Vestibular folds configuration in vocal nodule.
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Vocal nodules are among the most common laryngopathies that cause vocal functional disorders. The voice production mechanism is complex and demand interaction of different systems of the human body. The physiological role of the vocal folds as the glottic sound source is evident, however, there is no consensus regarding the vestibular folds' participation/influence in phonation. AIM: To verify if there is difference in the bidimensional configuration of the vestibular folds between two distinct groups of women, one with the diagnosis of vocal nodules and the other without vocal complaints and vocal fold lesions. STUDY DESIGN: Clinical with transversal cohort. MATERIAL AND METHOD: Ninety-six laryngeal images were evaluated, 48 from individuals without vocal complaints and 48 from patients with the diagnosis of vocal nodules. Angles were obtained and bilaterally measured in single frames of the vestibular folds during sustained phonation and those structures were morphologically classified as concave, linear or convex. RESULTS: Among the 96 vestibular folds evaluated in each group, there was predominance of the concave form, followed by the linear and the convex ones. In the control group, there was a single convex vestibular fold, 27 were linear and 68 were concave folds. In the group of vocal nodules, 8 were convex, 15 were linear and 73 were concave folds. However, the differences among groups were not statistically significant as well as those among the angles, whose average measures were proven quite similar. CONCLUSION: In the female gender, the vestibular folds presented similar behavior regarding the morphology in both patients with vocal nodules and women without vocal complaints. (+info)
Effects of laryngeal tuberculosis on vocal fold functions: case report.
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Laryngeal tuberculosis is the most common granulomatous disease of the larynx. In this study, the videostroboscopic findings and vocal assessments of a 28-year-old female with laryngeal and pulmonary tuberculosis were evaluated. Although it can be treated successfully, tuberculosis of the larynx may cause irreversible changes in voice quality which is very important for vocal professionals. (+info)
Schwannoma of the epiglottis: case report focusing on clinico-pathological aspects.
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Laryngeal schwannomas are uncommon lesions with only few cases reported. Herein we present a further case of a schwannoma of the epiglottis, occurring in a 62-year-old with a clinical history of a cutaneous malignant melanoma and laryngeal glottic keratosis. The schwannoma was incidentally discovered as a small polypoid lesion located on the laryngeal surface of the epiglottis and was removed endoscopically. The procedure was uneventful and the patient is well six months later. Authors focus on the diagnostic and therapeutic options for this unusual lesion and discuss the differential diagnosis of the spindle cell proliferation of the larynx. (+info)
Dysphonia as first symptom of late-onset myasthenia gravis.
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Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction that causes muscle weakness and fatigue. Fluctuating fatigue of skeletal muscles is the key clinical feature. Late-onset MG is more frequent in elderly men and is often misdiagnosed. While involvement of oropharyngeal musculature has been described with symptoms of dysphagia and slurred speech, the presence of fluctuating dysphonia as the first symptom of late-onset MG has not been emphasized. The case of an elderly man, who demonstrated voice changes and later swallowing impairment with weight loss, is reported. This case presentation of late-onset MG emphasizes that this form of the disease should be considered in the differential diagnosis of acute onset dysphonia in elderly persons. (+info)
Acoustic analysis of voice in patients treated by reconstructive subtotal laryngectomy. Evaluation and critical review.
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Aim of this investigation was to analyse the voice in a group of 20 patients submitted to supracricoid partial laryngectomy (cricohyoidopexy, sparing two arytenoids) by the Multi Dimensional Voice Programme acoustic analysis system. Results revealed the following sound characteristics: high rate of noise, lack of periodic component of the signal, high rate of segments with no sound signal, vocal segments with marked air-turbulent flow, variation amplitude and frequency coefficients doubled compared to normal values, average fundamental frequency, if present, extremely variable and unsteady. These results show that the phonatory ability of the residual larynx, due to the altered anatomo-physiology of the structure after surgery, has to be completely re-estimated. In fact, the residual larynx determines a definitely reduced periodic acoustic signal, rich in noise and which can not be modulated. Good phonatory results of this treatment are basically due to preservation of a still understandable (but not perfect!) speech which, by ensuring the subjects' speech ability, overcomes and has little influence on the really poor quality of the vocal signal in these patients. However, the patient obtains a "new voice" as far as concerns acoustic features and this is very important for communication and social life. Moreover, the possibility of objectively estimating acoustic vocal function ability allows monitoring of the trend and results of possible speech therapy and/or phonosurgical rehabilitation treatment which should start from new anatomical and physiological bases, as well as from the new physical acoustic mechanism of signal production. (+info)
Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia.
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Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia the adductor spasmodic dysphonia is a severe vocal disorder characterized by muscle laryngeal spasms during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms come from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold strain, pressed one against another and increased glottic resistance. AIM: report the results in the impact in vocal quality in neurectomy of the thyroarytenoid branch of the inferior laryngeal nerve by endoscopic route associated with partial myectomy of the thyroarytenoid muscle with co2 laser. MATERIAL E METHODS: the surgery was done in 07 patients (06 females and 01 male), aged 22 to 75, with adductor spasmodic dysphonia. They were submitted to vhi (voice handicap index) before and after surgery. RESULTS AND CONCLUSIONS: the vocal improvement was obtained in all studied patients, deterioration in vocal quality after surgery was not noticed. There was evident difference in the vhi before and after surgery. This surgical technique proved to be efficient and innovative in the treatment of adductor spasmodic dysphonia. (+info)
Vocal assessment in patients submited to CO2 laser cordectomy.
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AIM: To evaluate voice outcomes in patients with early glottic carcinoma treated by CO2 laser cordectomy. METHOD: 15 patients with glottic Tis and T1 squamous cell carcinoma treated with CO2 laser were analyzed. The assessment consisted of perceptual voice analysis, objective voice evaluation and video-laryngo-stroboscopic exam. In addition, patients rated their voices and completed the Voice related Quality of Life (VR-QOL) questionnaire. The results were compared with those obtained in a matched control group. RESULTS: Most of the patients presented some degree of hoarseness on perceptual voice analysis, mainly rough and breathy voices. Their acoustic evaluation compared with the control group showed a small increase in fundamental frequency, but with no statistically significant difference, and the values of jitter, shimmer and noise to harmonic ratio were worse and statistically significant. As regards to videolaryngo-stroboscopic findings, better results were achieved in the less extensive resection group. Patients have had minimal repercussion in their life quality in respect to voice. CONCLUSIONS: In spite of voice alterations in patients submitted to cordectomy by CO2 laser, functional results are acceptable, with minimal repercussion in their quality of life. (+info)
Laryngeal dystonia: case report and treatment with botulinum toxin.
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Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and inappropriate spasms of vocal muscles, having the adductor type as the most common one. It is characterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature. (+info)