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Introduction: Electromyography (EMG) of the larynx provides information on the electrophysiological condition of laryngeal muscles and innervation. Integration of information obtained from the EMG exams with the clinical parameters as obtained by other methods for laryngeal assessment (endoscopy, perceptual and acoustic analysis, voice self-assessment) provides a multidimensional picture of dysphonia, which is of particular importance in patients with vocal fold (VF) mobility disorders accompanied by glottic insufficiency. Aim: The aim of this study was to evaluate laryngeal EMG records acquired in subjects with unilateral vocal fold immobilization with signs of atrophy and glottic insufficiency. Material and methods: From the available material of 74 EMG records of patients referred for the exam due to unilateral laryngeal paralysis, records of 17 patients with endoscopic features suggestive of complete laryngeal muscle denervation were selected. The EMG study of thyroarytenoid muscles of mobile and immobile VFs was evaluated qualitatively and quantitatively at rest and during volitional activity involving free phonation of vowel /e/ [ε]. Results: In all patients, the EMG records from mobile VFs were significantly different from those from immobile VFs. Despite endoscopic features of paralysis, no VF activity whatsoever was observed in as few as 2 patients so as to meet the neurophysiological definition of paralysis. In 88% of cases, electromyographic activity of the thyroarytenoid muscle was observed despite immobilization and atrophy of the vocal fold. In these patients, neurogenic type of record was observed with numerous high--amplitude mobility units. On the basis of the results, quantitative features of EMG records indicative of paralysis and residual activity of the thyroarytenoid muscle were determined. Conclusions: Qualitative and quantitative analysis of laryngeal EMG records provides detailed information on the condition of vocal fold muscles and innervation. EMG records of mobile vs immobile VFs differ significantly from each other. Endoscopic evaluation does not provide sufficient basis for the diagnosis of complete laryngeal muscle denervation. [ABSTRACT FROM AUTHOR]

Introduction: Patient-reported outcome measures have been used within the otorhinolaryngologic disorders' field for many years to compare patient's perception of the severity of symptoms and the effectiveness of a therapeutic approach. Questionnaires that evaluate dysphagia are relatively complex instruments aimed mostly at patients with neurological or malignant diseases. The ICD-10 classification specifies only one broad term - dysphagia (R13). Introduction of Muscle Tension Dysphagia (MTDg) in 2016 by Kang completed the spectrum of the nomenclature. This dysphagia type is defined as a type of laryngeal muscle tension disorder manifesting primarily as swallowing difficulty with or without any accompanying organic cause, laryngeal hyperresponsiveness and/or nonspecific laryngeal inflammation. Aim: Since there were no clear diagnostic and therapeutic perspectives on the group of patients with MTDg, the aim of this work was to analyse selected diagnostic tools used for the evaluation of swallowing disorders in the context of finding the most suitable tools for patients with Muscle Tension Dysphagia. Material and method: The material of the work included 61 patients. Each patient underwent otolaryngologic, phoniatric and speech therapist's examination, Functional Endoscopic Evaluation of Swallowing (FEES) and filled out questionnaires concerning dysphonia and dysphagia symptoms. Results: The results of the work showed that patients with MTDg were characterised by correct results of FEES examination, prolonged swallowing, features of inappropriate mucous and oropharyngeal muscle function. Conclusions: The Swallowing Disorder Scale (SDS), developed by the authors, correlated best with the cause of dysphagia. The questionnaire corresponded well with the degree of severity. In the diagnostic process of MTDg one of the key tasks is the differentiation with patients with non-normative swallowing patterns. Apart from specialistic consultations with otolaryngologist and speech therapist, while diagnosing MTDg we recommend using objective (FEES, videofluroscopy, SEMG) and subjective (SDS, DHI, EAT-10 surveys) assessment tools. In our opinion, the inclusion of questionnaires to detect reflux syndromes is also important in the causal treatment of ailments. [ABSTRACT FROM AUTHOR]

Introduction: Coexistence of dysphagia with voice disorders is a topic rarely raised in the literature. Particular attention is paid to the aspect of dysfunction of laryngeal and pharyngeal muscles. Aim: The aim of the study was to analyse cases of patients with dysphonia in relation to coexistence of swallowing disorder. Material and method: The material of the study included 515 patients hospitalised due to dysphonia in 2018. Patients whose interview indicated swallowing difficulties were subjected to additional diagnosis for dysphagia (FEES, extended speech therapy test, SEMG). R esults: 11.8% of people requiring treatment for voice disorders reported coexistence of swallowing difficulties. Dysphagia was diagnosed in 9.3%. The percentage of respondents diagnosed with swallowing disorder differed depending on the type of underlying disease and was the highest in the group with neurological disorders. Analysis of the correlation between the severity of dysphagia (according to the assessed grade, DHI, EAT-10 results) and the severity of VHI showed a weak correlation between VHI and EAT-10 (p = 0.1), statistically significant correlations (p < 0,05) between the value of VHI and RSI in people with diagnosed neurological disease, between the value of VHI and DHI in people with hyperfunctional dysphonia and the value of VHI and BMI and EAT-10 in people with chronic laryngitis. Moreover, statistically significant correlations were found between the severity of dysphagia and EAT-10 and DHI (p < 0.05). The speech therapy test indicated the co-existing problem of non-normative swallowing pattern. The electromyographic study showed the largest asymmetries in recording the average and maximum amplitude from masseters. C onclusions: Treatment of patients with voice disorders requires interdisciplinary care. A history of dysphagia in these patients should complement the medical history of voice disorders. The characteristics of swallowing disorders vary depending on the cause of the voice disorder and their co-occurrence affects on average 9.3% of patients. Coexistence of muscle tension dysphagia with voice disorder requires separate diagnostic protocol. Logopaedic procedure ought to be a key element in the interdisciplinary care of patients suffering from muscle tension dysphagia. [ABSTRACT FROM AUTHOR]

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Introduction: The diagnostic procedure of phonation is dominated by subjective assessment tools. It seems reasonable to seek methods of quantitative glottal cycle assessment. Objective: The aim of our study was the analysis of open quotients (OQ) of the glottis. Methods: One hundred and twenty-four people were included in the study. Methodology was based on tools available in everyday phoniatrics practice – laryngovideostroboscopy (LVS) and electroglottography (EGG). There were statistically significant differences between control and studied group. Vocal fold polyps, nodules and edema influence glottal function in a different manner, what can be illustrated by objective glottal function parameters. Establishing Videostroboscopic Open Quotient values from three parts of glottis and Electroglottographic Quasi Open Quotient (QOQ) value, can help in dividing patients with benign lesions of vocal folds according to the type of disease. Results and conclusions: Measurement of the open quotient from three parts of the glottis helps to differentially diagnose and localize glottal vocal fold lesions. Videostroboscopic Open Quotient and Electroglottographic QOQ values can be used to quantify the glottal cycle. Videostroboscopic Open Quotient, Electroglottographic QOQ and their ratio varies depending on the type of organic dysphonia. [ABSTRACT FROM AUTHOR]

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Electromyography (EMG) of the larynx provides information on the electrophysiological condition of laryngeal muscles and innervation. Integration of information obtained from the EMG exams with the clinical parameters as obtained by other methods for laryngeal assessment (endoscopy, perceptual and acoustic analysis, voice self-assessment) provides a multidimensional picture of dysphonia, which is of particular importance in patients with vocal fold (VF) mobility disorders accompanied by glottic insufficiency.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to evaluate laryngeal EMG records acquired in subjects with unilateral vocal fold immobilization with signs of atrophy and glottic insufficiency.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Material and methods:&lt;/b&gt; From the available material of 74 EMG records of patients referred for the exam due to unilateral laryngeal paralysis, records of 17 patients with endoscopic features suggestive of complete laryngeal muscle denervation were selected. The EMG study of thyroarytenoid muscles of mobile and immobile VFs was evaluated qualitatively and quantitatively at rest and during volitional activity involving free phonation of vowel /e/ [ε].&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; In all patients, the EMG records from mobile VFs were significantly different from those from immobile VFs. Despite endoscopic features of paralysis, no VF activity whatsoever was observed in as few as 2 patients so as to meet the neurophysiological definition of paralysis. In 88% of cases, electromyographic activity of the thyroarytenoid muscle was observed despite immobilization and atrophy of the vocal fold. In these patients, neurogenic type of record was observed with numerous high- -amplitude mobility units. On the basis of the results, quantitative features of EMG records indicative of paralysis and residual activity of the thyroarytenoid muscle were determined.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; Qualitative and quantitative analysis of laryngeal EMG records provides detailed information on the condition of vocal fold muscles and innervation. EMG records of mobile vs immobile VFs differ significantly from each other. Endoscopic evaluation does not provide sufficient basis for the diagnosis of complete laryngeal muscle denervation.&lt;/br&gt.

The vocal folds play a key role in the process of phonation. Cyclical movements of the vocal folds model a space called glottis, what leads to voice formation. The space contains surface between the vocal folds and the inner surface of the arytenoid cartilages. The best indicator of the vocal folds vibratory function is the mucosal wave. The presence and size of the mucosal wave is widely recognized as an indicator of tension and plasticity of vocal folds. It is also essential in the process of creating a proper, resonant voice. In the article, current knowledge of mucosal wave imaging techniques is given. Imaging can be carried out directly and indirectly. Among the direct methods, the following are distinguished: laryngostroboscopy, laryngovideostroboscopy, videokymography and high-speed digital imaging. Indirect methods include: electroglottography, photoglottography and ultrasonography., (© 2016 MEDPRESS.)

Background: Voice disorders resulting from glottic insufficiency are a significant clinical problem in everyday phoniatric practice. One method of treatment is injection laryngoplasty. Our study aimed to assess the voice quality of patients treated with hyaluronic acid injection into the vocal fold., Material and Methods: We studied 25 patients suffering from dysphonia, conducting laryngological and phoniatric examination, including videostroboscopy and acoustic voice analysis, before the operation and 1, 3, and 6 months later., Results: In all cases there was complete or almost complete glottic closure after the operation. One month after the procedure, videostroboscopic examination revealed reappearance of vocal fold vibration in 8 cases; after 3 months this had risen to 15 cases. Perceptual voice quality (as assessed by the GRBAS scale) in patients with glottic insufficiency was improved. The most significant improvement was obtained 1 month after surgery (p=0.0002), and within the next months further statistically significant improvements (p=0.000002) were noted. Multidimensional voice analysis showed statistically significant and rapid improvement in frequency parameters, especially vFo. Other parameters were also improved 3 and 6 months after surgery., Conclusions: Injection of hyaluronic acid into the vocal fold improves phonatory functions of the larynx and the quality of voice in patients with glottic insufficiency. It may be a safe and conservative method for treatment of voice disorders. Hyaluronic acid injection to the vocal fold is an easy, effective, and fast method for restoration of good voice quality.

Introduction: Thanks to videostrobokymography the vocal fold vibration from particular area of glottal chink, can be assessed in an objective way., Aim: Evaluation of objective parameters of vocal fold vibration with the usage of videostrobokymography in patients with different voice disorders., Material and Methods: Material of the study included patients treated in the Institute of Physiology and Pathology of Hearing, Audiology and Phoniatrics Clinic. 82 patients with normal voices, vocal fold nodules, polyps, Reinke edema, vocal cord paralysis and functional dysphonia were enrolled into the study. Open Quotient (OQ) from frontal, middle and dorsal third of vocal folds were measured. T-Student test was used for statistical analysis., Results: The study revealed differences of OQ in control group and patients with organic or functional dysphonia. Differences in parameters were calculated for each vocal fold region. The mean value of OQ in control group was 0.56 (frontal third), 0.55 (middle third), 0.597 (dorsal third). Statistical significant differences of OQ calculated from separate glottal chink areas, were observed in Reinke edema (from frontal and middle third) and vocal cord paralysis (from frontal third)., Conclusions: Videostrobokymography is an useful complement to classical stroboscopy. Objective parameters enables the objectification of vibratory activities. Videostrobokymography is helpful in differential diagnosis of voice disorders., (Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: Asthma treatment requires control and monitoring. According to Global Initiative For Asthma (GINA) asthma severity is described by degree of control. The aim of the present study was to compare self-patients' opinions about asthma control with Asthma Control Test (ACT) scores. Furthermore factors associated with asthma control were analyzed in the examined group of patients. Age, BMI, the length and the degree of asthma treatment, concomitant diseases, physical activity, exposition to the tobacco smoke, needs for education and self-control were assessed., Material and Methods: The study was based on a 36-point questionnaire that evaluated last two years of asthma duration, the reference data were obtained by objective evaluation with ACT. Fifty three patients, 37 women and 16 men, median age 54 years (24-80 years), from outpatients clinic were enrolled into the study. According to ACT score the patients (pts) were divided into 3 groups: 25 points - well controlled asthma (group 1), 20-24 points - partially controlled asthma (group 2) and less than 20 points - lack of asthma control (group 3). Kruskal-Wallis test and Chi-square test were used to compare the characteristics of subjects in different ACT groups. Pearson's test was used for assessment of correlation between different parameters., Results: Twenty seven of 53 pts (51%) were treated with low dose of inhaled steroids and long acting beta-agonists (third degree of treatment according to GINA). During last two years the treatment was intensified in 37 pts (70%) due to exacerbation, and 19 of them (36%) were hospitalized in the course of exacerbation. Although 36 out of 53 pts (68%) claimed their asthma was fully controlled, ACT showed full control only in 5/53 (9%) of cases, partial control in 18/53 (34%), lack of control - in 30/53 (57%). Older age (p 〈 0.05) and longer duration of the disease (p 〈 0.01) were the factors significantly influencing lack of asthma control. A tendency towards worse asthma control was combined also with overweight and greater number of concomitant diseases (mainly coronary artery disease, diabetes and gastro-esophageal reflux). The presence of influenza vaccinations in medical history was associated with better asthma control (p = 0.05)., Conclusions: A discrepancy between subjective assessment of asthma control and ACT score was observed in the examined group of patients. The frequency of asthma exacerbations (according to questionnaire) was describing the degree of asthma control more precisely than self-assessment. Older age and longer disease duration were combined with significantly worse asthma control. Better asthma control was combined with the presence of influenza vaccinations in medical history.