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Ferri-Angulo D, Yousefi-Mashouf H, Michel M, McLeer A, Orgéas L, Bailly L, Sohier J. Versatile fiber-reinforced hydrogels to mimic the microstructure and mechanics of human vocal-fold upper layers. Acta Biomater 2023; 172:92-105. [PMID: 37748548 DOI: 10.1016/j.actbio.2023.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
Human vocal folds are remarkable soft laryngeal structures that enable phonation due to their unique vibro-mechanical performances. These properties are tied to their specific fibrous architecture, especially in the upper layers, which comprise a gel-like composite called lamina propria. The lamina propria can withstand large and reversible deformations under various multiaxial loadings. Despite their importance, the relationships between the microstructure of vocal folds and their resulting macroscopic properties remain poorly understood. There is a need for versatile models that encompass their structural complexity while mimicking their mechanical features. In this study, we present a candidate model inspired by histological measurements of the upper layers of human vocal folds. Bi-photonic observations were used to quantify the distribution, orientation, width, and volume fraction of collagen and elastin fibers between histological layers. Using established biomaterials, polymer fiber-reinforced hydrogels were developed to replicate the fibrillar network and ground substance of native vocal fold tissue. To achieve this, jet-sprayed poly(ε-caprolactone) fibrillar mats were successfully impregnated with poly(L-lysine) dendrimers/polyethylene glycol hydrogels. The resulting composites exhibited versatile structural, physical and mechanical properties that could be customized through variations in the chemical formulation of their hydrogel matrix, the microstructural architecture of their fibrous networks (i.e., fiber diameter, orientation and volume fraction) and their assembly process. By mimicking the collagen network of the lamina propria with polymer fibers and the elastin/ground substance with the hydrogel composition, we successfully replicated the non-linear, anisotropic, and viscoelastic mechanical behavior of the vocal-fold upper layers, accounting for inter/intra-individual variations. The development of this mimetic model offers promising avenues for a better understanding of the complex mechanisms involved in voice production. STATEMENT OF SIGNIFICANCE: Human vocal folds are outstanding vibrating soft living tissues allowing phonation. Simple physical models that take into account the histological structure of the vocal fold and recapitulate its mechanical features are scarce. As a result, the relations between tissue components, organisation and vibro-mechanical performances still remain an open question. We describe here the development and the characterization of fiber-reinforced hydrogels inspired from the vocal-fold microstructure. These systems are able to reproduce the mechanics of vocal-fold tissues upon realistic cyclic and large strains under various multi-axial loadings, thus providing a mimetic model to further understand the impact of the fibrous network microstructure in phonation.
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Affiliation(s)
- Daniel Ferri-Angulo
- MATEIS, CNRS, Université de Lyon, INSA de Lyon, Université Claude Bernard Lyon 1, UMR5510, 69100 Villeurbanne, France
| | - Hamid Yousefi-Mashouf
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, 38000 Grenoble, France; Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, 38000 Grenoble, France
| | - Margot Michel
- Laboratory of Tissue Biology and Therapeutic Engineering, CNRS, University of Lyon, Claude Bernard University Lyon 1, UMR5305 LBTI, 69007 Lyon, France
| | - Anne McLeer
- Univ. Grenoble Alpes, CHU Grenoble Alpes, INSERM U1209, CNRS UMR5309, Institute for Advanced Biosciences, 38000 Grenoble, France
| | - Laurent Orgéas
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, 38000 Grenoble, France
| | - Lucie Bailly
- Univ. Grenoble Alpes, CNRS, Grenoble INP, 3SR, 38000 Grenoble, France
| | - Jérôme Sohier
- Laboratory of Tissue Biology and Therapeutic Engineering, CNRS, University of Lyon, Claude Bernard University Lyon 1, UMR5305 LBTI, 69007 Lyon, France.
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Zhang J, Liss J, Jayasuriya S, Berisha V. Robust Vocal Quality Feature Embeddings for Dysphonic Voice Detection. IEEE/ACM TRANSACTIONS ON AUDIO, SPEECH, AND LANGUAGE PROCESSING 2023; 31:1348-1359. [PMID: 37899766 PMCID: PMC10602198 DOI: 10.1109/taslp.2023.3261753] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Approximately 1.2% of the world's population has impaired voice production. As a result, automatic dysphonic voice detection has attracted considerable academic and clinical interest. However, existing methods for automated voice assessment often fail to generalize outside the training conditions or to other related applications. In this paper, we propose a deep learning framework for generating acoustic feature embeddings sensitive to vocal quality and robust across different corpora. A contrastive loss is combined with a classification loss to train our deep learning model jointly. Data warping methods are used on input voice samples to improve the robustness of our method. Empirical results demonstrate that our method not only achieves high in-corpus and cross-corpus classification accuracy but also generates good embeddings sensitive to voice quality and robust across different corpora. We also compare our results against three baseline methods on clean and three variations of deteriorated in-corpus and cross-corpus datasets and demonstrate that the proposed model consistently outperforms the baseline methods.
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Affiliation(s)
- Jianwei Zhang
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe, AZ 85281, USA
| | - Julie Liss
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA
| | - Suren Jayasuriya
- School of Arts, Media and Engineering and the School of Electrical, Computer and Energy Engineering at Arizona State University, Tempe, AZ 85281, USA
| | - Visar Berisha
- College of Health Solutions and School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe, AZ 85281, USA
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Sargunaraj JJE, Mathews SS, Paul RR, Michael RC, Thomas M, Gowri M, Albert RRA. Role of Narrow Band Imaging in Laryngeal Lesions: A Prospective Study from Southern India. Indian J Otolaryngol Head Neck Surg 2022; 74:5127-5133. [PMID: 36742616 PMCID: PMC9895569 DOI: 10.1007/s12070-021-02945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
To assess the utility of Narrow Band Imaging (NBI) as a diagnostic tool in evaluating laryngeal pathology in patients presenting with hoarseness. Study design: Prospective cross sectional diagnostic study. Methods: 200 patients with voice change were recruited and laryngeal findings documented with high definition flexible endoscopy with both white light and narrow band light and the representative still images recorded for analysis. The NBI intraepithelial papillary capillary loop (IPCL) patterns was compared with the histopathology report. Of the 200 patients evaluated, 84 lesions were biopsied which included both benign and malignant lesions. The sensitivity obtained was 73.3% [54.1-87.7% with 95% CI] and the specificity was 87% [75.1-94.6% with 95% CI] for detecting malignant lesions. NBI can be considered as a useful diagnostic tool in evaluating laryngeal pathology and can be used to detect early premalignant and malignant lesions.
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Affiliation(s)
| | - Suma Susan Mathews
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Roshna Rose Paul
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Rajiv C. Michael
- Department of Head and Neck Surgery, Christian Medical College, Vellore, 632004 India
| | - Meera Thomas
- Department of General Pathology, Christian Medical College, Vellore, 632004 India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, 632004 India
| | - Rita Ruby A. Albert
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
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Mishra AK, Sinha VR, Suhag V, Nilakantan A. Evaluation of Voice After Definitive Radiotherapy in Patients of Early Stage Squamous Cell Carcinoma of Larynx (Glottis): A Prospective Observational Study. Indian J Otolaryngol Head Neck Surg 2022; 74:2386-2394. [PMID: 36452620 PMCID: PMC9701973 DOI: 10.1007/s12070-020-02193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022] Open
Abstract
Post treatment voice quality is an important consideration in choosing the management option for laryngeal cancer. We assessed voice quality after radiotherapy in patients of early squamous cell carcinoma of glottis comprehensively using Videolaryngostroboscopy (VLS), Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) scores and Voice Handicap Index (VHI)-10. Fifty four consenting patients of early squamous cell carcinoma of glottis (Tis, T1 and T2) awaiting definitive radiotherapy were recruited consecutively. Voice was evaluated by VLS, GRBAS scores and VHI-10 before radiotherapy as well as 3 months and 12 months after radiotherapy. There were 52 males and 2 females in the study. Hoarseness of voice was the commonest presenting symptom. Mean duration of symptoms was 2.45 months (± 0.80), ranging from 1 to 4 months. 35 (64.82%) were T1 while 19 (35.18%) were T2 lesions. They received 60-70 Gy of radiotherapy in 28-35 fractions. There was only one recurrence on follow up for 12 months. On VLS at 12 months post-RT the periodicity, phase symmetry, mucosal waves and amplitude were normal in 74.07%, 70.37%, 56.67% and 78.7% cases respectively. Complete glottic closure was obtained in 72.22%. The voice was 'acceptable' (Grade 1 or 2 on VLS parameters) in more than 90% cases. Mean total GRBAS score was 3.39 (± 2.67). Mean total VHI-10 was 6.7 (± 1.75). All indices were significantly better than pre RT levels. Good quality of voice can be expected after radiotherapy for early glottic cancer in majority of patients.
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Fischer J, Özen AC, Ilbey S, Traser L, Echternach M, Richter B, Bock M. Sub-millisecond 2D MRI of the vocal fold oscillation using single-point imaging with rapid encoding. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:301-310. [PMID: 34542771 PMCID: PMC8995286 DOI: 10.1007/s10334-021-00959-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The slow spatial encoding of MRI has precluded its application to rapid physiologic motion in the past. The purpose of this study is to introduce a new fast acquisition method and to demonstrate feasibility of encoding rapid two-dimensional motion of human vocal folds with sub-millisecond resolution. METHOD In our previous work, we achieved high temporal resolution by applying a rapidly switched phase encoding gradient along the direction of motion. In this work, we extend phase encoding to the second image direction by using single-point imaging with rapid encoding (SPIRE) to image the two-dimensional vocal fold oscillation in the coronal view. Image data were gated using electroglottography (EGG) and motion corrected. An iterative reconstruction with a total variation (TV) constraint was used and the sequence was also simulated using a motion phantom. RESULTS Dynamic images of the vocal folds during phonation at pitches of 150 and 165 Hz were acquired in two volunteers and the periodic motion of the vocal folds at a temporal resolution of about 600 µs was shown. The simulations emphasize the necessity of SPIRE for two-dimensional motion encoding. DISCUSSION SPIRE is a new MRI method to image rapidly oscillating structures and for the first time provides dynamic images of the vocal folds oscillations in the coronal plane.
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Affiliation(s)
- Johannes Fischer
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Ali Caglar Özen
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,German Consortium for Translational Cancer Research Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Serhat Ilbey
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Louisa Traser
- Freiburg Institute for Musicians' Medicine, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Bernhard Richter
- Freiburg Institute for Musicians' Medicine, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bock
- Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Easwaran M, Martinez JD, Ramirez DJ, Gall PA, Erickson-DiRenzo E. Short-term whole body cigarette smoke exposure induces regional differences in cellular response in the mouse larynx. Toxicol Rep 2021; 8:920-937. [PMID: 33996505 PMCID: PMC8099918 DOI: 10.1016/j.toxrep.2021.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/11/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022] Open
Abstract
Short-term CSE induced regional differences in murine laryngeal cellular responses. Basal cell hyperplasia accompanies adaptive cell proliferation in the vocal folds. Increased subglottic cell proliferation persists even after CS cessation. SEM revealed vocal fold microprojection damage with possible necrotic features. Subglandular acidic mucins decreased and neutral mucins increased post-CSE.
The larynx is an essential organ in the respiratory tract and necessary for airway protection, respiration, and phonation. Cigarette smoking is a significant risk factor associated with benign and malignant laryngeal diseases. Despite this association, the underlying mechanisms by which cigarette smoke (CS) drives disease development are not well elucidated. In the current study, we developed a short-term murine whole body inhalation model to evaluate the first CS-induced cellular responses in the glottic [i.e. vocal fold (VF)] and subglottic regions of the larynx. Specifically, we investigated epithelial cell proliferation, cell death, surface topography, and mucus production, at various time points (1 day, 5 days, 10 days) after ∼ 2 h exposure to 3R4F cigarettes (Delivered dose: 5.6968 mg/kg per cigarette) and following cessation for 5 days after a 5 day CS exposure (CSE). CSE elevated levels of BrdU labeled proliferative cells and p63 labeled epithelial basal cells on day 1 in the VF. CSE increased proliferative cells in the subglottis at days 5, 10 and following cessation in the subglottis. Cleaved caspase-3 apoptotic activity was absent in VF at all time points and increased at day 1 in the subglottis. Evaluation of the VF surface by scanning electron microscopy (SEM) revealed significant epithelial microprojection damage at day 10 and early signs of necrosis at days 5 and 10 post-CSE. SEM visualizations additionally indicated the presence of deformed cilia at days 5 and 10 after CSE and post-cessation in the respiratory epithelium lined subglottis. In terms of mucin content, the impact of short-term CSE was observed only at day 10, with decreasing acidic mucin levels and increasing neutral mucin levels. Overall, these findings reveal regional differences in murine laryngeal cellular responses following short-term CSE and provide insight into potential mechanisms underlying CS-induced laryngeal disease development.
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Key Words
- AB/PAS, Alcian blue/Periodic acid Schiff
- BLOQ, below limits of quantitation
- BSA, bovine serum albumin
- BrdU, 5-bromo-2′-deoxyuridine
- CBF, ciliary beat frequency
- CC3, cleaved caspase-3
- CO, Carbon monoxide
- CS, cigarette smoke
- CSE, cigarette smoke exposure
- Cell death
- Cell proliferation
- Cigarette smoke
- DAB, 3,3′-diaminobenzidine
- FTC/ISO, Federal Trade Commission/International Standard Organization
- GSD, geometric standard deviation
- H&E, Hematoxylin and Eosin
- HIER, heat-induced antigen retrieval
- HPF, high power field
- MCC, mucociliary clearance
- MMAD, Mass median aerodynamic diameter
- Mucus production
- Murine larynx
- NMR, nicotine metabolite ratio
- OECD, organization for economic co-operation and development
- PAHs, polycyclic aromatic hydrocarbons
- RE, respiratory epithelium
- REV, reversibility
- ROS, reactive oxygen species
- SCIREQ, Scientific Respiratory Equipment Inc
- SEM, scanning electron microscopy
- SSE, stratified squamous epithelium
- SWGTOX, Scientific Working Group for Forensic Toxicology
- Surface topography
- TBST, tris-buffered saline-tween 20
- TPM, total particulate matter
- TSNA, tobacco-specific nitrosamines
- UPLC-MS/MS, ultra-performance liquid chromatography-tandem mass spectrometer
- VF, vocal fold
- VSC, veterinary service center
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Affiliation(s)
- Meena Easwaran
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Joshua D Martinez
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniel J Ramirez
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Phillip A Gall
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth Erickson-DiRenzo
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Luo C, Lv K, Liu Q, Wen Y, Lin M, Wang Z, Zhu X, Jiang A, Wen W, Lei W. Comparison of laser microsurgery and open partial laryngectomy for T1-2 laryngeal cancer treatment. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:464. [PMID: 33850861 PMCID: PMC8039688 DOI: 10.21037/atm-21-135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background This study aims to investigate the clinical efficacy of transoral laser microsurgery and open partial laryngectomy (OPL) in treating T1-2 laryngeal cancer. Methods A retrospective analysis was conducted of 182 patients with T1-2 cancer with anterior vocal commissure (AVC) involvement. The local control (LC), disease-free survival (DFS) and overall survival (OS) rates at 5-year follow-up and the influencing factors were analyzed. Results No significant difference was observed in the LC or DFS rates between the two groups at 3- and 5-year follow-up. No significant difference was found between the two groups with T1-stage disease. The 5-year LC rates were significantly different from patients with grade 3 or 4 tumors on indirect laryngoscopy and patients with class III or IV tumors on the modified Mallampati test (MMT) (log-rank test: χ2=8.037, P=0.005). The 3-year LC rate of OPL in the depth of pathological infiltration (3-5 mm) group was found to be significantly higher than that of TLM. Significant differences in pathological infiltration depth (3-5 mm) existed between the two groups (log-rank test: χ2=5.786, P=0.016). Conclusions T1 lesions are generally limited and superficial, and laser surgery can be well-controlled. For patients with difficult airway exposure, surgeons should have extensive surgical experience and skills. It is recommended that a variety of equipment should be ready so that surgeons can convert to open surgery at any time. For patients with a deep infiltration depth, surgeons should examine laryngoscopy imaging results before surgery.
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Affiliation(s)
- Chunlin Luo
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kexing Lv
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qihong Liu
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yihui Wen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Meiya Lin
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhangfeng Wang
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaolin Zhu
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Aiyun Jiang
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weiping Wen
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wenbin Lei
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Armando F, Godizzi F, Razzuoli E, Leonardi F, Angelone M, Corradi A, Meloni D, Ferrari L, Passeri B. Epithelial to Mesenchymal Transition (EMT) in a Laryngeal Squamous Cell Carcinoma of a Horse: Future Perspectives. Animals (Basel) 2020; 10:ani10122318. [PMID: 33297475 PMCID: PMC7762370 DOI: 10.3390/ani10122318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/30/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Squamous cell carcinoma (SCC) is one of the most common cancers in horses, and it can arise at any site on the skin and mucosae. Recent studies associated equine papillomavirus type 2 (EcPV2) infections with this type of cancers of the oral tract and genitals. Larynx and pharynx are frequently recognized as sites of SCC. In humans, squamous cell carcinoma of the larynx (SCCL) is a common cancer associated with papilloma virus (PV) infection and epithelial to mesenchymal transition (EMT). EMT can occur under different biological conditions, upon the same programmed changes: embryogenesis and organ development fibrosis, wound healing, and cancer metastases. This work reports for the first time in a SCCL of a horse a wide immunohistochemical EMT characterization, by analyzing main epithelial markers (E-cadherin, β-catenin, and pan-cytokeratin AE3/AE1), main mesenchymal markers (N-cadherin and vimentin), and the main EMT-related transcription factors (TWIST-1, ZEB-1, and HIF-1α). This work illustrates an example of tumor cell adaptation during the metastatic process in the equine SCCL, taking also into consideration the potential influence provided by EcPV2 oncoproteins on the EMT process. Abstract Squamous cell carcinoma (SCC) is one of the most frequent tumors of skin and muco-cutaneous junctions in the horse. Equine papillomavirus type 2 (EcPV2) has been detected in equine SCC of the oral tract and genitals, and recently also in the larynx. As human squamous cell carcinoma of the larynx (SCCL), it is strongly etiologically associated with high-risk papillomavirus (h-HPV) infection. This study focuses on tumor cells behavior in a naturally occurring tumor that can undergo the so-called epithelial to mesenchymal transition (EMT). A SCCL in a horse was investigated by immunohistochemistry using antibodies against E-cadherin, pan-cytokeratin AE3/AE1, β-catenin, N-cadherin, vimentin, ZEB-1, TWIST, and HIF-1α. EcPV2 DNA detection and expression of oncogenes in SCC were investigated. A cadherin switch and an intermediate filaments rearrangement within primary site tumor cells together with the expression of the EMT-related transcription factors TWIST-1, ZEB-1, and HIF-1α were observed. DNA obtained from the tumor showed EcPV2 positivity, with E2 gene disruption and E6 gene dysregulation. The results suggest that equine SCCL might be a valuable model for studying EMT and the potential interactions between EcPV2 oncoproteins and the EMT process in SCCL.
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Affiliation(s)
- Federico Armando
- Pathology Unit, Department of Veterinary Science, University of Parma, Strada del Taglio 10, 43126 Parma, Italy; (F.A.); (A.C.); (L.F.); (B.P.)
| | - Francesco Godizzi
- Department of Veterinary Science (DIMEVET), University of Milan, Via dell‘Università 6, 26900 Lodi, Italy;
| | - Elisabetta Razzuoli
- National Reference Center of Veterinary and Comparative Oncology (CEROVEC), Piazza Borgo Pila 39/24, 16129 Genoa, Italy;
- Correspondence: ; Tel.: +39-010-542274; Fax: +39-010-566654
| | - Fabio Leonardi
- Department of Veterinary Science, Strada del Taglio 10, 43126 Parma, Italy; (F.L.); (M.A.)
| | - Mario Angelone
- Department of Veterinary Science, Strada del Taglio 10, 43126 Parma, Italy; (F.L.); (M.A.)
| | - Attilio Corradi
- Pathology Unit, Department of Veterinary Science, University of Parma, Strada del Taglio 10, 43126 Parma, Italy; (F.A.); (A.C.); (L.F.); (B.P.)
| | - Daniela Meloni
- National Reference Center of Veterinary and Comparative Oncology (CEROVEC), Piazza Borgo Pila 39/24, 16129 Genoa, Italy;
| | - Luca Ferrari
- Pathology Unit, Department of Veterinary Science, University of Parma, Strada del Taglio 10, 43126 Parma, Italy; (F.A.); (A.C.); (L.F.); (B.P.)
| | - Benedetta Passeri
- Pathology Unit, Department of Veterinary Science, University of Parma, Strada del Taglio 10, 43126 Parma, Italy; (F.A.); (A.C.); (L.F.); (B.P.)
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Chatelet F, Wagner I, Bizard A, Hans S, Chabolle F, Bach CA. Does advanced age affect treatment of early glottic carcinoma? Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:68-72. [PMID: 32654987 DOI: 10.1016/j.anorl.2020.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Early glottic carcinoma is currently managed by radiation therapy or endoscopic surgery. Both are effective in elderly patients, but their respective indications are poorly determined. The present study assessed our management of very elderly patients with early glottic carcinoma. MATERIAL AND METHODS A retrospective single-center study included all patients aged 75 years and older at diagnosis, treated by radiation therapy or endoscopic surgery with curative intent for T1 or T2 glottic carcinoma between 2004 and 2018. RESULTS Records of 33 patients (27 men and 6 women; mean age, 82.2 years (range, 76.1-93.1 years)) were reviewed. 24 patients received radiation therapy and 9 endoscopic resection. The only factor for choice of treatment was anterior commissure involvement. Overall survival was 87% at 2 years and 62% at 5 years. 19% of patients relapsed within 5 years and had to undergo further treatment. There were no treatment-related deaths. Radiation therapy was associated with more acute local complications, with two temporary treatment interruptions and one uncompleted treatment. Surgical treatment was more likely to result in dysphonia, found in 80% of cases. CONCLUSION Treatment of early glottic cancer in elderly subjects can consist in either radiotherapy or endoscopic surgery. Age should not affect management. Surgical treatment is shorter and better tolerated, although with poorer vocal outcome, and may be preferred in the most comorbid patients.
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Affiliation(s)
- F Chatelet
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, 92150 Suresnes, France
| | - I Wagner
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, 92150 Suresnes, France
| | - A Bizard
- Service de Gériatrie, Hôpital Foch, 92150 Suresnes, France
| | - S Hans
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, 92150 Suresnes, France; Université de Versailles Saint-Quentin en Yvelines, UFR de Médecine Paris Ouest Saint-Quentin en Yvelines, Guyancourt 78280, France
| | - F Chabolle
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, 92150 Suresnes, France; Université de Versailles Saint-Quentin en Yvelines, UFR de Médecine Paris Ouest Saint-Quentin en Yvelines, Guyancourt 78280, France
| | - C-A Bach
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, 92150 Suresnes, France.
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Svistushkin VM, Reshetov IV, Chuchueva ND, Saltykov BB. [Combined application of modern endoscopic techniques in the detection of precancerous and malignant lesions of larynx]. Vestn Otorinolaringol 2019; 84:32-36. [PMID: 31486424 DOI: 10.17116/otorino20198403132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Early detection of malignant laryngeal tumors is crucial but still challenging. And 5-year survival rate depends on a stage of revealing. The aim of the study - assessment of the effectiveness of combined application of narrow band imaging and contact endoscopy in visualization of neoangiogenesis. MATERIAL AND METHODS 102 patients were included in this study. All the patients were evaluated by means of narrow band imaging and contact endoscopy. RESULTS Combined application of narrow band imaging and contact endoscopy gained a high level of effectiveness: accuracy - 93.9%, sensitivity - 96%, specificity - 93.4%, positive predictive value - 94.3%, negative predictive value - 93.4%. CONCLUSION Combined application of narrow band imaging and contact endoscopy may contribute to early detection of malignant laryngeal tumors.
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Affiliation(s)
- V M Svistushkin
- Department of ear, nose, throat diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russia, Moscow, Russia
| | - I V Reshetov
- Department of oncology, plastic and reconstructive surgery and radiology, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russia, Moscow, Russia
| | - N D Chuchueva
- Department of ear, nose, throat diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russia, Moscow, Russia
| | - B B Saltykov
- Department of pathological anatomy, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russia, Moscow, Russia
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Lungova V, Chen X, Wang Z, Kendziorski C, Thibeault SL. Human induced pluripotent stem cell-derived vocal fold mucosa mimics development and responses to smoke exposure. Nat Commun 2019; 10:4161. [PMID: 31551422 PMCID: PMC6760204 DOI: 10.1038/s41467-019-12069-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 08/15/2019] [Indexed: 01/27/2023] Open
Abstract
Development of treatments for vocal dysphonia has been inhibited by lack of human vocal fold (VF) mucosa models because of difficulty in procuring VF epithelial cells, epithelial cells' limited proliferative capacity and absence of cell lines. Here we report development of engineered VF mucosae from hiPSC, transfected via TALEN constructs for green fluorescent protein, that mimic development of VF epithelial cells in utero. Modulation of FGF signaling achieves stratified squamous epithelium from definitive and anterior foregut derived cultures. Robust culturing of these cells on collagen-fibroblast constructs produces three-dimensional models comparable to in vivo VF mucosa. Furthermore, we demonstrate mucosal inflammation upon exposure of these constructs to 5% cigarette smoke extract. Upregulation of pro-inflammatory genes in epithelium and fibroblasts leads to aberrant VF mucosa remodeling. Collectively, our results demonstrate that hiPSC-derived VF mucosa is a versatile tool for future investigation of genetic and molecular mechanisms underlying epithelium-fibroblasts interactions in health and disease.
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Affiliation(s)
- Vlasta Lungova
- Department of Surgery, University of Wisconsin Madison, Wisconsin Institute for Medical Research, Madison, WI, USA
| | - Xia Chen
- Department of Surgery, University of Wisconsin Madison, Wisconsin Institute for Medical Research, Madison, WI, USA
| | - Ziyue Wang
- Department of Biostatistics & Medical Informatics, University of Wisconsin Madison, Madison, WI, USA
| | - Christina Kendziorski
- Department of Biostatistics & Medical Informatics, University of Wisconsin Madison, Madison, WI, USA
| | - Susan L Thibeault
- Department of Surgery, University of Wisconsin Madison, Wisconsin Institute for Medical Research, Madison, WI, USA.
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Lukes P, Zabrodsky M, Syba J, Lukesova E, Votava M, Plzak J. Efficacy of Transnasal Flexible Videoendoscopy With Narrow Band Imaging for Follow-Up of Patients After Transoral Laser Cordectomy. Lasers Surg Med 2019; 52:333-340. [PMID: 31385332 DOI: 10.1002/lsm.23143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Transoral laser surgery is the optimal surgical treatment modality for the early stages of glottic cancer. To allow for further treatment to be as effective and as minimal as possible, persistent or recurrent tumors should be detected very soon. The main aim is to minimize the risk of necessity of performing a total laryngectomy. Flexible videoendoscopy with narrow band imaging (NBI) was recommended by the European Laryngological Society as a diagnostic method for the follow-up of patients treated for laryngeal cancer. Nevertheless, the efficacy of this technique has not been extensively studied in patients after transoral laser cordectomies for vocal fold cancer. The aim of this study was to evaluate the efficacy of in-office transnasal NBI flexible videoendoscopy in the follow-up of patients after transoral laser cordectomy for glottic cancer. We also focused on describing the specific characteristics of recurrent tumor appearance. MATERIALS AND METHODS The presented study was conceived as a prospective study. Ninety-four consecutive patients who underwent transoral laser cordectomy for severe dysplasia, Tis, T1, and T2 glottic cancer in the period from June 2010 to August 2015 were enrolled in the study. All patients were postoperatively regularly followed using transnasal videoendoscopic examinations with NBI. Whenever a suspect lesion was identified during in-office examination, its nature was proven histologically. RESULTS We discovered 23 suspect findings in 21 patients by means of flexible videoendoscopy with NBI. Fifteen (65.2%) of them were histologically confirmed as recurrent tumors, whereas in 8 (34.8%) of them, the recurrent tumor was not proven. In two patients, the recurrent tumor was evident on computed tomography or magnetic resonance imaging, but NBI endoscopy did not reveal relapsing disease. The rest (71 patients) were considered true negative. Of the 15 recurrent tumors detected by NBI-coupled videoendoscopy, 8 (53.3%) were identified as submucosal masses with nonsignificant or no vascular changes, 4 (26.7%) were noted as the progression of leukoplakia without visible vascular changes, only 2 (13.3%) showed typical vascular changes, and, in 1 (6.7%) case, evident, significantly exophytic tumor with pathological vascularization was discovered. The sensitivity, specificity, and positive and negative predictive values of the in-office transnasal videolaryngoscopy with NBI were calculated to be 88%, 92%, 71%, and 97%, respectively. CONCLUSIONS The results of the study demonstrate that transnasal endoscopy with NBI in an outpatient setting is an excellent method for the follow-up of patients after transoral laser cordectomy for glottic cancer. The method achieves high sensitivity, specificity, and negative predictive value and a slightly low positive predictive value. Nevertheless, we must bear in mind that recurrent tumors after previous endoscopic resection may have a completely different appearance than new tumors originating from previously untreated tissues. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Petr Lukes
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Michal Zabrodsky
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jaroslav Syba
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Eva Lukesova
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Michal Votava
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jan Plzak
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Goncalves M, Aubreville M, Mueller SK, Sievert M, Maier A, Iro H, Bohr C. Probe-based confocal laser endomicroscopy in detecting malignant lesions of vocal folds. ACTA ACUST UNITED AC 2019; 39:389-395. [PMID: 30745593 PMCID: PMC6966779 DOI: 10.14639/0392-100x-2121] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 04/10/2018] [Indexed: 11/23/2022]
Abstract
Probe-based confocal laser endomicroscopy (CLE) is an innovative technique for real-time, non-invasive analysis of the surface epithelium. While being successfully used for diagnosis by experts, this method has not yet been established in clinical routine, partly due to the lack of standards and criteria for classifying various lesions. Our aim was to determine the diagnostic value and inter-rater reliability of CLE in detecting malignant lesions of the vocal cords. 58 video sequences were extracted from the probe-based CLE (GastroFlex probe with a Cellvizio® laser system) examinations of 3 patients with squamous cell carcinomas and 4 patients with benign alterations of the vocal folds. Two ENT surgeons, who were blinded to the histological result, were asked to identify the sequences representing a carcinoma. We showed an accuracy, sensitivity, specificity, PPV and NPV of 91.38-96.55%, 100%, 87.8-95.2%, 77.27-89.47% and 100%, respectively, with an inter-rater reliability of k = 0.89 (“almost perfect agreement”). Probe-based CLE is a promising method for diagnosis and assessment of vocal fold lesions in vivo. Our results suggest that, with adequate training, the diagnostic value of this technique can be improved and potentially provide important information during oncological surgery.
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Affiliation(s)
- M Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - M Aubreville
- Pattern Recognition Lab, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S K Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - M Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - A Maier
- Pattern Recognition Lab, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - H Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - C Bohr
- Department of Otorhinolaryngology, Head and Neck Surgery, Universität Regensburg, University Hospital, Regensburg, Germany
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Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery. Eur Arch Otorhinolaryngol 2018; 276:459-466. [PMID: 30569190 PMCID: PMC6394425 DOI: 10.1007/s00405-018-5256-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/14/2018] [Indexed: 12/15/2022]
Abstract
Purpose Flexible transnasal endoscopy is a common examination technique for the evaluation of laryngeal lesions, while the use of narrow band imaging (NBI) has been reported to enhance the diagnostic value of white light endoscopy (WLE). The purpose of this study is to assess observer variability and diagnostic value of both modalities and investigate the possible influence of previous laryngeal surgery on the detection rates of laryngeal malignancy. Methods The study was based on the retrospective evaluation of 170 WLE and NBI images of laryngeal lesions by three observers in a random order. The histopathological diagnoses serve as the gold standard. Results In identifying laryngeal malignancy, the sensitivity of NBI proved to be higher than that of WLE (93.3% vs. 77.0%). NBI was also superior to WLE in terms of accuracy (96.3% vs. 92%) and diagnostic odds ratio (501.83 vs. 120.65). Both modalities had a specificity of 97.3%. The inter-observer agreement was substantial (kappa = 0.661) for WLE and almost perfect (kappa = 0.849) for NBI. Both WLE and NBI showed a high level of intra-observer agreement. The sensitivity was significantly lower in images with history of previous laryngeal surgery compared to those without. Conclusions Flexible transnasal endoscopy has been proved to be a valuable tool in the diagnosis of laryngeal malignancy. The use of NBI can increase the sensitivity and observer reliability in that context and can also provide a diagnostic gain in cases with previous laryngeal surgery
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Ding Y, Wang B. Efficacy of laser surgery versus radiotherapy for treatment of glottic carcinoma: a systematic review and meta-analysis. Lasers Med Sci 2018; 34:847-854. [DOI: 10.1007/s10103-018-2695-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/22/2018] [Indexed: 01/11/2023]
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Moccia S, Vanone GO, Momi ED, Laborai A, Guastini L, Peretti G, Mattos LS. Learning-based classification of informative laryngoscopic frames. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 158:21-30. [PMID: 29544787 DOI: 10.1016/j.cmpb.2018.01.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/18/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Early-stage diagnosis of laryngeal cancer is of primary importance to reduce patient morbidity. Narrow-band imaging (NBI) endoscopy is commonly used for screening purposes, reducing the risks linked to a biopsy but at the cost of some drawbacks, such as large amount of data to review to make the diagnosis. The purpose of this paper is to present a strategy to perform automatic selection of informative endoscopic video frames, which can reduce the amount of data to process and potentially increase diagnosis performance. METHODS A new method to classify NBI endoscopic frames based on intensity, keypoint and image spatial content features is proposed. Support vector machines with the radial basis function and the one-versus-one scheme are used to classify frames as informative, blurred, with saliva or specular reflections, or underexposed. RESULTS When tested on a balanced set of 720 images from 18 different laryngoscopic videos, a classification recall of 91% was achieved for informative frames, significantly overcoming three state of the art methods (Wilcoxon rank-signed test, significance level = 0.05). CONCLUSIONS Due to the high performance in identifying informative frames, the approach is a valuable tool to perform informative frame selection, which can be potentially applied in different fields, such us computer-assisted diagnosis and endoscopic view expansion.
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Affiliation(s)
- Sara Moccia
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy; Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy.
| | - Gabriele O Vanone
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Elena De Momi
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Andrea Laborai
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy
| | - Luca Guastini
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy
| | - Giorgio Peretti
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy
| | - Leonardo S Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
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Góis ACB, Pernambuco L, de Lima KC. Prevalence and Associated Factors With Voice Disorders in Brazilian Community-dwelling Older Adults. J Voice 2018; 33:806.e1-806.e7. [PMID: 29678439 DOI: 10.1016/j.jvoice.2018.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 02/28/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to estimate the prevalence and factors associated with voice disorders (VDs) in Brazilian community-dwelling older adults. STUDY DESIGN This is a cross-sectional study. METHODS The sample comprised 463 older adults (60 years or more) of both sexes living in a Brazilian northeastern city. Variables were related to socioeconomic and demographic profile, lifestyle, and general health conditions, in addition to the validated "Screening for Voice Disorders in Older Adults" (RAVI) questionnaire. A bivariate analysis was performed using the Pearson chi-square test or the Fisher exact test, and the magnitude of the association was the prevalence ratio (PR). Poisson regression model was performed, considering only the variables with a critical value of P < 0.20. The significance level was 5%. RESULTS There was a prevalence of women (60.9%), and the average age of participants was 70 (±7.74) years. The prevalence of VDs was 51.4% (95% confidence interval [CI]: 46.8-55.9). The most common symptoms were throat sensation of phlegm (46.9%) and dry throat (46.7%), both related to physical sensations of laryngeal discomfort. Multivariate analysis indicated that the prevalence of VDs was independently associated with hyposalivation (PR = 2.28, 95% CI = 1.80-2.88), smoking (PR = 2.04, 95% CI = 1.65-2.52), self-reported hearing loss (PR = 1.51, 95% CI = 1.28-1.78), and not seeking a physician or other health professional care for VDs (PR = 0.73, 95% CI = 0.60-0.88). CONCLUSION VDs are prevalent among Brazilian community-dwelling older adults and are associated with variables related to general health and lifestyle.
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Affiliation(s)
- Amanda C B Góis
- Post-Graduate Program in Public Health (PPgSCol-UFRN), Universidade Federal do Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Leandro Pernambuco
- Department of Speech, Language and Hearing Sciences, Universidade Federal da Paraíba (UFPB), Paraíba, Brazil; Post-Graduate Program in Speech, Language and Hearing Sciences (PPgFon-UFPB/UFRN), Paraíba, Brazil.
| | - Kenio Costa de Lima
- Post-Graduate Program in Public Health (PPgSCol-UFRN), Universidade Federal do Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
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Yang Y, Fang J, Zhong Q, Xu W, Ma H, Feng L, Shi Q, Lian M, Wang R, Hou L. The value of narrow band imaging combined with stroboscopy for the detection of applanate indiscernible early-stage vocal cord cancer. Acta Otolaryngol 2018; 138:400-406. [PMID: 29043905 DOI: 10.1080/00016489.2017.1388542] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Narrow band imaging (NBI) and stroboscopy are non-invasive techniques to detect the malignant lesions of the vocal cord. This study was to assess the diagnostic value of combined endoscopic analysis in the applanate indiscernible early-stage vocal cord cancer. METHODS A total of 110 patients with 160 suspicious vocal cord malignant lesions were included in this retrospective study. Stroboscopy was immediately performed after NBI and white light endoscopy (WLE) were performed in all patients. Excisional biopsy was performed to examine histopathology examination. RESULTS We found that the diagnostic specificity and PPV were higher in the NBI and WLE combined with stroboscopy group than in the NBI and WLE group without stroboscopy (88.9% vs 72.5%, 88.4% vs 60.9%). However, the diagnostic sensitivity was not significantly different in those two groups (69.3% vs 67.7%). CONCLUSION NBI and WLE combined with stroboscopy is a promising method to detect early-stage vocal cord cancer with the advantage of clinical feasibility and diagnostic specificity.
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Affiliation(s)
- Yifan Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jugao Fang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
- Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing, China
| | - Qi Zhong
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Wen Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Hongzhi Ma
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Ling Feng
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Qian Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Meng Lian
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Ru Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
| | - Lizhen Hou
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing, China
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Aicha AB. Noninvasive Detection of Potentially Precancerous Lesions of Vocal Fold Based on Glottal Wave Signal and SVM Approaches. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.procs.2018.07.293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tafiadis D, Toki EI, Miller KJ, Ziavra N. Effects of Early Smoking Habits on Young Adult Female Voices in Greece. J Voice 2017; 31:728-732. [DOI: 10.1016/j.jvoice.2017.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/19/2017] [Accepted: 03/21/2017] [Indexed: 11/27/2022]
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Galli A, Giordano L, Sarandria D, Di Santo D, Bussi M. Oncological and complication assessment of CO2 laser-assisted endoscopic surgery for T1-T2 glottic tumours: clinical experience. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 36:167-73. [PMID: 27214828 PMCID: PMC4977004 DOI: 10.14639/0392-100x-643] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 01/10/2016] [Indexed: 01/22/2023]
Abstract
Several therapeutic options are used for treatment of early stage glottic carcinoma (Tis/T1/T2): open partial laryngectomy (OPL), radiotherapy and CO2 laser-assisted endoscopic surgery. Laser surgery has gradually gained approval in the management of laryngeal cancer. We present our experience in endoscopic laser surgery for early stage glottic carcinomas. This was a retrospective analysis of 72 patients with T1-T2 glottic cancer treated with laser cordectomy between 2006 and 2012. All patients had at least a 36-month follow-up period. Percentages for disease-specific survival, disease-free survival (DFS) and laryngeal preservation rates were 98.6%, 84.7% and 97.2% respectively. Considering neoplastic features that could predict long-term oncological outcome, tumoural involvement of anterior commissure and pathological staging (pT) significantly correlate with local recurrence (p = 0.021 and p = 0.035) and with a lowered DFS (p = 0.017 and p = 0.023). Other variables such as clinical staging, type of cordectomy, involvement of other structures and surgical margin status showed no significant impact on oncological endpoints. CO2 laser surgery is a reliable technique for T1-T2 glottic cancer considering oncological outcomes. The recurrence rate seems to be affected by involvement of anterior commissure and pT stage.
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Affiliation(s)
- A Galli
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - L Giordano
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - D Sarandria
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - D Di Santo
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - M Bussi
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
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Tafiadis D, Kosma EI, Chronopoulos SK, Papadopoulos A, Toki EI, Vassiliki S, Ziavra N. Acoustic and Perceived Measurements Certifying Tango as Voice Treatment Method. J Voice 2017; 32:256.e13-256.e24. [PMID: 28709765 DOI: 10.1016/j.jvoice.2017.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 10/19/2022]
Abstract
Voice disorders are affecting everyday life in many levels, and their prevalence has been studied extensively in certain and general populations. Notably, several factors have a cohesive influence on voice disorders and voice characteristics. Several studies report that health and environmental and psychological etiologies can serve as risk factors for voice disorders. Many diagnostic protocols, in the literature, evaluate voice and its parameters leading to direct or indirect treatment intervention. This study was designed to examine the effect of tango on adult acoustic voice parameters. Fifty-two adults (26 male and 26 female) were recruited and divided into four subgroups (male dancers, female dancers, male nondancers, and female nondancers). The participants were asked to answer two questionnaires (Voice Handicap Index and Voice Evaluation Form), and their voices were recorded before and after the tango dance session. Moreover, water consumption was investigated. The study's results indicated that the voices' acoustic characteristics were different between tango dancers and the control group. The beneficial results are far from prominent as they prove that tango dance can serve stand-alone as voice therapy without the need for hydration. Also, more research is imperative to be conducted on a longitudinal basis to obtain a more accurate result on the required time for the proposed therapy.
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Affiliation(s)
- Dionysios Tafiadis
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece.
| | - Evangelia I Kosma
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Spyridon K Chronopoulos
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Aggelos Papadopoulos
- Department of Paediatrics, Karamandanio General Children's Hospital NHS, Patra, Greece
| | - Eugenia I Toki
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Siafaka Vassiliki
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Nausica Ziavra
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
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Tafiadis D, Chronopoulos SK, Kosma EI, Voniati L, Raptis V, Siafaka V, Ziavra N. Using Receiver Operating Characteristic Curve to Define the Cutoff Points of Voice Handicap Index Applied to Young Adult Male Smokers. J Voice 2017; 32:443-448. [PMID: 28709764 DOI: 10.1016/j.jvoice.2017.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/10/2017] [Accepted: 06/13/2017] [Indexed: 02/02/2023]
Abstract
Voice performance is an inextricable key factor of everyday life. Obviously, the deterioration of voice quality can cause various problems to human communication and can therefore reduce the performance of social skills (relevant to voice). The deterioration could be originated from changes inside the system of the vocal tract and larynx. Various prognostic methods exist, and among them is the Voice Handicap Index (VHI). This tool includes self-reported questionnaires, used for determining the cutoff points of total score and of its three domains relevant to young male Greek smokers. The interpretation of the calculated cutoff points can serve as a strong indicator of imminent or future evaluation by a clinician. Consistent with previous calculation, the VHI can also act as a feedback for smokers' voice condition and as monitoring procedure toward smoking cessation. Specifically, the sample consisted of 130 male nondysphonic smokers (aged 18-33 years) who all participated in the VHI test procedure. The test results (through receiver operating characteristic analysis) concluded to a total cutoff point score of 19.50 (sensitivity: 0.838, 1-specificity: 0). Also, in terms of constructs, the Functional domain was equal to 7.50 (sensitivity: 0.676, 1-specificity: 0.032), the Physical domain was equal to 7.50 (sensitivity: 0.706, 1-specificity: 0.032), and the Emotional domain was equal to 6.50 (sensitivity: 0.809, 1-specificity: 0.048).
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Affiliation(s)
- Dionysios Tafiadis
- Department of Speech & Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece.
| | - Spyridon K Chronopoulos
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Evangelia I Kosma
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Louiza Voniati
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
| | - Vasilis Raptis
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Vasiliki Siafaka
- Department of Speech & Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Nausica Ziavra
- Department of Speech & Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
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Robert A, Pointreau Y, Janoray G, Bardet É, Fesneau M, Garaud P, Chapet S, Lafond C, Dupuis O, Calais G. A large French multicenter retrospective series of T1-T2N0 vocal cords carcinomas treated with exclusive irradiation. Cancer Radiother 2017; 21:286-290. [DOI: 10.1016/j.canrad.2017.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 10/19/2022]
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Tafiadis D, Kosma EI, Chronopoulos SK, Papadopoulos A, Drosos K, Siafaka V, Toki EI, Ziavra N. Voice Handicap Index and Interpretation of the Cutoff Points Using Receiver Operating Characteristic Curve as Screening for Young Adult Female Smokers. J Voice 2017; 32:64-69. [PMID: 28392085 DOI: 10.1016/j.jvoice.2017.03.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 11/17/2022]
Abstract
The relationship between smoking and alterations of the vocal tract and larynx is well known. This pathology leads to the degradation of voice performance in daily living. Multiple assessment methods of vocal tract and larynx have been developed, and in recent years they were enriched with self-reported questionnaires such as Voice Handicap Index (VHI). This study determined the cutoff points of VHI's total score and its three domains for young female smokers in Greece. These estimated cutoff points could be used by voice specialists as an indicator for further clinical evaluation (foreseeing a potential risk of developing a vocal symptom because of smoking habits). A sample of 120 female nondysphonic smokers (aged 18-31) was recruited. Participants filled out the VHI and Voice Evaluation Form. VHI's cutoff point of total score was calculated at the value of 19.50 (sensitivity: 0.780, 1-specificity: 0.133). Specifically, the construct domain of functional was 7.50 (sensitivity: 0.900, 1-specificity: 0.217), for physical it was 8.50 (sensitivity: 0.867, 1-specificity: 0.483), and for emotional it was 7.50 (sensitivity: 0.833, 1-specificity: 0.200) through the use of receiver operating characteristic. Furthermore, VHI could be used as a monitoring tool for smokers and as a feedback for smoking cessation.
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Affiliation(s)
- Dionysios Tafiadis
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece.
| | - Evangelia I Kosma
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Spyridon K Chronopoulos
- Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - Aggelos Papadopoulos
- Department of Paediatrics, Karamandanio General Children's Hospital NHS, Patra, Greece
| | - Konstantinos Drosos
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Eugenia I Toki
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Nausica Ziavra
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
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Pernambuco L, Espelt A, Góis ACB, de Lima KC. Voice Disorders in Older Adults Living in Nursing Homes: Prevalence and Associated Factors. J Voice 2017; 31:510.e15-510.e21. [PMID: 28069466 DOI: 10.1016/j.jvoice.2016.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 11/16/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To estimate the prevalence and the associated factors with voice disorders (VDs) in older adults living in nursing homes. STUDY DESIGN Cross-sectional. METHODS A sample of 117 Brazilian individuals of both sexes and preserved cognitive function, aged >59 years, living in 10 nursing homes, was studied. VDs were screened using the validated tool "Rastreamento de Alterações Vocais em Idosos" (RAVI-Screening for Voice Disorders in Older Adults). Associated factors included variables related to socioeconomic and demographic profile; nursing home; general health; ear, nose, and throat conditions; lifestyle; functionality; and psychosocial status. Bivariate analysis was performed by Pearson's chi-square or Fisher's exact test. Multivariate analysis was performed by multiple binomial regression. The significance level was 5%. RESULTS The prevalence of VDs was 39.3% (95% confidence interval [CI] = 30.4-48.1). There was no significant difference in prevalence according to age and sex. Multivariate analysis revealed that the prevalence of VDs were independently associated with anxiety symptoms (prevalence ratio [PR] = 1.97, 95% CI = 1.17-3.29), smoking (PR = 1.56, CI = 1.02-2.38), general daily inactivity (PR = 1.62, CI = 1.10-2.38), temporomandibular disorder (PR = 1.68, CI = 1.11-2.54), choking (PR = 1.53, CI = 1.06-2.20), and self-reported hearing loss (PR = 1.52, CI = 1.04-2.21). CONCLUSION VDs are common among older adults with preserved cognitive function living in nursing homes. The associated factors with VDs in this population can be prevented, diagnosed, controlled, or treated. Screening procedures and early intervention should be considered.
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Affiliation(s)
- Leandro Pernambuco
- Department of Speech, Language and Hearing Sciences, Federal University of Paraíba (UFPB), Paraíba, Brazil.
| | - Albert Espelt
- Customer Service and Drug Addiction Prevention, Public Health Agency of Barcelona (ASPB), Barcelona, Spain; School of Psychology, Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona (UAB), Bellaterra, Spain; Carlos III Health Institute, CIBER in Epidemiology and Public Health, Madrid, Spain
| | - Amanda C B Góis
- Post-Graduate Program in Public Health (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Kenio Costa de Lima
- Post-Graduate Program in Public Health (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
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Tafiadis D, Tatsis G, Ziavra N, I. Toki E. Voice Data on Female Smokers: Coherence between the Voice Handicap Index and Acoustic Voice Parameters. AIMS MEDICAL SCIENCE 2017. [DOI: 10.3934/medsci.2017.2.151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Byeon H, Lee D, Cho S. Relationship between women's smoking and laryngeal disorders based on the urine cotinine test: results of a national population-based survey. BMJ Open 2016; 6:e012169. [PMID: 27872114 PMCID: PMC5129095 DOI: 10.1136/bmjopen-2016-012169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES There is a possibility of underestimation in the smoking rate surveyed by self-reported questionnaires. This study investigated the difference between the Korean female smoking rate as determined by self-reports and that determined by a biochemical test and elucidated the relationship between women's smoking and laryngeal disorders. DESIGN Nationwide cross-sectional survey. SETTING 2008 Korea National Health and Nutrition Examination Survey. PARTICIPANTS 1849 women who completed the health survey, urinary cotinine test and laryngoscope examinations. MAIN OUTCOME MEASURE This study defined smokers as those with urine cotinine contents of 50 ng/mL and over. Confounding factors included age, level of education, household income, occupation and problem drinking in the past year. For statistical tests, OR and 95% CI were presented by using complex samples logistic regression. RESULTS While there was no relationship between smoking as determined by a self-reported questionnaire and laryngeal disorders, smoking as determined by the urine cotinine test had a significant relationship with laryngeal disorders (p<0.05). After all the confounding factors were adjusted, those with urine cotinine concentrations of over 50 ng/mL had a 2.1 times higher risk of laryngeal disorders than those with urine cotinine concentrations of <50 ng/mL (OR=2.05, 95% CI 1.11 to 3.78) (p<0.05). CONCLUSIONS This national cross-sectional study verified that smoking is a significant risk factor for laryngeal disorders. Longitudinal studies are required to identify the causal relationship between smoking and laryngeal disorders.
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Affiliation(s)
- Haewon Byeon
- Department of Speech Language Pathology & Audiology, School of Public Health, Nambu University, Gwangju, Republic of Korea
| | - Dongwoo Lee
- Department of Physical Therapy, School of Public Health, Honam University, Gwangju, Republic of Korea
| | - Sunghyoun Cho
- Department of Physical Therapy, School of Public Health, Nambu University, Gwangju, Republic of Korea
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Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness-causes and treatments. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 112:329-37. [PMID: 26043420 DOI: 10.3238/arztebl.2015.0329] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/03/2015] [Accepted: 03/03/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hoarseness (dysphonia) is the reason for about 1% of all consultations in primary care. It has many causes, ranging from self-limited laryngitis to malignant tumors of the vocal cords. METHODS This review is based on literature retrieved by a selective search in PubMed employing the terms "hoarseness," "hoarse voice," and "dysphonia," on the relevant guideline of the American Academy of Otolaryngology -Head and Neck Surgery, and on Cochrane reviews. RESULTS Hoarseness can be caused by acute (42.1%) and chronic laryngitis (9.7%), functional vocal disturbances (30%), and benign (10.7-31%) and malignant tumors (2.2-3%), as well as by neurogenic disturbances such as vocal cord paresis (2.8-8%), physiologic aging of the voice (2%), and psychogenic factors (2-2.2 %). Hoarseness is very rarely a manifestation of internal medical illness. The treatment of hoarseness has been studied in only a few randomized controlled trials, all of which were on a small scale. Voice therapy is often successful in the treatment of functional and organic vocal disturbances (level 1a evidence). Surgery on the vocal cords is indicated to treat tumors and inadequate vocal cord closure. The only entity causing hoarseness that can be treated pharmacologically is chronic laryngitis associated with gastro-esophageal reflux, which responds to treatment of the reflux disorder. The empirical treatment of hoarseness with antibiotics or corticosteroids is not recommended. CONCLUSION Voice therapy, vocal cord surgery, and drug therapy for appropriate groups of patients with hoarseness are well documented as effective by the available evidence. In patients with risk factors, especially smokers, hoarseness should be immediately evaluated by laryngos - copy.
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Affiliation(s)
- Rudolf Reiter
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Department of Otorhinolaryngology, University Hospital Klinikum rechts der Isar, Technische Universität München, Munich
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Lee BS, Kim HJ, Hwang JW, Cheong KH, Kim KA, Cha HY, Lee JM, Kim CH. The Dual Inhibition of Met and EGFR by ME22S, a Novel Met/EGFR Bispecific Monoclonal Antibody, Suppresses the Proliferation and Invasion of Laryngeal Cancer. Ann Surg Oncol 2016; 23:2046-53. [PMID: 26812910 DOI: 10.1245/s10434-015-5084-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE It has been reported that the abnormal activation of receptor tyrosine kinases is associated with the development of many human carcinomas and the high activation of EGFR and Met mediates the tumorigenicity of laryngeal carcinoma. In this study, we have done the therapeutic efficacy of ME22S (a novel EGFR/Met bispecific antibody) in laryngeal carcinoma in vitro and in vivo was thoroughly evaluated. METHODS The effects of ME22S on cell viability was assessed through MTT assays, and then Western blotting and immunocytochemistry were used to determine the expression of EGFR and Met. Also, wound healing and invasion assays were performed to observe the inhibitory effects of ME22S. RESULTS We found the ability of ME22S reducing the expression of both EGFR and Met and significantly inhibiting the cell migration, invasion, and proliferation of SNU899 and HN3 in vitro. Also, the notably reduced levels of p-Met, p-ERK, and p-AKT were found when the cells were treated with only ME22S alone or with HGF together. Meanwhile, ME22S, interestingly enough, caused caspase-3-dependent apoptotic cell death when HN3 cells were treated with ME22S for 72 h, decreased the HGF-induced Slug expression, and also inhibited the tumor growth of HN3 cells in a xenograft model in vivo. CONCLUSIONS Taken together, our findings suggest that the dual inhibition of EGFR and Met through ME22S largely suppresses the invasion and growth of laryngeal carcinoma both in vitro and in vivo, hence, can be a practical approach as a novel therapeutic strategy for the treatment of laryngeal carcinoma.
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Affiliation(s)
- Bok-Soon Lee
- Department of Otolaryngology, School of Medicine, Suwon, Republic of Korea
| | - Haeng-Jun Kim
- Department of Otolaryngology, School of Medicine, Suwon, Republic of Korea.,Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Jae-Woong Hwang
- Samsung Biomedical Research Institute, Samsung Advanced Institute of Technology (SAIT), Suwon, Republic of Korea
| | - Kwang Ho Cheong
- Samsung Biomedical Research Institute, Samsung Advanced Institute of Technology (SAIT), Suwon, Republic of Korea
| | - Kyung-Ah Kim
- Samsung Biomedical Research Institute, Samsung Advanced Institute of Technology (SAIT), Suwon, Republic of Korea
| | - Hyun-Young Cha
- Department of Otolaryngology, School of Medicine, Suwon, Republic of Korea
| | - Ji Min Lee
- Samsung Biomedical Research Institute, Samsung Advanced Institute of Technology (SAIT), Suwon, Republic of Korea
| | - Chul-Ho Kim
- Department of Otolaryngology, School of Medicine, Suwon, Republic of Korea. .,Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea.
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A Population-Based Cross-Sectional Study of Alcohol Consumption and Risk of Benign Laryngeal Disease in Korean Adults. J Voice 2016; 30:443-7. [PMID: 26810937 DOI: 10.1016/j.jvoice.2014.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/23/2014] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Studies on alcohol consumption and benign laryngeal disease (BLD) in the general population are rare. The aim of this study was to investigate the relationship between alcohol consumption and BLD in the Korean general population. STUDY DESIGN This was a cross-sectional study of a national health survey. MATERIALS AND METHODS Subjects were 3141 noninstitutionalized civilian adults older than 19 years (1313 men and 1828 women) who completed the laryngeal examination of the Korea National Health and Nutrition Examination Survey of 2008. Frequency of drinking was classified into less than once per week, two to three times per week, and more than four times per week. Binge drinking was defined as five or more drinks (≥61 g of alcohol) per episode for men and as four or more drinks (≥41 g of alcohol) per episode for women. Poisson regression analyses were conducted to examine the relationship between alcohol drinking and BLD. RESULTS Adjusting for covariates (age, sex, income, level of education, occupation, and cigarette smoking), it was found that those who drank more than four times a week, compared with those who drank less than once per week, were more likely to have BLD (risk ratio = 2.15, 95% confidence interval: 1.01-4.59, P < 0.05). However, the amount of alcohol consumed was not associated with BLD. CONCLUSIONS Frequent drinking (ie, more than four times a week) was found to be a risk factor for BLD.
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Kishimoto Y, Suzuki R, Kawai Y, Hiwatashi N, Kitamura M, Tateya I, Hirano S. Photocoagulation therapy for laryngeal dysplasia using angiolytic lasers. Eur Arch Otorhinolaryngol 2016; 273:1221-5. [DOI: 10.1007/s00405-015-3887-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 12/29/2015] [Indexed: 11/28/2022]
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Loos E, Meulemans J, Vranckx J, Poorten VV, Delaere P. Tracheal Autotransplantation for Functional Reconstruction of Extended Hemilaryngectomy Defects: A Single-Center Experience in 30 Patients. Ann Surg Oncol 2015; 23:1674-83. [DOI: 10.1245/s10434-015-5033-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Indexed: 11/18/2022]
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Taylan M, Can OF, Cetincakmak MG, Ozbay M. Effect of airway dynamics on the development of larynx cancer. Laryngoscope 2015; 126:1136-42. [PMID: 26372301 DOI: 10.1002/lary.25645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study aimed to investigate and measure airway dynamics in anatomical regions where laryngeal cancer was most common in comparison to other regions of the larynx, thereby determining the effect of airway dynamics on the development of laryngeal cancer. STUDY DESIGN AND METHODS Pulmonary function test airflow data and larynx anatomy measurement data obtained by three-dimensional computed tomography. A healthy male adult was modeled by simulation using the ANSYS program. Analysis of air flow rates, pressure, and force were also made. RESULTS The supraglottic region average pressure was higher when compared to the subglottic region and clearly lower when compared to the glottic region. The subglottic had the lowest pressure and force levels. The glottic region was the first ranked location for laryngeal cancer; the supraglottic region was the second; and the frequency of laryngeal cancer was much lower in the subglottic region. Our data suggests that the high pressure and force contribute to an increased amount of contact and interaction between toxic particles and mucosa and to increased diffusion of the particles, leading to an increased carcinogenic effect and frequency of cancer. CONCLUSION Laryngeal cancer was found more frequently in regions with an increased pressure and force stress and reduced air velocity, with a subsequent increase in penetration of the inhaled toxic agents. These findings demonstrate the importance of basic physical fluid mechanics in cancer pathogenesis. LEVEL OF EVIDENCE NA. Laryngoscope, 126:1136-1142, 2016.
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Affiliation(s)
- Mahsuk Taylan
- Department of Chest Disease, Dicle University, Diyarbakir, Turkey
| | - Omer Faruk Can
- the Department of Mechanical Engineering, Dicle University, Diyarbakir, Turkey
| | | | - Musa Ozbay
- Department of Otolaryngology, Dicle University, Diyarbakir, Turkey
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Byeon H. Relationships Among Smoking, Organic, and Functional Voice Disorders in Korean General Population. J Voice 2015; 29:312-6. [DOI: 10.1016/j.jvoice.2014.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 07/25/2014] [Indexed: 10/24/2022]
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Byeon H. The association between lifetime cigarette smoking and dysphonia in the Korean general population: findings from a national survey. PeerJ 2015; 3:e912. [PMID: 25945309 PMCID: PMC4419546 DOI: 10.7717/peerj.912] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/05/2015] [Indexed: 11/29/2022] Open
Abstract
This study aims to investigate the relationship between current smoking and lifetime amount smoked and the incidence of dysphonia using data from a national cross-sectional survey that represents the Korean population. Subjects were 3,600 non-institutionalised civilian adults over the age of 19 (1,501 males and 2,099 females) who completed the laryngeal examination of the 2008 Korea National Health and Nutrition Examination Survey (KNHANES). For lifetime amount smoked, subjects were classified as light smokers (≤26.7 pack years), medium smokers (26.7–40.5 pack years), heavy smokers (40.5–55.5 pack years), and very heavy smokers (55.5–156 pack years) based on pack years (packs smoked per day × years as a smoker). The odds ratio (OR) for the statistical test was presented using hierarchical logistic regression. When adjusted for covariates (age, gender, level of education, income, occupation, alcohol consumption and pain/discomfort during the last two weeks), current smokers had a 1.8 times (OR = 1.77, 95% CI [1.17–2.68]) higher risk for self-reported voice problems than non-smokers. Moreover, current smokers had a 1.6 times (OR = 1.56, 95% CI [1.02–2.38]) higher risk of laryngeal disorder (p < 0.05). In terms of pack years, very heavy smokers were significantly more likely to have laryngeal disorder, while self-reported voice problems were significantly more likely for heavy smokers but not very heavy smokers. The results of this study imply that chronic smoking has a significant relationship with dysphonia. Longitudinal studies are required in future work to verify the causality between lifetime smoking amount and dysphonia.
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Affiliation(s)
- Haewon Byeon
- Department of Speech Language Pathology & Audiology, Nambu University , Gwangju , Republic of Korea
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Unger J, Lohscheller J, Reiter M, Eder K, Betz CS, Schuster M. A Noninvasive Procedure for Early-Stage Discrimination of Malignant and Precancerous Vocal Fold Lesions Based on Laryngeal Dynamics Analysis. Cancer Res 2014; 75:31-9. [DOI: 10.1158/0008-5472.can-14-1458] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy. Case Rep Pulmonol 2013; 2013:308092. [PMID: 23762724 PMCID: PMC3671292 DOI: 10.1155/2013/308092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/17/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction. Although the role of TNF-α in tumor development is not fully understood, an increased risk of malignancy with TNF-α-inhibitors, such as infliximab, has been suggested. Case Presentation. We present a 54-year-old nonsmoking female sarcoidosis patient. After seven months of infliximab therapy a T1aN0M0 larynx carcinoma of the right vocal cord was found and excised. Within a year, whilst still on treatment, a second larynx carcinoma of the opposite vocal cord appeared. Discussion. A bilateral vocal cord tumor is rare, especially in a never smoker. Evidence on the role of infliximab in carcinogenesis is inconclusive. To date, there are no follow-up studies evaluating malignancy risk of infliximab therapy in sarcoidosis patients. No studies in other diseases focus on laryngeal carcinomas during infliximab use. We argue that infliximab treatment might have attributed to the rapid progression of vocal cord carcinomas in this patient with an a priori low risk tumor profile. This case illustrates that caution remains warranted in patients with previous malignancies when considering initiation of TNF-α-inhibitors.
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Byeon H, Lee Y. Laryngeal pathologies in older Korean adults and their association with smoking and alcohol consumption. Laryngoscope 2012; 123:429-33. [PMID: 22991190 DOI: 10.1002/lary.23603] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/06/2012] [Accepted: 06/26/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study's objectives were to assess the prevalence rate of laryngeal pathologies in the Korean elderly, and to examine the association of smoking and alcohol consumption with laryngeal diseases. STUDY DESIGN Cross-sectional study. METHODS Data were from the 2008 Korea National Health and Nutritional Examination Survey. Subjects were 663 elderly persons (261 men and 402 women) between the ages of 65 and 84 years who completed the laryngoscopic examination. Weighted prevalence of laryngeal pathologies was compared by demographic characteristics, smoking, alcohol drinking, body mass index, and self-reported voice problems. Multiple logistic regression analyses were conducted to examine the independent as well as combined influence of smoking and alcohol consumption on laryngeal lesions. RESULTS The prevalence of laryngeal pathologies in the Korean elderly between the ages of 65 and 84 years was 8.1%. The prevalence of laryngeal lesions increased with age and was higher among men, middle school and high school graduates, manual workers, current smokers, current alcohol drinkers, and those with self-reported voice problems. Adjusting for covariates, current smokers, compared with nonsmokers, were more likely to have laryngeal pathologies (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.01-4.67). Current alcohol drinking was not independently associated with laryngeal diseases. Concurrent smoking and alcohol drinking, however, were associated with a significantly higher risk of laryngeal pathologies (OR, 3.29; 95% CI, 1.22-8.88). CONCLUSIONS Smoking and alcohol consumption may increase the risk of laryngeal diseases in later life.
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Affiliation(s)
- Haewon Byeon
- Department of Language Therapy, Daelim University College, Anyang, Republic of Korea
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