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Objective: Appropriately managing laryngeal and tracheal trauma is important. However, coherent reports on this appropriate management are limited and include inconsistent treatment methods. We sought to survey the causes, pathophysiology, and treatment methods of laryngeal and tracheal trauma in Japan. Furthermore, we aimed to propose a classification and treatment guidelines that enable consistent evaluation and treatment regardless of the evaluator or facility., Methods: Based on a survey conducted at facilities certified by the Japan Broncho-Esophagological Society, we retrospectively evaluated 86 patients., Results: There were 84 cases of laryngeal trauma, of which 2 cases were complicated by tracheal trauma. Tracheal trauma was reported in 2 cases. The median age was 35.5 years; 68 (81 %) were male patients. The most common mechanism was sports-related laryngeal trauma (39 %). Airway management was performed in 11 patients (13 %), including tracheostomy in 9 patients. Laryngeal fractures were observed in 29 (35 %) patients, with reduction being performed in 12 patients. Based on clinical symptoms, the severity was classified according to the classification proposed by Umeno et al. [1]: group 1, 24 cases (28 %); group 2, 8 cases (9 %); group 3, 19 cases (22 %); group 4, 2 cases (2 %); unclassified, 13 cases (14 %); and no abnormalities, 21 cases (24 %)., Conclusions: We proposed Severity Classification and Treatment Guidelines for laryngeal trauma that could only evaluate the presence or absence of four clinical findings. Using this classification, the severity of almost all cases could be classified; treatment plans could be determined accordingly. Furthermore, the addition of comprehensive judgment using phonatory ability tests and acoustic analysis would enable consistent evaluation and treatment that are unlikely to differ among evaluators and institutions, which is expected to help establishing treatment of blunt laryngeal trauma in the future., Competing Interests: Declaration of competing interest The authors report no conflicts of interest., (Copyright © 2025. Published by Elsevier B.V.)

Objective: Fibrotic changes in the vocal fold mucosa have been observed in patients with vocal fold scarring, aged vocal fold, and sulcus vocalis, which often lead to severe voice disorders. Previous research suggests that the basic fibroblast growth factor (b FGF) improves variations in vocal fold properties [1,2]. Although clinical studies on b FGF treatments have been conducted [3,4,5], these studies only demonstrated the efficacy of this drug over a short period. The present study is the first to investigate the long-term efficacy of b FGF treatment., Methods: b FGF injections were performed in six patients from January of 2016 to December of 2017 at our institution. Patient follow-up continued for at least two years after the last injection. Three patients had vocal fold scarring, two had aged vocal fold atrophy, and one patient had sulcus vocalis. Each vocal fold was injected with 10 µg of b FGF four times. Voice and stroboscopic examinations were performed after surgery (at one month, three months, six months, one year, two years). Fundamental frequency, maximum phonation time (MPT), mean flow rate (MFR), amplitude perturbation quotient (APQ), pitch perturbation quotient (PPQ), and noise-to-harmonic ratio (NHR), and voice handicap index-10 (VHI-10) were examined and compared statistically between the pretreatment time and at each posttreatment time point., Results: The speaking F0 had an obvious decreasing tendency, with significant differences suggesting the increase in volume in the vocal folds. Aerodynamic parameters also showed small improvements. The most remarkable improvement was observed in the acoustic parameters, indicating that the treatment could improve the vocal fold to make vibrations symmetrically and regularly for a long period. Achievement of symmetry and regularity on vocal fold vibrations suggested the property changes had happened in the vocal folds. Consequently, the score of VHI-10 had improved, indicating high patient satisfaction with this treatment., Conclusion: b FGF injections could be a reliable treatment option for diseases that deteriorate the property of vocal fold., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: Conventional pharyngeal flap surgery, which closes the median portion of the velopharynx, has been performed for dysarthria patients with velopharyngeal insufficiency (VPI). However, for VPI due to unilateral pharyngeal paralysis, median closing disrupts pharyngeal contraction of the unaffected side and allows pharyngeal pressure to escape through the nose at the lateral portion of the affected side during speech and swallowing. The purpose of this study was to evaluate the effectiveness of lateral pharyngeal flap (LPF) surgery for unilateral VPI., Methods: Seven patients with unilateral VPI (five males and two females with an average age of 54 years) underwent LPF surgery combined with other transoral surgeries for dysphagia. The LPF surgical technique was as follows: after the laterocaudal-based pedicle flap of the soft palate and cranial-based pedicle flap of the posterior pharyngeal wall on the affected side were transorally elevated, each mucosal pedicle flap was sutured together. Functional oral intake scale (FOIS) scores and swallowing pressure before and after surgery were compared., Results: Unilateral velopharyngeal closure preserved nasal breathing after LPF surgery in all patients. Rhinolalia aperta improved postoperatively in all patients except one. The mean FOIS scores were 2.3 preoperatively and 3.7, 5.3, and 5.9 at 2 weeks, 1 month, and 6 months postoperatively, respectively. The mean pressures significantly increased at the velopharynx (from 49±30mmHg to 92±45mmHg) and oropharynx (from 48±18mmHg to 66±15mmHg) six months after the surgery., Conclusion: LPF surgery leaving the unaffected side intact can be an effective surgical procedure for patients with unilateral VPI., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Surgical management of cricoarytenoid joint (CAJ) ankylosis is challenging and has the risk of worsening voice quality. In the present case, augmentation surgery was performed on the cartilaginous portion of the vocal fold in a patient with CAJ ankylosis. A 24-year-old man sustained blunt trauma to the anterior neck three years prior to developing severe breathiness. Posterior glottal insufficiency resulting from lateral fixation of the right vocal fold was observed during phonation under laryngoscopy. In addition, electromyography and CT scan revealed severe ankylosis of the right CAJ. Type I thyroplasty performed on the right vocal fold did not improve postoperative vocal function. Therefore, augmentation surgery on the cartilaginous portion of the right vocal fold was performed via endolaryngeal microsurgery under general anesthesia with jet ventilation. A piece of temporalis fascia was autotransplanted into the submucosal space created at the posterior cartilaginous portion of the right vocal fold. This resulted in the narrowing of the posterior glottal gap during phonation, leading to improvement in hoarseness. Microsurgical management with autologous fascia augmentation of the cartilaginous portion of the vocal fold can be effective in patients with lateral vocal fold fixation due to CAJ ankylosis., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Cricoid cartilage fractures usually occur concurrently with disorders of laryngeal function. In, particular, displaced cricoid lamina fractures can affect arytenoid movement. However, functional, recovery may require proper repositioning of the cricoid lamina, which is associated with a high rate of, complications. Here we present a case in which an isolated cricoid cartilage fracture with arytenoid, immobility due to displacement of the fracture in the cricoarytenoid joint space was successfully, treated. Our findings suggest that a combination of external approaches with temporary, cricothyrotomy and wide suturing of the entire cricoid framework has the potential to improve, arytenoid movement and prevent associated complications., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)