1. Study of the adjustment of the Ambu laryngeal mask under magnetic resonance imaging.

    Science.gov (United States)

    Monclus, Enric; Garcés, Antonio; De Jose Maria, Belen; Artés, David; Mabrock, Maged

    2007-12-01

    Our aim in this study was to analyze the adjustment of the laryngeal mask, Ambu AuraOnce, in pediatric patients during magnetic resonance imaging (MRI) and to look for a correlation between clinical parameters such as the sealing pressure and the ease of introduction with radiological parameters. One-hundred and twenty-one pediatric patients from 4 months to 17 years who required a cranial MRI for other reasons were enrolled in the study. General anesthesia was induced with sevofluorane and no relaxant was used. Insertion attempts, sealing pressure, desaturation episodes and maintenance of anesthesia were recorded. Spontaneous ventilation was maintained throughout all procedures and no episodes of desaturation below 95% were seen. Patients without cough or pharyngeal pain were discharged after 1 h. Data were classified into three groups according to the size of the used laryngeal mask (group 1 for laryngeal mask number 1(1/2); group 2 for laryngeal mask number 2, and group 3 for laryngeal mask number 2(1/2)). Sagittal MRI cuts were reviewed to calculate neck flexion, laryngeal mask position and its relationship with the trachea. First-attempt introduction rate of the laryngeal mask was 96%, and it was 100% after a second attempt. Sealing pressure was 22.1+/-4.15 mmHg for group 1, 22.23+/-3.94 for group 2, and 23.83+/-3.28 for group 3. The angles between the laryngeal mask and the four first cervical vertebrae were calculated (group 1, 33.65+/-8.05; group 2, 28.09+/-6.65; group 3, 25.79+/-4.26). Distances between trachea and proximal and distal cuffs were measured to evaluate proper fitting of the laryngeal mask. Anomalous placement seen on MRI, using distances from proximal and distal cuff to trachea, occurred in 23.5% in group 1, 10.9% in group 2, and 13.8% in group 3. We found no correlation between this anomalous position of the laryngeal mask and sealing pressure or ease of introduction. The Ambu AuraOnce can be regarded as a safe product for airway maintenance

  2. Postoperative discomfort and emergence delirium in children undergoing dental rehabilitation under general anesthesia: comparison of nasal tracheal intubation and laryngeal mask airway

    Science.gov (United States)

    Keles, Sultan; Kocaturk, Ozlem

    2018-01-01

    Background Several studies have identified side effects of general anesthesia with endotracheal intubation, such as laryngeal pain, dysphonia, and postoperative nausea and vomiting (PONV). The laryngeal mask airway (LMAw) is believed to decrease these side effects. The aim of this trial was to compare postoperative discomfort, emergence delirium, and recovery time of patients who received either an LMAw or nasotracheal intubation (NTI). Patients and methods A total of 70 children were randomly assigned to the LMAw group (n=35) or the NTI group (n=35). Both groups underwent mask induction with 8% sevoflurane. The NTI group received muscle relaxant, whereas the LMAw group did not. Postoperative laryngeal pain, dental pain, dysphonia, and PONV were assessed immediately and at 1 hour and 6 hours postoperatively. The Wong–Baker Faces Scale was used to evaluate the patients’ self-reported pain. In addition, decayed, missing, and filled teeth (dft/DMFT) values, dental procedure type, number of dental procedures, duration of the dental operation, duration of anesthesia, recovery time, emergence delirium, pediatric dentist’s access to the mouth, and parents’ satisfaction levels were recorded. Data were analyzed using descriptive statistics, chi-square tests, and two-sample t-tests. Results The incidence of postoperative laryngeal pain was significantly higher in the NTI group immediately (97.2% vs. 8.5%, P=0.00), 1 hour (94.2% vs. 0%, P=0.00), and 6 hours postoperatively (25.7% vs. 0%, P=0.00). There were no statistically significant differences between the two groups in dental pain scores, dft/DMFT values, duration of anesthesia, duration of the dental operation, number of dental procedures, the incidence of PONV, or pediatric dentist’s access to the mouth (P>0.05). Emergence delirium and recovery time were significantly higher in the NTI group (P<0.05). Conclusion The LMAw provided a more comfortable postoperative period than NTI for children who underwent full

  3. Intrinsic rotation with gyrokinetic models

    International Nuclear Information System (INIS)

    Parra, Felix I.; Barnes, Michael; Catto, Peter J.; Calvo, Iván

    2012-01-01

    The generation of intrinsic rotation by turbulence and neoclassical effects in tokamaks is considered. To obtain the complex dependences observed in experiments, it is necessary to have a model of the radial flux of momentum that redistributes the momentum within the tokamak in the absence of a preexisting velocity. When the lowest order gyrokinetic formulation is used, a symmetry of the model precludes this possibility, making small effects in the gyroradius over scale length expansion necessary. These effects that are usually small become important for momentum transport because the symmetry of the lowest order gyrokinetic formulation leads to the cancellation of the lowest order momentum flux. The accuracy to which the gyrokinetic equation needs to be obtained to retain all the physically relevant effects is discussed.

  4. Effect of chemical stimuli on nerves supplying upper airway muscles.

    Science.gov (United States)

    Weiner, D; Mitra, J; Salamone, J; Cherniack, N S

    1982-03-01

    Studies of upper airway resistance suggest that the activity of cranial nerves supplying upper airway muscles changes with chemical drive and that imbalances in the activation of these nerves as compared to the phrenic play a role in causing upper airway obstruction. We assessed the effect of hypoxia and hypercapnia on the activity of the hypoglossal nerve, the recurrent laryngeal nerve, and phrenic nerve in paralyzed anesthetized artificially ventilated dogs. Comparison of hypoglossal and phrenic nerves were also repeated after vagotomy. Both hypoglossal and recurrent laryngeal nerves exhibited increased activity with inspiration. Hypoxia and hypercapnia increased phrenic nerve activity as well as the activity of the two cranial nerves. While linear increases occurred in phrenic and recurrent laryngeal nerve activity with both chemical stimuli, the relationship between hypoglossal and phrenic nerve activity was curvilinear. At lower levels of chemical drive, changes in hypoglossal nerve were less than in the phrenic, and the reverse was true at higher levels of chemical stimulation. There were also differences in the response of both cranial nerves and the phrenic to changing vagal stimulation. The dissimilarities observed in the cranial response of the nerves (versus the phrenic) could potentially affect the forces developed during inspiration and lead to obstruction in the upper airway.

  5. Laryngeal sensitivity evaluation and dysphagia: Hospital Sírio-Libanês experience

    Directory of Open Access Journals (Sweden)

    Orlando Parise Junior

    Full Text Available CONTEXT: Laryngeal sensitivity is important in the coordination of swallowing coordination and avoidance of aspiration. OBJECTIVE: To briefly review the physiology of swallowing and report on our experience with laryngeal sensitivity evaluation among patients presenting dysphagia. TYPE OF STUDY: Prospective. SETTING: Endoscopy Department, Hospital Sírio-Libanês. METHODS: Clinical data, endoscopic findings from the larynx and the laryngeal sensitivity, as assessed via the Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST protocol (using the Pentax AP4000 system, were prospectively studied. The chi-squared and Student t tests were used to compare differences, which were considered significant if p < or = 0.05. RESULTS: The study included 111 patients. A direct association was observed for hyperplasia and hyperemia of the posterior commissure region in relation to globus (p = 0.01 and regurgitation (p = 0.04. Hyperemia of the posterior commissure region had a direct association with sialorrhea (p = 0.03 and an inverse association with xerostomia (p = 0.03. There was a direct association between severe laryngeal sensitivity deficit and previous radiotherapy of the head and neck (p = 0.001. DISCUSSION: These data emphasize the association between proximal gastroesophageal reflux and chronic posterior laryngitis, and suggest that decreased laryngeal sensitivity could be a side effect of radiotherapy. CONCLUSIONS: Even considering that these results are preliminary, the endoscopic findings from laryngoscopy seem to be important in the diagnosis of proximal gastroesophageal reflux. Study of laryngeal sensitivity may have the potential for improving the knowledge and clinical management of dysphagia.

  6. Role of miR-145 in human laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Karatas, Omer Faruk; Yuceturk, Betul; Suer, Ilknur; Yilmaz, Mehmet; Cansiz, Harun; Solak, Mustafa; Ittmann, Michael; Ozen, Mustafa

    2016-02-01

    Laryngeal squamous cell carcinoma (SCC), being an aggressive malignancy, is one of the most commonly diagnosed malignant types of head and neck SCC worldwide. Incidences of laryngeal SCC have been reported to increase recently. In this study, we aimed to explore the biological effects of miR-145 on laryngeal cancer cells. The relative miR-145 level in laryngeal SCC tumor tissues and normal samples was investigated. Then, Hep-2 cells were utilized for functional analysis of miR-145. The proliferation abilities of transfected cells were measured using MTS assay. Scratch assay and single colony migration assay were performed to observe the alterations in migration behavior of transfected cells. Caspase assay and cell cycle analysis were used to investigate the underlying reasons of proliferative inhibition in cells in which miR-145 is overexpressed. Moreover, expression of SOX2 was analyzed using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot analysis in Hep-2 cells upon miR-145 transfection and its expression was evaluated in tumor and normal tissue sample of the larynx. The miR-145 expression in laryngeal SCC tumor samples has been shown to be downregulated. The miR-145 overexpression caused inhibition of proliferation and migration in Hep-2 cells through induction of apoptosis and cell cycle arrest. The SOX2 level was demonstrated to be overexpressed in tumor samples and its expression was significantly decreased in miR-145 overexpressed Hep-2 cells. We have demonstrated the deregulation of miR-145 and SOX2 in laryngeal SCC. Based on these results, we propose that miR-145, as an important regulator of SOX2, carries crucial roles in laryngeal SCC tumorigenesis. © 2015 Wiley Periodicals, Inc.

  7. The risk factors of laryngeal pathology in Korean adults using a decision tree model.

    Science.gov (United States)

    Byeon, Haewon

    2015-01-01

    The purpose of this study was to identify risk factors affecting laryngeal pathology in the Korean population and to evaluate the derived prediction model. Cross-sectional study. Data were drawn from the 2008 Korea National Health and Nutritional Examination Survey. The subjects were 3135 persons (1508 male and 2114 female) aged 19 years and older living in the community. The independent variables were age, sex, occupation, smoking, alcohol drinking, and self-reported voice problems. A decision tree analysis was done to identify risk factors for predicting a model of laryngeal pathology. The significant risk factors of laryngeal pathology were age, gender, occupation, smoking, and self-reported voice problem in decision tree model. Four significant paths were identified in the decision tree model for the prediction of laryngeal pathology. Those identified as high risk groups for laryngeal pathology included those who self-reported a voice problem, those who were males in their 50s who did not recognize a voice problem, those who were not economically active males in their 40s, and male workers aged 19 and over and under 50 or 60 and over who currently smoked. The results of this study suggest that individual risk factors, such as age, sex, occupation, health behavior, and self-reported voice problem, affect the onset of laryngeal pathology in a complex manner. Based on the results of this study, early management of the high-risk groups is needed for the prevention of laryngeal pathology. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  8. Muscle tension dysphonia in Vietnamese female teachers.

    Science.gov (United States)

    Nguyen, Duong Duy; Kenny, Dianna T; Tran, Ninh Duy; Livesey, Jonathan R

    2009-03-01

    There has been no published research on muscle tension dysphonia (MTD) in speakers who use a tonal language. Using a sample of 47 Northern Vietnamese female primary school teachers with MTD, we aimed to discover whether professional voice users of tonal languages presented with the same symptoms of MTD as speakers of nontonal languages and whether they presented with additional symptoms as a result of speaking a tonal language. The vocal characteristics were assessed by use of a questionnaire and expert perceptual evaluation. Laryngeal features were assessed by photolaryngoscopy. The results showed that MTD was associated with a larger number of vocal symptoms than previously reported. However, the participants did not have the same vocal symptoms reported in English speakers, for example, hard glottal attack, pitch breaks, unusual speech rate, and glottal fry. Factor analysis of the vocal symptoms revealed three factors: "vocal fatigue/hyperfunction," "physical discomfort," and "voice quality," all of which demonstrated high reliability. The major laryngeal characteristic was a glottal gap. The glottal shapes observed included: 44.7% had an incomplete closure, 29.8% a posterior gap, 12.8% an hourglass-shaped gap, 8.5% a spindle-shaped gap, and 4.3% had complete glottal closure. The findings implied a potential contribution of linguistic-specific factors and teaching-related factors to the presentation of this voice disorder in this group of teachers.

  9. Incentives and intrinsic motivation in healthcare

    Directory of Open Access Journals (Sweden)

    Mikel Berdud

    2016-11-01

    Conclusions: The conclusions could act as a guide to support the optimal design of incentive policies and schemes within health organisations when healthcare professionals are intrinsically motivated.

  10. Algebraic description of intrinsic modes in nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Leviatan, A. (Los Alamos National Lab., NM (USA))

    1990-01-01

    We present a procedure for extracting normal modes in algebraic number-conserving systems of interacting bosons relevant for collective states in even-even nuclei. The Hamiltonian is resolved into intrinsic (bandhead related) and collective (in-band related) parts. Shape parameters are introduced through non-spherical boson bases. Intrinsic modes decoupled from the spurious modes are obtained from the intrinsic part of the Hamiltonian in the limit of large number of bosons. Intrinsic states are constructed and serve to evaluate electromagnetic transition rates. The method is illustrated for systems with one type of boson as well as with proton-neutron bosons. (author).

  11. Algebraic description of intrinsic modes in nuclei

    International Nuclear Information System (INIS)

    Leviatan, A.

    1990-01-01

    We present a procedure for extracting normal modes in algebraic number-conserving systems of interacting bosons relevant for collective states in even-even nuclei. The Hamiltonian is resolved into intrinsic (bandhead related) and collective (in-band related) parts. Shape parameters are introduced through non-spherical boson bases. Intrinsic modes decoupled from the spurious modes are obtained from the intrinsic part of the Hamiltonian in the limit of large number of bosons. Intrinsic states are constructed and serve to evaluate electromagnetic transition rates. The method is illustrated for systems with one type of boson as well as with proton-neutron bosons. (author)

  12. Anesthetic management of a patient in prone position with a drill bit penetrating the spinal canal at C1-C2, using a laryngeal mask.

    Science.gov (United States)

    Valero, Ricard; Serrano, Silvia; Adalia, Ramón; Tercero, Javier; Blasi, Annabel; Sánchez-Etayo, Gerard; Martínez, Gloria; Caral, Lluis; Ibáñez, Guillermo

    2004-05-01

    Airway management in patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. A 19-yr-old patient was brought to the emergency room in prone position with a drill bit protruding from the posterolateral aspect of his neck. The bit had entered the spinal canal below the first cervical vertebra, and placed near the odontoid peg. He was referred for surgical removal of the drill. The use of an inhaled induction of anesthesia, avoiding muscle relaxants, and ventilation through a laryngeal mask airway inserted in the prone position seemed to offer a satisfactory approach. Management of patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. Anesthesia may be induced and the airway can be managed with the patient already in the prone position for surgery.

  13. Use of PET/CT to detect local and regional laryngeal cancer recurrence after surgery

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    Allegra E

    2017-06-01

    Full Text Available Eugenia Allegra,1 Vincenzo Saita,2 Massimo De Natale,2 Nicolò Marino,2 Serena Trapasso,1 Stefania Tamburrini,3 Caterina Alessio,4 Massimo Ippolito5 1Otolaryngology, Department of Health Sciences, University of Catanzaro, Catanzaro, 2Department of Otolaryngology, Cannizzaro Hospital, Catania, 3Department of Radiology, Pellegrini Hospital, Naples, 4Department of Experimental and Clinical Medicine-Radiology, University of Catanzaro, Catanzaro, 5Department of Nuclear Medicine, Cannizzaro Hospital, Catania, Italy Background: Laryngeal cancer is the second most common cancer of the head and neck after cancer of the oral cavity. The primary causes of death in cases of laryngeal cancer are the recurrence of locoregional disease and distant metastasis. Anatomic and tissue alterations resulting from surgery and/or radiotherapy of primary laryngeal tumors can make it difficult to determine a locoregional recurrence or residual disease by physical examination or computed tomography (CT/magnetic resonance imaging (MRI. The majority of studies have shown a high accuracy in the detection of local and regional recurrence of head and neck cancer after different treatment modalities, using fluorodeoxyglucose (FDG-positron emission tomography (PET/CT.Aim: To determine the diagnostic accuracy of PET/CT in patients with suspicion of locoregional recurrence from laryngeal carcinoma after surgery with or without adjuvant radiotherapy.Materials and methods: This was a retrospective study. Forty-five patients who previously underwent surgical treatment with or without adjuvant radiotherapy for primary laryngeal squamous cell carcinoma and who underwent examination using FDG-PET/CT imaging after clinical and instrumental (CT/MRI suspicion of locoregional recurrence (T or N were recruited.Results: Overall specificity, sensitivity, and accuracy of PET/CT were found to be 88%, 100%, and 93.3%, respectively. With respect to the suspected cases of recurrence in the primary

  14. Geochemical indicators of intrinsic bioremediation

    International Nuclear Information System (INIS)

    Borden, R.C.; Gomez, C.A.; Becker, M.T.

    1995-01-01

    A detailed field investigation has been completed at a gasoline-contaminated aquifer near Rocky Point, NC, to examine possible indicators of intrinsic bioremediation and identify factors that may significantly influence the rae and extent of bioremediation. The dissolved plume of benzene, toluene, ethylbenzene, and xylene (BTEX) in ground water is naturally degrading. Toluene and o-xylene are most rapidly degraded followed by m-, p-xylene, and benzene. Ethylbenzene appears to degrade very slowly under anaerobic conditions present in the center of the plume. The rate and extent of biodegradation appears to be strongly influenced by the type and quantity of electron acceptors present in the aquifer. At the upgradient edge of the plume, nitrate, ferric iron, and oxygen are used as terminal electron acceptors during hydrocarbon biodegradation. The equivalent of 40 to 50 mg/l of hydrocarbon is degraded based on the increase in dissolved CO 2 relative to background ground water. Immediately downgradient of the source area, sulfate and iron are the dominant electron acceptors. Toluene and o-xylene are rapidly removed in this region. Once the available oxygen, nitrate, and sulfate are consumed, biodegradation is limited and appears to be controlled by mixing and aerobic biodegradation at the plume fringes

  15. Protein intrinsic disorder in plants.

    Science.gov (United States)

    Pazos, Florencio; Pietrosemoli, Natalia; García-Martín, Juan A; Solano, Roberto

    2013-09-12

    To some extent contradicting the classical paradigm of the relationship between protein 3D structure and function, now it is clear that large portions of the proteomes, especially in higher organisms, lack a fixed structure and still perform very important functions. Proteins completely or partially unstructured in their native (functional) form are involved in key cellular processes underlain by complex networks of protein interactions. The intrinsic conformational flexibility of these disordered proteins allows them to bind multiple partners in transient interactions of high specificity and low affinity. In concordance, in plants this type of proteins has been found in processes requiring these complex and versatile interaction networks. These include transcription factor networks, where disordered proteins act as integrators of different signals or link different transcription factor subnetworks due to their ability to interact (in many cases simultaneously) with different partners. Similarly, they also serve as signal integrators in signaling cascades, such as those related to response to external stimuli. Disordered proteins have also been found in plants in many stress-response processes, acting as protein chaperones or protecting other cellular components and structures. In plants, it is especially important to have complex and versatile networks able to quickly and efficiently respond to changing environmental conditions since these organisms cannot escape and have no other choice than adapting to them. Consequently, protein disorder can play an especially important role in plants, providing them with a fast mechanism to obtain complex, interconnected and versatile molecular networks.

  16. Protein intrinsic disorder in plants

    Directory of Open Access Journals (Sweden)

    Florencio ePazos

    2013-09-01

    Full Text Available To some extent contradicting the classical paradigm of the relationship between protein 3D structure and function, now it is clear that large portions of the proteomes, especially in higher organisms, lack a fixed structure and still perform very important functions. Proteins completely or partially unstructured in their native (functional form are involved in key cellular processes underlain by complex networks of protein interactions. The intrinsic conformational flexibility of these disordered proteins allows them to bind multiple partners in transient interactions of high specificity and low affinity. In concordance, in plants this type of proteins has been found in processes requiring these complex and versatile interaction networks. These include transcription factor networks, where disordered proteins act as integrators of different signals or link different transcription factor subnetworks due to their ability to interact (in many cases simultaneously with different partners. Similarly, they also serve as signal integrators in signalling cascades, such as those related to response to external stimuli. Disordered proteins have also been found in plants in many stress-response processes, acting as protein chaperones or protecting other cellular components and structures. In plants, it is especially important to have complex and versatile networks able to quickly and efficiently respond to changing environmental conditions since these organisms can not escape and have no other choice than adapting to them. Consequently, protein disorder can play an especially important role in plants, providing them with a fast mechanism to obtain complex, interconnected and versatile molecular networks.

  17. Computed tomographic imaging of dogs with primary laryngeal or tracheal airway obstruction.

    Science.gov (United States)

    Stadler, Krystina; Hartman, Susan; Matheson, Jodi; O'Brien, Robert

    2011-01-01

    Seventeen dogs with clinical signs attributable to nonneoplastic obstruction of the larynx, trachea, or large bronchi underwent computed tomography (CT) imaging. In 16 of the 17 dogs, CT was performed without general anesthesia using a positioning device. Fifteen of these 16 dogs were imaged without sedation or general anesthesia. Three-dimensional (3D) internal rendering was performed on each image set based on lesion localization determined by routine image planes. Visual laryngeal examination, endoscopy, video fluoroscopy, and necropsy were used for achieving the cause of the upper airway obstruction. The CT and 3D internal rendering accurately indicated the presence and cause of upper airway obstruction in all dogs. CT findings indicative of laryngeal paralysis included failure to abduct the arytenoid cartilages, narrowed rima glottis, and air-filled laryngeal ventricles. Laryngeal collapse findings depended on the grade of collapse and included everted laryngeal saccules, collapse of the cuneiform processes and corniculate processes, and narrowed rima glottis. Trachea abnormalities included hypoplasia, stenosis, or collapse syndrome. The CT findings in tracheal hypoplasia consisted of a severely narrowed lumen throughout the entire length. Tracheal stenosis was represented by a circumferential decrease in tracheal lumen size limited to one region. Tracheal collapse syndrome was diagnosed by severe asymmetric narrowing. Lobar bronchi collapse appeared in CT images as a narrowed asymmetric lumen diameter. CT imaging of unanesthetized dogs with upper airway obstruction compares favorably with traditional definitive diagnostic methods. © 2011 Veterinary Radiology & Ultrasound.

  18. Reducing the negative vocal effects of superficial laryngeal dehydration with humidification.

    Science.gov (United States)

    Levendoski, Elizabeth Erickson; Sundarrajan, Anusha; Sivasankar, M Preeti

    2014-07-01

    Environmental humidification is a simple, cost-effective method believed to reduce superficial laryngeal drying. This study sought to validate this belief by investigating whether humidification treatment would reduce the negative effects of superficial laryngeal dehydration on phonation threshold pressure (PTP). Phonation threshold pressure data analysis may be vulnerable to bias because of lack of investigator blinding. Consequently, this study investigated the extent of PTP analysis reliability between unblinded and blinded investigators. Healthy male and female adults were assigned to a vocal fatigue (n = 20) or control group (n = 20) based on their responses to a questionnaire. PTP was assessed after 2 hours of mouth breathing in low humidity (dehydration challenge), following a 5-minute break in ambient humidity, and after 2 hours of mouth breathing in high humidity (humidification). PTP significantly increased following the laryngeal dehydration challenge. After humidification, PTP returned toward baseline. These effects were observed in both subject groups. PTP measurements were highly correlated between the unblinded and blinded investigator. Humidification may be an effective approach to decrease the detrimental voice effects of superficial laryngeal dehydration. These data lay the foundation for future investigations aimed at preventing and treating the negative voice changes associated with chronic, surface laryngeal drying.

  19. Laryngeal cancer in nondrinker nonsmoker young patients: a distinct pathological entity?

    Science.gov (United States)

    Bradley, Patrick J

    2016-04-01

    Laryngeal cancer published literature was reviewed, with emphasis on reporting on young patients (cause and genetic/molecular profile rather than a spectrum of the classic disease. Head and neck cancer in young patients is documented at a rate of 0.4-3.6%, with laryngeal cancer being identified in less than 2% of all diagnosed head and neck cancer patients overall. Head and neck cancer in nondrinking nonsmokers has been reported from tertiary clinical hospitals only, with few patients having a diagnosis of laryngeal cancer, and thus their documented drinking and smoking habits may be considered suspect. Most of the molecular or genetic studies on young patients, who probably have had varying degrees of drinking and smoking habits, have been reported on nonlaryngeal head and neck sites. These finding should be confirmed on a 'pure group' of young patients (laryngeal cancer who confirm that they have been nondrinkers, and nonsmokers. Many authors comment that laryngeal cancer in young (likely explained by some molecular or genetic level abnormality rather than histological and should be considered a distinct group. However, because of a low incidence of such patients and the rapid development in genetic sequencing, that such a project be completed requires greater collaboration between clinicians and pathologists.

  20. Laryngeal features in Latundê (Northern Nambikwára

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    Stella Telles

    2013-08-01

    Full Text Available This paper is about the status of laryngeal features in Latundê, a language of the Northern Nambikwára subgroup. Data were collected in the field by the author between the years 1997-2001. The available literature on other languages of the family was also taken into consideration for the analysis. The article is organized in five sections: in the first section, information on the Nambikwára family and the segmental inventories of three languages of the family will be provided; in the second section, the phonological charts (consonants and vowels of Latundê are presented; in the third section data that demonstrate the realization of laryngeal features in the consonants (glottalization and aspiration and vowels (creaky voice of Latundê can be found; considerations on laryngeal variation are provided in the fourth section; in the final section, correspondences between segments with laryngeal features in Latundê and Mamaindê, a closely related Northern Nambikwára language, will be considered. The research shows that in Latundê laryngeal features were neutralized for consonants, while for vowels, creaky voice remained contrastive. Within the Northern Nambikwára branch, the correspondence between Mamaindê and Latundê consonants seems to indicate that the latter language is the most innovative in the process of historical change.

  1. Voice-related of quality of life after treatment for laryngeal cancer

    International Nuclear Information System (INIS)

    Oridate, Nobuhiko; Furuta, Yasushi; Homma, Akihiro; Suzuki, Seigo; Suzuki, Fumiyuki; Hatakeyama, Hiromitsu; Taki, Shigenari; Sakashita, Tomohiro; Fukuda, Satoshi

    2007-01-01

    There are many methods of treating laryngeal cancers: definitive irradiation with or without concurrent chemotherapy, endoscopic laser surgery, partial surgery techniques, and total laryngectomy. Few studies have been reported on vocal function and quality of life of patients after the definitive treatment for laryngeal cancer, using single voice related QOL measures. The aim of this study was to examine voice related QOL in patients treated with various modalities using a Voice-Related Quality of Life (V-RQOL) questionnaire as well as Voice Handicap Index-10 (VHI-10) questionnaire. Between August 2006 and May 2007, survey data on voice utilizing the V-RQOL and VHI-10 were obtained from a total of 130 patients who had received definitive treatment for laryngeal cancers with follow-up at the Hokkaido University Hospital, and who were alive with no evidence of malignancy at the time of survey. Mean V-RQOL scores of the patients who received radiation therapy (n=63), chemoradiotherapy (n=29), laser resection (n=14) and total laryngectomy (n=27) as the final treatment for laryngeal cancer were 92.6, 92.9, 85.5, and 68.4, respectively. Mean VHI-10 values were 2.87, 2.34, 5.43, and 11.26. Such measures of quality of life are important endpoints to help judge the overall effectiveness of treatment options for laryngeal cancers. (author)

  2. High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer.

    Science.gov (United States)

    Mora, Francesco; Missale, Francesco; Incandela, Fabiola; Filauro, Marta; Parrinello, Giampiero; Paderno, Alberto; Della Casa, Palmiro; Piazza, Cesare; Peretti, Giorgio

    2017-01-01

    Transoral laser microsurgery (TLM) for early to intermediate laryngeal squamous cell cancer (SCC) can be technically challenging when adequate exposure of the posterior laryngeal compartment is required due to the presence of the orotracheal tube. The goal of our study was to analyze the efficacy of high frequency jet ventilation (HFJV) in achieving appropriate laryngeal exposure and safe oncologic resection of lesions located in such a position. We reviewed the clinical records of 62 patients affected by Tis-T2 SCC of the posterior laryngeal compartment treated by TLM between 02/2012 and 12/2016. The cohort was divided into two groups according to the anesthesiologic technique used: Group A included patients treated using intraoperative infraglottic HFJV, while Group B encompassed patients treated by standard orotracheal intubation. The main outcome was postoperative surgical margin status. Group comparison analysis was performed. Significant difference in deep margin status was observed between the two groups: in Group A, the rate of negative deep margins was 86% compared to 56% in Group B ( p  = 0.04). A trend of better overall and superficial margin control was observed for patients treated using HFJV (Group A), although no statistical significance was achieved. Use of HFJV during TLM allows easier and safer management of patients affected by Tis-T2 SCC of the posterior laryngeal compartment, reducing the rates of positive superficial and deep surgical margins.

  3. High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Francesco Mora

    2017-11-01

    Full Text Available BackgroundTransoral laser microsurgery (TLM for early to intermediate laryngeal squamous cell cancer (SCC can be technically challenging when adequate exposure of the posterior laryngeal compartment is required due to the presence of the orotracheal tube. The goal of our study was to analyze the efficacy of high frequency jet ventilation (HFJV in achieving appropriate laryngeal exposure and safe oncologic resection of lesions located in such a position.MethodsWe reviewed the clinical records of 62 patients affected by Tis-T2 SCC of the posterior laryngeal compartment treated by TLM between 02/2012 and 12/2016. The cohort was divided into two groups according to the anesthesiologic technique used: Group A included patients treated using intraoperative infraglottic HFJV, while Group B encompassed patients treated by standard orotracheal intubation. The main outcome was postoperative surgical margin status. Group comparison analysis was performed.ResultsSignificant difference in deep margin status was observed between the two groups: in Group A, the rate of negative deep margins was 86% compared to 56% in Group B (p = 0.04. A trend of better overall and superficial margin control was observed for patients treated using HFJV (Group A, although no statistical significance was achieved.ConclusionUse of HFJV during TLM allows easier and safer management of patients affected by Tis-T2 SCC of the posterior laryngeal compartment, reducing the rates of positive superficial and deep surgical margins.

  4. Swallowing assessment in early laryngeal cancer patients treated either with surgery or radiotherapy

    International Nuclear Information System (INIS)

    Celedon L, Carlos; Gambi A, Galo; Royer F, Michel; Esquivel C, Patricia; Arteaga J, Patricia; Valdes P, Constanza

    2008-01-01

    Swallowing is a complex neuromuscular process that requires anatomical indemnity and an adequate coordination of several organs. Laryngeal cancer treatment may cause swallowing disorders. Traditionally, a high frequency of this type of disorder after surgery has been reported, but no actual data concerning its incidence in patients undergoing radiotherapy for early laryngeal cancer has been published. Aim. To compare swallowing disorders frequency posterior to treatment in early laryngeal cancer patients. Material and Method. Two groups of early laryngeal cancer patients were transversally studied, one treated with vertical partial surgery (CP), and the other treated exclusively with radiotherapy. Each patient had otorhinolaryngological, nasofibroscopic and video fluoroscopic evaluations after treatment. Differences between groups were compared using the - square test. Results. Twenty patients per group were entered in this study, predominantly males of similar age. Both groups presented a high incidence of aspiration symptoms (55% in RT and 35% in CP). There were no significant differences between both groups. Discussion and Conclusion. A high incidence of swallowing disorders in patients treated for early laryngeal cancer was found. It should then be considered as a frequent alteration in this group of patients, either treated with RT or CP

  5. Neural correlates of abnormal sensory discrimination in laryngeal dystonia

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    Pichet Termsarasab

    2016-01-01

    Full Text Available Aberrant sensory processing plays a fundamental role in the pathophysiology of dystonia; however, its underpinning neural mechanisms in relation to dystonia phenotype and genotype remain unclear. We examined temporal and spatial discrimination thresholds in patients with isolated laryngeal form of dystonia (LD, who exhibited different clinical phenotypes (adductor vs. abductor forms and potentially different genotypes (sporadic vs. familial forms. We correlated our behavioral findings with the brain gray matter volume and functional activity during resting and symptomatic speech production. We found that temporal but not spatial discrimination was significantly altered across all forms of LD, with higher frequency of abnormalities seen in familial than sporadic patients. Common neural correlates of abnormal temporal discrimination across all forms were found with structural and functional changes in the middle frontal and primary somatosensory cortices. In addition, patients with familial LD had greater cerebellar involvement in processing of altered temporal discrimination, whereas sporadic LD patients had greater recruitment of the putamen and sensorimotor cortex. Based on the clinical phenotype, adductor form-specific correlations between abnormal discrimination and brain changes were found in the frontal cortex, whereas abductor form-specific correlations were observed in the cerebellum and putamen. Our behavioral and neuroimaging findings outline the relationship of abnormal sensory discrimination with the phenotype and genotype of isolated LD, suggesting the presence of potentially divergent pathophysiological pathways underlying different manifestations of this disorder.

  6. Acute laryngeal dyspnea as first presentation of granulomatosis with polyangiitis.

    Science.gov (United States)

    Pajor, Anna Maria; Kwiatkowska, Sylwia; Kroczyńska-Bednarek, Jadwiga; Piotrowski, Wojciech J

    2015-01-01

    Granulomatosis with polyangiitis (GPA) is a multi-organ disease which mostly affects lungs, kidney, and head and neck region. We report a rare case of acute laryngeal dyspnea and rapidly progressive pulmonary changes as first manifestations of disease. A 53 year-old woman presented with symptoms of two-week dyspnea, which aggravated rapidly in the preceding hours. Laryngological examination revealed subglottic infiltrations and vocal fold oedema which required urgent tracheotomy. During few days she developed gingival ulcerations and pulmonary infiltration with negative serum c-ANCA titers. The histopathological examination of subglottic and gingival biopsies and the clinical picture established the diagnosis of GPA. She was treated with prednisone and cyclophosphamide with recovery; however, during over 3 years of follow-up, pulmonary symptoms relapsed and subglottic stenosis persisted. The difficulties in diagnosis and treatment in this unusual presentation of GPA are outlined with conclusion that in patients with subglottic infiltration, which develops rapidly, even when this is a sole presentation of the disease, and when c-ANCA are negative, GPA should always be considered.

  7. The use of laryngeal mask airway for adenoidectomy.

    Science.gov (United States)

    Boroda, Nickolas; Malesinska, Monika; Kars, Michelle S; Smith, Lee P

    2018-04-01

    Airway management during adenoidectomy is traditionally performed through endotracheal intubation (ETT). Laryngeal mask airway (LMA) may be less stimulating to the airway and allow for shorter overall operating room time. Previous studies report LMA use during adenotonsillectomy. There has been no prior evaluation of LMA use during adenoidectomy alone. In this study, we attempt to identify the rate and contributing factors of LMA failure during adenoidectomy. All pediatric patients undergoing adenoidectomy between January 1, 2016 and June 30, 2017 were reviewed. Demographic and clinical data were collected and analyzed to determine the need for conversion to ETT and the occurrence of any complications. Our study revealed 139 pediatric patients who underwent adenoidectomy during the study period. 110 patients had adenoidectomy performed with LMA and 27 patients had ETT. Two patients (1.8%) required conversion to ETT because of difficulty with ventilation when the mouth gag was in place. There were no complications. Mean operating room time was 20 min less in the LMA group (P < 0.05). The use of an LMA in adenoidectomy may be a safe and effective alternative to ETT. More study is required to determine overall complication rates. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Tobacco Exposure and Complications in Conservative Laryngeal Surgery

    Directory of Open Access Journals (Sweden)

    Francesca Romana Fiorini

    2014-08-01

    Full Text Available Smoking is an important risk factor in the development of head and neck cancer. However, little is known about its effects on postoperative complications in head and neck cancer surgery. We performed a retrospective analysis on 535 consecutive laryngeal cancer patients submitted to open partial laryngectomy at the Otolaryngology-Head and Neck Surgery Department of Florence University to evaluate a possible correlation between smoking and surgical complications. Patients were grouped in non smokers and smokers and evaluated for airway, swallowing, local and fistula complications by multivariate analysis: 507 (95% patients were smokers, 69% presented supraglottic, 30% glottic and 1% transglottic cancer. The most common operation was supraglottic horizontal laryngectomy in 58%, followed by supracricoid partial laryngectomy in 27% and frontolateral hemilaryngectomy in 15% of cases. The incidence of overall complications was 30%, airway complications representing the most frequent (14%, followed by swallowing (7%, local (6% and fistula complications (3%. Smokers developed more local complications (p = 0.05, univariate, p = 0.04, multivariate analysis and pharyngocutaneous fistula (p = 0.01, univariate, p = 0.03, multivariate analysis.

  9. [About a case of laryngeal location of SAPHO].

    Science.gov (United States)

    Vatin, L; Jean, E; Rivière, D; Montava, M; Giovanni, A; Dessi, P; Lagier, A

    2017-10-01

    Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) is a syndrome that combines dermatological, articular and osseous inflammatory manifestations. Bilateral laryngeal immobility relative to cricoarytenoid joint origin is very uncommon. This article presents a case of bilateral cricoarytenoid joint ankylosis in a SAPHO syndrome context. A 53-year-old patient presenting with a two year history of intermittent bouts of dyspnea. A SAPHO syndrome was discussed on repeated thoracic CT-scan. The link between dyspnea and SAPHO syndrome had not been made immediately given the absence of any known anteriority. However, having ruled out other etiologies and after having had to perform a tracheotomy due a worsening of the respiratory condition, this diagnosis was considered. Treatment by corticosteroids and infliximab permitted a clinical improvement of the patient. This clinical case report should increase awareness of possible cricoarytenoid joint involvement in SAPHO. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  10. Comparative analysis of radiotherapeutic results in locally widespread laryngeal carcinomas

    International Nuclear Information System (INIS)

    Goldobenko, G.V.; Kudryavtseva, G.T.; Sidorchenkov, V.O.; Mardynskij, Yu.S.; Senyukov, M.V.

    1981-01-01

    The results of different procedures of radiotherapy of 118 patients with locally widespread laryngeal carcinomas are analyzed. 30 of them received a telegamma therapy, 20 a combined radiotherapy, 36 an electron therapy, 32 an electron therapy with synchronization of the tumor cell cycle by 5-fluorourazil. The therapeutic results were evaluated according to the regression extent of the tumor and to the duration of the period without recurrence. The best immediate effect was obtained by electron therapy (55.5 +- 8.3% of patients), in the other groups there was a complete regression of the tumor in 28-33% of the patients. Recurrences developed in the first 3 years in all patient groups with predominance in the first 2 years. A further tumor growth occurred after complete (about 40-54% of patients) as well as after partial regression of the tumor (about 78-86%). All groups showed the same late results independently of the method of treatment: 5 years and more 27.8-29.3% of the patients are living without recurrences. Radiation responses of the skin and of the mucosa developed significantly more seldom in electron and combined therapy. (author)

  11. SIMPLE, TIMELY, SAFELY? LARYNGEAL MASK AND PEDIATRIC AIRWAY.

    Science.gov (United States)

    Karišik, Marijana

    2016-03-01

    Laryngeal mask airway (LMA) was a useful, powerful airway management device for routine pediatric airway management, pediatric difficult airway, and in pediatric emergency situations. Over years, various designs, induction and insertion techniques have been described. LMA provides ease of placement and removal as compared with endotracheal intubation, less traumatism for the respiratory tract, better tolerability by patients, improved hemodynamic stability during emergency, less coughing, less sore throat, avoidance of laryngoscopy, and hands free airway. On the other hand, LMA is not suitable to overcome functional airway problems and mechanical airway obstruction in children. Simple airway management in pediatric patients is normally easy in experienced hands, for anesthesiologists working in specialized hospitals with appropriate personnel and equipment that guarantee optimal safety in these patients. On the other hand, pediatric airway management is a great challenge for anesthesiologists working in departments with a small number of pediatric surgical procedures. Careful preoperative evaluation, preparation and training in the recognition of challenges in pediatric airway are essential for the management of the airway in children. LMA plays a special role in the management of difficult pediatric airway; as a supraglottic airway device, it is incorporated into difficult pediatric airway algorithms.

  12. Reinforced laryngeal mask airway compared with endotracheal tube for adenotonsillectomies.

    Science.gov (United States)

    Doksrød, Simen; Løfgren, Brith; Nordhammer, Anita; Svendsen, Martin V; Gisselsson, Lars; Raeder, Johan

    2010-11-01

    The endotracheal tube (ETT) has traditionally been considered the best airway device during adenotonsillectomy because a well protected and secured airway is provided. This has been challenged by the introduction of the reinforced laryngeal mask airway (RLMA). It does not kink, is less traumatic during insertion and better tolerated during emergence. The purpose of this study was to compare the use of the RLMA with ETT with regards to postoperative pain, nausea, vomiting and perioperative efficacy in a series of children due for adenotonsillectomy. One hundred and thirty-four children, aged 3-16 years and scheduled for ambulatory adenotonsillectomies, were randomly assigned to two groups where the airways were secured with either the ETT (n = 62) or the RLMA (n = 69). We registered the incidence of peroperative and postoperative anaesthesiological complications and time consume, in addition to postoperative pain, nausea and overall satisfaction. The Group RLMA scored significantly lower for maximal pain during the first 4 h postoperatively (P = 0.015). There were no significant differences in pain scores at 24 h or rescue pain medication postoperatively. The Group RLMA spent mean 4.2 min less in the operating room after surgery (P = 0.001). There were no significant differences in postoperative nausea. In those patients finally treated with ETT, including five conversions from RLMA, significantly more patients (10 vs. 2) had airway irritations (P children, with beneficial effects on airway irritations, operating room efficiency and early postoperative pain.

  13. Allergy and the risk of selected digestive and laryngeal neoplasms.

    Science.gov (United States)

    Bosetti, C; Talamini, R; Franceschi, S; Negri, E; Giacosa, A; La Vecchia, C

    2004-06-01

    The relation between allergy and cancer has been investigated within an integrated series of case-control studies of digestive tract and laryngeal neoplasms conducted in Italy since the early 1990s. These included 598 patients with incident, histologically confirmed cancer of the oral cavity and pharynx, 304 of the oesophagus, 1225 of the colon, 728 of the rectum, 460 of the larynx and 4999 controls, selected among patients admitted to the same network of hospitals as cases for acute, non-neoplastic diseases. Inverse associations with history of allergy were found for all cancer sites examined (odds ratio=0.44 for oral cavity and pharynx, 0.80 for oesophagus, 0.76 for colon, 0.54 for rectum and 0.33 for larynx). The associations were consistent in strata of age and sex, and when subjects with a first diagnosis of allergy 5 or more years before cancer diagnosis or hospital admission were considered. The present study therefore provides further evidence for a possible protective effect of prior history of allergy on cancer risk.

  14. Using endografts from superelastic titanium-nickelid-based alloy singular tissue plural tissues in organ-preserving surgery of laryngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kulbakin, D. E., E-mail: kulbakin-d@mail.ru [Tomsk Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634050 (Russian Federation); Tomsk State University, 36, Lenin Avenue, Tomsk, 634050 (Russian Federation); Mukhamedov, M. R., E-mail: muhamedov@oncology.tomsk.ru [Tomsk Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634050 (Russian Federation); Siberian State Medical University, 2, Moscow Highway, Tomsk, 634050 (Russian Federation); Choynzonov, E. L., E-mail: choynzonov@gmail.com [Tomsk Cancer Research Institute, 5 Kooperativny Street, Tomsk, 634050 (Russian Federation); Siberian State Medical University, 2, Moscow Highway, Tomsk, 634050 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Gynter, V. E., E-mail: tc77@rec.tsu.ru [Tomsk State University, 36, Lenin Avenue, Tomsk, 634050 (Russian Federation); Research Institute of Medical Materials, 17, 19 Gv. Divizii, Tomsk, 634034 (Russian Federation)

    2015-11-17

    Our study has demonstrated feasibility of performing larynx preservation surgeries in patients with recurrent laryngeal cancer after failure of radiotherapy. The technique of combined laryngeal reconstruction with endografts from superelastic titanium-nickelid-based alloy Singular tissue Plural tissues results in improvement of life quality by preserving laryngeal functions.

  15. Muscle biopsy.

    Science.gov (United States)

    Meola, G; Bugiardini, E; Cardani, R

    2012-04-01

    Muscle biopsy is required to provide a definitive diagnosis in many neuromuscular disorders. It can be performed through an open or needle technique under local anesthesia. The major limitations of the needle biopsy technique are the sample size, which is smaller than that obtained with open biopsy, and the impossibility of direct visualization of the sampling site. However, needle biopsy is a less invasive procedure than open biopsy and is particularly indicated for diagnosis of neuromuscular disease in infancy and childhood. The biopsied muscle should be one affected by the disease but not be too weak or too atrophic. Usually, in case of proximal muscle involvement, the quadriceps and the biceps are biopsied, while under suspicion of mitochondrial disorder, the deltoid is preferred. The samples must be immediately frozen or fixed after excision to prevent loss of enzymatic reactivity, DNA depletion or RNA degradation. A battery of stainings is performed on muscle sections from every frozen muscle biopsy arriving in the pathology laboratory. Histological, histochemical, and histoenzymatic stainings are performed to evaluate fiber atrophy, morphological, and structural changes and metabolic disorders. Moreover, immunohistochemistry and Western blotting analysis may be used for expression analysis of muscle proteins to obtain a specific diagnosis. There are myopathies that do not need muscle biopsy since a genetic test performed on a blood sample is enough for definitive diagnosis. Muscle biopsy is a useful technique which can make an enormous contribution in the field of neuromuscular disorders but should be considered and interpreted together with the patient's family and clinical history.

  16. Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults.

    Science.gov (United States)

    Guedes, Renata; Azola, Alba; Macrae, Phoebe; Sunday, Kirstyn; Mejia, Veerley; Vose, Alicia; Humbert, Ianessa A

    2017-05-15

    Swallowing maneuvers are routinely trained in dysphagia rehabilitation with the assumption that practiced behaviors transfer to functional swallowing, however transfer is rarely examined in the deglutition literature. The goal of this study was to train the volitional laryngeal vestibule closure (vLVC) maneuver, which is a swallowing maneuver that targets prolonged laryngeal vestibule closure (LVC). In two different training experiments, 69 healthy adults underwent Long-hold (hold vLVC as long as possible) or Short-hold vLVC training (hold vLVC for 2s). Before and after vLVC training, natural swallows (swallowing without a therapeutic technique) were completed. The outcome variables included laryngeal vestibule closure reaction time and the duration of laryngeal vestibule closure. Results indicate that during both Long-hold and Short-hold vLVC trainings, vLVC swallows had faster laryngeal vestibule closure reaction times and longer durations of laryngeal vestibule closure than in pre-training 5ml liquid swallows. However, only faster laryngeal vestibule closure reaction times transferred to post-training 5ml liquid swallows (20-24% faster), but not prolonged durations of laryngeal vestibule closure. Our findings suggest that swallowing maneuver training has the potential to induce transfer of what was practiced to functional swallowing behavior, although not all practiced behaviors may generalize. These findings are significant for bolstering the effectiveness of dysphagia management in medical settings and should be tested in individuals with dysphagia. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. LEADERSHIP STYLE AND EMPLOYEES' INTRINSIC JOB ...

    African Journals Online (AJOL)

    Abstract. This study investigates the impact of leadership style on employees' intrinsic job satisfaction in the Cross River State Newspaper Corporation, Calabar,. Nigeria. The study examined the problem of dissatisfaction in the work place as far as intrinsic factors of job satisfaction are concerned. Structured questionnaire ...

  18. Intrinsic bioremediation of landfills interim report

    International Nuclear Information System (INIS)

    Brigmon, R.L.; Fliermans, C.B.

    1997-01-01

    Intrinsic bioremediation is a risk management option that relies on natural biological and physical processes to contain the spread of contamination from a source. Evidence is presented in this report that intrinsic bioremediation is occurring at the Sanitary Landfill is fundamental to support incorportion into a Corrective Action Plan (CAP)

  19. Differential scanning microcalorimetry of intrinsically disordered proteins.

    Science.gov (United States)

    Permyakov, Sergei E

    2012-01-01

    Ultrasensitive differential scanning calorimetry (DSC) is an indispensable thermophysical technique enabling to get direct information on enthalpies accompanying heating/cooling of dilute biopolymer solutions. The thermal dependence of protein heat capacity extracted from DSC data is a valuable source of information on intrinsic disorder level of a protein. Application details and limitations of DSC technique in exploration of protein intrinsic disorder are described.

  20. Intrinsic bioremediation of landfills interim report

    Energy Technology Data Exchange (ETDEWEB)

    Brigmon, R.L. [Westinghouse Savannah River Company, Aiken, SC (United States); Fliermans, C.B.

    1997-07-14

    Intrinsic bioremediation is a risk management option that relies on natural biological and physical processes to contain the spread of contamination from a source. Evidence is presented in this report that intrinsic bioremediation is occurring at the Sanitary Landfill is fundamental to support incorportion into a Corrective Action Plan (CAP).

  1. An Intrinsic Coordinate System for Fingerprint Matching

    NARCIS (Netherlands)

    Bazen, A.M.; Gerez, Sabih H.; Bigun, J.; Smeraldi, F.

    2001-01-01

    In this paper, an intrinsic coordinate system is proposed for fingerprints. First the fingerprint is partitioned in regular regions, which are regions that contain no singular points. In each regular region, the intrinsic coordinate system is defined by the directional field. When using the

  2. The Value of Identifying External Branch of Superior Laryngeal Nerve in Post-Operative Voice Performance: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mehdi Asgari

    2016-12-01

    Full Text Available Background Injury to the external branch of the superior laryngeal nerve (EBSLN results in deterioration of postoperative voice performance. The aim of this study was to asses the impact of exploring and identifying the EBSLN during thyroidectomy in reducing nerve injury and consequently preserved voice performance. Methods Ninety patients, in 2 groups, underwent a thyroidectomy and a total of 122 upper poles were dissected. After 2 to 4 weeks, patients with voice complaints were evaluated by electromyography of cricothyroid muscle. Results There were 4 unilateral injuries (10% in the explored group whereas in the non-explored group (9 unilateral and 2 bilateral (P = 0.28, there were 11 (22%. A total of 7.4% of 54 upper thyroid poles injuries were observed in the explored group whereas 16% injuries of 68 upper thyroid poles in the non-explored group (P = 0.12. Conclusions The injury to the EBSLN decreased when upper thyroid pole dissection was accompanied with nerve exploring. The EBSLN should be explored and identified during the thyroidectomy because it makes a noticeable change in the postoperative voice performance.

  3. Trapezius squeeze test as an indicator for depth of anesthesia for laryngeal mask airway insertion in children

    Directory of Open Access Journals (Sweden)

    Sarla Hooda

    2012-01-01

    Full Text Available Background: Clinical tests, such as loss of verbal contact, eyelash reflex, corneal reflex, and jaw relaxation, are used to assess the depth of anesthesia. "Trapezius squeeze test" (TST is one such clinical test. It is a simple test to perform in which 1-2 inches of trapezius muscle is held and squeezed in full thickness and response is evaluated in the form of toe/body movement. Materials and Methods: One hundred pediatric patients between 3 and 5 years of age, scheduled to undergo elective surgery, were included in this study. We evaluated negative TST as an indicator for optimal anesthesia depth for laryngeal mask airway (LMA insertion in anesthetized spontaneously breathing children. Anesthesia was induced using 4% sevoflurane in oxygen. As the child lost the verbal contact or loss of body movement, TST was performed. Test was repeated every 15 s till it became negative. When the TST became negative, a well lubricated, appropriate-size LMA was inserted. Results: Mean time for TST to become negative in our study was 271.80 ± 55.8 s and ease of insertion was excellent in 91 patients and acceptable in 9 patients. LMA was successfully inserted in first attempt in 96% patients. Conclusions: Negative TST is a reliable indicator for placement of LMA in spontaneously breathing children. Excellent conditions for LMA placement are present in majority of the patients without any untoward effects at this point of time.

  4. Trapezius squeeze test as an indicator for depth of anesthesia for laryngeal mask airway insertion in children.

    Science.gov (United States)

    Hooda, Sarla; Kaur, Kiranpreet; Rattan, Kamal N; Thakur, Anil K; Kamal, Kirti

    2012-01-01

    Clinical tests, such as loss of verbal contact, eyelash reflex, corneal reflex, and jaw relaxation, are used to assess the depth of anesthesia. "Trapezius squeeze test" (TST) is one such clinical test. It is a simple test to perform in which 1-2 inches of trapezius muscle is held and squeezed in full thickness and response is evaluated in the form of toe/body movement. One hundred pediatric patients between 3 and 5 years of age, scheduled to undergo elective surgery, were included in this study. We evaluated negative TST as an indicator for optimal anesthesia depth for laryngeal mask airway (LMA) insertion in anesthetized spontaneously breathing children. Anesthesia was induced using 4% sevoflurane in oxygen. As the child lost the verbal contact or loss of body movement, TST was performed. Test was repeated every 15 s till it became negative. When the TST became negative, a well lubricated, appropriate-size LMA was inserted. Mean time for TST to become negative in our study was 271.80 ± 55.8 s and ease of insertion was excellent in 91 patients and acceptable in 9 patients. LMA was successfully inserted in first attempt in 96% patients. Negative TST is a reliable indicator for placement of LMA in spontaneously breathing children. Excellent conditions for LMA placement are present in majority of the patients without any untoward effects at this point of time.

  5. Successful hyperbaric oxygen therapy for laryngeal radionecrosis after chemoradiotherapy for mesopharyngeal cancer. Case report and literature review

    International Nuclear Information System (INIS)

    Abe, Madoka; Terashima, Kotaro; Matsuo, Mioko; Uehara, Satoru; Shioyama, Yoshiyuki; Hara, Iwao

    2012-01-01

    Laryngeal radionecrosis is one of the most troublesome late complications of radiotherapy, because it is frequently resistant to treatment and laryngectomy is required in the worst case. Here, we report a case of laryngeal radionecrosis, successfully treated by use of hyperbaric oxygen (HBO) therapy, in which laryngectomy was avoided. A 67-year-old male received radical chemoradiotherapy (CRT) for mesopharyngeal cancer, which included radiotherapy with a total dose of 71.4 Gy/38 Fr and chemotherapy with CDDP + S-1. He developed dyspnea and throat pain 9 months after completion of CRT. Laryngoscopy revealed vocal cord impairment because of severe laryngeal edema. He was diagnosed as having laryngeal radionecrosis and initially received conservative therapy combined with antibiotics, steroids, and prostaglandins. Because his dyspnea was persistent despite this treatment, HBO therapy was administered 20 times, and resulted in complete remission of the dyspnea. HBO therapy, therefore, is regarded as an effective conservative therapeutic option for laryngeal radionecrosis. (author)

  6. Laryngeal Cryptococcosis Associated With Inhaled Corticosteroid Use: Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Daniel Jun Yi Wong

    2017-11-01

    Full Text Available Laryngeal cryptococcosis is a rare clinical entity. There have been a limited number of case reports in the literature with no consensus regarding optimal management. This review contributes two additional case reports of immunocompetent patients with cryptococcal infection of the larynx in whom exposure to high doses of inhaled corticosteroids is proposed as a significant risk factor. Twenty cases were identified from review of the literature. All patients presented with hoarseness and a spectrum of microlaryngoscopic features, often mimicking laryngeal malignancy. The majority of cases were treated with systemic antifungal therapy, three cases had surgical excision alone, and another three had a combination of medical and surgical management. Risk factor modification, in the form of a reduction in inhaled corticosteroid was employed in the two new cases, and in some previously published cases. Risk factor modification, such as reduction of inhaled corticosteroid dose, in addition to oral antifungal agents can be effective in managing cryptococcal laryngitis.

  7. [Metastatic tumor of the right ventricle: an unusual location of tumor involvement in laryngeal carcinoma].

    Science.gov (United States)

    Rangel, Inês; Gonçalves, Alexandra; de Sousa, Carla; Macedo, Filipe; Maciel, Maria Júlia

    2012-12-01

    Secondary tumors are much more frequent than primary tumors, but cardiac metastasis of laryngeal carcinoma is uncommon. The authors report the case of a 71-year-old man, with a history of laryngeal carcinoma, admitted to the emergency room with symptoms of two weeks' evolution suggestive of respiratory infection. Due to lack of therapeutic response and progressive clinical deterioration, a transthoracic echocardiogram was performed which revealed a large infiltrating mass within the right ventricle, involving the apex, interventricular septum and free wall, not causing significant right ventricular outflow tract obstruction. Evaluation by computed tomography showed signs of widespread metastasis from the previously diagnosed laryngeal cancer. Copyright © 2011 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  8. Association of history of allergies and influenza-like infections with laryngeal cancer in a case-control study.

    Science.gov (United States)

    Filippidis, Filippos T; Schwartz, Stephen M; Becker, Nikolaus; Dyckhoff, Gerhard; Kirschfink, Michael; Dietz, Andreas; Becher, Heiko; Ramroth, Heribert

    2015-08-01

    Prior studies suggest that history of allergy and infections early in life might be inversely associated with cancer. We explored the association between allergies, recent influenza infections and laryngeal cancer risk. We used data from a case-control study which included 229 cases of laryngeal cancer and 769 population controls matched for age and sex. History of a physician-diagnosed allergy, influenza-like infections in the past 5 years, smoking, alcohol consumption and occupational exposure to carcinogens were self-reported. Allergies were classified into two groups (Type I and Type IV), according to the underlying immunologic mechanism. Conditional logistic regression models were fitted using laryngeal cancer as the outcome, adjusting for smoking, alcohol consumption and occupational exposure and stratified for age and sex. Having any allergy was not associated significantly with laryngeal cancer. Although Type I and Type IV allergies were non-significantly associated with laryngeal cancer, Type IV allergies showed a strong inverse association after adjusting for smoking and alcohol (OR 0.50, 95 % CI 0.22-1.2). Participants who reported at least one influenza-like infection during the past 5 years were significantly less likely to have laryngeal cancer (OR 0.57, 95 % CI 0.39-0.81). After considering fever (≥38.5 °C) as a criterion for influenza infection, the association between influenza infection and laryngeal cancer was even stronger (OR 0.29, 95 % CI 0.13-0.63). We found no significant association between any allergy and laryngeal cancer, some indication of an inverse association between Type IV allergy and laryngeal cancer, whereas recent influenza infections were inversely associated with laryngeal cancer risk.

  9. Transoral robotic-assisted laryngeal cleft repair in the pediatric patient.

    Science.gov (United States)

    Leonardis, Rachel L; Duvvuri, Umamaheswar; Mehta, Deepak

    2014-09-01

    To assess the feasibility of performing robotic-assisted laryngeal cleft repair in the pediatric population. Retrospective chart review at a tertiary academic children's hospital. All patients underwent transoral robotic-assisted laryngeal cleft repair from March 2011 to June 2013. Demographics, robotic docking time, operative time, and postoperative course and swallowing function were collected and analyzed. Five children, three male and two female, underwent successful transoral robotic-assisted laryngeal cleft repair for closure of a type I laryngeal cleft. Mean age at time of surgery was 21.6 months (standard deviation 6.1 months; range, 15-29 months). From case 1 to case 5, robotic docking time (18-10 minutes), robotic operative time (102-36 minutes), and total operating room time (173-105 minutes) decreased. There were no complications with time until extubation (range, 2-3 days), length of intensive care unit stay (range, 3-4 days), and total hospital stay (range, 3-5 days) within acceptable range following laryngeal cleft repair. Modified barium swallow (two patients) or fiberoptic endoscopic evaluation of swallowing (three patients) was performed postoperatively, with all patients showing complete resolution of penetration and aspiration. In addition, all patients experienced subjective resolution of dysphagia and/or choking with feeds postoperatively. Transoral robotic-assisted laryngeal cleft repair may offer specific advantages over a traditional endoscopic approach. In our experience, the procedure was well tolerated and associated with definitive surgical cure in all patients. The scope of robotic technology continually expands and should be considered a feasible tool at an institution-based level. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  10. MDCT in the assessment of laryngeal trauma: value of 2D multiplanar and 3D reconstructions.

    Science.gov (United States)

    Becker, Minerva; Duboé, Pier-Olivier; Platon, Alexandra; Kohler, Romain; Tasu, Jean-Pierre; Becker, Christoph D; Poletti, Pierre-Alexandre

    2013-10-01

    The purpose of this study was to analyze fracture patterns and related effects of laryngeal trauma and to assess the value of 2D multiplanar reformation (MPR) and 3D reconstruction. Among 4222 consecutively registered trauma patients who underwent emergency MDCT, 38 patients had presented with laryngeal trauma. Axial, 2D MPR, 3D volume-rendered, and virtual endoscopic images were analyzed retrospectively by two blinded observers according to predefined criteria. Laryngeal fractures, soft-tissue injuries, and airway compromise were evaluated and correlated with clinical, endoscopic, surgical, and follow-up findings. Fifty-nine fractures (37 thyroid, 13 cricoid, nine arytenoid) were present in 38 patients. They were isolated in 21 (55%) patients. The other 17 (45%) patients had additional injuries to the neck, face, brain, chest, or abdomen. Laryngeal fractures were bilateral in 31 (82%) patients and were associated with hyoid bone fractures in nine (24%) patients. Arytenoid luxation was present in eight cartilages. Axial imaging missed 7 of 59 (12%) laryngeal fractures, six of eight (75%) arytenoid luxations, and four of nine (44%) hyoid bone fractures. Additional 2D MPR imaging missed 5 of 59 (8%) laryngeal fractures, five of eight (62.5%) arytenoid luxations, and two of nine (22%) hyoid bone fractures, whereas 3D volume-rendered images depicted them all. Virtual endoscopy and 3D volume rendering added diagnostic accuracy with respect to the length, width, shape, and spatial orientation of fractures in 22 of 38 (58%) patients; arytenoid luxation in six of eight (75%) luxations; and the evaluation of airway narrowing in 19 of 38 (50%) patients. Three-dimensional volume rendering was not of additional value in evaluation of the cricoid cartilage. The use of 2D MPR and 3D volume rendering with or without virtual endoscopy improved assessment of thyroid and hyoid bone fractures, arytenoid luxations, and laryngotracheal narrowing, providing helpful data for optimal

  11. Concurrent Chemotherapy and Intensity-Modulated Radiotherapy for Locoregionally Advanced Laryngeal and Hypopharyngeal Cancers

    International Nuclear Information System (INIS)

    Lee, Nancy Y.; O'Meara, William; Chan, Kelvin; Della-Bianca, Cesar; Mechalakos, James G.; Zhung, Joanne; Wolden, Suzanne L.; Narayana, Ashwatha; Kraus, Dennis; Shah, Jatin P.; Pfister, David G.

    2007-01-01

    Purpose: To perform a retrospective review of laryngeal/hypopharyngeal carcinomas treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT). Methods and Materials: Between January 2002 and June 2005, 20 laryngeal and 11 hypopharyngeal carcinoma patients underwent IMRT with concurrent platinum-based chemotherapy; most patients had Stage IV disease. The prescription of the planning target volume for gross, high-risk, and low-risk subclinical disease was 70, 59.4, and 54 Gy, respectively. Acute/late toxicities were retrospectively scored using the Common Toxicity Criteria scale. The 2-year local progression-free, regional progression-free, laryngectomy-free, distant metastasis-free, and overall survival rates were calculated using the Kaplan-Meier method. Results: The median follow-up of the living patients was 26 months (range, 17-58 months). The 2-year local progression-free, regional progression-free, laryngectomy-free, distant metastasis-free, and overall survival rate was 86%, 94%, 89%, 92%, and 63%, respectively. Grade 2 mucositis or higher occurred in 48% of patients, and all experienced Grade 2 or higher pharyngitis during treatment. Xerostomia continued to decrease over time from the end of RT, with none complaining of Grade 2 toxicity at this analysis. The 2-year post-treatment percutaneous endoscopic gastrostomy-dependency rate for those with hypopharyngeal and laryngeal tumors was 31% and 15%, respectively. The most severe late complications were laryngeal necrosis, necrotizing fascitis, and a carotid rupture resulting in death 3 weeks after salvage laryngectomy. Conclusion: These preliminary results have shown that IMRT achieved encouraging locoregional control of locoregionally advanced laryngeal and hypopharyngeal carcinomas. Xerostomia improved over time. Pharyngoesophageal stricture with percutaneous endoscopic gastrostomy dependency remains a problem, particularly for patients with hypopharyngeal carcinoma and, to a lesser

  12. Fasudil inhibits proliferation and migration of Hep-2 laryngeal carcinoma cells

    Directory of Open Access Journals (Sweden)

    Zhang X

    2018-02-01

    Full Text Available Xiaowen Zhang,1 Nan Wu2 1Medical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; 2The Core Laboratory for Public Health Science and Practice, The First Affiliated Hospital of China Medical University, Shenyang, China Background: Rho-kinase signal pathway is a new target for cancer therapy. Fasudil, a selective Rho-kinase inhibitor, is found to exert antitumor effects on several types of cancer, but whether fasudil has antitumor effects on laryngeal carcinoma is still unknown. The aim of this study was to determine the effects of fasudil on laryngeal carcinoma and explore the underlying molecular mechanisms in this process. Methods: After treatment with fasudil, changes in biological behaviors, including the growth, proliferation, clone formation, apoptosis, and migration of human laryngeal carcinoma cells (Hep-2 cells were observed. The influences on apoptotic protease activity factor-1 (APAF-1-mediated apoptosis pathway and the activities of matrix metalloproteinases (MMP-2 and MMP-9 were measured by Western blotting and gelatin zymography assay. Results: Half-maximal inhibitory concentration of fasudil to Hep-2 cells was ~3.40×103 µM (95% CI: 2.53–4.66×103 µM. Moreover, fasudil treatment significantly decreased the ability of growth, proliferation, clone formation, and migration of Hep-2 cells, while remarkably increased the apoptosis rate. Furthermore, the expressions of APAF-1, caspase-9, and caspase-3 significantly increased in fasudil treatment group. Meanwhile, fasudil led to a remarkable decrease in the expressions and activities of MMP-2 and MMP-9. Conclusion: Our findings first demonstrate that fasudil not only inhibits the proliferation of laryngeal carcinoma cells through activating APAF-1-mediated apoptosis pathway, but also prevents migration by inhibiting the activities of MMP-2 and MMP-9. Therefore, fasudil is an attractive antitumor drug candidate for the treatment of laryngeal carcinoma

  13. Effects of Voice Rehabilitation After Radiation Therapy for Laryngeal Cancer: A Randomized Controlled Study

    Energy Technology Data Exchange (ETDEWEB)

    Tuomi, Lisa, E-mail: lisa.tuomi@vgregion.se [Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Andréll, Paulin [Department of Molecular and Clinical Medicine/Multidisciplinary Pain Center, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden); Finizia, Caterina [Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg (Sweden)

    2014-08-01

    Background: Patients treated with radiation therapy for laryngeal cancer often experience voice problems. The aim of this randomized controlled trial was to assess the efficacy of voice rehabilitation for laryngeal cancer patients after having undergone radiation therapy and to investigate whether differences between different tumor localizations with regard to rehabilitation outcomes exist. Methods and Materials: Sixty-nine male patients irradiated for laryngeal cancer participated. Voice recordings and self-assessments of communicative dysfunction were performed 1 and 6 months after radiation therapy. Thirty-three patients were randomized to structured voice rehabilitation with a speech-language pathologist and 36 to a control group. Furthermore, comparisons with 23 healthy control individuals were made. Acoustic analyses were performed for all patients, including the healthy control individuals. The Swedish version of the Self Evaluation of Communication Experiences after Laryngeal Cancer and self-ratings of voice function were used to assess vocal and communicative function. Results: The patients who received vocal rehabilitation experienced improved self-rated vocal function after rehabilitation. Patients with supraglottic tumors who received voice rehabilitation had statistically significant improvements in voice quality and self-rated vocal function, whereas the control group did not. Conclusion: Voice rehabilitation for male patients with laryngeal cancer is efficacious regarding patient-reported outcome measurements. The patients experienced better voice function after rehabilitation. Patients with supraglottic tumors also showed an improvement in terms of acoustic voice outcomes. Rehabilitation with a speech-language pathologist is recommended for laryngeal cancer patients after radiation therapy, particularly for patients with supraglottic tumors.

  14. A cohort evaluation of the laryngeal mask airway-Supreme™ in children.

    Science.gov (United States)

    Jagannathan, Narasimhan; Sohn, Lisa E; Chang, Edwina; Sawardekar, Amod

    2012-08-01

    To assess the clinical performance of the laryngeal mask airway-Supreme in children. The purpose of this prospective audit was to evaluate the feasibility of the laryngeal mask airway-Supreme in clinical practice and generate data for future comparison trials. The laryngeal mask airway-Supreme is a new second-generation supraglottic airway that was recently released in limited pediatric sizes (sizes 1, 2). One hundred children, ASA I-III, newborn to 16 years of age, and undergoing various procedures requiring a size 1, 2, or 3 laryngeal mask airway-Supreme were studied. Assessments included insertion success rates, airway leak pressures, success of gastric tube insertion, quality of airway, and perioperative complications. The first-time insertion success rate was 97%, with an overall insertion success rate of 100%. The mean initial airway leak pressure for all patients was 22.3 ± 6.6 cm H(2) O. Gastric tube placement was possible in 98% of patients. Complications were noted in six patients: coughing or laryngospasm (n = 3), sore throat (n = 1), and dysphonia (n = 2). The laryngeal mask airway-Supreme was inserted with a high degree of success on the first attempt by clinicians with limited prior experience with the device. It was effectively used for a variety of procedures in children undergoing spontaneous and mechanical ventilation with minimal complications. The leak pressures demonstrated in this study, along with access for gastric decompression, suggest that the laryngeal mask airway-Supreme may be an effective device for positive pressure ventilation in children. © 2012 Blackwell Publishing Ltd.

  15. Effects of Voice Rehabilitation After Radiation Therapy for Laryngeal Cancer: A Randomized Controlled Study

    International Nuclear Information System (INIS)

    Tuomi, Lisa; Andréll, Paulin; Finizia, Caterina

    2014-01-01

    Background: Patients treated with radiation therapy for laryngeal cancer often experience voice problems. The aim of this randomized controlled trial was to assess the efficacy of voice rehabilitation for laryngeal cancer patients after having undergone radiation therapy and to investigate whether differences between different tumor localizations with regard to rehabilitation outcomes exist. Methods and Materials: Sixty-nine male patients irradiated for laryngeal cancer participated. Voice recordings and self-assessments of communicative dysfunction were performed 1 and 6 months after radiation therapy. Thirty-three patients were randomized to structured voice rehabilitation with a speech-language pathologist and 36 to a control group. Furthermore, comparisons with 23 healthy control individuals were made. Acoustic analyses were performed for all patients, including the healthy control individuals. The Swedish version of the Self Evaluation of Communication Experiences after Laryngeal Cancer and self-ratings of voice function were used to assess vocal and communicative function. Results: The patients who received vocal rehabilitation experienced improved self-rated vocal function after rehabilitation. Patients with supraglottic tumors who received voice rehabilitation had statistically significant improvements in voice quality and self-rated vocal function, whereas the control group did not. Conclusion: Voice rehabilitation for male patients with laryngeal cancer is efficacious regarding patient-reported outcome measurements. The patients experienced better voice function after rehabilitation. Patients with supraglottic tumors also showed an improvement in terms of acoustic voice outcomes. Rehabilitation with a speech-language pathologist is recommended for laryngeal cancer patients after radiation therapy, particularly for patients with supraglottic tumors

  16. Radiotherapy of locally advanced laryngeal cancer: the Gliwice Center of Oncology experience, 1990-1996

    International Nuclear Information System (INIS)

    Mucha-Malecka, A.; Skladowski, K.; Wygoda, A.; Sasiadek, W.; Tarnawski, R.

    2001-01-01

    The aim of the study was to assess the efficacy of radiotherapy alone in patients with locally advanced laryngeal cancer T3 - T4, and to establish the prognostic value of the size and the location of the extra laryngeal infiltrations and of emergency tracheostomy. 296 patients with advanced squamous cell cancer of the larynx were radically treated with radiotherapy alone in Center of Oncology in Gliwice between the years 1990 and 1996. There were 221 cases of supraglottic cancer (75%) and 75 of glottic cancer (25%). The stages were as follows: supraglottic cancer: T3 - 113 (51%), T4 - 108 (49%), glottic cancer: T3 - 69 (92%), T4 - 6 (8%). Positive neck nodes were found in 100 patients with supraglottic cancer (45%), and only in 11 patients with glottic cancer (15%). In cases of extra laryngeaI invasion (T4) the pyriform recess was involved in 33%, the base of tongue and valleculae glosso-epiglotticae in 30%, the hypopharyngeal wall in 9% of cases, while a massive involvement of the larynx, the pyriform recess and the base of the tongue was found in 6% of patients. Cartilage involvement was suspected in 22% of patients. Thirty six patients (12%) underwent emergency tracheostomy. Generally, the 3-year local control rate (LC) and disease free survival rate (DSF) were 46% and 41%, respectively. The probability of LC was similar in both supraglottic and glottic cancer: 44% and 47.5% respectively. The presence of involved neck nodes significantly decreased LC and DFS rates in both groups (about 20%). For stage T4 laryngeal cancer the LC rate was correlated with the location of the extra laryngeal infiltrations. Best prognosis was connected with the suspicion of cartilage infiltration - 56% of 3-year LC rate. The worst results were noted in cases of massive infiltrations spreading from larynx through the hypopharynx - 13.5% of 3-year LC rate. Emergency tracheostomy before radiotherapy was very significantly linked to poorer treatment results. The 3-year LC rate in

  17. Sharp v Port Kembla RSL Club: establishing causation of laryngeal cancer by environmental tobacco smoke.

    Science.gov (United States)

    Stewart, Bernard W; Semmler, Peter C B

    2002-02-04

    A New South Wales Supreme Court jury has decided that environmental tobacco smoke (ETS) can cause or materially contribute to the development of laryngeal cancer. Evidence presented that ETS may cause or materially contribute to laryngeal cancer included the molecular genetics of tobacco-smoke-induced carcinogenesis, and two relevant epidemiological studies. The plaintiff's exposure to ETS was established indirectly, on the basis of occupational history involving work as a bar attendant in licensed premises. The jury's decision seems likely to encourage other "passive smoking" cases, and may result in measures to reduce occupational exposure to ETS.

  18. Prenatal Diagnosis and Pathology of Laryngeal Atresia in Congenital High Airway Obstruction Syndrome

    Directory of Open Access Journals (Sweden)

    Piya Chaemsaithong

    2012-01-01

    Full Text Available Congenital high airway obstruction syndrome is a rare but life-threatening condition. Therefore, prenatal diagnosis is important. The obstruction can be due to laryngeal/tracheal atresia or external compression. While a differential diagnosis with congenital cystic adenomatoid malformation (CCAM type III may be difficult, it is still possible with ultrasonography. In this study, we report a case of bilateral echogenic lungs with hydrops fetalis. After the prenatal diagnosis of laryngeal atresia, the couple opted to have an elective termination of pregnancy performed at 20 weeks of gestation. The diagnosis was confirmed by a complete pathological examination.

  19. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias

    Science.gov (United States)

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

    2016-01-01

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

  20. Getting Muscles

    Science.gov (United States)

    ... re thinking about aren't possible for kids. Superheroes, of course, aren't real, and professional athletes ... can make you stronger. Why? Because you're using your muscles when you do it. Eat Strong ...

  1. Muscle cramps

    Science.gov (United States)

    ... the lower leg/calf Back of the thigh (hamstrings) Front of the thigh (quadriceps) Cramps in the ... Names Cramps - muscle Images Chest stretch Groin stretch Hamstring stretch Hip stretch Thigh stretch Triceps stretch References ...

  2. Algebraic description of intrinsic modes in nuclei

    International Nuclear Information System (INIS)

    Leviatan, A.

    1989-01-01

    We present a procedure for extracting normal modes in algebraic number-conserving systems of interacting bosons relevant for collective states in even-even nuclei. The Hamiltonian is resolved into intrinsic (bandhead related) and collective (in-band related) parts. Shape parameters are introduced through non-spherical boson bases. Intrinsic modes decoupled from the spurious modes are obtained from the intinsic part of the Hamiltonian in the limit of large number of bosons. Intrinsic states are constructed and serve to evaluate electromagnetic transition rates. The method is illustrated for systems with one type of boson as well as with proton-neutron bosons. 28 refs., 1 fig

  3. Algebraic description of intrinsic modes in nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Leviatan, A.

    1989-01-01

    We present a procedure for extracting normal modes in algebraic number-conserving systems of interacting bosons relevant for collective states in even-even nuclei. The Hamiltonian is resolved into intrinsic (bandhead related) and collective (in-band related) parts. Shape parameters are introduced through non-spherical boson bases. Intrinsic modes decoupled from the spurious modes are obtained from the intinsic part of the Hamiltonian in the limit of large number of bosons. Intrinsic states are constructed and serve to evaluate electromagnetic transition rates. The method is illustrated for systems with one type of boson as well as with proton-neutron bosons. 28 refs., 1 fig.

  4. Neuroprosthetics for Auricular Muscles: Neural Networks and Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Mikee Liugan

    2018-01-01

    Full Text Available The mammalian external ear houses extrinsic and intrinsic auricular muscles. There are three extrinsic auricular muscles—the posterior, superior, and anterior auricular muscles—and six intrinsic muscles—the helicis major and minor, tragicus, anti-tragicus, transverse and oblique muscles. These muscles have been considered vestigial in humans. However, numerous therapeutic and diagnostic wearable devices are designed to monitor and alleviate the symptoms of neurological disorders, brainstem injuries, emotional states, and auditory functions, by making use of the neural networks of the auricular muscles and their locations, which are easily accessible for ergonomic wearable biomedical devices. They can also serve as a bio-controller of human neuroprosthetics. The functionality of these auricular muscles remains elusive and requires further experimentation for a more in-depth understanding of their anatomy. The aims of this review are (1 to provide a detailed account of the neural networks of the extrinsic and intrinsic auricular muscles, (2 to describe diagnostic and therapeutic functions of these muscles as demonstrated in the current literature, and (3 to outline existing and potential neuroprosthetic applications making use of the auricular muscles and their neural networks.

  5. Eletromiografia laríngea em pacientes com disfonia e fechamento glótico incompleto Laryngeal electromyography in dysphonic patients with incomplete glottic closure

    Directory of Open Access Journals (Sweden)

    Noemi Grigoletto De Biase

    2012-12-01

    Full Text Available O diagnóstico de comprometimento do nervo laríngeo superior e de ramos do laríngeo recorrente demanda eletromiografia, pois as alterações à laringoscopia são inespecíficas. OBJETIVO: Avaliar eletrofisiologicamente a função dos nervos laríngeo superior e inferior por meio da atividade elétrica dos músculos por eles inervados, em pacientes com disfonia com coaptação incompleta das pregas vocais à fonação. MÉTODO: Estudo prospectivo; 39 indivíduos com disfonia e fechamento glótico incompleto foram submetidos à eletromiografia dos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente. Foram avaliadas atividade de inserção, no repouso (fibrilação, onda positiva e fasciculação e durante contração voluntária dos músculos (recrutamento, amplitude e duração do potencial e latência entre início da atividade elétrica e a sonorização. RESULTADOS: Não observamos alteração na atividade de inserção e no repouso. Nenhum paciente apresentou recrutamento alterado. A média da amplitude dos potenciais elétricos esteve compatível com a normalidade nos músculos testados, assim como a duração do potencial e o tempo de latência entre o início da atividade elétrica e a sonorização. CONCLUSÃO: Não observamos sinais de desnervação nos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente nos pacientes estudados.The lack of specificity in laryngoscopical examination requires that the diagnosis of superior laryngeal and recurrent laryngeal nerve involvement be carried out with the aid of electromyography. OBJECTIVE: This study aims to assess the electrophysiological function of the superior and inferior laryngeal nerves by measuring the electrical activity of the muscles they innervate in dysphonic patients with incomplete closure of the vocal folds during phonation. METHOD: Thirty-nine patients with incomplete glottic closure were enrolled in a

  6. Randomised Comparison of the AMBU AuraOnce Laryngeal Mask and the LMA Unique Laryngeal Mask Airway in Spontaneously Breathing Adults

    OpenAIRE

    Williams, Daryl Lindsay; Zeng, James M.; Alexander, Karl D.; Andrews, David T.

    2012-01-01

    We conducted a randomised single-blind controlled trial comparing the LMA-Unique (LMAU) and the AMBU AuraOnce (AMBU) disposable laryngeal mask in spontaneously breathing adult patients undergoing general anaesthesia. Eighty-two adult patients (ASA status I–IV) were randomly allocated to receive the LMAU or AMBU and were blinded to device selection. Patients received a standardized anesthetic and all airway devices were inserted by trained anaesthetists. Size selection was guided by manufactur...

  7. Comparison of laryngeal mask airway supreme and laryngeal mask airway proseal for laryngopharyngeal trauma and postoperative morbidity in children.

    Science.gov (United States)

    Aydogmus, Meltem Turkay; Eksioglu, Birsen; Oba, Sibel; Unsal, Oya; Türk, Hacer Sebnem Yeltepe; Sinikoglu, Sitki Nadir; Tug, Aslihan

    2013-01-01

    Laryngeal mask airway (LMA), which has been used frequently in airway management, can cause laryngopharyngeal injury and morbidity. In this trial, we compare the macroscopic changes on laryngopharyngeal structures and the postoperative laryngopharyngeal morbidity by using LMA supreme with LMA proseal in children. We divided patients into two groups. We inserted size three LMA proseal into the first group and size three LMA supreme into the second group. Before LMA insertion and after LMA removal, we performed direct laryngoscopy on the patients. We compared hyperemia, mucosal injury and blood staining on LMA removal, as well as insertion time, rate of success in gastric tube insertion on the first attempt, nausea, vomiting, and sore throat between the two groups. We recorded no significant differences between the two groups for mean operation time, sex, age, weight, rate of success in gastric tube insertion on first attempt, nausea, vomiting, sore throat and mucosal injury. Mean insertion time for the LMA proseal group was significantly longer than the LMA supreme group (p = 0.0001). The ratio of blood staining on LMA removal was significantly higher in the LMA proseal group than the LMA supreme group (p = 0.034). The patients with blood staining on LMA removal exhibited significantly more mucosal hyperemia and injury than the patients with clear LMA (p = 0.0001, p = 0.020). LMA supreme insertion is faster and easier than LMA proseal and causes less laryngopharyngeal injury than LMA proseal in children. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  8. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both?

    Science.gov (United States)

    Seitz, Amee L; McClure, Philip W; Finucane, Sheryl; Boardman, N Douglas; Michener, Lori A

    2011-01-01

    The etiology of rotator cuff tendinopathy is multi-factorial, and has been attributed to both extrinsic and intrinsic mechanisms. Extrinsic factors that encroach upon the subacromial space and contribute to bursal side compression of the rotator cuff tendons include anatomical variants of the acromion, alterations in scapular or humeral kinematics, postural abnormalities, rotator cuff and scapular muscle performance deficits, and decreased extensibility of pectoralis minor or posterior shoulder. A unique extrinsic mechanism, internal impingement, is attributed to compression of the posterior articular surface of the tendons between the humeral head and glenoid and is not related to subacromial space narrowing. Intrinsic factors that contribute to rotator cuff tendon degradation with tensile/shear overload include alterations in biology, mechanical properties, morphology, and vascularity. The varied nature of these mechanisms indicates that rotator cuff tendinopathy is not a homogenous entity, and thus may require different treatment interventions. Treatment aimed at addressing mechanistic factors appears to be beneficial for patients with rotator cuff tendinopathy, however, not for all patients. Classification of rotator cuff tendinopathy into subgroups based on underlying mechanism may improve treatment outcomes. 2010 Elsevier Ltd. All rights reserved.

  9. Randomized crossover study assessing oropharyngeal leak pressure and fiber optic positioning : Laryngeal Mask Airway Supreme™ versus Laryngeal Tube LTS II™ size 2 in non-paralyzed anesthetized children.

    Science.gov (United States)

    Gasteiger, L; Ofner, S; Stögermüller, B; Ziegler, B; Brimacombe, J; Keller, C

    2016-08-01

    As there are currently no data available comparing the practicability of the laryngeal mask airway (LMA) Supreme™ size 2 versus the laryngeal tube LTS II™ size 2 in children, this trial was conducted to quantify the differences between these two airway devices concerning leak pressure and fiber optic-controlled positioning in non-paralyzed, anesthetized pediatric patients. A total of 56 children aged 1-6 years and weighing between 11 and 23 kg were enrolled in the study. Anesthesia was intravenously induced according to local standards using fentanyl and propofol. After induction of anesthesia both airway devices were inserted consecutively in accordance with the randomization protocol. The mean oropharyngeal leak pressure was significantly higher for the LTS II™ (33±8 cmH2O) than for the LMA Supreme™ (21±7 cmH2O, p insertion (55Supreme LMA vs. 43LTSII, p insertion time (25 s Supreme LMA vs. 34 s LTSII, p laryngeal tube LTS II™. We conclude that oropharyngeal leak pressure, fiber optic position, first attempt insertion success rate and bloodstaining differed between the LMA Supreme™ and the LTS II™ in children.

  10. Biofeedback therapy for spastic dysphonia.

    Science.gov (United States)

    Watanabe, H; Komiyama, S; Ryu, S; Kannae, S; Matsubara, H

    1982-01-01

    Spastic dysphonia is a disorder of phonation which is characterized by a strained, creaking, and choked vocal attack, a tense and squeezed voice sound. Spastic dysphonia in a functional voice disorder can be classified into two types from the viewpoint of activities of the extrinsic and intrinsic laryngeal muscle groups. A functional voice disorder pertaining to abnormal activities of the intrinsic and extrinsic laryngeal muscles results in spastic dysphonia. The adductor spastic dysphonia may be due to abnormal actions of the intrinsic laryngeal muscles as such is relieved by sectioning of the recurrent nerve, while spastic dysphonia mainly dealing with the extrinsic laryngeal muscles is relieved by relaxation on monitoring an electromyographic feedback system. Within 3 months we encountered two patients whose extrinsic laryngeal muscles were hyperactive on phonation. A trial on injection of lidocaine into extrinsic laryngeal muscles made their muscles relax. So, biofeedback therapy of relaxation was began using a monitoring system of EMG burst regarding to hypertonicity of the extrinsic laryngeal muscles. Normal vocal abilities were recovered using a biotrainer as a monitoring device of electromyographic feedback.

  11. Intrinsic endometriosis of ureter: a case report

    International Nuclear Information System (INIS)

    Hong, Myung Sun; Kim, Ho Chul; Yun, Ku Sup; Choi, Chul Soon; Bae, Sang Hoon; Kim, Sung Yong; Shin, Hyung Sik

    1995-01-01

    Endometriosis is a rare cause of an ureteral obstruction. We report a case of intrinsic ureteral endometriosis resulting in severe hydroureteronephrosis. The diagnosis of ureteral endometriosis may be considered in women with flank pain and ureteric obstruction within true pelvis

  12. The Intrinsic Dynamics of Psychological Process

    NARCIS (Netherlands)

    Vallacher, Robin R.; van Geert, Paul; Nowak, Andrzej

    2015-01-01

    Psychological processes unfold on various timescales in accord with internally generated patterns. The intrinsic dynamism of psychological process is difficult to investigate using traditional methods emphasizing cause–effect relations, however, and therefore is rarely incorporated into social

  13. Deuterium NMR, induced and intrinsic cholesteric lyomesophases

    International Nuclear Information System (INIS)

    Alcantara, M.R.

    1982-01-01

    Induced and intrinsic cholesteric lyotropic mesophases were studied. Induced cholesteric lyomesophases based on potassium laurate (KL) system, with small amounts of cholesterol added, were studied by deuterium NMR and by polarizing microscopy. Order profiles obtained from deuterium NMR of KL perdenderated chains in both induced cholesteric and normal mesophases were compared. The intrinsic cholesteric lyotropic mesophases were based on the amphiphile potassium N-lauroyl serinate (KLNS) in the resolved levo form. The study of the type I intrinsic cholesteric mesophase was made by optical microscopy under polarized light and the type II intrinsic cholesteric lyomesophase was characterized by deuterium NMR. The new texture was explained by the use of the theory of disclinations developed for thermotropic liquid crystals, specially for cholesteric type. (M.J.C.) [pt

  14. Association between Obesity and Chronic Laryngitis in Women--Data from the Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Joo, Young-Hoon; Han, Kyung-Do; Lee, Seong-Su

    2015-01-01

    This study aimed to investigate the relationship between obesity and chronic laryngitis in South Korea using data from the Korea National Health and Nutrition Examination Surveys (KNHANES) collected during 2008-2010. KNHANES was a cross-sectional survey of the civilian, non-institutionalized population of South Korea (n = 13,819). Obesity status was measured by using BMI and waist circumference. Among the population over 19 years of age, the prevalence of chronic laryngitis was 4.0 ± 0.4%. Chronic laryngitis was significantly associated with age, BMI, waist circumference, fat proportion, both systolic and diastolic blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein cholesterol in women. Old age and current smoking were significantly associated with chronic laryngitis in men. Obese women were at a higher risk for chronic laryngitis than women without obesity (odds ratio (OR) 2.022, 95% confidence interval (95% CI) 1.412-2.895) after further adjustment for confounders. Women with abdominal obesity were also at higher risk for chronic laryngitis (OR 1.475, 95% CI 1.024-2.126). Obese women in Korea have an elevated risk for developing chronic laryngitis. Further epidemiological and experimental studies are necessary to clarify the impact of obesity on this condition. © 2015 S. Karger GmbH, Freiburg.

  15. Ultrasound-Guided Laryngeal Air Column Width Difference as a New Predictor for Postextubation Stridor in Children.

    Science.gov (United States)

    El Amrousy, Doaa; Elkashlan, Mohamed; Elshmaa, Nagat; Ragab, Ahmed

    2018-03-01

    To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. Prospective observational study. Single, tertiary care pediatric hospital. This study was carried out at PICU and surgical ICU, Tanta University Hospital on 400 ventilated children between January 2015 and May 2017. Patients who received mechanical ventilation and met criteria for a weaning trial were included. Laryngeal ultrasound and cuff leak test. Ultrasound-guided laryngeal air column width and cuff leak test were measured before extubation. Laryngeal air column width is the width of air between the vocal cords seen by laryngeal ultrasonography. Laryngeal air column width difference is the width difference of air column passed through vocal cords with the balloon cuff inflated and deflated. Three-hundred fifty six patients (89%) had no postextubation stridor, whereas 44 patients (11%) developed postextubation stridor. Postextubation stridor was associated with younger age, less weight, female gender, prolonged duration of intubation, and ICU stay (p column width difference and cuff leak test showed significant decrease (p column width difference at cutoff point of less than 0.8 mm gave a sensitivity of 93%, specificity of 86%, and accuracy of 91%, whereas cuff leak test at less than 11% yielded a sensitivity of (61%), specificity of (53%), and accuracy of (59%) for predicting postextubation stridor. Laryngeal air column width difference measurement may serve as a simple reliable noninvasive method for predicting postextubation stridor in children.

  16. Family history of cancer and the risk of laryngeal cancer: a case-control study from Italy and Switzerland.

    Science.gov (United States)

    Garavello, Werner; Turati, Federica; Bosetti, Cristina; Talamini, Renato; Levi, Fabio; Lucenteforte, Ersilia; Chiesa, Fausto; Franceschi, Silvia; La Vecchia, Carlo; Negri, Eva

    2012-02-01

    Only limited data is available on the relationship between family history of laryngeal and other neoplasms and laryngeal cancer risk. We investigated the issue using data from a multicentre case-control study conducted in Italy and Switzerland between 1992 and 2009 including 852 cases with histologically confirmed laryngeal cancer and 1970 controls admitted to hospital for acute, non neoplastic conditions. Unconditional logistic regression models adjusted for age, sex, study center, education, tobacco smoking, alcohol drinking and number of siblings were used to estimate the odds ratios (ORs) of laryngeal cancer. The multivariate OR was 2.8 (95% confidence interval [CI], 1.5-5.3) in subjects reporting a first-degree relative with laryngeal cancer, as compared to subjects with no family history. The OR was higher when the relative was diagnosed before 60 years of age (OR = 3.5, 95% CI 1.4-8.8). As compared to subjects without family history, non-smokers, and moderate drinkers, the OR was 37.1 (95% CI 9.9-139.4) for current smokers, heavy drinkers, with family history of laryngeal cancer. Family history of colorectal (OR = 1.5, 95% CI 1.0-2.3) and kidney (OR = 3.8, 95% CI 1.2-12.1) cancer were also associated to an increased risk of laryngeal cancer, while no significant increase in risk was found for family history of cancer at all sites, excluding the larynx (OR = 1.1). Copyright © 2011 UICC.

  17. Intrinsic and acquired resistance mechanisms in enterococcus

    Science.gov (United States)

    Hollenbeck, Brian L.; Rice, Louis B.

    2012-01-01

    Enterococci have the potential for resistance to virtually all clinically useful antibiotics. Their emergence as important nosocomial pathogens has coincided with increased expression of antimicrobial resistance by members of the genus. The mechanisms underlying antibiotic resistance in enterococci may be intrinsic to the species or acquired through mutation of intrinsic genes or horizontal exchange of genetic material encoding resistance determinants. This paper reviews the antibiotic resistance mechanisms in Enterococcus faecium and Enterococcus faecalis and discusses treatment options. PMID:23076243

  18. The Composition of Microbiome in Larynx and the Throat Biodiversity between Laryngeal Squamous Cell Carcinoma Patients and Control Population.

    Directory of Open Access Journals (Sweden)

    Hong-Li Gong

    Full Text Available The throat is an ecological assemblage involved human cells and microbiota, and the colonizing bacteria are important factors in balancing this environment. However, this bacterial community profile has thus been poorly investigated. The purpose of this study was to investigate the microbial biology of the larynx and to analyze the throat biodiversity in laryngeal carcinoma patients compared to a control population in a case-control study. Barcoded pyrosequencing analysis of the 16S rRNA gene was used. We collected tissue samples from 29 patients with laryngeal carcinoma and 31 control patients with vocal cord polyps. The findings of high-quality sequence datasets revealed 218 genera from 13 phyla in the laryngeal mucosa. The predominant communities of phyla in the larynx were Firmicutes (54%, Fusobacteria (17%, Bacteroidetes (15%, Proteobacteria (11%, and Actinobacteria (3%. The leading genera were Streptococcus (36%, Fusobacterium (15%, Prevotella (12%, Neisseria (6%, and Gemella (4%. The throat bacterial compositions were highly different between laryngeal carcinoma subjects and control population (p = 0.006. The abundance of the 26 genera was significantly different between the laryngeal cancer and control groups by metastats analysis (p<0.05. Fifteen genera may be associated with laryngeal carcinoma by partial least squares discriminant analysis (p<0.001. In summary, this study revealed the microbiota profiles in laryngeal mucosa from tissue specimens. The compositions of bacteria community in throat were different between laryngeal cancer patients and controls, and probably were related with this carcinoma. The disruption of this bio-ecological niche might be a risk factor for laryngeal carcinoma.

  19. The intrinsic resistome of bacterial pathogens

    Directory of Open Access Journals (Sweden)

    Jorge Andrés Olivares Pacheco

    2013-04-01

    Full Text Available Intrinsically resistant bacteria have emerged as a relevant health problem in the last years. Those bacterial species, several of them with an environmental origin, present naturally a low-level susceptibility to several drugs. It has been proposed that intrinsic resistance is mainly the consequence of the impermeability of cellular envelopes, the activity of multidrug efflux pumps or the lack of appropriate targets for a given family of drugs. However, recently published articles indicate that the characteristic phenotype of susceptibility to antibiotics of a given bacterial species depends on the concerted activity of several elements, what has been named as intrinsic resistome. These determinants comprise not just classical resistance genes. Other elements, several of them involved in basic bacterial metabolic processes, are of relevance for the intrinsic resistance of bacterial pathogens. In the present review we analyse recent publications on the intrinsic resistomes of Escherichia coli and Pseudomonas aeruginosa. We present as well information on the role that global regulators of bacterial metabolism, as Crc from P. aeruginosa, may have on modulating bacterial susceptibility to antibiotics. Finally, we discuss the possibility of searching inhibitors of the intrinsic resistome in the aim of improving the activity of drugs currently in use for clinical practice.

  20. Incentives and intrinsic motivation in healthcare.

    Science.gov (United States)

    Berdud, Mikel; Cabasés, Juan M; Nieto, Jorge

    It has been established in the literature that workers within public organisations are intrinsically motivated. This paper is an empirical study of the healthcare sector using methods of qualitative analysis research, which aims to answer the following hypotheses: 1) doctors are intrinsically motivated; 2) economic incentives and control policies may undermine doctors' intrinsic motivation; and 3) well-designed incentives may encourage doctors' intrinsic motivation. We conducted semi-structured interviews à-la-Bewley with 16 doctors from Navarre's Healthcare Service (Servicio Navarro de Salud-Osasunbidea), Spain. The questions were based on current theories of intrinsic motivation and incentives to test the hypotheses. Interviewees were allowed to respond openly without time constraints. Relevant information was selected, quantified and analysed by using the qualitative concepts of saturation and codification. The results seem to confirm the hypotheses. Evidence supporting hypotheses 1 and 2 was gathered from all interviewees, as well as indications of the validity of hypothesis 3 based on interviewees' proposals of incentives. The conclusions could act as a guide to support the optimal design of incentive policies and schemes within health organisations when healthcare professionals are intrinsically motivated. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Balloon Dilatation of Pediatric Subglottic Laryngeal Stenosis during the Artificial Apneic Pause: Experience in 5 Children

    Directory of Open Access Journals (Sweden)

    J. Lisý

    2014-01-01

    Full Text Available Introduction. Balloon dilatation is a method of choice for treatment of laryngeal stenosis in children. The aim of procedure in apneic pause is to avoid new insertion of tracheostomy cannula. Patients and Methods. The authors performed balloon dilatation of subglottic laryngeal strictures (SGS in 5 children (3 girls and 2 boys without tracheotomy. Two of them with traumatic and inflammatory SGS had a tracheal cannula removed in the past. The other 3 children with postintubation SGS had never had a tracheostomy before. The need for tracheostomy due to worsening stridor was imminent for all of them. Results. The total of seven laryngeal dilatations by balloon esophagoplasty catheter in apneic pause was performed in the 5 children. The procedure averted the need for tracheostomy placement in 4 of them (80%. Failure of dilatation in girl with traumatic stenosis and concomitant severe obstructive lung disease led to repeated tracheostomy. Conclusion. Balloon dilatation of laryngeal stricture could be done in the absence of tracheostomy in apneic pause. Dilatation averted threatening tracheostomy in all except one case. Early complication after the procedure seems to be a negative prognostic factor for the outcome of balloon dilatation.

  2. Exercise-induced laryngeal obstructions: prevalence and symptoms in the general public

    DEFF Research Database (Denmark)

    Christensen, Pernille Melia; Thomsen, S F; Rasmussen, N

    2011-01-01

    Respiratory difficulties caused by exercise-induced laryngeal obstructions (EILOs) are reported with increasing frequency. The aim of this study was to assess the prevalence and symptoms of EILOs and their relation to airway hyperresponsiveness (AHR). In total, 556 randomly selected youths in Cop...

  3. Treatment of Laryngeal Radionecrosis with Hyperbaric Oxygen Therapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Ying-Che Hsu

    2005-02-01

    Full Text Available An 81-year-old male with early-stage laryngeal carcinoma had been treated with 60 Gy curative radiotherapy. He complained of a sore throat, foul odor in the mouth, progressive dyspnea, and fever 2 months after the completion of radiotherapy. Direct laryngoscopy revealed narrowing of the glottis with diffuse ulcerative necrotic tissue. Biopsies at multiple sites and pathology revealed intense coagulation necrosis with complete denudation of covering epithelium without any malignancy. Since laryngeal radionecrosis was suspected, the patient received hyperbaric oxygen (HBO therapy 40 times for 1 hour of 100% O2 at 2 atm absolute pressure. His clinical symptoms gradually improved and repeated endolaryngeal biopsies were undertaken near the end of HBO therapy and again 6 months later. The patient's larynx healed completely with diffuse fibrosis and no malignant cells were found on pathology. Radionecrosis must be differentiated from cancer recurrence following curative radiotherapy for early laryngeal cancer. HBO therapy could be a useful treatment adjunct for laryngeal radionecrosis.

  4. Transforming growth factor alpha and epidermal growth factor in laryngeal carcinomas demonstrated by immunohistochemistry

    DEFF Research Database (Denmark)

    Christensen, M E; Therkildsen, M H; Poulsen, Steen Seier

    1993-01-01

    Fifteen laryngeal squamous cell carcinomas were investigated for the presence of transforming growth factor alpha (TGF-alpha) and epidermal growth factor (EGF) using immunohistochemical methods. In a recent study the same material was characterized for epidermal growth factor receptors (EGF recep...

  5. Vein Wrapping Technique for Nerve Reconstruction in Patients with Thyroid Cancer Invading the Recurrent Laryngeal Nerve

    Directory of Open Access Journals (Sweden)

    Young Moon Yoo

    2012-01-01

    Full Text Available Recurrent laryngeal nerve paralysis is the most common and serious complication after thyroid cancer surgery. The objective of this study was to report the advantages of the vein wrapping technique for nerve reconstruction in patients with thyroid cancer invading the recurrent laryngeal nerve and its effects on postoperative phonatory function. The subjects were three patients who underwent resection of the recurrent laryngeal nerve during surgical extirpation of papillary thyroid cancer. Free ansa cervicalis nerve graft or direct neurorrhaphy with a vein wrapping technique was used to facilitate nerve regeneration, protect the anastomosed nerve site mechanically, and prevent neuroma formation. One-year postoperative laryngoscopic examination revealed good vocal cord mobility. Maximum phonation time (19.5 ± 0.3 sec was longer than a previously-reported value in conventional reconstruction patients (18.8 ± 6.6 sec. The present phonation efficiency index (7.88 ± 0.78 was higher than that previously calculated in conventional reconstruction (7.59 ± 2.82. The mean value of the Voice Handicap Index-10 was 6, which was within the normal range. This study demonstrates improvement in phonation indices measured 1 year after recurrent laryngeal nerve reconstruction. Our results confirm that the vein wrapping technique has theoretical advantages and could be favored over conventional reconstruction techniques for invenerate nerve injuries.

  6. [Bilateral recurrent laryngeal nerve paralysis in a child following a neurosurgical operation].

    Science.gov (United States)

    Hattori, Shinichi; Ohata, Hiroto; Dohi, Shuji

    2005-06-01

    We experienced a case of 7-year-old boy who developed bilateral recurrent laryngeal nerve paralysis following an elective neurosurgical operation under oxygen-nitrous oxide-isoflurane anesthesia. He underwent a removal of brain tumor in the supratentorial region on supine position. After the removal of the endotracheal tube in the intensive care unit, he developed marked respiratory effort and inspiratory stridor. A diagnosis of bilateral recurrent laryngeal nerve paralysis was made by a direct diagnostic laryngoscopy. The patient needed continuous care for his airway patency with tracheotomy tube in place, and his normal vocal cord mobility recovered on the 23 rd postoperative day. Common cause of recurrent nerve injury following general anesthesia is either the procedure of endotracheal intubation itself or trauma due to surgical manipulation. In the present case, an endotracheal tube, a transesophageal stethoscope and a nasogastric tube inserted into the narrow laryngeal space might have been a cause of this complication. Moreover, accidental extreme flexion of his neck which occurred during the surgery might also be an additional cause. This case suggests that recurrent laryngeal nerve paralysis due to anesthetic instruments around the larynx is a possible cause of complications during general anesthesia in pediatric patients.

  7. Relation of the external laryngeal nerve to superior thyroid artery in ...

    African Journals Online (AJOL)

    The external laryngeal nerve runs parallel to superior thyroid artery and later crossing the artery either above or below the upper pole of the thyroid gland. This relatively high anatomic variability demonstrates inter-population differences. However, datum among the Kenyan population is lacking. Knowledge of normal and ...

  8. Quantitative Study of Vibrational Symmetry of Injured Vocal Folds via Digital Kymography in Excised Canine Larynges

    Science.gov (United States)

    Krausert, Christopher R.; Ying, Di; Zhang, Yu; Jiang, Jack J.

    2011-01-01

    Purpose: Digital kymography and vocal fold curve fitting are blended with detailed symmetry analysis of kymograms to provide a comprehensive characterization of the vibratory properties of injured vocal folds. Method: Vocal fold vibration of 12 excised canine larynges was recorded under uninjured, unilaterally injured, and bilaterally injured…

  9. Laryngeal High-Speed Videoendoscopy: Rationale and Recommendation for Accurate and Consistent Terminology

    Science.gov (United States)

    Deliyski, Dimitar D.; Hillman, Robert E.; Mehta, Daryush D.

    2015-01-01

    Purpose: The authors discuss the rationale behind the term "laryngeal high-speed videoendoscopy" to describe the application of high-speed endoscopic imaging techniques to the visualization of vocal fold vibration. Method: Commentary on the advantages of using accurate and consistent terminology in the field of voice research is…

  10. Yearly chest radiography in the early detection of lung cancer following laryngeal cancer

    NARCIS (Netherlands)

    Engelen, A. M.; Stalpers, L. J.; Manni, J. J.; Ruijs, J. H.; van Daal, W. A.

    1992-01-01

    In a retrospective study of 556 patients (505 men, 51 women) with laryngeal cancer the incidence and prognosis of lung malignancies was studied in patients who were examined yearly by chest radiography. In 69 patients (12.4%) a lung malignancy was diagnosed, with 28 having a histologically confirmed

  11. Ortner's Syndrome: Secondary Laryngeal Paralysis Caused by a Great Thoracic Aorta Aneurysm.

    Science.gov (United States)

    Zangirolami, Ana Claudia Alves; Oliveira, Frederico Vieira de; Tepedino, Miguel Soares

    2015-04-01

    Introduction Recurrent laryngeal nerve injury caused by cardiovascular disease is a rare condition, and often it is the only prominent sign of an imminent break of an aortic artery aneurysm. Objective To report left laryngeal paralysis caused by a great aortic arch aneurysm and to highlight the importance of an otorhinolaryngologic evaluation along with a thoracic radiologic study. Resumed Report A 42-year-old man complained of thickness of his voice and dysphagia for 3 months, but no thoracic pain or other relevant complaints. Video laryngoscopy revealed immobility of his left vocal fold in the paramedian position. Imaging was obtained for investigation, including magnetic resonance imaging of his thorax, which showed a fusiform aneurysm in the aortic arch, leading to recurrent compression of the left laryngeal nerve. The patient was successfully treated with endovascular repair of the aneurysm. At 2-month follow-up, there was still no recovery of the laryngeal mobility. Conclusion An aortic artery aneurysm can suddenly break, requiring emergency heart surgery, and the results can be fatal in many cases. We suggest routine exam of the vocal folds in all patients with a heart condition, and we review the literature and suggest the use of imaging to reduce the number of emergency procedures.

  12. Ortner's Syndrome: Secondary Laryngeal Paralysis Caused by a Great Thoracic Aorta Aneurysm

    Directory of Open Access Journals (Sweden)

    Zangirolami, Ana Claudia Alves

    2015-01-01

    Full Text Available Introduction Recurrent laryngeal nerve injury caused by cardiovascular disease is a rare condition, and often it is the only prominent sign of an imminent break of an aortic artery aneurysm. Objective To report left laryngeal paralysis caused by a great aortic arch aneurysm and to highlight the importance of an otorhinolaryngologic evaluation along with a thoracic radiologic study. Resumed Report A 42-year-old man complained of thickness of his voice and dysphagia for 3 months, but no thoracic pain or other relevant complaints. Video laryngoscopy revealed immobility of his left vocal fold in the paramedian position. Imaging was obtained for investigation, including magnetic resonance imaging of his thorax, which showed a fusiform aneurysm in the aortic arch, leading to recurrent compression of the left laryngeal nerve. The patient was successfully treated with endovascular repair of the aneurysm. At 2-month follow-up, there was still no recovery of the laryngeal mobility. Conclusion An aortic artery aneurysm can suddenly break, requiring emergency heart surgery, and the results can be fatal in many cases. We suggest routine exam of the vocal folds in all patients with a heart condition, and we review the literature and suggest the use of imaging to reduce the number of emergency procedures.

  13. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available BACKGROUND: Swallowing dysfunction (also known as dysphagia, which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. METHODS: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. RESULTS: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. CONCLUSIONS: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

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

    Science.gov (United States)

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

    2014-12-11

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

  15. Exercise-induced laryngeal obstructions: prevalence and symptoms in the general public

    DEFF Research Database (Denmark)

    Christensen, Pernille Melia; Thomsen, S F; Rasmussen, N

    2011-01-01

    Respiratory difficulties caused by exercise-induced laryngeal obstructions (EILOs) are reported with increasing frequency. The aim of this study was to assess the prevalence and symptoms of EILOs and their relation to airway hyperresponsiveness (AHR). In total, 556 randomly selected youths...

  16. Cortactin is associated with perineural invasion in the deep invasive front area of laryngeal carcinomas

    DEFF Research Database (Denmark)

    Ambrosio, Eliane Papa; Rosa, Fabíola Encinas; Domingues, Maria Aparecida Custódio

    2011-01-01

    The cortactin gene, mapped at 11q13, has been associated with an aggressive clinical course in many cancers because of its function of invasiveness. This study evaluated CTTN protein and its prognostic value in the deep invasive front and superficial areas of laryngeal squamous cell carcinomas. T...

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

    Science.gov (United States)

    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.

  18. A case with laryngeal atresia and partial trisomy 9 due to maternal 9;16 translocation

    NARCIS (Netherlands)

    van den Boogaard, M. J.; de Pater, J.; Hennekam, R. C.

    1991-01-01

    A newborn with a partial trisomy 9 and a partial trisomy 16q is described. The child died shortly after birth because of laryngeal atresia. The chromosome anomaly was the result of a 3:1 segregation of a maternal translocation t(9;16) (q22;q24). The pertinent literature on both partial trisomy 9 and

  19. Screening for second primary lung cancer after treatment of laryngeal cancer.

    NARCIS (Netherlands)

    Ritoe, S.C.; Krabbe, P.F.M.; Janssen, M.L.H.; Festen, J.; Joosten, F.B.M.; Kaanders, J.H.A.M.; Hoogen, F.J.A. van den; Verbeek, A.L.M.; Marres, H.A.M.

    2002-01-01

    OBJECTIVES/HYPOTHESIS: As a result of smoking, patients who have received curative treatment for laryngeal cancer run a high risk of developing lung cancer. Therefore, these patients enter a screening program that aims to detect lung cancer at an asymptomatic stage. The study evaluated whether

  20. Effects of Masking Noise on Laryngeal Resistance for Breathy, Normal, and Pressed Voice

    Science.gov (United States)

    Grillo, Elizabeth U.; Abbott, Katherine Verdolini; Lee, Timothy D.

    2010-01-01

    Purpose: The purpose of the present study was to explore the effects of masking noise on laryngeal resistance for breathy, normal, and pressed voice in vocally trained women. Method: Eighteen vocally trained women produced breathy, normal, and pressed voice across 7 fundamental frequencies during a repeated CV utterance of /pi/ under normal and…