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Aims: To compare voice quality as defined by formant analysis using a sustained vowel in patients who have undergone a partial glossectomy with a group of normal subjects. Methods & Procedures: The design consisted of a single centre, cross-sectional cohort study. The setting was an Adult Tertiary Referral Unit. A total of 26 patients (19 males) who underwent partial glossectomy and 31 normal volunteers (18 males) participated in the study. Group comparisons using the first three formant frequencies (F1, F2 and F3) using linear predictive coding (Laryngograph Ltd, London, UK) were performed. The existence of any significant difference of F1, F2 and F3 between the two groups using the sustained vowel /i/ and the effects of other factors, namely age, first presentation versus recurrence, site (oral cavity, oropharynx), subsite (anterior two-thirds of the tongue, tongue base), stage, radiation, complication, and neck dissection, were analysed. Outcomes & Results: Formant frequencies F1, F2 and F3 were normally distributed. F1 and F2 were significantly different in normal males versus females. F1, F2 and F3 were not different statistically between male and female glossectomees. Comparison of only women showed significant differences between normal subjects and patients in F2 and F3, but none in F1. This was the opposite in men where F1 was significantly different. Age, tumour presentation, site, subsite, radiation and neck dissection showed no significant difference. Postoperative complications significantly affected the F1 formant frequency. Conclusions: The study found that the formant values in patients following a partial glossectomy were altered significantly as compared with the normal control subjects. Only gender and complications and not the age, site, subsite, radiation and neck dissection were seen to influence the formant scores. (Contains 6 figures and 3 tables.)

Squamous cell carcinoma involving the oral cavity (OC) and oropharynx regions are a major cause of morbidity and mortality world-wide. The recent discovery of a strong association between human papilloma virus (HPV) infection and OC and oropharyngeal (OP) cancer has prompted world-wide research into the exact etiology and pathogenesis of these cancers in relation to the HPV. HPV-positive OC/OP cancers generally present at a relatively advanced stage (by virtue of cervical nodal involvement) and are more commonly seen in younger patients without significant exposure to alcohol or tobacco. These factors are implicated in prognosis, regardless of HPV association. In this article, we review the biology and epidemiology, risk factors, association, molecular analyses, treatment response and prognosis of HPV-related cancers. Role of HPV vaccination in HPV-related OC/OP cancers has also been discussed. [ABSTRACT FROM AUTHOR]

We analyzed a series of adults with an implanted voice prosthesis that had malfunctioned and required removal as a result of the attachment and growth of microorganisms. Our goal was to determine the characteristics of these colonizing microbes. We swabbed the esophageal side of each prosthesis to obtain microbial flora for analysis with standard culture media. In all, we studied 22 prostheses in 18 patients (3 patients had received multiple prostheses). We found mixed contamination (both yeast and bacteria) in 19 of the 22 cultures (86.4%); the other 3 cultures yielded bacteria only, and there was no instance of yeast only. The most common yeast isolated was Candida albicans (68.2% of cultures), and the most common bacterium was Pseudomonas aeruginosa (63.6%). The average lifetime of the prostheses was 201 days (~6 mo, 3 wk). This study, which was the first of its kind in India, revealed that the microbial picture here was different from that found in previously reported studies of European populations. We presume the differences are attributable to different lifestyles and dietary habits. [ABSTRACT FROM AUTHOR]

We present the case of a 23-year-old woman with aggressive fibromatosis of the oropharynx that was initially treated elsewhere as a peritonsillar abscess. We discuss the characteristics of this rare tumor and review the literature, stressing the importance of postoperative follow-up for peritonsillar abscesses to avoid missing other important diagnoses, such as the one described here. [ABSTRACT FROM AUTHOR]

Twenty-seven total laryngectomy patients (19 males and 8 females) and 18 normal control subjects (10 males and 8 females) were subjected to electroglottography-based single voice recordings using sustained vowels and connected speech. The results showed poorer values and larger variability for all the voice measures for the total laryngectomy patients (TO speech) as compared to that of normal subjects. There were statistically significant differences (p<0.05) for all study parameters between the TO and normal speech. This study shows that robust and reliable data can be obtained using electroglottography in laryngectomees with both a sustained vowel and connected speech. Using these parameters, TO speech is significantly different from normal speech and is highly variable. This methodology has enormous potential for further investigations in laryngectomees and other patients with head and neck cancer. [ABSTRACT FROM AUTHOR]

Purpose: To conduct prospective electroglottographic analyses of voice outcomes after radical chemoradiotherapy for locally advanced laryngopharyngeal cancers and to compare them with patients who have undergone total laryngectomy (TL). Patients and Methods: Twenty-one patients (19 male, 2 female, median age [range] 65 [50–85] years) with Stage III/IV laryngopharyngeal cancer received induction chemotherapy followed by radical chemoradiotherapy. Electroglottography, using the sustained vowel /i/ and connected speech, was performed before treatment and 1, 6, and 12 months after treatment. In addition, single voice recordings were taken from 21 patients (16 male, 5 female, aged 65 [50–84] years) who had undergone TL and surgical voice restoration and from 21 normal controls (18 male, 3 female, aged 65 [33–80] years). Results: Before treatment the vocal measures for the chemoradiotherapy patients were significantly different from normal controls in jitter (p = 0.02), maximum phonation time (MPT) (p = 0.001), and words per minute (WPM) (p = 0.01). At 12 months after treatment MPT and WPM had normalized, but jitter and normalized noise energy were significantly worse than in normal controls. Comparison of voice outcomes at 12 months for chemoradiotherapy patients revealed superiority over the TL group in all parameters except MPT (18.2 s vs. 10.4 s, p = 0.06). Analysis of the recovery of voice up to 12 months after treatment revealed progressive improvement in most electroglottographic measures. Conclusions: This prospective study demonstrates significantly better outcome for patients treated with chemoradiotherapy as compared with TL. Progressive normalization of many voice parameters occurs over the 12 months following chemoradiotherapy. [Copyright &y& Elsevier]

Optimal care of patients with head and neck squamous cell cancer (HNSCC) involves a pre-determined period of post-treatment follow-up for the detection of recurrent or persistent disease, metastases and second primaries at the earliest opportunity. There is little evidence in literature as to whether the surveillance schemes should be based on patient survival, quality of life or cost-adjusted parameters. This article aims at highlighting some of the issues pertinent to the optimization of surveillance strategies in HNSCC. [ABSTRACT FROM AUTHOR]

Primary tracheoesophageal puncture (TEP) is now considered to be the preferred method for voice rehabilitation after laryngectomy . The traditional method of creating a puncture with a no. 11 stab knife often leads to an eccentric puncture with irregular ragged margin, leading to scarring in the future. In this report we describe the innovative way of creating a TEP using a carbon dioxide (CO(2)) laser. This novel method of using a laser for the creation of a precise TEP could, perhaps, influence peri-prosthetic leakage and lead to better voice rehabilitation for patients that have undergone laryngectomy. [ABSTRACT FROM AUTHOR]

The article focuses on voice restoration through esophageal speech, electrolarynx, and surgical voice restoration (SVR) using a valve in alaryngeal speakers. It states that total laryngectomy remains the procedure of choice for advanced-stage laryngeal cancer. Today, the SVR technique has become the preferred method for voice restorations.

We present a case of a 39-year-old female patient with acute stridor due to a large tumor located at the level of the upper third of her thoracic esophagus. Parathyroid gland tumors are unusual in the differential diagnosis of mediastinal tumors. This tumor was removed via a thoracocervical approach, which offers multiple advantages when used for tumors in this location. The eventual diagnosis on histology was parathyroid adenoma. The patient had no clinical evidence of metabolic abnormalities and her pre- and postoperative calcium and postoperative parathyroid hormone (PTH) levels were within normal limits. This case poses the interesting question of whether identification of elevated PTH levels is an absolute prerequisite for diagnosing parathyroid adenomas. It is an example of a difficult diagnostic and therapeutic problem. [ABSTRACT FROM AUTHOR]

Mucosal melanoma of the nasal cavity and paranasal sinuses is seldom encountered in routine ENT practice. These tumors have poor prognosis owing to higher rates of locoregional recurrence and distant metastasis. Various treatment modalities have been employed over time but the ideal treatment approach still remains an open issue. This article presents some commonly accepted guidelines in treating these rare mucosal neoplasms. [ABSTRACT FROM AUTHOR]

Focuses on technological advancement in electronic voice aids or artificial larynx (AL). Types of AL; Use of space age materials to improve type of machine; Changes on power sources of AL devices.