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Complete subglottic stenosis is often managed with surgical resection. However, involvement of the high subglottis can limit candidacy for open resection, and there are few treatment options for these patients. We refined an endoscopic approach that evolved into a tracheal rendezvous technique with T-tube placement as an alternative to open surgical resection. Here, we present our series, technique, and outcomes. A retrospective review was performed to identify patients who underwent endoscopic management of complete high subglottic stenosis at the University of California San Diego. The surgical technique was initially a two-step staged procedure and was subsequently revised to a single-stage procedure with stenosis ablation, dilation, and insertion of a T-tube, which was completed in one day. Patients were seen at regular follow-up intervals for reassessment. Five patients were identified with complete stenosis not amenable to surgical resection. The average age of the cohort was 44.8 years. The etiology of stenosis in all patients was related to prolonged intubation and tracheostomy, and the average length of stenosis was 19.6 mm. Stenosis resection was accomplished via laser ablation and balloon dilation, and the average T-tube length was 50.3 mm. All patients were discharged on postoperative day one. Two patients developed airway crusting within the T-tube and required emergency department visits. Decannulation was attempted in three patients, although failed in two. Tracheal rendezvous is a safe and effective procedure for patients with grade IV subglottic stenosis. This provides a feasible endoscopic alternative to patients who are not candidates for open surgical resection, ye are motivated to have phonatory capacity.

The article presents an interview focuses on the poignant experience of a Ukrainian refugee family and the author's reflections on a conversation with an Israeli writer about the loss and recovery of speech. Topics include the refugee's inability to speak due to stress, the author's reminiscences about Aharon Appelfeld's experience with aphasia, and an artist's contributions to metro station designs.

A 6-month-old intact male domestic shorthair cat presented with a history of aphonia, vomiting, regurgitation, chronic purulent nasal discharge, and recurrent signs of respiratory infection. Radiographic examination revealed alveolar lung pattern and generalized megaesophagus at the thoracic and caudal cervical region. Additional examinations by computed tomography and virtual tracheoscopy revealed a large mass on the nasopharyngeal area that occupied about 90% of the tracheal lumen. With the aid of tracheostomy, the mass was removed with traction and sharp excision. According to histopathological findings the mass was diagnosed as nasopharyngeal polyp. A recheck examination performed a week later and the clinical manifestations of the megaesophagus were resolved and also three years later during a phone call, his owner reported he was doing well. To the best of the knowledge of the authors, megaesophagus following nasopharyngeal polyp is only reported in three other cats. [ABSTRACT FROM AUTHOR]

Purpose: This study was a modest beginning to determine dominance and entrainment between three soft tissues in the larynx that can be set into flow-induced oscillation and act as sound sources. The hypothesis was that they interact as coupled oscillators with observable bifurcations as energy is exchanged between them. Methodology: The true vocal folds, the ventricular (false) folds, and the aryepiglottic folds were part of a soft-walled airway that produced airflow for sound production. The methodology was computational, based on a simplified Navier--Stokes solution of convective and compressible airflow in a variable-geometry airway. Results: Three serially connected sources could all produce flow-induced selfoscillation with soft wall tissue and small cross-sectional area. When the glottal cross-sectional areas were similar, bifurcations such as subharmonics, delayed voice onset, and aphonia occurred in the coupled oscillations. Conclusions: Closely spaced sound sources in the larynx are highly interactive. They appear to entrain to the source that has the combined advantage of small cross-sectional glottal area and proximity to a downstream vocal tract that supports oscillation with acoustic inertance. [ABSTRACT FROM AUTHOR]

Background: This paper reports the innovative use of a modified nasopharyngeal airway device as a temporary stent in patients with laryngotracheal stenosis. It also discusses the technique of endoscopic stent placement, and our experience in terms of the indications and suitability. Method: The nasopharyngeal airway device was modified to use as an airway stent by trimming it to the desired length. Next, the stent was inserted endoscopically and anchored using a novel approach. Results: The surgery was performed successfully without complications. The patients had full use of their voice while the stent was in situ. No significant granulation tissue was observed. Conclusion: This paper demonstrates the feasibility of using a nasopharyngeal airway device as a temporary stent to prevent restenosis in cases where the patients have a strong demand for phonation. The modified nasopharyngeal airway device is potentially very promising, but cases must be selected carefully to avoid compromising efficacy and safety. [ABSTRACT FROM AUTHOR]

Objective: The main purpose of this study was to retrospectively evaluate the efficiency of DoctorVox voice therapy in psychogenic dysphonia or aphonia patients, and to share the mid- to long-term results of the method. Methods: The study was carried out on patients who underwent DoctorVox voice therapy for psychogenic dysphonia or aphonia between January 2015 and September 2019. The evaluation methods used were: the Voice Handicap Index-10; the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale; and videolaryngostroboscopy recordings. Results: The mean Voice Handicap Index-10 values of the patients were 30.91 ± 2.97 before treatment, 8.14 ± 3.82 after treatment, and 3.36 ± 1.78 in the final follow-up examination. The grade, roughness, breathiness, asthenia and strain scale scores were: 9 ± 0.67 pre-treatment, 0.78 ± 0.80 post-treatment, and 0.57 ± 0.64 at the final follow up. Conclusion: DoctorVox voice therapy seems to be an efficient treatment method for psychogenic dysphonia or aphonia; it helps develop phonatory muscle functions, using multidimensional biofeedback mechanisms, and increases the patients' therapy adherence. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article addresses the issue of voice changes during the COVID-19 pandemic in patients and convalescents and briefly presents information on voice disorders are their causes. According to the literature, voice changes (phonasthenia, dysphonia, and aphonia) are not uncommon in patients with coronavirus infection, although less common than the typical COVID-19 symptoms, and the incidence of voice change is proportional to the disease severity and can persist in convalescents. Therefore, it requires an additional emphasis on identifying the cause of this symptom and proper treatment/medical rehabilitation of such patients. In the context of treatment in patients with various voice disorders, both functional (phonasthenia) and organic (dysphonia/aphonia), Homeovox can be helpful since its effectiveness has also been proved in treating laryngitis associated with the new coronavirus infection.

Objective The aim of the study was to specify and collect important information on the anatomy of the laryngeal nerves and the types of paralysis, as well as paresis and fixation, which is not due to dysfunction of the recurrent laryngeal nerve, but is caused by immobility of the vocal fold as a result of a mechanical obstruction. We focused on the analysis of this condition in terms of clinical symptoms contributing to phoniatric disorders, including dysphonia in the majority of patients with palsy of the laryngeal nerves, as well as the occurrence of dysphagia in slightly more than 30% of people suffering from paralysis. Changes in the patient’s quality of life are significant enough to develop the subject in terms of presenting the possibilities of diagnosis, and to present the types of treatment of phoniatric dysfunctions, because an increasing number of patients decide to undergo surgical rehabilitation, including such surgical procedures as thyreoplasty,aimed at improving the quality of life of patients. Review Methods The focus was on finding the most up-to-date information from the world of science, both on the Internet and in printed literature. Searching Internet resources was carried out with the use of medical publication databases Embase and UpToDate. In addition, part of the bibliography was found on PubMed and PubMed Central. The exploration process was based on key words. A review of the literature was carried out using the basic terms: retrograde laryngeal nerve, in combination with the following entries: paralysis, aphonia, diagnosis, treatment. All the publications selected, with one exception about acute bilateral recurrent palsy of the laryngeal nerve, published in 1988, were published in the 21st century. Special emphasis was placed on presenting the most up-to-date knowledge possible, therefore the vast majority of the literature was published after 2014. Several items published in the current calendar year can be found in the bibliography. Clinical trials were also taken into account, paying particular attention to the number of patients tested, the selection of the research group, research methods and analysis of the results. Many of the online sources found did not meet the selected criteria, most often because the subject was incomplete or the results were reported from too small a group of patients. The criteria adopted while browsing the printed literature were primarily the year of publication and the thematic scope of the issues described.

Congenital laryngeal webs are rare and are defined as thick epithelium‐covered fibrous tissue lying between the vocal folds; the anterior glottis is the most common site of involvement, with possible extension to the subglottic region. The association with chromosome 22q11.2 deletion syndrome has also been reported. Symptoms have been abnormal or absent crying and airway obstruction since birth. Management strategies range from endoscopic division using cold instruments to open surgery for severe webbing. In endoscopic surgery, the need for tubeless anesthesia and spontaneous breathing is fundamental for obtaining the best surgical outcome. Here, we describe the case of a 4‐month‐old female patient affected by a type II glottic web according to Cohen, who was treated by simple endoscopic division in spontaneous breathing. [ABSTRACT FROM AUTHOR]

Laryngeal traumas in children are quite rare due to the anatomical features and properties of cartilaginous tissue. However, we cannot rule out possible damage to the larynx in case of impact injury in the neck area. The symptoms can develop later, several hours after the injury up to a life-threatening state.

A 33-year-old woman admitted to our hospital for further examination of severe non-productive cough lasting for about two months. Her symptom did not ameliorate by treatments including long acting β2 agonists. She had a medical history of drug allergy to non-steroidal anti-inflammatory drugs. At the initial visit, she could not speak at all and communicated with us in writing. Chest auscultation revealed no wheezes, rhonchi and other crackles. Laboratory findings showed a mild eosinophilia with normal total and specific serum immunoglobulin E. The results of an electrocardiogram, a chest X-ray and a chest CT were unremarkable. A fractional exhaled nitric oxide value was within normal limit. Based on these observations, a diagnosis of atopic cough (AC) was suspected, and we started treatment with a histamine H1 receptor antagonist (H1-RA). She had become able to speak again in association with complete disappearance of cough by eight-weeks after treatment initiation, and her symptoms did not recur even after cessation of treatment. By the confirmation of remarkable clinical improvement in response to a H1-RA, a diagnosis of AC was made. To the best of our knowledge, this is the first report of an AC patient who presented severe cough with aphonia. [ABSTRACT FROM AUTHOR]

Objective: Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes. Methods: Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. We distributed questions regarding the patient communication experience and relevant questions from the validated V-RQOL questionnaire (Voice-Related Quality of Life). Patients were offered a tablet with the electronic communication application Verbally. Pre- and postintervention groups were compared with chi-square analyses. Results: Surveys were completed by 35 patients (n = 18, preintervention; n = 17, postintervention). Prior to using augmentative technology, 89% of patients who were aphonic reported difficulty communicating, specifically noting breathing or suctioning (56%), treatment and discharge plans (78%), or immediate needs, such as pain and using the bathroom (39%). Communication difficulties caused anxiety (55%), depression (44%), or frustration (62%), and 92% of patients were interested in using an electronic communication device. Patients reported less trouble communicating after the intervention versus before (53% vs 89%, P =.03), including less difficulty communicating about treatment or discharge plans (35% vs 78%, P <.01). V-RQOL scores were unchanged. Discussion: Acute loss of phonation arising from surgery can be highly distressing for patients, and use of augmentative technology may alleviate some of these challenges by improving communication. Further studies are needed to identify what additional strategies may improve overall well-being. Implications for Practice: Electronic communication devices may benefit patients with acute aphonia. [ABSTRACT FROM AUTHOR]

Conversion disorder is featured by the presence of deficits affecting the motor and sensory functions without any organic basis. It excludes the symptoms fully explainable by a general medical condition, substance abuse or culturally sanctioned behaviour. It mimics a neurological disorder. Dissociative/conversion disorders affect nearly 31% of children and adolescents. These children experience pivotal impairments in their academics, and daily functioning. Incidence of psychiatric comorbidities such as anxiety and depression is high in these population. Pseudoseizures followed by motor symptoms were the common presentations of conversion disorder in adolescents in India. Few of the other symptoms are weakness, aphonia, gait disturbances, abnormal movements, loss of vision and severe pain. Hysteria was observed to be the commonest neurotic disorder in children. Conversion disorder is by far the commonest form of somatoform disorder found in children. Latest research proves neural correlates for persons with genetic susceptibility for conversion symptoms. Study by Kozlowska states that larger grey matter volume in the supplementary motor area, superior temporal gyrus, and dorsomedial prefrontal cortex reflects the genetic variability that predisposes the children to react to psychological stress with functional neurological symptoms. [ABSTRACT FROM AUTHOR]

Background: Suprastomal granulation tissue is a common complication of long-term tracheostomy. It may be associated with bleeding, aphonia, airway obstruction and delayed decannulation. Methods: This study describes the experience of a tertiary paediatric medical centre with CoblationTM-assisted suprastomal granulation tissue excision. Results: Thirteen children (mean age, 5.7 years) who underwent the procedure from 2013 to 2019 because of delayed decannulation or aphonia were included. Lumen obstruction ranged from 50 to 90 per cent, with a mean of 68.8 per cent. After the procedure, decannulation was successfully performed in 7 patients, and voice quality improved in 10 patients. There were no peri- or post-operative complications. Conclusion: This is the largest series to date that describes Coblation used for the treatment of suprastomal granuloma. Coblation has advantages of high precision, relatively low temperature (thereby avoiding thermal injury to adjacent tissue), haemostatic resection and feasibility for use for even large granulomas. The promising results should prompt further studies in larger samples. [ABSTRACT FROM AUTHOR]

Tracheoesophageal voice puncture and prosthesis (TEP) is a common method of voice restoration following total laryngectomy. A variety of complications, both minor and major, can be associated with the TEP and require timely intervention/management. Some of those complications include premature leakage, periprosthetic leakage, granulation tissue growth, TEP dislodgement, or embedding of the TEP. Patients may present with problems and/or complications with the voice prosthesis in an emergency setting or after clinic hours when a trained speech pathologist is not present or readily available for evaluation and management. This manuscript aims to provide guidance for management of acute TEP complications to otolaryngology responders, especially those who may be less familiar with TEP troubleshooting.Experiential and literature review was undertaken by a group of head and neck specialized Speech Language Professionals in high volume Head & Neck Oncology practices, to develop consensus guidelines for emergency TEP management.TEP emergencies were categorized as (1) leakage through, (2) leakage around, (3) sudden loss of voicing, (4) loss of prosthesis, still in tract, (5) loss of prosthesis, not in tract. Management strategies for each form of emergency were developed to achieve patient safety and stability until definitive measures could be performed by the patient’s Speech Language Professional.The goals of emergency management of TEP problems focused on minimizing risk of aspiration pneumonia, risk of foreign body aspiration, risk of wound complications at the puncture site. A simple management algorithm was developed for emergency or on-call otolaryngology responders. [ABSTRACT FROM AUTHOR]

Background: Inferior alveolar nerve block (IANB) is frequently applied in mandibular dental procedures. Neurological complications develop very rarely due to IANB, and most of the complications are temporary. Case Presentation: We present a 79-year-old man with partial Horner's syndrome, hyperlacrimation, aphonia, dysphagia, severe cough, and foreign body sensation in the throat after IANB. All symptoms disappeared 3 hours after local anesthetic injection. Conclusion: It was aimed to investigate the underlying pathophysiological causes of complications together with clinical and anatomical data. Neuronal blockade of the carotid plexus, nervus laryngeus superior and inferior can develop after IANB. In addition, it is critical to accurately determine the IANB injection site in obese and thick-short neck patients. [ABSTRACT FROM AUTHOR]

Objective. The aim of the study was to specify and collect important information on the anatomy of the laryngeal nerves and the types of paralysis, as well as paresis and fixation, which is not due to dysfunction of the recurrent laryngeal nerve, but is caused by immobility of the vocal fold as a result of a mechanical obstruction. We focused on the analysis of this condition in terms of clinical symptoms contributing to phoniatric disorders, including dysphonia in the majority of patients with palsy of the laryngeal nerves, as well as the occurrence of dysphagia in slightly more than 30% of people suffering from paralysis. Changes in the patient's quality of life are significant enough to develop the subject in terms of presenting the possibilities of diagnosis, and to present the types of treatment of phoniatric dysfunctions, because an increasing number of patients decide to undergo surgical rehabilitation, including such surgical procedures as thyreoplasty, aimed at improving the quality of life of patients. Review Methods. The focus was on finding the most up-to-date information from the world of science, both on the Internet and in printed literature. Searching Internet resources was carried out with the use of medical publication databases Embase and UpToDate. In addition, part of the bibliography was found on PubMed and PubMed Central. The exploration process was based on key words. A review of the literature was carried out using the basic terms: retrograde laryngeal nerve, in combination with the following entries: paralysis, aphonia, diagnosis, treatment. All the publications selected, with one exception about acute bilateral recurrent palsy of the laryngeal nerve, published in 1988, were published in the 21st century. Special emphasis was placed on presenting the most up-to-date knowledge possible, therefore the vast majority of the literature was published after 2014. Several items published in the current calendar year can be found in the bibliography. Clinical trials were also taken into account, paying particular attention to the number of patients tested, the selection of the research group, research methods and analysis of the results. Many of the online sources found did not meet the selected criteria, most often because the subject was incomplete or the results were reported from too small a group of patients. The criteria adopted while browsing the printed literature were primarily the year of publication and the thematic scope of the issues described. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Information Technologies & Communications / Revista de Tecnologías de la Información & Comunicaciones is the property of ECORFAN-Mexico S.C. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The poem "The Mute's Lament" by John Carlin is presented. First Line: I move--a silent exile on this earth; Last Line: And happy with the angels sing forever!

Cells in the maculae flavae (MFe) are inferred to be involved in the metabolism of extracellular matrices of the human vocal fold mucosa. The latest research has supported the hypothesis that the tension caused by phonation (vocal fold vibration) regulates the behavior of these cells in the MFe of the human vocal fold. Tensile and compressive strains have direct effects on cell morphology and structure including changes in cytoskeletal structure and organization. Cytoskeletons are one of the structures which play a role as mechanoreceptors for the cells. The microstructure of the intermediate filaments and the expression of their proteins were investigated regarding the cells in the MFe of the human vocal fold unphonated over a decade. The adult vocal fold mucosa of a 64-year-old male with cerebral hemorrhage unphonated for 11 years was investigated by immunohistochemistry and electron microscopy. The intermediate filaments in the cytoplasm of the cells had become fewer in number. And the expression of their characteristic proteins (vimentin, desmin, GFAP) was also reduced. The results of this study are consistent with the hypothesis that mechanotransduction caused by vocal fold vibration could possibly be a factor in regulating the function and fate of the cells in the MFe. [ABSTRACT FROM AUTHOR]

Foreign accent syndrome (FAS) has historically been attributed to a neurological etiology. However, recent research has identified psychogenic causes of FAS, where patients present to health care services with medically unexplained FAS symptomology. Due to the rare nature of psychogenic FAS, there is currently no evidence-based psychological treatment for this syndrome. Although patients with psychogenic FAS do not meet the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) or the International Classification of Diseases (ICD)-10 diagnostic criteria for a diagnosis of somatization disorder, there are some similarities in presentation between psychogenic FAS and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for somatic symptom disorder (SSD). These include the presence of distressing and disruptive symptoms that result in increased health care utilization. Given the emerging evidence for cognitive behavioral therapy (CBT) for SSDs, it is arguable that CBT could help patients with psychogenic FAS to manage the psychological distress they experience. This paper aims to explore the use of CBT in reducing the psychological distress of a patient with no organic explanation for FAS using a single-case (A-B) experimental design. The results suggest that CBT was effective in reducing distress, as measured using the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM). This paper highlights the value in using an individualized formulation-driven CBT approach for presentations that do not yet have evidence-based guidelines. In this case, cognitive restructuring, activity scheduling, and stress management appear to be key mechanisms of change in reducing psychological distress associated with FAS. [ABSTRACT FROM AUTHOR]

Prior studies have evaluated various populations at increased risk of voice impairment. However, minimal data is available for military Drill Instructors, a population known to have significant vocal demands. The purpose of this study was to determine the prevalence of subjective, perceptual, and objective dysphonia in this population and to evaluate contributing factors and impact on job performance. Cross-sectional analysis. United States Marine Corps base (Marine Corps Recruit Depot, San Diego, California). Active US Marine Corps Drill Instructors. A survey was administered investigating subjective measures of dysphonia and its impact on occupational function. Standardized voice samples were recorded for objective and perceptual voice analysis. Prevalence of subjective (Voice Handicap Index-10 and Glottal Function Index scores), perceptual (CAPE-V score), and acoustic (Cepstral-spectral index of dysphonia) measures of dysphonia. Subjective dysphonia was present in 47.7% by the Voice Handicap Index-10 and 70.2% by the Glottal Function Index. 51% of subjects reported periods of aphonia, while 47% reported voice problems limiting job function in the month prior to being surveyed. The Cepstral-Spectral Index of Dysphonia Mean was abnormal in 95.3% and CAPE-V overall severity score was abnormal in 94%. There was significant improvement in subjective, perceptual, and acoustic voice outcomes as the amount of time since last training cycle (ie, relative voice rest) and as experience as a Drill Instructor increased, however the VHI-10 was the only measure that normalized. There is a very high prevalence of self-reported dysphonia in Drill Instructors, with near-universal prevalence of some degree of objectively and perceptually-rated dysphonia. Nearly half of those surveyed reported that dysphonia limited their job performance. Relative voice rest and experience seem to mitigate severity, but normal ratings were rare. While objective and perceptually-rated dysphonia are persistent and highly prevalent, it does not necessarily translate into a perceived impairment in this population. For these reasons and considering the importance of extraordinary vocal function in this occupation, Drill Instructors appear to be in dire need of proper voice care to both maximize job performance and mitigate long-term voice-related problems. [ABSTRACT FROM AUTHOR]

Even though the absence of the body prevents sure conclusions, the death of Alexander the Great remains a hot topic of retrospective diagnosis. Due to the serious mishandling of ancient sources, the scientific literature had Alexander dying of every possible natural cause. In previous works, the hypothesis that typhoid fever killed Alexander was proposed, based on the presence of the remittent fever typical of this disease in the narrations of Plutarch and Arrian. Here we provide additional evidence for the presence of stupor, the second distinctive symptom of typhoid fever. In fact, based on the authority of Caelius Aurelianus and Galen, we demonstrate that the word ἄφωνος, used to describe the last moments of Alexander, is a technical word of the lexicon of the pathology of Hippocrates. Used by him, the word defines a group of diseases sharing a serious depression of consciousness and motility. The association of stupor with the remittent fever strengthens the typhoid fever hypothesis. [ABSTRACT FROM AUTHOR]

This case study describes the experience of a woman in her late 40s with chronic recurrent episodes of dysphonia. The patient reported that the purchase and use of a robot vacuum resulted in a significant decrease in the levels of dust in her home, particularly in locations she found difficult to clean thoroughly with a conventional vacuum (e.g., under the bed). She observed a concomitant decrease in a previously established pattern of work-related dysphonia, reporting fewer days of atypical voice quality and no episodes of aphonia across a one-year period. For patients whose dysphonia is exacerbated by environmental allergens, use of a robot vacuum is an automated, relatively inexpensive strategy to consider as a possible adjunct to more conventional approaches. [ABSTRACT FROM AUTHOR]

We describe an unusual case of post‐operative conversion aphonia in a pediatric patient. It indicates the importance of discussing its presentation, and amplifies the need for emotional support in the immediate post‐operative period for young patients with heightened anxiety. Laryngoscope, 133:1737–1738, 2023 [ABSTRACT FROM AUTHOR]

Background: According to the literature, the rate of laryngeal paralysis after thyroid surgery is as high as several percent. For oncological operations the rate can reach 20%. The return of laryngeal function depends on the degree of nerve damage. Surgical procedures are required to increase the likelihood of nerve function recovery. Three methods of phonosurgery are currently used. The first is based on injecting auto or alloplastic materials into the vocal fold. The second interferes with the skeleton of the laryngeal cartilages; according to the Isshiki classification, it includes type I thyreoplasty (medialisation thyreoplasty), optionally with complementary arytenoid adduction. The third method reconstructs the laryngeal nerves. Combinations of the three methods are increasingly used. Conservative treatment including phoniatric voice rehabilitation should be started as early as possible. Case report: The paper presents a case report of a patient after thyroid surgery due to papillary carcinoma, complicated by bilateral laryngeal paralysis and aphonia. Conclusions: Functional Voice Therapy started just after healing of the postoperative wound in the neck eliminated abnormal compensatory mechanisms of phonation. Reconstruction of the laryngeal nerves is an opportunity to quickly return laryngeal function and prevents unwanted secondary functional mechanisms within the vocal organ. [ABSTRACT FROM AUTHOR]

The source of the human voice is obscured from view. The development of the laryngoscope in the late 1850s provided the potential to see the action of the vocal folds during speaking for the first time. This new instrument materially contributed to the understanding of vocal fold neuroanatomy, neurophysiology, and neuropathology. The laryngoscope led to elaborated understanding of disorders that previously were determined by changes in sound. The objective of this paper is to detail the consequences of this novel visualization of the larynx, and to trace how it aided in the development of understanding of the movements of the vocal folds. This is demonstrated through an examination of the activities and practices of a group of London clinicians in the second half of the nineteenth century. [ABSTRACT FROM AUTHOR]

Résumé L'auteur présente une revue de la littérature sur la laryngite allergique, qui est une pathologie encore trop sous-diagnostiquée à ce jour. L'insuffisance de diagnostic peut être liée, soit à la complexité des symptômes, soit aux plaintes trop peu importantes par rapport au reste du tableau clinique ou liée à la méconnaissance de la pathologie. Les symptômes du patient qui peuvent consister entre autres en une dysphonie ou aphonie sont, cependant, très gênants dans un contexte social où la communication prend beaucoup d'importance. L'allergologue, l'ORL et le phoniatre pourront enfin collaborer ensemble afin d'optimaliser le diagnostic. Abstract The author presents a review of the literature concerning allergic laryngitis. This condition continues to be underdiagnosed today. The inadequacy of diagnosis may be due to the complexity of symptoms or to patient complaints that seem trivial against the overall clinical picture, or to poor knowledge of the disease. The patient's symptoms, which may include dysphonia or aphonia, are nevertheless very troublesome in social contexts where communication is very important. Ultimately, allergists, ENT specialists and phoniatricians may work together to ensure optimal diagnosis. [ABSTRACT FROM AUTHOR]

The current study explores whether Mandarin initial and medial voiceless unaspirated and voiceless aspirated stops differ in their tongue positions and post-vocalic voicing during closure. Ultrasound tongue imaging and acoustic data from five Mandarin speakers revealed (1) no consistent pattern for tongue positions among speakers, and (2) no difference in degree of voicing during closure between the two stop series. These findings suggest that tongue position is not a reliable articulatory correlate for Mandarin laryngeal contrasts. This further suggests that aspiration is not correlated with tongue position differences, unlike the reported correlation between voicing and tongue root advancement., (© 2024 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).)

Isolated thyroid rupture and hematoma are rare following blunt neck injury and can lead to airway compromise and the need for emergency management. We report a 23-year-old male patient who presented with neck swelling and aphonia following a road traffic accident. Contrast-enhanced CT scan showed laceration and hematoma involving left thyroid lobe. The patient underwent left hemithyroidectomy and accomplished complete recovery. A high index of suspicion for thyroid rupture must be maintained when patients presented with voice changes or respiratory distress. [ABSTRACT FROM AUTHOR]

Purpose. To determine the main voice disorders of humanitarian departments' teachers, their reasons and effective methods to keep the voice in a health condition. Material. In the research participated 142 teachers of H. S. Skovoroda Kharkiv National Pedagogical University and National Aerospace University - "Kharkiv Aviation Institute" (n=106 women, n=36 men). The study involved auditory assessment of teachers' voice and questionnaire in order to determine teachers' professional voice problems and factors influenced on the status and quality of the voice. Results. It was determine the maximum phonation time for participants of genders, the voice disorders frequency, typical problems with teachers' voice, the positive and negative factors affecting the voice system condition. Also participants answered the questionnaire's questions about voice using. Conclusions. The study showed that teachers take their voice for granted and do not always care about it; use their voice in an unhealthy condition and they are not always aware of the negative consequences for their health. [ABSTRACT FROM AUTHOR]

Jane Campion's work regularly revolves around women's often complex relationship with socio-cultural discourses and their articulation in language, whether in familial and institutional structures or in cultural and creative practice. In this sense, Campion's filmmaking continues a feminist tradition of exploration regarding female subjectivity, identity and desire as it is represented in language (cinematic or otherwise). In the Cut (2003), adapted from Susanna Moore's novel of the same name, again places language and the (dis)articulation of the female voice at its heart: the renewal of which is positioned within the film as crucial to women's survival. In taking its cue from Hélène Cixous's 'The Laugh of the Medusa' (1976) and later writings such as 'Castration or Decapitation?' (1981) and 'Coming to Writing' (1991), this article frames its discussion of Campion's interrogation of 'Woman's' attempts at the articulation of the self as an exemplar (in both theme and form) of Cixousian strategies. The article will argue that techniques such as a cinematic écriture feminine, and the appropriation and adaptation of the language of Hollywood genre film, form part of Campion's feminist inquiry into the discourses and legacies of a phallogocentric patriarchal culture which traditionally delimit Woman as a 'speaking' subject. In this way, In the Cut exposes the tensions between what Cixous calls the 'Absolute Woman' of culture (the aphonic hysteric) and attempts towards agency, thus challenging phallogocentric representations of women. In using these strategies, Campion's adaptation creates a polyphonic artefact which not only revises Moore's novel but also re-visits (in order to reclaim) female articulation; re-writing phallogocentric claims to agency and subjectivity, imagining women's 'survival' through language. In this sense, then, adaptation itself can be thought of as a feminist act of subversion. [ABSTRACT FROM AUTHOR]

Background: There are 215 families of plants that contain insoluble needle-shaped calcium oxalate crystals on the surface of their tissues. Upon mucosal contact, injury can cause extreme pain, soft-tissue swelling, salivation, dysphagia, and even aphonia. This presentation can resemble angioedema or anaphylaxis.Case Report: A 55-year-old Asian female presented to the emergency department complaining of oral pain, swelling, and numbness. Her family reported that she began to experience sharp pain of the tongue and lips immediately after eating "elephant root." Physical examination revealed a patient sitting in an upright position, leaning forward with pooling secretions. She had few lingual petechiae, a subtle diffuse erythema, and mild edema of the lower lip. Due to pain, she was unable to speak and swallow. Her vitals remained within normal limits. The patient was taking lisinopril for hypertension. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Injury by calcium oxalate crystals is a relatively common occurrence that will present to the emergency department. Although most exposures are benign, patients can develop critical illness, requiring emergent therapies and airway management. Due to the nature of presentation, exposure can easily be misdiagnosed as anaphylaxis or hereditary and drug-induced angioedema. Severe pain and the temporal relationship to plant ingestion distinguish insoluble calcium oxalate crystal exposure from these alternative causes of angioedema. There is minimal evidence-based data evaluating treatment of these injuries. Standard treatment regimen includes a local anesthetic, corticosteroids, opioids, and antihistaminergic agents. Given the relative low cost, ease of administration, and benign adverse effect profile, sodium bicarbonate rinse may have a role as an adjunct therapy, however, research is needed. [ABSTRACT FROM AUTHOR]

Background: Voice disorder is now considered a 'public health concern'. Epidemiological studies of yesteryears performed in the West disseminate the importance of prevention and early identification of the change in voice. In India 'Vocology' or study of voice production is slowly emerging with specific attention to vocal health and voice care. Aim of the study: The present study implemented a retrospective observational design to identify prevalence of voice disorders in a tertiary care hospital. Method: The Diagnostic register of Department of Audiology and Speech-Language Pathology of a semi-urban hospital was accessed from January 1st 2007 till January 31st 2018. Patients diagnosed with a voice disorder, in-isolation and/or in conjunction to a medical condition, were tabulated. The data was tallied under the following categories: type of voice disorder; nature of voice disorder; age of onset; gender and perceptual features. Results: Results of the study suggested 21.4% prevalence of voice disorder. In addition the study also noted maximum prevalence of vocal nodule; adult male subjects exhibited a higher rate of vocal fold pathology and increased prevalence of perceptually hoarse voice. Conclusion: The data from the study accounts voice problems to be on higher side with vocal fold hyper-function disorder topping the chart. [ABSTRACT FROM AUTHOR]